The Meadows Blog

Tuesday, 18 January 2011 19:00

Notes From Tucson

Notes From Tucson

Debra L. Kaplan
M.A., CSAT-3, EMDR-II

It was a sad day in Tucson, Arizona, as a lone gunman made a foiled assassination attempt on the state's Congresswoman Gabriel Giffords while she was conducting a meet-and-greet at a local supermarket. On that Saturday, January 8th Tucsonans and the greater nation became aware of the tragedy as the day unfolded. As the events became known we learned that 19 people were shot and six people were left dead.

The lingering question for most people is, "Why- why did this happen?" That answer or a variation of the truth may remain unsolved. However, the answer, with or without the facts is that an unstable mind coupled with aggression can be, and in this case was, a dangerous coefficient.

The fallout from this devastation will linger, certainly for the lives of those affected. On a broader scale, however, the damage remains with the potential for secondary trauma as we look on from the sidelines and are left to ponder our own lives and human fragility.

In the days since this tragic event I have noticed a strong need for people to share their thoughts and feelings on the topic. Regardless of their political or personal persuasion, one thing is clear to me. As communities lay witness to these events both within our own backyards and around the nation's landscape, I see signs of psychological distress due to the increasing frequency of senseless violence against others and our loved ones.

In the helping profession we know this to be vicarious trauma. Vicarious trauma (or secondary trauma) is a trauma response that results from the cumulative effect of contact with and exposure to survivors of violence or disaster. This can occur over a period of time with delay after days, months or years of direct or indirect contact. Those of us who work with and treat psychological trauma know that we are vulnerable to this condition and therefore, take steps toward increasing self care on a regular basis.

So it comes as no surprise to me that as our society is increasingly exposed to acts of violence certain individuals who already struggle with their own internal distress, inch that much closer to an inability to cope. Still, for others who are on the cusp of emotional fragility, their ability to stay functional might become greatly compromised as a result of an event or a series of events such as this and move toward an emotional unraveling.

One's ability to handle a traumatic experience(s) is not formulaic. Further, no two individuals will respond nor manage the distress in quite the same way. For some, violent acts such as this, will elicit a healthy call-to-action in the service of political or social change. For others these events might induce an emotional decompensation rendering them emotionally unable to function as before.
In the aftermath of a crisis or crises, an already fragile emotional structure is likely to become more vulnerable to the duress and re-experience an old, but, unresolved traumatic response. As the unresolved and underlying trauma is triggered, the response in the here and now can be physiological, psychological or emotional in nature. A few of those moderate signs and symptoms include: sadness, anxiety, social withdrawal, increased signs of depression, loss of appetite, sleep disturbance, and anxiety to name a few.

Just how an individual copes is based on several factors; their internal strengths, available family/social support, and/or learned coping skills. Those individuals who have worked through their grief and loss due to trauma will have an easier time moving forward past an event. That event becomes a momentary pause versus a roadblock beyond which one is unable to move. When an individual continues to struggle with unresolved trauma they could have a strong identification with current crisis such as the shooting event in Tucson. Others' grief and loss becomes the catalyst for a re-experiencing of one's old trauma wounding.

For those that are struggling with this event or others that are traumatic I encourage self care in the following ways:

  • Seek support from your identified support system whether that be family or friends.
  • Attend 12-step groups to ensure ongoing sobriety for those in recovery.
  • Make mindful connections to the positive influences in your world.
  • Remember your personal connection with others and the love and support that your presence in their life brings.
  • Be of service to individuals who are in need. Giving of one self helps ensure an empathic connection in a time of need, both to your self and to others.

Last, it is always important to remember that reaching out for professional help when or if it is needed is an act of courage and strength. It takes a strong person to reach out for help and present oneself the gift of compassion, love and support.

Shelley Uram, M.D.

January 4, 2011

The Meadow's Overview of the Core Issues and how they relate to our psychological and behavioral symptoms is the most encompassing model I have worked with. This model accurately captures our nature at birth, and how the chronic psychological "bumps and bruises" through our formative years can distort our underlying nature. Ultimately, many of us develop psychological and behavioral symptoms that are directly rooted in these early psychological traumas. These symptoms can include inflexible or inadequate coping mechanisms, addictions, mood and anxiety disorders, personality disorders, etc.

