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May

How to Feel Better by Ending Rumination

You probably know the feeling: you’re a bit bored at work or home, or maybe you’ve just gotten into bed, when some thought pops into your head and you can’t let it go. Maybe it’s something embarrassing you did when you were a child or something you’re worried might happen at some undefined point in the future.

Maybe you start replaying a conversation, thinking about all the things you should have said. The next thing you know, you’ve been rehashing these thoughts for 20 or 30 minutes, perhaps even longer. You haven’t gotten anything done, you haven’t slept, and now you feel more depressed and anxious than you did before.

This is rumination and it’s strongly associated with mental health issues such as depression, anxiety, and PTSD. When you’re recovering from a substance use disorder, ruminating definitely doesn’t help, but it’s also a hard habit to break. The following tips can help you quit ruminating and feel better.

Learn to recognize rumination.

Like other bad habits, you can start ruminating without even being aware of it. You quickly get swept up in your thoughts and are not aware of what your mind is even doing.

If you want to stop ruminating, then you have to learn to notice when you’re doing it. This is a skill called metacognitive awareness — being aware of what you’re thinking about. The first step is to label rumination whenever you catch yourself doing it.

It’s important that you do not scold yourself when you realize you’ve been ruminating. Instead, congratulate yourself for noticing: “Ah, there’s rumination again, good catch!”

Notice your rumination triggers.

Noticing rumination is only the first step. Your real goal is to better understand what’s causing it.

Rumination typically has triggers, just like any bad habit. That is, it doesn’t come out of the blue but rather is caused by something you hear or see — or even a particular train of thought.

When you catch yourself ruminating, notice what you’re ruminating about and notice what triggered it. For example, maybe you were reading an article that mentioned a topic you recently argued with someone about or that reminded you of a bad decision you made, perhaps years ago.

You will probably notice there are only a few topics you get stuck ruminating about and your triggers are likely things closely related to these topics. Once you are aware of your triggers, you can be more vigilant about falling into the rumination trap in the first place.

Distract yourself.

Our minds are very associative and once you fall into the rumination trap, it’s hard to get out just by trying to force yourself to think of something else. If you’re sitting or lying in the same position, in the same room, trying to do the same task, you’ll probably keep getting drawn back into the rumination.

Although rumination has negative outcomes, it is also more interesting to your mind than whatever you’re supposed to be doing because your mind thinks it’s solving a problem. If someone were running toward you and yelling, you would definitely pay attention to them even if you’d rather not have to deal with that situation.

Rumination is similar, except the threat you’re preoccupied with might be far in the past or a hazy possibility in the future.

To get out of that rut, you may have to change more than your focus. You might have to get up and walk around for a while, switch to a different task, go to a different room, or do something that demands more attention than whatever you’re ruminating about.

Maybe get some exercise or play a video game. The more you ruminate on a particular topic, the deeper that groove gets in your brain.

That means you fall into that rut more easily and have a harder time escaping. Distracting yourself will limit rumination and help keep that groove from getting much deeper.

Write down your thoughts.

Writing down your thoughts helps with rumination in several ways. First, it helps you recognize when you’re ruminating, identify your triggers, and distract yourself, as discussed above.

When you write about rumination, you’re automatically enlisting some of your metacognitive awareness. Second, when your mind ruminates, it believes it’s solving a problem, except that it never gets very far.

It just keeps rehearsing the initial steps. Typically, it’s gotten hold of some insight it doesn’t want to forget, so it gets stuck in a loop.

Writing down your thoughts commits them safely to paper so your brain can stop rehearsing it. Writing it down also helps you actually make progress thinking through the problem instead of repeating the first few thoughts.

This helps you process whatever it is you’re ruminating about. If it’s something you’re worried about happening in the future, it can even lead you to some concrete steps that might help you solve the problem and worry less about it.

Practice mindfulness meditation.

Mindfulness meditation is one of the best ways to expand metacognitive awareness, since it’s essentially a practice of spending 20 or 30 minutes a day just watching thoughts and emotions rise and fall in your mind.

With practice, you learn to avoid getting swept up in your thoughts. Mindfulness meditation also helps moderate activity in the brain’s default mode network, which is active during rumination.

Remember that it takes practice.

Finally, keep in mind that getting rumination under control will take practice and persistent effort. Rumination is a habit, probably one that you’ve been doing for years.

Breaking it for good will probably take months. The good news is that every time you catch yourself ruminating and take some definite action to stop it, you’re also sparing yourself a lot of pointless anxiety and self-criticism. After a while, you will notice rumination gradually diminish.

When you’re recovering from addiction, it’s crucial to look after your mental health. Anxiety, depression, PTSD, and other mental health issues are common among people recovering from substance use disorders and they are all conditions highly associated with rumination. Awareness is key, followed by action.

At The Foundry, we know that recovery begins in the mind. That’s why we use cognitive behavioral therapy, dialectical behavioral therapy, mindfulness meditation, and other treatment modalities to help our clients become emotionally resilient. To learn more about our treatment options, call us today at 1-844-955-1066 or explore our website.

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May

When Do You Need More Than the 12 Steps to Beat Addiction?

AA and the many mutual-aid programs they’ve inspired have been helping people get sober since 1935. Working the 12 steps is a time-tested method for quitting alcohol and drugs, and millions of people are now staying sober one day at a time. The social support of mutual aid meetings like AA is especially important, which is why most people go to meetings even after completing professional treatment programs. However, it’s important to remember that 12-Step meetings are just one approach to recovery. Everyone has different needs when trying to overcome addiction. For many people, AA or NA will be all they need. Others may require more help. The following are some reasons you might need something more than your neighborhood 12-Step meeting.

When You’re Facing a Tough Detox

You don’t have to be sober to attend a 12-Step meeting; you only need to want to be sober. Unfortunately, beyond possibly offering some helpful advice, your 12-Step group won’t be able to help you detox. Sometimes, you will be able to tough it out at home, but other times that might be too difficult or too dangerous to attempt. For example, people trying to quit opioids often have a hard time making it all the way through detox because the withdrawal symptoms get too intense. It can be hard to take care of yourself when you’re experiencing what many have said feels like the worst flu you’ve ever had.

If you’re detoxing from a serious drinking problem or a benzodiazepine addiction, your life may even be at risk. Severe alcohol detox, DTs, can come on without warning and lead to death in a small percentage of cases.

It’s hard to know when you might need a medical detox and when you can do it at home. It’s always a good idea to consult with your doctor before deciding. If you have any medical conditions, especially cardiovascular issues or pregnancy, a medical detox is typically a good idea. If you’ve had a difficult time detoxing in the past, it’s likely the next time will be tough too. In general, the longer and more heavily you’ve been drinking and using drugs, the harder detox is likely to be.

When You Have Comorbid Health Issues

As noted above, if you have any medical conditions, it’s best to detox under medical supervision. However, medical issues can continue to be a challenge even after acute withdrawal symptoms have subsided. Many people starting in recovery have problems related to malnutrition, weak immune systems, and other issues related to substance use. Spending some time in a residential treatment program can help you avoid complications and restore your health more quickly. You get healthy meals, plenty of sleep, a bit of exercise, and easy access to medical care, should something go wrong.

When You Have a Co-occurring Mental Health Challenge

Perhaps the most common problem that mutual-aid groups aren’t well suited to deal with is mental health issues. According to the National Institute on Drug Abuse, at least half of people with substance use disorders have co-occurring mental health issues, such as major depression, anxiety disorders, PTSD, ADHD, personality disorders, schizophrenia, and others. Many of these conditions require specialized care and medication. That’s far beyond the support that a mutual-aid meeting can provide.

Trying to get sober without diagnosing and treating co-occurring mental health issues is extremely hard and probably won’t succeed for long. For most people with co-occurring disorders, the mental health issues are the main driver of their substance use. Mental health issues and substance use each tend to make the other worse, so only treating the addiction is not likely to solve the problem for long.

