The Meadows is pleased to announce the launch of our new blog, addictionrecoveryreality.com, featuring articles by some of the most well-respected and innovative experts in the treatment and recovery fields of drug addiction, alcohol addiction, gambling addiction, depression and anxiety, relationships and childhood trauma.
Contributors to the blog include leaders in the treatment of addiction and trauma: Pia Mellody; John Bradshaw, MA; Bessel A. van der Kolk, MD; Peter Levine, PhD; Maureen Canning, MA, LMFT; Jerry Boriskin, PhD; and Shelley Uram, MD. These experts write about a wide range of addiction-related topics.
If you are interested in writing for addictionrecoveryreality.com, please send submissions to firstname.lastname@example.org.
COMPLEX PTSD AND ADDICTIVE DISORDERS: WHY SIMPLISTIC SOLUTIONS DO NOT WORK
By Jerry Boriksin, PhD
The logic is easy but seems to elude the most brilliant of minds: Some complicated conditions require multiple approaches delivered skillfully and in the proper sequence. A single solution, no matter how powerful, tends to fail when up against sufficient intensity and complexity. To put this into simpler language: If a tornado leveled your home, you wouldn't rebuild by simply calling a plumber. You would need to call in a team of craftspeople - in the right sequence - in order to repair the damage. Calling in the roofer before restoring the walls would be absurd.
Individuals who have sustained severe emotional damage or multiple traumas, or who had their foundations damaged by early childhood neglect or abuse, tend not to do well with singular, well-intended, or even well-delivered therapeutic approaches. Repeated attempts and failures reinforce the hopelessness and futility that are central to the inner beliefs of those who suffer. Essentially, they believe they are broken beyond repair. This is what we refer to as nihilism (i.e., "I am hopeless and there is no meaning, no escape... nothing will work"). The result is often a resumption of self-medicating: indulging in drugs, alcohol, risky sexual behavior, bad relationships, etc. Addiction is a frequent cohort of pain, futility, and hopelessness.
Researchers have been trying for decades to develop singular, powerful treatments for the cure of PTSD. Whereas the treatments are better, even the best treatment techniques fail when facing complex PTSD with co-occurring conditions. Very often, immersion in a safe, sane environment is needed in order to gain some traction. This is why we often need a higher level of care to start the process of rebuilding.
The very first foundations are:
2. Restored sleep cycle. Once this foundation is secure, additional techniques can be employed. However, it is important to recognize that we are dealing with complex problems. We need multiple approaches - delivered skillfully, cooperatively, and rationally - with several specialty artists who can work comfortably with the necessary complexity, honesty, and skill.
While science has helped and will help us further, no magic, medicine, or technique will rebuild the damage inflicted by severe childhood abuse, war, and subsequent disasters. We need to utilize a team with a wide range of tools and skills. We need to embrace the complexity, rather than deny its reality. So, sobriety first, sleep second; then the rebuilding can begin. Do not minimize how much structural work is needed; almost any building can be rebuilt, but it requires a team with many disciplines and several tools, all used in a synthetic, not simplistic, fashion.
Isn't the term"sex addiction" just an excuse for bad behavior?
By Maureen Canning
News stories about celebrities struggling with sexual addiction have raised questions about the legitimacy of sexual addiction as a disorder. Many say the diagnosis is an excuse for bad behavior. But assessing someone's behavior from afar is not an effective tool for understanding another's reality. Some may use sex addiction as an excuse, but it is important to understand it as a viable disorder that, when left untreated, can have serious consequences.
Sexual addiction is a progressive disorder; if not treated, it will become worse over time. Consequences will build up and wreak havoc in one's life. As the disease progresses, so do the consequences: depression, sexually transmitted disease, financial loss, relational conflict, isolation, low self-esteem, and suicidal thoughts or gesturesThe individual spirals out of control to the point where the need to act-out sexually becomes his/her only priority.
Sex addicts have tunnel focus; they are hypervigilant when seeking another "hit." Meeting a friend at local restaurant is not about connecting emotionally, sharing, or catching up. It turns into an opportunity to objectify others or flirt with the server or attractive patrons. Addicts becomes frustrated when expected to be present in the conversation. They feel trapped and limited by their inability to catch another glimpse or slip their phone number to a possible hookup.
As the addiction progresses, it takes more time, energy, and resources. It may drain bank accounts, cause marriages to end in divorce, cost opportunities at the work place, and rob hobbies of interest. Despite obvious changes, addicts are experts at believing their own lies. They minimize their behaviors, believing they still have control. They distort reality to justify continuing the addiction.
Typically addicts don't seek treatment until the pain of their behaviors outweighs the gain. Self-motivation is crucial. An intervention with stiff consequences may be necessary to create the motivation. Most important is the knowledge that treatment is available for the sexually addicted individual. Within the context of a healing environment, addicts are able to break through the denial and begin a restorative process.
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.
Getting to the Truth of "Body, Mind, and Spirit"
By Shelley Uram, MD
I've been a psychiatrist for more than 20 years, and I've heard the phrase "body, mind, spirit" many, many times. I was very pleased with this newly emerging holistic concept when I was a psychiatrist-in-training. It captured the concept of the spirit, which was usually ignored in American medicine, and the phrase included the mind, whose influence on the body had also been minimized.
I consider myself a holistic psychiatrist, but that is not the "bottom line" of my interest. The inclusion of these three aspects of the self provides a far more accurate description of each of us, when compared to traditional American medicine's interest in addressing the physical body. If you are searching for a deeper level of truth, I would like to share my perspective with you.
Ultimately, before passing from this earth in death, most people become serious about reflecting upon their lives. They usually want to know if they have lived as they should have, and they want to know more deeply who they "really" are. This is the final reckoning. Our lives boil down to these and a few other questions.
So what does this have to do with "body, mind, spirit"?
The real powerhouse of the three is spirit. It is our soul, or essence, that can ultimately bring us peace in our minds, emotions, and body. Ignoring or choking our essence brings pain and suffering. Our American culture is not imbued with respect for, or recognition of, this most basic essence in every one of us. We suffer the consequences of this individually and as a nation.
So what is the truth about "body, mind, spirit"?
They are not equal.
They are all very important, but they are not equal.
Peace, at the level of the spirit/soul, can generate peace in the body and mind. Even if the body is ill or impaired, we can experience ongoing peace if that is what we feel deep within. The corollary is that, no matter how healthy the body is, it does not bring long-lasting peace to the mind/emotions/spirit.
Therefore, the more a therapeutic intervention addresses our essence, or spirit, the greater impact it will have on the mind/emotions and body. For many years, I have been a big fan of Pia Mellody's treatment model. By addressing what are called "core issues," I have seen many people settle into a centered, respectful, moderate, and calmer place within. From this space, a portal opens to soul-knowingness. When people come to honor this inner knowing, the payoff is remarkable.
A continued "cleaning up" in the five core issue areas is needed in order for the portal to remain open and grow a larger connection with the essence of the person, or soul. When the wisdom and peace of the spirit are tapped into, the mind and body usually quickly follow its lead with healing and a sense of great relief.