Todays Date:
Inspiring Success on the Road to Recovery

Wednesday, April 30, 2014

Advancing Heros - The Best Thing That’s Happened to Me

By Allen Nohre, Terros

Today, many veterans and active service members are returning from combat with physical battle wounds, but some also have deep emotional scars, including Post-Traumatic Stress (PTS). The effects of PTS include flashbacks, nightmares, sleeplessness, anger, anxiety and depression. Many live in fear of triggers, from large crowds or noises that remind them of explosions or gunfire, to something as simple as someone walking by the apartment. The fear, an aftermath of the traumatic incident, can lead to isolation and withdrawal from people and places and overuse of alcohol or drugs. And families may be in disarray trying to adjust to a changed person. The Rand Corporation reports that nearly twenty percent of military service members who have returned from Iraq and Afghanistan – 300,000 in all – report symptoms of PTS, and slightly more than half have sought treatment.

I Have Been My Own Prisoner 

Dominic, a 28 year-old veteran of the Iraq war, struggled with the effects of PTS for more than eight years. Through his active participation in Advancing Heroes, a program that works collaboratively with veterans and active duty service members to determine and remove the obstacles to recovery, Dominic is finding hope.
With passion and conviction, Dominic says, “Since my medical discharge, I have been a prisoner of my fear. We went over there to protect freedom for our families, friends, and country, and some of us came back without our own freedom. Here’s an example of how fearful I have been. As a favor for my brother, I offered to stay in his apartment while he was on a trip. Naturally, people walk by apartment buildings and there are noises. I was so anxious, I kept looking out the window, fearful about my safety and I was not able to go to sleep. I went two days without any sleep and I collapsed from exhaustion. But because of Advancing Heroes, I am no longer a slave to myself, constantly fearful and avoiding people. I am happier, less stressed, sleeping better and much freer to be my real self.”

Uncovering the “Stuck Point”

Cognitive Processing Therapy (CPT), an effective therapy for PTS, is a key component of Advancing Heroes. Ray Young and Mireya Roe, Terros clinicians trained in CPT, do not ask the veterans to re-live their trauma. Dominic and other veterans wrote out their traumatic event at the beginning of the CPT group. But attention is directed to their current thoughts and beliefs that originated from the event and are blocking recovery. Group members learn to identify what they call their “stuck points.” Dominic’s stuck point was “you can’t trust anyone.”
When Dominic was in Iraq, his military group was in a combat zone, and they had a translator they trusted. But she betrayed the group by providing mission details to the enemy, and Dominic’s vehicle was hit by an improvised explosive device (IED). Dominic was severely injured, with wounds to his legs that required multiple surgeries. After the explosion, Dominic came to the conclusion, “you can’t trust anyone,” and he firmly held to that belief. His overwhelming mistrust began to get in the way of the process of recovery. In the CPT group, Dominic was gradually able to see that he was generalizing that no one can be trusted because of the translator. Uncovering his belief that every person could be a threat to him and realistically examining that belief, he began to realize it was the translator who couldn’t be trusted, not everyone else.

The Power of Alternative Medicine

Advancing Heroes combines wellness activities and CPT to get the body and the mind effectively working together. Participants in Advancing Heroes are able to choose from a variety of wellness activities, including acupuncture, yoga, equine therapy, art activities, pet therapy, spinal networking, therapeutic recreation and a two-day family experience. Dominic chose to participate in three wellness activities: acupuncture, equine therapy and yoga.
 “Relax with five needles in each ear? Are you kidding me? But that is what happened,” exclaimed Dominic. “As my body slowly began to relax lying in the lounge chair with needles in my ear, I felt deep, deep emotions inside and I began to ‘leak’. We don’t use the word ‘cry’. I felt the hate and resentment from the attack in 2006 leak out of me in my tears and I laid there a bit more relaxed and somewhat more peaceful. My stress was decreasing.”

Acupuncture has been used for about 2,500 years. Today, it is an adjunctive treatment for stress, anxiety, depression, chronic pain, post-traumatic stress, and drug and alcohol withdrawal. Auricular acupuncture focuses on treating alcoholism, substance abuse, or chemical dependency, as well as provides the benefits of relaxation and stress relief. Cathy Paddack, certified auricular acupuncturist at Terros, administers auricular acupuncture and has given the Advancing Heroes group members the names of acupuncture practitioners so they can continue with acupuncture after the program ends.

“The Horses Taught Us” 

Another wellness activity Dominic chose was equine therapy. It was introduced into the United States in 1960, with therapeutic origins dating back to ancient Greece, and is used as a supporting therapy for many conditions, including PTS. Dominic said, “It is hard to believe, but during our sessions of equine therapy, the horses actually taught us about ourselves. The horses can feel what we are feeling. The horse I chose during our first session was Sam. He came up to me, and he really picked me as much as I picked him. We had an important connection. When I walked other horses around the obstacle course and they veered away from an obstacle, I saw myself. It was like the horse was a mirror and I could see myself in what the horse did. During the six sessions, we never rode the horses. Just walking with a horse and being with him was a learning experience.”
Sahika Riley, equine therapist at Horse Rhythm Foundation, wraps up each session with the horses by helping the veterans understand what was going on between them and the horses.

“Allowing Me to De-stress”

Christy Burnette, yoga instructor from Yahweh Yoga, describes yoga as a blend of movement, meditation and breath work to support emotional and physical shifts of the body. Here is what the veterans said about their yoga experiences:
“Yoga has been amazing for my body. My limbs are moving in ways they haven’t in years. I’ve been able to get back to old hobbies of mine, and it has also improved my overall strength.”
“The breathing and relaxation techniques transfer to my everyday life, allowing me to de-stress, like when I am stuck in traffic.”
“Yoga has improved my ability to trust. During the first session, I wasn’t able to close my eyes for more than a second. Now I am able to close my eyes and completely relax at the end of every session.”
Four members of the group have already selected yoga studios near their homes to continue their yoga practice after the conclusion of 12-week Advancing Heroes program.

Finding Hope and Healing

Advancing Heroes’ mission is to work collaboratively with veterans and active duty service members to determine and address obstacles to recovery so each participant can begin to heal from their unique traumas. The CPT group helps the veteran get “unstuck,” and the alternative therapeutic activities aid each person’s healing process. Dominic is a testimony to the process.
Ray said, “The change in Dominic is amazing. He and others in the group have moved forward because this process is really working for them.” Mireya also stated, “I believe the program has been very helpful for these veterans, and I look forward to working with more groups of Advancing Heroes.”
To ensure that his recovery continues, Dominic is going to continue with yoga, acupuncture and go on an Equine Retreat. He is also offering his services as a peer volunteer mentor to the next group of Advancing Heroes. He has shared his story with the readers of Together AZ so others can learn about the program. He said “This is the best thing that has happened to me.”

Advancing Heroes: About the Program

Six months into his second tour of duty in Baghdad, Brian Mancini was hit by a roadside bomb and suffered major facial and head injuries. It took nearly four years of surgeries and rehabilitation to learn how to talk and walk again. In addition to his physical injuries, Brian struggled with PTS. He knew he needed something more. “I needed to find help — more than I was receiving and I found it in alternative therapies.” Brian discovered that wellness activities like yoga, pet therapy, tai chi, recreational therapy, and fly-fishing helped him reduce the amount of medication he was on and continue on a path of wellness and healing. Brian personally discovered the benefits of wellness activities to cope with his PTS. He says, “I know from my experience that there are innovative ways we can help vets and their families help themselves. That’s the good news.”
Inspired by Brian’s story, Terros talked with veterans and their families in order to learn how our veterans could be better served, not only with traditional therapies, but also from a broader perspective of overall health and wellness. In focus groups, they said they wanted help with issues such as anxiety, returning to normal sleeping patterns, being part of a healthy family, and addressing issues like depression and excessive use of alcohol or drugs. They also said the complicated struggles that are a result of PTS and TBI need to be addressed.
Terros presented the Arizona Department of Veterans’ Services (ADVS) with the need to address PTS with our veterans and active duty service members and ADVS provided startup funding to develop and deliver a program. The design of the 12-week innovative program, Advancing Heroes, began to take shape.
“Many people are exposed to traumatic events. In the time immediately following a trauma, most people will have the symptoms of PTS. However, over time, for many people, those symptoms naturally decrease, and they are not diagnosed with PTS. In other words, they naturally recover from the traumatic event. There are some people who do not recover and are later diagnosed with PTS. Based on that, it is helpful to think of PTS as a problem of recovery. Something got in the way of that natural process of recovery.” (Cognitive Processing Therapy: Veteran/Military Manual)
You can view Brian’s story and more about Advancing Heroes on the YouTube link below.