Depressive conditions very commonly develop from these earlier childhood psychological traumas.

There are currently over 21 million American adults diagnosed with a depressive disorder, or almost 10% of all American adults. These numbers do not include the many, many more who have not sought professional help. This is a staggering number of people!

When someone feels the pain of depression, they want relief; the state of depression feels very uncomfortable and negative. In our country, the vast majority of people who go to a doctor for depressive symptoms are treated with antidepressant medication.

Many people feel significant relief within a few to several weeks after starting the medication. Later on, if the depression recurs, they will likely, once again receive a prescription for antidepressant medication. Eventually, many patients are instructed to remain on this medication for years to come in order to prevent a recurrence of their depression.

One of the current popular recommendations from our national and local psychiatric associations is that psychiatrists should treat patients with medication, striving towards a goal of 100% relief of symptoms. Most patients are happy with feeling so much better; however, they have not addressed the underlying issues that initially lead to the depressive state.

Why does this matter? Why should we address the underlying issues behind the depressive state if medication takes away the symptoms?

In my opinion, we are all ultimately trying to master the challenges that show up in our lives. There is a subtle "push" in all species to keep on evolving their mastery skills and ability to cope. We develop better mastery skills with our relationships, health, life stressors, etc. We all stumble and fail at times; sometimes we are flat out stymied by life circumstances. Ultimately, we want to come to some kind of terms with the challenges that show up in our lives, and feel more at peace with them.

In my opinion, many people who suffer from depression are in a "stymied" state of dealing with life challenges. Very often, it is their coping skills that are not adequately flexible or mature enough to successfully deal with the challenge. They are left feeling overwhelmed or "shutdown". In this condition, they are simply not able to master the circumstances at hand.

In my opinion, if a patient is overwhelmed by their symptoms, antidepressant medication may be helpful to alleviate some of the symptoms. The patient can then enter into a "working zone" of being able to actively participate in psychotherapy, and eventually reach a new level of mastery in dealing with their life-stressors.

I think it is wise to utilize antidepressant medication if it is an adjunct to the patient MASTERING the underlying issues.Unfortunately, the trend in our country is to replace the psychotherapy with only symptom relief through medication.

If a person's coping skills are not maturing, they are just as vulnerable to another bout of depression as they were the first time. Research has actually shown that a person is even more vulnerable to further depression episodes with each new episode of depression.

In my opinion, we psychiatrists should tailor our medication prescribing to meet their ideal needs in psychotherapy. For example, if a patient ideally needs to experience some sadness or anxiety in order to be motivated to master the underlying issue in therapy, I think it is appropriate to let them have some of their symptoms, but to a tolerable degree.

I view some depressive or anxiety symptoms as a "barometer"that tells us how we are doing inside. Instead of automatically silencing these depressive or anxiety "signals" with medication, these symptoms can frequently be utilized to motivate us to dig deeper in psychotherapy.

The Meadow's Overview of the Core Issues, is an excellent diagnostic and treatment model upon which to base psychotherapy. It is from this model that mental health professionals can analyze where a patient is psychologically "stuck", and in what therapeutic directions to move. In patients that medication would serve the purpose of alleviating certain symptoms that would stand in the patient's way of utilizing this psychotherapy, then the two treatment modalities could become a unified and useful treatment approach.

Exceptions to the above would include patients who are not interested in mastering the underlying issues and improving their coping skills. If a patient clearly wants to just have the symptoms removed, I do not see a problem utilizing only a medication approach. Other possible exceptions include patients who suffer from other disorders, such as psychosis, Bipolar I disorders, Schizoaffective disorders, etc. When patients have reached an extremely distressed state and have thoughts of harming themselves or others, then the medication route is often helpful in bringing some relief, after which the psychotherapy can play an increasingly important role.

