The Meadows Blog

March 10th

Mary King, MA, LLP, CSAT 3 will be speaking at The Meadows Free Lecture on March 10, 2011, at 7pm at the Baronette Renaissance Detroit-Novi Hotel in Novi, Michigan. Do you feel out of balance, living life in extremes? "Empower Your Recovery with Value, Power and Abundance". Based upon Pia Mellody's model of Codependency, the focus of this lecture will be on attaining balance through learning to embrace your inherent worth, live in action instead of reaction, with a sense of contentment. Specific suggestions will be offered to explore balanced living in mind, body and soul. Contact Jenna Pastore at 815-641-2185 for more information. No registration required. We look forward to seeing you.

Sunday, 30 January 2011 19:00

Why Extended Care?

by Kathy Golden, Director/Manager of Extended Care at The Meadows

Most people seem to come to primary treatment because they are sick and tired of being sick and tired. When they near the end of their primary treatment, the counselor starts recommending extended care. The client may think, "I can't do this. I have a job; I can't afford to spend the money. I don't want to spend more time away from my husband, children, family..." They feel the best they've felt, perhaps in many years, and can't imagine why they need to continue treatment. I always ask my clients to consider treatment as one little inch out of the mile that is life. Clients most likely have spent years developing acting-out patterns, being depressed, wondering why they are so reactive to things that don't seem to bother other people, being filled with shame that they continue to sabotage their lives.

I ask them: "Do you think you have completely addressed all of your issues in the space of 29 to 35 days? Do you believe that you have worked through all of the trauma issues that have developed throughout your life journey?" The "pink cloud"that most people have as they near the end of treatment soon dissipates as they hit the real world and the reality of their life journey. They may have changed, or at least begun to make changes, however their best friends haven't changed with them. Those co-workers they can't get along with haven't changed or been to treatment. Perhaps their family attended Family Week sessions and has good intentions, without the benefit of 30 days in treatment.

The benefits of extended care can be immeasurable. They provide the chance to continue to address trauma issues, solidify the best relapse-prevention plan possible, encourage necessary self-examination, and provide time to incorporate the tools learned in primary care so they become a new way of life- a life of recovery and health. Extended care allows a recovering person to transition into the real world through supported outside activities, outside 12 Step meetings, a relationship with a sponsor, Step work, limit setting, and structure development. Those with co-occurring disorders can benefit greatly from extended care; the extra time, support, and scope of an extended-care treatment process can make a significant difference.

Statistics show that, the longer a person can remain in extended care, the lower the probability of relapse. In a study by Castle Craig Hospital, 48 percent of those who completed a recommended period of continued treatment had "maintained unbroken continuous abstinence (from all drugs including alcohol and cannabis), and a further 14 percent were in a good outcome category, abstinent at the time of follow-up. The abstinent and improved outcome figures for this group of treatment completers was 62 percent. The results, therefore, for this group of clients who completed an average of 17 weeks in extended care are very good indeed."

Extended care at The Meadows helps a client develop a personalized treatment plan, continue trauma-reduction work, and settle into a new life of recovery. We recommend a minimum 90-day stay: 30 days in primary care at The Meadows and another 60 or more at Mellody House, Dakota, or The Meadows Texas. Each of these facilities addresses trauma reduction through use of Pia Mellody's model. Additionally, Dakota helps clients continue to address compulsive sexual behaviors, while The Meadows Texas provides a safe place for women to continue their recovery journeys.

John Marsich, CASAC, will be speaking at The Meadows Free Lecture Series on March, 8, 2011 from 7pm-8:30pm. The lecture will be held at The Church of St. Paul the Apostle, Room 101, 405 West 59th St., New York, NY. (Cross streets of 59th & 9th Ave) The title of the lecture is "Using the Tools of Recovery to Create Successful Relationships." John will discuss many kinds of relationships... with spouses, family, friends, coworkers, neighbors, etc. and provide recovery tools to use in your relationships in order to cope, deal with, exist and function in a healthy way. John will also discuss using these tools in order to live the life we were meant to live, as well as the importance of joy, love, and laughter.

Contact Judy Smith at 866-633-5533 or for more information. No registration required. I hope you are able to join us for this great event!