Information and Support
To learn more about Advancing Heroes, please call Marianne Watts at 602-658-6074 or Marianne.watts@terros.org You can contact Marianne if you or your organization would like to donate in-kind services or supplies, volunteer, donate dollars or have ideas you would like to share to contribute to this innovative effort.

Allen Nohre is a writer for Terros. He has held senior management positions with healthcare companies in Minneapolis, Chicago and Phoenix.

Terros is a healthcare organization helping to create life solutions for people, families and communities. Terros offers substance abuse, mental health, community prevention and primary care medical services. For information or assistance, call 602-685-6000 or visit www.terros.org

Linking Sexual Shame and Addiction

By Robert Weiss, LCSW,CSAT-S

Flawed, Defective, Unworthy of Love and Happiness

It’s no great secret that most alcoholics, drug addicts, and behavioral addicts live with deeply felt feelings of shame.

In fact, shame is nearly always part of the underlying matrix of psychological conditions that can typically lead to addiction. Shame leads to extreme emotional discomfort and the gnawing belief that one is inherently flawed, defective, and unworthy of love. These feelings can in turn lead to depression, severe anxiety, and lifelong challenges with intimacy and relationships. And all of the above can create a powerful desire to escape and dissociate via the use of addictive substances and/or behaviors. Over time, a pattern of self-medicating life stressors and emotional discomfort can easily escalate to full-fledged addiction, with all of the usual negative life consequences.

Healthy Shame, Toxic Shame and Guilt

Over the past few decades, numerous clinical writers have developed the concepts of healthy shame — the feeling a person gets when he or she has done something that goes against his or her belief system — and toxic shame — the belief that one is inherently flawed, bad, and/or defective. More recently, Dr. Brené Brown has re-labeled what most therapists have been calling healthy shame as what it actually is, which is guilt, and toxic shame as just plain old shame. Guilt is useful motivation for positive behavior change, whereas as shame is self-defeating and depression/anxiety producing. I bring up this distinction now for two reasons:
I strongly prefer Dr. Brown’s newer and more descriptive terminology (much less shaming, is it not?)
I want to make it clear that when I use the term shame in this article, I am referring to what many readers may currently think of as toxic shame.

The Mystery of Sexual Shame

Most addiction treatment specialists are relatively in-tune with the general connection between shame and addiction. What often goes unrecognized, however, is the powerful role that sexual shame and adult romantic/sexual behaviors often play when it comes to addiction. For starters, sexual shame is among the most powerful and devastatingly painful forms of shame. As Patrick Carnes has often said, “sexual secrets are often the cause of our greatest emotional shame, yet they are the secrets we are least likely to reveal.”
Sexual shame often forms in childhood, most often as the result of early sexual trauma (overt, covert, or even societal) coupled with emotional abuse/neglect. Many sexually shamed children begin to self-medicate these painful feelings relatively early in life, usually during adolescence and sometimes even before. (Body image issues, shame about being looked at and/or touched inappropriately, and feeling icky about too much trust and affection can all begin very early in childhood.) 

For the luckless kids in these and similar family-attachment situations, the process of self-medicating typically involves alcohol and/or either prescription or illicit drugs. That said, many such children also learn that they can self-soothe with sexual behaviors (including sexual fantasy and masturbation), usually by eroticizing and reenacting their sexual shame — which, unfortunately, exacerbates their preexisting sexual shame, creating an even deeper sense of emotional discomfort and a more powerful need/desire to escape and dissociate.
Sadly, the early childhood survival practice of using drugs and/or sexual arousal to self-soothe the pain of early-life sexual trauma typically carries forward into adulthood, making long-term sobriety incredibly difficult. 

At Elements Behavioral Health facilities, especially in the multiple programs I’ve created with an emphasis on bringing intimacy and sexuality into the addiction treatment conversation, we see this all the time. In these programs, shame-based adult clients typically enter treatment for substance abuse or a behavioral addiction with an extensive history of relapse that is directly tied to their hidden unaddressed sexual shame. Very often, these clients are actively engaging in adult sexual behaviors that either mirror their early-life sexual trauma or violate their moral code. When this occurs, of course, their preexisting sexual shame grows worse, new sexual shame forms, and the desire for self-medication increases.

For some sexually shamed addicts, substance abuse and adult sexual behaviors can fuse into a single co-occurring addiction. In such cases, substance addiction and sexual behaviors continually reinforce one another, creating over time a surefire paired trigger for relapse. Usually in these cases the primary substance of abuse is a stimulant like cocaine or crystal meth, as these drugs allow users to simultaneously stay high and be sexual for hours or even days at a time. Men with this dual issue may also abuse Viagra, Cialis, Levitra, and other erection-enhancing drugs for rather obvious reasons. And both genders can abuse benzodiazepines and similar “downers” as a way to relax and get some sleep when the party finally ends. Once again, when this behavior occurs the client’s preexisting sexual shame grows worse, new sexual shame forms, and the desire for self-medication increases.

Effectively Addressing Sex, Sexual Shame, and Addiction

It has become increasingly clear to me over the years, as I work to evolve both substance abuse and intimacy disorders treatment, that past/current/future challenges with sexual shame, emotional intimacy, and adult sexuality must often be treated in concert with addiction — rather than just assuming that the establishment of chemical sobriety will also clear up a client’s shame-related devastation. This means that in order to achieve lasting sobriety when sexual shame is driving and/or triggering the addiction, adult sexual behavior patterns (addictive or not) must be dealt with concurrently and in an integrated manner. Without treatment for both the addiction and the sexual shame/behaviors, many people may not heal from either issue.
In a way, this is a novel approach to addiction treatment. In fact, very few substance abuse or behavioral addiction treatment centers are currently equipped for this duality of work, notable exceptions being the Substance Abuse and Intimacy Disorders Program at Promises, Malibu (for men) and The Center for Relationship and Sexual Recovery at The Ranch in Tennessee (for women). The clients being treated at these facilities often report histories of isolation and broken relationships in addition to the usual health and life-productivity losses that naturally occur with all forms of addiction. Mostly, though, they report lengthy histories of relapse, with those relapses nearly always tied to their unaddressed sexual shame.
For the most part, effective treatment of men and women whose substance and/or behavioral addictions are deeply integrated with sexual shame (and shame-based adult sexual behaviors) parallels that of effective addiction treatment in general – primarily cognitive behavioral therapy coupled with group therapy, social learning, and 12-step work – but with the added element of a deeper than usual examination of the individual’s sexual shame, sexual history, and current-day sex and relationship patterns. I cannot stress strongly enough the need for sexual shame and sexual secrets to be discovered and addressed as quickly as possible, as talking about sexual shame is the key to defeating it. In addition, effective treatment includes education about the ways in which sexually shamed clients might be able to be sexual in the future without reinforcing preexisting sexual shame or creating new sexual shame. In fact, the concept of healthy sex in sobriety should always be an integral portion of relapse prevention work with sexually shamed addicts.
In sum, the key to lasting sobriety for many addicts is recognizing the role that sexual shame plays in the formation and maintenance of their additions. As such, when sexual shame is uncovered it must be dealt with quickly and effectively, usually by sharing about sexually shaming events with an empathetic and supportive therapist and/or a similarly traumatized therapy group. Simply put, when sexually shamed addicts share about their pasts – the experiences that cause them to feel defective, unworthy, and unlovable right now – even long after their sexually shaming events occurred, their stress levels decrease and their overall mental and physical health improves, greatly increasing their odds of lasting sobriety (no matter their primary addiction).
Robert Weiss LCSW, CSAT-S is Senior Vice President of Clinical Development with Elements Behavioral Health. A licensed UCLA MSW graduate and personal trainee of Dr. Patrick Carnes, he founded The Sexual Recovery Institute in Los Angeles in 1995. He is author ofCruise Control: Understanding Sex Addiction in Gay Men and Sex Addiction 101: A Basic Guide to Healing from Sex, Porn, and Love Addiction, and co-author with Dr. Jennifer Schneider of bothUntangling the Web: Sex, Porn, and Fantasy Obsession in the Internet Age and the upcoming 2013 release, Closer Together, Further Apart: The Effect of Technology and the Internet on Parenting, Work, and Relationships, along with numerous peer-reviewed articles and chapters.

Motivational Interviewing

by Elisabeth Davies, MC

Motivational Interviewing first emerged in Norway in 1982. It is a collaborative conversation style between a guide (helper) and someone desiring to make a positive change. Motivational Interviewing (MI) is designed to strengthen motivation for and commitment to a specific goal. The guide creates an atmosphere of acceptance and compassion while asking open-ended questions that elicit the person’s own reasons for making a behavior change. MI can be used as a stand-alone treatment; although when combined with other evidence — based treatments it enhances treatment outcomes.

The styles of communication used in MI has been found to produce positive results for people struggling with substance abuse and proved effectual with probationers in lowering recidivism rates, and with insubordinate employees in increasing cooperation with supervisors in the workplace. Many mental health facilities worldwide have added MI to their assessing and treatment planning protocol for behavior change with their clientele.