©2011 Shelley Uram

Bessel A. van der Kolk, MD

Trauma, Attachment and the Body
February 11, 2011

Universal City, California
In recent years there has been an explosion of knowledge about how experience shapes biology and the formation of the self. Within the disciplines of psychiatry and psychology, the study of trauma has probably been the most helpful in understanding the relationship between the emotional, cognitive, social, and biological forces that shape human development. Trauma research has revealed new insights about how extreme experiences can profoundly impact memory, affect regulation, biological stress modulation, and interpersonal relatedness. These findings, along with a range of new therapy approaches, have led to new and unexpected ways to help traumatized individuals. This lecture will present current research findings about post-traumatic responses at different developmental levels and in various domains, and will explore the treatment implications of these findings.

Learning Objectives
Participants will be able to:

  • Identify and discuss recent advances in the neurobiology of trauma.
  • Identify the ways in which somatic experience contains the imprints of the traumatic experience.
  • Discuss and demonstrate ways in which these imprints must be reprocessed for a successful treatment outcome.

About the Presenter
Bessel A. van der Kolk, MD, Clinical Consultant for The Meadows and Mellody House, is one of the world's foremost authorities in the area of post-traumatic stress and related phenomena. His research work has ranged from the psychobiology of trauma to traumatic memory, and from the effectiveness of EMDR to the effects of trauma on human development. He is professor of psychiatry at Boston University School of Medicine and medical director of the Trauma Center in Boston, a Community Practice Site of the National Child Traumatic Stress Network. The Trauma Center is one of the foremost training sites in the country for psychologists and psychiatrists specializing in the treatment of traumatized children and adults.

Dr. van der Kolk has published extensively on the impact of trauma on development, borderline personality and self-mutilation; cognitive development in traumatized children and adults; and the psychobiology of trauma. He's currently studying the effects of treatment on brain function, the effectiveness of EMDR, theater groups working with traumatized inner-city youth, and yoga. His most recent book is Traumatic Stress. He has taught in universities, hospitals and clinics on five continents.

Location
Hilton Los Angeles
Universal City
555 Universal Hollywood Drive
Universal City, CA 91608
818-623-1479
Self-parking at hotel is $9.

Schedule
Registration: 8:30 a.m. 9 a.m.
Lecture: 9 a.m. 12 p.m.
Lunch: 12 p.m. 1 p.m. (boxed lunch provided)
Lecture: 1 p.m. 4 p.m.

Earn 6 Continuing Education Credits

To register: http://www.themeadows.org/events/index.php?rm=event_details&param1=show&param2=144&

Bessel A. van der Kolk, MD
 

Trauma, Attachment and the Body
February 11, 2011

Universal City, California
In recent years there has been an explosion of knowledge about how experience shapes biology and the formation of the self. Within the disciplines of psychiatry and psychology, the study of trauma has probably been the most helpful in understanding the relationship between the emotional, cognitive, social, and biological forces that shape human development. Trauma research has revealed new insights about how extreme experiences can profoundly impact memory, affect regulation, biological stress modulation, and interpersonal relatedness. These findings, along with a range of new therapy approaches, have led to new and unexpected ways to help traumatized individuals. This lecture will present current research findings about post-traumatic responses at different developmental levels and in various domains, and will explore the treatment implications of these findings.

Learning Objectives
Participants will be able to:

  • Identify and discuss recent advances in the neurobiology of trauma.
  • Identify the ways in which somatic experience contains the imprints of the traumatic experience.
  • Discuss and demonstrate ways in which these imprints must be reprocessed for a successful treatment outcome.

About the Presenter
Bessel A. van der Kolk, MD, Clinical Consultant for The Meadows and Mellody House, is one of the world’s foremost authorities in the area of post-traumatic stress and related phenomena. His research work has ranged from the psychobiology of trauma to traumatic memory, and from the effectiveness of EMDR to the effects of trauma on human development. He is professor of psychiatry at Boston University School of Medicine and medical director of the Trauma Center in Boston, a Community Practice Site of the National Child Traumatic Stress Network. The Trauma Center is one of the foremost training sites in the country for psychologists and psychiatrists specializing in the treatment of traumatized children and adults.

