Todays Date:
Inspiring Success on the Road to Recovery

Tuesday, August 6, 2013

When Addictions Collide

By Lesley L. Williams, M.D.

For women and men with co-occurring eating and substance abuse disorders, the two issues form concentric circles. Sufferers typically have the same predisposing genetic and environmental factors where the circles intersect. However, there may be some aspects that are unique to each disorder. At the core, the eating disordered behaviors and substances are used as tools to cope with underlying issues. Treatment can be very challenging. It involves abstinence from substance use and bingeing and purging behaviors with simultaneous exposure to normal eating habits. The multiple moving parts involved in the treatment of both disorders can make recovery a slow and methodical process. Typically, as the symptoms for one improve, symptoms for the other exacerbate. That is why it is necessary to treat both aggressively and simultaneously.

Eating and substance abuse disorders are a common marriage because they share so many characteristics in common. Patients who suffer from both are likely to have low self-esteem, anxiety, depression, prior physical or sexual abuse and a family history of substance abuse or eating disorder. They are also individuals who tend to be vulnerable to social and societal pressures. Both disorders impact the brain similarly. Those who suffer from the disorders describe intense cravings, a preoccupation with thoughts regarding the substance/ED behavior, compulsive use of the substance or engagement in the ED behaviors and secrecy regarding those behaviors Research by the National Center on Addiction and Substance Abuse at Columbia University found that “Up to 50 percent of individuals with an eating disorder abuse alcohol or illicit drugs compared to approximately nine percent in the general population. Up to 35 percent of alcohol or illicit drug abusers have an eating disorder compared to up to three percent in the general population.”

One aspect of eating disorders that is unique when compared with substance abuse is the inability to completely abstain from the substance of choice- food. In order to survive and maintain optimal health, we need to eat at least 3 balanced meals daily and preferably 3 snacks. That requires eating disordered patients to have to navigate use of their “drug of choice’ up to six times a day. Singular substance abuse treatment allows sequestration from the substance of abuse in a safe and secure environment. Eating disorder treatment cannot provide that same isolation. The challenge is like asking an alcoholic to drink six cocktails daily and maintain control.

Treatment from both eating and substance abuse involves developing alternative coping skills. In both instances, the maladaptive behaviors serve a purpose. Whether they are being used to mask the pain of a less than nurturing childhood or express emotions that the person cannot verbalize, they are engaging in the behavior for a reason. The hallmarks of treatment are to identify the function of the behavior, address the underlying issue and teach more appropriate coping mechanisms. This can be a long and arduous process filled with triumphs and set backs. Even the most motivated person finds that dealing with all of this at once often feels overwhelming.

At Remuda Ranch, we are up to the challenge of effectively treating co-occurring substance abuse and eating disorders. We couple our rich history of eating disorder treatment with the innovative trauma and substance abuse treatment practices that we have learned from our partnership with The Meadows. Incorporating both, we are able to best equip patients for their journey to full recovery. If you or someone you know suffers from substance abuse and/or an eating disorder, please call us for more information.

Facts about Eating Disorders

62.3 percent of teenage girls report trying to lose weight (compared to 28.8 percent of teenage boys), 58.6 percent are actively dieting (compared to 28.2 percent of boys) and 68.4 percent exercise with the goal of losing weight or to avoid gaining weight(compared to 51 percent of boys).

19.1 percent of teenage girls fast for 24 hours or more (compared to 7.6 percent of teenage boys), 12.6 percent use diet pills, powders or liquids (compared to 5.5 percent of boys) and 7.8 percent vomit or take laxatives to lose weight or to avoid gaining weight (compared to 2.9 percent of boys).

Many individuals who engage in unhealthy weight-control behaviors or have full-blown eating disorders use or abuse substances such as caffeine, tobacco, alcohol, cocaine, heroin and over-the-counter medications such as appetite suppressants, diuretics, laxatives and emetics.

Caffeine is used to alleviate hunger or boost energy. People with eating disorders often consume large amounts of diet sodas which frequently are high in caffeine content.