William Miller, Ph.D., further developed MI in the U.S. during the late 80’s while treating drug and alcohol dependent clients at an inpatient substance abuse treatment center. Miller’s colleagues complained clients were ‘difficult,’ ‘resistant,’ ‘in denial,’ and ‘out of touch with reality.’ When he was working with these clients, he did not experience the same problems. It made him question whether or not the complaints were a client problem or a counselor skill issue. He then set out on a quest to discover how to counsel in a way that evoked people’s own motivation for change rather than putting them on the defensive.

After years of researching specific communication styles that decreased resistance and increased successful outcomes, Miller  along with Stephen Rollnick, Ph.D., published their findings, in the book Motivational Interviewing: Preparing People to Change Addictive Behavior.
Their findings showed when MI techniques were used there was a 51 percent decrease in alcohol use, substantially fewer relapses, and double many of the positive outcomes of 12-step, or Cognitive Behavioral Therapy treatments.

There are two main components to MI; relational and technical. Relational encompasses the interpersonal relationship between the guide and person desiring the change. The underlying perspective is each individual is the expert on him or herself, so the guide does not direct the person on what to do or how to proceed. The second component, technical is incorporated through the use of open-ended questions, which evoke internal strengths and resources.

Why, What, How, Tell Me

Most open-ended questions start with Why, What, How, and Tell me. Some examples are:
Why do you think you have a drinking problem?
What kind of a life do you have to create that would make you want to stay sober for it?
How do you want your life to be different?
Tell me what you don’t like about the way your life is now

Through working with thousands of clients, Miller and Rollnick discovered when people experience themselves as unacceptable they are immobilized and their ability to change is blocked. When on the other hand people experience being accepted as they are, they are free to change. They also found the more accurate empathy a counselor showed toward a client, the less they would relapse with drugs and alcohol. These discoveries led them to design four specific skills necessary for interviewers to use when working with people who verbalize wanting to make life changes.

Acceptance — prizing the inherent worth and potential of the person wanting to make the  change
Accurate Empathy —  actively being  interested in understanding the person’s own perspective and frame of reference for desiring the change
Autonomy Support —  allowing the person to choose their own way and determine what  changes they want to make for their own life
Affirmation— acknowledging the person’s strengths and the efforts they have already made in working toward their goals for change

It is not uncommon for people to experience ambivalence when they are considering a change. They contemplate thoughts about making the change and wrestle with reasons to sustain their current behavior. When they verbalize this indecision it is important  the interveiwer doesn’t try to persuade them one way or another, because this often calls forth resistance against the advice. When clients experienced resistance it prevents change. Instead, the interviewer can collaborate using the four key processes of MI:

Engaging — establishing a helpful connection and collaborative relationship with the client (A prerequisite for MI to be effective)
Focusing — developing and maintaining a specific direction in the conversation about the change the client wants to make.
Evoking — eliciting the clients own motivation for change, usually done with open-ended questions such as, “What do you think would be some advantages   to making this change?”
Planning — formulating a concrete plan of action the client is motivated to follow, once they have committed to making the change

Miller and Rollnick discovered through reflective listening that commitment language predicted behavior change in people. Commitment language is when the person speaks of:
Their desire to change
Their belief that they have the ability to make the change
Their reasons and need for the change to occur
Their verbalization of goals and plans to acquire the change

It is possible to help people make positive changes in their lives— and Motivational Interviewing can help the process.
The rationale for change can come about for many reasons; some people feel forced to make changes due to outside circumstances beyond their control, while others desire changes because they want to better themselves or generate more positive outcomes in their life. Whatever the basis for change, using the MI approach can move people toward the transformation to which they aspire.
If you are interested in becoming trained in the MI approach visit http://www.motivationalinterviewing.org/ for training dates.

Elisabeth Davies, MC is the author of Good Things Emotional Healing Journal: Addiction

5 things to do at home #EndMedicineAbuse

Safeguarding your prescriptions is a must. This will not only prevent your own teen, but his or her friends who come over, from taking drugs out of your medicine cabinet or kitchen.

So where do you keep your meds? Here are five things you can do at home to protect your medicines that can make a huge difference in keeping your family safe.

1. Treat them like your best watch or necklace. Think about medicine in the same way you do jewelry or other valuables. There’s no shame in protecting those items, and the same should hold true for your prescriptions and cough medicine.

2. Take them out of the medicine cabinet or kitchen. While convenient, the medicine cabinet or kitchen are obvious and easily accessible locations; so keep your medicine in a place that only you know about.

3. Lock them up. Consider keeping your medicines in a lock box or a safe – and don’t share the key or combination.

4. Count, monitor and dispose of them. Take an inventory of all of the medicine in your home - and dispose of what you don’t need.

5. Tell relatives to do the same. Once you’ve taken the above precautions, it’s time to tell others about doing the same – especially grandparents, relatives and the parents of your teen’s friends. A quick chat can go a long way.

Safety is Not our Goal

While driving on a country road I passed the parked truck of a tree trimming service. High above the vehicle a workman stood in a cherry picker, sawing overhanging branches. Beside the truck, facing the road, stood a large sign, bold black letters against a bright orange background: SAFETY IS OUR GOAL.
Something about the message bugged me. While I recognize the importance of safety on the job, there is much more to that job—and to life—than staying safe. If safety is your main goal, you won’t get much done and you won’t have any fun. In a way, the sign was a lie. If safety was the real goal, the workers could come back to their supervisor at the end of the work day, and he would ask them, “How’d you make out today?” They would answer, “We didn’t get any trees trimmed, but we stayed safe.” If that conversation truly took place, the company would soon be out of business.
I played in my mind with various scenarios of how the world would be different if safety were more important than progress:

Exploration: Columbus to Queen Isabella: “Are you crazy? I’m not going out on that ocean to look for a new world. If the earth is really flat, my ships will fall off the edge of the world.”

Politics: Barack to Michelle Obama: “We’ve never had an African-American President. Do you realize how much money we could lose and how embarrassed I would be if I ran and lost?”

Sex: “I could get a disease, or have an unwanted baby, or God might punish me for having so much pleasure. Even worse, I could get intimate, involved, and committed.”

Air flight: Captain to passengers: “Studies show that the chances of crashing are greater if we get into the air, so we are going to just sit on the runway.”

Business: Steve Jobs’ parents to Steve: “Why risk your career on the fantasy of a personal computer? Stick with a safe career in calligraphy.”

Business, thirty years later, parents to child: “Why risk a career in calligraphy? Stick with a safe career in computers.”

There are two basic attitudes to life: Reparative and Creative. The reparative path is based on survival, self-protection, and fixing what is broken. Life is a problem and our role is to make the best of a bad situation. The creative path is founded on exploration, expansion, and celebration. Life is an adventure to enjoy. The sign on the reparative path reads, “Safety is our Goal.” The sign on the creative path reads, “Plucking the Fruit of Life is our Goal.”

Certainly there are moments when we need to fix stuff and deal with what is broken. But that is the lesser part of the game, just as safety is the secondary goal of tree-trimming. Fix what you need to fix when you need to fix it, but get back to creation as soon as possible. Even if you have to fix something, an attitudinal shift can make the process fun.

A lovely essay was going around the Internet, musing about how much fun we had as kids without needing all the protection prescribed today. We pedaled bikes without helmets, rode in cars without seat belts, and went trick-or-treating without parents shadowing us to keep us from getting molested. Somehow we survived childhood without elaborate defenses, and had fun in the process. I am not saying kids should abandon helmets, seatbelts, or parental supervision on Halloween. I am just suggesting that there is more to life than protection.

For a penetrating lesson in the contrast between trust and protection, watch a delightful documentary called Babies. The film follows the social training of babies in four different cultures: African, American, Japanese, and Mongolian. An opening scene shows the African baby, sitting naked on a dusty plain, playing with some bugs, having a grand time. Next we see an upwardly mobile San Francisco family bundling their child in Oshkosh designer wear, strapping him onto a complicated bike seat, protected to the hilt with all manner of safety devices. The African kid looked happier, and so did his parents. One has to wonder just how much protection our children need to be safe and happy? And us?
In 85-year-old Nadine Stair’s famous essay, “If I Had my Life to Live Over,” the author confesses, “I’ve been one of those persons who never goes anywhere without a thermometer, a hot water bottle, a raincoat and a parachute. If I had to do it again, I would travel lighter than I have.”
It’s never too late to travel light or to have a happy childhood. Perhaps it’s time to post a new sign by the truck: SUCCESS IS OUR GOAL, AND WE’RE HAVING A GOOD TIME GETTING THERE. Trim the trees where you must, but enjoy them where you can.