Dr. van der Kolk has published extensively on the impact of trauma on development, borderline personality and self-mutilation; cognitive development in traumatized children and adults; and the psychobiology of trauma. He’s currently studying the effects of treatment on brain function, the effectiveness of EMDR, theater groups working with traumatized inner-city youth, and yoga. His most recent book is Traumatic Stress. He has taught in universities, hospitals and clinics on five continents.

Location
Hilton Los Angeles
Universal City
555 Universal Hollywood Drive
Universal City, CA 91608
818-623-1479
Self-parking at hotel is $9.

Schedule
Registration:  8:30 a.m. – 9 a.m.
Lecture:  9 a.m. – 12 p.m.
Lunch:  12 p.m. – 1 p.m. (boxed lunch provided)
Lecture:  1 p.m. – 4 p.m.

Earn 6 Continuing Education Credits

To register:    http://www.themeadows.org/events/index.php?rm=event_details&param1=show&param2=144&

Tuesday, 28 December 2010 19:00

Home for the Holidays

Admittedly, I have never met Jerry Siegel, co-creator of Superman, the fictional comic book superhero. Had I been granted the opportunity, I first would have thanked him for the borrowed Superman metaphor I often employ in therapy with my clients. Then I would have asked him if Krypton, Superman's native planet, held any resemblance to Mr. Siegel's own homeland of Cleveland, Ohio.

As it was written, Superman was jettisoned to earth in a rocket ship only moments before Krypton exploded into smithereens. Krypton's demise was due to its unstable radioactive core, perhaps a deliberate tribute to Cleveland's Cuyahoga River, infamous for its frequent fires on the water caused by pollution slicks.

I mean no disparaging sentiment for the Clevelanders reading this, but I can't but help wonder: What did Mr. Siegel have in mind when he decided that the one and only element that can strip Superman of his superhuman powers - and perhaps even kill him - is the element that comes from his home planet? The reference is too obvious for this therapist to ignore. Better yet, it's too beautiful a talking point to overlook.

I want to know how Mr. Siegel felt about his family of origin. Was the family contentious and dysfunctional - or warm, connected, and validating? Was Krypton like the home of Mr. Siegel's own family of origin? I'll never know, because Jerry Siegel died in 1996, and his co-creator, Joe Shuster, died in 1992.

Were it not for holiday family gatherings - and oftentimes destructive family feuds - I wouldn't need to employ my cautionary but appropriate reference to Superman. Every year, as Thanksgiving approaches, not a week goes by that I don't pull Superman out of hiding and speak of his comic-bound strength and invulnerability. I ask, "What is the one thing that renders Superman powerless?"

I'm often met with a bewildered look. Those clients old enough to remember mumble, "Kryptonite?"

I quickly exclaim, "Kryptonite! Exactly!"

"And where," I ask, "does Kryptonite come from?"

"Krypton?" they ask more enthusiastically.

"Right again!"

I confess to my clients that I cannot say what Jerry Siegel had in mind, but it is ironic that Superman could be stopped by only one thing: an element from his homeland. Even the most therapy-savvy among us, those who have risen out of dysfunction and family disorientation, are rendered powerless while returning home for the holidays. It can seem as though time has stood still, waiting for our return to fill the family roles-of-old.

As much as we'd like to think we've arrived at therapeutic transcendence, returning to our families of origin during the holidays often challenges our ability to maintain self-care and personal boundaries. It takes mindful awareness to remain immune from family havoc, and such success is not always achievable.

By way of my comic book metaphor, I remind my clients that even the strongest among us is susceptible. Even though a luscious glance from Lois Lane couldn't bring Clark Kent to his knees, Superman was susceptible to the destabilizing effects of Kryptonite. So we seek progress, not perfection. And as the holidays approach and we find ourselves facing a trip to Krypton or Cleveland we have choices: Stay home, or go visit the family. Just take along your favorite superhero for protection.

