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Inspiring Success on the Road to Recovery

Tuesday, May 1, 2018

#metoo



By Suzanne Berndt – MC, LAC, MHSA

A few months ago, I had the opportunity to sit with Barbara as she recalled the sexual assault she experienced in her home decades ago. She shared her confusion around the triggers she recently experienced as the #MeToo movement grew from a small grass roots advocacy group to an international phenomenon.

The Media Explosion

The subsequent media blitz filled our homes and workplaces with first-hand accounts by both men and women of sexual abuse and assault. The perpetrators were identified as acquaintances, strangers, family members, friends, trusted people in authority, media figures and political leaders.

I sensed that Barbara was somewhat confused and embarrassed by her emotional response. She felt she had “recovered” from her traumatic experience and the resultant struggle with substance abuse and compulsive sexual behavior. She had done her work and her sobriety was a testament to that. She was a survivor and had moved on with her life and left the trauma in her past — or so she thought.
April was National Sexual Assault Awareness and Prevention Month. It is sponsored by RAINN (www.rainn.org) – Rape, Abuse, Incest National Network which is the nation’s largest anti-sexual violence organization. Recent statistics provided on the RAINN website illustrate just how endemic sexual violence is within our culture.

Every 98 seconds an American is sexually assaulted.


  • 1 out of every 6 American women has been the victim of an attempted or completed rape. 
  • 1 out of every 10 rape victims are male.
  • 33% of women who are raped contemplate suicide while 13% attempted suicide.
  • Rape survivors are 3.4 times more likely to use marijuana, 6 times more likely to use cocaine and 10 times more likely to use other major drugs.


All of these data points represent individuals. Women, children and men marginalized by misogyny, intolerance, powerlessness, race and circumstance. Sexual assault, violence and abuse create trauma unlike any other trauma in that our insidious rape culture often leads to secret keeping, shame, guilt and isolation.

Rape Culture Defined

Rape culture is the sociological concept that describes an environment in which sexual violence is normalized and women are objectified. It is a victim blaming, slut shaming environment perpetuating a belief that sexual assault is inevitable.

During our time together, Barbara and I began to explore the concept of trauma and how it is often misunderstood. Freud defined trauma as, “A breach in the protective barrier against overstimulation, leading to overwhelming feelings of helplessness.” Peter Levine, PhD, a psychologist specializing in trauma defines it as “A loss of connection – to ourselves, to our bodies, to our families, to others and to the world around us.”

Traumatic symptoms are not caused by the event itself. In the case of sexual assault or abuse, it is not the event per se but rather the response in the nervous system. Often times what we consider to be the trauma, in Barbara’s case being raped and her life threatened, is only part of the story.

The After Affects of a Traumatic Event

Trauma is often viewed as a finite, acute event that we can easily identify. However, the real trauma can come after the identified event. Consider the response of Barbara’s parents when she told them of the rape. Her mother distanced herself from Barbara by referring to her as “your daughter” when she told her father of the rape. Then, to add insult to injury, Barbara was physically assaulted yet again by another man – this time, tragically, by her father. The medical professionals she encountered proved to be less than supportive and Barbara picked up on their unspoken message that she was to blame for the sexual violence she endured.

As the statistics bear out, Barbara’s experience is not an isolated one. A few years ago, I was asked to work with a woman who disclosed that in her early 20’a she had been drugged and raped by a well-known celebrity. She described herself as young, naive and passionate about working in the entertainment business. She was encouraged by her agent to meet with this powerful man under the guise that she was “special.” He offered to be her coach and mentor in an industry which was notoriously difficult to find opportunity and success. She later discovered that her female agent had been a “pimp” of sorts, offering her up to be sacrificed to a known perpetrator.

As a result of her shame, she spent years struggling with alcoholism and found it almost impossible to be emotionally vulnerable enough to have meaningful relationships. Her struggle to parent her children in a functional way and to connect with her husband was ever-present. In her recovery, she became an activist and champion for others victimized by this man. However, because she was only one of multiple accusers the prosecuting attorneys told her that her case was not as compelling as some of the other accusers’ cases and as a result she would never have her day in court.

She “lost” in the competition to have the best assault story buoyed by the most comprehensive evidence. The legal system minimized her experience of rape and assault — the very institution that she sought to represent her. Another example of piling on trauma to what was already a traumatic event.

Human beings are social animals and there is an inherent belief or social contract within the species. We are tribal. We are clannish. We have an overriding desire to belong. If there is a need for help or support, it is in our DNA to reach out and connect. If that connection is lost, denied or in some other way unavailable, feelings of betrayal, abandonment, isolation, anger, sadness and fear set in. The lack of support can be traumatic all on its own, separate from the traumatic event.

It is a breach within the human “family” system in which we play a part. In the case of sexual abuse and rape it can be devastating. For example, the trauma experienced by being in a car accident or natural disaster is often met with compassion and support. Sexual trauma is frequently stigmatized by our culture leading to shame and a reticence in coming forward to share the emotional and physical injuries one must endure. Self-esteem, self-confidence, connection to others and to the world at large are negatively impacted

Grief: A Frequent Byproduct of Trauma

Grief related to sexual violence is complicated. There is loss of identity, safety, innocence and trust — all difficult in their own way. The assault is confirmation that not only the world, but one’s own body is not a safe place. These “little deaths” must often be cloaked in secrecy and isolation. Survivors may find little room to grieve in the aftermath of sexual assault because of societal judgement. Acknowledging that one is a survivor of sexual trauma can be met with scrutiny, disbelief and blame.

In addition, a victim’s sense of shame perpetuates the negative belief that they have no right to grieve. This is disenfranchised grief. In our society, sexual assault might not be considered an “acceptable” loss. It is neither socially sanctioned nor publically mourned. Well-meaning friends and family, struggling with their own emotional intolerance and lack of resiliency, are not able to provide a space in which the survivor can acknowledge their loss. They encourage the survivor not to cry, to move on and to not think about it so that they do not have to think about it.

Victims of sexual abuse often describe the feeling of living a short distance outside of their bodies. This feeling is a result of having experienced an inescapable attack and the body being unable to fight or flee which is the natural animal instinct in an attack. With no other available option, the body and often the mind enter a state of “freeze.” It is no longer safe to be in the body and as a result, physical sensation and emotional response can overwhelm the nervous system. This “body narrative” can evolve from “I feel bad” to “I am bad,” often resulting in addictive behavior — the need to numb what cannot be tolerated, regulated and for which there is no resiliency. Where there is trauma — sexual or otherwise — there is an increased chance for addictive behavior.

Barbara’s struggle with drug and alcohol abuse after the rape makes sense in that it buffered not only her somatic response to the assault but also the negative beliefs that often stem from victim shame.

Her reported promiscuity is not unusual for survivors of sexual assault and abuse. Sexually acting out is a type of trauma repetition. There is a need to make sense, gain mastery and find meaning in our trauma.

All Sexual Trauma is about Violation and the Exercise of Power 

Our sacred space, our very essence is shattered and our energetic, spiritual, emotional and sexual boundaries are ruptured. Physical injury may not be treated due to a lack of resources, a lack of empathy and advocacy within the medical system or the minimization/denial of the injury due to the survivor’s feelings of guilt and shame.

Unresolved trauma experiences can lurk underneath the surface of our consciousness and reside deep within the brain. Post traumatic stress disorder might be assigned as a diagnosis but to my mind it is more like a post traumatic stress injury. There is nothing disordered about a response to the deepest wound experienced by the physical organism (body) and spiritual identity (soul). Not everyone who experiences trauma will develop PTSD, but a traumatic experience can alter brain function.

Thankfully, the brain is pliable and “plastic.” This means that while trauma from the past can alter our brains, our brains can also change in response to what we experience now and in the future.

Picture the brain as a beautiful, living example of the evolutionary process. Anatomical function from the front of the brain to the back of the brain represents “newest” to “oldest” development. The most “evolved” or newest anatomical development in the brain is the pre-fontal cortex which is located behind the forehead. It is the thing that makes us human. No other animal has this.

Simply put, it is the “thinking” part of the brain, where rational thought, personality, empathy, problem solving, and decision making reside. The less evolved or “older” mid-brain or limbic system is the “emotion regulation” center and is where memory, compulsivity and addictive behavior is generated. Finally, the most ancient part of the brain known as the amygdala or reptilian brain is the “fear center.” When trauma occurs the functional connection between the amygdala and the frontal lobe can be affected. The amygdala will become over activated as if “the house is on fire” even if the threat is gone.