Alan Cohen is the author of Enough Already: The Power of Radical Contentment. Join Alan and other notable teachers for an inspiring A Course in Miracles retreat on Maui, December 7-12. For information on this program, Alan’s books, life coach training program, free daily inspirational quotes, and his weekly radio show, visit www.alancohen.com, email info@alancohen.com.

The Benefits of Sober Living

By Jason Bordonaro

I can remember my early days of recovery,  and it was the community and fellowship along with the 12-steps that carried me through to where I am today.
I lived in a house with sober people and spent most of my time around them. We shared the struggles and victories of early recovery over early morning coffee or late night television, hikes through the mountains or walks through the city streets.  We went to meetings together and shared the growing pains and the joys of living life on life’s terms. All of us were committed to our own recovery and supported each other on our journeys. One of the main things was — we had fun in sobriety and were deeply involved with our recovery.
In today’s world there is the benefit of treatment centers and transitional facilities also known as sober living facilities that can assist in the recovery process. They offer the benefit of community and the feeling that overcoming addiction and alcoholism doesn’t have to be accomplished alone. We can recover together. What do people in recovery do? We help each other. It’s one of the many ways we can exhibit grace to one another.

The Power of Community

For most of us, for way to long we battled life alone, fighting the demons in our heads and lives as best we could which usually meant drowning the thoughts and feelings out with alcohol and drugs. We treated loneliness with isolation. The more we felt separate from our communities, the more we pushed our loved ones away. It became a downward spiral that was impossible to break free from with self  and will power alone.

Sober living offers a completely different way to stay on the road to recovery. Structure, support, 12 step recovery and community are just a few of the benefits of being a part of a sober living home. Many people in the early stages of recovery struggle to keep commitments and follow through on the actions needed for recovery.

Sober living provides the needed context and support through scheduled programming, accountability, mentorship, coaching, self-discovery and house rules to empower residents to thrive in their journey of recovery. Rather than simply maintaining a baseline state of physical sobriety, residents are encouraged and guided through a thoughtful integration of 12 step recovery with a variety of life skills and personal development workshops. They are challenged to tap into their own potential and discover the person they lost to addiction.

Research shows that 90 days in sober living increases the chances for long-term sobriety by over 40 percent. 

This is due to the power of habit and the development of new behaviors. Aristotle said, “We are what we repeatedly do, therefore excellence is not an act but is a habit.”
Sober living homes create an environment for the residents to thrive. In recovery we have a saying, progress not perfection. At the same time we live each day the very best we can, living in gratitude and service to others, doing our best to carry the message of recovery to those that are still struggling. There is a lifestyle of sobriety that is far greater than your wildest dreams.
Sober living is not the solution to addiction. However, it can play a major role in helping the addict remain clean. Combined with continued treatment, peer and family support many recovering addicts are now living positive lifestyles free from drugs and alcohol.

Jason Bordonaro is the co-founder of SpringBoard Recovery, a sober living center for men located in Scottsdale, Arizona. Jason and his business partner, Tim Lambright, both share a passion for recovery. Each of them struggled with addiction in the past and now gratefully are men in long term recovery. 
Jason can be reached at jason@springboardrecovery.com and at 928-710-3016

The Lost Art of Listening

He says, “That is a pretty dress on her.” She hears, “ He’s attracted to that woman and losing interest in me”. She says, “I am spending the evening with Diane on Friday.” Her friend hears, “ I’m being replaced as her best friend.” She says, “I am not quite ready to be married,” and he hears, “We are never going to get there;  she’s interested in someone else.”
 We don’t know how to listen anymore because we filter what others say through our own fears and past betrayals. The problem, of course, is that we instantly future-scape right into crisis mode. Our ears slam shut, we respond in inappropriate ways, and we are very often wrong in our assumptions.
Mark Goulston in his book, Just Listen, says we go through five different stages in our listening process.

The first is the Oh F#@$*&^! Reaction. This is a disaster, I’m screwed and it’s over.
The second response is Oh God, This Sg#%-stuff always happens to me and I am going to be stuck with this mess.
Oh Jeez I can fix this but it’s not going to be fun.
Oh Well, I am not going to let this ruin my life, I need to decide what will make it better, and finally,
OK, I am ready to fix or deal with this.

The problem is that in the first three OH’s our experience of every fear and betrayal comes up like a tsunami and out of our mouth rolls every inappropriate response that we then also have to clean up.
We fill up that red wagon of past pain and haul it right into the middle of our current situation even though not a single bit of it has to do with what is currently going on. That, my friends, is both a curse and a blessing. The curse part is that we stop listening. Here’s the blessing part…
If we can calm the storm inside and stay present with a boundary that allows the other to have his or her feelings without making it about us, we will discover that 99.9% of the time it actually isn’t about us at all. Why because every response we have is from our past. That’s all we have and all we know. The future isn’t here yet.

Here’s an Example: 

Sally is in the living room curled up in the corner of the couch crying. Phil comes in, sees her and asks, ”What is wrong with you?” Sally responds, “ I am so lonely I could die.” Phil immediately takes this personally, sees it as a failure on his part and responds, “Jeez, I have spent every night for the last two weeks with you at home and we spent two weekends this month with friends. When is enough, enough?” He stomps out and Sally’s feelings are right where they were — unresolved and painful.

Let’s try it again 

Sally is in the living room curled up in the corner of the couch crying. Phil comes in, sees her and asks, ”What is wrong with you?” Sally responds, “ I am so lonely I could die.” Phil responds with, “That sounds awful, honey, what’s making you feel that way?” Sally tells him her best friend Lydia has just told her she is moving to Dallas. “As a kid,” she tells Phil, “ I was an Army brat and we moved every six months. I never had any friends much less a best friend. This just makes me so sad and brings all of that back.” Phil lovingly comforts her and they create a loving connection that is healing. Big difference… and all he did was listen.
Sometimes we choose not to listen because we fear being made responsible, being made wrong or being unable to fix the situation. Actually, none of those things are our job. As loving partners, family members and friends, our only job is to listen and try to understand how the other person’s truth is true for him or her. You don’t even have to agree or share the same reality. When we are authentically heard, we can fix the problems ourselves. In fact, normally the problem is resolved just by talking through the issue or pain.
 Listening is a great gift you can give to those you love. Imagine how the world might change if we just slowed down enough to share our feelings and truly be heard without judgment or expectation that anyone should fix it for us. Let’s start now.

Dr. Evan is a life/soul coach in Arizona working with individuals, couples and corporations.  She  specializes in relationships, personal and professional empowerment, compassion and consciousness. For more information 602-997-1200, email drdbe@attglobal.net or visit www.DrDinaEvan.com.

‘The Big Book’ is 75

By Dr. Howard Markel

April 10, 1939, marked the publication date of “Alcoholics Anonymous: The Story of How Many Thousands of Men and Women Have Recovered from Alcoholism.” One of the best-selling books of all time (it has sold more than 30 million copies), the volume is better known to millions of recovering alcoholics and addicts as “the Big Book.” Its influence on the world’s health and the treatment of alcoholism and other addictions is immeasurable. In 2011, Time magazine placed the Big Book on its 100 most influential books written in English since 1923 (not coincidentally the year the magazine was founded). In 2012, the Library of Congress designated it as one of the 88 books that shaped America.
The book’s copyright application, filed April 19, 1939, lists William G. (“Bill”) Wilson, the co-founder of Alcoholics Anonymous, as the sole author. In reality, the
book was very much a group effort. Dozens of recovering alcoholics, many who attended the earliest AA meetings and who had an average sobriety time of 1 to 1.5 years, helped Bill Wilson with the writing of the book in 1938. Their express purpose was to spread the life-saving premises of Alcoholics Anonymous.
The heart of the Big Book can be found in the first 164 pages, which outlines the now famous 12 steps of recovery; advice to the alcoholic’s spouse, family and employer; as well as counsel for the agnostic who seeks the spirituality felt to be necessary for those seeking recovery but who has questions about the existence of a higher power. Equally compelling is the compendium of personal stories that follows these chapters and which was designed to give “experience, strength and hope” to those seeking recovery.
As of January 1, 2013, the General Services Office of Alcoholics Anonymous estimated there are 114,642 AA groups in more than 170 nations with more than 2,131,549 members. And “the Big Book” is their basic, and most important, text.
One of the best-known stories about AA’s origins concerns a business trip to Akron, Ohio, made by the newly recovering Bill Wilson in 1935. Stuck in the hotel lobby, between a bar and a phone booth with a registry of local churches, he began calling the various clergymen to inquire if they would recommend a suffering alcoholic he could work with in order to buttress his own sobriety. It took more than a few calls, but he was finally given the name of a once successful and now well-oiled surgeon named Bob Smith. Bill went over to Dr. Bob’s house and history was made. The two initially recruited other suffering alcoholics both in New York and Akron. With time and support by many physicians, journalists and the philanthropy of John D. Rockefeller Jr., AA chapters sprung up across North America.
The skeptical have dismissed Bill Wilson’s spiritual awakening, sobriety and even the remarkably important book he helped write, as mere products of belladonna hallucinations; others have argued that it was the result of delirium tremens or the symptoms of alcohol withdrawal. Wiser men and women have accepted that something else happened to Bill Wilson on that long ago night, something that medical science simply cannot explain.
In the end, millions of people around the world who have benefited from Alcoholics Anonymous, and the life-changing book bearing its name, would say that such pharmacological, physical or spiritual parsing hardly matters. For them, the most important thing is that it worked.

