Maureen Canning, Clinical Consultant of The Meadows and Dakota, was recently featured in an interview on iVillage. In Tiger Woods in Sex Rehab: What Really Goes on in There, Anyway?, Canning described some indicators of a sexual addiction, and what goes on during a typical day of sex addiction treatment. Canning was also quoted in a Time.com article, What Happens in Sex Rehab?
On a related note, the work of The Meadows Senior Clinical Advisor Pia Mellody was described in an article on love addiction on Albany.com. The article outlines Mellody's book Facing Love Addiction: Giving Yourself the Power to Change the Way You Love , and describes the symptoms, causes, and steps to overcome love addiction.
For more information on the treatment of sexual addiction, visit The Meadows, The Meadows Dakota or Maureen Canning’s Sexual Addiction Blog.
Note: This article was originally published in the Fall 2005 issue of MeadowLark, the magazine for alumni of The Meadows.
Remembering Who We Are: Tools to Gain Clarity
Kathleen O'Brien, LCSW
"I want to change, but I don't know how."
How many times have you heard yourself utter these very words? Most people come to counseling knowing that their lives need to change, but they often don't feel confident enough in their abilities to make that happen.
Confusion about what is most important can lead, at the very least, to poor choices and mildly co-dependent behavior and, in the extreme, to serious addiction problems.
It doesn't work for us to behave in ways that go against our own values. We can suffer depression and/or anxiety when we ignore what we believe to be most important. We then "treat" our unhappiness with self-destructive behaviors, such as dysfunctional relationships, substance abuse, irresponsible spending and so forth. One poor choice leads to another, and soon we find ourselves at the bottom of a very deep hole.
That downward spiral is daunting, to say the least. My experience both personally and professionally has shown me that, in order to make a significant life change, we need to remember who we are, i.e. to have clarity about what we value most.
The truth is that most people know intuitively what is most important to them. When a client finds herself in a predicament, I ask what she would tell a son or daughter to do in the same situation. Almost without fail, she has an instant answer for the problem at hand. It is as though she can access her wisdom for someone else's benefit (especially her child's), but not for her own. It's not that she doesn't know the answer; she just doesn't feel entitled to act on her own behalf. As a result, she usually doesn't develop the skills necessary to get her needs met in a healthy way.
Take a few moments to ponder the following:
The point here is to focus on remembering who you are. Pia Mellody calls this "remembering that you are precious."
Over the years, I've tried many techniques to help clients clarify how they feel and what they value. I call this "accessing one's own wisdom." Here are some techniques I've found helpful:
In conclusion, remember that the way to heal yourself is to know who you are and to live according to what is true for you. When a person acts in truth, it resonates down to the cellular level. You are your own best healer!
Note: This article was originally published in the Summer 2008 issue of MeadowLark, the alumni magazine of The Meadows.
Science and Ancient Wisdom: Treatment Here-and-Now
Before reading further, take 20 to 30 seconds to do this exercise: Let your gaze leave this article and let your eyes look around wherever, and at whatever, they want - just 20 seconds or so. (Really, try it, and then come back to reading.) People in my Somatic Experiencing® (SE) Trauma Treatment courses who try this are surprised that, in a very short time, they feel noticeably more relaxed, peaceful, and in the "here-and-now." Some say they should do this all the time!
Thanks to the forward-thinking people at The Meadows, the connection between trauma and addiction is better understood and more effectively treated. Part of this treatment at The Meadows' extended-care facilities consists of working with the trauma-resolution skills of Peter Levine’s Somatic Experiencing®. The relationship between trauma and the exercise you just tried is that, according to Bessel van der Kolk, post-traumatic stress is fundamentally a disorder in the ability to be in the here-and-now. This means that the state of- the-art in trauma therapy is no longer intense regressive or cathartic therapy. Instead, state-of-the-art therapy is the process of becoming alive to the moment.
For those I train in SE, like those at The Meadows, working in the here-and-now is a cornerstone of clinical theory and practice. When doing his dissertation decades ago, Peter Levine met Stephen Porges and explored his research. Porges' "Polyvagal Theory" (Porges, 2001) shows how one pathway of the nervous system engages freeze and another relates to social engagement. Levine discovered how to work with the transition of the nervous system through these phases (freeze and engagement), as well as the phases of fight and flight. This is SE. This article’s focus is on the engagement phase, which must be integrated into all other nervous system phases.
