The Meadows Blog

The Meadows, America's premier center for the treatment of addiction and trauma, is pleased to present an ongoing series of videos featuring the most prominent names in the mental health field, including Maureen Canning, John Bradshaw, and Dr. Jerry Boriskin, among others.

Maureen Canning is a clinical consultant and senior fellow at The Meadows. She also is a clinical consultant at Dakota, The Meadows' extended-care facility dedicated exclusively to the treatment of sexual addiction and trauma. In her introductory video, Ms. Canning discusses her relationship with the Meadows and her work treating sexual disorders.

"I came by this work honestly," she explains. "I'm a recovering person myself, and I have a lot of passion for the work that I do."

She continues, "There's a lot of stigma around this particular disorder, especially for women, so I feel blessed to support people around the recovery process and to see people make progress and move toward healthy sexual expression."

Other videos in the series by Ms. Canning deal with the nature of healthy sexuality, shame and sex addiction, what partners of sex addicts need to know, and other critical issues relating to the treatment of sexual disorders.

An internationally recognized lecturer in the fields of sexual addiction and trauma, Ms. Canning, MA, LMFT, has extensive experience treating sexual disorders. Her clinical experience includes individual, couples, and family counseling; workshops; educational trainings; and interventions. She is a level II EMDR-trained therapist, a certified hypnotherapist, and the author of Lust, Anger, Love: Understanding Sexual Addiction and The Road to Healthy Intimacy.

To view this and other videos in this informative series from The Meadows, see www.youtube.com/themeadowswickenburg. For more about The Meadows’ innovative treatment program for addictions and trauma, see www.themeadows.org or call The Meadows at 800-244-4949.

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"It's enough," said the 64-year old.... "Something has changed. The world feels strange now. Even the way the clouds move isn't right." (Excerpted from an article on the 7.1-magnitude aftershock in northeastern Japan, USA Today, April 8, 2011.)

Dissociation: Personal Transition in a Chaotic World

Traumatic events set off a chain reaction of biological, emotional, psychological, interpersonal, and spiritual changes that can disrupt your entire sense of self and how you view things going forward. When your world is shaken and you no longer feel safe, you can lose your sense of identity. The resulting shifts in perspective and perception can cause a disintegration of your baseline ego.

Survivors of traumatic events say things like:
"I was so frightened, I stopped feeling. It was like I reached a point where I didn't care anymore if I lived or died."
"Once I got through this and accepted my own death, my fear went away. I was able to get through."
"It is odd; I would look at myself, look at my hand, and it was like it was no longer attached. Everything shifted from three dimensions to two; it is like colors disappeared, yet everything was intense. I can't really describe it; I just went numb. I became disconnected from my body."

Such shifts in perspective and dimensionality are a core component of dissociation, which tends to follow in the wake of absolute fear or panic. Permitting one to detach from emotion, it can be very adaptive. For instance, it can help soldiers to act as a team and follow orders. In Vietnam, many soldiers would recite a simple chant while doing horrible tasks: "Just another day, no big thing...." This helped to desensitize them, reinforce dissociation, and establish the numbness required for survival.

Dissociation also permits emergency room personnel to disengage from the horrors they see and do their jobs. ER workers who are “in touch with their emotions” may not be able to act as efficiently in a crisis as a focused, emotionally dissociated team. Optimally, rescuers need to perform first and process their emotions later.

Soldiers, healers, and survivors encounter problems if they cannot reattach to their bodies or emotions after the intensity diminishes. If they remain in a state of constant arousal, it negatively affects their sense of balance, communication, self-awareness, and connection to loved ones. Once your core is shaken, it is difficult to resume a "normal" perspective. Everything feels different. On one hand, things that upset others might not set you off. New crises are familiar, almost expected; they may even be welcomed or become "the new normal." Survivors often adapt well to overload. They feel comfortable, perhaps even comforted, within new arenas of challenge or intensity. This, in part, is why so many soldiers devastated by war would enlist again if offered the option. They get used to functioning well at the edge; it almost becomes addictive.

