In a recent TED Talk, journalist and author Johann Hari suggests that “Everything you think you know about addiction is wrong.” He argues that most people in our society see addiction as a simple chemical dependency, when it is actually the result of a failure to connect ─ with family, with friends, with the community, with God, or with a larger sense of purpose.
His ideas are proving to be somewhat controversial in the recovery and addiction communities, not so much because of his basic premise, but because of his assertion that these ideas are “new.” (The studies he sites have been well known to psychologists and addiction professionals for years.) He does also seem to oversimplify, in some ways, what is often a very complicated and nuanced problem. And, he calls for the legalization of all recreational drugs as a possible solution, an idea which always sparks a strong debate.
In spite of some of the questionable aspects of his speech, at The Meadows, we do agree with his core principle: that disconnection─ with peers, with communities, with one’s sense of self and/or with a higher power ─ can play a major role in triggering addiction and other behavioral issues.
One of the most important goals we have for our patients at The Meadows is that they learn how to become interdependent. The Meadows Model, developed by Pia Mellody, names dependency as one the four core issues that must be addressed before a person can make a full recovery from addiction or mood disorders. Doing so requires one to reconnect with the child he or she once was. Being too dependent comes from not having needs and wants met as a child. Being anti-dependent comes from being shamed for having needs and wants as child.
Becoming interdependent means learning how to balance your own needs and wants with those of others. If you are interdependent, you are able to ask for help when you need it, help others when they make a reasonable request, and say “no” when necessary to prevent yourself from stretching yourself too thin and becoming resentful.
Without interdependence, there is no recovery. As an addict, the ability to rely on others for help and emotional support, and to give that help and support to others, is critical to staying sober. Without the tools to make and maintain these connections, recovery is impossible to sustain.
Step 11 in the 12 Step Model for Recovery requires the addict to find a connection with a higher power:
“Sought through prayer and meditation to improve our conscious contact with God as we understand Him, praying only for knowledge of his will for us and the power to carry that out.”
In most cases, addicts have either always struggled to connect with God, their Higher Power, or their sense of purpose; or, in some way, they got disconnected along the way. Recovery is about getting connected or reconnected.
Jim Corrington, Director of The Meadows Outpatient Services, likes to use the analogy of an orange extension cord to explain:
An orange extension cord is useless and without purpose when it’s hanging on the wall. You have to plug it in to a source of power to give it potential. It does not reach its full potential until you plug something else into IT. So, too, an individual must stay plugged in to their source of power, AND, stay connected to others around them to reach sobriety, and with it, their full potential.
Addictions manifest in those areas where people are disconnected but seeking to connect. “Faulty wiring” caused by childhood trauma can make it difficult for them to connect with others or with their sense of purpose, so they end up trying to fill the gap with substances or unhealthy behaviors.
At The Meadows, we take a holistic approach to healing that helps patients to reconnect through their minds, bodies and spirits. Therapy sessions and workshops allow them to find out how they became disconnected, to work on ways to build better relationships with others, and to learn how to nurture themselves. Our new brain center helps them to address any dysregulation they may be experiencing in the brain and nervous system. And, physical activities like Yoga, Tai Chi, equine therapy and ropes courses, allow them to gain even deeper insights into themselves.
If you or a loved one are struggling with an addiction or a disorder and are seeking ways to reconnect, we can help. Contact us for more information.
According to a recent report from the Centers for Disease Control, the rate of heroin-related deaths has quadrupled in the past 10 years. Of people surveyed between 2011 and 2013, nearly 663,000 said they had used heroin in the past year; 379,000 said they had between 2002 and 2004.
Scott Davis, Clinical Director at The Meadows, says that the path that leads to heroin addiction is often different than that of other drug addictions. In many cases, it begins with a prescription for an opioid painkiller, such as hydrocodone or oxycodone. (In others, it begins with prescriptions for Benzodiazepines, such as Xanax or Ativan.)