In contrast, the frontal cortex is under activated and cannot provide a cohesive message telling the fear center “we are no longer in danger.” In a metaphorical sense, the smoke detector is going off in the absence of smoke. 

Unresolved trauma can also stay “stuck” within our bodies. When we are unable to fight or run due to an inescapable attack we go into a “freeze” response which is high activation. This leads to an inability to complete an active, defensive response. Trauma energy generated by biochemical response can collect in our bodies at a cellular level. This can become toxic and inflammatory and lead to autoimmune disease and other physical pathologies. Survivors of sexual assault often carry this trauma energy in their pelvic region resulting in a significant predisposing risk for somatization of chronic pelvic pain and other pelvic pathologies.

Finding Recovery

Sexual assault, rape and incest are life altering experiences but recovery is possible. Finding a compassionate therapist who specializes in trauma and understands its affects, including mood disorders and addiction can be a first step. Therapeutic modalities aimed at trauma resolution include:

Eye Movement Desensitization and Reprocessing Therapy (EMDR) uses subtle eye movement and/or bilateral stimulation – to rewire the brain and modify the way a survivor processes the event.

Somatic Experiencing (SE) works with the felt sense of the body to build emotional resiliency and tolerance. It addresses the dysregulated autonomic nervous system.

Cognitive Behavioral Therapy (CBT) addresses the negative core beliefs we carry about ourselves and reframes them. For example the idea of “I am bad” can be reframed to “I feel bad” and transformed into “A bad thing happened to me.”

Trauma Informed Yoga is a body based modality that can facilitate the safe return to one’s body.

Mindfulness Based Stress Reduction (MBSR) is a national program developed by Jon Kabot-Zinn out of the University of Massachusetts Medical Center. It is an eight week long, evidenced based program designed to reduced emotional and physical pain through the practice of mindfulness.

Bio-feedback is an evidenced based modality used to increase functional brain activity and reduce trauma symptoms through brain training exercises. It can also help to address addictive behaviors and compulsivity. 

In the wake of the #METOO movement, fueled by the self-reports of survivors and the unmasking of perpetrators, I observed the flurry of celebrities, politicians and pundits who quickly shared their thoughts and feelings. Many expressed outrage and disbelief. They were “Shocked!” at the extent to which sexual abuse and misogyny ran as a rampant thread throughout the tapestry of our culture.

I was shocked that they were “Shocked!” They were quoted time and again as having said, “I have a mother, sister, daughter, wife and I cannot condone this behavior!” I do not recall hearing, “I have a father, brother, son, husband and I cannot condone this behavior,” when a male was identified as a survivor or perpetrator.

My interpretation of this message is female survivors of sexual violence are acknowledged, valued and legitimized when they are identified in relation to others, usually men. While male survivors and victimizers were seen as individuals unto themselves who needed no point of relational reference to define their humanity. Women were “second-tiered” even in the acknowledgement of their trauma.

The female survivor’s experience was hijacked and redirected to address how the traumatic experience affected others, usually men.

I am hopeful that the #MeToo movement will continue to re-energize the women’s rights movement of the 1970’s. This has been an ongoing battle to define who and what we are in an often unforgiving and maddening society. I am thankful for women like Barbara, who bravely step out of the shadows and into the light to share their stories of sexual trauma and recovery.

Perhaps not unlike our evolving brains, we can evolve from “only me” to “me, too” and then on to “we, in connection to me”.

Suzanne Berndt – MC, LAC, MHSA, is a licensed associate counselor with a masters in counseling and a masters in health services administration  from Arizona State University. She holds a bachelors degree is in psychology and anthropology from the University of Michigan. She is trained in Somatic Experience which addresses unresolved trauma that may be carried in the felt sense of the body.

Suzanne works closely with clients to achieve goals and develop lasting skills that will support them in life’s journey.  These skills may include setting functional boundaries, creating mindfulness practices, defining wants and needs in recovery, providing relapse prevention support, developing a healthy sense of self, utilizing sound coping skills and supporting resiliency and self-agency to address unresolved trauma and grief. 

Visit www.pcsearle.com


New to the Valley



Continuum Recovery Center is a treatment facility located in Phoenixwith two locations offering nationally recognized evidence-based treatment. CCR provides a comprehensive holistic approach to overcoming chemical dependency, alcoholism and co-occurring mental health disorders in a safe, confidential and supportive environment.
Continuum offers the following:
  • Primary Care Treatment with Housing 30 to 45 Days
  • Extended treatment with housing 45 to 60 Days
  • Intensive Outpatient Treatment with Sober Living 60 to 90 Days
  • Individual, Group, Family, Relapse Prevention Therapy
  • Life Skills, Job/Re-Entry Programs
  • Art and Music Therapy
  • Weekend Outings including monthly trip to Sedona
  • Aftercare and Alumni Groups
  • Nutrition, Acupuncture, B-12 Shots
  • Fitness, yoga, meditation, massage and chiropractic services
For more information visit www.continuumrecoverycenter.com. For immediate help call 
855-370-1562 or 602-354-4032.




Detoxification, is often the first step in addiction treatment and recovery. 

Footprints to Recovery —  brings a cutting edge, modern and comfortable medically supervised detox option to Mesa, Arizona.

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At the state-of-the-art facility individuals work with clinicians and specialists far beyond just withdrawal management. Through individual and group therapy, as well as their gained peer support network clients are encouraged to begin to work on identifying the cause and underlying issues associated with their addictions. www.footprintstorecovery.com. 877-628-0410.

7 Things Children of Alcoholics Can Be Grateful For

By Dr. Tian Dayton

How many times have I heard people share that they “do not regret the past?" People, who have, by the way, experienced extreme trauma including child abuse, domestic violence, affairs, and addiction. So what can anyone who has grown up with childhood trauma be grateful for?
“Whatever brought me into recovery” says Sharon M., “has helped me to make such positive life changes that I truly feel appreciative more than resentful, much more in fact. I know it sounds odd but I even feel grateful to the pain that led me to see so much about myself, other people and this thing we call life, that I have learned to live and love a day at a time.”

For starters, you are not alone
More than 26 MILLION Americans are Adult Children of Alcoholics (ACoA). Many of those who have found recovery have also found these seven trauma-grown gifts.


1. A Sense of Gratitude and Appreciation for an Ordinary Day

When you have lived with the pain and angst of addiction, you have stared into the jaws of hell. You have seen first hand how bad choices can destroy a life. This is true not only for the addict but for all those who live with an addict. When you have been a part of recovery, you have seen first hand how good choices can make a life. And at the very center of this feeling is how it impacts each day.

An ordinary, normal day, one in which problems are normal ones, dinner finds its way onto a table and there is normal conversation, some laughter, some quiet, some chit-chat, comes to have an almost spiritual quality. It feels soothing, real, alive and worthwhile.We no longer take these days for granted. We know the beauty of an ordinary day.

2. Relationship Sobriety

When we lack emotional sobriety because we have lived with the constant stress of addiction, our relationships lack emotional sobriety as well. As our own inner world feels less manageable, our relationships come to mirror this unmanageability. We don’t know where we leave off and others begin, the inevitable overlapping of inner worlds that happens naturally in intimacy, becomes codependent rather than inter-dependent. Tensions become exaggerated and easy good times make us anxious because we do not expect them to last. We look for problems before they look for us, it’s part of the hyper-vigilance that is the legacy of trauma.

In recovery we learn new ways of being with ourselves and with others. We learn to tolerate and manage emotions, to talk out feelings rather than act them out. As our trust in ourselves increases our ability to trust ourselves with others does as well. We learn how to have boundaries that take care of both ourselves and the relationship; boundaries become porous rather than rigid. We can relax, let go and enjoy being in the presence of others rather than needing to withdraw from connection, because we cannot hold onto a sense of self in connection with others.

3. Learn What NOT To Do

We learn as much by negative examples as by positive ones. Growing up with addicted parents and witnessing first hand the cost to the family can make us, if we accept that lesson, never want to be the agent of such destruction in our own lives. There are many problems we encounter in life that we have to accept and cope with as best we can, but both addiction and enabling have an element of choice. We can choose recovery and health.

4. A Sense of the Depth and Wonder of Life

If as Socrates said, “the unexamined life is not worth living,” then living with addiction makes the choice ever more stark. Choosing addiction is choosing a slow walk to the grave. Choosing to examine and understand all that drives us to our own destruction opens the door, in fact flings the door open to choosing life.