People with eating disorders smoke cigarettes to suppress their appetite and provide themselves with an alternative oral activity to eating. The link between smoking and weight concerns can be seen in girls and women of all ages.

Alcohol abuse is common in people with eating disorders, particularly bulimia. Bulimic women who are alcohol dependent report a higher rate of suicide attempts, anxiety disorders, personality disorders, conduct disorder and other substance dependence than bulimic women who are not alcohol dependent.
Illicit drug use is particularly common among bulimics. Drugs such as heroin and cocaine are used to facilitate weight loss by suppressing appetite, increasing metabolism and purging.

In addition to appetite suppressants, other over-the-counter medications that are used by people with eating disorders — often inappropriately to facilitate purging — include diuretics, emetics and laxatives. Like substance abuse, the adverse effects of eating disorders are well documented and often quite severe, ranging from hair loss, tooth decay  and osteoporosis to heart failure and a destabilization of virtually all body systems. Severe cases may be fatal.
Eating disorders occur in five to 10 million Americans, mostly girls and young women. Although white, upper-middle class girls and young women are the primary victims, the population afflicted by these disorders is becoming more diverse.
 Western culture idealizes thin women and, as a result, many women equate being thin with self-worth. The advertising, marketing and entertainment industries, which inundate adults and children with iconic images of thin beauty, have become a major force in the development of women’s body dissatisfaction and disordered eating attitudes and behaviors. Women’s magazines contain 10.5 times more ads and articles related to weight loss than men’s magazines-- the same sex ratio reported for eating disorders. While the average American woman is 5’4” tall and weighs approximately 140 pounds, the average model is 5’11” tall and weighs 117 pounds.
The commercial world, including the diet, cigarette and alcohol industries, have not shied away from targeting women’s desire to be thin in order to promote their products. In particular, the tobacco companies understood the relationship between smoking and weight control long before the public health experts.

What Parents Can Do

To help prevent eating disorders and substance abuse in their children, parents should model and promote healthy, positive and reasonable messages about eating and exercise as well as consistent messages about the dangers of substance use.

What Schools Can Do

Schools should make it a priority to educate parents, teachers, administrators and coaches to recognize the relationship of eating disorders and substance abuse and intervene quickly and effectively.

Dr. Lesley Williams has been with Remuda Ranch since 2004. She is a Certified Eating Disorder Specialist and and passionate about the work she does with women and girls at Remuda. Her clinical responsibilities include medically managing the care of all adult and adolescent patients. She also oversees the nutritional aspects of their treatment. Dr. Williams graduated from the University of Kentucky College of Medicine. She went on to complete her family medicine residency at Mayo Clinic in Scottsdale, AZ. Upon completion of her residency training, Dr. Williams joined the Remuda Ranch medical staff. She is a member of the American Academy of Family Physicians and the International Association of Eating Disorder Professionals and certified as a Diplomate of the American Board of Family Medicine. In addition to her clinical duties, Dr. Williams continues to be an active participant of the Remuda Ranch “Speakers Bureau”.  Over the years, she has given numerous local and national presentations on a variety of eating disorder topics.

Visit www.remudaranch.com 

When Relapse Turns Deadly: What You Need to Know About Drug Overdose

By David Sack, M.D., CEO of Elements Behavioral Health

Friends and fans are reeling in the wake of Glee actor Cory Monteith’s overdose on a mixture of heroin and alcohol. Suffering a similar fate as Kriss Kross rapper Chris Kelly and others who have passed this year, his lengthy battle with drugs ended tragically on July 13 in his hotel room.
Could his story have ended differently? What can others learn from this tragedy? Monteith’s passing highlights important lessons for anyone who struggles with addiction or cares about an addict (which, with 23 million people suffering from addiction, is most of us).

While celebrity overdoses draw the public’s attention, 100 people die from drug overdoses every day in the U.S. After increasing every year from 1999 to 2010, drug overdose is now the number one cause of accidental death, surpassing car accidents. This increase is largely attributed to the epidemic of prescription painkiller abuse. The Centers for Disease Control and Prevention recently warned that more women are dying from prescription painkiller overdoses than ever before, a 400 percent increase in just the last decade.