Dr. Howard Markel writes a monthly column for the PBS NewsHour, highlighting the anniversary of a momentous event that continues to shape modern medicine. He is the director of the Center for the History of Medicineand the George E. Wantz Distinguished Professor of the History of Medicine at the University of Michigan.
Editor’s note: This story has been updated to reflect the following correction: In the original caption under the picture of an Alcoholics Anonymous meeting it was stated that the 12 steps were to aid recovery from addiction. The 12 steps written about in the book “Alcoholics Anonymous” are for recovery from alcoholism.

The Taboo Subject

I just watched The Lost Weekend with Ray Milland — again. If you’re too young to remember this film classic, but interested in seeing alcoholism at its grittiest — this is a must see. It is a very chilling honest look at the disease. 

TMC host Robert Osborn talked about the difficulty the studio had releasing the film back in the mid 1940’s. Who would want to see a film about an alcoholic? 

But it was a revolutionary, ground-breaking motion picture — and the first time Hollywood had seriously tackled the taboo subject, creating social awareness of alcoholism as a modern illness. Its release was threatened when the alcohol industry offered to purchase the film’s negative and remove it from circulation, but then praised and supported the film following its popular release and success.

Audiences, critics and the studio (before its release) viewed the film’s subject matter as sensational, controversial, daring, and starkly real. The drab, black and white cinematography of the film emphasized the menacing, warping, and harrowing power of alcohol, as some of the booze-soaked scenes were shot through or in the presence of numerous whiskey bottles and shot glasses. The main character, an alcoholic writer, loses his money, his freedom, and his sense of reality when confined in an alcoholic ward.

I had many a lost weekend, just like Milland’s character. I hid bottles from friends, family and myself. Often I couldn’t remember where they were when drink time came. It was a painful and ugly time in my life. I felt “watched”, “shamed” and “guilty,” looking for a few drops at the bottom of a found bottle. My memories of drinking are still like looking through a foggy glass. 

By the Grace of a loving Higher Power, the 12 step fellowship I call home, the amazing strong, wise and gifted people who have led the way before me — I’m the privileged to live an amazing sober life.
We are not taboo. Our disease is no longer hidden in the shadows. I ask you to continue to fight the stigma associated with drug and alcohol addiction — along with me.

Tuesday, April 8, 2014

Innovative Addiction Treatment available for first time in AZ

For nearly 20 years the FDA approved medication, naltrexone, has proven that it nearly eliminates the desire for alcohol and opiates, and eliminates the euphoria from drinking and taking opiates. However, the traditional pill and injection form of naltrexone made the effects short term and prevented an addict’s compliance with taking this medication.
 Now, Start Fresh Recovery in Arizona is the only program providing naltrexone in a yearlong pellet form. With the pellet, a person’s addiction is nearly eliminated for about a year. Coupled with life coaching the program’s goal is a long-term addiction free life. A completely outpatient program, Start Fresh treats both the medical and behavioral aspects of addiction and provides an effective complimentary service to any other type of addiction treatment.
 Ray is the owner of Ray Eyewear in Phoenix. He has five children and five grandchildren. In recent years he has struggled with alcohol addiction, and has used inpatient and outpatient treatment services. “I kept asking my doctors, isn’t there another option to treat this addiction? I finally found the answer with the Start Fresh program.”
 Ray’s addiction hit a climax when his only son was deployed to Afghanistan. “I was in the depths of despair and started drinking heavier than ever before. Then a family friend told me about Start Fresh. I had the pellet and honestly my cravings were eliminated the same day.” Ray explains he even “tested” the effects by pouring his routine glass of wine by his TV chair before going to bed. He forgot about drinking it and went to bed later that evening. When he awoke the full glass was right where he left it. He was amazed. “I was the guy buying travel sized bottles of alcohol at the drug store every day to drink anywhere and everywhere I could.”

How it works

Start Fresh inserts two small pellets (together only one inch long) just under the top layer of the skin, typically on the side of the abdomen or under the bikini line for women. This is done in an outpatient doctor’s office in about 15 minutes with only a few stitches. Within 48 hours the person starts life coach sessions with their assigned coach by phone or skype. The life coach also provides support outside of the sessions as needed, including texting.
“I could not afford to take more time away from my family and business. Start Fresh gave me the convenience of effective treatment without time away.” Ray now focuses on improving his mental health, “My life coach, Terry, is also a recovering alcoholic and really relates to what I am experiencing. And he has been there for me every day. I still have a long way to go to treat my mental health. But I know I can now deal with my demons head on without the addiction distracting me.” Life coaching services are provided by an Arizona licensed, mastered degreed counselor.
 According to articles and clinical trials published by the National Institute of Health, “Naltrexone acts as an antagonist at the opioid receptors, which are known to mediate the rewarding effects of alcohol and thus thought to reduce desire or craving of alcohol. Studies have found that naltrexone is more effective than placebo in promoting abstinence, reducing heavy drinking days and decreasing relapse rates, particularly when it is combined with cognitive behavioral therapy.”[1]
 Start Fresh is also accustomed to treating the “rich and famous.” Jeremy Miller, the childhood actor who played Ben Seaver on the popular TV show Growing Pains, was a Start Fresh client and now a spokesperson. Jeremy shares that he struggled with alcohol dependence throughout his young adult life with chronic relapses well into adulthood, “I typically would drink myself to sleep then wake up during the night to drink again so I could get back to sleep.” Jeremy emphasizes that nothing is a magic pill, “Start Fresh eliminated my cravings and thanks to the tools I learned from the life coaching, I am still alcohol free today years later.”
 Effective for both alcohol and opiate addiction, the Start Fresh combination of the pellet and convenient mental health treatment increases effectiveness in improving mental health and preventing relapse in the long term. (Note: This is not the medication Antabuse, which causes nausea; naltrexone does not have this side effect. Side effects are minimal or non-existent.)
 In an article also published by the NIH, “It was established that application of naltrexone decreased probability of relapse of drug abuse, facilitated an inclusion of a patient into a program of therapy and rehabilitation, increased a number and quality of remissions as well as it also decreased a tendency to alcohol and sedative drugs administration. Naltrexone had no side effects and was well tolerated by the patients.”[2]
 The Start Fresh program goal is to complement and work in collaboration with other addiction treatment services, “We highly value the existing relationship a patient has with their providers and therapy, including AA,” stresses Joan Pedicini, Start Fresh CEO. “It is important to keep the network of services strong. We will always encourage that a patient retain their relationship with their existing addiction treatment provider, doing whatever it takes to help them be strong and addiction free. Even our life coaching works in tandem with existing psychotherapy treatment.”
 Start Fresh partners with existing physician practices to insert the pellets and has two locations in Phoenix and Scottsdale. More locations are opening soon throughout Arizona. Start Fresh is seeking to enroll additional doctor’s offices that are interested in being approved to insert the pellets. Contact Karen Kansfield at Start Fresh if you are interested in being a program partner at karenk@startfreshsw.com.
 Previously only treating alcohol addiction, Start Fresh is now also treating opiate addiction. Start Fresh accepts cash and insurance, provides discounts for hardship, and 100% financing.
 Read more at StartFreshAddictionRecovery.com. Contact Start Fresh Recovery in Arizona toll free, 24/7, at 855-393-HOPE (4673).

One Foot in Front of the Other

By Tian Dayton, PhD

We should feel proud as a professional community, the addictions field has impacted the entire mental health field by being among the first to incorporate yoga, meditation, exercise, journaling, guided imagery and good nutrition into the treatment of the whole person. Researchers routinely “prove” what we have already learned through clinical trial and error, that these simple approaches are effective and life changing. Even our gratitude lists are now becoming evidence based. Now research is taking a deeper look at the power of affirmations in shoring up that ephemeral thing we call a sense of self.
What positive affirmations appear to do is by affirming the self, the self feels, at least temporarily strengthened which helps us perform better in tasks that benefit from a relaxed, attentive state of mind. Affirmations strengthen our ability to use attention and creative thinking to solve the problem or task at hand. They act as a buffer against threats to our sense of self and our ability to meet the demands of the moment.
Self-affirmation theory posits that the goal of the self is to protect one’s self-image when threatened and that one way to do this is through affirmation of valued sources of self-worth. New studies headed by J. David Creswell, assistant professor of psychology in CMU’s Dietrich College of Humanities and Social Sciences at Carnegie Melon, demonstrate that affirmations can actually help us to manage our stress responses and build resilience.