Tuesday, 28 December 2010 19:00

Equine Assisted Psychotherapy & The Meadows

Upon arriving at The Meadows, many patients are charmed by the view of equine activities at nearby ranches. They frequently ask about having Equine Assisted Psychotherapy (EAP) as part of their primary treatment program. As a direct result of these requests, EAP is among the newest offerings coming to The Meadows. The initial challenge was finding a provider who was knowledgeable about both EAP and The Meadows' unique model of treatment. Molly Cook, LCSW, LISAC, has experience as a family and primary counselor at The Meadows, as well as at other addiction treatment centers; she also has been trained in EAP by the Equine Assisted Growth and Learning Association (EAGALA). Working around horses since she was a teen, Molly has significant experience using EAP in her private practice. She now blends her EAGALA training and her experience with The Meadows' model into effective therapeutic sessions.

Equine Assisted Psychotherapy supports patients in recognizing the life patterns that create obstacles for them. By incorporating horses, EAP allows individuals to experience how those patterns play out with someone other than family or friends. Participants learn how to relate to others - and their own addictions - by interacting with horses. Horses are dynamic and living beings who have fixed roles within their herd, much like the roles in a family or group of friends. When humans are introduced to horses, they are incorporated into the horse herd and its social structure. In this joining, the horses start to recognize and reflect the unspoken emotions of humans, demonstrating exactly what human body language tells them. In this demonstration lie metaphors and lessons about the patients that can facilitate change. A healing bond encourages the recognition and change in behaviors. Because of the intimacy that can develop between humans and horses, positive results can start immediately.

For example, a recent patient was struggling with her role as a victim due to childhood traumas. By interacting with the horses, she was able to recognize her previous reality about herself and see that she was precious in her own right. Her role as a victim disempowered her; as she experienced EAP and gained more self-knowledge, her new confidence and skills enabled her to begin to see her own power. She was able to set boundaries, express her needs, share her feelings, and face her fears and anxieties - all without her previous coping mechanisms. Through interaction with horses, she gained the confidence necessary to use these new tools in her life. She gained a sense of self-trust and continues to use her newfound skills to build the self-assurance needed to face the issues of day-to-day life.

During treatment, new coping skills are taught to patients who need new ways to deal with past trauma and addictions. In EAP, these new coping skills are demonstrated, practiced, and reinforced. This experiential modality allows patients to utilize the knowledge gained at The Meadows. It then provides the opportunity to apply the tools learned in treatment to real-life situations. In addition, patients who are struggling with releasing old behaviors, ideas, patterns, and thoughts can be challenged with a new therapeutic technique that mirrors the reactions of those around the patient. The size of the horses allows patients an opportunity to overcome fear and develop confidence. While interacting with horses, patients have the ability to integrate boundary work and reinforce coping skills, such as expressing their needs or asking for help. They also develop intimacy with those around them. Patients who are resistant to letting go of old patterns or ideas can utilize EAP models to see the lack of control their old ideas bring into their lives. In treatment, patients gain information and knowledge. However, without practice, patients may not be able to make the necessary changes. EAP allows patients to enhance their new knowledge with experience that helps to solidify personal changes.

Equine Assisted Psychotherapy is an experiential, interactive, hands-on mode of therapy that can help patients see any issues that have been blocking progress in treatment. With the dynamic medium of equine assistants, patients can see which ideas work and which don't.

Anyone can participate in Equine Assisted Psychotherapy; no prior horse or riding experience is necessary. It is completely safe; no riding is involved, and all activities are done on the ground under the supervision of equine professionals.

Sunday, 26 December 2010 19:00

John Bradshaw: Discusses his work

The Meadows, America's premier center for the treatment of addiction and trauma, is pleased to present an 11-part video interview with John Bradshaw, senior fellow, world-famous educator, counselor, motivational speaker, author, and leading figure in the field of mental health.

In the 10th video of his series, Mr. Bradshaw talks about his long association with The Meadows and its people.

"When I was asked to come to The Meadows, I considered it an honor," he says. "They have some of the top people in the field."

He then describes some of those people and their contributions. Peter Levine, a pioneer on the impact of trauma on the body. Pia Mellody, whose intuitive genius and personal history helped make The Meadows’ treatment model accessible to non-professionals. Bessel van der Kolk, who shaped the field of PTSD. Maureen Canning, a leading expert in sex addiction and trauma.

"It's wonderful to be part of a class act," Mr. Bradshaw adds. "We give something to people, and they get something out of it."