While Porges' emphasis is based on single linear phase transitions, in SE we work with non-linear and rapid cycling states, for instance, freeze and fight, or flight and orientation. Traumatic symptomology such as intrusion of fight, flight and freeze means that the past has become the present. Flashbacks are the classic example of such disorientation - innocuous cues can trigger an all-out response. In other words, the person temporarily experiences a state that is disconnected from the actual here-and-now environment. One of the antidotes to this traumatic recollection is orientation. I provisionally define orientation as "connecting to the environment through the senses" - in other words, coming back to our senses. This is a broader understanding of engagement than social engagement, per se. For clients whose early life experiences were marked by trauma and abuse, social engagement is actually a trigger for fight, flight and freeze. In this process of orientation, rather than being inundated with a cycle of feelings, thoughts, and sensations associated with unresolved trauma, the client's attention can be directed to the reality of the environment that is available through the senses. Typically we see decreased blood pressure and decreased heart rate, as well as the subjective experience of greater relaxation and interest. In other words, it is the difference between stopping to smell the roses and reliving getting stuck by a thorn!
With many severely disoriented clients, much of the initial therapeutic work (in addition to establishing rapport) consists of the stabilization that comes from establishing better cognitive pathways or habits of here-and-now sensory attention. In attending to the sensory experiences of the external world, physiological mechanisms for assessing safety are allowed to occur without undue influence from traumatic memory. The mechanisms of this assessment are far too important, in a survival sense, for the slow processing of linear thought or conscious effort. Porges aptly names this subconscious process of safety assessment "neuroception" (Porges, 2004). Thus, a natural orientation to the external environment via the senses facilitates the neuroception of safety.
This approach is receiving increasing scientific and popular attention (Time Magazine: Mind & Body Special Issue, January 27, 2007, pp. 55ff). Whether incorporated into CBT, DBT or meditation, the role of the observer is crucial. The process of orientation is fundamental to this cognitive activity. However, many traditions that recommend observation may not adequately reinforce with clients the importance of orientation to the outer versus the inner environment. For those with significant disorientation, it is nearly impossible to track the interior landscape without being involuntarily drawn into what SE terms the "Trauma Vortex." The involuntary and repetitive attraction to this "vortex" is the disruption of the approach-avoidance system, and it is one of the dynamics that underlies addiction and compulsive behaviors in general. Although somatically informed therapists draw from Levine's work, they often make the mistake of inviting clients' attention to the inward sensate experience, without consideration to the vital criteria that indicate whether a client can negotiate such attention without reactivating and reinforcing trauma states. For instance, one of the most common beginner's mistakes is when a therapist asks an anxious client to focus on that sensation in the body. For some clients, this can work well and provide a sense of relief and transition to a more relaxed state; for others, this can lead to further discomfort and other states of disintegration. It is vital for the therapist to immediately and accurately assess the client's capacity in order to determine the appropriate intervention. Without such assessment skill, the safer route is to begin with external orientation, which can stimulate the innate orienting response and build stability.
Once relative stability is attained, a balance of interior and exterior attention can be facilitated. Then a more neutral and practiced observation of the range of experiences can be enjoyed, as the attention can shift naturally between affective experiences, both positive and negative. (This fundamental process at the heart of SE is known as "pendulation," which I discussed briefly in the Summer 2006 edition of The Cutting Edge) This natural swing between polarities is the normal condition of the balanced nervous system. And interestingly, the resulting integration that comes from this innate oscillation is a broader and more nuanced life in the here-and-now. The experience brings awareness, presence, and a greater ability to experience life on its own terms, without undue constriction or elation. Obtained after significant work of attending, this resulting state can yield an expanse of awareness with an increasing ease of relation and a connectedness to everything that is. This state, known among meditative adepts, is simply our human mind freed of its overlay of conditioning hewn by survival networks related to approach-avoidance. Freed from the dominance of an ill-conditioned approachavoidance paradigm, one enjoys engagement with what is now, new and alive. And so, as clinicians, we can orient to the fact that we live in a time of opportunity, when mind and body are becoming reacquainted, and when science can shake hands with ancient wisdom.
Hoskinson, S. (2006) "SE's Systemic View of Functional Reward Systems." The Cutting Edge, Summer 2006. See TheMeadows.org.
Porges S. W. (2001) "The polyvagal theory: phylogenetic substrates of a social nervous system." International Journal of Psychophysiology, 42, 123-146.
Porges, S. (2004) "Neuroception: A subconscious system for detecting threats and safety." Zero to Three [Online] National Center for Infants, Toddlers and Families. No. 5, May. See zerotothree.org.