When You Have Trouble Sticking with a Program

Mutual-aid programs can be very effective in helping you to stay sober if you keep going. The problem is that most people don’t keep going. They may go to a few meetings but that’s all. One study¹ found that only about 10 percent of people who go to AA meetings keep going for three months. Some of the features that make AA attractive, such as free attendance, anonymity, and open doors, also make it easy to quietly disappear.

When you invest in a professional treatment program, you are far more likely to stick with it. For one thing, you may actually be in residence, perhaps far from home, so you’re less likely to just stop showing up. You can leave, of course, but your level of commitment is much higher, especially if you’re paying to be there. What’s more, the staff and other clients are more invested in your success. People will definitely notice if you don't show up for group therapy or other activities. You also form connections to others more quickly in treatment and that social bond creates an incentive to stay engaged.

When You Don’t Fit In

There are many effective approaches to addiction recovery, but unfortunately, some people who have succeeded through 12-Step meetings don’t always see it that way. Some groups are fairly rigid and dogmatic, which can put people off. Since 12-Step groups aren’t centrally organized, there is a lot of variation among meetings. However, if you’re in a place without many options, you might have trouble engaging with a group where you don’t feel welcome or comfortable. You may have to explore other options.

Twelve-Step meetings like AA and NA can be a great option for many people who want to get sober, but sometimes meetings alone are not enough. If you might face a hard detox, have co-occurring mental health issues, have had trouble sticking with the program, or you just don’t feel comfortable with the available groups, you might need something more. At The Foundry, we use the time-tested 12-Step principles combined with evidence-based modalities for treating co-occurring issues. To learn more, call us today at 1-844-955-1066 or explore our website.

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Sep

Why Cannabis Use Disorder Should Be Taken Seriously

“Marijuana (cannabis) use directly affects the brain — specifically the parts of the brain responsible for memory, learning, attention, decision making, coordination, emotions, and reaction time,” warns the Centers for Disease Control and Prevention (CDC) on its fact sheet. “Long-term or frequent marijuana use has been linked to increased risk of psychosis or schizophrenia in some users.”

Despite these known health risks, 18 states have legalized recreational marijuana. In 2012, Colorado and Washington became the first states to legalize the recreational use of cannabis following the passage of Amendment 64 and Initiative 502. Additionally, 36 states and the District of Columbia currently allow cannabis for “medical” use although the federal Food and Drug Administration (FDA) continues to list cannabis as an illegal schedule I substance “due to its high potential for abuse, which is attributable in large part to the psychoactive effects of THC, and the absence of a currently accepted medical use of the plant in the United States.”

As a result of the continuing normalization of cannabis use, a majority of Americans—including teenagers—perceive little or no risk in using it. Thirty-eight percent of high school students report having used marijuana at least once (although it is only legal for people 21 and older).

The health risks connected with cannabis use are real, however, notwithstanding years of promoting it as a medicinal remedy. “Researchers know that prolonged and heavy cannabis use can alter brain circuitry. However, the specific pathophysiological mechanisms are yet unclear. In terms of addiction, tetrahydrocannabinol (THC) is the primary molecule responsible for the reinforcing properties of marijuana,” report Jason Patel and Raman Marwaha in Cannabis Use Disorder.

THC, acting through cannabinoid receptors, activates the brain’s reward system, which includes regions that govern the response to healthy pleasurable behaviors such as sex and eating. Like most other drugs that people misuse, THC stimulates neurons in the reward system to release the signaling chemical dopamine at levels higher than typically observed in response to naturally rewarding stimuli. The surge of dopamine teaches the user to repeat the rewarding behavior, helping account for marijuana’s addictive properties.

According to a research report of the National Institute on Drug Abuse (NIDA), “THC is able to alter the functioning of the hippocampus and orbitofrontal cortex, brain areas that enable a person to form new memories and shift his or her attentional focus. As a result, using marijuana causes impaired thinking and interferes with a person’s ability to learn and perform complicated tasks. THC also disrupts the functioning of the cerebellum and basal ganglia, brain areas that regulate balance, posture, coordination, and reaction time. This is the reason people who have used marijuana may not be able to drive safely.”

Cannabis use can induce significant behavioral or psychological changes such as impaired motor coordination, euphoria, anxiety, hallucinations, a sensation of slowed time, impaired judgment, increased appetite, dry mouth, and even tachycardia.

In his 2015 book Marijuana, psychiatrist and addiction specialist Kevin Hill listed three popular myths: that cannabis is not harmful, that it cannot lead to addiction, and that stopping the use of marijuana cannot cause withdrawal symptoms.

Cannabis or marijuana use disorder is common in the United States, is often associated with other substance use disorders, behavioral problems, and disability, and goes largely untreated, according to a 2016 study conducted by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of the National Institutes of Health.

Approximately a third of cannabis users develop a clinically diagnosable cannabis use disorder (CUD) at some point in their lives. A major study published in Oct 2020 updated the number of users developing an addiction from 10 to 30 percent, a change that is most likely driven by higher potency use. People who begin using marijuana before the age of 18 are four to seven times more likely to develop a cannabis use disorder than adults.

“Often, patients who use cannabis heavily will report that it helps them with anxiety or insomnia irrespective of whether they have a common comorbid diagnosis such as general anxiety disorder, social anxiety disorder, posttraumatic stress disorder, or attention-deficit hyperactivity disorder,” reported Kevin Hill and Arthur Williams in 2019. “Although the short-term benefits of using cannabis may help with anxiolysis or treating early insomnia, in general cannabis, especially via rebound withdrawal symptoms, can worsen these underlying conditions over time (much like how patients with heavy alcohol use often develop worsening anxiety and irritability).”

We need to emphasize that today’s marijuana is much more harmful than it used to be. Cannabis products are now vastly more potent than the “reefers” of the 20th century.

In the seventies, joints averaged a THC concentration of about one percent, close to the natural levels of the cannabis plant. In the early nineties, the typical THC concentration had increased to three percent. Now it often exceeds 30 percent. In addition to that, cannabis is used in an extremely concentrated form called hash oil or wax. So-called “dabbing” refers to the inhalation of concentrated THC products created through butane extraction. Butane hash oil (BHO) can reach incredible concentrations of over 50 percent—that is 50 joints of the seventies rolled into one!

The legalization of the recreational use of cannabis products in recent years has also led to the commercial production and sale of incredibly potent drugs that bear almost no resemblance to 1970s vintage joints. “To say that we have legalized weed is misleading,” Foundry Steamboat CEO Ben Cort explained in a 2018 TED talk. “We’ve commercialized THC.”

The relentless commercialization has had consequences. Advertising and location of cannabis retailers influence adolescents' intentions to use marijuana, according to a 2020 study in the Journal of Health Communication by Washington State University researchers who conducted a survey of 13- to 17-year-olds in Washington State to find out how marijuana advertising and the location of marijuana retailers influence adolescents' intentions to use the drug. Their research shows regular exposure to marijuana advertising on storefronts, billboards, retailer websites, and other locations increased the likelihood of adolescents using marijuana.

Watch "Surprising truths about legalizing cannabis," a TedTalk delivered by Foundry Steamboat CEO Ben Cort. https://www.youtube.com/watch?v=SmqtPaMMVuY

And the billboards are advertising ever more powerful products. “Concentrates are everywhere and are not just being used by the fringe; they are mainstream and they are what many people picture when they talk about marijuana,” Cort wrote in his 2017 book Weed, Inc. “You are going to think some of this must be talking about hardcore users on the edge, but it’s not; concentrates are everywhere and have become synonymous with weed for this generation of users.”

The higher the concentration of THC and the more frequent the use of such products, the higher the risk of addiction. The current edition of the Diagnostic and Statistical Manual of Mental Disorders or DSM-5 used by psychiatrists in the United States lists—analog to other substance use disorders—eleven criteria for cannabis use disorder:

Cannabis is often taken in larger amounts or over a longer period than was intended.
There is a persistent desire or unsuccessful efforts to cut down or control cannabis use.
A great deal of time is spent in activities necessary to obtain cannabis, use cannabis, or recover from its effects.
Craving, or a strong desire or urge to use cannabis.
Recurrent cannabis use results in failure to fulfill role obligations at work, school, or home.
Continued cannabis use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of cannabis.
Important social, occupational, or recreational activities are given up or reduced because of cannabis use.
Recurrent cannabis use in situations in which it is physically hazardous.
Cannabis use continues despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by cannabis.
Tolerance, as defined by either: (1) a need for markedly increased cannabis to achieve intoxication or desired effect or (2) a markedly diminished effect with continued use of the same amount of the substance.
Withdrawal, as manifested by either (1) the characteristic withdrawal syndrome for cannabis or (2) cannabis is taken to relieve or avoid withdrawal symptoms.

