The Meadows Blog

The Meadows is sponsoring a free lecture in Austin, Texas on Thursday, August 9 given Dr. Pamela Monday, LPC, LMFT, on the topic of "Trans-Generational Patterns." It will be held at the Riverbend Church from 7:00 to 8:30pm and no registration is required.

The topic will focus on exploring the unconscious family patterns that continue to be passed down across the generations, and then learn how to transform those patterns into healthy behaviors. Learning objectives include identifying three family myths or rules that people keep repeating in spite of best efforts at recovery; identifying which family loyalties are keep people stuck in dysfunctional patterns; and setting specific goals about how to interrupt those patterns and creating more functional behaviors moving forward.

Dr. Monday is a Licensed Marriage and Family Therapist and Licensed Professional Counselor. She completed her doctoral training at the University of Texas and has been a therapist for more than 30 years.

The Meadows sponsors free lectures in various cities throughout the country. Speakers include local therapists familiar with The Meadows' model. Lectures are free and open to the public. Attendees can earn 1.5 Continuing Education Credits. For more information, contact Betty Ewing Dicken at 972.612.7443 or

The Meadows, located in Wickenburg, Arizona, is an industry leader in treating trauma and addiction through its inpatient and workshop programs. To learn more about The Meadows' work with trauma and addiction contact an intake coordinator at (866) 856-1279 or visit

For over 35 years, The Meadows has been a leading trauma and addiction treatment center. In that time, they have helped more than 20,000 patients in one of their three inpatient centers and 25,000 attendees in national workshops. The Meadows world-class team of Senior Fellows, Psychiatrists, Therapists and Counselors treat the symptoms of addiction and the underlying issues that cause lifelong patterns of self-destructive behavior. The Meadows, with 24 hour nursing and on-site physicians and psychiatrists, is a Level 1 psychiatric hospital that is accredited by the Joint Commission.

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One of the most desirable fruits of the recovery process is a greater sense of serenity and peace. Yet, for those who are recovering from addiction and trauma, each day can bring challenges, both large and small, to one's sense of serenity. Encountering opinions that are different from our own, especially when they bring our own values and beliefs into question, can certainly stir powerful emotions and threaten our serenity.

In the United States, we are nearing the end of a long political season, yet the grueling presidential election process is bound to bring even more opportunities for personal and interpersonal friction. Nevertheless, it is important that we remain involved in the political process and take part in civic duties. The question is do we let politics rob us of our serenity? And if our intention is to maintain serenity, how do we go about doing that?

Recently, I was faced with this very question when I received a politically charged email from an acquaintance. Fortunately, in that moment, I found just enough space and serenity to write my feelings down (instead of shooting off my mouth). My own political views and those of the email's author are not important, no matter where we stand on the political spectrum we will face moments when our serenity is challenged. Here is my written response in the moment that my serenity was on the line:

"A contemplative response (for my own sake),

My initial response to this email was a familiar one; I felt a tightening in my chest and a churning in my gut. The world around me seemed to contract and become very small, very narrow. The gentle breeze and the sun's warmth were lost as my mind fixated on little black letters and the spaces between them.

Thankfully, I happened upon a moment of pause a brief opening of light in that familiar dark tunnel. In that micro-moment of pause came space and I realized that what I was reading and feeling wasn't the totality of me in that moment. In that space, I could reach out and feel the rushing of the river without getting carried away in it.

The space also brought a sense of curiosity and openness about what was happening inside me. It came to my mind that, far from being an exercise in logic, rational thinking, and reasonable dialogue, politics often strike at the heart of our perceptions of ourselves, others, and the world around us. For me, politics are wholly an emotional affair.

Having been happily derailed from my usual emotional ruts, I reread the attached article with a degree of mindfulness. Instead of finding my old friend "anger", I touched into a deeper well of "fear". First and foremost, I could sense the author's fear: fear of differentness, fear of powerlessness, and most of all, fear of change.

It was as if the author's barbed terms were meant to catch on the fabric of time itself and stop the world from spinning out of control. Often, implicit in this idea is that, as a society, we can pull from our past a caricature of security and purity and somehow freeze the present day in its image. Yet, this would be like flying into space, chasing the brilliant shimmer of a desired star, only to find that the star had long since disappeared, leaving only its light to travel through space.

The essence of life is change... to fear it is to fear life itself.

The other emotion I found under my defensive anger was that of "pain". At first this was confusing and uncomfortable. Paradoxically, it is much easier for me to sit with anger than with pain. In anger, I don't have to look at myself, there is plenty for me to blame "out there". However, in pain, I am invited to look inward to find the wound.

As I sat with the uncomfortableness of the pain, I began to see its source... for me, it stemmed from the idea of "separateness". The author uses highly-charged terminology that I think is meant to create a sense of distinction and separateness; an "us-against-them" mentality. It seems to me that the very purpose of the article is to use fear, anger, and anxiety to "call people to arms" and to "take sides".

