DR. JERRY BORISKIN ON ADDICTION AND COMPLEX PTSD
The Meadows, one of America's leading centers for the treatment of addiction and trauma, is pleased to present a series of videos in which Dr. Jerry Boriskin discusses post-traumatic stress disorder and complex PTSD.
In the third video of his 10-part series, Dr. Boriskin, senior fellow at The Meadows, discusses the relationship between addictive disorders and complex PTSD, the most complicated form of post-traumatic stress disorder.
"Simple PTSD runs a simpler pattern," he explains. "It's more responsive to simpler, singular treatment."
"Most of the research data is based on simple PTSD. When we get complex PTSD, it morphs into a multidimensional monster, creating a whole new set of maladaptive responses. And one of the ways survivors try to deal with it is by self-medicating with chemicals."
While the chemicals create the illusion of fixing the problem, Dr. Boriskin stresses that the relief is only temporary. Ultimately, the price to be paid is very high. He acknowledges that treating both disorders at the same time is often a challenge: "Treat the addictive disorder first, but don't delay treating the trauma-based disorder. Getting the sequence right is vital."
Jerry Boriskin, Ph.D, is an author, lecturer, and clinician with expertise in trauma, PTSD, and addictive disorders. An early advocate for the use of extended care, he developed two extended residential treatment programs for co-occurring disorders. He also 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.
Other videos in The Meadows' series include interviews with leading experts in the mental health field, including John Bradshaw and Maureen Canning. To view, visit www.youtube.com/themeadowswickenburg.
For more about The Meadows' innovative treatment program for PTSD and other disorders, see www.themeadows.org or call The Meadows at 800-244-4949.
LEGALIZATION OF MARIJUANA IN ARIZONA
by Jerry Boriskin, PhD
Arizona Legalizes Medical Marijuana: www.cbsnews.com/8301-504763_162-20022928-10391704.html
The following Time Magazine article, "How Marijuana Got Mainstreamed" looks at the issue from a national perspective: http://www.time.com/time/nation/article/0,8599,2030768,00.html
As a professional who treats individuals with PTSD and other co-occurring conditions, I want to encourage you to be careful in separating hype, culture, science, and fact in making decisions about using marijuana as a tool, distraction, or method of coping with emotional and/or physical discomfort. Perhaps the most important thing to know is the difference between a drug and a medicine. Cannabis may in fact have some medicinal ingredients; separating the medicine from cannabis" 400 other chemicals will require additional science, some of which is already under way. I list below my key concerns:
1. You might feel mellow when you smoke or consume cannabis, but your ability to learn, drive a car, or function in a relationship may become more impaired than you would ever dream. There is evidence that young brains, not fully developed, may be permanently injured or altered by marijuana use.
2. Self-medicating with drugs, alcohol, and/or marijuana can make things much worse, not better. We know that alcohol increases depression and the risk of violence. The negative impact of cannabis is more subtle for most, and dramatic for a few. For some individuals, anxiety is relieved temporarily but increases over time. Some long-term users develop full-blown panic attacks.
3. Regular use of cannabis can increase the risk of schizophrenia, a serious psychiatric disorder. Modern marijuana tends to contain higher levels of hallucinogens than did the pot of the 1960s. We also believe that marijuana increases the risk of the onset of bipolar disorder. We do not fully understand all the causative factors for these serious illnesses, but genetic and environmental risk factors do exist. The use of marijuana appears to increase the risks.
4. Cannabis is addictive. There are some disputes regarding the formal definition of "addiction," but recent evidence indicates that cannabis meets the criteria of an addictive substance. Those of us who treat addictions have seen many older and sober patients who have been addicted to marijuana for decades; one of the most common observations is "I don't know how I lost the last 20 years. I got nothing done."
5. Smoking marijuana may mask symptoms of PTSD - delaying treatment, recovery, and natural mastery of powerful symptoms.
6. Self-medicating is not the same as treatment. When you self-medicate, you cannot control the content, quality, or dose of what you consume, and you are at great risk of becoming impaired, addicted, or out of control in ways you might not see for a long time.
Bottom line: If you are a trauma survivor, you should be aware that self-medicating for PTSD and other psychiatric disorders is risky. I am an advocate of your good physical, emotional, and interpersonal health. I urge you to avoid self-medicating with alcohol as well as cannabis; staying sober and clear-headed will help you recover from the symptoms that bring you to our doors.
In a series of brief articles, beginning below, Pia Mellody illustrates how living The Meadows' model has brought balance to her life.