The DSM-5 specifies three levels of severity for substance use disorders such as CUD. Two or three criteria indicate a mild cannabis use disorder, four or five indicate a moderate CUD, and six or more criteria indicate a severe cannabis use disorder.

According to Patel and Marwaha, cannabis misuse can also lead to a number of marijuana-related issues such as cannabis-induced sleep disorder, cannabis-induced anxiety disorder, or cannabis-induced psychotic disorder.

Sadly, people presenting with CUD do not enjoy the same support from society as people with other substance use disorders, says Cort. “If you go to your doctor saying ‘I need to get off the bottle’ or ‘I need to stop shooting dope’ you can expect encouraging words and specialist referrals. If you say ‘I’m smoking too much weed’ you often only get a ‘so what’ kind of shrug.” Many doctors think that cannabis use is fairly harmless, if not beneficial.

“We even encounter people in treatment whose CUD had been dismissed as ‘only weed’ because our society does not recognize cannabis as an addictive substance,” says Cort. In treatment, Foundry Steamboat has to prepare clients for a trigger-rich environment with ubiquitous “pot shops” and billboards advertising cannabis products—especially in Colorado.

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Apr

Why is Group Therapy So Commonly Used to Treat Addiction?

One aspect of addiction treatment most people are familiar with is group therapy. Every film or TV show about addiction and recovery will have a scene where a character either goes to a 12-Step meeting and shares or participates in a group therapy session in rehab. For many people considering treatment, this might seem a bit intimidating. It’s a bit too much like public speaking and on top of that, the subject of conversation may include your worst thoughts, memories, and emotions. It’s no wonder that people are often hesitant to participate. However, group therapy is a staple of addiction treatment for good reasons. What’s more, once people get started, they usually find group therapy helpful, rewarding, and even enjoyable. Here are some reasons why group therapy is so common in addiction treatment programs.

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You’ll See You’re Not Alone

Shame, stigma, alienation, and isolation are among the biggest barriers to recovery for people with substance use disorders. Trauma is perhaps the single element that people with substance use issues have most in common. This could be in the form of childhood abuse or neglect, domestic abuse, sexual assault, or some traumatic event. By some estimates, half of people with substance use disorders also have symptoms of post-traumatic stress disorder, or PTSD.

Addiction is commonly the result of trying to cope with shame. Most people’s instinctive reaction to shame is to try to hide it, bury it, or push it away, but that only makes shame more powerful. The best way to deal with shame is to open up about it in a safe environment, such as individual or group therapy. What makes group therapy especially good for healing shame is that group members quickly learn that they are not alone. Whatever they experienced in childhood, whatever they did during active addiction, there are almost certainly other members of the group who have had similar experiences. Being able to open up about these experiences and know you’re not alone is liberating.

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Group Dynamics Give the Therapist Insight into Your Behavior

One of the limitations of individual therapy is that, for the most part, you control what information your therapist has. Even if you aren’t deliberately distorting events that you relate in therapy, you necessarily see things through your own perspective. That limits the information your therapist has to work with. However, in group therapy, the therapist can see how you interact with others. Maybe you have a tendency to be defensive or critical without realizing it. Maybe you are friendly to women but not to men. Maybe you believe you’re hopelessly awkward but in fact are charming. These are things that are far more obvious in real interactions than in the privacy of an individual session.

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You Enjoy Social Support

Feeling socially connected is one of the most important parts of a strong addiction recovery. For many people, drugs and alcohol are a way to try to fill a void, which is often caused by a lack of belonging or purpose. There are many different reasons people feel this way and you are likely to find in the group some people who understand.

There are also more concrete reasons social support matters. For one, it creates a greater sense of accountability. People are more likely to show up to sessions, and show up on time, and be engaged if they know other group members are depending on them. In other words, it matters that group therapy is about helping as well as receiving help. Having a connection with the group also makes people a little more reluctant to slip up because they know they will have to tell the group.

Social support has benefits outside of the group as well. One challenge a lot of people face early in recovery, especially as they transition back to regular life, is that they have to distance themselves from friends who drink or use drugs. Sometimes there is stress within the family and they have to work on maintaining boundaries. These kinds of behaviors are easier when you feel like you have people supporting you, even if they aren’t physically with you at the moment.

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You Get Many Different Perspectives

Another particular advantage of group therapy over individual therapy is that group therapy gives you many different perspectives. As an expert, your therapist’s perspective may be well informed but your therapist is still just one person. The group will have had many different experiences and will have many different ways of thinking about things. These will sometimes be surprising and illuminating. Problems that seem intractable to you might seem easy to someone else and being open to other perspectives can expand your repertoire of solutions.

You can also get different perspectives on your own behavior. Part of the challenge of resolving interpersonal conflicts is that it can be hard to tell whether we are acting reasonably. Getting feedback from the group is one way to orient yourself and better understand if your attitude is fair. It can also help you understand someone else’s perspective. For example, if you’ve been arguing with your spouse, it’s possible that your spouse can’t explain themselves well and perhaps someone in the group could be a better advocate with less emotional investment.

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You Can Practice Vital New Skills

Recovering from addiction is, at its core, about learning a lot of new skills for managing emotions, thinking, and behavior. It’s one thing to know, rationally, how to do these things and another thing entirely to be able to use these skills when they matter. For example, if you tend to explode when you are criticized, that will lead to a lot of unnecessary stress and conflict but it’s also hard to practice responding better in real time. The group is the perfect time to practice these kinds of skills in a safe, moderated environment. If someone gives you feedback you don’t like, for example, it’s a perfect time to practice, perhaps with the help of the therapist, using your strategies for responding more constructively. This is why modalities like dialectical behavioral therapy, or DBT, specifically include group therapy rather than relying solely on individual therapy.

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Group therapy can be intimidating at first but most people end up finding it helpful and they even enjoy it. The sense of connection you can find in group therapy is one reason so many people say they’ve met their best friends during addiction treatment. Group therapy heals shame and isolation, it gives your therapist extra insight, it provides social support, and gives you a valuable opportunity to practice new skills. At The Foundry, we use a variety of evidence-based methods, including group therapy and DBT, to provide clients with individualized, holistic treatment. To learn more about our programs, call today at 1-844-955-1066.

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Mar

COVID-19: From Our CEO

As coronavirus (COVID-19) continues to gain momentum and impact others across the globe, proactively communicating the safety precautions that we have taken to ensure the safety of our participants and staff is necessary. The evolution of this pandemic has been, and will be, something that we closely monitor and thoroughly heed the instructions given by Centers for Disease Control and Prevention (CDC).

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Due to the highly contagious nature of this virus, we felt that our two-tier detox continuum needs to be Highlighted. Two years ago, we partnered with Steamboat Emergency Room (SBER) which has become our first line of defense for situations just like the one our country is currently experiencing. Every participant’s journey with Foundry STARTS here, where they are promptly taken to a private room and immediately seen by medical professionals. During this first phase of our detox and assessment process, they are given a comprehensive physical and thoroughly screened for symptoms of COVID-19 following the strict protocol enforced by the CDC. Once cleared for residential treatment, they are transported to our facility (15 minutes outside of town on a secluded 48-acre Ranch) for the second phase of our detox process, and continued monitoring from members of our medical team for at least 24 hours. Once in our care, the following steps are being strictly enforced by every member of our team at Foundry Treatment Center Steamboat.

1) The clients will have limited "off campus" activities. This means they will not be attending 12 step meetings off campus. They will either take part in an in-house or online meeting, structured by our lead residential managers. Wellness activities will either be on campus or involve limited exposure to those in the community.

