The Meadows Blog

The Meadows was pleased to welcome Sean Walsh as the new executive director approximately 90 days ago when he assumed the day-to-day leadership of The Meadows Wickenburg campus.

"We are so fortunate and blessed that Sean has joined our team. His passion for the work we do is contagious. In just three months, he has made impressive inroads into every aspect of The Meadows organization," said Jim Dredge, The Meadows CEO.

According to Sean, his focus was to become familiar with the staff, the systems, and the overall processes for patient care, in addition to looking for areas to grow and strengthen.

One of these areas is the relationship between The Meadows and its referral sources. "I see a key part of my role to be a liaison between referral sources and the clinical team. I've been looking for ways to bridge the gap and strengthen relationships," Sean said. "With a clinical background, I can often speak to referral sources about clinical matters more keenly than the average administrator."

In Sean's first 30 days he instituted the daily FlashMeeting. He saw it as a need or potential avenue for the department heads to have a centralized meeting to staff every patient every day. "Over the last two months it has served as a good venue for the management and leadership team to feel confident that they know what's happening on campus every day," Sean explained.

Streamlining The Meadows' ATA process is another area where Sean has concentrated his attention to have more of a sense of urgency for presenting patients. "We've developed a new system of identifying urgent admissions so that they can get in front of our psychiatric or medical teams. This allows the attending physicians to determine if a potential patient is appropriate for the Meadows in a timely manner," Sean said. "We know the patients and families are eagerly awaiting those decisions. This will help streamline the ATA process and make it more efficient by having a higher level of urgency for presenting patients."

Another important part of the admissions process, according to Sean, is the exclusionary criteria that The Meadows implements. "If we're not the right fit and the patient needs services that we can't provide, we want to make sure they get the care they are in need of. We want to connect them with other quality providers around the country so they get the treatment they are in need of, Sean emphasized.

In June, Sean attended the 23rd Annual International Trauma Conference in Boston that The Meadows has sponsored for the last seven years. The leading neuroscientists and treatment developers on how trauma affects mental and brain functioning presented to nearly 700 attendees during the four-day conference. "It was great to see the world-class leaders in trauma and the partnership that The Meadows has developed with the conference and Dr. Bessel van der Kolk, one of The Meadows Senior Fellows, and the conference director," Sean noted. "Another Meadows Senior Fellow, Dr. Shelley Uram, also attended giving us the opportunity to learn the newest cutting-edge research and best practices that we can take and bring back and incorporate into the treatment that we are already providing."

Sean recognizes the value of the Senior Fellows on the Wickenburg campus which allows the staff to take advantage of their latest research and findings. "The Meadows clinical staff has participated in several extremely rich training weekends with Senior Fellows Dr. Peter Levine, the founder of Somatic Experiencing, and Dr. Bessel van der Kolk, one of the foremost trauma research psychiatrists in the world. Other Meadows' Senior Fellows who have given shorter trainings are myself and Dr. Jerry Boriskin. Ana DoValle,  a cutting-edge, world renowned trauma therapist, has also provided two training weekends for the staff," said Dr. Shelley Uram, Meadows' Senior Fellow.

Each week The Meadows offers a variety of one-of-a-kind, five day workshops that are available to all interested individuals. These workshops specifically address the needs of those who have not been in inpatient treatment, but are also a source of renewal for anyone who has undergone treatment. "People forget The Meadows is not just a 35 day inpatient program. Our workshops are a vital part of what we do and provide a great resource for those in need, Sean pointed out. "It can be a good catalyst for patients who aren't in need of inpatient level care, but still need that intensive foundation they can build off of in individual therapy when they return home. Workshops can also be beneficial for patients who are hesitant to enter the inpatient program. Often they will try a workshop to begin to understand what we do here at the Meadows and then occasionally decide to go into inpatient treatment. The workshops are a great tool regardless of where the patient is at in their recovery."

According to Sean, patient safety is The Meadows number one priority. "If we can't keep our patients safe, we aren't able to do the great work and treatment we pride ourselves in," Sean explained. "We're constantly looking at what we can do to provide a safe environment and a level of accountability that our patients need. Something that distinguishes us from other providers is being a Level 1 acute facility that provides 24 hour nursing."

