I N M E MO RY O F S T E V E N
M AY 2 018 | VO LUM E 7 | I SS U E 5
A N AW A R D W I N N I N G N A T I O N A L M A G A Z I N E
TRAUMA
THEN AND NOW
By Nancy Jarrell O’Donnell, MA, LPC, CSAT
THE CREATIVE ARTS COMFORT AND HEAL DURING CHAOTIC TIMES
By Ericha Scott, Ph.D., LPCC917, ATR-BC, REAT, ICRC
WHAT IS ART THERAPY AND HOW DOES IT HELP? By Rebecca Wilkinson, MA, ATR-BC, LCPAT
MOSAICS AS ART THERAPY FOR GRIEF
By Tabitha Fronk, LPCC, ATR-BC, ATCS, CCLS
The 9th Annual West Coast Symposium on Addictive Disorders (WCSAD) presents a unique series of educational workshops highlighting the Creative Art Therapies for Trauma and Addiction
2
www.thesoberworld.com
A LETTER FROM THE PUBLISHER Dear Readers, I welcome you to The Sober World magazine. The Sober World is an informative award winning national magazine that’s designed to help parents and families who have loved ones struggling with addiction. We are a FREE printed publication, as well as an online e-magazine reaching people globally in their search for information about Drug and Alcohol Abuse.
(under the age of 18 yrs. old) and bring them to the facility you have chosen. There are long term Residential Programs (sometimes a year and longer) as well as short term programs (30-90 days), there are Therapeutic Boarding Schools, Wilderness programs, Extended Living and there are Sober Living Housing where they can work, go to meetings and be accountable for staying clean.
We directly mail our printed magazine each month to whoever has been arrested for drugs or alcohol as well as distributing to schools, colleges, drug court, coffee houses, meeting halls, doctor offices and more .We directly mail to treatment centers, parent groups and different initiatives throughout the country and have a presence at conferences nationally.
Many times a Criminal Attorney will try to work out a deal with the court to allow your child or loved one to seek treatment as an alternative to jail. I know how overwhelming this period can be for you and I urge every parent or relative of an addict to get some help for yourself. There are many groups that can help you. There is Al-Anon, Alateen (for teenagers), Families Anonymous, Nar-Anon and more. This is a disease that affects the whole family, not just the parents.
Our monthly magazine is available for free on our website at www.thesoberworld.com. If you would like to receive an E-version monthly of the magazine, please send your e-mail address to patricia@thesoberworld.com Drug addiction has reached epidemic proportions throughout the country and is steadily increasing. It is being described as “the biggest manmade epidemic” in the United States. More people are dying from drug overdoses than from any other cause of injury death, including traffic accidents, falls or guns. Many Petty thefts are drug related, as the addicts need for drugs causes them to take desperate measures in order to have the ability to buy their drugs. The availability of prescription narcotics is overwhelming; as parents our hands are tied. Purdue Pharma, the company that manufactures Oxycontin generated $3.1 BILLION in revenue in 2010? Scary isn’t it? Addiction is a disease but there is a terrible stigma attached to it. As family members affected by this disease, we are often too ashamed to speak to anyone about our loved ones addiction, feeling that we will be judged. We try to pass it off as a passing phase in their lives, and some people hide their head in the sand until it becomes very apparent such as through an arrest, getting thrown out of school or even worse an overdose, that we realize the true extent of their addiction. If you are experiencing any of the above, this may be your opportunity to save your child or loved one’s life. They are more apt to listen to you now than they were before, when whatever you said may have fallen on deaf ears. This is the point where you know your loved one needs help, but you don’t know where to begin. I have compiled this informative magazine to try to take that fear and anxiety away from you and let you know there are many options to choose from. There are Psychologists and Psychiatrists that specialize in treating people with addictions. There are Education Consultants that will work with you to figure out what your loved ones needs are and come up with the best plan for them. There are Interventionists who will hold an intervention and try to convince your loved one that they need help. There are detox centers that provide medical supervision to help them through the withdrawal process, There are Transport Services that will scoop up your resistant loved one
To Advertise, Call 561-910-1943
Addiction knows no race or religion; it affects the wealthy as well as the poor, the highly educated, old, young-IT MAKES NO DIFFERENCE. This magazine is dedicated to my son Steven who graduated with top honors from University of Central Florida. He graduated with a degree in Psychology, and was going for his Masters in Applied Behavioral Therapy. He was a highly intelligent, sensitive young man who helped many people get their lives on the right course. He could have accomplished whatever he set his mind out to do. Unfortunately, after graduating from college he tried a drug that was offered to him not realizing how addictive it was and the power it would have over him. My son was 7 months clean when he relapsed and died of a drug overdose. I hope this magazine helps you find the right treatment for your loved one. They have a disease and like all diseases, you try to find the best care suited for their needs. They need help. Deaths from prescription drug overdose have been called the “silent epidemic” for years. There is approximately one American dying every 17 minutes from an accidental prescription drug overdose. Please don’t allow your loved one to become a statistic. I hope you have found this magazine helpful. You may also visit us on the web at www.thesoberworld.com. The Sober World wishes every mother a Happy Mothers Day! We are on Face Book at www.facebook.com/pages/TheSober- World/445857548800036 or www.facebook.com/steven. soberworld, Twitter at www.twitter.com/thesoberworld, and LinkedIn at www.linkedin.com/grp/home?gid=6694001 Sincerely,
Patricia
Publisher Patricia@TheSoberWorld.com
For Advertising opportunities in our magazine, on our website or to submit articles, please contact Patricia at 561-910-1943 or patricia@thesoberworld.com.
3
centerpointe_changingpt_soberwrld_18_print.pdf
1
2/1/18
The Changing Pointe ALCOHOL & SUBSTANCE USE TREATMENT FOR ADULTS C
M
Y
CM
MY
CY
Detox | 4-week Residential Treatment | Outpatient Programs Medication-Assisted Treatment | Aftercare | Family Support
CALL 800-345-5407
24-hour Confidential Assessment with Caring and Compassionate Counselors. No Cost for the Initial Assessment. Most Major Insurances Accepted.
Hope For A Bright Future
CMY
K
The Changing Pointe at CenterPointe Hospital 4801 Weldon Spring Pkwy St. Charles, MO 63304
CenterPointeHospital.com
4
www.thesoberworld.com
4:45 PM
877.284.0353 | Beachway.com | 2600 Quantum Blvd | Boynton Beach | FL | 33426
A D UAL D IAG N OSIS T R E AT M E N T C ENTER
A team of caring, dedicated, licensed, credentialed professionals A variety of evidence-based treatments Beachway Therapy Center’s clinical campus comprises individual therapy offices, large group rooms, an arts and music studio room, and a modern cafeteria where clients can relax and enjoy lakeside views. Every aspect of our facility’s design has been developed to promote comfort and serenity, leaving clients free to focus on the work of recovery and healing.
A comprehensive continuum of care A compassionate treatment community A serene and peaceful environment conducive to healing Individualized treatment planning An inclusive family support program Continuing care and alumni services
877.826.7044 FirstStepDetox.com 2901 Broadway West Palm Beach | FL | 33407
WEST PA LM BEACH
INPATIENT DETOX AND RESIDENTIAL TREATMENT Regain control of your life First Step is a detoxification center providing personalized care and assistance for patients dealing with various types of substance abuse.
To Advertise, Call 561-910-1943
5
A MOTHER’S SECRET HOPE By Deja Gilbert, Ph.D.
“Youth fades; love droops; the leaves of friendship fall; a mother’s secret hope outlives them all.” ~ Oliver Wendell Holmes Let her hope for you be the hope you see for yourself and the catalyst for change. It used to be so simple. Wasn’t it? As kids, it always seemed easy and fun to plan a way to celebrate Mother’s Day or give her a special heart-felt gift. We wanted to show love and care to the person who showed us the same affection during childhood. “How can I celebrate mom’s special day?” “Where should I take her to eat?” “What kind of flowers should I get?” “What would be the perfect gift?” Years later, a lot has changed – including our relationship with mom. Today, as we are creating our own lives, having our own children and dealing with our own struggles, we often rely on mom for advice and support and we begin to appreciate our moms in new ways as we understand more and more what she really did for us when we were young. As a new mom, I am becoming intimately aware of this. Being a mother requires a level of devotion to another person that is simply unmatched. I get why new moms sometimes have the urge to call up their moms just to say ‘thank you’ for the late nights, the infinite amount of diaper changes, hugs, and of patience and selflessness. I’m also keenly aware of how our moms watch with a mix of pride and anxiety as we begin to make our own decisions - the good and the bad. Even if she knows the road we’ve chosen is a rough one, or she sees that wrong turn as it’s happening, she knows that there are some lessons that cannot be taught, that you can only learn the hard way. As a professional working in the addiction field with young adults and college students, I have heard so many similar personal stories from both those who struggle with addiction as well as their families. For the son dealing with an opioid addiction, for example, the only thing his mom wants is to have him back in her daily life. She wants to spend time with him, enjoying the young man she’s missed for so long. She wants to enjoy the simplicity of feeling connected and knowing he’s safe and healthy again. The truth is that moms facing similar situations just want to have their kids back. There is no substitute. When a child, either young or grown, suffers from addiction, moms live in a constant state of fear and worry. The addiction takes away their ability to sleep through night, to feel peace; it breaks away at her heart every day. But she continues to fight for you, even if she may not know the best way how. For you, the addiction is like a black cloud for which the rest of the world cannot see. But you are a part of her, and she knows that you are still in there looking for a way out and, she will continue to fight for you (and sometimes with you) in order to help guide you to recovery. But now, this Mother’s Day is the time to fight for yourself in order to give her and yourself what she truly wants this mother’s day – a healthy and happy you.
6
Entering treatment will help you take back control of your life by helping you understand what drives your addiction and teach you the skills to not only avoid drugs and alcohol, but how to live a more purposeful and joyful life. With sobriety, you can have life again and feel connected to those who matter most to you and who champion for you…like mom. Give her the chance to see you enjoy life – sober and free of addiction. The best programs teach you to love yourself and your family to help you through treatment. You’ll build a strong support system and your loved ones will know more about your addiction and the path to recovery. Studies show that you have a greater chance at recovery when those close to you are involved during treatment and that family involvement in treatment can even improve the relationships after recovery. When you are supported in treatment and recovery by family, you significantly increase the chances of long-term success in recovery, but it can also be helpful for mom, too. Through educational workshops designed to provide information to family members, therapy sessions both with and without the patient, and visitation days, she can begin to better understand your struggle and learn how she can best support your recovery and get the help she needs for her own well-being. It’s the greatest thing you can do for yourself—and the greatest gift you can give to those you love. Dr. Deja Gilbert received her Ph.D. in Human Services in Counseling Studies and is a Licensed Mental Health Counselor (LMHC) and Licensed Professional Counselor (LPC). Dr. Gilbert began her career in the addiction treatment field over 15 years ago, starting with facilitating primary counseling sessions which is where she first witnessed the positive impact quality therapy coupled with a compassionate, dignified approach can have on changing the lives of her clients and their families. Dr. Gilbert is currently Chief Operating Officer of Futures of Palm Beach where she is proud to lead an exceptional staff providing the highest level of care to their clients. www.futuresofpalmbeach.com
www.thesoberworld.com
CONNECT AGAIN. A mother’s hope is to have her child be healthy and safe. This Mother’s Day, give your mother what she really wants – you. Addiction can tear relationships apart, but there is always hope for reconnection. We believe everyone deserves the opportunity to live a healthy life, which is why we provide a compassionate and supportive approach to both addiction treatment and co-occurring disorders. Our integrated approach to care includes family therapy to help improve outcomes and encourage healing in relationships and lasting recovery.