2) All staff are expected to immediately wash their hands upon arrival on the Foundry campus with soap and water for at least 20; or use an alcohol-based hand sanitizer that contains at least 60% alcohol if soap and water are not available.

3) Throughout their shift, staff are required to frequently maintain CDC standards of hand washing hygiene.

4) Did we mention we are encouraging staff and clients to WASH THEIR HANDS with soap and water?

5) Staff will wipe down the facility at shift exchange with soap and water or wipes. This means the office will be wiped down a minimum 3x per day.

6) During morning opener, clients will be asked if they are experiencing a fever, lower respiratory symptoms, coughing, shortness of breath. If a client endorses any of these symptoms they are to be removed from the milieu and stationed in their room until medical can meet with them to determine next steps. When staff enters a room in which a client may be ill, they will wear a mask and gloves, disposing of the mask and gloves and immediately washing hands once removed.

7) Staff will contact their superior immediately and stay home if they feel ill (fever, respiratory difficulty, cough or just not feeling well) to protect co-workers, clients and the program as a whole.

8) Staff and clients are asked to cover their cough or sneeze with a tissue, throw the tissue in the trash, and wash their hands immediately after.

The SAFETY of our Participants has been and will always be our #1 Priority and will continue to follow the instructions given by the professionals on the front lines of this pandemic.

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Latest Posts

Mar

What Is Evidence-Based Treatment?

When looking for an addiction treatment program, one of the most important factors is whether that program uses evidence-based treatment methods. Evidence-based simply means there is some scientific evidence that a treatment method works. Treatment methods are typically compared to a placebo, to other common methods, or to doing nothing at all. The idea is that if you are going to put time, money, and effort into some form of treatment, you want some kind of indication that it is better than doing nothing and certainly some assurance that it isn’t harmful.

For example, if you go to the doctor, you assume whatever treatment the doctor prescribes will be evidence-based. The standard way of developing medical treatment is to try one treatment on one group and another treatment on another group and see which treatment helps more people. For a medication to get FDA approval, it has to go through a rigorous process testing both its safety and effectiveness. For a new drug to be considered effective, it has to perform better than placebo with no active ingredient.

Unfortunately, testing treatment methods related to addiction is not so straightforward. For example, it’s hard to create placebo psychotherapy. A bigger problem has to do with the nature of the disease. Mental health issues play a significant role in addiction but you can’t monitor mental the same way you would an infection or cancer. As a result, it’s hard to quantify the effectiveness of an intervention for, say, depression, because symptoms are erratic and evaluation is subjective.

Despite these challenges, some treatment methods do appear to work better than others and evidence-based treatment has become an increasingly important aspect of addiction treatment – and mental health treatment in general – in recent decades. Not only is evidence-based treatment important in itself to ensure you’re doing something that actually works, but when a treatment program uses evidence-based methods, that indicates that the staff and administrators keep up on new developments in the field.

The following are some common evidence-based treatment methods for addiction and common co-occurring conditions that you should look for when choosing a treatment program. Keep in mind that a program doesn’t have to use all of these or use them exclusively, but their main focus should be evidence-based.

12-Step Facilitation

Twelve-step facilitation is the oldest method on here, based on AA, which was developed 85 years ago. The 12 steps are also the basis of many professional treatment programs, including those at Foundry Treatment Center. Since so many people have used 12-Step programs to get sober, researchers have long been interested in evaluating its effectiveness. The key elements of 12-Step facilitation include accepting you have a problem; surrender to your higher power, the program, and support structure; and active participation in 12-Step meetings and activities. As you might expect, the strongest evidence for the efficacy of 12-Step facilitation exists for people who want to stop drinking, especially if their peer group supports drinking. However, there is evidence that it is also effective for other substances, including cocaine.

Cognitive Behavioral Therapy

Cognitive-behavioral therapy, or CBT, is currently considered the gold-standard for psychotherapy. CBT is a collection of techniques and strategies to manage your behavior and thinking. Whereas other forms of therapy might focus on your past, CBT tends to focus on the present, especially your underlying thoughts and assumptions that may be creating challenging emotions. CBT also includes behavioral strategies like thinking of positive and negative consequences for actions, coping with cravings, and avoiding high-risk situations. What makes CBT especially effective is that it involves learning a set of skills that clients retain after treatment, essentially allowing them to act as their own therapist.

There are also a number of other treatment methods based on CBT. Dialectical behavioral therapy, or DBT, is one that is commonly used to treat addiction and related conditions, including borderline personality disorder, suicidal depression, and eating disorders. Other methods based on CBT include acceptance and commitment therapy, or ACT, and mindfulness-based cognitive therapy, or MBCT.

Motivational Interviewing

Motivational interviewing is a process of helping someone find their own motivation for getting sober and staying sober. It is not a persuasion technique like an intervention where you might lay out an overwhelming case that someone has a problem and needs treatment. Rather, it’s a process of helping someone think about their substance use, its effects on their life, and how that relates to their values and priorities. Pretty much everyone enters treatment feeling ambivalent about sobriety and these tensions can undermine recovery. Motivational interviewing is typically a series of a few conversations that can help people resolve their internal conflicts, freeing them to succeed in recovery. Motivational interviewing is just a first step, designed to help clients commit to a treatment plan. It also appears to be most effective for people trying to quit alcohol and marijuana, while being less effective for opioids and stimulants.

Family Behavior Therapy

It is often said that addiction is a family disease. This is true both in terms of genetics and behavior. If you struggle with addiction, there is a very good chance that at least one parent also had substance use issues or that you grew up in a family with some kind of dysfunction. Often, people assume their own family environment is normal and don’t realize how it may have contributed to their addiction and the same is true for other family members. Family therapy is often an effective element of treatment, especially for adolescents and young adults. It helps to resolve family conflicts, improve communication, help family members set and maintain healthy boundaries. This creates a better family environment for everyone and a more supportive environment for addiction recovery.

It’s important to note that there are significant variations among individuals, even those that are apparently struggling with the same problems. For example, there is mounting evidence that depression may be several kinds of conditions with similar symptoms. Treatment that works for one kind of depression may not work as well for another. An evidence-based approach is not a guarantee that a particular treatment will work for you, only that there is good reason to try it. Quality programs typically incorporate a number of evidence-based treatments and focus on providing individualized care.

Steamboat Springs, located in the Rocky Mountains, provides a setting for the natural stimulation of mind and body, allowing for a return to our innate senses and a new foundation from which to build. Foundry Treatment Center’s vision was formed through personal experiences and continues to grow through the dedicated compassion of the Foundry team. We share a commitment to provide a comprehensive, whole-body treatment program that encourages each to seek their values and beliefs through innovative and evidence-based treatment modalities. For more information on how we can help you or a loved one, call us today at 1-844-955-1066.

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Mar

Have You Suffered Emotional Abuse?

Abuse is a major risk factor for developing mental health issues such as major depression and anxiety and for developing substance use issues. This can happen to both children and adults and while childhood abuse and neglect have a greater effect on people over the lifespan, abuse is a major concern for adults too.

When we think of abuse, physical and sexual abuse are typically the first things to come to mind. However, emotional abuse can be just as damaging and more insidious. While people are typically aware they are being physically or sexually abused, emotional abuse is often more subtle. Part of the power of emotional abuse is its deniability and emotional abusers are often adept at making you doubt your own judgment.

As with physical abuse, the goal of emotional abuse is to control you. However, while physical abuse mainly works through intimidation, emotional abuse gets inside your head and undermines your confidence and judgment. People who are emotionally abused often feel like they are incapable or unworthy of leaving an abusive situation. Although they may know they are unhappy, they may not be aware that what they’re experiencing is emotional abuse. The following are some common signs of emotional abuse and what to do about it.