5. A Sense of Community

You always have a place to go. Alanon, ACoA and CODA are world wide self help organizations that offer safe haven, connection and a sense of community. If you move, travel or find yourself with either time or personal need, you can enter “the rooms” and find like minded people, you can find caring and support.

6. A New Design for Living

It’s not only the addict who finds a “new design for living”: through recovery. Children, spouses and family members can and do as well. Recovery is about awareness, acceptance and action. Choice. Recovery allows and encourages us to examine life, to become humble and vulnerable enough to grow and stretch and be open to change. We become capable of embracing the mystery of life.


7. The Gift of Recovery, Including Mindful Living

All of the above points are what those of us who no longer “regret the past nor wish to close the door on it,” would see as a part of recovery. Living on purpose is its own reward, making one positive choice leads to another and taking responsibility for our own happiness puts us in the driver’s seat.

Make a gratitude list today!
Whether you choose to say thank you to someone who does something nice, or express appreciation to someone you care about or even think grateful thoughts, the science behind gratitude is clear.
A one time grateful thought and act of gratitude or appreciation produces a 10% bump up in happiness and 35% reduction in depressive symptoms.
These happy effects and feelings, according to the study conducted by Martin E. Seligman, the father of positive psychology and his team, disappear within three to six months. That’s a pretty good return on an investment if you ask me. It also makes clear that the benefits of regular, even weekly “attitudes of gratitude” and their corresponding acts, can be literally medicine to our body and our mental health.
So say thank you to someone today, including yourself and see what happens!
This article was originally published by the Huffington Post.

Dr. Dayton is a Senior Fellow at The Meadows. She is the author of fifteen books including Neuropsychodrama, Visit www.tiandayton.com 

20 Lies Addicts Say to Justify their Addiction


Addicts lies to themselves and others in order to justify continuing their behaviors, have you ever used any of these?

“It’s not that bad.” At the first sign of confrontation, addicts minimize their addiction by claiming it isn’t that bad. They might even say they were far worse in the past.

“I only use it occasionally.” Instead of flatly denying, they might admit to far less than what they are doing. The rule of thumb is that an addict admits to less than half of their actual usage.

“I can’t deal with (fill in the blank) without it.” The irony of this statement is the addict begins to look for reasons to use their drug of choice. They might even create unnecessary problems to support it.

“I can stop whenever I want to.” To keep from thinking they are addicted, they deceive themselves into believing they can stop at any time. They might even go for a short period of time to prove it, but it is only temporary.

“I’m not like … he/she is worse.” By comparing themselves to others, addicts can minimize the effects of the addiction while highlighting the severity of another person.

“I’m different than …” Again, they pick another addict that is strongly disliked and say they are not like them. This comparison might even be accurate but it doesn’t diminish the reality of the addiction.

“Everyone else does it.” This is a larger comparison where an addict claims everyone they know does the exact same thing and therefore, they can’t have an addiction. It is a type of group think.

“This is my thing, not yours.” Addicts tend to become weirdly possessive of their drug of choice. It is an affair of sorts where they are uniquely connected to the substance.

“Life without it is boring.” This is further evidence of a substance affair. An addict sees life as dull and meaningless without the use of the substance.

“I just like how it feels.” True addicts develop a personal relationship with their substance and assign properties to it as if it was a human. The substance can generate feelings within the addict.

“I can’t be social without it.” A common belief is an addict is unable to engage in society or with family and friends without the using.

“If everyone is, I have to too.” Addicts will claim everyone else does it and they have to too, as if there were no other options.

“I need it to be creative.” This lie actually gives the substance credit for the addict’s creativity instead of the person doing the task.

“I need it to relax.” Instead of dealing with stress and anxiety, they cover it up with their substance usage. But the problem that brought on the stress still remains.

“You are trying to take away my fun.” As soon as the addict receives some resistant from others for using, they resort to believing everyone is trying to keep them from enjoying life.

“It makes me a better person.” To justify their usage, addicts will say without the substance they are more angry, frustrated, anxious, depressed, and/or bitter.

“It hasn’t changed me.” The contrast to the previous statement is the substance doesn’t have any effect on the abuser. In reality, the worse the addiction, the more dramatic the personality changes.

“I’m not hurting you.” After being confronted, an addict will minimize the effects of their addiction by claiming they are not doing any harm to others.

“I’m still working, so it’s not that. ” To prove they are not addicted, an addict will use their ability to continue with work as justification. Many addicts are able to function.

“The kids don’t know, so it’s okay.” Another common lie is the belief that kids won’t notice the addiction. Unfortunately, most kids are very observant.


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“I Am Jane Doe”

Documentary reveals the sordid world of underage sex trafficking, specifically as it pertains to young women who were forced into prostitution, their ‘services’ made available on the online classified site Backpage.com.



J.S. was an honor student who played the violin and ran on her high school’s track team. But in the spring of 2010, her free-spirited nature led to her wanting more. Living in the Seattle suburbs, the 15-year-old decided to run away to the city, where she quickly met a man twice her age who seduced her with gifts and a place to stay.
It didn’t take long for the 32-year-old man to abuse the trust J.S. had placed in him, beating and raping her before posting explicit photos of her in an ad on Backpage.com. And just like that, her new life was being raped for money.

“All the people that responded to the Backpage ad of this ninth-grade girl would come over and engage in what is essentially child rape,” said Erik Bauer, a Washington-based attorney representing J.S. in her lawsuit against Backpage.com. “It was a horrific situation.”

The legal battle between Backpage.com, J.S., and other girls like her who were forced into the multimillion-dollar sex trafficking industry, are the focus of the new documentary I Am Jane Doe, which debuted last February is now available on Netflix. In light of recent events of the alleged trafficking facilitator and classified advertising website being seized by the FBI under accusations including facilitating prostitution and money laundering, this film is extremely important.

J.S.’s story is not uncommon 
She was forced to meet with men in hotel rooms around the clock, was raped repeatedly for months.
“At one point, I finally accepted this was my fate and this was what I was going to be doing for the rest of my life,” says J.S., now 22. “I just kind of gave up.”
Fortunately for her, J.S.’s family never gave up looking for her. In a police sting operation, she was rescued from her nightmare. J.S.’s pimp was convicted of promoting commercial sex abuse of a minor, third-degree child rape and second-degree assault. He was sentenced to 26 years in prison.
But she was still only a child, and she struggled to regain a sense of normal life after what she had been through. “I was scared, I didn’t know if I was going to be in trouble or if my parents were going to be mad.”

About the Film

But J.S’s story is just one of many. I Am Jane Doe follows the epic battle that several mothers are waging on behalf of their daughters who became victims of sex trafficking through Backpage.com when they were underage.

Narrated by Academy Award-nominee Jessica Chastain, the documentary reveals how, after rescuing their daughters, these mothers filed lawsuits against Backpage. Although many of the lawsuits have been an uphill battle, their efforts sparked a political movement that included a Senate investigation.
The Jane Doe girls featured in the film include middle schoolers from Boston, a 15-year-old violinist from Seattle, and a 13-year-old girl from St. Louis. The documentary follows the journey of these young girls and their mothers in real time as they run head-on at Backpage but also with judges, government groups, and tricky internet freedom laws.
To give back to the issue, 50% of all profits from this project have been donated back to non-profit organizations which serve Jane Doe children.


By the Numbers

We live in a world that needs to see solid numbers to legitimize an issue. Unfortunately, since sex trafficking is an underground business, those numbers are hard to come by. But a lot of what we do know about the current state of the industry comes from survivors, and they have a lot to say about how porn and the internet were largely connected to or included in their trafficking experience.

According to anti-trafficking nonprofit, Rescue:Freedom, in 9 countries, 49% of women in prostitution said that pornography was made of them while they were in prostitution and 47% said they had been harmed by men who had either forced or tried to force them to do things they had seen in porn.

By some estimates, 4.5 million people are trapped or forced into sexual exploitation globally. (International Labor Organization)
In one survey, 63% of underage sex trafficking victims said they had been advertised or sold online. (Thorn)

 Sex trafficking is big business — it generates $99 billion annually, just from commercial sexual exploitation alone. (International Labor Organization)

Sex trafficking is a local issue, as well as a global one, it doesn’t help when we ignore the issue in our own backyards and choose to look the other way.
Supporting one area of the sex trade fuels the demand for other areas — porn, prostitution, and sex trafficking are deeply interlinked. Each of us can start conversations by highlighting the heavy connection between these toxic industries. By taking a stand, we can make a difference and help the world fight for real love. Show your support for the victims of trafficking by spreading the word that porn is anything but harmless entertainment.