Another benefit of strengthening one’s sense of self through positive affirmation is that people with a fairly flexible, non defensive ego structure are better able to make use of any criticism that comes their way and learn by it rather than freeze up, get defensive or shut down. Defensiveness, researchers posit, can also have a deleterious effect on subsequent relating. The upshot of this is that statements that affirm our sense of self and act as a buffer against perceived threats to the self better allow us to remain flexible and present. We can make use of negative feedback without warding it off and we don’t alienate the people around us by fending off their well meaning advice before even listen to it. (Sherman, D. K., & Cohen, G. L. (2006).
Cresswell and his team caught my attention by claiming that self-affirmation, something near and dear to the hearts of many in recovery, can protect against the “damaging effects of stress on problem-solving performance”. “ These new studies examine the effect of self-affirmation on actual problem-solving performance under pressure. Their work suggests that a brief self-affirmation activity at the beginning of a school term can boost academic grade-point averages in underperforming kids throughout the semester. “Understanding that self-affirmation — the process of identifying and focusing on one’s most important values - boosts stressed individuals’ problem-solving abilities will help guide future research and the development of educational interventions” says Cresswell. What positive affirmations appear to do is by affirming the self, the self feels, at least temporarily strengthened which appears to shore up problem-solving performance under high-stress conditions.

A Protective Factor

Living in the trenches of addiction and codependency, high stress to be sure, can make one curiously open minded. Having to shore up a sense of self in situations where one’s sense of self is under a constant barrage of attack, can inspire us to reach for anything (non addictive) to feel better, fast! We become very willing to give what seems to be helping us a good try. Affirmations, it turns out, do just what we thought they did when we advise clients to look at themselves in the mirror each morning and tell themselves they are “good, worthy and capable people”.
They shore us up when we’re under stress; they buffer us from a feeling of impending harm. They help us to perform better under stress, whether that stress is suiting up and showing up for life while coping with the strains of addiction and recovery, or solving math problems in a testing environment.
“High levels of acute and chronic stress”, according to David Creswell et al, “are known to impair problem-solving and creativity on a broad range of tasks. But despite this evidence, we know little about protective factors for mitigating the deleterious effects of stress on problem-solving. Building on previous research showing that self-affirmation can buffer stress, we tested whether an experimental manipulation of self-affirmation improves problem-solving performance in chronically stressed participants.” Affirmations appear to strengthen our ability to use attention and creative thinking to solve the problem or task at hand. They act as a “protective factor” against stress inducing threats to our sense of self, which enhances our ability to meet the demands of the moment.
This, of course, is resilience building as it allows the self to function with greater adaptability, spontaneity and strength in the moment. And hopefully we get a positive self fulfilling prophecy going rather than a negative one.

When Do Affirmations Backfire?

Apparently affirmations need to feel real in order to feel effective. Canadian researcher Dr. Joanne Wood at the University of Waterloo and her colleagues at the University of New Brunswick who have recently published their research in the Journal of Psychological Science, found that if affirmations are done in a way that blocks out any awareness of negative emotions, they can actually make people with low self esteem feel worse than if they said no affirmation at all. When someone is asked to repeat, for example. “I am a lovable person, it can make them feel less lovable if it doesn’t go along with what they already think of themselves. When the researchers asked participants in their low self esteem group to repeat positive self affirmations, they felt worse than before, while those in the high self esteem group felt only marginally better, though they did feel better.
One needs of course to take into account cultural variability and the structure of the test, but this research does suggest that we cannot just ramrod ourselves into a happy state of mind. Apparently the tacit pressure to block out negative thoughts can actually have a deleterious effect, it can make us feel even more preoccupied with those pesky, little down cast thoughts as they drag at the corners of our minds. The researchers found that those in the low self esteem group, actually did better when they felt free to entertain negative as well as positive feelings.
Mindful living is also being incorporated into the culture at large and the world of recovery. Ekhart Tolle author of The Power of Now, encourages a kind of “presence” in the moment that does allow for the negative, or what he refers to as the “pain body” to emerge. He advises simply that we allow it to be, that we don’t give pain or negativity our energy and focus but that we accept it and give it space. In giving it space we relieve ourselves from a host of subsequent thoughts about pain, we allow contrasting thoughts simply to emerge into the moment and pass through our consciousness as we witness or observe them rather than think more about them.
So what seems to work and this is what is particularly interesting to me as it is what I have always felt, is to head towards the positive while giving the negative a little breathing room.

My Personal Experience with Affirmations

I have written several affirmations books over the years, most recently One Foot in Front of the Other. In fact Forgiving and Moving On has been to date, my best seller edging close to a million copies. When I began writing affirmations I always included the struggle along with the positive. I wrote (in the first person style) about the struggles that I faced (just being an ACoA) and that my clients faced in recovery from addiction, codependency and childhood trauma.
I opened each affirmation with the direction I wanted to head in, “today will….sort of thing”. Then the body of the affirmation was about processing all of the negative feelings that came up in me (or in my clients) when I considered heading in this positive direction. I then made an affirmative statement for at the end of each affirmation that I could hold in my hand (and mind) throughout the day, a psychological goal post so to speak. And I always added a quote that I found inspiring, a quote that let me know that someone very interesting had struggled with these thoughts and issues before me and appeared to have made some progress.
I am thrilled with all of this research into an area that has been so much a part of my writing life. And I am also pleased to see, that in culling through the various studies, the style I have used over the years proves to be a useful one. In One Foot in Front Of the Other I’ve integrated program basics and wisdom with neuropsychological findings into a user friendly “I” format. The idea is to line out the process of recovery and a new design for living in a manner that can be easily metabolized each morning, that can help to set a tone for the day that makes personal growth feel attainable and desirable, a little companion to let the reader know “there are those who have been there.”

Dr. Dayton is the Director of Program Development for Breathe Life Healing Center. She is the author of fifteen books most recently The ACoA Trauma Syndrome, Emotional Sobriety,Trauma and Addiction:, Forgiving and Moving On , The Living Stage, and has developed a model for using sociometry and psychodrama to resolve issues related to Relationship Trauma Repair. Tian Dayton has a masters in educational psychology and a PhD in clinical psychology and is a board certified trainer in psychodrama, sociometry and group psychotherapy.

Masters in our Midst

As commuters hustled through the Washington, D.C. metro station on a cold winter morning, a musician stood next to a wall playing his violin, the case at his feet open for tips. He played six Bach pieces for 43 minutes. A few people stopped and listened for a moment, then hurried on their way. Some threw some change or a dollar into the violin case. The musician’s most attentive audience was a three-year-old boy holding his mother’s hand. He wanted to stay and listen, but his mother tugged him along. Finally the violinist retrieved $32 from the case, put his instrument away, and disappeared into the crowd. No one applauded or thanked him.

Not one of the 1,036 passersby realized that the violinist was Joshua Bell, one of the world’s greatest violin virtuosos. The pieces he played were extraordinarily demanding, performed on a violin borrowed from the Smithsonian, worth three and a half million dollars.  Days earlier Bell had played to a sold-out crowd in Boston, tickets at $100. Bell’s impromptu concert was sponsored by The Washington Post as a social experiment to determine if people would perceive greatness in their midst if they were not told about the talent before them. The commuters did not expect genius, so they overlooked the rare gift offered. They were busy. They had jobs to get to, kids to get to school. Who has time to stop and listen to music on the way to work?

Might we all have moments in our life when we are in the midst of genius without recognizing it? What if you smoked pot with Barack Obama in a Hawaiian high school? Or the band rehearsing in the garage next door was the Beatles? Or you performed in a local community play with young Meryl Streep? Chances are that at the time you would have had no idea of the skill and fame your peer would achieve. The seeds of greatness lie latent in many places we do not expect them, to sprout and flower at a time destiny claims.
Every Somebody was a nobody at sometime. Every nobody could become a Somebody anytime. We would be wise to keep our antennae raised for divinity masquerading as humanity. To find God showing up as people. Grace and divine intervention rarely appear as a big golden hand descending from the clouds. That’s Hollywood. God’s gifts to humanity are delivered through people—sometimes those you would never expect.