TAKE THE FIRST STEP TO A HEALTHIER LIFE.
RE COVE RY
HE ALT HCARE
Welcome Dr. Deja Gilbert Futures of Palm Beach is proud to introduce Dr. Deja A. Gilbert PhD, LMHC, LPC, to the Sober World community. Futures sincerely looks forward to having Deja embody our stated mission of giving everyone the chance to lead a healthy life in recovery. Her inspiration to begin and succeed in the behavioral healthcare field is deeply rooted in Deja’s experience as a primary counselor and witnessing the positive impact quality therapy coupled with a compassionate, dignified approach had on the lives of her adolescent clients and their families.
DETOXIFICATION I RESIDENTIAL INPATIENT I PARTIAL HOSPITALIZATION I INTENSIVE OUTPATIENT
To learn more or to help a loved one, contact us today.
561.475.3288 | www.futuresofpalmbeach.com To Advertise, Call 561-910-1943
7
TRAUMA THEN AND NOW (PART 1 OF 3) By Nancy Jarrell O’Donnell, MA, LPC, CSAT
The word “trauma” originated in the late 17th century from the Greek language. The literal translation is to “wound or damage.” The Greek word was specific to physical injury and has been used in medical terminology since. In psychology, psychological trauma or emotional trauma refers to damage to the psyche. Trauma and the painful and sometimes debilitating resulting symptoms are not new. Any study of world history will reveal the presence of traumatic events that include the tragedy of war and cultural mores. Historians have found chronicles of psychological disturbance as far back as ancient Egyptian life. What is trauma? The definition I have shared with patients and their families over the years is: trauma is an over whelming emotional experience in which one has a real or perceived threat to their life and/or safety or the life and/or safety of another. The definition can encompass a multitude of experiences. The definition lends to subjectivity and the idea that it is not the event itself which is traumatic, but rather the individual’s experience of the event. As an example, a divorce may not be traumatic for one, but it may be to another. A child of divorcing parents could experience the divorce as traumatic if she feared for her very survival learning she would be moving back and forth between the two parents, and one parent is someone she feels terrified of. Depending on a child’s age, maturity level, and relationship with each parent, a divorce could feel life threatening. SAMHSA (Substance Abuse and Mental Health Services Administration) defines trauma as “an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or life threatening and that has lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual well-being.” This definition too speaks to the subjectivity and personal experience of an event. There are a myriad of life experiences that an individual could define as being traumatic. We know that those who fare better after experiencing a traumatic event are individuals who did not feel utterly helpless at the time of the event and have been able to make some sense out of what happened. Some will suffer more than others. Suffering and unresolved trauma are synonymous. Suffering may result from the experience of physically and/or emotionally debilitating events that feature resulting painful responses to undesirable perceived or real harm. Suffering does not discriminate. Trauma does not discriminate. There is no zip code, address, state, or country immune from trauma and suffering. Current statistics from the National Institute of Health, Department of Veteran Affairs, and the Sidran Institute estimate that 70% of adults in the United States have experienced some type of traumatic event at least once in their lives. They further estimate that 20% of these adults have or will develop Post Traumatic Stress Disorder. History of Identification of Trauma in The U.S. The American lexicon when veterans returned home from battle in World War I with emotional and mental disturbances was “shell shock.” After World War II the terminology became “battle fatigue.” As American war veterans returned to society, some with clear physical and emotional scars, despite recognition, the issue was not addressed and sadly, some veterans were viewed as cowards due to their uncontrollable responses to horror. History also speaks to the suffering of The Revolutionary War and The Civil War. I recently viewed a documentary that followed a group of 9 participants from diverse backgrounds that attended weeklong intensive workshops every three months for a year and were seeking healing from childhood wounds. An African
8
American participant spoke of the multi-generational “slavery trauma” that he still felt effected by today. His pain was profound. Then in 1952, the first Diagnostic and Statistical Manual of Mental Disorders (DSM) was published. The manual identified “gross stress reaction” which was defined as a stress syndrome resulting from exceptional physical or mental stress. Specifically battle or natural disasters were the criteria provided as events that could cause the stress. In 1968, the first revision to the manual, DSM-II was published and no longer included any stress disorder diagnoses. Some surmised that this was due to the diagnosis being so closely attached to combat and the second DSM was written during a relatively peaceful era. I argue this explanation however; as 1963 was the year President John F Kennedy was assassinated. In April of 1968 Martin Luther King, Jr. was assassinated, as was Robert F Kennedy in June of 1968. There was no shortage of cultural and political stress in our country. While recently watching the CNN series American Dynasties: The Kennedys, I was struck by the commentator’s statement while describing Robert Kennedy’s bid for the presidency in 1968. He cited that Jackie Kennedy tried to support him publically as best she could but was suffering severe PTSD as a result of her husband’s assassination in 1963. This diagnosis was not defined until 1980. The footage of Jacqueline Kennedy revealed a woman looking fatigued and minimally present. Her comments and movements seemed to take great effort, her speech measured and slow. I was again reminded of how trauma does not discriminate and how psychological help did not exist at that time. Sadly, the lack of any stress disorder in the DSM-II also left no accepted diagnosis for returning Vietnam War veterans and as this war became more unpopular, the suffering veterans received no adequate treatment for their psychological disturbances, which were then exacerbated by the contempt many returned home to. Despite the lack of a formal diagnosis however, research increased finding more evidence that a variety of stressful experiences resulted in significant and consistent symptoms for anyone. Thus, the DSM III recognized that after experiencing something so severe and outside of normal human familiarity that any individual could be significantly impacted. The DSM-III was published in 1980 with a new diagnosis: “posttraumatic stress disorder.” The diagnosis became widespread and clinicians began to generalize the concept to include what were considered more mild stressors not intended to be included in the PTSD diagnosis by the collaborators of the DSM-III. Continued on page 28
www.thesoberworld.com
DUI And Criminal Defense Car Accidents and Slip and Falls Office Located in Palm Beach County
561-588-2781
WWW.BOTTARIANDDOYLE.COM
-DRAMATIZATION. NOT AN ACTUAL EVENT-
To Advertise, Call 561-910-1943
9
LIVING BEYOND
By Dr. Asa Don Brown, Ph.D., C.C.C., D.N.C.C.M., F.A.A.E.T.S.
A DEADLY COMBINATION: EATING DISORDERS AND ADDICTION “Rivers know this: there is no hurry. We shall get there some day.”
~ A. A. Milne
One spring evening in mid-2000, I was driving up the Interstate-5 corridor returning to my home in British Columbia; when I received a call from a panic stricken mother. As a psychologist, I have always been very liberal with my contact information, and this particular evening, it was a long term patient who had reached out to me. As I answered my phone, I soon realized that the caller was on the verge of a nervous breakdown. Let me clarify, while a nervous breakdown is not a psychological or medical diagnosis; it provides the clearest image of what was unfolding.As I was familiar with this patient, I could tell that the mother’s anxiety and level of stress were at a heightened state. The mother’s uncontrollable sobbing brought me to tears as I listened and learned of her painful experience involving her daughter’s lifelong struggle with an eating disorder and addictive habit.The mother explained that her daughter had struggled throughout her adolescence and early adulthood with an eating disorder, issues of self-esteem and self-image and an addiction to drugs and alcohol. The mother went on to explain that she had nowhere else to turn and felt at odds with her own emotions. Prior to calling my number, the mother had received a call from a distraught roommate of the daughter. The roommate had explained that her daughter had been taking a cocktail of barbiturates, alcohol, and sleeping pills. She further explained that the daughter had not eaten much in weeks and that she was skin and bones. Unfortunately, the mother lived in an entirely different province and had no particular ties to the community with which the daughter was currently residing. The helplessness experienced when a parent is unable to curtail a child’s behavior is unexplainable and unimaginable unto most parents. Losing a parent is always difficult, but losing a child is beyond comprehension. I have heard countless parents weep and plead for mercy. I have sat with an untold number of children and parents to discuss his or her addictive habits, but it’s the combination of chemical addiction and an eating disorder that seems to bring forth a profound challenge. Which do you treat first is always the question? Why must my son or daughter have this particular and deadly combination? Is it not bad enough that my child have an eating disorder, but also to have a comorbid issue like alcohol and drug addiction? EATING Eating is a natural and essential part of life. The function of food is to nourish the body, but was created to be enjoyed by human beings, as well. For many, few thoughts are more exaggerated or obsessed than those who struggle with eating disorders. An eating disorder cannot only consume your every thought, but it can, and often does, consume your very existence. You become a prisoner of your own thoughts, and are robbed of many of the joys of everyday living. Liken to its counterpart, a chemical addiction drives a similar urge within the mind of the individual. For some, the urge is so uncontrollable that they would rather be high than eat. Therefore, the eating disorder may be a combination of an eating disorder, as well as disordered eating. REFLECTING BACK As a clinician, I have worked with many who have struggled with eating disorders and disordered eating. Eating disorders can be defined as disorders that are characterized by abnormal or disturbed eating habits. “An eating disorder is a collection of interrelated eating habits, weight management practices and attitudes about food, weight and body shape that have become disordered. This disordered eating behavior is usually an effort to