SHARE this article to spread the word on how pornography is inseparably linked to prostitution and human sex trafficking. Check out “I Am Jane Doe,” available now on Netflix.

Addiction is an Intimacy Disorder


By Robert Weiss LCSW, CSAT-S

Addiction and Early-Life Trauma

Addicts are people who’ve lost control over their relationship with a substance or behavior. They use when they don’t want to, when they have promised themselves and others they will stop, when it pushes them away from family, friends, and other important people. They use when it impacts their work, schooling, finances, reputation, freedom, etc. They tell egregious lies to themselves and others to rationalize and justify their actions. They do this no matter how abominable their behavior gets, no matter how many problems their addiction creates.

And contrary to popular belief, addicts do this not because they enjoy it. They do it to escape. Addictions are not about feeling good, they’re about feeling less. Addicts cope with stress, depression, anxiety, loneliness, boredom, attachment deficits, and unresolved trauma by numbing out instead of turning to loved ones and trusted others who might provide emotional support.

Addicts choose their addiction rather than other people as a coping mechanism because, for them, unresolved childhood trauma has poisoned the well of attachment. Other people can (and often have) hurt them, let them down, and left them feeling abandoned, unloved, or intruded upon. They fear and don’t feel secure with emotional intimacy, and refuse to turn to others, even empathetic loved ones, for help when they’re struggling. Instead, they self-soothe by numbing out with an addictive substance or behavior.

Napoleon

Not so long ago, one of the worst possible forms of punishment was not prison or even death; it was exile. In 1814, after ten years as self-proclaimed Emperor of France, Napoleon Bonaparte was exiled to the Mediterranean isle of Elba. A year later he escaped, returned to France, and retook his throne for approximately 100 days before his ultimate defeat at Waterloo. As punishment, they exiled him again, this time to a much smaller and more remote island, St. Helena, 1,000 miles from the nearest land mass in western Africa.

In the 1800s, you could be drawn and quartered, tortured on the rack, beheaded, hung, and subjected to all sorts of other incredibly nasty punishments. But the meanest, most miserable thing they could think of for a despot like Napoleon was exile. And frankly, not much has changed.
When people do something wrong in modern society, we send them to prison, a form of exile. If they misbehave in prison, we put them in solitary confinement, an extra layer of exile. So, despite the Western ethos telling us we must make it on our own, being alone has long been viewed as a terrible thing.

Consider Henry David Thoreau. Despite what his writings might suggest, in the two years he spent at Walden Pond he was hardly isolated. His cabin, sitting on land owned by his closest friend, Ralph Waldo Emerson, was a thirty-minute walk to the town of Concord and he traveled there frequently, usually to spend time at the local pub with Emerson and other friends. He also had frequent visitors at the cabin, most notably his mother. So, even in self-imposed isolation Thoreau craved connection.

The Isolation of Addiction

Addicts don’t seem to understand this basic human need for intimacy and connection. They choose to live in emotional exile, and do not break this exile even if they visit the local pub like Thoreau. Addicts almost universally say they feel most alone when they’re in the company of other people. And yes, “other people” includes spouses, family, and other loved ones.
This occurs because addicts have learned, usually early in life through neglect, abuse, and other forms of traumatic experience, to fear and avoid emotional vulnerability. They distance themselves from others, turning to addictive substances and behaviors.

When addicts become emotionally needful —related to stress, losses, anxiety, depression, and even joyful experiences—they automatically and without conscious thought turn not to other people but to their addiction, using it as a source of emotional distraction and numbing.

Addicts exile themselves because they learned early on turning to other people for support, validation, and comfort leaves them feeling worse than before they reached out. They avoid the type of deep relational connections that, for healthier people, bring needed consolation, emotional resolution, stability, consistency, and reward, finding it more familiar and thus easier and emotionally safer to escape and numb out via addictive substances and behaviors. They use their addiction as a maladaptive distraction from their painfully unmet womb-to-tomb emotional dependency needs.

Addictions are not moral failings. Addictions are not weakness. Addictions are not a lack of moral fiber. Addictions are an intimacy disorder.

Overcoming Addiction

When addiction is conceptualized in this way — as an intimacy disorder—we see the best long-term treatment for addiction is not the pursuit of in-the-moment sobriety, it’s the pursuit of healthy, intimate, ongoing connection. Thus, a fundamental task of treatment, once the addict has broken through his or her denial and established a modicum of sobriety, is developing and maintaining healthy and supportive emotional bonds. It is this approach—not willpower, or babysitters, or shaming, or threatened consequences—that is most likely to create lasting sobriety, emotional healing, and a happier, healthier life.

With proper direction, support, and a fair amount of conscious effort, individuals who were not graced with secure childhood attachments (and therefore the ability to easily and comfortably connect in adulthood) can develop earned security via long-term therapy, 12-step groups, and various other healthy and healing relationships—the most important of which are healthy connections with loved ones. This means the dysfunctional lessons learned by addicts in childhood can be unlearned (experienced differently) through empathetic and supportive emotional interactions, especially with loving, healthfully supportive family members and friends.

Interestingly, addiction treatment specialists and the 12-step community have unconsciously operated with “addictions are an intimacy disorder and healthy connections are the antidote” as an underlying principle for decades. In fact, much of what occurs in well-informed, group-focused addition treatment and 12-step recovery programs is geared, either directly or indirectly, toward the development of reliably healthy social bonds.

Developing healthy intimate connections can be difficult, especially for addicts, who, as discussed, nearly always have histories of childhood trauma and other forms of early-life dysfunction that make intimate attachment uncomfortable and difficult. For addicts, learning to trust, reducing shame, and feeling comfortable with both emotional and social vulnerability takes time, ongoing effort, and a knowledgeable, willing, and empathetic support network (therapists, fellow recovering addicts, friends, employers, and, of course, prodependent loved ones). The good news? Both research and countless thousands of healthy, happy, long-sober addicts have shown us such healing can turn an isolated and addicted life into a life of joy and connection.


Robert Weiss LCSW, CSAT-S is a digital-age intimacy and relationships expert specializing in infidelity and addictions—most notably sex, porn, and love addiction. An internationally acknowledged clinician, he frequently serves as a subject expert on human sexuality for multiple media outlets including CNN, HLN, MSNBC, The Oprah Winfrey Network, The New York Times, The Los Angeles Times, and NPR, among others.

He is the author of several highly regarded books, including “Out of the Doghouse: A Step-by-Step Relationship-Saving Guide for Men Caught Cheating,” “Sex Addiction 101: A Basic Guide to Healing from Sex, Porn, and Love Addiction,” “Sex Addiction 101: The Workbook,” and “Cruise Control: Understanding Sex Addiction in Gay Men.” Visit robertweissmsw.com, or follow him on Twitter, @RobWeissMSW.

Emergency medicine experts lead national effort to reduce harm from opioids


  Yale emergency physicians Dr. Arjun Venkatesh and Dr. Kathryn Hawk are lead investigators for a $1.4 million initiative to disseminate best practices and implement evidence-based interventions in the Emergency Department to reduce harm from opioids. The grant supports a unique collaboration between Yale School of Medicine, Brigham and Women’s Hospital, the American College of Emergency Physicians, and the Addiction Policy Forum.
Emergency physicians are often the first to treat patients suffering harm from opioid use, such as overdoses. Yet many emergency departments (EDs) lack access to resources to improve outcomes for patients. To address this issue, the three-year grant will fund the creation of an Opioid Initiative for dissemination through the Emergency Quality Network (E-QUAL), a national quality-improvement network of emergency departments, co-led by Venkatesh and launched through the Centers for Medicare and Medicaid Services Transforming Clinical Practice Initiative.
“The Emergency Quality Network includes over a 1,000 Emergency Departments from across the United States, and we are excited to leverage this successful platform to combat the biggest epidemic facing the nation today,” said Venkatesh.

With support from the Addiction Policy Forum, the initiative will: recruit emergency departments nationwide to collaborate on opioid-focused interventions; develop a best-practice toolkit based on available evidence; collect data on quality of care; assess the current state of ED and hospital care; and study the effectiveness of engaging EDs in quality improvement efforts.