Thursday, 27 January 2011 19:00

Shelly Uram, MD in Scottsdale, Az

Shelley Uram, MD, Senior Fellow at The Meadows, presented on January 17th Free Lecture in Scottsdale, Arizona. I was so inspired by the presentation, that I wanted to share a bit about my experience. I have one word to describe Dr. Shelley Uram's presentation at The Meadows' Free Lecture in Scottsdale last night: amazing! I am sure I am not the only attendee still inspired by the outstanding lecture on trauma, addiction, and the brain.

Dr. Uram's professional training and expertise were complemented by the nonthreatening and compassionate manner in which she delivered the information.

During the presentation, Dr. Uram discussed Pia Mellody's model of Developmental Immaturity, which is used as the main treatment model at the Meadows Treatment Centers. She presented the five core issues of codependency which include problems with boundaries, self esteem, dependency, reality, and moderation and discussed the ways in which trauma affects each of these areas. Many people have been exposed to information about these five core issues and have learned about the negative impact of trauma on development due to its incredible success in helping people heal.

Dr. Uram took this information a step further and presented the ways in which trauma effects the development and functioning of the brain. As I listened to her explain how traumatic experiences can affect the various parts of the brain, I looked around the room and saw people starting to have a greater understanding of why we do the things that we do. Dr. Uram continued in her presentation and gave us a sense of hope when she discussed how we are able to actually change the structure of our brains with bottom-up treatment approaches so that we may live happier and healthier lives. I learned a great deal from this event and anxiously await additional presentations by this knowledgeable and charismatic speaker.

Thank you, Dr. Shelley Uram!

Tuesday, 25 January 2011 19:00

An Evening with John Bradshaw

An Evening with John Bradshaw

What an incredible evening! The vibes and energy could be felt in Dallas recently when John Bradshaw spoke for The Meadows' Dallas Lecture Series. According to one of the 498 attendees, "Sometimes you attend an event and afterward you think, "I wish so and so had been here..." Tonight was one of those nights... I spread the word about John Bradshaw's lecture, and I brought several of my friends. But I kept wishing I had held a candlelight vigil on Monday night to prepare for this event! What an awesome scholar and spiritual force to kick off the new year. Well done. Well done!"

The Meadows' Dallas Lecture Series meets the third Tuesday of every month at Unity Dallas. The next lecture is Tuesday, February 15, when Cole Adams, LCSW, CSAT, discusses "Relapse Warning Signs."

Sunday, 23 January 2011 19:00


The following is excerpted from a presentation, "Eliminating Resentment... Solidifying Recovery," given as part of The Meadows' Michigan Lecture Series on November 10, 2010, by Dan O'Neil, MALLP.


The word "resentment" has two parts: "re," which means "again," and "sentment," which is "to feel." So resentment is to feel again, or a feeling that is re-sent. Resentment is the internal revisiting of old wrongs or mistreatments. Resentment operates by mentally replaying, reliving, or reexperiencing actual or imagined injuries from the past. Resentment is the recycling of past anger, hurt, or pain. Resentment is a deep, reflective displeasure at the conduct of another.

Resentment is actually secondary to the original feeling. For example, if we are hurt by someone, we feel the hurt. Resentment begins when we replay, refeel, and remind ourselves of that original hurt. Resentment is fueled and fortified by errors in thinking. Assumption, justification, blaming, and playing victim are common thinking errors used to solidify resentment.

Resentment is then held onto, fostering increased bitterness and a grudge. Resentment takes on a life of its own and is often more severe than the original hurt. "I resent that" is more intense and threatening than "I feel hurt" or "I feel insulted."

There is an old story about two monks who meet up with a woman in their travels. One of the monks helps the woman across a river, even though monks are forbidden to touch females. The next day, the other monk bursts into a rage, exclaiming, "You should not have carried that woman across the river!" The other replied, "Perhaps I shouldn't have, but you are still carrying her." Resentment is hanging onto the anger inside.

Resentment can be collected at anytime from anywhere. Resentment can be born from others telling us what to do, how to run our lives, what we need, how we should act or feel, and what they think is best for us. Resentment can rise if we are lied to, abused, judged, falsely accused, or discriminated against. Resentment can be created when others abuse their power or deprive us of what we need.