10
solve a variety of emotional difficulties about which the individual feels out of control. Males and females of all social and economic classes, races and intelligence levels can develop an eating disorder.”.Hollywood perpetuates many of these distorted ideals by placing a high value on vanity and perfection. Teenagers are especially impacted by these unrealistic standards, and are daunted by societal pressures to the point of self-sabotage and self-abuse. Unfortunately, in the case of eating disorders, food is the weapon of choice and the individual is the victim of faulty generated beliefs. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has three primary classifications for eating disorders. They are: Anorexia Nervosa, Binge Eating, and Bulimia Nervosa. The DSM-5 has defined the primary types and symptoms of eating disorders as being: Anorexia nervosa: Anorexia nervosa, which primarily affects adolescent girls and young women, is characterized by distorted body image and excessive dieting that leads to severe weight loss with a pathological fear of becoming fat. Binge Eating Disorder: Binge eating disorder is defined as recurring episodes of eating significantly more food in a short period of time than most people would eat under similar circumstances, with episodes marked by feelings of lack of control. Someone with binge eating disorder may eat too quickly, even when he or she is not hungry. The person may have feelings of guilt, embarrassment, or disgust and may binge eat alone to hide the behavior. This disorder is associated with marked distress and occurs, on average, at least once a week over three months. Bulimia Nervosa: Bulimia nervosa is characterized by frequent episodes of binge eating followed by inappropriate behaviors such as self-induced vomiting to avoid weight gain. Eating disorders are rarely caused by food consumption, weight preoccupation, and preoccupation with food.In a majority of eating disorder cases, the patient is suffering, coping, or afflicted with a much graver psychological dynamic. The dynamic may ignite stress or an anxiety causing an unmanageable pressure, tension, or an emphasis on a specific aspect of one’s life. Furthermore, the stressor may be related to a social, environmental, behavioral, interpersonal, or intrapersonal event. The thoughts of someone struggling with an eating disorder often reflect the following sentiments: • “I am feeling overwhelmed by my degree plan.” • “I feel pressured by my boyfriend to have sex.” • “My girlfriend tells me not to worry about my weight, but it consumes my every thought.” • “Food is my only ally.” • “I have never felt likable, acceptable, or approvable.” • “I feel unattractive.” • “My life is out of control.” • “I don’t deserve happiness.” Eating disorders have no allies. THE DEADLY COMBINATION The eating disorder alone is a powerful weapon. However, this weapon is not fighting good-and-evil, but rather the precious life of the individual. According to the National Eating Disorders Association, NEDA, “Up to 50% of individuals with eating disorders abused alcohol or illicit drugs, a rate five times higher than the general population. Up to 35% of individuals who abused or were dependent on alcohol or other drugs have also had eating Continued on page 24
www.thesoberworld.com
Outpatient Detox
Relapse Prevention
ALL Drugs Including
Naltrexone & Vivitrol Available
Opiates, Benzodiazepines & Alcohol
Suboxone Maintenace Available
Safe, Effective, & Affordable
Outpatient Psychiatry & Aftercare
Same Day Urgent Appointments Available
DBT Psychotherapy
Slower and More Comfortable Than Inpatient Detox
Smart Recovery Meetings
Delray Center for Addiction Medicine 103 SE 4th Ave | Suite 103 | Delray Beach, FL 33483 | P: 888-376-2011 | F: 561-266-0033
www.MyDrugDetox.com
To Advertise, Call 561-910-1943
11
RECOGNIZING THE CHOICE OF RELAPSE PREVENTION (PART 2 OF 2) By Maxim W. Furek, MA, CADC, ICADC
In the last issue of The Sober World, aspects of Relapse Prevention were explored. But, there is still much more to the story. Sobriety assumes a million faces, showing up in a host of different ways. It is never the same, never follows a systematic, calculated rule. Some wrestle with the pros and cons of using, of abstaining, and of making a commitment to a life of abstinence. Some have attended AA meetings drunk and have kept on using right up until their ah-ha moment of clarity. Some never stop and continue to use until the end. It is important to note that stopping is the first part, the prerequisite. Everything else comes later. This is when the program, the second phase, begins. Unfortunately, according to the National Survey on Drug Use and Health (NSDUH), 20.8 million people who needed treatment for substance abuse did not receive it in 2017. But there is help. Sobriety works if you work it and, one soon discovers plenty of sayings to memorize along the road to recovery. One such saying is that “stopping is the easiest part.” Conversely, the hard part is to continue to abstain. The hard part is to identify triggers and especially emotional triggers that, if not controlled and diverted, can lead to relapse. Relapse is a process typically caused by exposure to risk factors triggering a return to alcohol and drug abuse. Relapse is sadly common among recovering addicts, with the tired and overused saying “relapse is the rule and not the exception” repeated far too often. Even so, relapse can be prevented by adhering to certain precautions. Relapse prevention strategies are vital, especially to those in early recovery. When reintroduced to the world as sober individuals, addicts are faced with new challenges and temptations. The clarity brought on by sobriety can provide focus working towards recovery goals and there are many pathways leading to the same destination. Here are additional suggestions that can be used as part of a relapse prevention plan. • Avoid isolating. Reach out and connect with others. Call another recovering addict, a sponsor or a trusted friend. Bill Wilson spoke of “drunks talking to drunks” as key to his sobriety. Make a list of people that you can call at 3:00 in the morning, or at any unexpected and inconvenient time, when you have that urge to revisit your addiction. Talk until you can get to the root of why you think it would be okay to use. This support group can consist of other recovering addicts who are working a program, your sponsor, or, family and friends who are healthy, positive and understand what you are doing. It is important to set aside time in your daily life to connect with those who support your recovery. • Express gratitude. Make a list on paper of things you are grateful for. When you express gratitude daily, life becomes better as you focus on the positive. Practicing gratitude invites more good things into your life. It also helps you stay centered and selfsatisfied. If you are feeling restless, irritable and discontent, check your gratitude — it may be lacking. • Resist temptation. Just because you have an opportunity to use is not the reason to take it. This is your greatest moment of challenge, the moment when temptation knocks at your back door. Make yourself wait by stating to yourself “No matter what, I won’t get high today.” Usually things change in a day, and urges will pass. Attitudes and situations will shift. Tomorrow will probably look better. If it doesn’t, than force yourself to wait yet another day. • Be a 12-stepper. Help someone out. Alcoholics Anonymous’ 12th step encourages us to help someone who needs a helping hand. There is something powerful about helping others and taking the focus off ourselves. Being in the service of others helps us to connect with other individuals and can be an important component of relapse prevention. In the program they often say, “you cannot keep it until you give it away.”
12
• Reflect on any losses that you experienced during your addiction. Write a letter to your addiction and list all of the things that you have lost, squandered or destroyed. Allow yourself to feel the emotions associated with these personal losses. And quickly move on. • Make amends. You must make amends, or attempt to make amends, to those who you have harmed during your addiction. It is a means of healing and an attempt to acknowledge the past and move beyond the dark days. • Know the enemy. The elements of your addiction include the seduction, titillation, drug procuring ritual, engagement in secret activities, fear and apprehension of getting caught, and all of the other variables that comprise the nucleus of addiction. It’s not just about getting high. And it’s not good enough to just stop drinking or drugging. Recognize the subtle elements of your addiction and begin to cast them out of your life. • Address the consequences. Ask yourself “Then what?” and remind yourself that the harmful and self-destructive high is short lived and the real consequences are not. Some people refer to this as “playing the tape through to the end.” Recognize the ways that substance abuse will make a bad situation even worse. • Avoid euphoric recall. Do not dwell on your addiction and do not revisit the perceived “good times” when you were using. Avoid fantasizing about your drug or alcohol. The seductive music, cigarette smoke and smell of stale beer in a darkened barroom can have a certain romantic appeal to the addict. But don’t allow yourself to daydream. Discipline your mind to sidestep euphoric recall, and instead, refocus on positive in-the-moment recovery themes. • Address triggers. Triggers are inevitable and can include people, places, things and situations that may make you want to use. Triggers assume sundry forms, such as emotional upset, past traumas, negative influences, specific individuals or certain objects, specifically drug-related paraphernalia. It is important to avoid people you know are using, even if they are friends or family. Avoiding certain people, places and things is one of the most important strategies to prevent relapse. Associating with recovery ‘buddies,” who can help you maintain the principals of sobriety, is another. Above all, stay positive. You can overcome any obstacle and every challenge if you believe in yourself and your capacity to stay focused on your recovery goals. There is strength in numbers. You have a network of people in recovery to call. Getting clean and sober is a major achievement, and relapse prevention will help you maintain that feeling of joy and empowerment. Maxim W. Furek has a rich background that includes aspects of psychology, addictions, mental health and music journalism. His book Sheppton: The Myth, Miracle & Music blends facets of the psychological, miraculous and supernatural in a true ordeal of survival. Learn more at shepptonmyth.com
www.thesoberworld.com
Free assessments offered 24/7. Call 954-388-9660 to start your recovery with us.
Struggling with addiction or a behavioral health issue? We can help. We provide: • Inpatient Treatment • Outpatient Programs • Detoxification Services
Treatment for: • Children • Adolescents • Adults • Older Adults
Specialized programs for LGBTQI and veterans. Accepting most insurances including Medicare, Managed Medicare, HMO, and Managed Medicaid.