A Post-Rehab Danger

It is a sad irony that rehab is life-saving, yet the weeks and months immediately following checkout are among the most vulnerable times in an addict’s recovery. It can take up to a year for the areas of the brain responsible for impulse control and emotion regulation to return to normal functioning. In addition, people are often still struggling with powerful drug cravings and then return to an environment where they are surrounded by reminders of their drug use.
Particularly when addicts receive short-term treatment (30 days or less), they haven’t had much time to address the issues underlying their addiction or practice their new coping skills. Old, familiar coping strategies remain far more comfortable and automatic. A recovering addict who thinks they’ve got their drug problem under control after a short stay in rehab is likely to return to life as usual rather than creating a new life in recovery, greatly increasing the risk of relapse.
Relapse is part of the disease of addiction
Many people go on to achieve lasting recovery following one or more slips. However, in the weeks and months following a stay in rehab, addicts need a great deal of education and support not only to protect their recovery but also their lives. The risk of accidental overdose rises sharply during this time, largely because of reduced tolerance.
People who use a drug regularly develop a tolerance for it; that is, they require larger doses to get the same effects. Just as quickly, tolerance can diminish. After even a brief period of abstinence, which often takes place in detox, rehab or prison, the brain becomes less accustomed to — or less tolerant of —the presence of drugs. As a result of this increased sensitivity, if an addict goes back to the same dose they used prior to rehab, they are at high risk of fatal overdose.
Most overdoses occur when multiple drugs are abused, most commonly alcohol, benzodiazepines such as Valium and Xanax, cocaine and heroin. Illicit drugs are often implicated in drug overdoses because their potency is unpredictable and they reach the brain rapidly. Other risk factors for drug overdose include taking drugs alone (two-thirds of overdoses occur when a person is using at home alone) and having experienced a non-fatal overdose in the past.
Most overdoses occur because the drugs that are used stopped the person’s breathing. This effect is most profound with opiates (drugs similar to morphine and heroin, including prescription painkillers). Overdoses due to prescription drugs now exceed all other causes and the tragedy is that many of these can be prevented by a simple and safe medicine that blocks the effects of opiates on breathing.
One approach is a medication called naltrexone. Naltrexone can be given as a single monthly injection (Vivitrol) that virtually abolishes the risk of an accidental overdose in someone who uses after treatment.

Why isn’t this being used more often? 

The answer is complex. Many recovering drug users don’t accept that they remain vulnerable to relapse. Family members don’t want to “make an issue” of going on Vivitrol when their relative is doing so much better at the end of treatment. Relapse is perceived by many as a choice, so they don’t believe a drug can make a difference.
The reality is that Vivitrol helps in two important ways: It decreases drug cravings, making relapse less likely, and it prevents an accidental overdose if the person slips so that a single bad choice does not become a death sentence.

A Long-Term Approach to a Lifelong Problem

Although many people believe that going to rehab is a permanent solution to a drug problem, it is actually the start of a lifelong process — a process that often involves an intricate dance of forward and backward progress. Relapse can’t always be prevented, but accidental drug overdose can. So what can be done?
The only sure-fire way to prevent overdose is to avoid using drugs. However, refraining from mixing drugs, using drugs alone, or using at the same level as before a period of abstinence are essential once the decision to use has been made. Loved ones can work with addicts on an overdose plan that covers who to call and what to do in the moments before relapse.
Follow-up care is another important protective factor. As a chronic disease similar to diabetes and heart disease, addiction requires ongoing care. Research shows that long-term treatment (90 days or more) improves outcomes, especially if the addict makes a gradual transition back into regular life. This may involve outpatient treatment, ongoing therapy, support groups or a sober living home.
Drug overdoses are among the most tragic outcomes of addiction. For most people, relapse is not the end of recovery; it’s another step on the journey. But those who accidentally overdose — often people who are sincerely trying to get better — make one miscalculation and suffer the only fate that means hope is lost.