“The CDC recently announced a 30-percent increase in emergency room visits for opioid overdoses between July 2016 and September 2017. As the numbers continue to grow, it is vital we work together to develop evidence-based methods and practices to assist emergency departments as they respond to overdoses and the increasing number of patients struggling with a substance use disorder,” said Addiction Policy Forum’s president and CEO Jessica Hulsey Nickel. “We fully support this initiative and are dedicated to working collaboratively to address addiction in our healthcare system.”

At the end of the grant period, the Yale team and its collaborators anticipate delivering a free, online quality-improvement toolkit for EDs with proven results.

Venkatesh, the principal investigator, is assistant professor of emergency medicine and the director of performance improvement in the Department of Emergency Medicine at Yale School of Medicine and scientist at the Yale New Haven Hospital Centers for Outcomes Research and Evaluation. Hawk, co-principal investigator, is assistant professor of emergency medicine and a NIDA K12 Drug Use, Addiction, and HIV research scholar.

https://news.yale.edu/2018/04/16/emergency-medicine-experts-lead-national-effort-reduce-harm-opioids

Listening to the In Between

By Dr. Dina Evan

Dr. Evan specializes in relationships, personal and professional empowerment, compassion and consciousness. 602-997-1200, 602-571-8228, Dina.Evan@gmail.com and www.DrDinaEvan.com. 



Therapists are taught to listen, mostly to the in-between where the truth is, in what is not said, in body language, in facial expressions, in hesitation, discomfort and sometimes even obvious lies.  We are taught to listen differently in ways that could benefit all of us actually.
I would bet five bucks that you have had an exasperating moment recently when you thought, “People just don’t listen.” 

You are right.

Most people don’t listen well, and they don’t for a variety of reasons, most of which are fear based. We have a tendency to make a snap judgment about people or their issue. In doing so, we miss a world of opportunity to go deeper into understanding each other, learning about diversity and difference, chances to deepen our relationships and families and the world around.

When you can’t or don’t listen at a deeper level, you may as well be locked in a box with only your own perceptions and limited ideas. It’s like living with the windows and doors to a greater realty shuttered, your level of consciousness.

You can’t learn. You can’t create a greater understanding of people and the world and you can’t expand in knowledge and wisdom.
Being closed minded fosters confusion and creates distance.  It shatters families and causes divorces. Whereas being open minded creates learning opportunities and an expansive level of acceptance and grace. It’s character building and worth the effort.

I have learned that one of the most important questions in my tool bag as a therapist and as a compassionate human being is, what don’t I know.  That question opens up curiosity and leads to more questions like what am I hoping to hear, what am I afraid to hear, why am I feeling disconnected and what don’t I trust about myself and my own safety?

Listen in a Different Way

Perhaps if we could listen differently we could create less distance and hostility. For instance, in L.A., years ago, a couple of women came in for therapy. One, who I will call Sue, was dressed in a business suit and looked professional and somewhat at ease. The other was tattooed from head to toe, had an angry expression and was clearly pissed about being in my office. I asked what brought them in.

Erin motioned to Sue, to start talking. Sue explained that she had become fearful of Erin because her anger has caused her to start being physical and although she had not hurt her badly, Sue was afraid it would progress to that and their marriage was in jeopardy. I watched as Sue spoke and clearly Erin was uncomfortable. I asked her what she felt about what Sue had said.

She took a deep breath and tried to hold back tears, toughly responding “I love her and would never want to hurt her.”  I said I believed her and asked her where she thought the anger was coming from. She said she grew up with many tough challenges. Sue put her hand lovingly on Erin’s shoulder and said, softly, “Tell her.”  Erin then disclosed that she had watch her father kill her mother when she was a teen and had never processed the trauma or the pain with anyone.

We live in a world of judgment. So much so that many of us never talk about our pain and suffering, our challenges and we don’t even speak about our accomplishments for fear people will think we are bragging.

What might happen if we could learn not to judge anyone but rather just be open to knowing each other and what unfolds in the center of our relationships? Wouldn’t we want to know what others have overcome and how others have achieved what they have achieved, inspire us?  Maybe the next time we say “Tell me who you are, we could mean it.”

In that openness, — in that in between — is teaching both for the teller and the listener.  It doesn’t even matter what truth is there. It’s only matters what our response to that sacred space filled with opportunity makes us feel.

It’s all about how we respond, what are our values, what are our judgments and what is our heart space.  And, if your heart breaks open as you hear and hold the truth, you have done what you came there to do, because under that broken heart is the real you, the unprotected, courageous you.

Why Not?


Last fall the #metoo movement opened the floodgates on sexual harassment and other despicable acts that have happened for eons — but gone unmentioned in such a mainstream way, until recently. Today, as I write this, actor, Bill Cosby was found guilty for his actions against many women. When I heard the verdict, I won’t apologize — I was glad to hear it. 

I want to express my gratitude to Suzanne Berndt – MC, LAC, MHSA and Dr. Marcus Earle of PCS (Psychological Counseling Services) whom I met with about writing this article. I had no intention on sharing my personal experience with them, yet it emerged in our conversation. Not only did I feel safe as the story unfolded, their office walls were filled compassion, understanding and listening. In their line of work, they help clients with these issues every day overcome sexual related trauma and addiction. 

As I left our meeting I felt a bit spacey, but thought, “Why Not? Why not be as open with this thread of your story as you are with your recovery? Why not share it?” Together AZ is about discovery and recovery, for ourselves and those we care about. 

And here’s what I propose to you. Let’s keep the dialog open. If you are willing to share your story we welcome hearing from you. If you have questions or concerns on something that might be happening in your life right now, please do not stay silent. Reach out to me at aztogether@yahoo.com, or call PCS at 480-947-5739 for professional help. 

Let’s hold our heads high and move forward in our recovery 
together. Let’s be a “We.”

Wednesday, April 4, 2018

Integrated care can provide key to treating an epidemic

By Saul Perea, MD, Integrated Care Medical Director, Terros Health

6749

Six thousand, seven hundred, forty-nine. 


Since Governor Doug Ducey proclaimed an opioid epidemic on June 15, 2017, that’s the number of suspected opioid overdoses in Arizona (as of March 22, 2018). Sixteen percent of those — 1,080 — were fatalities.

By the time you read this, no doubt those numbers will be higher. You can check real-time information at the Arizona Department of Health Services website – www.azdhs.gov – search opioid.

The statistics are startling. And believe it or not, there are states in far worse shape than ours. 

It might seem like the word opioid has crept into our daily vernacular overnight. The truth is that the issue has been sneaking up on us for several years. 

Opioids are a class of drugs that serve as strong pain-killers. Prescription drugs include oxycodone (OxyContin®), hydrocodone (Vicodin®), codeine and morphine. The illegal drug heroin also is an opioid. 

The cause of the opioid epidemic is debatable. But we do know that during the 1990s and 2000s, there was a push for physicians to identify and treat pain. As physicians, we want to help – we don’t want to see people in pain. So, we took this mandate to heart and began more regularly prescribing opioids. 

You likely know the drill. Perhaps you’ve just had surgery — maybe even as “minor” as wisdom tooth extraction. You’re shown a bunch of little faces from “all smiles” to “agony” and you rate your pain accordingly. If your pain is severe enough, the doctor writes you a prescription. You’re happy to be out of pain. The doctor is happy because he or she has helped you. 
Sounds good. 
But there’s a big problem: opioids are highly addictive. 

To understand this, it requires a mini-lesson on brain chemistry. 

When someone takes opioid medication, the drug enters the bloodstream, creating a “surge” of artificial endorphins and dopamine – neurotransmitters that create happiness and even euphoria. This is different than the “rush” you get from the naturally occurring neurotransmitters. The only way you can experience it is to use the drug again. 

Long-term opioid use changes brain chemistry. The nerve cells grow used to having opioids around, so when they are suddenly taken away, the brain goes through withdrawal symptoms. 

So, there are very real reasons why people become addicted. It starts with a prescription for pain – given by a trusted physician. But if opioids are used too long, the pain might be gone, but the opioid effect has taken hold on the brain, causing a physical dependence. 

In order to continue getting the “high,” people have been known to “doctor shop” to obtain multiple prescriptions. They also can turn to the black market where the pills are very expensive. That’s why many who start with a prescription end up heading to the streets for heroin, which is cheaper and easier to obtain. A 2014 survey found that nearly all respondents in treatment for opioid addiction resorted to using heroin for that very reason. 