ftlauderdalebehavioral.com Admissions Fax: 954-734-2100 With limited exceptions, physicians are not employees or agents of this hospital. Model representations of real patients are shown. Actual patients cannot be divulged due to HIPAA regulations. For language assistance, disability accommodations and the non-discrimination notice, visit our website. 181789
To Advertise, Call 561-910-1943
13
WHAT TO EXPECT FROM NEW OPIOID DRUG POLICY (PART 1 OF 2) By John Giordano, Doctor of Humane Letters, MAC, CAP
Recently, the President rolled out his three pronged approach that he believes will curb our raging opioid epidemic, parts of which sound remarkably close to those of Philippine President Duterte’s; a person our president has openly praised. Looking into his past, it becomes clear how, with a little encouragement, President Duterte’s declaration of a “War on Drugs” came to be. Duterte has always presented himself as a ‘tough on crime’ politician. He speaks openly of personally killing suspected criminals as Mayor of Davao to set an example for local police. His detractors claim Duterte, nicknamed “The Punisher” by Time magazine, is using the violent and deadly “War on Drugs” as a political tool intended to rally his base. It’s a sad commentary on humanity when the weakest of us, the downtrodden and often mentally ill, are imprisoned and summarily executed for a disease they didn’t ask for and played no part in getting. We see this all too often in third-world countries; but recent comments from the White House amid their new opioid policy makes me wonder if this great country of ours might start turning a blind eye to humanity like the Philippines did while being steered in that direction. Everyone agrees we have a raging opioid epidemic growing exponentially, yet there is no one consensus on how to end it. Some experts believe Medication-Assisted Treatment (MAT) is the way to go; while other experts who are proponents of abstinence believe MAT only moves addicts from one opioid to another, doing little to ease the suffering. There are other arguments and considerations as well. However, if I had to speculate, I think nearly all addiction professionals would agree that the policy shift being set forth by the administration is an abomination that completely ignores facts and will perpetuate this epidemic into eternity. Albeit the president was elected as someone with fresh new ideas on how to approach the major issues we face today, I don’t think anyone touched by addiction, either professionally or personally, quite expected this. I want to draw your attention to a speech the president made on March 2018 in New Hampshire – one of the states hardest hit by opioid addiction and overdose deaths – revealing his administration’s three prong opioid response plan. You can find the speech in its entirety online; but the short version is: build a wall – ostensibly to prevent the importation of illicit drugs from Mexico – a ‘just say no’ advertising campaign and death penalty for some drug dealers. To be frank, I was taken aback watching the President’s rollout of new policies on TV. It was a moment of déjà vu. Never in my wildest dreams did I ever imagine reverting back to what most addiction experts believe to be the biggest abject failure of the 80’s, known as “The War On Drugs,” as being the ‘new’ direction for our opioid policy. What I found particularly interesting while watching the president on TV was just how little this administration understands about addiction and this epidemic, let alone what to do about it. I suppose the most logical place to start is at the beginning, or in this case, the wall. The administration believes, or at the very least postulates, that their iconic proposed multi-billion dollar wall will prevent the importation of illicit drugs from our southern border. I have a lot to say on this, but for now let us look at the facts. The Mexican drug lords have proven just how resourceful they are when it comes to smuggling drugs into the US. They use mules that swallow condoms containing drugs and cross the border. They have submarines and fleets of their own aircraft. Last year, customs agents found drugs in the tires of brand new ford cars built in Mexico and being shipped by rail road to US destinations. Illicit drugs are coming into this country through every point of entry you can imagine and a few that you can’t. The administration wants to focus on the southern border while untold amounts of fentanyl are being smuggled in from the north. Just last month
14
Canadian officials shut down a fentanyl lab in Calgary, Alberta; their third major bust – just in Alberta – in less than a year. The Royal Canadian Mounted Police Clandestine Lab Enforcement and Response (CLEAR) Team discovered 18 kilos of suspected fentanyl in two different locations. To give you an idea just how deadly fentanyl is, an amount approximately equal to the size of the head of a pin can kill you if you just touch it! Many of the Canadian smugglers barter fentanyl with US traffickers for cocaine and other illicit drugs more popular in Canada. Perhaps Canada should build a wall to keep illicit drugs from creeping into their country from their southern border? Canada is just the tip of the iceberg. The DEA and United Nations narcotics monitors have identified China as the primary source of most of the fentanyl in U.S. street drugs. In a one year study conducted by Senate’s permanent subcommittee on investigations, looking at only six online sellers (five based in China) offering fentanyl, all of which can be found through a simple Google search, investigators identified $230,000 in payments in 500 financial transactions with U.S.-based individuals or businesses – an amount that would translate into $766 million worth of fentanyl, based on its U.S. street value. So just how did the fentanyl find its way from China into the US; hundreds of packages were sent to more than 300 U.S. based individuals’ doorsteps via United States Postal Service, FedEx, and other private shipping companies. Bear in mind, this is merely one congressional study of just 6 vendors selling fentanyl online. Who knows how much is coming into this country through our postal system and other private shipping companies. It is also important to note that because this was a congressional study, the administration does have access to it. Suffice it to say that it’s going to take far more than a wall to curb illicit drug trade into the US. For reasons unbeknownst to me, this administration appears to be enamored with the nearly forty-year-old “Just Say No” campaign. Both the President and the Attorney General have spoken fondly of it on numerous occasions and incorporate it into their prevention plan. Perhaps it is because of its affiliation with the Reagan administration or because it was promoted by Nancy Reagan; then again it may be they find it fondly reminiscent of an earlier era of a president appearing ‘tough on crime;’ it’s anybody’s guess really. For whatever their reason, the sentiment seems misplaced. The 80’s was a time when cocaine and crack cocaine use exploded in the US. President Reagan vowed to crack down on substance abuse and reprioritize the War on Drugs when he came into office. He signed the Anti-Drug Abuse Act in 1986, allotting $1.7 billion to Continued on page 30
www.thesoberworld.com
The Center for Sobriety, Spirituality & Healing N
O
W
O
P
E
N
The Fountains Center of Boca Raton Anthony G. Foster, Ph.D. announces the opening of a new counseling office that specializes in the unique challenges associated with alcoholism and addiction recovery. • Have you struggled to sustain your sobriety? • Do you have trauma associated with your Alcohol and Substance Abuse issues? • Do you struggle with the Spiritual aspects of 12 Step programs? • Have you damaged relationships with your use of alcohol or drugs? • Are you ready to do something about your struggles with alcohol and substance abuse? We offer Individual and Group Counseling in Relapse Prevention Therapy, Spiritual Awareness and Development, Family and Relationship Counseling and 12-Step Facilitation. We also offer Clinical Hypnosis with Rapid Resolution Therapy for Trauma. Also available for Consultation Services to Substance Abuse Facilities at all levels of care.
The Center for Sobriety, Spirituality & Healing 7 1 0 0 W . C A M I N O R E A L , S U I T E 3 0 2 - 6 | B O C A R AT O N , F L O R I D A 3 3 4 3 3 754-245-0332 | w w w . So b e r Sp i r i t He a l i n g . c o m To Advertise, Call 561-910-1943
15
Located in The Shoppes of Atlantis 5865 S. Congress Ave. Lake Worth, FL 33462
561-214-9191 WithinRecoveryCafe.com
Special events this month at Within! Bingo De Mayo! May 5, 2018 Play for a chance to win the Jackpot in our first ever Bingo Night! Join us from 5 - 7pm. $1 per card is necessary to participate. Non-alcoholic Cinco De Mayo-themed refreshments available at the Café.
Mother’s Day Special May 13, 2018 Celebrate Mother’s Day with a Mom-cchiato! All Macchiatos on Mother’s Day will be $1 OFF.
April 2018 Groups at Within Cafe Monday
Tuesday
Hope Starts Here (Open AA) 5:30pm
On Awakening (Open AA) 7:00am (Open) AA Candlelight Meditation 7:00pm
WITHIN Wednesday
Thursday
Back to Reality (Open AA) 12:00pm
Women in Sobriety (Open AA) 10:30am
Worthy of Love & Respect (Open AA) 7:00pm Caduceus (Closed AA) 7:30pm
Located in the Shoppes of Atlantis
Within Lantana Rd.
N
I-95
. ve sA
Located in The Shoppes of Atlantis 5865 S. Congress Ave. Lake Worth, FL 33462
Open NA 7:00pm
es gr
Facebook.com/WithinBooksBoutiqueCafe @WithinBoutique @WithinCafe
*open for events
Contact us to book your next event!
n Co
Follow us on social media!
M, W, Th 7:30am-8:00pm Tuesday 7:00am-8:00pm Friday 7:30am-5:00pm* Saturday 8:00am-4:00pm* Closed Sunday*
Space Available
Al-anon (Open) 12:00pm
Military Trail
TTC Alumni Events Held Here
Friday
5865 S. Congress Ave. Lake Worth FL, 33462
Part of L I F E LO N G A D D I CT I O N R ECOV E RY
16
www.thesoberworld.com
L I F E LO N G A D D I CT I O N R ECOV E RY
IMAGINE STAYING
Sober Alumni Support Line: (561) 714-0541 Residential Inpatient Treatment
Utilizing the newest techniques in addiction treatment, The Treatment Center’s in-house doctors and nurses is ready to provide you with a comfortable detox and ďŹ rm foundation for recovery.
Outpatient Care Our Intensive Outpatient Program and Partial Hospitalization Program is available after detox and stabilization for those who need support in our community. O U T P A T I E N T
S E R V I C E S
Faith-based Options Road to Freedom is our faith-based inpatient program led by Pastors, therapists and medical professionals. Our program has in-house church and worship services and individualized groups.
TheTreatmentCenter.com To Advertise, Call 561-910-1943
(855) 602-4082 17
WCSAD EXHIBITION OF 9TH ANNUAL WEST COAST SYMPOSIUM ON ADDICTIVE DISORDERS (WCSAD) PRESENTS A UNIQUE SERIES OF EDUCATIONAL WORKSHOPS HIGHLIGHTING THE CREATIVE ART THERAPIES FOR TRAUMA AND ADDICTION Renowned clinician and author Ericha Scott, PhD, LPCC917, ICRC, ATR-BCt and five additional faculty including Rebecca Wilkinson, MA, ATR-BC, LCPAT; Anin (Nina) Utigard, MA, MFT, REAT; Rebecca Sledge Johnson, LPC-MHSP, ATR; Deborah Schroder, MS, ATRBC, LPAT; and Tabitha Fronk, LPCC, ATR-BC, ATCS, CCLS will be presenting a unique series of educational workshops highlighting the Creative Art Therapies for Trauma and Addiction at the 9th Annual West Coast Symposium on Addictive Disorders (WCSAD), held May 31-June 3, 2018 in La Quinta, CA. The series consists of lectures, workshops and a panel discussion designed to illuminate the integration of behavioral health and creative self-expression in treatment. Ericha will be the keynote speaker and is the Planning Chair for the new creative arts therapy educational track.
“As the field focuses on more individualized treatment, there needs to be a broader understanding of the many and varied paths to recovery. C4 can be a bridge to the knowledge and skills necessary to excel as a clinician and to have greater impact on the clients by utilizing expert faculty to showcase these different avenues and techniques,” states Dee McGraw, Vice President of Education and Event Services at C4 Recovery Foundation. “The faculty and the program for the art track are of the highest quality, and our goal is to expose clinicians to new types of therapies, improve on existing techniques and discuss broader business implications in the implementation of new programming.” WCSAD will also feature An Exhibition of Creative Art Therapy during the opening reception to showcase client works.
The host of the conference, C4 Recovery Foundation, is offering a special discount to Registered/Certified Art Therapists as well as Art Therapy students. For more information about the track or discount, contact susan@c4recovery.org.
18
www.thesoberworld.com
CREATIVE ART THERAPY WHAT IS ART THERAPY AND HOW DOES IT HELP? By Rebecca Wilkinson, MA, ATR-BC, LCPAT
Although many people have heard about art therapy, often they are under the impression that it is mostly for children. Indeed, it is helpful with kids; it is also useful with teens, adults, couples and families, people who are medically ill or have mental illness, as well as those who are trying to overcome substance abuse and dependence, trauma, grief, and loss. In effect, art therapists work with anyone who is struggling and in pain, who wants to be happier, and who is trying to improve the quality of his/her life.
loneliness (Figure 1). Although initially she trivialized her artwork as trite and childish, she noticed that the image was really quite dynamic. She recognized that it represented more anger than sadness, and also power. She thought that it looked like a gown, something that was serving to protect her from others who had hurt her.
What Makes Art Therapy Helpful?
In a similar way, for people who have experienced a loss—whether it was someone they loved, a capacity they had that was taken away, or the surrender of a destructive addiction that nevertheless helped them cope— the art making process can provide a reprieve from their grief. When people make artwork about that which was dear Figure 1 to them, it gives them a reassuring connection to those things and helps ameliorate the pain of their loss. It reveals that the void that they were experiencing at those losses is not as hollow and empty as it seemed.
Doing art certainly makes sense if we’re working with children— art can be playful, expressive, and naturally lends itself to earlier stages of psychological and physical development. For those very reasons, doing art may seem regressive to adults. Most “grownups” have not made art since they were young and doing art may seem inappropriately childish in the face of whatever serious matters initiated their need for therapy. Nevertheless, the playful nature of art may be one of its most useful qualities. It engages us in ways that verbal therapy does not. It accesses and reveals parts of our experience—feelings, memory, perception—that words alone cannot. Art’s effects on the brain and on the body as a whole are what make it uniquely useful to the therapy process. What Does Making Artwork Do? • • • • • • • • • • • •
Reduces anxiety, negative emotions, and depression Increases focus and energy Provides a healthy distraction from distress Increases positive emotions and counters the impact of negative emotions Improves mood and sense of well-being Reduces physical pain Improves health and immune functioning Promotes divergent thinking Shifts perceptions Induces flow--a sense of being absorbed and fully engaged Promotes sense of connection and identification with others Provides opportunities for self-efficacy, mastery, accomplishment and pride
The Meaning of Artwork There are times when it can be helpful for clients to explore the meaning behind their imagery. Even the simplest drawing offer insights into the artists’ unique personality, e.g. through the type of materials chosen, the colors and mark-making used, the way the figures/objects interact with each other, etc. Art therapists do not have simple formulas for interpreting visual imagery; rather, they explore meaning based upon the interplay between the clients’ process in creating the work, their thoughts about the imagery, and the visual elements in the actual artwork. In other words, because art and the art-making process provide a bridge between a client’s inner experience and the outer world, it serves as a message from the self to the self and a message from the self to others. If the therapist and others share their impressions of the imagery with the client, it also becomes as a message from others back to the self, often resulting in a shift in perspective and insight for everyone involved.
