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Wednesday, January 31, 2018

Recovering Addicts and Their Family

recovering addicts familyAddicts and Alcoholics affect at least 5 other people while they are actively using drugs and alcohol. The family is usually the most adversely affected by an addict’s behavior, and has probably spent years of their life focused on and worried about their loved one, who has been suffering from the disease of addiction. By the time someone gets into long term treatment, the family has probably tried just about everything to help their loved one and has experienced emotional pain, anger, sadness, and great amounts of fear on a regular basis. The family also has asked themselves numerous questions like: What did I do? Is it my fault? How can I fix this?

Often times an addict will blame, manipulate, control, and lie to their family in order to continue using drugs. This behavior isn’t because they don’t love their family, it is because when an addict is using drugs they love the drug more. An addict can’t stop using because their family loves them or because they love their family. Love isn’t enough to heal an addict or make them stop using. If that was the case we wouldn’t have the need for treatment, because a parent’s love would be enough.

So, what is enough? What can the family do? How can a person get clean and sober with the family’s help? Many times a family will say “They are the addict, they need help” and then say “I’m fine, I don’t have a problem, if they get clean I’ll be fine”. That would be true if the above statement about every addict affecting at least 5 people wasn’t true. A family needs as much help to recover from this devastating illness as the person who is the addict.

Research has shown that an alcoholic/addict has a better chance of remaining clean and sober (long term) if their families are included in their treatment and participate in their own form of recovery and therapy. There are many organizations out there that are designed specifically for the family members of alcoholics/addicts. There are 12 step groups like Al-Anon & Nar-Anon, based on the same 12 steps of Alcoholics Anonymous. There is an organization called PALS (Parents of Addicted Loved Ones) and Families Anonymous in certain areas of the country. CoDa (Codependents Anonymous) is another group for people who suffer from codependency, which can be a symptom of living with an alcoholic.

The best way for an addict to heal fully, once the detox is over and they have committed to live a life of recovery, is to have their families be a part of their ongoing recovery and treatment. Addicts want to reconcile and heal their family relationships and so do the families. They cannot do this alone because of the devastating effects of the abuse on themselves and their family. This is why family workshops and support groups are so important. It allows the family and the addict to share the same language and gives a frame work for the healing to begin. It takes time but eventually both the addict/alcoholic and the family come to the same conclusion “I can’t control it” “I didn’t cause it” and “I can’t cure it” alone!

Janet E. Bontrager – Primary Therapist

Friday, January 26, 2018

Mindfulness in Substance Use Treatment

mindfulness substance abuse When a person is addicted to alcohol or drugs, as well as other process addictions (sex, food, gambling, shopping), their mind is highly preoccupied with attaining the substance, using it, and recovering from it. This process can be quite consuming, and often individuals are left with little time for the present moment. In fact, the present moment (if sober) becomes more and more frequently a place to avoid, as that is where the shame and guilt set in. 

Over the past few decades, mindfulness-based therapies have become increasingly widespread and recognized as effective in the treatment of substance use. The practice of mindfulness, defined as a non-judgmental awareness of the present, is a fantastic tool to help a person become more in touch with the present-state they so often attempt to avoid and to learn to cope with painful emotions and stressors that may have contributed to substance use.

Utilizing the concept of mindfulness for treatment of addiction, the emphasis lies on relapse prevention. One of the most important goals in relapse prevention is the discovery of why a person uses, which is most often driven by emotions; whether fear, insecurity, anger, or anxiety. Mindfulness techniques in relapse prevention aim to increase self-awareness of these emotional triggers and subsequent compulsive, automatic behaviors related to substance use.

Cravings are cognitive responses to stimuli, also known as “triggers,” and are comprised of a complex system of environmental cues and cognitive responses. Mindfulness meditation can be utilized to disrupt this automatic system by providing heightened awareness of the initial craving and intervening before the action (self-medication with drugs or alcohol) takes place.

In relapse prevention, the goal is to identify and modify deficits in coping skills, increase self-efficacy, and focus on a balanced lifestyle that sometimes includes inserting a more positive activity in the space addiction once held. Mindfulness can take the form of more traditional approaches, such as meditation, yoga, and deep-breathing techniques, or can involve someone’s favorite calming activities, such as listening to relaxing music, taking a walk, or journaling.

Practicing balance in emotional responses and avoided automatic reactions can greatly reduce stress and anxiety, which are common triggers for substance use. Furthermore, when a person learns to experience nonjudgmental responses to feelings and thoughts, a sense of compassion or self is learned, rather than the abusive self-talk that is commonly associated with addictive behaviors. 