I saw an inspiring documentary called Bōtso (www.botsomovie.com), about a boy who grew up in the Soviet Union during the Stalin regime. Botso’s father was arrested as an enemy of the state and sentenced to death. On the eve of his execution he was allowed twenty final minutes with his son. That precious time proved to be a defining moment in Botso’s life. He went on to endure many hardships, including fighting in the Russian army, being captured by the Nazis, and never seeing his mother again. Yet in spite of his challenges Botso remained true to his love of life and music. He eventually came to the United States where he became a beloved music teacher and changed the lives of thousands of students. At age 91 he is spry, healthy, creative, and more vital than ever. He celebrates every moment and transmits his passion to all.
While Botso would not be considered a spiritual teacher, his huge spirit teaches by example. He has chosen happiness. Is there any better teaching? Many books and seminars tell how to be happy. One man modeling happiness is more powerful than all the words that point to it.

Let’s take the greatness vision one step further 

What if the genius in your midst is you? What if your passion and unique talent has the potential to change many lives, including your own? What if you own a gift no one else can give, and your purpose on earth is to deliver it? What if the master you seek lives within you, and is calling for expression?
While overconfidence can be a drawback, under confidence is a killer. The enemy of humanity is not bloated ego. Often people with bloated egos deliver talent to the world that less confident egos would hide. The real enemy of humanity is deflated ego. Humility does not imply self-diminishment. Real humility recognizes the gifts that Great Spirit has given you, and you humbly go about delivering them.
The story is told about a group of old monks who lived in a monastery dying due to lack of passion. One night a mysterious stranger showed up and stayed with the monks for several days. “One of you is the messiah,” he told them, and departed. Soon a new air of excitement filled the monastery. All the monks treated each other as a potential messiah. Many wondered, “Could it be me?” Their vocation was renewed, and in the light of their newfound inspiration many spiritual seekers visited for inspiration and upliftment. Ultimately no one monk became the messiah. In a way, they all did.
There are masters in our midst. Let us recognize and celebrate them.

To view the video of the Joshua Bell experiment go to https://www.youtube.com/watch?v=hnOPu0_YWhw

Alan Cohen is the author of Enough Already: The Power of Radical Contentment. If you would like to become a professional life coach or incorporate life coaching skills in your career or personal life, join Alan’s celebrated Life Coach Training Program beginning in September. 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

The Recovery Continuum of Care Spectrum

By Seth Born

Finding help for a loved one battling addiction can feel like a daunting task: Which facility is the right for them? Whose services should I use? What kind of treatment do they need?
There are many factors to consider when weighing these issues, but most importantly is finding the proper level of care. In order to find the right facility for treatment, it’s essential to understand where in the spectrum of recovery services your loved one fits.
The intensity and length of the user’s drug and alcohol abuse/dependency history often is the most important factor when determining the proper level of treatment intervention.
When the family is at a point of crisis the experienced help of a certified interventionist is the ideal starting point, especially if the user is unwilling to seek, or even discuss, treatment. The treatment process then begins with a detoxification, often monitored by medical personnel, to ensure the loved one is stabilized to receive treatment.
Below is a list of the Recovery Spectrum and the typical, approximate time frame for each phase:

  • Detoxification (1-7 days)
  • Primary, In-Patient therapy (28-90 days)
  • Secondary or Outpatient treatment – IOP, OP, Aftercare (180 days)
  • Structured Residential Sober Living (often combined w/secondary Tx)
  • Transitional Living (3 mos.-24 mos.)
  • Participation in 12 Step Groups (continual)
  • Sober coaching (continual)

Each of the above can be seen on a recovery timeline and are indicated individually or collectively according to how the individual presents and the case management plan. Often, especially for severe cases, it is recommended to begin with a primary, in-patient treatment. This is where intensive educational curriculum is provided and emotional therapy work begins. The time frame of 28 days allows the body and mind to initiate the physical healing process.
In the past, this was where the treatment continuum stopped. The patient was given a “prescription” to attend 12-step meetings, and sent on their way.
Over the course of the last 20-30 years data has shown that this model is ineffective for long-term remission from the disease of addiction. Now it is recognized by the medical establishment, including the AMA and the NIH, that for effective treatment for addiction, a secondary, longer engagement in a recovery center yields the best results.
This crucial, second step in the recovery process ideally includes structured residential sober living coupled with a clinical IOP/OP component. Here the patient is able to continue the critical therapy begun in primary treatment and learn how to live “life on life’s terms.” The rigors of daily life in new sobriety can be distressing, and without a solid support system, the individual will often relapse at this point trying to recover on their own. Having a professional program to guide the individual through this time produces positive results.
Also, if the intervention on the individual is done at an early stage in alcohol or drug abuse, it is possible that a stand-alone IOP program may halt the addiction process before it reaches chronic, late-phase status.
Most programs in the secondary treatment phase are approximately six months in length. This time frame correlates directly with the physiological changes of the neurological system in which the balance of neurotransmitters begins to return to “normal” levels. Due to this fluctuation in the neuro-healing process, Post-acute Withdrawal Symptoms typically manifest, and if not properly managed, can cause the individual to revert to negative coping mechanisms. Having the support of peers and those experienced in the recovery process greatly increases the remission rate and help the individual feel that they are not alone.
After this phase, depending on the individual, it is often recommended the individual step down in the continuum of care to transitional living, also commonly referred to as sober living, or a ¾ house. Here the amount of oversight and regulations lessen, while remaining a safe, sober environment. The individual is also encouraged to continue individual therapy and 12 step participation. This phase allows the individual to ease back into their independent life.
 This spectrum illustrates that recovery from drugs and alcohol is an active process and not a one-time event. Although for some, it may seem that these time frames are too lengthy to engage, it is also important to remember that by increasing the odds with continued care your loved one can gain lasting remission from chemical dependency, and go on to lead healthy, productive, happy lives—which makes it all worthwhile!
If you or a loved one needs help finding appropriate treatment for someone battling with addiction or alcoholism, please reach out for help and make sure you chose a licensed, certified facility.

For a list of certified sober living facilities visit www.myAzRHA.org

Seth Born is the Outreach and Marketing Coordinator for Chapter 5 Recovery, a non-profit organization dedicated to helping those in need find recovery. Their facilities encompass the continuum of care. Seth can be reached at Seth@Chapter5Recovery.com. Chapter5Recovery.com. Helpline: 888-541-0690

It’s Time to Spring

We are sitting on the edge of Spring, the season of rebirth and rejuvenation. For the earth, it’s time to blossom. The changes energize us and we begin to think about the changes we want to make in our own lives because of this sense of renewed energy. However, we often greet the idea of change with the perception that it is difficult, problematic and hard. We do that, usually, while sitting in the middle of our extreme discomfort and ignoring the urge to begin again.

Why is change so frightening? 

Moreover, why do we wait until the discomfort is unbearable or the possibility of ecstasy grabs us by the collar?
Maybe it’s because like death we are stuck in the perception that it happens to everyone else but certainly not us! You can take some comfort in knowing that if you are not changing, you are probably standing still in your own ego, afraid of being wrong. If you are changing, you are one of those courageous souls, who are awake and doing life instead of simply watching from the sidelines. Everyone experiences change. The key is to experience on your own terms. How do we do that?

First, be willing to tap into the collective wisdom of the sages in your life.

Talk to people, give yourself an information gathering time, and permission to NOT make any sudden changes until all the information is in — and your wise mind tells you that you are ready. We can become scared simply because we don’t have all the facts and are pushing ourselves to change before we are ready. I have a friend in California that never does anything until she talks to everyone this side of Mississippi. I use to think she was over doing it until I began to see how much valuable information she gathered before she made decisions. She seldom had to change her mind and almost never felt regret for the decisions she made.

Second, be willing to ask yourself to do a reality check on your beliefs. 

Are they current? Are they ideas from family and friends you gathered over the years, but with which you are really not aligned?  In other words, are they still serving you? If not, be willing to revise and up date your perception. Once you realize that your perceptions may be outdated or incorrect, it becomes easier to let them go. Actually, your perception is everything. If you think change will be hard, it usually is. If you think it will be fun and beneficial, it will be.
Third, clean up your language. Words like, “I’m trying,” or “I should,” or “I might,” leave the door open for failure. I am, It is and I have are words that indicate you have taken personal responsibility and are in the NOW. They are more empowering.
Fourth, give yourself permis
sion for change to be a journey, not an end result. Know that you will make adjustments and corrections along he way and being perfect is NOT THE GOAL. The goal is to be forever in the process of changing and growing. I hope that much of what you thought 20 years ago is very different than what you think today.

Change is inevitable 

When I do executive training, I tell corporate managers a piece of truth that is correct for all of us. ANY change will result in some good result. Change wakes us up. It reflects back to us how we are doing and it tells us what areas of our lives need attention. Change is a vote for you and the quality of your life. Some changes are monumental and these are the ones that put our priorities in order and renew our sense of purpose and ethics in life. They are a wake up call that says, Do what you came here to do and get your life back on track. In the midst of change, we are not always comfortable. However, if you look back on your life I know you will be able to see the gifts that change has brought you.
So the point is, it is time for you to start to blossom again. Trust yourself to create a life that is vibrant and worth living. Give yourself the gift of newness and exploration. You are worth it and this is the season. Go stir things up and see what blooms…maybe you will.