“A lot of the people who are coming to us with opiate addictions don’t necessarily fit the mold for most addiction. They don’t typically have the family history of addiction or the long-term dependence on the drug that you see with many other addicts.” “That doesn’t mean that they don’t have trauma, or that their family doesn’t have issues—in fact, they may have issues which exacerbated their dependence on the drug and made the addiction more likely—but, they might not have otherwise found themselves addicted had they not been prescribed an opiate as a pain killer.”
Once the pills become difficult to obtain, it can be easy for a person to slip into heroin abuse. Heroin’s chemical structure is very similar to that of prescription pain medications and works in the same group of receptors in the brain. It’s also cheaper.
For heroin and opiate addicts, there are typically three levels of pain that they must overcome in order to reach sobriety: the physical pain that led them to drug, the pain of detoxing from the drug, and emotional pain that led to their addiction.
For many opioid addicts, their drug problems start with chronic physical pain. That pain is real and needs to be taken into account when developing a treatment program for the patients.
At The Meadows, we have a full-time medical doctor on our staff to help patients address the pain and the medical issues that are causing it. Patients cannot thoroughly address any underlying psychological aspects of their addiction if they are suffering too much from the physical pain that lead them to abuse drugs in the first place.
Heroin disrupts the brain’s natural opiate production process, which helps reduce pain and calm the nervous system. So, when a person stops taking the drug, he or she feels pain and anxiety more intensely than before. This makes detoxing from heroin especially painful. The Meadows highly-trained medical team, which includes a 24-hour nursing staff, can help patients safely and comfortably detox from heroin and opiates onsite. They develop a detox plan for each person that helps them to stabilize more quickly, experience less pain, and avoid some of the withdrawal symptoms they would have if they went off the drug cold turkey. Easing patients through detox makes it a whole lot easier for people to stay in treatment and stay off of the drug.
In many treatment systems, patients detox in a hospital or other setting and then go to the treatment program. Because we have the ability to help patients detox in-house at The Meadows, they don’t have to wait to begin treatment. As long as the patient is feeling well enough, they can begin attending classes and therapy sessions within the first two to three days after their arrival on campus. This makes the transition into treatment easier for them and allows them to start developing coping strategies for living without the drug right away.
While the path that led to heroin use may have begun with a need to address physical pain, the user probably soon found that it also minimized their emotional and psychological pain as well. Whatever coping mechanisms the addict had used before to manage their stress and anxiety may have fallen by the wayside, as the drug was able to do the trick much more quickly and effectively.
That’s why a key component of the treatment program at The Meadows focuses on addressing trauma, family issues, and emotion regulation. Our staff works with patients to help them identify and address any buried psychological pain and repressed feelings that may have played a role in triggering their addiction.
Many people who become addicted to heroin found their way to the drug unintentionally. Many of them may also be the only people in their families with an addiction problem, which can contribute to feelings of isolation and shame. Scott Davis says that one thing that makes The Meadows program especially well-suited for them is that there is no shame attached.
“We’re not going to tell them that they are bad people. We’re not going to tell them that it’s all their fault and that they should have known better. Because drug addiction is a disease. We’re going to look at the chemical addiction, and we’re also going to deal with the underlying issues that make this drug particularly potent for them in a non-judgmental way.”
If you think you or someone you love may have a problem with heroin or prescription medications, The Meadows can help. Give us a call at 800-244-4949 today or contact us online here.
At The Meadows, we are honored to provide behavioral health and substance abuse inpatient services, with an emphasis on trauma, PTSD, and addictive disease disorders, to active duty military members, retirees and dependents of the TRICARE West Region.
In the interview below, US Army infantryman Alex Horton depicts what readjusting to life after the war really means. The struggle to justify his actions in war against his moral compass leaves Horton with a feeling of self-doubt and self-criticism that never goes away. This struggle is known as “moral injury”.
