Upon arriving at The Meadows, many patients are charmed by the view of equine activities at nearby ranches. They frequently ask about having Equine Assisted Psychotherapy (EAP) as part of their primary treatment program. As a direct result of these requests, EAP is among the newest offerings coming to The Meadows. The initial challenge was finding a provider who was knowledgeable about both EAP and The Meadows' unique model of treatment. Molly Cook, LCSW, LISAC, has experience as a family and primary counselor at The Meadows, as well as at other addiction treatment centers; she also has been trained in EAP by the Equine Assisted Growth and Learning Association (EAGALA). Working around horses since she was a teen, Molly has significant experience using EAP in her private practice. She now blends her EAGALA training and her experience with The Meadows' model into effective therapeutic sessions.
Equine Assisted Psychotherapy supports patients in recognizing the life patterns that create obstacles for them. By incorporating horses, EAP allows individuals to experience how those patterns play out with someone other than family or friends. Participants learn how to relate to others - and their own addictions - by interacting with horses. Horses are dynamic and living beings who have fixed roles within their herd, much like the roles in a family or group of friends. When humans are introduced to horses, they are incorporated into the horse herd and its social structure. In this joining, the horses start to recognize and reflect the unspoken emotions of humans, demonstrating exactly what human body language tells them. In this demonstration lie metaphors and lessons about the patients that can facilitate change. A healing bond encourages the recognition and change in behaviors. Because of the intimacy that can develop between humans and horses, positive results can start immediately.
For example, a recent patient was struggling with her role as a victim due to childhood traumas. By interacting with the horses, she was able to recognize her previous reality about herself and see that she was precious in her own right. Her role as a victim disempowered her; as she experienced EAP and gained more self-knowledge, her new confidence and skills enabled her to begin to see her own power. She was able to set boundaries, express her needs, share her feelings, and face her fears and anxieties - all without her previous coping mechanisms. Through interaction with horses, she gained the confidence necessary to use these new tools in her life. She gained a sense of self-trust and continues to use her newfound skills to build the self-assurance needed to face the issues of day-to-day life.
During treatment, new coping skills are taught to patients who need new ways to deal with past trauma and addictions. In EAP, these new coping skills are demonstrated, practiced, and reinforced. This experiential modality allows patients to utilize the knowledge gained at The Meadows. It then provides the opportunity to apply the tools learned in treatment to real-life situations. In addition, patients who are struggling with releasing old behaviors, ideas, patterns, and thoughts can be challenged with a new therapeutic technique that mirrors the reactions of those around the patient. The size of the horses allows patients an opportunity to overcome fear and develop confidence. While interacting with horses, patients have the ability to integrate boundary work and reinforce coping skills, such as expressing their needs or asking for help. They also develop intimacy with those around them. Patients who are resistant to letting go of old patterns or ideas can utilize EAP models to see the lack of control their old ideas bring into their lives. In treatment, patients gain information and knowledge. However, without practice, patients may not be able to make the necessary changes. EAP allows patients to enhance their new knowledge with experience that helps to solidify personal changes.
Equine Assisted Psychotherapy is an experiential, interactive, hands-on mode of therapy that can help patients see any issues that have been blocking progress in treatment. With the dynamic medium of equine assistants, patients can see which ideas work and which don't.
Anyone can participate in Equine Assisted Psychotherapy; no prior horse or riding experience is necessary. It is completely safe; no riding is involved, and all activities are done on the ground under the supervision of equine professionals.
Admittedly, I have never met Jerry Siegel, co-creator of Superman, the fictional comic book superhero. Had I been granted the opportunity, I first would have thanked him for the borrowed Superman metaphor I often employ in therapy with my clients. Then I would have asked him if Krypton, Superman's native planet, held any resemblance to Mr. Siegel's own homeland of Cleveland, Ohio.
As it was written, Superman was jettisoned to earth in a rocket ship only moments before Krypton exploded into smithereens. Krypton's demise was due to its unstable radioactive core, perhaps a deliberate tribute to Cleveland's Cuyahoga River, infamous for its frequent fires on the water caused by pollution slicks.