Paradoxically, little things can cause overreaction. A partner's complaint about a failure to clean the kitchen, for example, might result in a temper tantrum, a fit of righteous indignation, or a violent clash. The big things become little, and the little things become big. The new normal is numbness, punctuated by fits of rage or terror. In this "fifth dimension," everything is scrambled. You are numb and detached; nothing hurts. It's "just another day, same old thing...." Yet everything is different - even the clouds.

Dr. Jerry Boriskin is a Senior Fellow at The Meadows. He is an author, lecturer, and clinician with expertise in trauma, PTSD, and addictive disorders. Dr. Boriskin is a licensed psychologist and addiction specialist who recently resumed working with traumatized soldiers at the V.A. of Northern California. He is the author of "PTSD and Addiction: A Practical Guide for Clinicians and Counselors" and co-authored "At Wit's End: What Families Need to Know When A Loved One is Diagnosed with Addiction and Mental Illness."

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The fields of psychiatry and psychotherapy are peppered with uninformed beliefs and misjudgments. For instance, individuals can be pejoratively diagnosed as borderline or, perhaps more accurately, viewed as exhibiting symptoms of complex traumatic stress. In cases of the latter, old unresolved traumas are reenacted in the here and now and, to say the least, are difficult to clinically modulate.

Betrayal is not Borderline

Nowhere is the borderline label less fitting but more frequently appended than in the case of a betrayed spouse. The label is applied to individuals who present in therapy as "help-me-no-don't," chronically angry, scared, defensive, and reactive. Unfortunately, the label is all too frequently applied by uninformed clinicians dealing with an angry, emotional, scared, "leave me-now-no-don't" spouse who has learned of a partner's sexual indiscretions, compulsivity, or addiction. Few spouses comport themselves with grace in the face of betrayal, yet the insinuation or diagnosis of borderline disorder is all too readily affixed. And by brandishing the borderline label, the clinical community serves to reactivate the emotional wounding and reinjure the person already reeling from betrayal and violation.

It's currently debated - not-so-nicely at times - whether sex addiction is an addiction at all. Is it merely a hall pass for out-of-control behavior, or is it an addiction warranting legitimate attention? The psychiatric and psychological camps contend that it's objectionable to label a behavior as an addictive disorder without rigorous scientific support. Assessment, diagnosis, and practice based solely on anecdotal experience may not be legitimate, yet the field of psychotherapy often treats issues and behaviors with modalities and techniques that have yet to be invited to the scientific table of clinical legitimacy.

Judge Not the Name

So it makes sense that borderline personality disorder and sex addiction find their way into the same scrape. An individual who exhibits reactivity and another who exhibits out-of-control sexual behavior tend to face negative public reception, while the pain and wounding that drive the behaviors are overlooked. By brandishing a label, the professionals with whom the pain can be shared reinforce disapproval of the behavior and invalidate the pain.

The American Psychological Association determines what is included in the Diagnostic and Statistical Manual of Mental Disorders, the fifth edition of which is to be released any year now. The term "borderline personality disorder" is currently under reconsideration; it is quickly becoming a term of old to describe a cluster of symptoms driven by trauma-induced stress.

A more appropriate term is "complex traumatic stress," which speaks to abuse inflicted by an attachment figure, the loss of the authentic self due to repeated trauma and abuse, or problems in regulating emotion. Whether that description finds its way into the upcoming DSM remains to be seen. So far the jury is out, and confusion still rules. Clearly, this is not an exact science.

We must realize that an individual who struggles with a behavior by any name is an individual who suffers. As clinicians, we are at the forefront of healing and facilitating growth. Whether addictive behavior centers around sex, drugs, or rock-and-roll, it involves pain and suffering. To label the pain or question its legitimacy is to shut down an opportunity for growth and healing - for both the clinician and the client.