Given this all-too-common scenario, seeking treatment is vital. It’s difficult to seek help, especially with the stigma attached to the word “addiction.” But understanding the physical reasons should help us understand that it’s important to treat addiction, just as it’s important to treat heart disease, diabetes or a myriad of other conditions. 

I believe an integrated approach is vital to successful addiction treatment. A multi-faceted problem requires a multi-faceted solution. Integrated health care provides a “one stop shop” approach for the needs of a person’s mind and body. 

Terros Health treats opioid addiction, and other addictions, using Medically Assisted Treatment (MAT). MAT refers to the use of FDA-approved medications used in conjunction with individual, group and/or family counseling to treat substance abuse disorders. We also offer and encourage whole health with the availability of primary care for our patients challenged with addiction.

Here’s how the process works: 

A patient will first be evaluated by a primary care physician, so we have a comprehensive picture of everything affecting his or her health. We get a full physical, which includes testing for HIV or Hepatitis C, common conditions when people share needles. I need to know everything that’s going on before I introduce something in the patient’s system to treat addiction. 

Next, the patient will meet with a master-level substance abuse counselor who will help us get a picture of any co-occurring mental health issues that need to be managed. 

Because we are an integrated health center, these evaluations occur in the same location, typically on the same day, with all of us communicating and conferring on the best course of treatment. 
There are three Federal Drug Administration (FDA)-approved MAT methods – methadone, naltrexone or buprenorphine. At Terros Health, we use the latter two, depending on the circumstances. 

Buprenorphine reduces or eliminates withdrawal symptoms, including drug cravings, without producing the euphoria or dangerous side effects of heroin and other opioids. Naltrexone blocks the brain’s opioid receptors and can rapidly reverse or block the effects of other opioids. 

Once the patient is cleared for treatment, I will meet with him or her for about one to two hours to determine the right course of action and the initial dosage. The patient, who will be in withdrawal, is monitored and will go home the same day, returning over the next few days as we adjust the dose. 

Patients are closely monitored for side effects and randomly drug tested. Medications are ordered daily from pharmacies and none are kept at any of Terros Health’s sites. 

A key component – and in fact a requirement – of MAT, is the use of intensive individual and group therapies to help patients realize their ability to change their lives by developing essential coping skills and behavior changes. Throughout the treatment journey, patients have a network of support that is essential to recovery. We give patients the first week to adjust to their new reality and then mandate that they participate in intensive therapy. If they don’t attend, I don’t give them the medication. That’s our deal and we each need to honor it. 

Addiction is a complex illness, with biological and psychological components. Medication pacifies the addicted brain’s receptors that produce cravings and rewards, while psychosocial rehabilitation helps the wounded, traumatized individual manage his or her depression and illness. Together, they produce the best outcome. We are very lucky in Arizona because AHCCCS covers 100 percent of this treatment, so cost is not a barrier to getting clean and sober. 

A 2016 report by The Pew Charitable Trusts concluded MAT is the most effective intervention to treat opioid-use disorder, more useful than behavioral interventions or medication alone. The treatment can significantly reduce illicit opioid use, compared to non-drug approaches. Further, it has been demonstrated that increased access to these combined therapies can reduce overdose fatalities.

It is possible to get beyond opioid addiction. The work is challenging and sobering. But the success stories keep us going. 

For the past year or so, we’ve been working with a married couple, Jacob and Amber, who fell into this dizzying spiral of opioid addiction. Things got so bad that their children were taken from them. 

Fortunately, they received the wake-up-call before it was too late. We were able to provide the help they needed, and they did the hard work of following the plan to the letter. 

Today, Jacob is working, and he and Amber are expecting another child. Their children are back with them. Both are clear-headed and committed to putting their addictions behind them and moving forward with their lives. 

There are a lot of Jacobs and Ambers out there. They’re normal people like you and me who fell victim to a seductive drug. Addiction isn’t picky. 

But thanks to integrated health care, MAT programs, increased education (especially for younger kids) and better data, we can find the solution and will hopefully see a day in the not-too-distant future when the opioid epidemic is no more. 

Integrated health care can help with prevention, as well. The whole health/whole person model changes the paradigm of care by helping physicians and other clinicians uncover a patient’s source of pain and evaluate alternatives to prescription drugs like cognitive behavioral therapy and mindfulness-based stress reduction. Patients and physicians work in partnership to treat not just a single ailment, but toward overall better health, physically and mentally. If there are signs of mental health issues or addictions of any kind, those can be dealt with in the earliest stages before they take a greater toll on a person’s physical health. 

If you or anyone in your family has been prescribed opioids, it would be important to bring that up during an exam. An integrated health intake can help identify the signs of drug use and abuse in their early stages – signs such as drowsiness or sedation, slurred speech, uncharacteristic problems with attention and memory and constricted pupils – before they turn into an addiction. 
In addition, if you’ve been prescribed medication after surgery and have extra pills on hand, make sure they’re in a locked box or dispose of them properly. Look on the FDA’s website – www.fda.gov – for recommendations on proper disposal. It is never a good idea to save medications of any type — but especially opioids — for a “rainy day” when you or a family member might be experiencing pain. 

If you would like to experience the transformative power of integrated health care or if you are in need of addiction care services, please call Terros Health at 602-685-6000.  With integrated health care, there’s literally no downside – patients win, families win, and society wins. www.terros.org


Dr. Saul Perea is the integrated care medical director of Terros Health, a nonprofit, integrated health care organization in Arizona that specializes in mental health and addiction care for adults, adolescents, children and families, while also providing physical health care services to achieve whole health and wellness for their patients. Dr. Perea studied at the University of Baja California, Mexicali, Mexico and the University of Arizona, Tucson, and completed a Psychosomatic Medicine Fellowship at Harvard University. He is certified with the American Board of Psychiatry and Neurology, Psychosomatic Medicine/Consultation Psychiatry, and the American Board of Addiction Medicine. 

Oh, the Lessons I have Learned

By Dina Evan, PhD

Dr. Evan specializes in relationships, personal and professional empowerment, compassion and consciousness. 602-997-1200, 602-571-8228, Dina.Evan@gmail.com and www.DrDinaEvan.com.

When you hit an age greater than the speed limit, you take a deep breath and look back at all the lessons you have learned and want to share those.

So, I will, albeit I have to admit like so many of us I only learned them through, often excruciating, personal experience and it’s likely you will too. But, for those of you who can pick up a tool or two and spare yourself a bit of grief...here goes.

The worst lies are those you tell yourself. Lies such as I can’t or he/she won’t let me, or you make me feel are just things you say to postpone what you really came here to do and who you came here to be.

 Everything in this life is a lesson - not a punishment and not a reward. You can waste time ignoring lessons, but they always come around again because you chose them before you came here. You can take time to step into your power, but...why waste time? Remember, we only get stronger, when there is a challenge. And, oddly enough, the moment you step into the challenge, you discover you are bigger than it is.

I’ve learned making yourself the priority is not selfish, it is self-loving. You can’t give something to another, you haven’t given to yourself.

Never choose to be a victim. It’s always a lie. We come from incredibly strong stock, generations of powerful people who have gone through wars, demonstrations, a multitude of challenges and stood up. So, the greatest secret in life is that what happens to you is not nearly as important as what you do with what happens to you.... and how you choose to respond to it.

The moment you realize there is nothing and no one that can truly ruin you, except you, you have awakened to the greatest truth and you are able to solve any problem.

Remember uncertainty is what happens when we don’t have all the answers, when nothing seems clear. Without uncertainty, there is no space for new information, because we think we already have all the answers. Be open to not knowing and uncertainty. They are your best friends. Out of not knowing, comes new ideas, possibilities and probabilities.  It’s a great space to play in.

This life is a school. Take full responsibility for everything that happens in your life because the truth is, nothing happens without your conscious or unconscious choice, consent or request, and all of it is in service to you becoming the powerful person you are.

Reconsider frequently if something is not working. Reconsideration means stepping back, taking a second look at the bigger picture. It means thinking over what you thought to be true, the decisions you made, the priorities you lived by, and the life you want going forward. It means that some choices and some beliefs are simply not serving you and those get to be changed. Not because you did something wrong, but, because the universe is ever changing and we need to change with it.

Remember, no matter what the question is, you can always find the right answer by asking, What would love do?

When life gets tough, it’s helpful to remember the and word. We can end up feeling and saying, “Life sucks,” but we forget “and I have so many people who love me.” “I am broke right now and I have a great future ahead of me.” “This is a difficult day and tomorrow can be filled with joy.” Joy always follows sadness and challenge always follows success. That’s how we grow.