David Sack, M.D., is board-certified in psychiatry, addiction psychiatry and addiction medicine. He is CEO of Elements Behavioral Health, a network of mental health and addiction treatment centers that includes Promises, The Ranch, Right Step, The Recovery Place, The Sexual Recovery Institute, Malibu Vista, and Spirit Lodge.www.elementsbehavioralhealth.com

The Controlling Self

By Mike Finecey, MA, LPC, LISAC

If our childhood included pain and we didn’t have someone to teach us what to do or we were unable figure out what to do, the controlling self was created.
The purpose of the controlling self is to instill necessary defenses and avoidances so we can survive the pain. Growing up, we learn what we need to do and what works or not to solve the emotional issues of our life. We also learn how to take care of what we feel, what we want and need to create a life where we can exist, and how to have control over our environment.
Somewhere around the sixth grade someone may have told us “don’t let them see you hurt.” This is an age where our brain begins to understand our surroundings and we begin to interpret and solve our problems of the day. Each of us at some time began to develop a defense system allowing us to have control over our lives.
Our defenses can be healthy when we have support from others, and we’ve been taught how to take care of ourselves in a healthy manner with healthy boundaries.
The rest of us needed a way to cope with the pain of being a child long before we knew how to resolve the hurt. And the effect as we grow older is to use defenses to find places to hide, numb out or simply repress. Some of unhealthy defenses can be rage and anger which pushes people away, people-pleasing, protecting ourselves from being rejected, showing a fake smile and not being authentic so one will know our core pain and hurt. Addiction is another route in which masks our pain.

Seeking Pleasure vs. Avoiding Pain

Addiction often times is disguised in the power of pleasure and can become a false god used to support the inability to cope with the reality of being “me”. How many times have we sought pleasure as a relief from pain? We’ll even argue that “getting high” is about pleasure. All the while, our reality is lost in the pleasure. The possibility exists that we rarely seek pleasure, but seek to remove ourselves from pain. We create a controlling self to keep the pain away and it is the controlling self that found addiction to minimize, ignore, hide, repress and deny the pain. Even the drug we choose can define the pain of our childhood. Opioids can be used by someone who has seen traumatic events as these drugs allow the addict to finally close their eyes in quiet and isolation.
Work, as an addiction is often used by someone who was never taught how to be vulnerable and intimate.
The controlling self, is often created long before the sixth grade and it had to develop skills to hide pain before our brain was developed to solve problems in a healthy way. The pain masked from childhood by the controlling self can also be a trigger no one notices.
When we are seven or eight and couldn’t deal with fear, more than likely we still do not know what to do with fear if it occurs today. If we believed we were not enough at nine, we may still believe it today. We may know the truth in our logical thinking, but emotionally, we continue to believe we’re not enough.

Choosing To Be Enough

As adults we need to make a choice of who’s running our life, a ten year old controlling self or an adult. We need to thank the controlling self for the job they did in keeping us from hurting so much. Without them, our fear may have overwhelmed us. Today, it’s time to thank that part of us and create a new direction of support and genuine self-care. We can choose to matter. The need to matter evolves from a fear of being alone; a fear of rejection or abandonment and can create neediness or shame that “I don’t matter.”
Today we must be responsible not to reject ourselves and realize no one has the permission to reject us without our permission. We can choose to be enough. The need to be enough evolves from a fear of being known; a fear of intimacy and can create shame that “I not enough” or “I’m unworthy.” We must be willing to be vulnerable and share who we are to be enough. When we believe we’re not enough, we will prove it. When we believe we matter, are worthy or enough, we will prove that too. We no longer need to control what we feel, but as adults learn to protect who we are, share what we feel and know what we want and desire to resolve our emotions in a healthy manner. Healthy boundaries along with healthy intimacy will create the person we want to be. To be the adult knowing  — we are worthy to be as we were born to be.