Mindfulness and meditation can quite simply cause a person to feel better and more relaxed in general. The reasons for the improved moods associated with these methods are in-depth and backed by scientific studies. For example, mindfulness and meditation help to lower the stress hormone cortisol and streamline the body’s ability to rid itself of toxins, such as lactic acid, that build up in the muscles and blood and impact neurotransmitter receptors, which can lead to improved mood.

There are numerous reasons to incorporate mindfulness into one’s recovery, with the first step being to allow for the present moment to exist, without judgment, without need to escape from the feelings of that moment, and just let it be.

Thursday, January 18, 2018

Family Dynamics in the Recovery Process

family dynamics recovery processThere is a saying that addiction is a family disease, and this couldn’t be more true. Any person who is in relationship with an addict is negatively affected, whether it be emotionally, physically or financially. A person in active addiction creates absolute chaos in their personal lives and the lives of those around them. Maladaptive Addictive behavior includes lying, manipulation, theft, intense emotional dysregulation, unexplained anger and endless other destructive things. Families tend to develop their own maladaptive behavioral and communication patterns in turn with the addict. These patterns often involve codependent and enabling behavior. The family will give into the addict’s manipulation in the form of giving them money, a place to stay, and cleaning up problems the addict carelessly creates instead of allowing the addicted individual to face the natural consequences of their actions. This behavior not only allows the addict to live in their sickness, it also keeps the family unit hostage to the chaos and pain the addict creates.

It is natural for a family to want to protect their loved one from pain. Many families are motivated by the fear that without their help their loved one will face the ultimate consequence of addiction, which is death.

It is easy to understand why a family would continue to enable their loved one, however these behaviors and dynamics generally continue once the addict has stopped using drugs. This is partly because addicts are master manipulators and partly because these dynamics become so deeply engrained it can feel impossible to change.

It is important for the family to be actively involved in the addict’s treatment. A lot of damage has been created and there is generally very little trust, if any, left in these relationships. Families need to learn how to communicate openly and honestly with each other, this includes expressing resentment, making amends for past wrongs done, and sharing how each persons behavior impacts the family as a whole. The family members and the addict need to be willing to examine their own behavior and take accountability for their part in the dysfunction. Learning how to set and hold boundaries on both sides of the relationships is another important part in healing the dysfunction and pain that has occurred. 

It’s also helpful for families to seek outside support in the form of individual or group therapy, or 12-step based programs such as AL-ANON, which is a program of self-discovery for loved ones of alcoholics and addict. This also helps families build a support network of their own to continue healing.

Thursday, January 11, 2018

Emotional Wellbeing in Recovery

emotional wellbeing recoveryResearch has demonstrated that psychological factors play an important role in physical health and overall wellness, particularly when it comes to recovery and the treatment of addiction related issues. Studies have demonstrated significant measurable relationships between cognitions, emotions, and immune functioning; indicating that happier individuals have healthier functioning immune systems, engage in healthier behaviors, have more energy, and better coping skills to manage challenges that are common to early recovery. Additional research also suggests that having a sense of meaning and purpose reduces the risk for countless diseases and provides individuals in recovery strength and motivation. There is substantial evidence that psychological health and emotional well-being are closely linked to physiological health factors and more sustainable recovery.

Social support, friendships, humor, and love also have documented positive impacts on health. For example, positive social support and friendships have been associated with greater resistance to disease of all types, lower rates of heart disease, and lower mortality rates. Social support can also speed up recovery processes and encourage health-promoting behaviors. Laughter and humor are other factors that enhance emotional well-being and health. Experimental studies have shown that laughter can increase certain antibodies that help to fight off infection while lowering blood pressure. Similarly, some researchers have proposed that music can increase positive mood and thereby lower stress hormones, decrease blood pressure, and increase endorphins - all of which provide relapse prevention techniques for the addict in early recovery to continue to develop and implement over time.

Conversely, current research suggests that the presence of certain negative emotions such as depression and anxiety are strong predictors of overall poor health status, increased substance use, and increased relapse rates. When it comes to experiencing trauma, addiction, mood disorders, and other difficult emotions, appropriate emotional expression is important for the maintenance of good health and wellness. Both verbal and nonverbal expressions such as art and writing can have significant therapeutic value. One study showed that after writing about a personal traumatic experience, individuals exhibited marked improvement in physical health indicators including reductions in blood pressure, better immune system responses, decline in visits to the health center, and reduction in distress. It is clear that attempts to control or suppress negative emotions can have an injurious impact on overall health, while healthy emotional expression produces improvements in overall emotional and physical health. Similar studies have supported the efficacy of utilizing verbal and nonverbal expressions to process cravings for drugs and/or alcohol, obsessions, and urges to use and/or act out in process addictions.