Mr. Bradshaw has enjoyed a long association with The Meadows, giving insights to staff and patients, speaking at alumni retreats, lecturing to mental health professionals at workshops and seminars, and helping to shape its cutting-edge treatment programs. His New York Times best-selling books include Homecoming: Reclaiming and Championing Your Inner Child, Creating Love, and Healing the Shame That Binds You.

Other videos in this series include interviews with leading experts in addiction and trauma, including Dr. Jerry Boriskin and Maureen Canning. View the videos at www.youtube.com/themeadowswickenburg.

For more about The Meadows' innovative treatment program for addictions and trauma, visit www.themeadows.org or call The Meadows at 800-244-4949

The holiday season can be a time of joyous celebration with our loved ones, a time when we begrudgingly drag ourselves to dreaded events, or a time when feelings of loneliness can be overwhelming. For many of us, some combination of all three is present this time of year. In many cases, the holidays are a time when stressors, triggers for relapse, and old wounds are more abundant.

This season also brings the opportunity to continue or start off the new year in recovery mode. We at The Meadows would like to offer you a 12 Step plan for doing just that. We honor the work that many of you have done to re-engage in your life, leaving old habits behind. We also honor those who continue to struggle with addiction. Below is a 12 Step guide for surviving the holidays in sobriety - "the 12 Steps of Holidays Anonymous," if you will. (Disclaimer: The steps below are loosely based on the 12 Steps of Alcoholics Anonymous and are not a replacement for them.)

The 12 Steps of Holidays Anonymous

1. Make sobriety your first priority. Acknowledge the vast amount over which you are powerless (your family situation, the location of events, etc.). Be aware that you are, however, empowered to choose to maintain what you have lovingly worked so hard to achieve. Assess what you want and need for your sobriety and relational engagements with others.

2. Believe that you can be restored to sanity. Plan ahead and have realistic expectations. If your family looks more like The Family Stone than Ozzie and Harriett, ground in reality and be open to the flaws and imperfections of your family system. Detach from expectations and practice acceptance and forgiveness.

3. Turn your care over to a higher power, or at least someone with more experience staying sober during the holiday season. Have a safety plan. Speak with your support network prior to the holidays and share any concerns and plans. Remember that, in previous years, many of your peers in the program have survived and thrived during the holiday season. Some common techniques used in the recovery community include driving yourself to events so you can leave whenever necessary, taking the number to a taxi service if driving yourself is not an option, asking a sober friend to accompany you, or hiring a sober escort. Keep in mind: The impact of bringing someone with you or leaving an event early is small compared to the impact of a relapse on your relationships with your loved ones and self.

4. Make a searching and fearless inventory of yourself, and practice boundaries and grounding. Setting limits is a loving and respectful thing to do for yourself and others. If you have awareness that you are willing and able to participate in a holiday activity for one hour rather than five, set a limit with yourself and share this limit with your loved ones or holiday celebration peers.

5. Admit to God, self, and one other person any concerns and potential triggers you may have going into the holiday season. Remember: Those around you cannot support you unless you are willing to be rigorously honest with yourself and your sober support system, i.e., your sponsor, home group, and therapist.

6. Be entirely ready to remove all defects of character. Remember this is for you only; your willingness to assist family members in identifying and removing their defects of character before they are ready avails no one and is NOT relational.

7. Humbly ask the higher power of your understanding to remove your shortcomings, recognizing that your shortcomings do not subtract from your value. Be respectful of others. If one of your tendencies is to judge others, make a resolution to contain your comments on Uncle Marvin's lovely twinkle-light reindeer sweater (not that there's anything wrong with battery-operated clothing).

8. Make a list. Chaotic, last-minute trips to the mall can be destabilizing and stressful. Honor yourself by not overextending to make others happy. Take a personal inventory of yourself and your finances. This is a self-care technique that can help you turn inward and avoid future resentments. Also, don't forget to include yourself on your gift list. Gifting oneself, in a moderate way, is an act of self-care and acknowledgment.