Overdose Not a Pretty Picture

By Theodore Caputi on Twitter: www.twitter.com/TheodoreCaputi

2014 may very well be the most tumultuous year for drug and alcohol research and policy in recent history. The CDC has declared the rise in opioid (heroin and prescription painkiller) abuse a national epidemic, and more people are now dying from prescription drug overdoses than automobile accidents. States are legalizing and decriminalizing marijuana — legislation that, just a few years ago, could never have gained any traction. New advancements in drug and alcohol prevention, intervention and treatment programs occur nearly every day.

So what does all this mean for teens and college students today? Here’s what you need to know.

The opioid epidemic is big news

If you get nothing else from this article, get this:  opioids, including prescription painkillers like hydrocodone and oxycodone as well as heroin, are among the most serious drugs out there. Most people know heroin is a serious drug, but many don’t see the peril in prescription painkillers. Because painkillers have a legitimate pharmacological purpose, many teens, college students and adults alike start taking these pills without fully understanding their danger. How bad could a drug be if your dentist gave it to you when you had your wisdom teeth removed? The answer? Pretty darn bad. In fact, more people now die from prescription painkillers than from heroin and cocaine. Combined.
It didn’t used to be this way. Ask your parents. Opioids (mainly heroin) were “dirty” drugs, used only by the most serious drug users. Prescription painkiller use has tripled in the last two decades, and it’s affecting the inner cities, middle class suburbs and everywhere in between. Because opioids are new to so many communities, people need to realize how deadly and addictive they are.

Even if recreational marijuana is legal in some states, it can still damage your health

Whether or not you agree with recent legislative changes regarding marijuana, research proves that marijuana use prevents you from performing at your peak. Ask yourself: what are your short and long-term goals? Do you want to do well in school? Are you passionate about something you want to change in the world?
Marijuana seems harmless enough. (True, marijuana overdose is unlikely.) But marijuana can interfere with your motivation and cause you to fall behind on your goals. Most of the young people I know who have stopped using marijuana are happier and better off for it. Further, even if overdose is unlikely, marijuana use is associated with addiction and other long-term health consequences.
Just because marijuana is legal in some places doesn’t mean it’s the right decision for you.

Call for help

Overdose is a real danger. It’s one of the leading causes of death among teens, and a big part of the problem is under-reporting. We’ve all been in that situation. We’re at a party, and some kids are binge drinking or using drugs. A few kids are throwing up in the bathroom, and you find a guy passed out on the couch. Great party, huh? But does this guy on the couch need help? He’ll be fine, right?
Please don’t make that decision on your own. Trust me, calling the authorities is worth it — worth embarrassing yourself, worth stopping the party and even worth getting in trouble. Just log on to International Overdose Day’s website to see how “worth it” calling 911 is.
NOTE: Many states and college campuses have a “good samaritan” rule that will prevent you from getting in trouble for reporting a potential overdose.

Overdose isn’t the only thing we’re worried about

High schools and colleges are focused on overdose, but that view may be myopic. Of course, overdose is the most visible issue for teens and college students, but in America alone, 23.5 million people struggle every day with addiction (approximately 7.5 percent of the American population).
Out of those 23.5 million people, I am guessing that none of them woke up one morning with the plan to get addicted to drugs. Addiction is sneaky. It starts with a series of seemingly benign mistakes. Once a person is addicted, however, it’s an uphill, lifelong battle. Treatment for addiction works — but you can never be “cured.” If you become addicted to a substance, you’ll spend the rest of your life with the threat of relapse.
Don’t think it could happen to you? Neither did 23.5 million Americans.

Treatment is available

Just over 10 percent of Americans struggling with addiction actually get help, and 90 percent of Americans struggling with addiction started using drugs before they turned 18-years-old. Put two and two together: there are probably a lot of teens and college students who need help but aren’t getting it.
Fortunately, help is on the way. Addiction treatment is certifiably effective. And it’s available to you. Under the Affordable Care Act, substance use care is now considered an essential health benefit (EHB), meaning all individual and small group health care plans are required to provide substance use care. Further, teens and college students are now eligible to stay on their parents’ plan until they turn 26-years-old. If you feel like you have a problem with addiction, if you find yourself using drugs or alcohol alone, or if you feel like your day isn’t complete without a fix, it may be time to seek professional help.

The Dangers of Process Addictions

Addiction has long been limited to the abuse of chemical substances that leads to physical and emotional dependence. While still debated by some experts, many now agree that there are indisputable similarities between traditional substance addictions and what are called process addictions. These are addictions to any kind of activity or behavior, and do not involve ingesting a substance like a drug or alcohol.
Growing evidence from the addiction research community is showing that process (or behavioral) addictions share more things in common with drug addictions than previously thought. There are differences, too, but when all the similarities are realized, people who struggle with process addictions may get access to better treatment options.

What Are Process Addictions?

Even if you have minimal personal experience with substance addictions, it is easy to understand what they are. A chemical substance is ingested, produces changes in the body and mind, and eventually becomes a necessity. We call this addiction. What distinguishes a substance addiction from a process addiction is that process addiction involves no chemical substance. Any addiction that involves ingesting or taking in a drug or alcohol is a substance addiction, and anything else would be classified as a process addiction.
The activities and behaviors that can qualify as process addictions are nearly limitless. More common examples include gambling, sex or pornography, eating, shopping, Internet and video gaming. In fact, gambling has been officially recognized as an addictive disorder. Any activity or behavior, however, can become a process addiction.

Characteristics of Addiction

Process addictions are similar to substance addictions in many ways. As with substance addictions, a process addiction often begins when the addict uses a behavior or activity to cope with negative emotions. Just as an alcoholic might drink to drown out thoughts of an early trauma, someone addicted to shopping might go on a buying binge to cope with stress or a bad day. Not all addictions start this way, but it is a common theme.

Another commonality between process and substance addictions is the feeling of a high. Drugs and alcohol are mind-altering substances. They change chemicals in the brain and cause a feeling of euphoria. Although process addictions don’t involve chemicals, they still produce a high. An overeater experiences pleasure when binging on food, for instance. To achieve that high requires more and more of the substance or activity over time. This development is called tolerance and it is seen in both types of addiction.
When an addict stops using his drug of choice, he experiences withdrawal symptoms as his body copes with not having the substance. People with process addictions have these cravings and feelings of withdrawal as well. When a problem gambler cannot get to a casino or an online poker game, she may feel physically and emotionally distressed.

One of the most important ways in which process addictions are similar to substance addictions is in the way that they can overtake the life of the addict. Using a substance or engaging in an activity can become an obsession to the extent that it becomes the main controlling factor in the addict’s life. This leads to all kinds of negative consequences: disrupted relationships, loss of work, negative health impacts, financial problems and even legal trouble.

Many of the characteristics that have long been understood to be a part of chemical addictions are seen in cases of process addiction. This evidence lends support to the idea that they are genuine addictions, though they lack the chemical substance factor. But what are the implications of these similarities?
As experts come to better understand process addictions, the consequences should be positive for addicts. Addiction is largely recognized as a disease that requires medical treatment like any other illness. If experts can agree to include process addictions in this category, those who suffer from them may be able to access support and care that was previously used only for substance addicts. Currently, people with process addictions are generally not taken as seriously as other addicts and they don’t get the same kind of help as a result. With more research will come more knowledge, and everyone will benefit.

Printed with permission Elements Behavioral Health

What Is

Like any human being, I don’t always care for the circumstances and curve balls life throws at me.  My question is, are they really curve balls and cosmic 2 by 4’s that bang us on the head? 
Maybe so — it always gets my attention. Yet sometimes it is still difficult to accept what is. 
Over the years I’ve known many sober addicts and alcoholics (myself included) who continue to struggle with acceptance.  People, places and things aren’t meeting our needs or wants. Life happens, we experience and feel all sorts of emotional pain, and the big picture is out of our control.  Why do we fail to remember there is a greater hand at work? 

I am but one thread in the canvas of life. I am part of …..not the whole story. It is my choice to make to a difference and contribute something of value — or not. I can spend days and months whining about how unfair everything is — or choose to be patient and see what the next moment brings. Sounds simple, but letting go is never easy and I sometimes have a built in forgetter.

In his book Enough Already, Alan Cohen says, 

“To keep pain from becoming suffering, minimize resistance. Decrease indignation and increase allowance. Quit trying to manipulate others, and manipulate your viewpoint. Find beauty, value and purpose in what is before you. Let yourself be what you are, and let life be what it is. 

You might find many gifts laid at your door that you would have otherwise overlooked.”
I need to memorize that.

Happy Spring!