I mean no disparaging sentiment for the Clevelanders reading this, but I can't but help wonder: What did Mr. Siegel have in mind when he decided that the one and only element that can strip Superman of his superhuman powers - and perhaps even kill him - is the element that comes from his home planet? The reference is too obvious for this therapist to ignore. Better yet, it's too beautiful a talking point to overlook.
I want to know how Mr. Siegel felt about his family of origin. Was the family contentious and dysfunctional - or warm, connected, and validating? Was Krypton like the home of Mr. Siegel's own family of origin? I'll never know, because Jerry Siegel died in 1996, and his co-creator, Joe Shuster, died in 1992.
Were it not for holiday family gatherings - and oftentimes destructive family feuds - I wouldn't need to employ my cautionary but appropriate reference to Superman. Every year, as Thanksgiving approaches, not a week goes by that I don't pull Superman out of hiding and speak of his comic-bound strength and invulnerability. I ask, "What is the one thing that renders Superman powerless?"
I'm often met with a bewildered look. Those clients old enough to remember mumble, "Kryptonite?"
I quickly exclaim, "Kryptonite! Exactly!"
"And where," I ask, "does Kryptonite come from?"
"Krypton?" they ask more enthusiastically.
I confess to my clients that I cannot say what Jerry Siegel had in mind, but it is ironic that Superman could be stopped by only one thing: an element from his homeland. Even the most therapy-savvy among us, those who have risen out of dysfunction and family disorientation, are rendered powerless while returning home for the holidays. It can seem as though time has stood still, waiting for our return to fill the family roles-of-old.
As much as we'd like to think we've arrived at therapeutic transcendence, returning to our families of origin during the holidays often challenges our ability to maintain self-care and personal boundaries. It takes mindful awareness to remain immune from family havoc, and such success is not always achievable.
By way of my comic book metaphor, I remind my clients that even the strongest among us is susceptible. Even though a luscious glance from Lois Lane couldn't bring Clark Kent to his knees, Superman was susceptible to the destabilizing effects of Kryptonite. So we seek progress, not perfection. And as the holidays approach and we find ourselves facing a trip to Krypton or Cleveland we have choices: Stay home, or go visit the family. Just take along your favorite superhero for protection.
The holiday season can be a time of joyous celebration with our loved ones, a time when we begrudgingly drag ourselves to dreaded events, or a time when feelings of loneliness can be overwhelming. For many of us, some combination of all three is present this time of year. In many cases, the holidays are a time when stressors, triggers for relapse, and old wounds are more abundant.
This season also brings the opportunity to continue or start off the new year in recovery mode. We at The Meadows would like to offer you a 12 Step plan for doing just that. We honor the work that many of you have done to re-engage in your life, leaving old habits behind. We also honor those who continue to struggle with addiction. Below is a 12 Step guide for surviving the holidays in sobriety - "the 12 Steps of Holidays Anonymous," if you will. (Disclaimer: The steps below are loosely based on the 12 Steps of Alcoholics Anonymous and are not a replacement for them.)
The 12 Steps of Holidays Anonymous
1. Make sobriety your first priority. Acknowledge the vast amount over which you are powerless (your family situation, the location of events, etc.). Be aware that you are, however, empowered to choose to maintain what you have lovingly worked so hard to achieve. Assess what you want and need for your sobriety and relational engagements with others.
2. Believe that you can be restored to sanity. Plan ahead and have realistic expectations. If your family looks more like The Family Stone than Ozzie and Harriett, ground in reality and be open to the flaws and imperfections of your family system. Detach from expectations and practice acceptance and forgiveness.
3. Turn your care over to a higher power, or at least someone with more experience staying sober during the holiday season. Have a safety plan. Speak with your support network prior to the holidays and share any concerns and plans. Remember that, in previous years, many of your peers in the program have survived and thrived during the holiday season. Some common techniques used in the recovery community include driving yourself to events so you can leave whenever necessary, taking the number to a taxi service if driving yourself is not an option, asking a sober friend to accompany you, or hiring a sober escort. Keep in mind: The impact of bringing someone with you or leaving an event early is small compared to the impact of a relapse on your relationships with your loved ones and self.