Published in Blog
Monday, 11 April 2011 20:00

Bessel van der Kolk on treating PTSD

In an article on NewsFirst5.com in Colorado Springs, they discussed treatment for Post-Traumatic Stress Disorder (PTSD). In the article, they discussed a conference in Colorado Springs, where Dr. Bessel van der Kolk discussed his concerns regarding treatment for soldiers diagnosed with PTSD. The article reports, "Local experts say that 10 to 30 percent of military coming home from war could be diagnosed with Post-Traumatic Stress Disorder." Dr. van der Kolk discussed the need for people to "feel safe." To read more about this go to:

http://www.newsfirst5.com/news/trauma-expert-says-common-ptsd-treatments-may-not-be-the-best/

Published in Blog
Friday, 08 April 2011 20:00

Healing Money Trauma

In the eyes of a child money is alive. Money leaps out of machines in a mysterious way and solves problems or creates others. Money jumps in the middle of parental arguments and draws its sword, threatening to separate a child from his family. Money leaves powerful messages in marriages; it "wakes" up emotions as it "writes letters" to the family in the form of bills or makes phone calls to the household in the form of bill collectors. Money-talks are frequently the most emotionally charged conversations that a child hears, and children become aware of the social implications of money as soon as they become aware of, and responsive to, others. Money becomes a god that Mother sacrifices Motherhood to obtain and Fathers forsake home life in pursuit of "making a living". Money is the visible representation that a child sees as individuals connect one to another and exchange the green stuff. A child observes the social contracts of money between people and knows that money itself is social; it creates agreements, happiness, and pain as it pulls people together or separates them forever.

Understanding our client's financial and work dilemmas requires much more skill than just offering them the telephone number for credit-consolidation companies. The behaviors themselves can be as varied as trauma repetition, mood-altering experiences, or acts of defiance, as well as many other possibilities. Debt may be for one individual an act that quiets a suppressed and unconscious fear of separation; for another it might be an angry response to feeling confined and trapped; to a third it might mean an anesthetizing behavior allowing one to "zone out".

Healing wounds made by money and work is best approached as if the behaviors themselves sat on a three-legged stool - not to be understood unless all three legs are available. For clinicians the first leg is to understand the Attachment and Trauma issues that arise out of early childhood experiences that serve to create templates for adult behaviors. The second leg is isolate the exact Temperament - answering the question that it is both nature and nurture that give us our attitudes and behaviors with money and work. The third leg is Affect - when we help our clients to understand that the phenomenon of debt creates feelings of emotional pain and fear - and sometimes it is the emotion itself that is most attractive to a traumatized individual.

The money and work disorders create a collage of dysfunctional behaviors.  Clients may display a pattern of compulsive shopping, spending and/or debting; some may have progressed into hoarding or shoplifting. Other clients become obsessed with money or work, and some retreat into deprivation and under-earning. Some gamble, either in traditional ways with slot machines and gaming tables or with high risk investments and business adventures. Still others might find themselves paralyzed by the wealth they have inherited or with which they have grown up, and are now unmotivated and untrusting, alone in a threatening world. Assessment of money disorders frequently shows a correlation between adaptations such as gambling with embezzlement, shopping with shoplifting, workaholism with at-risk entrepreneurship or embezzlement, or compulsive giving with relational issues (the "Financial ALANON Factor"). Regardless of how the puzzle pieces fit together to create the unique profile, the treatment follows a predictable course.

Specific steps that need to be taken by clinicians wishing to approach and understand the emotionally-charged, compulsive work and money behaviors include:
(1) An Assessment of disordered patterns of work and money.
(2) An Evaluation of client's temperament and confirmation of underlying personality-specific innate fears.
(3) Childhood memories narrative to determine template(s).
(4) Re-scripting of cognitive distortions regarding finances and work.
(5) Vision work to establish clear goals for future behavior.
(6) A relapse prevention plan based on knowing risk and trigger issues.

Money trauma and the related adult behaviors surrounding money are the unspoken burdens of shame that often take our clients into relapse. In the past twenty years we have made great strides in healing the wounds of sex addiction and we can now talk about sex openly. The time has come for us to talk about money as well and conquer the shame that has kept this subject in silence for too long.

Bonnie A. DenDooven
dendooven7@aol.com

Bonnie A. DenDooven, MC, LAC, a family workshop therapist at Gatehouse Academy, is a former business owner-turned-therapist. The author of the MAWASI© for therapy and healing of financial disorders and work behaviors, she is a former primary and family counselor and assistant clinical director for Dr. Patrick Carnes at The Meadows. Bonnie was schooled in Gestalt therapy and is a member of Silvan Tomkins Institute of Affect Script Psychology, an advocate of Martin Seligman Positive Psychology, and a champion for the initiative for VIA Classification of Strengths and Virtues (jokingly referred to as the "un-DSM").

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