What Happens in Art Therapy?
Art Therapy from a Positive Psychology Perspective
Art therapy can look very different depending upon who we are working with. Sometimes, because doing art is so therapeutic, the therapy will revolve around the art process; other times it might focus on exploring the imagery that was made, and sometimes it might include both.
As mentioned earlier, art therapists work with any number of different clients. They also operate from a broad range of orientations—psychodynamic, Jungian, Humanists, Solutionfocused, etc. Rebecca, the author, and her colleague art therapist Gioia Chilton, practice Positive Art Therapy, art therapy from a positive psychology perspective. Positive psychology attempts to shift the focus from “fixing what’s wrong” to “building what’s strong.” Positive psychology attempts to challenges the negativity bias, the natural propensity to devote our attention and resources to solving problems, and instead mobilizes efforts toward observing and building upon what is functional and working in our lives.
For example, for cancer patients, making art provides them with a soothing distraction that helps alleviate physical pain. The manual engagement not only absorbs their attention, but it induces the relaxation response and improves mood. Using imagery to express the complexity of their feelings about their illness helps make the latter more concrete and manageable. The art process also gives them opportunities to get in touch with and see parts of themselves that remain intact despite their illness. For people who are struggling with addiction, with self-destructive behaviors, and/or with overwhelming affect, doing artwork provides a way to channel and contain destructive urges, compulsions, or overpowering emotions. It allows access to and expression of feelings, followed by opportunities to develop more distance and equanimity towards those feelings. For example, Grace (a pseudonym), who was devastated by the end of her marriage, drew a spontaneous representation of her emptiness and
To Advertise, Call 561-910-1943
The focus of positive art therapy is on helping people experience the best version of themselves given whatever challenges they are either born with or facing in their lives. It begins with the inherently healing nature of doing artwork and its capacity to produce positive emotions, to promote engagement and focus, and to induce the relaxation response. It also capitalizes on art’s capacity to contain and transform negative emotions. As an example, in our work with Laura (also a pseudonym), a young woman who struggled with depression and hopelessness, drew a picture of herself encapsulated by a shell of pain and darkness that
Continued on page 30
19
WCSAD EXHIBITION OF THE CREATIVE ARTS COMFORT AND HEAL DURING CHAOTIC TIMES By Ericha Scott, Ph.D., LPCC917, ATR-BC, REAT, ICRC
It is one of the functions of art that it restores to us the whole of human history in optimum condition. In the face of fragmentation and alienation it restores our identity, reactivates our memory and gives us precisely the reorientation that we sometimes need... Art has wrought miracles in the past and there is no reason to think that they have come to an end. ~Vaclav Havel, 1990, New York Times
We are living in complicated and difficult times. We are all affected by what is happening on the world stage, regardless of nationality, political affiliation, gender, age, race or religion. Those of us who are privileged are not completely exempt, even if all that touches us is the cacophony of news reports about mass suffering. In fact, while writing this article, another public shooting event is unfolding on social media as it is happening in real time. The creative arts are able to help people find balance, meaning and purpose. The Greek root word for trauma means “wound”. Recently, it seems as if more people are able to relate to the term “wound” than “trauma”. We all have wounds, and most people are able to acknowledge that they have experienced a wound in the past, whether it is visible or not, and whether or not we still carry the impact of that wound with us. I believe that the arts, all of the arts, are well suited to address and ameliorate emotional and physical pain. Science supports this assertion. Broadly speaking, the creative arts therapies include a variety of the visual arts, music, dance, theater, and creative writing. Although the creative arts are not yet considered to be an evidence-based therapy, there is significant research supporting the efficacy and power of creative arts psychotherapies to heal. In fact, the creative arts appear to be especially effective for trauma. As a point of reference, up to 85 percent of the veterans at Walter Reed Hospital participate in art therapy groups. The creative arts therapies can be tailored to address trauma of all kinds, and people with various symptoms and diagnoses. Clinicians find that art therapy helps people put words to unspeakable or unbearable pain because the arts are better able to engage the pre-verbal, nonverbal, metaphorical, symbolic, imagistic and rightbrained processes. These processes which help elicit words and narratives are necessary to reduce symptoms of trauma and abuse, and they appear to be able to do so more effectively than traditional talk therapy alone.
There are few words in our language that adequately express pain. To express emotional or physical pain to another human being we often rely upon metaphor.
~Scott, 1999
For example, you may describe a headache as, “like I have my head in a vise,” “a jack hammer is pounding on my skull,” or “as if I have a ticking time bomb inside my head.” While there are many reasons the art therapies can be useful, one important reason is that by its very symbolic nature, the arts help us translate pain into expression and relief.
20
Not only are the art therapies well suited to address post-traumatic stress disorders, trauma, grief and loss - they are also well suited to help those who suffer from a variety of substance use and mental health issues. From a PsychLIT database search of 10 outcome studies, “most of the studies found significant symptom improvements using different outcome measures” for the following diagnoses: Substance Abuse, Eating Disorders, Complex Trauma/ Dissociative Disorders, Psychosomatic Symptoms, Borderline Personality Disorder, Anxiety Disorders, Suicidal Ideation, Schizophrenia and Mixed Diagnoses. The study suggested that the creative arts therapies offered the greatest positive impact for trauma and compulsivity. I have also found that the art therapies are able to support with the treatment of developmental delays, attachment disorders, traumatic brain injury, and as described often in the media, dementia. What I tell my trainees is that you can and may use art therapy with just about any issue or diagnosis. The challenge is to properly adapt and tailor the creative arts interventions for the specific individual needs of each person or clinical population. In an amusing and rather simplistic anecdote thirty years ago, I learned not to use wet paints with a traumatized child- unless I wanted to wear most of the colors home on my clothing. With regard to trauma, it all begins with trust. Trust between the client and therapist is an essential and critical aspect of successful counseling. As one might expect, victims of profound early childhood trauma have the most difficulty trusting. Simply put, they have been betrayed and their trust - not just their bodies and minds - was violated. Victims of childhood trauma experienced untrustworthy adult caretakers which were not necessarily their parents but a trusted adult. Therefore, trust was undermined due to the violation of the sanctuary of childhood innocence, especially, if the betrayal was by a loved one. This break between the caretaker and child when the child is small, vulnerable and just beginning to shape his or her world view, can last a life-time and is able to contaminate all future relationships with others and/or the self. In today’s world, many people, even those without an overt trauma history are expressing difficulty with trust. Many people feel betrayed or even sabotaged by recent financial and political upheavals. Others are frightened by serious illnesses that suddenly appear as threats from various parts of the world. Many of us in California - and elsewhere - have been concerned about drought conditions, earthquakes, extreme weather and/or natural disasters.
Fortunately, art is a gentle, silent, but powerful voice. Art, in a session, becomes the co-counselor and leaves space and place for me to align in a very proactive and supportive way with a client.
~Ericha Scott- FB PAGE
Often, it is the art that best challenges psychological blocks or denial. A client might look at an art piece and say something to the effect of, “Gosh, this art piece is so chaotic, and... so is my life, I never realized that before now.” I ask my clients to portray their whole life history of emotions, trauma and addiction on a life-sized silhouette (body map on butcher block paper).Body maps often include physical illnesses and surgeries. Sometimes, women and men who were sexually abused paint graphic descriptions of sexual abuse, STD’s, gynecological problems or surgeries and find that the representations of trauma visually overlaps with physical illness.
www.thesoberworld.com
CREATIVE ART THERAPY As patients progress, they can amplify and extend the healing process they experienced in the art therapy room to home and beyond. By taking art home, a patient is able to help maintain a bridge of connection to the therapist and safety in-between sessions. Art also helps clients see in a concrete and somewhat measurable form the psychological work they are doing. Often, clients understandably question “What have I accomplished in therapy?” even as their lives are improving because the processes of talk therapy can appear to be invisible and nebulous. Art functions as a memory mnemonic. In other words, art helps remind clients of the work they are doing and have done, even - or maybe especially, if trauma has negatively impacted their ability to focus and remember. The use of art therapy to address trauma and pain heals and that healing spills over into many areas of a client or patient’s life. One of the many aspects of art therapy that I cherish is how a therapeutic art process helps the client to become creative in all aspects of life. I am from Texas and we have a corny expression for this type of unexpected bonus, we call it a “two-fer”.
CLIENT ART TITLE: Holding the Paradox: The Juxtaposition of Joy and Pain
At this point, clients begin to realize the full impact of trauma on all aspects of their health, not just emotional. This art exercise helps clients recognize the self-sabotaging mechanisms of denial for both trauma and addiction. While looking at their finished body map the client becomes clear that they are not weak because they have PTSD and/or addiction, but in fact, they have been - in the true context of their life history - quite strong. While this would appear to be a painful process, it usually provides profound relief by bringing to consciousness a deeper implicitly known truth. Clients who have been historically frustrated by their body’s health problems begin to develop compassion and self-forgiveness for how the body tells the unspoken story. This imagistic narrative of a life story reframes cognitive distortions of failure associated with symptoms of trauma, and energizes, empowers and motivates clients to recover In the art piece that has been included in the heading of this article, the initial intent was to portray joy ... yet this clients trauma history clearly intruded, just as it does in life. The client has progressed to the point that she is able to acknowledge the concept of holding the paradox of joy and pain, freeing her from polarized, superficial and self-defeating ideas of emotional wellness. Decades ago, an alcoholic man who was looking at his art piece suddenly realized that he loved his family and said something to the effect of, “Suicide is no longer an option, I want my family back. I have to deal with the trauma because it is dealing with me, and I must stay sober to do it.” Suddenly, the client became assertive and proactive in his own treatment process. It seems as if the art product in therapy becomes a bridge to trusting the self. Trusting the self and/or the therapeutic process helps the client begin to trust the therapist. Then, what follows is- that as the client trusts the therapist, that trust helps the client trust others. Art can even work as a therapeutic transitional object. Just as a teddy bear is able to help comfort a young child while his or her parents are out for dinner, clients may refer to an art piece instead of a teddy bear to remind them of the safety of the therapy room.