Recently, Jonathan Henrichsen, a therapeutic and educational consultant toured The Meadows. He made the following observations echoing Sean's assessment of The Meadows:

I was really glad to have the opportunity to tour The Meadows. I was especially impressed with the continuum of care and the level of clinical sophistication the program is able to offer. When we have clients who are dealing with dual (or multiple) diagnoses, which is more often the case than not, we need a program that can be tailored to both adequately address all the issues as well as provide a longer term of care than is available under a traditional rehab model. The Meadows is able to do that.

Although The Meadows is known for having high-profile residents from time-to-time, as a visitor to the program I appreciated the steps The Meadows took to ensure the confidentiality of its clientele.

Residential treatment is a people business - it is only as good as the people who are providing it. Given that, I am very glad to have had the opportunity to meet with several different members of the clinical and administrative team, all of whom I found knowledgeable and professional, yet also very personable.

One of the areas that Sean was most excited about his first 90 days is The Meadows contract with TriWest Healthcare Alliance, a sub-contractor of TRICARE, to serve the military as a network provider. "The Meadows has a reputation of being an industry leader with expertise in treating trauma and addiction. We are honored that we can now provide that same treatment to our service members who have given so much to defend our country," Sean said. "The Meadows has set itself apart by going through the process of becoming a network provider with Triwest, which demonstrates The Meadows commitment to giving back."

Sean is now focusing on moving forward at The Meadows. Capital improvements to the campus are on the agenda, in addition to strengthening elements of the program and expanding new programs, such as the young adult population, in addition to strengthening and defining the military track.

Before coming to The Meadows, Sean was very familiar with its reputation. "After 90 days it's easy to see why The Meadows is known as one of the worlds best for treatment of trauma and addiction," Sean concluded.

The Meadows 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 www.themeadows.com.

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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Effective July 1, 2012, The Meadows Wickenburg will adopt an all-inclusive pricing model. This change responds to patients' requests to know what their program costs will be at the onset of treatment. As The Meadows launches the new fee structure, a special promotion will be offered to patients that admit to The Meadows five-week inpatient program for the time period July 1 - August 15, 2012.

The Meadows specializes in treating trauma, PTSD, alcohol addiction, drug addiction, codependency, depression, bipolar disorders, sexual compulsivity, love addiction, love avoidance, eating disorders, work addiction, and gambling addiction.

The Meadows is an industry leader in treating trauma and addiction through its inpatient and workshop programs. To learn more about how The Meadows can help you or your loved one take advantage of this limited-time inpatient discount offer, contact an intake coordinator at (866) 856-1279 or visit www.themeadows.com.

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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In recognition of June as PTSD Awareness Month, The Meadows trauma and addiction treatment center in Wickenburg, Arizona, is offering discounted in-patient services through June 30, 2012.

Post-Traumatic Stress Disorder (PTSD) often is associated with soldiers or police officers involved in life-threatening situations, but the disorder can be triggered by any overwhelming experience. Chances for developing it are greatest if the incident is extreme, long-lasting, or repeated over time.

Jerry Boriskin, Ph.D., a Meadows' Senior Fellow and a Senior Psychologist for the Northern California Veterans Health Care System, recently visited The Meadows Wickenburg campus to conduct a PTSD workshop for patients. According to Dr. Boriskin, PTSD never fully goes away but there are many tools to learn to live with it "and once you understand how it operates, the mystification and its almost demonic power can be tamed."

Dr. Boriskin, who has been at the forefront of the treatment of PTSD, addiction, and co-occurring disorders for more than 30 years, explained that in order to heal from PTSD, the individual needs to deal with the three S's - sleep, safety, and sobriety. What is needed, he said, is an environment that contains the addictive disorder while at the same time begins work on the post-traumatic stress disorder. He said that some systems, such as private sector, outpatient, residential, VA and non-VA, treat PTSD in a bifurcated process, which can delay healing.

"What is unique about The Meadows" program is the intent to do both at the same time; emphasizing first the sobriety and the detox, working on a recovery model that fits the individual's needs, yet at the same time beginning to look at what PTSD is about," said Dr. Boriskin. "That is an invaluable duality and simultaneity that permits more rapid progress."