You can read the interview here: War "Exists in an Outside Moral Universe"
The Meadows team is tremendously proud to help serve the health care needs of service members, veterans, and their families who have all been touched by moral injury. We would be happy to help determine eligibility and benefits that can be utilized and are committed to helping military beneficiaries and partnering with all aspects of the TRICARE healthcare alliance. We can help restore the sense of control and lessen the powerful hold of trauma. Contact Us Here or call an Intake Coordinator at 800-244-4949 to learn how The Meadows can help.
By Dr. Shelley Uram
What is it? Where does it come from? Why don’t most of us know about it?
Most of us are well acquainted with aspects of our personality, like being a nice person, an addict, a good employee, the therapist, the hero, the traumatized person, etc. The Authentic Self, however, transcends our personality, thoughts, and emotions.
Polonius says to his son, Laertes, who is about to embark on a long journey: ”This above all: To thine own self be true. And it must follow, as the night the day, thou canst not then be false to any man.”
I just love this quote! Shakespeare so wisely understood the importance of tuning in to, and following one’s own inner voice, or Authentic Self. Polonius instructed his son to prioritize this “above all” else.
I wholeheartedly agree!
Did Shakespeare mean we should be selfish? No; I think he meant we should be Selfish. What’s the difference? The meaning I am giving to the word, with a capital “S”, signifies the Self that is the Authentic Self, or the Essence, or Soul, Spirit, etc. It is the underlying core of each of us. It is to this unseen essence, or Self to which we should be “true.”
The Authentic Self, or Self for short, has the qualities of infinite wisdom, kindness, love, oneness, timelessness, “is-ness”, and acceptance. It is the UNSEEN Self we are born with and will ultimately die with; unchanged through our life’s journey.
Our ability to be attuned and aligned with our Self is of paramount importance! In my opinion, this is probably the most important task of our lives. It is the Self that can lead us to the best paths and choices we can make during our lifetime. When our personality is aligned with the wisdom and knowingness of the Self, it becomes a most valuable compass.
Unfortunately, we humans have brains that have many “survival” remnants left over from millions of years. These remnants “grab” our attention far more loudly and with much greater intensity than the ever soft, gentle whisper of Self. The manifestation of our Self typically becomes forgotten and turned away from at a very young age.
Those of you who have been active in 12-Steps may already be familiar with how dedicated we must be before our connection with Higher Power can be dusted off and revitalized. The “Self” in “To Thine Own Self Be True” is the same; the Self is the portal for Higher Power connection.
It is our Authentic Self that should be the compass from which our lives are guided; not just in the big picture, but also in the moment to moment experiences and choices that ultimately become the big picture.
What happened with these Authentic Self qualities that we were born with? I know few adults who consistently manifest these qualities. Yet, we all did as babies and young children! We couldn’t help but BE those qualities; that was who and what we were!
Here’s what happened…
When each of us was born, some parts of our brain began developing and maturing right away, while other parts came “online” more slowly.
One of those brain areas that began growing early is the part that enables us to have a sense of ourselves. At about 3 months of age, most humans experience their fi rst dawning awareness that there is a “me”. Before that, we were very well aware of others, aware of interacting with them, etc., but had no real knowing that a “me” existed.
Even though this ”me sense” is still quite rudimentary at the tender age of three months, it is nonetheless a huge alarm clock for the ancient survival brain areas. Now that our survival brain recognizes that there is a “me” who is wholly independent of anyone else, this part of our brain has a heyday as it recognizes that it must protect this newly identified person from any harm.
These survival brain areas become much more active; now that there is a “me” to protect. These brain areas interpret many more experiences as potentially dangerous. An analogy would be a dog whose family is away, versus that same dog whose family is present. The dog will be far more protective when the family members are present.
Our thinking brain continues to grow and mature throughout our early childhood years, leaving us with a more and more complex and sophisticated sense of “me”. Therefore, the survival response becomes intertwined and more often triggered as the defi nition of “me” grows in complexity and sophistication; there is more of a “me” to protect.
What does this “Survival Response” look like? It is usually packaged as a Fight, Flight, or Freeze response. Simply put, some areas of our very ancient brain signal other brain areas to release adrenaline and other chemicals to mobilize our body into quick and intense behaviors, like fleeing, fighting, etc. At the same time, there are electrical signals supporting these fight, flight and freeze responses, as well as hormonal responses that try to sustain the these survival responses, like cortisol.