Search for Meaning. Don’t choose to always play in the shallow end of the pool. If you ask emotionally, spiritually and mentally strong people about their lives before and after feeling strong they will tell you two things: their strength is in direct proportion to the challenges they faced. They grew from facing challenges, even the devastating ones.

Always remain teachable. Mental strength doesn’t exist in a vacuum, and even the strongest people need others to reflect back and validate their strength and teach them more. Wisdom comes not only from your experiences, but also from all the experiences of those who came before you. Learning from others, and listening for new truths, doesn’t make you weak, it makes you wise.

   Well, those are just a few thoughts for your tools bag and if they keep you from another bruised ego or the need to clean up a new mess, we all win. Try this exercise for yourself and make a list of the lessons you have learned. You may begin to see how wise you already are.

Healing from Childhood Trauma ( part 2)

 Adapted from newly released Unspoken Legacy  (Part 2)
Claudia Black, Ph. D., Senior Fellow of The Meadows and Clinical Architect of the 
Claudia Black Young Adult Center at The Meadows


 For many years Cognitive Behavioral Therapy (CBT) has been considered the gold standard of therapy.  It is a short-term, goal-oriented psychotherapy treatment that takes a hands-on practical approach to problem solving. Its goal is to change the underlying patterns of thinking or behavior that contribute to people’s difficulties and thus change the way they feel as well. 
Together, the therapist and client explore the client’s personal story, with the therapist asking the client questions and inviting him or her to explore certain memories, feelings, and beliefs.
In the hands of wise therapists, talk therapy can be extremely helpful. However, it’s essential to understand that talk therapy alone is not sufficient for healing trauma. To heal your trauma, you will need to engage both the traditional and nontraditional modalities of therapy, as trauma needs to heal in both your body and your brain.

Trauma therapy today is often thought of as a top-down, bottom–up approach. The top-down refers to the work that occurs via the prefrontal cortex (PFC). Remember, this is the logical thinking and reasoning part of our brain. CBT and other more traditional forms of talk therapy occur with the working of the PFC. Yet, it is difficult to access the prefrontal cortex when you are in a trauma response as the nervous system is dysregulated and the limbic system is on fire.

Bottom–up therapy is the work you do that regulates the nervous system (brainstem) and calms your limbic system. Grounding techniques such as yoga and meditation combined with more nontraditional therapies regulate both your autonomic nervous system and limbic system where talk has no impact. When your brain stem is regulated you have a larger perspective and develop an internal capacity to feel safe and calm. So a calm brainstem is the doorway to successfully working with the emotional and cognitive parts of the brain. Healing needs to occur from both a sensory and cognitive capacity.

Typically, trauma therapists combine some form of talk therapy with a combination of grounding practices and body mind connection therapies. Trauma work most always involves a combination of approaches best suited to each individual client.  They range from Eye Movement Desensitization and Reprocessing (EMDR), to Somatic Experience therapy, neurofeedback, energy psychology, action based roles plays and many more. 

While everyone’s experience of healing is unique and can involve many different healing approaches, the healing process involves moving into and through seven different layers of healing. While each layer naturally leads to the next, none of them has a hard-and-fast boundary. At times you may find yourself in two or three layers at once; occasionally, you may need to briefly circle back to a previous layer in order to continue moving forward.

Layer One: Grounding

In order to heal, you first need some inner stability. You also need to learn healthy ways to soothe yourself and feel safe in your own skin. These practices can help you manage your feelings, both when you experience pain in the present and when you examine painful events from your past. These practices are called grounding skills. These are teachable, learnable, tried-and-true tools to help your nervous system regulate and limbic system stay (or become) calm, especially when you’re feeling strong emotions such as fear, pain, guilt, or anger. These skills create a solid foundation for your prefrontal cortex to do its work, to be the CEO it was meant to be.

Grounding is a necessary foundation for the six layers of healing that follow it. But grounding is not something you move into, through, and out of. These skills are essential parts of every layer of healing, and you will practice them throughout your entire healing process. In fact, as you will discover, you will continue to use some of the grounding practices for the rest of your life.


As you explore your story in the second layer of the healing process, painful feelings will naturally arise. Grounding skills will help you stay calm, focused, and alert so that you can feel these emotions fully, process, tolerate, and if appropriate—when ready—let them go.

Grounding skills aren’t rocket science. In fact, you may already practice some of them. Many of them are fun, pleasurable, or rewarding, and most are free or inexpensive.
Grounding skills aren’t meant to be used once or twice. Ideally, they are regular practices you integrate into your life. Many people do one or more of these practices every day. You can also use any or all of them when you feel you are losing your focus, your serenity, or your inner stability.

Some common forms of grounding include:

  • Martial arts (qi gong, judo, karate, tae kwon do, etc.)
  • Tai chi, Yoga, Meditation
  • Creating art (painting, sculpting, drawing, photography, etc.)
  • Crafting (needlepoint, woodworking, origami, bead making, quilting, paper making, etc.)
  •  Dancing, Singing or chanting
  • Writing (including journaling and creative writing, poetry, etc.)
  • Physical exercise
  • Gardening, Spending time in nature
  • Acupuncture
  • Playing or working with an animal 
  • Doing crossword puzzles or Sudoku
  • Coloring, Knitting 

Layer Two: Exploring the Narrative

At your own pace, with some grounding and stability in your life, your next task is to explore the history of your trauma. As a part of this process, you will ask yourself and begin to answer questions such as, “What happened that hurt me?” and “What didn’t I get that I needed?” These kinds of questions will help you undo denial, acknowledge your trauma, and recognize and grieve your losses. These will set the stage for putting the past behind you, placing it in a larger perspective, and moving forward. This will not mean forgetting the past; it will mean no longer allowing the past to dictate how you live your life. It will mean letting go of an old, painful script and discovering new choices and greater freedom.

Layer Three: Moving into Your Emotions

There is a good reason why many people avoid facing and healing their trauma: they know the process will hurt, and they don’t want to feel that emotional pain. But if they are living with unhealed trauma, they are already hurting, day after day—and may have been hurting for months, years, decades. They fear the emotional pain will be unbearable or they will go crazy and do something foolish or violent. As frightening as that is, the fear is often greater than the reality.

Many people have survived by cutting themselves off from many of their emotions—by making themselves partially numb. They don’t just fear a spike in pain; they’re afraid a tsunami of all kinds of feelings will drown them. If these are your fears, you must do your work with a therapist, whose job is to create safety, to provide emotional support, and to guide you safely through the healing process. A therapist can both pace you and work with modalities that do not require “catharsis,” a strong emoting of feelings so often associated with therapy.

It’s important to know your feelings are a normal part of you; they are here to guide you, not hurt you. Emotions are neither right nor wrong; they simply describe your internal experience in the moment. They serve as an internal barometer. 
Feelings are an important part of who you are, but they neither rule you nor define you. If you have been cut off from certain emotions for a long time, when you begin to re-experience them they may seem foreign or unsettling or confusing. This is normal. Remind yourself that you have kept those emotions at bay for years. Now you are learning a healthier way to experience them.

Layer Four: Connecting the Past to the Present

As your healing progresses, you will need to ask yourself this important question: “How does my trauma affect me today?” 
As you explore this topic, I suggest you also consider these more detailed questions:

  • How does my trauma affect who I am as a spouse or romantic partner?
  • How does it affect who I am as a parent?
  • How does it affect who I am at work?
  • How does it affect who I am in my friendships?
  • How does it affect how I feel about myself?

Layer Five: Uncovering and Challenging Internalized Beliefs

As a result of your unhealed trauma, you may operate according to a belief system that you developed long ago. Today, this may determine much of what you do, think, and decide, often without your being aware of it. These beliefs may have helped you survive when you were young, but now they no longer serve a useful purpose. In fact, they probably get in the way of how you would like to live your life.

To begin this layer of your healing process, I ask you to reflect on these questions. 


  • What beliefs have I internalized as a result of my trauma?
  • How did those beliefs hurt or restrict me when I was young?
  • How did those beliefs help me when I was young?
  • How do they hurt or restrict me now?
  • How do those beliefs help me now?
  • How do they help, hurt, or restrict other people who play important roles in my life now?
  • Which of these beliefs do I want to keep?
  • Which ones do I want to get rid of?
  • What different beliefs do I want to live by instead?