To Advertise, Call 561-910-1943
There is much more to be said about the potential benefits of the practice of creative arts therapies when practiced by a certified art therapist. Contrary to common myths, the art therapies are much more than entertainment, arts and crafts, or a diversion and distraction from treatment. In fact, a certified art therapist generally has training above and beyond licensure requirements, not less. Another myth is that the art therapies are benign and cannot cause harm. In fact, in the hands of an untrained therapist, art can be too provocative and can even trigger excessive flooding of traumatic memories, overwhelming the clients’ defenses and ability to cope. Therefore, it is recommended that only certified art therapists be hired for individual, family or group sessions in substance use treatment programs. The arts are a different language and the therapist needs to be trained in the language that the arts speak. Fortunately, the clients who use art as a therapeutic tool often find that using art for healing enhances creativity in all aspects of life. Article adapted from an interview by Ms. Barbara Burke for The Malibu Chronicle 2017. References Provided Upon Request Dr. Ericha Scott - Licensed as E. Hitchcock Scott, Ph.D. has 32 years of professional experience working with those who have co-occurring addictions and complex trauma. She has published on topics of addiction and trauma, research on self-mutilation by dissociative disordered individuals, and her theory of creative arts therapy. Dr. Scott is an artist, a Board Certified Registered Art Therapist (ATR-BC), a Registered Expressive Arts Therapist (REAT), and an Internationally Certified Advanced Addiction Counselor (ICAADC). www.artspeaksoutloud.org.
21
WCSAD EXHIBITION OF CREATIVE ART THERAPY MOSAICS AS ART THERAPY FOR GRIEF By Tabitha Fronk, LPCC, ATR-BC, ATCS, CCLS
“Break a vase, and the love that reassembles the fragments is stronger than that love which took its symmetry for granted when it was whole”
~Derek Walcott
“If we’re willing to give up hope that insecurity and pain can be exterminated, then we can have the courage to relax with the groundlessness of our situation. This is the first step on the path”
~Pema Chodron
Broken Open I am an artist and an art therapist. I am also a trauma survivor. I came to art therapy, as many do, through my own intimate familiarity with the creative process, and its power to heal. I am most passionate about my role as witness and guide to others as they embark on their own journeys of healing, while sharing my love of art, and particularly mosaics. In art therapy, we are trained in the theories and practice of psychotherapy, in fine arts, and in the many nuanced, deliberate approaches of combining the two. We explore the symbolic and metaphorical content of the finished work, as well as the creative processes which led to its creation. Both artmaking and engaging in creative exploration of art materials with no particular product in mind, can amplify and accelerate the healing process for people recovering from grief, trauma, and addictions. Art makes the amorphous, overwhelming or hidden feelings of sorrow, shame and rage visible. Externalizing these feelings from our bodies onto paper, paint or clay, can concretize them, allow them to be more fully seen and worked through. Over time, the art therapist and client may review together the entire record of imagery produced during the course of art therapy, vividly documenting the healing process, and leading to new insights. Art therapists typically offer a wide range of materials, including those which are wet and dry, those which are loose and precise, familiar and unfamiliar to the client. We explore the inherent sensory/ kinesthetic, metaphorical qualities of various art materials, and help guide our clients by carefully selecting materials and techniques which are tailored to that unique person and their difficulties in that moment. The use of art helps us to assess developmental ruptures, traumatic experiences, and diagnoses. It also provides a safe container or buffer to allow clients to express themselves more openly, bring the unconscious to consciousness, and allow the person’s imagery to speak for them. In art therapy, sensitivity to “windows of tolerance”, the breadth of stimulation or challenge within which a person can comfortably participate, is critical. A skilled art therapist will continually modulate the offering of materials and pacing of directives, to match the client’s changing needs. When we talk about addiction, we are often also talking about trauma, grief and loss. For some, substance abuse was provoked by loss, and that subsequently disrupts the normal grieving process. When the person becomes sober, the unresolved grief becomes apparent, although it may at first appear as anger, resentment, guilt or depression. For others, significant losses are experienced during the course of their addiction. Art therapy is uniquely equipped to reveal loss and trauma, reaching people who are shut down emotionally due to substance abuse or other reasons. It is an ideal modality for treating people who are unresponsive, or have limited benefit, from more traditional forms of psychotherapy. Images, symbols and metaphors are key to our unconscious lives, our dreams, and our stories. They are a primary way we make
22
sense and meaning of the world. Pre-verbal, nonverbal, right brain and repressed experiences of trauma often arise spontaneously via the art making process, sometimes dysregulating clients with a flood of triggering memories. This is precisely why using art without proper training within psychotherapeutic contexts can be risky. As clinicians we have the duty to treat (not harm) our clients. It is common knowledge within art therapy circles (and largely unknown to others) that art has the potential to harm. It is imperative that art therapists have proper training and credentials, in order to provide the best possible care for our most vulnerable clients; particularly those with complex histories of trauma, poor reality testing due to dissociative or psychotic conditions, and those with suicidal and/or homicidal tendencies. This describes many individuals seen today within addiction and mental health treatment centers. In the US, each state regulates the scope and practice of art therapy, in coordination with the national Art Therapy Credentialing Board, to ensure the safest, best possible care for those seeking our treatment. Putting the Pieces Together What is broken can be mended, but often not in the way we first imagine. Perhaps what we perceive as fragmented, shattered, hopelessly chaotic is not quite as it seems. In these times when our lives are shattered by grief, loss or trauma, we are also receptive and open to new opportunities for insight, growth and healing. Much of my work over the years has been with mosaics. Making mosaics deliberately as a form of art therapy has many benefits. It involves several distinct phases, each of which has unique metaphorical/symbolic/healing properties. Other forms of art, such as collage and quilting, share some similar therapeutic qualities; however they differ in significant ways from mosaics. A mosaic is, simply, an image made of many pieces of something (usually broken tiles aka “tesserae”), glass, mirror, or stones. The breaking phase is satisfying in its cathartic nature, allowing the artist to acknowledge and release anger and pain. We may also spend time gathering and scavenging for treasures to include. Arranging is the phase where we “put the pieces together”. It is somewhat like a puzzle, but one where we ourselves determine the outcome, re-experiencing the variety and sharpness of each shard as we reassemble them into a new image. This phase is not always neat or pretty, but it does Continued on page 24
www.thesoberworld.com
To Advertise, Call 561-910-1943
23
LIVING BEYOND
By Dr. Asa Don Brown, Ph.D., C.C.C., D.N.C.C.M., F.A.A.E.T.S.
A DEADLY COMBINATION: EATING DISORDERS AND ADDICTION Continued from page 10
disorders, a rate 11 times greater than the general population.” While these particular statistics are concerning, there always remains a glimmer of hope. Moreover, the answer is not a punitive approach towards recovery. “In fact, studies have not found evidence in favor of harsh, punitive approaches, like jail terms, humiliating forms of treatment and traditional ‘interventions’ where families threaten to abandon addicted members.”.Punitive approaches are never the answer. The brain circuitry of individuals struggling from addiction and eating disorders are already struggling with self-defeat and negative experiences, one more punishment will not curtail the addictive process. THE MIRROR “We mirror what we see in life, and our empathy expands or contracts in response to our early encounters.” As children, we are behaviorally and psychologically conditioned, to think the thoughts we think, to ponder the ideas we think upon, and to perceive the world as we perceive it.“When our caretakers are inattentive, depressed, or filled with anger and resentment, the mirror they hold up for us offers a distorted vision of reality. Looking in the mirror of their confused thoughts and feelings, we see a distorted, unrealistic image of ourselves.” As the child begins to develop, they transform into the image that the parents have projected. Often times, this perception is illusive. When illusion is combined with disparaging beliefs about oneself, this delivers a detrimental blow to the child’s psyche. Eating disorders affect all ages, populations, genders and sexual orientations. “Eating disorders are serious emotional and physical problems that can have life-threatening consequences for females and males.” For far too long, eating disorders have been considered to be gender specific, but the reality is, eating disorders do not discriminate or differentiate between peoples. The challenge is to distinguish between healthy and unhealthy eating and learning the distinction between maintaining a normal weight, diet, and lifestyle. Moreover, a greater challenge occurs when you try to determine the catalyst of the eating disorder and the addiction. The mental health of the individual is the primary pursuit; they set out on this journey for a particular reason. What is the reason that this individual has this deadly combination? What really is the underlying issue? THE HEALING AND RECOVERY PROCESS There are no absolute cure-alls that will be the remedy for an eating disorder and/or an addiction.The truth is, the complexities surrounding an eating disorder and an addiction go well beyond what is presenting. Those who are struggling with such a combination of disorders could benefit from an eclectic body of practitioners (e.g. psychotherapy, medical management, social support and encouragement, and nutritional and health related education). The following are suggestions for encouraging those with eating disorders and issues of addiction. 1. 2. 3. 4. 5. 6. 7. 8. 9.
24
Recognize that you are not alone. Be willing to seek out professional services. Do not isolate yourself from the world. Relinquish your need for control, allow yourself to be vulnerable. Avoid environments and people that are hostile, unfriendly, and antagonistic. Learn to develop friendships for support, rather than seeking food or an addictive substance to be an ally. Be aware of your limitations and identify areas that need strengthening. Consider journaling your thoughts, feelings, and emotions. When journaling, be certain to journal a positive entry for every negative thought, frustration, or agitation. Maintain realistic goals and ambitions.