What It’s Not

First, it’s important to clarify that someone is not being emotionally abusive just because they do something we don’t like or something that makes us feel bad. Arguing, for example, is common in almost every close relationship because it’s normal for people to sometimes have conflicting needs and desires. Even yelling is typically not a sign of emotional abuse. Breaking up with someone or otherwise protecting your own boundaries is not emotional abuse, nor is honest communication. Emotional abuse is done with the intent to make someone feel bad, inadequate, stupid, guilty, or weak and usually for the purposes of control.

Disparaging Behavior

Perhaps the most obvious sign of emotional abuse is disparaging behavior. This is an overt assault on your sense of self-worth. Disparaging behavior may include name-calling, such as outright calling you stupid, weak, ugly, hysterical, fat, and so on. A slightly subtler way is to use “pet” names that are played off as playful or affectionate but are really belittling. If you’re the object of such a pet name, you can easily spot it by how it makes you feel. Other ways of disparaging include making sarcastic remarks, making jokes at your expense, or making light of your interests or accomplishments. This is all intended to make you feel worse about yourself so you feel like you need the abuser’s approval and so you don’t think you could do better elsewhere.

Isolating or Controlling Behavior

As noted above, emotional abuse is primarily a means of control and therefore any controlling behavior – overt or covert – is also a form of emotional abuse. Controlling behavior can take many forms. One way that has become disturbingly common is checking your partner’s phone for incriminating texts. This implies your partner is untrustworthy and it makes unfair demands on their privacy. If you believe your partner is cheating on you, you should ask. If you feel like you can’t trust your partner, then break up.

Another common and subtle way to control is withholding affection unless the other person does what you want. This tactic can be used by romantic partners or by parents and it can be especially harmful to children. However, it’s not the same as not being affectionate because you’re arguing or angry about something specific.

Isolating is another common control tactic. The idea is to keep the person dependent. The abuser might try to keep you from interacting with friends and family, for example. They don’t want you to have options they don’t approve of and they don’t want other people filling your head with ideas they don’t like.

Gaslighting

Gaslighting is a way of undermining your sense of reality. This is typically done by contradicting things they know to be true. For example, they might spring plans on you at the last minute and when you say you didn’t know anything about it, they might insist you talked about it last week. Over time, you start to doubt your own memory and start to rely on your partner, who seems to remember everything. Often, a gaslighter will lie about things that aren’t important at all just to undermine your confidence.

Having Unrealistic Expectations

Other tactic emotional abusers use to undermine your confidence is to have unreasonably high expectations. These might pertain to them specifically, such as expecting you to spend all your time with them or make unreasonable sacrifices on their behalf. It might also be more general, such as never being satisfied with anything you do, never complimenting you, always finding fault, and generally making you feel like you always fall short. If you set the bar high enough for someone you can always be sure they will fail, or at least feel like they’ve failed. This is especially damaging because it develops a sense of learned helplessness – nothing you do is good enough, so why try? It also keeps you seeking the abuser’s approval.

What to Do

Emotional abuse is hard to escape because much of the time, you’re not even sure it’s happening. Awareness is the first step. Pay attention to the patterns. Your parents, teachers, boss, spouse, or romantic partners aren’t supposed to make you feel bad about yourself. If you’re always walking on eggshells around them, something is wrong. Look out for the behaviors described above.

Next, know it’s not your fault. Emotional abusers often make a good show of being kind and supportive and it’s easy to fall for. If you experienced emotional abuse as a child, you probably just thought that it was normal. The sooner you realize it’s not, the better.

Get away from the abusive situation as soon as possible. If you can’t for some reason, work on setting boundaries. This can be incredibly hard and you may need the help of a therapist and possibly a support structure, which an emotional abuser certainly won’t like. What’s more, don’t fall into the trap of thinking you can fix an emotional abuser. They’re good at making apologies and promises, but they also have their own problems and they aren’t likely to change their behavior for good.

If you’ve been the victim of emotional abuse, it has probably caused you some problems, which might include depression, anxiety, or substance use issues. Of the 10 adverse childhood experiences, or ACEs, linked to increased addiction risk, emotional abuse accounts for two, each of which at least doubles your risk of addiction. Awareness is the first step.

At Foundry Treatment Center, we share a commitment to provide a comprehensive, whole-body treatment program that encourages each to seek their values and beliefs through innovative and evidence-based treatment modalities. For more information on how we can help you or a loved one, call us today at 1-844-955-1066.

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Mar

What is a Relapse Prevention Plan and How Does it Work?

Sobriety is no easy feat. Voluntary work is needed to get there and a focus on doing the work, one step at a time. One of the biggest fears of going into substance use treatment is facing life sober. These fears are not without warrant. Relapse statistics are alarming. However, it is possible to learn to live without substance use and experience joy and success. With a combination of supportive services, backed up by a strong prevention plan, there is hope and promise for people to recover.

Prevention Is Key

The difficult work of recovery does not start and end when the person decides to attend the program. It begins when the person finishes detox and starts to process the experience of a substance use disorder. Through therapeutic work, there are ways to look at the experience, uncover the issues, and identify triggers to avoid in the future.

The goal is to complete treatment with the right tools and confidence necessary to make healthier life choices. The proper aftercare and staying focused on goals helps ensure success.

Hitting Relapse Prevention Goals

Leaving a residential program may feel like going out into the world without support and it can cause some anxiety. It is important to connect with a network of people and continue with needed therapies to provide adequate support. Recovery is one day at a time, assisted by friends and supportive people who understand the journey and are available in times of need.

Defining and following a concrete plan that helps achieve set goals and instills self-confidence will only make success easier. Recognizing when these goals are met is added support on the journey. A relapse prevention plan is worked on in a group setting, sharing experiences, and receiving feedback.

It is a formal, written plan, but it may be hard to follow at first. Committing to the prevention of relapse takes intention. The person has to want to stay sober. Some common goals outlined in a relapse prevention plan include:

Changing thought patterns and behaviors.
Identifying and avoiding triggers.
Knowing how to handle cravings.
Managing life’s pressures.
Facing life’s ups and downs efficiently.

Counseling helps people reflect on the mindset that builds dependence. It helps to formulate a plan in which major targets are identified with a clear plan for reaching them. The family can be part of the process, along with learning specific tools developed through cognitive behavioral therapy, role-playing, and other practices.

Three Stages of Relapse

Relapse does not happen overnight. It evolves slowly, beginning with emotions and ending in action. With the three stages of emotional, mental, and physical relapse, it helps to understand how each stage sets the foundation of relapse prevention.

Emotional Relapse

Emotions are a huge part of recovery. There is no escaping emotions; sometimes, they bubble up out of nowhere. Those relapse triggers are red flags. The emotional relapse plan can include how to deal with post-acute withdrawal symptoms, along with breathing exercises, meditation, and finding support during times of sliding into old patterns. It makes a big difference for someone to find healing in recovery if they can manage their emotional states better.

Mental Relapse

The intention is key with a mental focus on relapse prevention. Minimizing life’s ups and downs will not help. Focusing on mental preparation and trying to avoid a situation that may present surprise triggers requires planning.

Actions often follow thoughts when there is no redirection and support. Going back to the old days where the beast is, will result in a person finding themselves on the doorstep of addiction again. The last thing people need is to focus on the past. Keep focused on the present and future to find hope again in recovery.

Physical Relapse

During the mental collapse, the thought process jumps to “one drink won’t hurt,” and “I've done the work to drink like others.” Without a plan, it is just a short hop towards using drugs again. One slip can lead to feeling guilt, shame, fear, and failure. Physically the body is going through a lot. Give it time, rest, eat well, and get enough sleep to help in the healing process.

If a person finds themselves isolated, skipping meetings, and dropping out of their recovery lifestyle, they may be at risk of relapse. Finding the best place to get help means strategizing who to call when the flags are flying, and the warning signs are there. Ask friends to be aware of any issues and to help pull the person out of the pit they’ve found themselves in, which will help them get support when they need it the most.

The following keys will help practice as much as possible mindfulness, healthy habits of living, and being around positive people who support recovery. Without this, it will be difficult to stay clean and sober. With the right help, the person in recovery can find hope. Completion of a program is a start, but plugging into the community, finding a mentor, and seeking support are key to encourage the journey forward.