To learn more about how The Meadows can help you or your loved one with PTSD or to take advantage of our limited time inpatient discount offer, contact an intake coordinator at (866) 856-1279 or visit http://www.themeadows.com.

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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By:  Brad J Kammer, MA, MFT, SEP

After Hurricane Katrina devastated the Gulf Coast, I had the great fortune to travel down to the area as part of a trauma outreach team, training local crisis workers on how to use the basic principles of Somatic Experiencing (SE) to help them manage the trauma that was now overwhelming the remaining residents. I had been following the news reports post-­‐Katrina, and vividly remembered the horror stories of looting and violence, particularly those coming out of the New Orleans Superdome - like stories out of Lord of the Flies - with reports of gang attacks, rapes and murder. Having worked in refugee camps on the Thai-Burma border amidst civil war, I understood how trauma could so immediately overwhelm people and communities that they would turn against each other in violence. But what I also understood was that in our most overwhelming crises, people also come together for protection, safety and healing. It happened in those first few days after 9/11 in New York City and elsewhere, and as I traveled down to the Gulf Coast region, I imagined that despite all the news reports to the contrary, it must have happened there too.

What I found when I arrived was almost exactly opposite of those news reports I had been following. All over southern Louisiana, individuals, families and communities had come together to support one another. I heard countless stories of strangers helping strangers, taking families into their homes, and other acts of selfless giving. The most startling story I heard, however, had to do with the New Orleans Superdome. I was talking with a woman who had been on the clean-­‐up crew after the last few hundred refugees were evacuated from the Superdome, expecting her to share horrifying images of what she observed. Instead, she shared with me the image of folding chairs placed in circles, all throughout the Superdome, stating that folks had come together to share stories, food, laughter and comfort.

In my years of teaching about stress and trauma, I have found that nearly everyone is familiar with the "fight and flight" survival response. However, very few people are aware of the "tend and befriend" survival response. In Somatic Experiencing, we turn to animals in the wild to understand how despite constant predator-­‐prey dynamics, wild animals are able to manage life-­‐threatening experiences and not develop the symptoms of post-­‐traumatic and other chronic stress disorders. We have carefully studied how wild animals are able to recover from high stress states by completing their fight/flight responses and thereby discharging the high arousal associated with threatening experiences. We have also understood the nature of the freeze response, which comes on-­‐line when we cannot successfully fight or flee from a life threat, and how in humans, going into freeze predicts the onset of developing PTSD and other chronic stress disorders. In Somatic Experiencing, we have developed strategies and tools to help individuals move out of freeze and restore the feeling of being in control, balanced, and capable of meeting further life challenges.

But what about this tend and befriend response? What is this all about? And how does this relate to recovering from trauma? If we look back to the wild animals, we see that there are numerous examples of herds of animals that when threatened or attacked, form protective circles. I've watched videos of zebras, elephants, sheep, and other animal species who on initial response to threat, do not immediately fight or flee, but come together as bands - and if we look closely enough, we see this beyond just mammalian herd behavior, we see this with flocking of birds, shoaling of fish, and the swarming behavior of insects.

Now let's look back to the Katrina refugees, huddled in shock, terror and confusion, locked in the Superdome with thousands of other shocked, terrified and confused refugees. These individuals were in a life-­‐threatening situation, and their very survival was at stake. It is true that there were instances of violence, most likely instigated by erratic attempts at fight or flight, but we cannot overlook the majority of individuals who bonded together with others for safety and comfort. In many ways we can see this in the various social institutions we've created as well, from national armies to gangs to families - we join together with others to protect and secure safety.

When threatened, our first biological response is to orient to the danger. Our senses are heightened and we will scan the environment for the source of threat. Maybe this has happened to you late at night while you're sleeping. You hear a noise downstairs and immediately startle, sitting up, and using your senses (ears, eyes, possibly even smell) to locate the source of the noise. I live in the country and see this happen frequently with deer. I'm walking on a trail and observe a deer some 30 yards ahead, standing still, but with probing eyes and shifting ears, attempting to evaluate if I am a source of threat. If I continue to walk closer, they will immediately run away (flight).