In beginning the draft of my fifth book, I find myself continuously re-examining the relationship between body, mind, and spirit. In doing so, I have become even more acutely aware of the spiritual battle that rages between the ego and the soul. This topic becomes more poignant as I watch The Meadows' treatment model continue to gain worldwide recognition as the "spiritual model for the treatment of trauma and addictions."
Treatment at The Meadows has always been all-encompassing, addressing the body, mind, and spirit. Treating the body through our Wellness Program contributes to the healing process. Treating the mind through readings, lectures, workshops, and group interactions leads to healing through a shift in cognition's role in our lives. Treating the spirit is about treating spiritual impoverishment; different forms of spiritual practice include, but are not limited to: meditation, tai chi, yoga, and following 12 Step practices. These, in effect, engage the patient in spiritual balance.
Looking at the role of ego in the spiritual battle, I see it as attached to "I," "me," and "my." Self-examination can reveal how the ego has been destructive in life processes. If the ego is too powerful, the individual cannot see how it's creating misery. Our treatment goal in this scenario is to get the patient to self-examine what he's doing via his own self-destructiveness. The ego is attached to the body and naturally seeks pleasure. Our senses lead us to addictive processes and compulsions to seek pleasure and thereby medicate ourselves. When we use substances (alcohol, drugs), processes (sex, gambling), or people (love addiction), ultimately we will experience misery, as we are self-medicating.
When we cover our soul with our ego, we lay the foundation for spiritual impoverishment. We have buried our value, power, and abundance. The soul, in this scenario, plays a pivotal role; it remembers that we - and others - have inherent worth.
As I work on the new book, I will continue to share my thoughts on the rich connections between mind, body, and spirit, as well as show how value, power, and abundance affect individuals and the greater world. In the next article, I will illustrate how to truly heal through the understanding and application of the five core issues.
Self-medication and PTSD: A Path to Greater Complexity and Addiction?
Readers familiar with their own journeys or observing the struggles that loved ones endure know that PTSD symptoms sometimes demand immediate relief. Mood-altering chemicals, especially alcohol and marijuana, often provide temporary relief from anxiety, anger, depression, and other "limbic" surges. For many, alcohol and marijuana "take the edge off." They numb intense feelings, appear to quiet repetitive thinking, and afford some sleep and relief from the aftermath of trauma. In fact, in Western culture, alcohol has been a favored method of "recovering" among warriors, firefighters, and others who engage in vital but dangerous missions. Temporary relief usually comes in the form of "feeling no pain."
Actually, for a small but significant percentage of survivors, alcohol and other chemicals permit relief from the absence of feeling. In other words, getting drunk or high permits some feeling - any feeling - to break through the numbing produced by PTSD. Self-medicating is a devilishly seductive way of managing trauma. Self-medication provides temporary relief - a shortcut with the illusion of healing - but, oh, the price you pay! Alcohol, for example, will add to depression, confuse thinking, poison core relationships and, for some, set off violent behavior. For many, self-medicating will become a full-blown addictive disorder. Instead of one problem (PTSD), they now have two! Self-medication can involve food, sex, and the usual suspects: cocaine, opiates, amphetamines, cigarettes, alcohol and marijuana.
Academics and clinicians differentiate drugs from medicines: Drugs are self-administered without controls for dose, purity, etc. Medicines are taken only as prescribed (but often abused by active addicts). It's an oversimplification to say that all medicines are good, and all self-medication is evil. Many medicines cause harm; benzodiazepines and some sleep medicines can become addictive. However, in the hands of a skilled practitioner, medicines can provide much-needed symptom relief while the patient masters natural techniques that are highly effective in managing PTSD's multidimensional symptoms.
Recovery takes hard work and support. Re-stabilizing one's body and soul requires more than simple, singular solutions, sayings or insights; it is a process we know works. Self-medicating is not only risky, it is often tragic. Too many soldiers and civilians have been further injured by self-medicating. Simplistic, seductive, addictive, compulsive, and self-administered "treatments" too often result in broken marriages, broken careers and broken bodies. Life is hard enough without trauma, and trauma is hard enough outside of addiction.
The path to healing takes work, and work sometimes requires peer and professional support. John Barleycorn and Jack Daniels are not healthy supports or tools for recovery. If you are new on the journey of healing, do not be seduced by the temporary fixes offered by alcohol, drugs or other self-medicating behaviors. Recovery requires new skills. It's a process of integrating and healing, achieving and connecting - not masking, numbing or avoiding. Keep it simple and do not be intimidated, distracted or seduced by the siren song of medicating oneself.