9. Make direct amends, except when doing so would injure others. Remember that one of the ways to make amends is with living amends. You can do this by maintaining your sobriety, acting within your value system, and being respectful of others. You may believe this is a good time to speak with those you have harmed, but do so with conscious thought. Grandma may prefer to spend her holidays watching the grandchildren unwrap gifts rather than discussing a way you can pay her back for totaling her car.

10. Continue to take personal inventory and, when you are wrong, promptly admit it. Remember HALT (the basics of self-care: Hungry, Angry, Lonely, Tired). In times of stress, we become more susceptible to allowing some of our defects of character to leak out. If you act outside of your recovery and value system, make prompt amends to avoid allowing unnecessary feelings of guilt to overtake the celebrations.

11. Seek through prayer and meditation; the holiday season can be busy and, in some cases, stressful. This is not an excuse to skip your morning meditation, meetings, or time with your sponsor. This is a time to hold these commitments even more strongly, or to kick it up a notch. Prearrange your meeting schedule and ensure that connection, sobriety, and self-care remain top priorities. It may come in handy to repeat the Serenity Prayer in your head as Uncle Jack attempts to dominate the season with his thoughts on the current political climate. This allows you to remain connected with your higher power and accomplish relational objectives, all while nodding your head during his share.

12. If you have had a spiritual awakening, try to carry this message: Acts of service can help us to reground, stay connected to our program, and just feel darn good! The holidays can be an important time to practice gratitude and giving. If your holiday plans this year are not what you had hoped for (or even if they are), volunteer to be a sober escort, speak at a meeting, or volunteer to clean up after one. Remember: Whatever your season looks like this year, it’s still a lot better than holidays spent living in addiction.

We at The Meadows wish you a sober, safe, and successful holiday season.

Friday, 17 December 2010 19:00

Decisions in Recovery

In "Fabled Truths and Family Lies," published in the Meadowlark Summer 2010 newsletter, I wrote about a client's experience with childhood sexual and emotional abuse, her skewed self-doubt, and her perceptions surrounding that abuse in her family-of-origin.

Specifically, I addressed the challenges that arose for Leah* as she confronted her family's collusion and denial regarding the abuse perpetrated by her father. The article explored Leah's heroic, albeit painful, journey into recovery as she turned a reflective lens inward on her own need for healing. By so doing, she rejected and separated from her family members' need to preserve their own version of the events.

That article hit an emotional nerve with many readers and, in the ensuing months, I've received several emails expressing relief and appreciation for the topic.

I also received a letter from a reader who described her own struggle with her decision to separate from her family-of-origin in order to begin her journey of healing. In her letter, she posed the question of whether her journey toward healing, which involved both physical and emotional distance from her family, was worth the price. That price, she went on to say, came in the form of missed opportunities to be with her family, emotional and physical distance from them, and the loss of a family bond. This reader closed her letter with this question:

"When we separate from dysfunctional family systems, are we in fact hurting that system? Or are we perhaps contributing to its healing by the void we leave in our place?"

There is no ONE correct answer, as each family system has its own fluid and relational dynamic. The healthier and preferred option for one individual (e.g., staying involved in an attempt to affect change) may not be applicable or recommended in another family system with different dynamics. The interaction that distinguishes one family system as healthier and adaptive might not be operative in a more dysfunctional, rigid, or disengaged/enmeshed family.

There are times when a void left by our absence beckons the very change we sought to achieve by our presence.

As a therapist, I often address such therapeutic quandaries. What one individual chooses to do in one circumstance may not be the best course of action for another, even when different individuals make those decisions within the same family unit. Hence, decisions made by siblings or other family members may be different, as each member's relationship to the family system is different.

Inevitably, all decisions that we make for healthy recovery come with consequences. This might be the only certainty: that a consequence is certain.

I often ask my clients to play out a proposed decision to their end. In so doing, I ask them to remain mindful of likely outcomes and, more importantly, to be aware of outcomes that are potential or perceived. As we work through this process, my clients must weigh the emotional, physical, spiritual, sexual, and financial cost/benefits of their decisions.

Leah's decision to separate from her family led to her desired outcome of healing and recovery. For another individual, staying in contact with her family - while using boundaries and increased self-care - may lead to, but by no means guarantee, the desired changes in the family system.