Mike Finecey, MA, LPC, LISAC is the co-founder and Clinical Director of North Pointe Counseling Center specializing in the treatment of Trauma, Abuse and Deprivation. He is the co-author and facilitator of Breaking Free...a Journey, a 20-hour intensive workshop that focuses on healing from traumatic life events. Breaking Free is offered monthly to the public and is privately contracted with organizations such as treatment centers and community-based foundations. For more information: 800-273-3429 or www.npccaz.com.

Brain Health Checklist

Aging can significantly change the way our brains function. As we get older, we become more likely to develop degenerative cognitive diseases such as dementia, Lou Gehrig’s disease, and Parkinson’s disease. While aging is unavoidable, many of the diet, exercise, and activity choices we make influence how well our brains perform over our lifetimes. Take a look at these brain-healthy social practices that can delay or prevent cognitive disorders and memory loss later in life.

Physical Exercise –
Muscles you don’t use begin to atrophy. Aside from keeping your body in shape, daily exercise has been shown to help prevent dementia and other diseases that lead to cognitive degeneration. Many experts say a daily 30-minute exercise routine can help you enjoy both improved physical and mental health.

Mental Stimulation –
Activities such as knitting, reading, and filling out crossword puzzles can reduce the risk of Alzheimer’s disease. Cognitive benefits occur with lifelong learners, so make sure to keep your brain engaged daily.

Prayer and Spirituality –
Scientists are continually baffled by intense displays of brain activity that are triggered by prayer and spirituality. No matter what faith or denomination individuals participate in, prayer and spiritual activities seem to increase moods, improve perception, and reduce stress. Dr. Andrew Newberg of the Myrna Brind Center for Integrative Medicine at Thomas Jefferson University uses imaging technology to show how various areas of the brain light up with activity, even as the participant remains still and silent. Morgan Freeman narrates a video about his research, called “Through the Wormhole: Your Brain on Prayer”. It details how the language and visual centers of the brain react during prayer. Many participants in these studies pray on a daily basis.

Living a Social Life –
Whether one is introverted or extroverted, our brains are wired to interact on a social level. The American Journal of Public Health has also noted that socially active individuals are less likely to succumb to dementia and other brain diseases. Those who live alone exhibit higher risks, so be sure to cultivate a wide social network and participate in group activities several times a week.

Meditation –
The potential effects of meditation are very similar to prayer – increased awareness, positive moods, and stress reduction. Meditation on a daily or weekly basis can help one experience some of these mental benefits.
There isn’t a single sure way to improve brain health and wellness. So many factors play a role in agile brain activity and memory maintenance that it’s difficult to parse them all out. However, the above steps are some of the best techniques we know of today. While aging is inevitable, these steps may help ensure a longer and more enjoyable life.
For more information and to read the report in its entirety visit http://www.onlinecollegecourses.com/2013/07/12/brain-health-checklist/

The Picture & The Frame

Sometimes I look around my house and all I see are projects. The light fixture in the living room needs to be rewired, leaves are clogging the rain gutters, and the Hibiscus hedge is due for a trimming. That’s just the beginning. For every project I get into, I notice three more to be done. This is a never-ending process. The day will never come when I will step back, look at my home, and say, “There—it’s done.”
When I saw the film Shining Night, (innerharmony.com) I received a reprieve from the onus of keeping the house perfect. This inspiring documentary about Morten Lauridsen, one of the world’s most gifted composers of chorale music, shows Mr. Lauridsen creating in his summer studio in the Pacific Northwest. I was struck by the humble, less-than-well-kept-up cottage in which this master creates his heavenly compositions. The house’s exterior paint is peeling, he composes on a slightly-out-of-tune piano, and creature comforts are minimal. The cottage is a launch pad for music that heals. Morten Lauridsen cares more about his music than the building in which he composes it.