However, part of this orientation - often overlooked due to the rapid firing of these instinctive survival responses - is an orientation to the herd. Before the deer run away, they are also orienting to the other deer. And before you get out of bed to check the noise downstairs, you might wake up your sleeping partner to check in with them. If others are there for us, we will come together in numbers to better assure protection and safety. And if not, we will move rapidly into fight, flight or freeze responses. These are not well thought-­‐out plans, these are instinctual, biological and genetic programs that are activated in the face of danger and threat. As humans, we are programmed to connect and collaborate for survival: this is the tend and befriend survival response.

Over the past 20 years, thanks to the emergence of incredible brain imaging technology, we can now map the brain and body like never before. These studies show us that the regulators of our minds and bodies are embedded in relationships. This goes beyond the realm of mere survival into the realms of understanding illness, health, and resilience. Research suggests that in terms of health and healing, social support is more powerful than anything besides genetics. And when there is an absence of appropriate social interactions, when individuals retreat into social and/or emotional isolation, substitutions are made in the form of such things as food, alcohol, drugs, sex, TV, computer and video games. Meanwhile, chronic stress builds in the nervous system which leads to a host of symptoms and chronic disorders. There is plenty of information showing us that isolation and lack of social engagement can make us sick. And yet, we live in a world where we retreat more and more, creating alternate realities and identities on digital screens, whispering messages of loves through text taps, and flirting with emoticons. Contrary to what we may believe, these forms of engagement are not bringing us closer together nor are they triggering the hard-­‐wired mechanisms in our brain and bodies that are required for supporting health and well-­‐being.

Some years ago, oxytocin, the "love" chemical, was discovered in the brain. Scientists observed that this chemical was released in both mothers and their babies during labor and birth, and during bonding between parents and their children. This chemical is released to support the loving feelings necessary for healthy bonding and attachment. As we have learned through studying bonding, the mother's presence and loving attention helps to regulate the newborn's not yet fully-­‐developed nervous system. Studies have shown that when there is an absence or oxytocin release, bonding suffers and proper infant development is threatened. For the baby, then, along with food, water and oxygen, the ability to feel connected assures their very survival.

But interestingly, oxytocin also shows up in the human body during times of close social connection including romantic encounters, trusted friendships, and even the comforting pat on the back or rewarding high-­‐five. Being a big basketball fan, I enjoyed reading a research study on the National Basketball Association (NBA) a few years back which compared the performance of a team with the number of times during a game players on that team use supportive touch with one another - anything from a handshake to a chest bump to a bear hug. This study demonstrated that there is a strong correlation between successful teams and the frequency of contact, with the Boston Celtics and LA Lakers, the two teams that met in the 2008 NBA Finals, being the two "touchiest" teams.

As scientists continued to research this neurochemical, they realized that not only does oxytocin coordinate social behavior with bonding, healthy development, and improved performance, but it also supports physical health. It acts to lower the neurochemicals associated with stress and anxiety, is analgesic (blocks pain), and anti-­‐inflammatory (aids in healing). Maybe this accounts for why children run to their parents when they fall off their bicycles and scrape their knees - maybe their mother's embrace actually triggers pain-­‐reducing, healing mechanisms in the skin. Maybe this is why being with friends and family during tragedy can help us stay balanced and sane. Maybe this is why all the Katrina refugees joined together in circles at the Superdome.

Many ancient cultural and religious rituals serve this very function. For example, in the Jewish tradition, close family and friends come together to mourn a loved one's death for seven days following their passing. This practice of "sitting shiva" allows for grieving family members to be supported by their community as they manage the intense emotions associated with the loss of a loved one, possibly inoculating them against the effects of depression and illness reactions. More recently, social, self-­‐help and therapeutic groups have served a similar function in our modern society. An informative research study from Stanford University was done with 50 women diagnosed with metastatic breast cancer. They followed two groups of women - one consisted of women who joined cancer support groups and the other were women who did not join any support groups. The results demonstrated that the women who joined a support group lived twice as long as the women who did not join a support group. Not only that, those women who joined a support group also reported a higher quality of living, including 50% less pain than those not in a support group.