One negative emotion in particular that is associated with declines in emotional, mental, and physical health is regret. Several research findings indicate that intense feelings of regret are often associated with more health problems particularly among the elderly. Similar to regret is the feeling of “life longing” or a sense that life is somehow incomplete. The emotions that accompany this experience of longing can result in significant decreases in health and well-being if left unaddressed. 12 step based approaches typically address these feelings of resentment, regret, and remorse as part of comprehensive program of spirituality, relapse prevention planning, and positive fellowship.

Marie Tueller, MEd, LPC

Thursday, January 4, 2018

Signs Your Loved One May Be Addicted

signs loved one addictedPopular stereotypes of drug addicts involve the person being unemployed, engaged in criminal activity, male, minority, homeless, disheveled, dirty, and basically standing out like a sore thumb in mainstream society. However, many drug addicts are in fact very difficult to identify and will not possess many, if any, of these stereotypes. The shame of addiction and stigma associated with being an addict can act as a powerful barrier to someone coming forward to ask for help, causing them to do whatever it takes to keep up appearances and avoid their addiction being revealed. Many people still think of addiction as a moral failing, in spite of overwhelming evidence that has proven addiction to be a “primary, chronic disease of brain reward, motivation, memory, and related circuitry” (ASAM). These stigmas can cause shame and embarrassment for the addict, and cause them to retreat further into secrecy around their addiction.

That being said, how can you find out if your loved one is addicted to drugs or alcohol? I would venture to say if you are asking yourself this question right now, chances are you’ve already witnessed behaviors in your loved one indicative of substance use, and your instincts may be right. I’m certainly not advocating contempt prior to investigation, but the fact is we are dealing with a cunning, baffling disease that will cause the user to minimize, deny, rationalize, and stop at nothing to hide the problem. Sometimes, all you will have is a “gut feeling,” and that feeling may be enough reason to take a closer look at what is actually going on with your loved one.

If your loved one is chronically addicted to drugs or alcohol, this means they are at the point where they must continue to use in order to function in their daily lives. This also means they desperately need help, as they’re at the point that they can’t stop on their own, even if they desperately want to. Even at this advanced level of addiction, a person may not display overtly obvious signs that they are using. Often, they may be able to continue working and maintaining relationships for a period of time without a problem being detected. However; it us usually only a matter of time before they start experiencing consequences of the substance use that affect them physically, legally, socially, and in their relationships.

Overt signs your loved one may be using drugs or alcohol include agitation and irritability, intense mood swings, periods of either sleeplessness or seeming to sleep all the time, slurred speech, “nodding out,” injection marks, glassy or blood shot eyes, and enlarged or constricted pupils. Other obvious signs might be if valuables or household items are missing or if the person seems to always need money in spite of earning enough money to self-sustain.

Periods of depression, anxiety, and euphoria are also common symptoms of substance use. The individual will fluctuate between craving, using, coming down, and contemplating their life situation - all of which greatly impact a person’s mood.

Other, more subtle signs could include: smell of drugs or alcohol, use of fragrances to mask the odor, changes in appetite, drowsiness, increased tolerance of drugs or alcohol, impaired or fixed concentration, and decreased coordination.

Another hallmark sign that a loved one is addicted to drugs or alcohol is that they will likely make themselves scarce. Where they once participated in family and social events, they may now avoid these interactions, as they interfere with the person’s using and also provide more opportunity for their habit to be discovered.

If you suspect your loved one is struggling with addiction, please get help immediately. You don’t have to confront this situation without support, as there are trained professionals that are well-equipped to offer guidance, intervention, and placement in treatment. Remember, you are not alone! Alcohol and drug addiction is more widespread than it has ever been, with the reasons people become addicted as varied as the population that struggles with this disease. DON’T beat yourself up trying to analyze every detail from your loved one’s past and identify why they started using or where you went wrong. That’s a rabbit hole you have no business going down right now, as it won’t help matters whatsoever. DO get them help and let the trained professionals take it from there!

American Society of Addiction Medicine. (n.d.). Retrieved November 29, 2017, from http://www.asam.org/