A Course in Miracles offers a striking metaphor for the contrast between spirit and form. In a section called The Two Pictures (Text, Chapter 17) we are offered two pictures and two frames.
One is “surrounded by a frame so heavy and so elaborate that the picture is almost obliterated by its imposing structure. Into the frame are woven all sorts of fanciful and fragmented illusions . . . The glitter of blood shines like rubies, and the tears are faceted like diamonds and gleam in the dim light. . . Look at the picture. Do not let the frame distract you. . . The frame is not the gift.”
Then the course suggests another picture, the beauty of which far outshines the frame: “. . . if you accept this gift you will not see the frame at all, because the gift can only be accepted through your willingness to focus all your attention on the picture.”

The only purpose of a house, car, technological device, or body is to serve as a vehicle for the expression of love. As long as the form is a venue for the spirit, it is useful. When the form ceases to serve the spirit, or the spirit ends up serving the form, the system becomes dysfunctional, it will engender pain, and dissolve. When any relationship, organization, institution, corporation, government, or religion ceases to help its constituents and begins to exist only to prolong itself, it has outlived its usefulness. The entire universe is set up to support life; when the spirit becomes absent, the form has no purpose and it must disappear.
The good news is that for every form that dies because the spirit is no longer present, a new form will live because the spirit has taken up residence there. Spirit cannot be killed. When you move with the river of life, you will always be alive and everything you do will flourish.

Consider your home, career, relationship, and any organization in which you participate, and ask yourself, “Is this bringing me greater life, or is it draining life from me?” “Am I looking at a picture that heals and empowers me, or have I become entrapped in a gaudy frame?” While such introspection can be challenging, it is the door to healing and freedom.

For many years I have attended and taught manifestation workshops—how to get stuff. As I observe my own life and the lives of people who have manifested lots of stuff, I notice that we eventually became more interested in the de-manifestation workshop—getting rid of the stuff we have accumulated that we don’t need. At a farmer’s market I was tempted to purchase a beautiful blown glass dolphin with a soft gold veneer. Then I thought, “Do I really want one more thing to keep somewhere, clean, protect, and then store in the garage?” I asked Dee if she wanted me to get it for her. “I don’t think we need any more stuff,” she replied. We shared a contented smile and walked on.
Morten Lauridsen’s humble cottage is lowly to the eye, but a cathedral to the soul. The music he generates there, free from the distraction of upkeep, will change the world and bless it far longer than his cottage will. One day his cottage will fall to dust. His music will stream through the ages.

As a result of Mr. Lauridsen’s example, I have a new attitude to my house and my possessions. My home has become my friend, not my intimidator. When I look at the leaves in the gutter, I know I will get to them. But for now I will get to my writing, my beloved, and my family. The Hibiscus flowers are gifts, not obligations.

I am not against stuff. I am for enough stuff. The good stuff. The appropriate stuff. The stuff that is truly helpful. If you love something, it is enhancing your life, and you are using it for upliftment, it is holy stuff. If it is cumbersome or bringing you down in any way, you cannot afford it. May all of your frames only enhance all of your magnificent pictures.

Alan Cohen is the author of many popular inspirational books, including Enough Already: The Power of Radical Contentment. Join Alan beginning September 1 for his acclaimed Life Coach Training to become a professional life coach or incorporate life coaching skills in your current career. For more information about this program, Alan’s other books, free daily inspirational quotes, and his weekly radio show, visit www.alancohen.com, email info@alancohen.com, or phone (800) 568-3079 or (808) 572-0001.

Commitments – Are You In or Out?

You said it. You meant every word, and you intended to do what you said that you would do. But, it didn’t happen. What did happen? What is the most important behavior to building trust and creating long-term successful relationships of any kind? Keeping your commitments!
This is the one key factor that sets the highly successful people and relationships in a category of being honorable. Ninety percent of our personal and the world’s problems and divorces result from people failing to keep their commitments. Politicos, heads of state, family members, partners and friends can point to the moment a relationship became skewed and doomed, due to a broken commitment.

So can you.