Layer Six: Learning New Skills

Your trauma did not make you helpless or useless. In spite of it, you learned a wide range of important life skills. Maybe you became a highly creative problem solver because you were often presented with situations that were difficult to handle. Maybe you became a skilled and efficient cook because if you didn’t prepare meals for yourself and your younger siblings, none of you would have gotten fed. Maybe you learned to listen thoughtfully and carefully because if you didn’t do exactly what you were told, you would be punished. The good news is that you get to keep all of those useful skills. As you heal, you can choose to keep those parts of yourself that you appreciate or feel are valuable; however, there are probably many life skills you did not learn. Some of these may be skills other people are routinely taught and take for granted. For instance, you may have trouble saying no or seeing options or choices available to a problem or being able to relax and kick back for several days in a row. Meanwhile, the people around you have no trouble doing the things you find so challenging. This isn’t because there is something wrong with you or because you’re inadequate in some way. You simply did not learn those particular skills when you were growing up. Your parents probably did not model them for you; in fact, they may have modeled (or demanded) different actions entirely.

The problem with not being taught some common life skills is that you may move into adulthood feeling like you are an imposter. In many everyday situations you may feel confusion or performance anxiety. Then you may try to hide that performance anxiety from others, fearing that if your missing skills are discovered, you will be ridiculed, fired, or shamed. You may also spend a great deal of time and energy manipulating your environment—and sometimes the people around you—so that no one discovers (or even suspects) your limitations.

Layer Seven Creating Your Own Narrative 

I conclude my book Unspoken Legacy with this last layer, guiding you through the process in a writing exercise where you have the opportunity to create a positive narrative of your recovery and healing.  The act of writing in response to the structure posed is enormously inspiring and empowering. As you come back periodically to your narrative you will steadily build resilience and hope, strengthening your healing and recovery.  
Your task now is to live that rewritten story by accepting the truth of your past, feeling the pain of healing, and moving through it into a more connected, more serene, more joyous future.

Unspoken Legacy is available on Amazon.com



Claudia Black Ph.D. is a renowned addiction author, speaker and trainer — internationally recognized for her pioneering and contemporary work with family systems and addictive disorders. In addition, her groundbreaking treatment program at the Claudia Black Young Adult Center is focused on treating complex addiction and mental health issues faced by youth, ages 18-26. These young adults struggle with unresolved emotional trauma, addictions, or have a dual diagnosis. Because Claudia is passionate about helping young adults overcome obstacles and strengthening families, she remains actively involved with the treatment team, the patients, and their families.
She is also a Senior Fellow at The Meadows Treatment Center, the nation’s premier program for treating trauma, alcohol, sex and drug addiction, as well as panic and anxiety disorders, post-traumatic stress disorder, codependency, depression, bipolar disorder and eating disorders. Visit www.claudiablack.com and www.themeadows.com. For immediate needs call 866-424-5476.

April is Alcohol Awareness Month

Founded and sponsored by NCADD, Alcohol Awareness Month was established in 1987 to help reduce the stigma so often associated with alcoholism by encouraging communities to reach out to the American public each April with information about alcohol, alcoholism and recovery. Alcoholism is a chronic, progressive disease, genetically predisposed and fatal if untreated. However people can and do recover. In fact, it is estimated that as many as 20 million individuals and family members are living lives in recovery!




Alcohol Awareness Month provides a focused opportunity across America to increase awareness and understanding of alcoholism, its causes, effective treatment and recovery. It is an opportunity to decrease stigma and misunderstandings in order to dismantle the barriers to treatment and recovery, and thus, make seeking help more readily available to those who suffer from this disease.

Each April, NCADD’s National Network of Affiliates and other supporting organizations across the country will use this opportunity to address the Nation’s number one public health problem through a broad range of media strategies, awareness campaigns, programs and events in their local communities.

With this year’s theme — “Changing Attitudes:  It’s not a ‘rite of passage.’ ” —the month of April will be filled with local, state, and national events aimed at educating people about the treatment and prevention of alcoholism, particularly among our youth, and the important role that parents can play in giving kids a better understanding of the impact that alcohol can have on their lives. Local NCADD Affiliates as well as schools, colleges, churches, and countless other community organizations will sponsor a host of activities that create awareness and encourage individuals and families to get help for alcohol-related problems.

An integral part of NCADD Alcohol Awareness Month is Alcohol-Free Weekend, which takes place on the first weekend of April to raise public awareness about the use of alcohol and how it may be affecting individuals, families, businesses and our communities. During Alcohol-Free Weekend, NCADD extends an open invitation to all Americans to engage in three alcohol-free days. Those individuals or families who experience difficulty or discomfort in this 72-hour experiment are urged to contact local NCADD affiliates, Alcoholics Anonymous (AA) and Al-Anon to learn more about alcoholism and its early symptoms.Founded and sponsored by NCADD, Alcohol Awareness Month was established in 1987 to help reduce the stigma so often associated with alcoholism by encouraging communities to reach out to the American public each April with information about alcohol, alcoholism and recovery. Alcoholism is a chronic, progressive disease, genetically predisposed and fatal if untreated. However people can and do recover. In fact, it is estimated that as many as 20 million individuals and family members are living lives in recovery!

Alcohol Awareness Month provides a focused opportunity across America to increase awareness and understanding of alcoholism, its causes, effective treatment and recovery. It is an opportunity to decrease stigma and misunderstandings in order to dismantle the barriers to treatment and recovery, and thus, make seeking help more readily available to those who suffer from this disease.

Each April, NCADD’s National Network of Affiliates and other supporting organizations across the country will use this opportunity to address the Nation’s number one public health problem through a broad range of media strategies, awareness campaigns, programs and events in their local communities.

With this year’s theme — “Changing Attitudes:  It’s not a ‘rite of passage.’ ” —the month of April will be filled with local, state, and national events aimed at educating people about the treatment and prevention of alcoholism, particularly among our youth, and the important role that parents can play in giving kids a better understanding of the impact that alcohol can have on their lives. Local NCADD Affiliates as well as schools, colleges, churches, and countless other community organizations will sponsor a host of activities that create awareness and encourage individuals and families to get help for alcohol-related problems.

An integral part of NCADD Alcohol Awareness Month is Alcohol-Free Weekend, which takes place on the first weekend of April to raise public awareness about the use of alcohol and how it may be affecting individuals, families, businesses and our communities. During Alcohol-Free Weekend, NCADD extends an open invitation to all Americans to engage in three alcohol-free days. Those individuals or families who experience difficulty or discomfort in this 72-hour experiment are urged to contact local NCADD affiliates, Alcoholics Anonymous (AA) and Al-Anon to learn more about alcoholism and its early symptoms.Founded and sponsored by NCADD, Alcohol Awareness Month was established in 1987 to help reduce the stigma so often associated with alcoholism by encouraging communities to reach out to the American public each April with information about alcohol, alcoholism and recovery. Alcoholism is a chronic, progressive disease, genetically predisposed and fatal if untreated. However people can and do recover. In fact, it is estimated that as many as 20 million individuals and family members are living lives in recovery!

Alcohol Awareness Month provides a focused opportunity across America to increase awareness and understanding of alcoholism, its causes, effective treatment and recovery. It is an opportunity to decrease stigma and misunderstandings in order to dismantle the barriers to treatment and recovery, and thus, make seeking help more readily available to those who suffer from this disease.

Each April, NCADD’s National Network of Affiliates and other supporting organizations across the country will use this opportunity to address the Nation’s number one public health problem through a broad range of media strategies, awareness campaigns, programs and events in their local communities.

With this year’s theme — “Changing Attitudes:  It’s not a ‘rite of passage.’ ” —the month of April will be filled with local, state, and national events aimed at educating people about the treatment and prevention of alcoholism, particularly among our youth, and the important role that parents can play in giving kids a better understanding of the impact that alcohol can have on their lives. Local NCADD Affiliates as well as schools, colleges, churches, and countless other community organizations will sponsor a host of activities that create awareness and encourage individuals and families to get help for alcohol-related problems.

An integral part of NCADD Alcohol Awareness Month is Alcohol-Free Weekend, which takes place on the first weekend of April to raise public awareness about the use of alcohol and how it may be affecting individuals, families, businesses and our communities. During Alcohol-Free Weekend, NCADD extends an open invitation to all Americans to engage in three alcohol-free days. Those individuals or families who experience difficulty or discomfort in this 72-hour experiment are urged to contact local NCADD affiliates, Alcoholics Anonymous (AA) and Al-Anon to learn more about alcoholism and its early symptoms.