When resentment harbors past anger, hurt, or pain, it impacts how we think, feel, and behave in the present. You may pout or fume. You may have a furrowed brow, gritted teeth, bodily aches and pains, or a fake smile. Resentment can be a factor in depression, sarcasm, cynicism, agitation, isolation, and lethargy. Appetite and sleep disturbances can be by-products of resentment. For those with addiction problems, cravings can arise from efforts to avoid or soothe the pain of harbored resentment.

Resentment happens when we continue to rent space in our heads to those we have worked so hard to evict. Resentment is self-torture. Resentment is like peeing your pants: No one is affected as much as you are.

Eliminating resentment is essential in developing a healthy attitude about yourself and your future successes. Eliminating resentment about the past will allow you to thoroughly enjoy the present.

Eliminating resentment will allow you to better ward off depression, fear, isolation, and other negative thoughts. Eliminating resentment can help keep you free of the mental traps that trigger escape into addictions.

Before resentment can be eliminated and possibly addressed with the offender, clarification is needed. The original feelings and underlying resentment have to be identified and described. This is best done by clearly writing about the original feelings. Asking three questions will help start the resentment clarification process:

Question #1: Why is it necessary for me to keep refeeling the original feeling?

You may be using resentment to replicate some family drama. You may be mentally confusing people in your present life with people in your past life. It is easier to harbor resentment than to feel insult, rejection, fear of inadequacy, or injury. Resentment gives an illusion of strength, and it seems to make you look better than others.

Question #2: How did I contribute to the situation?

You may have allowed it to happen. You may have made it worse. You may have been able to prevent the situation. Take a look at the other person's point of view (empathize). Admit if the fault is yours.Forgive if it is theirs.

Question #3: What did I learn from the situation? 

Resentment will be there until you know your part and learn from it. Look for a positive lesson. The best time to learn about resentment is when feeling resentful. Resolution comes when feelings and understanding unite. When you fall down, pick something up.

While working to eliminate resentment, avoid collecting any new issues that could turn into resentment. When you feel hurt, slighted, etc., talk to the person in a timely manner. Begin sentences with "I feel" instead of "you did."

Keep resentment away by practicing forgiveness. Forgiveness is for the forgiver. It is not forgetting, but letting go of hurt. Practice not keeping score; an eye for an eye makes the whole world blind. Live and let live. Tolerate your own mistakes.

Dan O'Neil, MALLP, is a therapist at the Birmingham Maple Clinic in Birmingham, Michigan. He has worked for more than 35 years with teens and adults in individual, group, and family therapy.

Thursday, 20 January 2011 19:00

Free Lecture Series

Novi, Michigan

Free Lectures hosted by The Meadows are popping all over the country. Last Thursday, January 13, 2011, The Meadows hosted a Free Lecture Series in Novi, Michigan at the Baronette Renaissance Hotel.

This series welcomed Alumni of The Meadows, professionals and the recovery community. Carrie Coen-Krawiec, LMFT, presented on the topic of Positive Involvement; Strengthening Family Interactions. The lecture focused on Family Systems work which is a key area of expertise within The Meadows model. The lecture provided insight into family roles and the dynamics within. It touched upon the impact of resentments in the family and how carried resentments can negatively impact recovery as well as provided helpful tips on repairing relationships, family problem solving steps and solutions.

The next lecture event is scheduled for Thursday, March 10, 2011 at 7pm. Mary King, MA, LLP, CSAT-3 will be presenting on Pia Mellody's work; "Value, Power and Abundance - Empowering Your Recovery"

Submitted By: Jenna Pastore, National Community Relations Representative

Emma K. Viglucci, CFT, LMFT, CIT will be presenting the Free Lecture in New York City on February 8, 2011 at The Church of St. Paul the Apostle, (Room 101), 405 West 59th St., NY, NY 10029. The title of the lecture is "Stop the Drama in your Relationship! Creating Healthy Boundaries." This lecture demonstrates how disempowering the codependent interactions can be in your relationship, how this ruptures the connection with your partner and how to transcend this debilitating pattern and replace it with healthy and satisfying interdependence. Contact Community Relations Represetnative, Judy Smith, at 866-633-5533 for more information. No registration required. We look forward to seeing you there.

Tuesday, 18 January 2011 19:00

Notes From Tucson

Notes From Tucson

Debra L. Kaplan

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

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