Steamboat Springs, located in the Rocky Mountains, provides a setting for the natural stimulation of mind and body allowing for a return to our innate senses and a new foundation from which to build. Foundry Treatment Center’s vision was formed through personal experiences and continues to grow through the dedicated compassion of the Foundry team. We share a commitment to provide a comprehensive, whole-body treatment program that encourages each to seek their own values and beliefs through innovative and evidence-based treatment modalities. For more information on how we can help you or a loved one, call us today at (844) 955-1066.

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Mar

“Why Do I Have to Go to Group Therapy?”

Group therapy is a central component of nearly every addiction treatment program. In fact, the original AA format is similar to a group therapy session in that people share their struggles and triumphs in a supportive and confidential setting. Unfortunately, many people are wary of participating in group therapy.

This is perhaps understandable. After all, you have to discuss difficult personal topics with people you hardly know. Although it can seem intimidating at first, most people end up getting a lot out of group therapy sessions and even enjoying it. The following are ways in which group therapy is especially effective for overcoming addiction.

You see you’re not alone.

Addiction can be a terribly alienating experience. One reason is that it tends to lead to physical and social isolation. People with substance use issues often go to great lengths to hide the fact, which may lead to secretive or deceptive behavior. People often isolate themselves to protect their drinking or drug use time, blowing off plans with friends and family.

Addiction is alienating in a psychological way too. Many people who struggle with addiction feel like they’re uniquely burdened. They don’t see other people having the same problems they’re having. What’s even worse, many people who develop substance use disorders have also experienced challenges such as trauma, sexual abuse or assault, and childhood abuse or neglect. They often have a deep sense of shame as a result of these experiences and that shame drives their addictive behavior.

Part of the power of group therapy is that when you get a group of people who have had similar experiences together, they start sharing and they discover they’re not alone after all. Many people have suffered the same abuse and reacted in similar ways. Many people have done things they aren’t proud of as a result of their substance use. Discovering you’re not alone is liberating and it’s when shame starts to heal.

Groups provide social support.

There are mainly two reasons social support from the group can aid therapy. First, it helps keep you engaged. People tend to be a little more motivated to show up on time and participate when they know others in the group are depending on them. Greater engagement leads to greater outcomes.

Second, the group can provide moral and emotional support. A lot of what you have to do in recovery is hard to do on your own. For example, you may have trouble maintaining boundaries with family members or friends who still drink or use drugs.

Your group can support you and assure you that you’re on the right track. You also feel a sense of connection and belonging in the group that you might not get elsewhere. For many people, this sense of support helps them heal and find a greater sense of purpose.

You get different perspectives.

One of the great things about group therapy is that you get a lot of different perspectives on your problems. A drawback of individual therapy is that your therapist can only offer one different perspective. Sometimes you end up feeling like, “Well, that’s just your opinion.” In group, you can get a range of perspectives, including that of your therapist.

You are more likely to believe something about yourself when several people tell you the same thing, especially if it’s something you don’t really want to hear. However, diverse perspectives aren’t just about your behavior. They can open you up to different ways people see things in general.

For example, if you hate conflict, it might shock you to discover that some people in your group just see it as a normal and inevitable part of life and not something to be feared and avoided. That kind of insight can change your view of life outside of therapy.

Group is a better approximation of life.

When you’re in individual therapy, you are able to control the narrative about your life. You get to characterize other people’s words and actions and your therapist is left to speculate about how honest you’re being. In group, it’s much harder to control the narrative because your therapist can see how you interact with other people in real life.

For example, if you are overly defensive or critical, that will soon become apparent in the way you interact with the group. Since many of our social habits are fairly general, it doesn’t matter so much that the other people in the group aren’t actually family, friends, or coworkers.

You improve your social skills.

Related to the point above, group therapy is also a chance to practice new behaviors and social skills in a safe environment. Some therapeutic methods, like dialectical behavioral therapy, or DBT, incorporate group therapy for this specific reason. DBT was developed to help people with borderline personality disorder but is now used for all kinds of difficult conditions, including addiction. People with borderline personality disorder tend to have a lot of relationship problems because of how they interpret other people’s behavior.

Group therapy is an opportunity to put new social skills into use before you have to use them out in the world. It’s an especially good way of learning to hear constructive feedback without getting angry or defensive and give feedback without being mean or critical. Improving your social skills is one of the best ways to strengthen your relationships and reduce the amount of stress in your life.

It’s more cost-effective.

No one likes to hear that their therapy is cost-effective because it sounds like another way of saying “cheap.” However, according to the American Psychological Association, group therapy has been found by more than 50 clinical trials to be as effective as individual therapy for treating a range of conditions, including substance use disorders and common co-occurring mental health issues.

If you are in an intensive addiction treatment program, you are likely getting both individual and group therapy and group therapy increases the number of hours you can spend in therapy each week without a commensurate rise in cost.

Group therapy can help you see that you’re not alone, it can provide support, show you different perspectives, and help you increase your social skills, all for a lower cost than individual therapy. Although it’s normal to be hesitant at first, you will probably derive a lot of benefits from group therapy and feel good about the experience. Foundry Treatment Center’s vision was formed through personal experiences and continues to grow through the dedicated compassion of the Foundry team. We share a commitment to provide a comprehensive, whole-body treatment program that encourages each to seek their values and beliefs through innovative and evidence-based treatment modalities. For more information on how we can help you or a loved one, call us today at (844) 955-1066.

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Mar

How to Stop a Relapse Before it Even Happens

We all want to feel like we have a hold on our addiction. We try to do everything right. We avoid people, places, and things, go to the meetings where we feel comfortable, and work through the steps with a sponsor. Unfortunately, no matter what we do, life is going to happen. We will be triggered, and we aren’t always going to be working our program perfectly. To avoid relapse, it's essential to learn the early warning signs that we might be closer to picking up than we’d like and how to walk through those signs in a healthy way.

When thinking of relapse, we often think of the part where we pick up and start using again, but just like everything else, there are phases we can look out for before we pick back up. Relapse begins with our emotions, then it becomes mental and, finally, physically, putting the substance into our bodies. These phases can be very gradual and hard to spot if you aren’t looking for them and adequately dealing with each stage as it comes.

Phase 1: Emotional

Emotional relapse often happens before we even consider picking up a substance. This phase can manifest in many different ways. We could notice that we are becoming angry by situations that generally wouldn’t bother us; it could be that you are noticing that you feel anxious more often than is typical. We could even begin to start eating and sleeping in ways that don’t feel healthy.

These could all be signs that you are beginning to slip down into emotional relapse, but the only way we can realize that we are slipping is by motoring our emotions. If you notice these, get connected to your support group. Verbalize the way you feel to people you trust. Consider meditation to quiet your mind and calm down or, physical exercise can be a healthy way to let out a lot of emotions.

Phase 2: Mental Relapse

Most people in recovery have two parts of their brains that are constantly at war. One part is the part of the brain that wants to remain sober and continue to lead your life in such a way that you can look back with pride and contentment at all of your achievements. On the other hand, there is also the part of the brain that misses the old life.

This part of our mind tends to forget all of the harm we caused others; all of the pain we put ourselves through and tends to focus on the good times. Everyone in recovery struggles with this, but when your thinking shift and the part of your brain looking back on those memories fondly takes the steering wheel, you’ve slipped into mental relapse.

If you notice mental relapse happening, it's time to fight harder than ever. Try and remember how dark active addiction was. “Play the tape forward’ and think about what your life would look if you went back into active addiction. Talk about it with your sponsor, your support group, your dog, your cat, anyone who will listen and listen to their suggestions and let them help you.

Phase 3: Physical Relapse

Physical Relapse is what most people probably imagine when they hear the word relapse. It is the action of actually consuming any form of mind-altering substance. Even just using one time can bring all of the old cravings back. Without help, often time, people find themselves exactly where they left off, which can be deadly. Our bodies aren’t used to consuming drugs and alcohol the way we used to, so it’s very easy to take too much and find yourself hospitalized or even dead.