4. Make a searching and fearless inventory of yourself, and practice boundaries and grounding. Setting limits is a loving and respectful thing to do for yourself and others. If you have awareness that you are willing and able to participate in a holiday activity for one hour rather than five, set a limit with yourself and share this limit with your loved ones or holiday celebration peers.
5. Admit to God, self, and one other person any concerns and potential triggers you may have going into the holiday season. Remember: Those around you cannot support you unless you are willing to be rigorously honest with yourself and your sober support system, i.e., your sponsor, home group, and therapist.
6. Be entirely ready to remove all defects of character. Remember this is for you only; your willingness to assist family members in identifying and removing their defects of character before they are ready avails no one and is NOT relational.
7. Humbly ask the higher power of your understanding to remove your shortcomings, recognizing that your shortcomings do not subtract from your value. Be respectful of others. If one of your tendencies is to judge others, make a resolution to contain your comments on Uncle Marvin's lovely twinkle-light reindeer sweater (not that there's anything wrong with battery-operated clothing).
8. Make a list. Chaotic, last-minute trips to the mall can be destabilizing and stressful. Honor yourself by not overextending to make others happy. Take a personal inventory of yourself and your finances. This is a self-care technique that can help you turn inward and avoid future resentments. Also, don't forget to include yourself on your gift list. Gifting oneself, in a moderate way, is an act of self-care and acknowledgment.
9. Make direct amends, except when doing so would injure others. Remember that one of the ways to make amends is with living amends. You can do this by maintaining your sobriety, acting within your value system, and being respectful of others. You may believe this is a good time to speak with those you have harmed, but do so with conscious thought. Grandma may prefer to spend her holidays watching the grandchildren unwrap gifts rather than discussing a way you can pay her back for totaling her car.
10. Continue to take personal inventory and, when you are wrong, promptly admit it. Remember HALT (the basics of self-care: Hungry, Angry, Lonely, Tired). In times of stress, we become more susceptible to allowing some of our defects of character to leak out. If you act outside of your recovery and value system, make prompt amends to avoid allowing unnecessary feelings of guilt to overtake the celebrations.
11. Seek through prayer and meditation; the holiday season can be busy and, in some cases, stressful. This is not an excuse to skip your morning meditation, meetings, or time with your sponsor. This is a time to hold these commitments even more strongly, or to kick it up a notch. Prearrange your meeting schedule and ensure that connection, sobriety, and self-care remain top priorities. It may come in handy to repeat the Serenity Prayer in your head as Uncle Jack attempts to dominate the season with his thoughts on the current political climate. This allows you to remain connected with your higher power and accomplish relational objectives, all while nodding your head during his share.
12. If you have had a spiritual awakening, try to carry this message: Acts of service can help us to reground, stay connected to our program, and just feel darn good! The holidays can be an important time to practice gratitude and giving. If your holiday plans this year are not what you had hoped for (or even if they are), volunteer to be a sober escort, speak at a meeting, or volunteer to clean up after one. Remember: Whatever your season looks like this year, it’s still a lot better than holidays spent living in addiction.
We at The Meadows wish you a sober, safe, and successful holiday season.
In "Fabled Truths and Family Lies," published in the Meadowlark Summer 2010 newsletter, I wrote about a client's experience with childhood sexual and emotional abuse, her skewed self-doubt, and her perceptions surrounding that abuse in her family-of-origin.
Specifically, I addressed the challenges that arose for Leah* as she confronted her family's collusion and denial regarding the abuse perpetrated by her father. The article explored Leah's heroic, albeit painful, journey into recovery as she turned a reflective lens inward on her own need for healing. By so doing, she rejected and separated from her family members' need to preserve their own version of the events.
That article hit an emotional nerve with many readers and, in the ensuing months, I've received several emails expressing relief and appreciation for the topic.