10. Always be considerate of your person. Avoid placing unnecessary stressors upon yourself. 11. Practice daily affirmations, breathing, and actions that will positively influence your person. “Begin each day by saying a positive affirmation in the mirror. The following is an example of a positive affirmation. I am a person of worth. I am a person of value. I am a person deserving of respect, love, and kindness. I am a person deserving of friendships and relationships. I am a person made up of my human mind, body, and spirit.” As a person, you are deserving of unconditional acceptance, love, approval, and grace. Dr. Asa Don Brown, Ph.D., C.C.C., D.N.C.C.M., F.A.A.E.T.S. Website: www.asadonbrown.com References Provided Upon Request
MOSAICS AS ART THERAPY FOR GRIEF By Tabitha Fronk, LPCC, ATR-BC, ATCS, CCLS
Continued from page 22
lead to a satisfying sense of clarity and order. We glue the pieces into place. Next, grouting involves covering the entire piece with a mud-like substance called grout. Grout, like mud and clay, tends to naturally conjure up primal associations with night, death, the seasons, and functions of the body. It is also the strongest part of the mosaic. The image is present, but still rough, and temporarily invisible. In the uncovering phase, the new, complete image is revealed. Beauty from the brokenness Japanese ceramicists have an ancient tradition called kintsugi. In this technique, fractures in beloved ceramic objects (vases, dishes, sculptures) are repaired with a resin mixed with pure gold, thereby imparting more value and beauty. The histories of these objects, sometimes turbulent, are viewed not with disappointment, but rather with awe and reverence. In mosaics, we undergo a metamorphosis, a profound transformation. Our new image which emerges from the blanket of grout has a renewed sense of wholeness, integrity, and permanence. The brokenness is preserved, as a necessary element in creating the beauty and strength of the finished product. Is it possible that we humans are like mosaics? That not despite of, but because of our wounds, fractures and imperfections, we are paradoxically stronger, more complex, more cohesive and more beautiful? Tabitha is a mosaic artist and art therapist. For the past twenty five years, she has worked primarily with people recovering from grief, trauma, depression, anxiety and addictions. She has facilitated the completion of numerous large-scale collaborative mosaic murals in Canada and the US. Currently, Tabitha provides art therapy to children, youth and adults, as well as clinical supervision, at her office in Culver City, CA. She is on faculty at Loyola Marymount University. In addition, Tabitha facilitates art therapy groups for cooccurring addiction/mental health recovery programs, and is artistin-residence/ mosaic muralist at an elementary school. For more information, please contact: TabithaFronk@aol.com or 310.403.9317 www.psychologytoday.com/profile/162743. www.linkedin.com/in/tabitha-fronk-lpcc-atr-bc-atcs-ccls-51b9266. References Provided Upon Request
www.thesoberworld.com
To Advertise, Call 561-910-1943
25
For the Families YOU MATTER, TOO! CREATE YOUR OWN BILL OF RIGHTS By Lorri A. Irrgang, LPRC
I was lost in the world of my son’s chaos! I no longer functioned as I used to. The activities I used to enjoy were second to being on 911 alert for any crisis that might occur. As the parent, I felt it was my responsibility to head off any poor decisions my son might make. I lived with worry, fear, and anxiety. I did not want to feel like this! My life absorbed many changes due to my son’s substance use illness. We often feel, as caregivers, that it is our responsibility to fix and take care of all those around us. We are always putting our personal needs and wants behind others. For many of us, this pattern of behavior has gone on for years. Why do we do this? Is it a lack of our own self-importance? Or is it the opposite? We are the only one available to help. Is it based on the feelings of guilt that we will feel if we do not make ourselves available? Is it based on the fear that our loved one is incapable? When our loved one has a substance use illness, we often step in to help or fix a situation. This prevents them from taking responsibility for themselves. By doing this, we are also instilling an unhealthy co-dependence. This creates an antibiotic relationship. One that is disadvantageous or even destructive to one of the people involved. The caretaker is likely to become the one at a disadvantage as you push your own needs to the side. You spend every waking moment trying to convince your loved one to stop using. Frustration will peak once you realize you are unable to control the situation. You, too, will suffer and become hopeless and fatigued. Feelings of guilt can surface when you unveil the secret your loved one is hiding. You may feel guilty because the genetic component is within yourself or from your side of the family. Feelings of guilt may come from not being able to control the chaos. This feeling will place you at a disadvantage. It is a very powerful feeling that weighs on a caregiver. You may ask questions like, “What could I have done different?” or “How did I not see the signs?” If you have other children that “turned out just fine”, you might wonder, “Where did I go wrong?” Caregivers must recognize that guilt allows you to be manipulated by your loved one. It will keep you from setting limits and standing up for your rights. Guilt is not helpful for yourself or your loved one. Most importantly, guilt can keep your life out of balance. For many parents and spouses, life takes on a new normal. Normal means obsessing over our loved one’s actions and no longer being easy going. Normal is no longer being productive at home and/ or at work. Your new normal is taking excessive amounts of time to complete what used to be simple jobs. Normal is a reluctance to make plans and staying home. Normal is sleeping with your purse and keys under your pillow. Normal is putting medications and valuables in a safe. Normal is diffusing situations that may lead to yelling or dangerous outbursts. Normal is locking bedroom doors. Normal is not knowing what makes your life happy any more. Normal is waiting for the other shoe to drop. If you do not make changes for yourself, your life will be in the hands of the disease that is consuming your loved one. It is like jumping out of an airplane and free falling without pulling your parachute open. You have a choice. You can choose to crash into the ground…or open your parachute and glide to safety. I chose to have some control over my life. It took time to get to this point but I did this by recognizing that “I” have rights. My being was shaped by someone else’s substance use illness from the later years of my marriage to four years ago. I became used to having my rights taken for granted and completely disrespected. My
26
normal was not healthy for me at all. I decided to dedicate some time to identify what rights were important to me. What rights was I going to incorporate to protect my own happiness and well-being. There are many different “Personal Bill of Rights” lists available on the web. Generally, the lists are similar but you can use them as a guideline to create a list that is personal to you. I will share the ones that I felt entitled to once I pulled the rip cord of my parachute during my free fall. These rights have helped me to glide into a safer and happier life. 1. I have the right to expect honesty from others. Alcoholism and addiction breed dishonesty. It kills trust in a relationship. Trust is important to me in a relationship. 2. I have the right to say no to requests or demands I cannot meet or for which I am not ready. This includes anything related to finances, my time, car or home. 3. I have a right to be healthier than those around me. If I do not take care of myself, no one else is going to. 4. I have a right to live in a safe, non-abusive environment. I do not have to walk on eggshells waiting for verbal or physical abuse. 5. I have a right to have my needs and wants respected by others, including time and space. Those who love me will want my needs and wants to be met. 6. I have the right to be treated with dignity and respect. If I do not expect this of myself, I will not receive it from others. 7. I have the right not to be responsible for others’ behaviors, actions, feelings, or problems. My loved one must be responsible for his own choices regardless of his illness. 8. I have a right to put myself first without feeling selfish. I do not have to feel guilty for this anymore. Please take the time to create your own “Bill of Rights.” Every one of you has the right to choose how you want to live and feel. You do not have to be at the mercy of the choices that your loved one is making. Lorri Irrgang is an author, a Certified Peer Recovery Coach and the President/CEO of “Let’s Get Real,” a family advocacy organization. She writes a column for the local paper, the Cecil Whig, called “Shift the Focus.” Lorri is a Family Peer Support Specialist for the Maryland Coalition of Families (MCF). She is a member of several local committees; Drug Free Communities Coalition and Drug Free Cecil. Lorri@letsgetrealmaryland.com.
www.thesoberworld.com
IMPORTANT HELPLINE NUMBERS
A New PATH www.anewpath.org Addiction Haven www.addictionhaven.com Bryan’s Hope www.bryanshope.org CAN- Change Addiction Now www.addictionnow.org Changes www.changesaddictionsupport.org City of Angels www.cityofangelsnj.org FAN- Families Against Narcotics www.familiesagainstnarcotics.org Learn to Cope www.learn2cope.org The Long Island Council on Alcoholism and Drug Dependence www.licadd.org Magnolia New Beginnings www.magnolianewbeginnings.org Missouri Network for Opiate Reform and Recovery www.monetwork.org New Hope facebook.com/New-Hope-Family-Addiction-Support-1682693525326550/ Not One More www.notonemore.net/
ALCOHOLICS ANONYMOUS WWW.AA.ORG AL-ANON WWW.AL-ANON.ORG 888-425-2666 NAR-ANON WWW.NAR-ANON.ORG 800-477-6291 CO-DEPENDENTS ANONYMOUS WWW.CODA.ORG 602-277-7991 COCAINE ANONYMOUS WWW.CA.ORG 310-559-5833 MARIJUANA ANONYMOUS WWW.MARIJUANA-ANONYMOUS.ORG 800-766-6779 NARCOTICS ANONYMOUS WWW.NA.ORG 818-773-9999 EXT- 771 OVEREATERS ANONYMOUS WWW.OA.ORG 505-891-2664 NATIONAL COUNCIL ON PROBLEM GAMBLING WWW.NCPGAMBLING.ORG 800- 522-4700 GAMBLERS ANONYMOUS WWW.GAMBLERSANONYMOUS.ORG 626-960-3500 HOARDING WWW.HOARDINGCLEANUP.COM NATIONAL SUICIDE PREVENTION HOTLINE WWW.SUICIDEPREVENTIONLIFELINE.ORG 800-273-8255 NATIONAL RUNAWAY SAFELINE WWW.1800RUNAWAY.ORG 800- RUNAWAY (786-2929) CALL 2-1-1 WWW.211.ORG ASSOCIATION OF JEWISH FAMILY AND CHILDRENS AGENCIES WWW.AJFCA.ORG 410-843-7461 MENTAL HEALTH WWW.NAMI.ORG 800-950-6264 DOMESTIC VIOLENCE WWW.THEHOTLINE.ORG 800-799-7233 HIV HOTLINE WWW.PROJECTFORM.ORG 877-435-7443 CRIME STOPPERS USA WWW.CRIMESTOPPERSUSA.ORG 800-222-TIPS (8477) CRIME LINE WWW.CRIMELINE.ORG 800-423-TIPS (8477) LAWYER ASSISTANCE WWW.AMERICANBAR.ORG 312-988-5761 PALM BEACH COUNTY MEETING HALLS CLUB OASIS 561- 694-1949 CENTRAL HOUSE 561-276-4581 CROSSROADS WWW.THECROSSROADSCLUB.COM 561- 278-8004 EASY DOES IT 561- 433-9971 THE TRIANGLE CLUB WWW.TRIANGLECLUBPBC.ORG 561-832-1110 LAMBDA NORTH WWW.LAMBDANORTH.NET
PAL - Parents of Addicted Loved Ones www.palgroup.org/
BROWARD COUNTY MEETING HALLS
Parent Support Group New Jersey, Inc. www.psgnjhomestead.com
101 CLUB 954-573-0050 LAMBDA SOUTH CLUB 954-761-9072 WWW.LAMBDASOUTH.COM PRIDE CENTER WWW.PRIDECENTERFLORIDA.ORG 954- 463-9005 STIRLING ROOM 954- 430-3514 4TH DIMENSION CLUB WWW.4THDIMENSIONCLUB.COM 954-967-4722 THE BOTTOM LINE 954-735-7178
P.I.C.K Awareness www.pickawareness.com Roots to Addiction www.facebook.com/groups/rootstoaddiction/ Save a Star www.SAVEASTAR.org TAP- The Addicts Parents United www.tapunited.org
To Advertise, Call 561-910-1943
27
TRAUMA THEN AND NOW - Part 1 of 3 By Nancy Jarrell O’Donnell, MA, LPC, CSAT
In 1987, the DSM- III-R was published and changed the PTSD definition expanding the range of symptoms and emphasized the psychological content of the stressor. The diagnosis no longer included criteria that an event is so severe that it would result in symptomology for anyone. Questions continued to arise however, as did it make sense to use this same diagnosis for someone who had been tortured and imprisoned for years and someone who was a passenger in a vehicular accident with minimal physical injuries? Was another differentiating diagnosis needed? DSM-IV was published in 1994. Like the previous two DSM the diagnosis remained open to interpretation. The definition was expanded however to include the experience of “a threat to the physical integrity of self or others”. The diagnosis now was no longer limited to an event only personally experienced by the individual. In addition, the diagnosis of Acute Stress Disorder was added which focused on criteria in which the individual had three out of five dissociative symptoms; numbing, reduced awareness of surroundings, derealization, depersonalization, and dissociative amnesia. Acute Stress Disorder is characterized by presentation of symptoms within 4 weeks after the stressor and is resolved within this same 4-week period. If symptoms continue after one month, the diagnosis is then changed to PTSD. In 2013, the DSM-V came out with increased criteria and specific differentiation for those 6 years of age and older and those under 6 years of age. Acute Stress Disorder remains and a conglomerate of disorders are also included under a chapter titled Trauma and Stressor-Related Disorders. Trauma and Addiction In the mid 1990’s I was privileged to develop my career at Sierra Tucson, an acute care licensed psychiatric hospital with both level one and level two units. Early on I was involved in the development of a program focused on the treatment of trauma and trauma recovery. Myself and 3 colleagues were given a blank slate on which to develop a program that supported the treatment of patients with history of sexual, physical, emotional, and mental abuse as well as neglect, abandonment and more with resulting symptoms of PTSD, alcohol and/or drug addiction, sexual addiction, relationship addiction, and other behavioral health issues. The four of us had no differing opinions as to our understanding of unresolved trauma manifesting itself in these unhealthy behaviors. We also developed a family component in which family members came to the facility and engaged in open and honest communication about the traumas, which included facing the shame of incest, neglect, abandonment and more. The program rolled out in 1997. The ACE (Adverse Childhood Experience) study was facilitated at Kaiser Permanente from 1995 – 1997. The study was conducted by The American Health Maintenance Organization, Kaiser Permanente, and the Center for Disease Control and Prevention. The study involved 17,000 plus participants surveyed on childhood experiences. Each was asked to identify if they experienced any of 10 pre-identified Adverse Childhood Experiences. The ACE score results demonstrated a high correlation of adverse childhood experiences with adult high-risk behaviors, and poor physical and mental health. Participants continued to be periodically evaluated over time. In short, the Ace Studies provide testament to the philosophy that addictions and other behavioral health issues are symptoms of underlying trauma. In 1996, my colleagues and I became familiar with the ACE studies and followed the research as it evolved.