Stengel, R. (Ed.). (2007). The brain: A user's guide [Mind and body special issue]. TIME, 169 (5).
ABOUT THE AUTHOR
STEVEN HOSKINSON, MA, MAT
Under the auspices of Hoskinson Consulting in Encinitas, California, Steven Hoskinson, MA, MAT, is an international consultant and trainer for clinicians and trauma treatment providers. Steven is a Senior International Instructor for the Foundation for Human Enrichment and has done research in creativity, myth and spirituality. His perspectives include evolutionary, developmental, cognitive-behavioral and systems approaches within a mindfulness framework. Other major influences include personal mentoring with Peter Levine, PhD, more than 20 years of experience in the contemplative arts, and a decade as a practicing aikidoist. www.HoskinsonConsulting.org
Maureen Canning, Clinical Consultant for The Meadows, recently discussed the topic of sexual addiction with Dennis Miller at Behavioral Health Central. In the interview, Canning explains many topics, including:
To listen to or read a transcript of the interview, visit the Behavioral Health Central website. To learn more about inpatient treatment for sexual compulsivity, visit www.themeadows.org, or for information on extended care for sexual recovery, visit www.themeadowsdakota.com
Note: This article originally appeared in the Spring/Summer 2009 edition of MeadowLark, the alumni magazine of The Meadows.
Would You Marry Yourself or Someone Like You?
By Debra L. Kaplan, MA, LAC, LISAC
Many magazines today offer practical advice and "how-to" strategies to pursue the man or woman of our dreams. Let's face it: Sexy taglines and catchy subtitles make for good print copy, but they do little to help us build healthy, sound relationships. By projecting our wants, expectations or intentions onto our partners-to-be, we serve only to foreshadow the inevitable relational demise. It is as if we incorporate our obsolescence from the very start.
"How is that possible," you may ask, "when I'm doing all the right things, paying close attention to selecting my partner, and looking at what he or she has to offer the relationship?" While I admit that these words sound counterintuitive, first consider this proposition:
Would you marry yourself or someone like you? Do you like the person you are - and that which you have to offer - enough to marry yourself?
Some time ago, I put this question to a client. In his plunge toward self-pity, he began to lament the state of his personal affairs, citing one futile relationship after another. "I don&'t know what else to do," he said with exasperation. He cynically sneered, "Just when I think I've found someone 'special' and things are going 'swell,' she leaves me. How does this happen that I pick women who cheat on me, time after time?"
That's when I asked him to humor me, as I was about to ask a question that might sound strange. "Geez, no," he answered. "I wouldn't marry anyone like me!" He went on to state that he was amazed that anyone liked him at all. That response, or a variation of it, often followed when I posed the question to clients.
Courage to look at our own fallibility and dark sides goes a long way in building healthy relationships - not just in romance, but in all of our personal interactions. Knowing our dark sides involves embracing those aspects of ourselves that cause us shame or guilt. While our tendency might be to bury or dismiss the parts that we don't want to acknowledge, this undermines the positive changes and inner strength we strive toward.
Initially, our tendency might be to assess what our partners bring to the proverbial party - without assessing what we have to offer. Are we emotionally available? Do we remain open to constructive criticism and risk being known, or do we defend ourselves into isolation, staunchly committed to our self-righteous deception? Is it okay to be lonely just as long as we are not "wrong"?
These are hard yet essential questions. Only when we like ourselves will we attract the same positive energy in others. The journey to know spiritual peace and fulfillment is an inside-out endeavor.
The first step begins with defining what we want to change about ourselves - and being honest about who we are. If we are too close for honest introspection, we can start by observing others' behaviors. Those behaviors we find uncomfortable or unpleasant reflect our internal barometers. Essentially, by noting unlikable behaviors in others, we face reflections of our true selves.
Defining what we want to change takes an honest assessment of what we reject in ourselves. How often are we drawn to attractive people while believing, deep down, that we are not equally attractive? When we accept and love our own qualities, we form the strongest foundation for intimacy.
By taking that simple but profound step, we begin the enlightened journey toward inner peace and fulfillment. As propositions go, there is no better partner with whom to say "I do!"
ABOUT THE AUTHOR
DEBRA L. KAPLAN, MA, LAC, LISAC
Debra L. Kaplan is a practicing licensed therapist in Tucson, Arizona. She integrates her training with Pia Mellody into her work with CPTSD and co-occurring addictions.