Easy, straightforward answers are rare. In matters concerning our families-of-origin, our only guarantee is that we will struggle in our path to serenity.

Wednesday, 15 December 2010 19:00

childhood sexual and emotional abuse

The Meadows is pleased to announce the launch of our new blog, addictionrecoveryreality.com, featuring articles by some of the most well-respected and innovative experts in the treatment and recovery fields of drug addiction, alcohol addiction, gambling addiction, depression and anxiety, relationships and childhood trauma.

Contributors to the blog include leaders in the treatment of addiction and trauma: Pia Mellody; John Bradshaw, MA; Bessel A. van der Kolk, MD; Peter Levine, PhD; Maureen Canning, MA, LMFT; Jerry Boriskin, PhD; and Shelley Uram, MD. These experts write about a wide range of addiction-related topics.

If you are interested in writing for addictionrecoveryreality.com, please send submissions to info@themeadows.com.

Tuesday, 14 December 2010 19:00

Romantic Relationships in Recovery

Romantic Relationships in Recovery

By Rabbi Shais Taub

There's an old piece of sage advice that old-timers in recovery like to say: "No relationships for the first year." If you hang around long enough, and watch enough people come and go, you'll see that the old-timers are right.

But why is getting intimately involved with another person so damaging in early recovery? And if it is a threat in early recovery, why does it somehow become all right later on?

All addiction is essentially addiction to self. Recovery is a spiritual growth process that enables the self-centered person to become available to make connections outside of self.

In other words, in active addiction, every connection is ultimately a connection to one's own ego. Even when it seems like I am connecting to you, I am really only connecting back to myself. It's like the old fable of the salmon who gets caught in the fisherman's net and hears him exclaim, "Oh great! A salmon! I will bring this to the king because the king loves lox." The salmon thinks to himself, "This fisherman is not very nice. He has taken me from my home. But he says that the king loves lox. The king will love me and be kind to me." The fisherman rushes to the palace and shows his catch to the palace guard, who immediately opens the doors, saying, "I will take you immediately to the royal chef, because the king loves lox." The salmon thinks, "I hope they get me to this king who loves lox already." They run to the royal kitchen, and the royal chef shouts with glee, "Bring the fish to me! You know how the king loves lox." Again, the salmon thinks, "Finally, when this lox-loving king arrives, I will be saved." The king enters the kitchen and watches with relish as the chef guts the fish on the table. The salmon suddenly realizes that he is to be the king's lunch and, with his last breath, mutters to himself, "These humans don't know what love is! They say the king loves lox, but he only loves himself."

The inner addict is like the king in this story, and the addict's "beloved" is like the salmon. The addict is incapable of being truly intimate with another person; the closer the addict tries to get to another, the closer he is to himself. This explains a seeming paradox: One of the best things an addict can do to start recovering is to hang out with and befriend other addicts, while one of the worst things an addict can do to start recovering is to become romantically involved with other addicts.

As the addict recovers, however, and learns life skills that enable him to move away from complete self-interest, it becomes increasingly possible for him to actually become close to another person. One of the ultimate objectives of recovery is to be able to form loving relationships with others. The ability to be involved in a romantic relationship is not just an indication of good recovery, but one of the goals of recovery.

Many times people stagnate in what we might call "the middle stages" of recovery. They basically get their lives together, but they never become capable of being involved in an intimate, loving, committed relationship. Many, unfortunately, are jaded by past heartbreaks; they say, "I'll never love again." That is, in my opinion, a great loss. Just as addiction is a destroyer of intimacy, recovery is the greatest catalyst for intimacy. Good recovery means good relationships. Indeed, I would venture to say - although this may be outside the scope of this blog post - that every troubled marriage, even when no addictive behavior can be identified, is lacking recovery.

In the end, it all depends on how you see it. If romantic love is something we see as "icing on the cake of recovery," then we're probably not ready for it. If, on the other hand, we see an intimate relationship as an obligation toward the god of our understanding, then not only are we ready for it, we are actually required to give of ourselves in this manner.

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