Continued from page 8
the results should be considered in the provision of treatment. Although on going, this study took flight over 20 years ago. How Trauma Affects Us Trauma can impact every aspect of one’s life. Behaviorally, we know that someone with unresolved trauma may over react to situations and under react as well. Anyone who is repeatedly exposed to frightening experiences and is unable, for whatever reason, to process the experience, receive understanding, or be provided comfort for their fears can become wired for extremes, leaving the individual either over-reacting or under-reacting to experience. Thus, unprocessed trauma can be seen in emotional, behavioral and psychological extremes. So, when something occurs that most would consider benign, a trauma survivor might present with an exaggerated response to the occurrence. Something seemingly small may result in a trauma survivor’s eruption as it may mimic a trigger or reminder of something terrorizing. In contrast, if a sudden unexpected crisis occurs, the trauma survivor might be the person presenting as calm and able to best manage the frightening situation. Why? Trauma can result in dysregulation of our physiology. Extreme stress and traumatic experience wreak havoc on the body and cause emotional, physical, and psychological pain. After exposure to a traumatic event or events, biological changes occur that can interfere with our respiration and digestion, immune function, perception, cognition, changes in limbic system functioning, and other areas of the brain involved in learning and memory. Trauma affects our autonomic nervous system. Trauma distorts and dramatizes every aspect of a person’s world. For those exposed to repeated frightening experiences, the state of psychological arousal and dealing with crisis becomes normal for the individual. Despite not liking how they feel, crisis becomes familiar and there is safety in familiarity. Someone with a high level of traumatic exposure often knows instinctively how to manage crisis. As treatment providers, it is essential that we forgive the extreme behaviors of the trauma survivor, as they do not choose these reactions. Good treatment must include empathy, nurturing, kindness, and compassion and target the treatment toward the trauma roots; not by having survivors verbalize the stories and details, but by working with the beliefs the survivor has created and how trauma has become stored within the body. In Part 2 we will talk about the Underlying Causes of Trauma Nancy Jarrell O’Donnell specializes in addiction and trauma treatment. She has spent most of her 25-year career working in residential and in-patient facilities. Her experience ranges from Psychotherapist to Clinical Director to President of Clinical Services/Operations. She is a licensed therapist in Arizona and a Neuropsychotherapist currently in private practice and provides clinical consulting for treatment facilities in the U.S. She developed The Sabino Model: Neuroscience Based Addiction and Trauma Treatment™ www.nancyjarrellodonnell.com ©Nancy Jarrell O’Donnell 2018
I mention this because I have found that addiction treatment has not kept pace with the research. Only in the past few years have many clinicians begun discussing the ACE studies and how
28
www.thesoberworld.com
FOUNDATIONS EVENTS
INNOVATIONS IN BEHAVIORAL HEALTHCARE NASHVILLE, TN | JW MARRIOTT
Up to 14 CE and CME credits will be available for psychologists, interventionists, therapists, psychiatrists, social workers, addiction counselors and medical personnel in the behavioral health field. Pending CE board approval.
KEYNOTE SPEAKERS BECCA STEVENS
Author, speaker, priest, social entrepreneur, and founder and president of Thistle Farms, which is a movement dedicated to supporting female survivors of trafficking, prostitution and addiction
MILES ADCOX
Owner and CEO of Onsite and Milestones at Onsite, author and speaker on topics such as emotional leadership, inspiration, communication, organizational health, creative flow, family systems, trauma and emotional wellness
July 2-3, 2018
FoundationsEvents.com
29
WHAT TO EXPECT FROM NEW OPIOID DRUG POLICY (PART 1 OF 2) By John Giordano, Doctor of Humane Letters, MAC, CAP continue fighting the War on Drugs; just one year after the cocaine centric Miami Vice TV show was nominated for 15 Emmy Awards. President Reagan also instituted mandatory minimum prison sentences for specific drug offenses; not all that different from what the president and Attorney general are proposing with their death penalty for some drug traffickers. Throughout the 80’s “Just Say No” TV commercials aired across the country. Ads appeared in newspapers and popular magazines. There really is no matrix that could indicate whether it was a success or failure as a deterrent to drug use. But what we do know is that drug use exploded during this period and nonviolent drug offenses increased over 8 fold, from 50,000 in 1980 to more than 400,000 by 1997. Kellyanne Conway, the President’s counselor and de facto drug czar, seems to have her own version of “Just Say No” that she revealed at a youth forum hosted by the White House last month. Her slogan “Eat the ice cream, have the french fry, don’t buy the street drug.” You can’t make this stuff up; I wish I was, but I’m not. Talking to a group of millennials, Conway offered up this little nugget of advice; “On our college campuses, your folks are reading the labels, they won’t put any sugar in their body, they don’t eat carbs anymore, and they’re very, very fastidious about what goes into their body, and then you buy a street drug for $5 or $10, it’s laced with fentanyl, and that’s it. So I guess my short advice is, as somebody double your age: eat the ice cream, have the french fry, don’t buy the street drug. Believe me, it all works out.” I don’t have the benefit of knowing Conway personally, so I don’t know if her comment was intended to be serious, or a failed attempt at humor. Regardless, taken on its own merits, this is a glaring flashing airport size red light warning us of just how little this administration knows in relation to addiction. I referred to Conway as the de facto drug czar because, well, she is. She leads a White House group of politicos with no health or addiction bone fides that advises the President much in the way former heads of the Office of National Drug Control Policy (ONDCP). This is probably because we haven’t had an acting head of the ONDCP, a/k/a Drug Czar, since January 2017. The current seat warmer is Jim Carroll – the third of this administration’s – who at this time last year was Washington counsel for the Ford Motor Company. Carroll may be a terrific attorney, I don’t know, but he also has no health or addiction education or work history. It is as if people with extensive addiction expertise critical to ending the opioid epidemic have become an endangered species in White House agencies and are being supplanted by blind loyalists to the administration. In fact, many of the top level executives at the ONDCP with extensive health and addiction education and work history vital to effective drug policy have resigned or been replaced by this administration’s loyalist with backgrounds similar to Carroll’s. I’m sure these new staffers are nice people, but they’re just in way over their heads. At the risk of hearing the answer, I have to ask, “What kind of leadership and support can we in the addiction treatment field expect from the ONDCP in the coming months?” We need to know this because with these policies in place, most experts I’ve spoken to believe we will be seeing more addicts and overdose deaths. There is far more to this story, but you are going to have to wait until the next issue of The Sober World Magazine. John Giordano, Doctor of Humane Letters, MAC, CAP, is the founder of ‘Life Enhancement Aftercare Recovery Center,’ an Addiction Treatment Consultant, President and Founder of the
30
Continued from page 14
National Institute for Holistic Addiction Studies, Chaplain of the North Miami Police Department and is the Second Vice President of the Greater North Miami Beach Chamber of Commerce. He is on the editorial board of the highly respected scientific Journal of Reward Deficiency Syndrome (JRDS) and has contributed to over 65 papers published in peer-reviewed scientific and medical journals. For the latest development in cutting-edge addiction treatment, check out his websites: www.PreventAddictionRelapse.com www.HolisticAddictionInfo.com
WHAT IS ART THERAPY AND HOW DOES IT HELP? By Rebecca Wilkinson, MA, ATR-BC, LCPAT
Continued from page 19
kept any “good” from getting in (Figure 2). Even in its simplicity, this image gave her some relief from the oppressive isolation she was experiencing. We wondered if she could imagine what it would look like “if the good got in.” In response, although Laura still included the red and black marks that represented her pain, the yellow marks of good could “flow through” (Figure 3). In addition, it wasn’t just that the image changed, her whole demeanor improved. She became more animated and others around her observed that she looked much brighter. Figure 2
Figure 3
Perhaps, most importantly, Laura felt more hopeful. Art helped her access the strength and willingness to keep going. This illuminates another important endeavor in positive art therapy, helping clients tap into their strengths and their capacity to cope and persevere. This includes, as in the case of Grace mentioned above, utilizing art’s ability to access and express parts of the self and then, in exploring that imagery, shifting negative beliefs and allowing for more positive and empowering perceptions. How to Access Art Therapy For clients and/or clinicians who would like to learn more about art therapy or access an art therapist, they can go to the American Art Therapy Association’s website (https://arttherapy.org/) for an overview of the profession and a database of art therapists. Rebecca Wilkinson is a licensed, registered, and board certified art therapist. She is co-founder of Creative Wellbeing Workshops (www.CreativeWellbeingWorkshops.com) which helps individuals and organizations manage stress, reduce burnout, and increase wellbeing. She is co-author with Gioia Chilton of Positive art therapy theory and practice: Integrating positive psychology with art therapy and teaches on the topic at George Washington University. She is also an Art therapy specialist and wellness counselor at Miraval Resorts in Tucson, Arizona.
www.thesoberworld.com
To Advertise, Call 561-910-1943
31
P.O. BOX 880175 BOCA RATON, FLORIDA 33488-0175 www.thesoberworld.com
The contents of this book may not be reproduced either in whole or in part without consent of publisher. Every effort has been made to include accurate data, however the publisher cannot be held liable for material content or errors. This publication offers Therapeutic Services, Drug & Alcohol Rehabilitative services, and other related support systems. You should not rely on the information as a substitute for, nor does it replace professional medical advice, diagnosis, or treatment. If you have any concerns or questions about your health, you should always consult with a physician or other health-care professional. Do not disregard, avoid or delay obtaining medical or health related advice from your health care professional because of something you may have read in this publication. The Sober World LLC and its publisher do not recommend nor endorse any advertisers in this magazine and accepts no responsibility for services advertised herein. Content published herein is submitted by advertisers with the sole purpose to aid and educate families that are faced with drug/alcohol and other addiction issues and to help families make informed decisions about preserving quality of life.
32
www.thesoberworld.com