If you find that you have physically relapsed, it’s not too late. It’s going to be easier to get help early on, rather than waiting until things get bad again. Don’t be afraid to reach out to people you trust. Going back to treatment might be the best option. It’s never a sign of weakness. You now are that much more educated about your disease and have better ideas of what to look out for.

Recovery is not something that everyone gets on the first try. Relapse is a part of many recovering addicts' stories, and if it happens, there is no shame in starting over. Of course, we want to save ourselves from being dragged through all of that pain and torment, if possible. The best way to avoid relapse is to be aware of these early warning signs and to take appropriate action when they come.

The most important thing to remember is that this a team sport and we all have to work together to have long and happy sober lives. Get a group of other sober people to walk through life with, avoid triggers, and always be aware of your mental health and keep pushing forward.

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Mar

Does Your Brain Fully Recover from Substance Use?

We’ve all heard someone say something like, “He’s fried his brain,” referring to someone whose drug or alcohol use has gotten out of control. If you have struggled with substance use, or someone you love has, you’ve no doubt seen changes in personality and cognition and wondered “Is this permanent?” It’s a distressing thought.

So much of who we are – our thoughts, memories, skills, and personalities – is encoded in the roughly three pounds of neurons in our skulls. Drugs and alcohol obviously have some effect on our brains, which is why people use them in the first place, and too much can have a pretty bad effect.

The belief that alcohol kills brain cells is widespread, but it doesn’t appear to be true. However, some drugs like methamphetamine, cocaine, and MDMA do appear to kill brain cells. While losing a few neurons among billions is not a big deal, it does add up over time. Heavy substance use can cause cognitive impairment, personality change, and behavioral change. If you’re worried that you or someone you love might suffer permanent effects from substance use, here are some things to consider.

Some effects fade quickly.

Most of the psychoactive effects of drugs and alcohol are temporary but if you’re using them all the time, you may not notice. In order to know what effects are temporary and which are longer-lasting, you actually have to go through withdrawal and get completely sober. This may sound obvious but a lot of people forget what their baseline even is after a period of continued substance use.

For example, alcohol is a depressant. If you are a heavy drinker, you may have depressive symptoms that are mainly caused by your drinking. These may include depressed mood, poor concentration, and poor memory. It’s possible that your depressive symptoms will abate once the alcohol is out of your system.

However, you may also have an underlying mental health issue to deal with too. The main point is that substance use interferes with the normal functioning of the brain and the first step in assessing your degree of impairment is to get the drugs and alcohol out of your system.

Some effects may last a year or more.

Unfortunately, the direct effects of drugs and alcohol on your brain are only part of the picture. Another part consists of the adaptations your brain makes to counter the effects of drugs and alcohol over time – in other words, you build a tolerance.

In the case of alcohol, for example, your brain gradually makes less of the inhibitory neurotransmitter GABA and more of the excitatory neurotransmitter glutamate. This is why you may feel like you need alcohol to relax and why you may experience irritability, shakiness, and even seizures when you quit drinking.

The worst of these symptoms – acute withdrawal symptoms – typically only lasts a week or two but other symptoms may last weeks or months. These are sometimes referred to as post-acute withdrawal syndrome, or PAWS. These symptoms may include emotional numbness, inability to concentrate, lack of interest in pretty much everything, and depressed mood.

This is thought to be the result of your neurotransmitters slowly returning to pre-addiction levels. Another factor likely has to do with changes in the limbic system. After months or years of using drugs and alcohol, your brain has gotten used to artificially elevated levels of dopamine so getting excited about having a nice dinner or going to the beach is pretty hard. It may take more than a year for that baseline to reset.

Some structural changes may never fully go back to normal.

As noted above, drugs and alcohol mainly mess with the brain’s limbic system, which is involved in pleasure, reward, and goal-seeking behavior. There appear to be three main brain structures involved with addiction: the basal ganglia, the extended amygdala, and the prefrontal cortex.

Areas of the basal ganglia are involved with motivation, reward, and creating habits. The extended amygdala regulates the brain’s reaction to stress and negative emotions like anxiety and irritability. The prefrontal cortex is responsible for “executive” functions like planning, prioritizing, and organizing – or “go” functions – as well as self-control and emotional regulation – or “stop” functions.

When we say addiction “hijacks” the brain, what we mean is that the massively disproportionate reward of substances causes the basal ganglia to tell the prefrontal cortex to organize its efforts in a way that prioritizes getting drugs and alcohol. At the same time, it undermines the “stop” functions of the prefrontal cortex, which get weaker from disuse.

This is the main area of debate when it comes to whether the brain ever fully recovers from addiction. On one hand, you have this miscalibrated basal ganglia that only goes back to normal very slowly and on the other hand, you have this impaired “stop” function in the prefrontal cortex.

The latter is much more malleable, which is why treatment strategies tend to focus on tools to regulate emotions and control behavior. There is also good news in that the urge to use drugs and alcohol typically declines the longer you stay sober. Most people say their cravings get noticeably weaker after one year and five years sober.

The brain is much more adaptable than we used to think.

If you’re concerned about whether your brain can ever fully recover from addiction, there is plenty of room for optimism. It has only been in the past decade or so that neuroscientists have come to believe that the brain keeps making new neurons in adulthood. We’ve also known for a long time that the brain has significant powers of adaptation.

Even people who have had strokes or experienced traumatic head injuries are often able to regain most or all of their cognitive functions. New technologies like transcranial magnetic stimulation may help heal brains even faster. The key is that your brain will adapt to whatever you consistently ask it to do. Your concentration, willpower, and memory will get stronger the more you use them, even after years of substance use.

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Mar

Navigating and Resolving Resentments

We all get resentments toward people around us, and when we do, it can be hard to sit down and have those uncomfortable talks. Looking another person in the eyes and telling them what they are doing is bothering you or admitting that you haven't been acting in a way you are proud of can be hard to do if we don't have a plan to do it reasonably, and mutually. As uncomfortable as these talks are, they are worth it if they can save a relationship with a friend or family member.

We can do things to make these talks easier for the other person and us. So, here are some tips for handling these awkward talks productively and positively.

Before We Even Have the Conversation

These talks can be anxiety-inducing and overall just icky feeling, but it helps to take time and make sure our intentions are clear, and we know what the goal of the conversation is. Often we assume we know why the other person did what they did. Try and clear what you think from your mind so that when they tell you their side of the story and you can be ready to hear that instead of just assuming you know best and walking away without anything changing.

It can be helpful to set aside a time and place to have this problematic talk. When thinking of a location, it's useful if the area is not in public. You don't want to be distracted by people around you or be worried that others are listening in on you while you are vulnerable. When you invite the person, you want to make sure that you are clear that you want to have this talk. Otherwise, the other person may feel ambushed. You could tell them, "hey, ___ I've noticed a tension between us about ___, would you be able to meet at my house around 8 to clear the air?". Warning the other person gives them the opportunity to think about there perspective on the situation so that they can be ready to talk about what is bothering them. Often if you spring a hard conversation on someone with no warning, they will become defensive, and they may throw excuses out, so it's better if you give the other party time to process things.

Time to Have a Hard Talk

Bringing up the topic can be scary. We frequently fear how the other person will react and if they will still like us after we bring this up. Remember, we are looking for a solution to save the relationship. If you don't have this talk, the feelings you are having won't go away. They will only get worse. So the first thing you need to do is state what upset you. Try and use specific examples and make it clear how you felt in those examples. Avoid using extremes such as "you always" or "you never." Have the mindset that you are going to fix this together.

You need to know the difference between what the other person's intentions were vs. how it impacted you. Likely, their plans were not to hurt. That doesn't change the fact that what they did DID hurt you. Giving the other person the benefit of the doubt can go along way in helping to resolve the conflict. It is still essential that you let them know that their actions did hurt you, but it's equally important to let them know that you are aware that they likely not their intention. A simple way of phrasing this is "when you did ___ it made me feel like ____, I don't think this was what you meant to do, but I need you to know how it made me feel so we can clear the air."

Listen to what they are saying.

After you explain the way you felt, you should ask for their version of the events. Listen to what they are saying, and after they've finished, acknowledge what they've said. "What I heard you say way ___."