Indeed, my initial response to the article was to tighten, constrict, wall-off, and begin drawing lines in the sand as an effort to define myself as separate and different from others. Somehow it seems "safe" to separate myself from others, to try and define people and issues in "black-and-white". However, I am beginning to understand that, for me, there is only emptiness to this sense of separateness.

As my approach to the essay began to soften, I felt a compassionate connection to people who fear that their most basic beliefs will be challenged or changed and to those people
who feel a need to separate themselves from others to maintain a solid sense of themselves. I also found in myself tenderheartedness for those individuals who feel desperate enough about their circumstances that they join an imperfect social movement, hoping for something better for themselves and others. In the end, these people didn't seem so different from each other or from me.

In many ways, we are all searching for ground in a world that is inherently groundless. We want bedrock, we want "a sure thing", we want predictability, and we want security.

For me personally, I feel more peaceful these days when I acknowledge my own fear of change and the pain I feel when I attempt to separate myself from others.

I find serenity in just recognizing the groundlessness of our common situation... and out of that commonality comes a feeling of compassion.

(By the way, I'm now feeling the gentle breeze and the warm sun here in Arizona... it's pretty nice.)

Thanks for the email,


Certainly we need people who are politically minded, that is people who are interested in the political process and make efforts to fulfill their civic duties. However, in a world that is increasingly divided along stark ideological lines, we also need people who are politically mindful. When we can mindfully respond instead of emotionally react, our political efforts can come from a place of inner meaning and truth. In that mental and emotional place, our political activism can be devoid of harsh judgment and filled with deep wisdom- something this world desperately needs. During this political season, let us cast our vote while maintaining our serenity.

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The political and emotional complexities of PTSD (post-traumatic stress disorder) and TBI (traumatic brain injury) can lead to stigmatization and inaccurate attributions. It has long been assumed that soldiers, especially those who have served in combat, are at higher risk for violence. Following WW II several congressmen introduced proposals to send returning combat troops to islands for "retraining" before returning to civilian life. Following Vietnam we had Rambo movies and veterans "going postal". The facts are both simple and confusing: sudden outbursts of violence are rare and very hard to predict.

The article referenced above summarizes some of what is clear: PTSD and TBI can produce shifts in emotional management and changes in "executive brain function" resulting in possible impulsiveness. Complex phenomena like PTSD and TBI are difficult to study and data is scattered, sometimes inconsistent or contaminated by selective sampling or agency agendas. What is clear is that spectacular episodes of sudden violence are extremely rare, despite media attention. There are often multiple factors involved and these include co-occurring disorders, use of drugs or alcohol, lack of sleep, number of tours, severity of symptom or injury, just to name a few. We would love to have instruments that predict these rare outbursts, but they do not exist. We are reduced to the old maxim I learned decades ago: "the best predictor of future behavior is past behavior".

I do not wish to oversimplify; however, I want to reassure readers, especially military readers, that they are not likely to explode in some horrific headline-grabbing fashion. The title of the Washington Post article is generally accurate. Put aside the complexities of multiple tours, diminished capacity, head injury, partial recall, fugue episodes, sleep deprivation, isolation, and alcohol, and let's focus on the reassuring take-away message. There is no data supporting the worst fear carried by many. Most veterans are well trained, restrained, disciplined, highly ethical, and filled with a sense of justice, loyalty and honor. Most veterans I have treated live with the dread that they could lose control of their impulses and inadvertently hurt someone. Newspaper headlines about sudden violence and suicide add to their burden of fear. As a 66 year old combat Marine with severe health and mobility problems recently stated, "I am still afraid of what I could do to others.- That's why I need to stay away from others." The fear of losing control results in isolation, self-medication, avoidance, and a whole host of symptoms we see with PTSD.

I would argue that the most common symptom is not violence but extreme dedication to work or mission. I do not have the statistics, but from my years of experience I see pro-social zealousness- not antisocial outbursts- as the most common coping mechanism. Over dedication to work/mission becomes almost addictive. It is easy to get lost in working excessive hours, and it is rewarded by recognition and increased revenue. Channeling one's anger is difficult, but workaholism is an extreme response rewarded in our culture. However, family members can be angry and confused, and the internal burden remains hidden. Sleepless nights, avoidance, occasional road rage and other symptoms flourish, often visible only to a few. Spectacular outbursts are rare. PTSD tends to be a condition that most often fits the following: "Great souls suffer in silence." (Friedrich Schiller). The articulation of suffering is often the first step toward recovery.

Jerry Boriskin, Ph.D, has been at the forefront of the treatment of PTSD, addiction, and co-occurring disorders for more than 30 years. He is the author of several books, including PTSD and Addiction: A Practical Guide for Clinicians and Counselors and At Wit's End: What Families Need to Know When a Loved One is Diagnosed With Addiction and Mental Illness. For more information about Dr. Boriskin, please visit his website at

For more about The Meadows' innovative treatment program for PTSD and other disorders, see or call The Meadows at 800-244-4949.

Published in Blog
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.

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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.

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