When working with individuals dealing with trauma, many are so engaged in managing the energy of their basic survival - which can be observed in such behaviors as conflict, avoidance and isolation, and such emotional states as rage, anxiety and depression - that their ability to be present and available for meaningful relationships suffers. This means that the most primary survival response - tend and befriend - goes off-­‐line, leaving individuals vulnerable to further effects of trauma and chronic stress disorders.

When working with Somatic Experiencing, we are focused on the unresolved dysregulation of the brain and nervous system, those neuro-­‐circuits which became dysregulated through our incomplete responses to danger and threat. In other words, a life experience overwhelmed our capacity to cope, leaving our brain and bodies disorganized and unbalanced. For example, what if upon waking in the middle of the night to that noise downstairs, you register that a hurricane had hit your home. You survive the environmental assault on your home, but your body might have not returned to the balance you experienced before this event. Now every time you hear a loud noise, you startle, or maybe you've even lost your ability to fall asleep and sleep restfully throughout the night. Unbeknownst to you, your body might be frozen in that past experience, still stuck in an incomplete fight/flight state, thereby creating a dysregulated nervous system.

Understanding the avenues of resolving the fight, flight and freeze states is essential in effective trauma treatment, but I remind my students to be on the lookout for the disrupted tend and befriend states as well. My work centers around supporting people in social engagement. I recognize that without social connection - when tend and befriend are off-­‐line we miss out on the healing process this behavior promotes. Part of this healing is to return to the feeling of one's sense of self before a traumatic experience disrupted one's life. To many cultures, the loss of connection with others equates to the loss of one's self.

A memory comes to mind of sitting around a refugee camp in Asia with my Burmese friends, eating good food, laughing at our poor language skills, and singing along to the guitar playing Burmese freedom songs. I was moved by the moment and by

their inspiring resiliency. I was curious as to what techniques or rituals they had in their culture to help them deal with the unrelenting trauma of social oppression. So I asked my friends what helped them deal with the brutal trauma they were experiencing. They looked at me puzzled, and finally Ko Yee Zaw, a dear friend, said "this". Right in front of my eyes, between us there that evening, safety was being established and healing promoted. Despite the very best efforts from international organizations and providers to equip the Burmese people with the technical, medical and educational support they needed to survive, my friends recognized the inherent support they already had with them - social connection.

What I've learned since is that safety translates to biology, meaning that if we trigger states of well-­‐being through personal connection, we can promote both psychological and physical health. Amidst unspeakable acts of human and environmental destruction, what I discovered in the refugee camps of Southeast Asia and the parishes of southern Louisiana was that relationships might just be the best medicine.

Brad J Kammer, MA, MFT, SEP is a Psychotherapist, Somatic Experiencing Practitioner and Assistant Trainer, and has been involved in bringing SE to various communities and cultures. Brad lives and works in Ukiah, California, but also has a private practice in San Francisco. Brad is an adjunct psychology instructor at Mendocino College and National University. To contact Brad or learn more about his work and teaching: www.body-­mindtherapy.com.

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The Meadows and The Refuge are hosting a free one-day trauma workshop for clinicians on June 8, 2012, in Delray Beach, Florida from 8:00am to 3:30pm.

This workshop will focus on both attachment and addiction; exploring how the lack of healthy attachment in childhood can lead to a variety of mental, emotional, social, and physical health problems in adulthood, effecting resiliency and a person's ability to function in a healthy manner. The presentation will also explore the neurobiology behind "the perfect storm" of addiction and how trauma replicates and fuels chemical dependence.

Presenters include Judy Crane, Founder and Executive Director of The Refuge; Dr. Jon Caldwell, psychiatrist at The Meadows; and Dr. Douglas Davies, neurobiologist. Titles of presentations include "The Loneliest Heart: "The Many Faces of Trauma,"" "Mindful Awareness of Attachment: "Fostering Emotion Regulation and Resiliency in Trauma Recovery,"" and "Neurobiology of Addictions and Trauma."

For more information and to register for the workshop, contact Shea Beasley at 352.512.8877. This event offers 5.5 Continuing Education Credits sponsored by The Institute for Continuing Education.
The Meadows 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 www.themeadows.com.

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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