I also received a letter from a reader who described her own struggle with her decision to separate from her family-of-origin in order to begin her journey of healing. In her letter, she posed the question of whether her journey toward healing, which involved both physical and emotional distance from her family, was worth the price. That price, she went on to say, came in the form of missed opportunities to be with her family, emotional and physical distance from them, and the loss of a family bond. This reader closed her letter with this question:
"When we separate from dysfunctional family systems, are we in fact hurting that system? Or are we perhaps contributing to its healing by the void we leave in our place?"
There is no ONE correct answer, as each family system has its own fluid and relational dynamic. The healthier and preferred option for one individual (e.g., staying involved in an attempt to affect change) may not be applicable or recommended in another family system with different dynamics. The interaction that distinguishes one family system as healthier and adaptive might not be operative in a more dysfunctional, rigid, or disengaged/enmeshed family.
There are times when a void left by our absence beckons the very change we sought to achieve by our presence.
As a therapist, I often address such therapeutic quandaries. What one individual chooses to do in one circumstance may not be the best course of action for another, even when different individuals make those decisions within the same family unit. Hence, decisions made by siblings or other family members may be different, as each member's relationship to the family system is different.
Inevitably, all decisions that we make for healthy recovery come with consequences. This might be the only certainty: that a consequence is certain.
I often ask my clients to play out a proposed decision to their end. In so doing, I ask them to remain mindful of likely outcomes and, more importantly, to be aware of outcomes that are potential or perceived. As we work through this process, my clients must weigh the emotional, physical, spiritual, sexual, and financial cost/benefits of their decisions.
Leah's decision to separate from her family led to her desired outcome of healing and recovery. For another individual, staying in contact with her family - while using boundaries and increased self-care - may lead to, but by no means guarantee, the desired changes in the family system.
Easy, straightforward answers are rare. In matters concerning our families-of-origin, our only guarantee is that we will struggle in our path to serenity.
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.
Romantic Relationships in Recovery
By Rabbi Shais Taub
There's an old piece of sage advice that old-timers in recovery like to say: "No relationships for the first year." If you hang around long enough, and watch enough people come and go, you'll see that the old-timers are right.
But why is getting intimately involved with another person so damaging in early recovery? And if it is a threat in early recovery, why does it somehow become all right later on?
All addiction is essentially addiction to self. Recovery is a spiritual growth process that enables the self-centered person to become available to make connections outside of self.
In other words, in active addiction, every connection is ultimately a connection to one's own ego. Even when it seems like I am connecting to you, I am really only connecting back to myself. It's like the old fable of the salmon who gets caught in the fisherman's net and hears him exclaim, "Oh great! A salmon! I will bring this to the king because the king loves lox." The salmon thinks to himself, "This fisherman is not very nice. He has taken me from my home. But he says that the king loves lox. The king will love me and be kind to me." The fisherman rushes to the palace and shows his catch to the palace guard, who immediately opens the doors, saying, "I will take you immediately to the royal chef, because the king loves lox." The salmon thinks, "I hope they get me to this king who loves lox already." They run to the royal kitchen, and the royal chef shouts with glee, "Bring the fish to me! You know how the king loves lox." Again, the salmon thinks, "Finally, when this lox-loving king arrives, I will be saved." The king enters the kitchen and watches with relish as the chef guts the fish on the table. The salmon suddenly realizes that he is to be the king's lunch and, with his last breath, mutters to himself, "These humans don't know what love is! They say the king loves lox, but he only loves himself."
The inner addict is like the king in this story, and the addict's "beloved" is like the salmon. The addict is incapable of being truly intimate with another person; the closer the addict tries to get to another, the closer he is to himself. This explains a seeming paradox: One of the best things an addict can do to start recovering is to hang out with and befriend other addicts, while one of the worst things an addict can do to start recovering is to become romantically involved with other addicts.
As the addict recovers, however, and learns life skills that enable him to move away from complete self-interest, it becomes increasingly possible for him to actually become close to another person. One of the ultimate objectives of recovery is to be able to form loving relationships with others. The ability to be involved in a romantic relationship is not just an indication of good recovery, but one of the goals of recovery.