All said, with the electrical, neuro-chemical, and hormonal activity, a person quickly becomes overrun with the physical and emotional responses to the Fight, Flight, Freeze activity. This activity feels quite uncomfortable to us. Just think of the last time you had a “close call” with something, like a near-miss car accident, and your heart was racing, and you had rapid breathing, shaking, emotionally feeling fear, etc. If these kinds of physiologic responses occur often, they can be very uncomfortable for us. When we are very young, our minds try their best to decrease these Fight, Flight, Freeze responses.
When we are little children, our thinking brain is one of those brain areas that take much longer to develop when compared to the survival brain areas. Therefore, we simply don’t understand much of what is going on around us, or why our caregivers are responding to us the way they do. This “not knowing” is a perfect setup for us to misinterpret the meaning of their behaviors and interactions with us. Our little imaginations can run wild and come to very erroneous conclusions. Many, therefore, of our misunderstandings of our caregivers actions can lead to these Fight, Flight, Freeze responses.
Aristotle and Sigmund Freud had described the pain-pleasure principle. Basically, this explains that human beings are “wired” to both move away from pain, and go towards pleasure.
When we were young children and our survival brains were triggering the Fight, Flight, Freeze responses, we would be left feeling quite uncomfortable. The Fight, Flight, Freeze responses are VERY stressful on the body and our emotional state.
We start making up “rules of life” of how to keep our parents and other important people happy with us. There are potentially thousands of these “rules”. The purpose of them is to navigate our lives more successfully with our caregivers, and to decrease the frequency of FFF response.
A few examples of these “rules”, or “Deep False Beliefs” are:
“Whatever I do, I better do well!”
“I shouldn’t get angry”
“I should be nice to other people.”
Now, these aren’t rules like we create when we are older and think and analyze things in our thinking brain; rather, these are safety strategies that our survival brain creates. These rules are the ones that are tightly bound with Fight, Flight , Freeze responses.
For example, the deep false belief “I shouldn’t get angry” often develops when a child is young and becomes very angry or rageful about someone or something. This is a totally normal reaction. When the child, however, sees the negative facial expression or reaction of their psychologically extremely important parents, the child may instantly go into a FFF reaction. After a few to several experiences like this, in order to avoid the powerful FFF bodily and emotional experience, the child’s relatively undeveloped thinking brain will fi gure out something like “Uh-oh, Mom looks like she doesn’t love me when I’m angry. I better stop it or I might lose her love.” Eventually, this belief may become something like: “I’m bad when I’m angry”.
Parallel to this ongoing process of our young brains making up these deep false beliefs, our personality is evolving and developing. Since survival responses “trump” all other brain wiring, including personality development, our personalities have to grow through and around these many deep false beliefs. Therefore, our personalities that we hold near and dear to us are actually products from having been heavily influenced by all of these “rules”. For example, our personality may be very “nice”. It’s important to ultimately understand what aspects of ourselves are authentic and genuine, versus a response to deep false beliefs.
By the time we are beginning school, most of us have layers of deep false beliefs that are meshed together with our personalities. We have lost touch with much of our Authentic Self. Is our Authentic Self gone or contaminated or pared down? No! It remains quietly present, usually without your awareness of it. In general, the “voice” of our conscious thinking brain and deep false beliefs are far louder than the “voice” (whisper) of the Authentic Self.
Now let’s move on to the next step of the flow chart in Figure 1:
What happens when a child has a deeply embedded deep false belief, like “Whatever I do, I better do well!”?
We form many, many expectations of others and ourselves from this one deep false belief. For example, the expectation of great school performance, or sports performance, etc., may become offshoots of the deep false belief of “Whatever I do, I better do well”. These expectations may become offshoots of the Deep False Belief “whatever I do, I better do well.” And remember that the Deep False Beliefs and expectations are bound together with the FFF responses. So that when we don’t perform well at school, that deep survival brain response will become triggered. Notice that this in different than our usual desire to do well at school; this FEELS within our body and emotion that we MUST perform well at school.