When you break enough promises to yourself, it won’t be long before you don’t believe in yourself any longer and others no longer believe you either. Keeping commitments to yourself is the reference point for doing the same with others.  That’s not selfish- it’s self-loving.
When you fail to keep a commitment, your brain immediately starts looking for excuse or scapegoat. You didn’t have enough time to commit to complete the project. It’s just you, how or who you are. You had to buy that television at such an incredible bargain. That is an incredibly disempowering attitude that is void of any personal responsibility.

The truth is that you are responsible for EVERYTHING THAT HAPPENS IN YOUR LIFE and when you get that, you have stepped into a mighty place of empowerment. The problem with this reasoning is it doesn’t really solve any problem. No, you can’t single-handedly make the stock market crash, but you are in charge of your response to everything that happens to you.

Acknowledge that keeping commitments to yourself is very important to you. Because we’re each individuals, we are the only ones who know what’s best or special, in our life. Don’t trick yourself with comments like “Well that’s just how I am or who I am.”

It’s not!

When you cannot keep your commitments, that is simply a red flag telling where your work is. Failing to keep your commitments, large or small, will cause those you love to question whether or not you can be trusted about anything. Be impeccable with your word.  
When you agree to do something — do it as agreed. When you agree to meet someone, be there on time. When you fail to keep a commitment, you fail yourself first and the other person second.                        
Your loved ones and professional partners are measuring your actions against your words because your ability to keep your commitments, following up and following through on your word, is the single best indication as to what people should expect from you regarding future commitments. It tells them whether or not; you can be trusted to care for them and the relationship.
Be careful what you agree to because many people find it easier to say yes than no. It is better to only agree to what you can do. If you disappoint someone because of being over-committed or because you have difficulty saying no, you appear to be an unreliable people pleaser who frequently disappoints, rather than one who sets and respects his own good boundaries.
Don’t hold committing back because you feel it means you are locked in without any options. Not to worry, there is a way out: it is called renegotiating commitments. Your loved ones and your friends know that life sometimes gets in the way of your best intentions. When you are genuine and authentic, there is always a way to renegotiate an agreement that works for everyone. Being honest and direct about change leaves the other feeling respected and not abandoned or betrayed even when he or she does not get what they want.
So why do you think you came here at this time to this planet? Do we really think it was to buy and sell houses, go on vacations, dance in and out of relationships and shop the racks of Needless Markup and Saks? You came to stop playing small and start stepping into your power. That is why at a deeper level, we create all these experiences with rich, meaningful opportunities to grow.
Ethical process is more important than the end result or goal. Process is the grand teacher – reaching your goal is the gift. You win if you are truthful and change commitments you must change, with compassion and understanding.

Getting In Tune with Our Core Beliefs

Beliefs are meanings about ourselves, other people, and the world we have come to trust and rely on. We develop these deep beliefs out of what has happened to us, what we have been told to believe, and from watching what happens around us.
Children often believe what they are told: “strangers are dangerous,” “Listen to and respect grown-ups.” “Don’t burden other people with your problems,” “You’re bad.”

If you witnessed violence in your home growing up, you may believe that caring people hurt each other, or you never leave a relationship no matter how damaging it might be. On the other hand, your past experiences may have led you to believe you are always safe, that you are in control of what happens to you, that others are always trustworthy, or no matter what happens, things will work out okay in the end.
Because beliefs are meanings, they are based on evidence, past facts, and experience. They are the lessons we draw on to help us know how best to act or react in the present. Once we have formed our core beliefs, we usually stop thinking much about them. They become a natural part of who we are and how we function. We tend to act on them automatically, as reflex.