Many times people stagnate in what we might call "the middle stages" of recovery. They basically get their lives together, but they never become capable of being involved in an intimate, loving, committed relationship. Many, unfortunately, are jaded by past heartbreaks; they say, "I'll never love again." That is, in my opinion, a great loss. Just as addiction is a destroyer of intimacy, recovery is the greatest catalyst for intimacy. Good recovery means good relationships. Indeed, I would venture to say - although this may be outside the scope of this blog post - that every troubled marriage, even when no addictive behavior can be identified, is lacking recovery.
In the end, it all depends on how you see it. If romantic love is something we see as "icing on the cake of recovery," then we're probably not ready for it. If, on the other hand, we see an intimate relationship as an obligation toward the god of our understanding, then not only are we ready for it, we are actually required to give of ourselves in this manner.
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.
Spoken Agreements and Silent Arrangements
Debra L. Kaplan
M.A., CSAT-3, EMDR-II
During a particularly tense session of couple's therapy, Kelly turned to Robert, her partner of eight years, and said, "You agreed that you would work at paying down your debt, but I don't see you doing that!" Robert, clearly offended, sprang forth with anger: "What right do you have to accuse me when I work hard everyday, just as hard as you do?" Kelly was about to go for his therapeutic jugular when I interrupted her.
"Kelly, when you met Robert, what information did you have about his financial situation, and what information did you choose to ignore?" I understood the situation, as this was a topic often addressed in couple's therapy.
When they met and started dating, Robert was dealing with a recent bankruptcy, and his financial situation was fragile. As Kelly described it, "Robert was reeling from a business deal gone awry, and he was doing the best he could to get back on his feet." Robert promised Kelly that, due to his business acumen, his situation would be short-lived. He maintained that he would bounce back from his mounting debts.
Although Robert's promise of financial rebound didn't materialize, the two moved in together early in their relationship. Before long, they started arguing about finances. Every few months, they came to resolve their issues in therapy - only to back away from the most obvious of issues between them. Kelly had agreed to move in with Robert based on what she knew, and she had chosen to avoid asking questions that would have helped her make a healthier decision.
This relationship, and many others like it, operates on two levels of understanding: The first level speaks to agreements based on information we know, and the second level speaks to the silent arrangements we make based on information we ignore.
Kelly knew about Robert's financial situation but chose to ignore the fact that he was struggling to make ends meet. Kelly also chose to ignore the fact that, rather than paying off his debts, Robert continued spending his money and building financial stress.
How many times do we venture forth in romantic relationships, despite our "our gut instinct" telling us that it isn't right? How many relationships begin with the ominous belief that "I don't care for her/his friends, but once we're together, s/he will change?" If we remain committed to blind hope or desire, we ensure relational demise.
We treat our relationships with ourselves as less important than relationships with others. We allow our hopes and/or desires to push us forward, "eyes wide shut." We risk losing our true selves as well as our potential for enduring positive change.
We often know more than we think we do when we make decisions regarding relationships and life choices. Because we cannot come to grips with the outcome, we often tune out important knowledge in lieu of walking away or sticking to what we know is right. At times, the very information we need in order to have a solid relationship is the very information that we neglect, even when it is in plain sight.
In the case of Kelly and Robert, his bankruptcy resulted from a less-than-stellar work ethic and poor choices. This did not change when he moved into Kelly's house, but she chose to ignore this vital information. Her need to have Robert move in was stronger than her need to ask for more information. Had she asked questions, Kelly may not have moved forward in the relationship. While that would have been painful for her, it would have been less painful than eight years of emotional turmoil, financial ups and downs, and unresolved relationship cycles.
The act of recovery means living life on life's terms and, at times, this means disappointing ourselves and/or another. Recovery demands that we be willing to disappoint ourselves and others in order to live healthy, fulfilled lives. Meeting the demands of life on life's terms is a formidable challenge for many of us. More difficult yet is the challenge to set and meet our own demands while being honest with ourselves. This rigorous honesty is no less necessary in a relationship. We must ask the tough questions and act upon reality as it is, rather than how we wish it to be.
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.