A personal example of this recently happened to me. I had been raised by parents who deeply valued academic performance. I would shudder when looking in their faces when I would bring home a “not so great” report card. At a young age, my brain created the Deep False Belief that went something like: “I better do well at school or Mom and Dad will be very unhappy with me.” My survival brain was clearly tied to this, as my body would go into terror (Flight mode), whenever I would bring home a poor report card. That was many years ago.
Cut ahead to several weeks ago: I took a quiz in Oprah Magazine that tested the reader’s clothing IQ. Even though I have little to no interest in this area, I found my heart racing, respirations increasing, and my hands trembling a bit when I tallied up my score and found I had badly failed the quiz!
This demonstrated that our Deep False Beliefs become deeply embedded in our psyche, and are tightly bound to our survival brain’s FFF response.
Other examples could be our performance in sports, a musical instrument, “looking right”, driving the right car, and so forth.
How many expectations could be spin offs of the one “Whatever I do, I better do well”? I would guesstimate thousands. I once tracked my thoughts for a whole day. Aside from being incredibly boring, I was amazed to find that I had expectations to do well with many, many things! For example how well I brushed my teeth, if I ate right for breakfast, if I drove too fast or slow.
We each have many thousands of these deep false beliefs… so how many expectations are most of us walking around with? Well, let’s do the math…
Most of us have thousands of deep false beliefs, and many of those have thousands of expectations that offshoot from the belief. I think we’re looking at a vast amount of expectations that are stored within each of us!
Again, what is happening with our Authentic Self as our mind/brain are inundated with expectations? We move farther and farther away.
By the time we reach the mid-adulthood years, many of us find we are not reaching an increasing number of our expectations that were put into place many years before. For example, we find that we simply cannot do many things well. Or we may find that we cannot perform so well in sports any more. Or that our marriages just didn’t work out as we had expected, etc. If we look at the flow chart in Figure 1, we see that negative feelings may follow when our expectations are not met.
Research has clearly shown that when a person harbors negative feelings for longer than a short period of time, i.e., anger, sadness, fear, our bodies “take a hit”; our immune function, heart function, resistance to cancer, heart disease, etc may become compromised.
Finally, we then fall to the very bottom of the flow chart, which is when we develop symptoms. This could be depression, anxiety, certain medical problems, etc. By the time we are adults, most of us have brains and nervous systems that are inundated with deep false beliefs, expectations, and Fight, Flight, Freeze responses. Our true Self is typically long forgotten about. It would be challenging to follow “To Thine Own Self Be True” simply because most of us are unaware of who the Self is.
If you want to increase the presence of your Authentic Self in your daily life, the two main strategies would be to:
1. decrease the frequency and length of time you fall down the “slippery slope” of the flow chart and you stay down there, and
2. work on the highest levels as possible on the flow chart.
If you’re stuck down in “symptoms” level of the flow chart, e.g., chronic depression, anxiety, etc., and your current sole strategy is to take your prescribed medication (which only addresses the bottom level of the Flow Chart), you may feel better for awhile, but you still have the same batch of Deep False Beliefs and expectations lodged in your psyche. It may just be a matter of time before more of our expectations from Deep False Beliefs are not met, and fall down the fl ow chart into having symptoms again.
In addition to taking your medication, you might also consider spiritual practice, like a 12-Step program, and/ or meditation or other mindfulness practice, and/or connecting with nature, or whatever brings you closer to your Authentic Self. These interventions would be working at the top level of the flow chart.
Additionally, anything that stabilizes the brainstem and limbic areas of our brain will generally lead to greater calm and relaxation. This will automatically make us more available to connection with our Authentic Self. Some examples: Mindfulness practices, slow paced yoga, Emotional Freedom Technique, acupuncture, neurofeedback, Heart Rate Variability training, Somatic Experiencing, Sensorimotor Psychotherapy, and many more.