Beliefs can and do Change 

Most of the time they change gradually as the weight of our experience shapes what we believe. The process is similar to the way a river gradually shifts its course as the surrounding terrain erodes. This process of belief change is called accommodation. It is possible to exert some control and influence over the process. With trauma, however, basic beliefs can change quickly and dramatically. A belief may intensify, become absolute, reverse itself, or collapse altogether.
Survivors of trauma often think in black-or-white — all-or-nothing terms. Overwhelmed with powerful feelings, they tend to feel completely safe or completely in danger, completely in control or completely out of control. This kind of thinking can occur as a reaction to trauma. When trauma shatters a basic belief it can seem best to believe the extreme opposite. It may feel most self-protective not to expect anything positive from yourself or others. If you thought you were safe and suddenly found yourself in a life-threatening situation, it may seem safer always to assume high risk rather than to assume safety. You may then feel better prepared to protect or defend yourself.
Trauma throws you for a loop because it changes your core beliefs about one or more of the five basic human needs: safety, trust, control, self-esteem, and intimacy. We need some minimum amount of each of these things for ourselves and for those close to us. When we don’t get enough of what we need, we can begin to experience distress.
If you are experiencing troubling post trauma reactions, it can probably be traced to a change in your thinking about one or more of these five needs. You may no longer feel safe or able to trust. You may feel out of control, worthless, or alone. You may have any or all of these reactions. If you do, your trauma experience has probably disrupted your beliefs about that need. What did that need mean to you before the trauma? How has it changed since the trauma? What lessons about that need did you draw from the trauma? Are there other possible meanings to events in your current life? Perhaps you do not need to feel hopeless about regaining a sense of safety, trust, or intimacy?

Basic needs often Disrupted by Trauma: 

Safety for yourself: The need to feel you are reasonable protected from harm inflicted by yourself, by others, or by the environment. Safety for others: The need to feel that people you value are reasonable protected from harm inflicted by yourself, by others, or the environment.
Trust in yourself: The need to rely on your own judgment. Trust in others: The need to rely on others.
Control of yourself: The need to feel in charge of your own actions. Control with others: The need to have some influence or impact on others.
Esteem for yourself: The need to value what you feel, think, and believe. Esteem for others: The need to value others
Intimacy with yourself: The need to know and accept your own feelings and thoughts. Intimacy with others: The need to be known and accepted by others.

Actual experience by itself isn’t always enough, we constantly filter or ignore experiences in our day-to-day lives. If you don’t not have an open mind, you will find it difficult to notice evidence when you see it. It is easy to dismiss, ignore, or explain away contradictory evidence automatically. This is natural, but not necessarily in your best interest. It is, of course, wise not to make big changes on the basis of a single experience. However, explaining away experiences as “exceptions” can happen so fast you may not notice what has actually happened.

Another Angel on my Shoulder

On July 2, my 86-year old mom transitioned from this world to the next,so I now have another angel on my shoulder.

She lived a very big life with many facets, and didn’t make much of a fuss near the end. During the weeks since she has passed, I’ve thought about her contagious laugh and her open arms, even when I was active in my addiction. She was my mom and she loved me — no matter what pain I caused her.

The gifts I received from her were many, from her artistic talent and sense of humor, to alcoholism.
Growing up, the word “alcoholic” was rarely, if ever spoken in our home, which I imagine only deepened her shame, because we all “knew.”

Back in the 50’s and 60’s women were almost ostracized for having this “affliction,” and certainly no one considered it a disease. If this type of chaos was happening in your home as it was mine, the rug was not big enough to push it under and the 800 pound elephant lived in every room of the house. There was always an eerie feeling when my mom drank — while it was right under our noses, it was a topic to be ignored and never to be discussed. In fact, I still remember declaring I would never follow in her footsteps, not me, I would never be an alcoholic. Obviously my plan to lead a straight and narrow life didn’t last long. Once I swallowed what I considered to be the magic elixir, there was no stopping me for many years. But that was then.

Today, I cannot imagine my life without sobriety.

While I went the 12 step route, my mom chose to “quit” on her own back in the late 70’s. That is where we differed. Yet there was never any judgment from either one of us about it.  In fact, when I moved here in 1990, she was the one who handed me my first meeting list. Just another gift.
Thank you Mom for the life you gave me, supporting me on my journey, the laughs, the love, the ups and downs  — and one last reminder — don’t ever leave my shoulder.*  With love, and forever your daughter.  Barbara

*Just hours before this issue went to press I found this photo of my angel on my shoulder.