The next very potent level of intervening in order to re-acquaint you with your Authentic Self could be identifying and correcting Deep False Beliefs. There are many ways to do this. Having a therapist initially could really speed up the process until you can do it more on your own. Therapists or books with cognitive approaches can assist you identify your Deep False Beliefs, and techniques like EMDR (Eye Movement Desensitization an Reprocessing), IFS (Internal Family systems (Richard Schwartz, founder), can help you clear them out.
Now, why do you think we would get a “bigger bang for the buck” with clearing deep false beliefs, over expectations?
Both approaches are actually fine, however, when you identify and pull up by the roots even one large Deep False Belief, many, many expectations are simultaneously uprooted. So one Deep False Belief, like “Whatever I do, I better do well!”, can have thousands of expectations that are offshoots. Many of them will disappear when the underlying belief is corrected. If you had approached the process by mainly identifying and clearing out your expectations, although this is very good, it is much more tedious work, and may not clear out the underlying Deep False Belief, that may continue to generate additional Expectations.
Some interventions work at all levels of the flow chart.
For example, the 5-day Survivors workshop at The Meadows addresses all levels of the flow chart.
Whatever approaches you choose to take in reclaiming your Authentic Self, just keep in mind WHERE on the chart you are working. This will help you over the long run to maximize your connection with Authentic Self.
Dr. Shelley Uram is a Harvard trained, triple board-certified psychiatrist and a Distinguished Fellow of the American Academy of Child & Adolescent Psychiatry. She speaks around the world about psychological trauma, and how it often interferes with our ability to thrive in life. She is best known for communicating very complex information in an interesting and easy to understand manner.
Dr. Uram is a Senior Fellow at The Meadows, where she teaches patients and staff, and assists with program development. She is also a Clinical Associate Professor of Psychiatry at The University of Arizona College of Medicine.
The 26th Annual International Trauma Conference, which focuses on psychological trauma: neuroscience, attachment, and therapeutic interventions, takes place May 27-30 and will feature a very special workshop to help soldiers rebuild trust, release pain and forge new bonds through song.
SongwritingWith:Soldiers (SW:S) uses songwriting as a catalyst for positive change. In SW:S retreat and workshop settings, service members are paired with professional songwriters to craft songs about their experiences, often about combat and their return home.
Bessel van der Kolk, MD, Conference Director, world-renowned trauma expert and Senior Fellow at The Meadows will present SongwritingWith:Soldiers work in the “Innovative Programs” session.
You can view the SongwritingWith:Soldiers video trailer here
For the past three decades the conference has examined how trauma affects psychological and biological processes, and how the damage caused by overwhelming life experiences can be reversed. This year the conference will explore new frontiers in this work, frontiers that transcend old paradigms of talking, analyzing and administering drugs.
The objective of this conference is to present current research findings on how people’s brains, minds, and bodies respond to traumatic experiences; how they regulate emotional and behavioral responses; and the role of relationships in protecting and restoring safety and regulation.
When: Wednesday, May 27, 2015 – Saturday, May 30, 2015
Where: Seaport World Trade Center, Boston, MA
Those who have experienced a traumatic event can benefit from seeking help. At The Meadows in Wickenburg, Arizona, clients are invited to recollect and share the emotions and sensations they experienced during the initial trauma or subsequent events.
At The Meadows, world renowned experts in treating psychological trauma guide each patient through a safe and effective process of uncovering and processing any issues related to unresolved trauma and PTSD.
We can help restore the sense of control and lessen the powerful hold of trauma. Contact an Intake Coordinator at 800-244-4949 and learn how The Meadows can help.
The Meadows has been selected to be part of the United Behavioral Health (UBH) Provider Network for the TRICARE Program. As a TRICARE Provider, The Meadows is honored to provide behavioral health and substance abuse inpatient services, with an emphasis on trauma, PTSD, and addictive disease disorders, to active duty military members, retirees, and dependents.