Own your part. If the other party has said that you did something that made them feel bad, take ownership of that, acknowledge what was said, and apologize for your role in that conflict. Owning your part could be as simple as saying, "when you did ___, I was hurt, so I was defensive for a few days, and I see how that could add strain to our relationship. I should have been up-front with you that I was hurt at that moment." Even if they don't mention anything you did, it's not a bad idea to let them know that there are ways you could have handled the situation better. Identify a few examples of your part in this before you have the conversation.

Come to a Solution

Ask them for ideas and listen to what they say and don't interrupt them. When you tell them your ideas for a solution, make sure to use we/us rather than me/you. Promise to try harder in the future and move on.

These conversations don't always go the way we want them to go. If it starts to feel like an argument, don't be afraid to tell them that you don't feel comfortable talking to them when emotions are running this hot. You can reschedule and come back to it later.

Steamboat Springs, located in the Rocky Mountains, provides a setting for the natural stimulation of mind and body, allowing for a return to our innate senses and a new foundation from which to build. Foundry Treatment Center’s vision was formed through personal experiences and continues to grow through the dedicated compassion of the Foundry team. We share a commitment to provide a comprehensive, whole-body treatment program that encourages each to seek their values and beliefs through innovative and evidence-based treatment modalities. For more information on how we can help you or a loved one, call us today at 1-844-955-1066.

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Feb

Recipes in Recovery: Steak Chimichurri

At The Foundry Treatment Center Steamboat, a healthy lifestyle is an important part of complete recovery. The link between the body and the mind is powerful, and a healthy diet combined with regular exercise is an integral component of lasting recovery from Substance Use Disorder.

There is a common misconception that healthy food is bland and without flavor or excitement. Our goal is to shift how our clients define "healthy food" and shift their lifestyles towards sustainable nutrition. Serving bland, flavorless food would only set the stage for old eating habits and patterns to return down the line.

Check out this fabulous recipe to add to your menu tonight.

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Chimichurri Sauce:1 bunch parsley1 bunch cilantro1 tablespoon garlic, chopped1/2 cup olive oilSalt and pepper to taste2 lemons, juicedCombine all ingredients except for olive oil and lemon juice in a blender. Start to slowly add olive oil and lemon juice. Adjust seasoning to your liking.Asparagus:

2 bunch asparagus

1/2 stick butter

1 tablespoon lemon juice

Combine ingredients together and wrap with foil. Cook in oven with steak.

Brown rice and quinoa:

1/2 cup quinoa*

1/2 cup brown rice*

*Cook according to instructions on package

Steak:

1 flank steak seasoned how you likeCook steak in oven at 375 until desired doneness. Place rice blend on plate, top with the asparagus. Slice steak and cover with the chimichurri sauce. ENJOY!

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Jan

Recipes in Recovery: Ginger-Garlic Chicken Salad

There is a common misconception that healthy food is bland and without flavor or excitement. Our goal is to shift how our clients define "healthy food", and shift their lifestyles towards sustainable nutrition. Serving bland, flavorless food would only set the stage for old eating habits and patterns to return down the line.

Below is the recipe for Ginger-Garlic Chicken Salad

- One of the many healthy meals served to clients at the Foundry Treatment Center Steamboat.

Dressing:

½ cup sesame oil

2 tbsp fresh ginger paste

1 clove garlic

1 TBSP coconut aminos

½ tsp salt

½ tsp black pepper

1/3 cup onion-diced

2 TBSP honey

1 TBSP lemon juice

1/3 cup rice wine vinegar

*Mix all ingredients and mix in a blender or in a bowl with a whisk

Salad:

1 cup kale shredded

1 cup cabbage shredded

½ cup carrots shredded

½ tbsp toasted peanuts

1 cooked chicken breast

Instructions:

1) season and cook chicken

2) mix greens, carrots and dressing

3) top with nuts

4) slice chicken and place on salad

5) ENJOY

Scott Przymus is the Executive Chef at The Foundry Treatment Center Steamboat, a rehab and substance use disorder treatment center located in Steamboat Springs, Colorado.

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Jan

Compassion Fatigue

Compassion Fatigue and the Need for Trauma-Informed Legal Practice

When earning my doctorate at Florida State University, my faculty mentor asked me and a group of my peers to assist in preparing the first book on Compassion Fatigue. Dr. Charles Figley’s Compassion Fatigue: Coping with Secondary Traumatic Stress Disorder in Those Who Treat the Traumatized (1) was published in 1995. Since that time, compassion fatigue and helping helpers to maintain their health and job satisfaction has been a focus of my career. I have trained many groups of helping professionals to better understand the relationship between burnout and secondary trauma and to look inward at the emotional and physical cost of working with traumatized clients in stressful situations.

Since 1995, recognition of the significant incidence of trauma in clients and families who seek assistance has magnified the importance of working within a trauma-informed culture where employee and organizational health, compassion fatigue, self-care, and honest organizational assessment are necessary. Over the years, I have wondered if other professions are starting to adopt similar trauma-informed practice.

My son Patrick is an attorney. Since passing the Bar in 2012, he has specialized in Workers Compensation and Personal Injury law. We have had many conversations about the rewards and struggles of working with clients who have experienced significant workplace injuries or serious and life threatening accidents. We have talked about the difficulty of working with clients who often present as controlling, hypervigilant, and who frequently respond to the legal process with frustration, anxiety, and emotional dysregulation.

A little over a year ago, Patrick and his family moved to Florida. As he prepared to take the Florida Bar, he began to consider the impact of his work with traumatized clients. As he identified the emotional cost that he and many of his peers have incurred as a result of their work as lawyers, he began to identify ways that he could assist other attorneys who have also struggled in this regard. As we discussed his desire to assist others (2), we researched trauma as an issue within the practice of law. It quickly became evident that lawyers, bar associations, and law school faculty were beginning to investigate the concept of Trauma-Informed practice (3,4,5).

Based on our findings it is clear that working with traumatized clients can impact every area of legal specialization. Personal injury attorneys assist clients who have experienced life-altering automobile accidents or work-related injuries. Civil litigators assist victims of violent crimes. Family lawyers assist victims of domestic violence and abuse. Veterans attorneys assist service members with combat-related struggles. Judges and other officers of the court are exposed to cases where testimony and other evidence requires almost constant emersion in traumatic material. Legal professionals in each specialty spend hours interacting with traumatized clients, listen to emotional stories of traumatic events and reviewing graphic photos and medical records.

The potential impact of trauma on legal professionals is significant and multifaceted. First, traumatized clients often present symptoms that challenge the legal team and its efforts to successfully represent their concerns. Traumatized clients typically enter the legal process with a strong need to feel safe. As the legal process is unfamiliar and potentially threatening, traumatized clients often enter the relationship with a need to be hypervigilant, to feel heard and believed, and in control of the process. Failure to recognize this need can result in distrust, manipulation, and conflict between the client and the legal team.

Second, trauma memories are often fluid and can change over time. A client's inconsistent accounting of what happened during the event can make case conceptualization, completion of a thorough and accurate assessment, and preparation for deposition or trial difficult. As members of the legal team become frustrated, they may avoid interacting with clients, which creates even greater conflict and increased efforts on the part of the client to regain control of the situation.

As caseloads build with traumatized clients, team members become more vulnerable to stress, burnout, and secondary trauma from their daily work responsibilities and client interactions. As a result, professionals can experience reduced job satisfaction and increased emotional consequences. In all helping professions these struggles can result in increased turnover, the desire to leave the profession, and increased problems with mental health and addiction issues. Recent research on turnover rates in law firms found that 44% of new associates change firms within the first three years of practice. This turnover rate is estimated to cost firms over $9 billion annually (6). Large numbers of attorneys are also leaving the profession. A 2014 report (7) stated that 24% of attorneys who were licensed in 2000 were no longer practicing law in 2012.

Addiction and mental health struggles are also evident in the legal profession. A 2016 survey (8) of 12,825 attorneys found that 20.6% screened positive for "hazardous, harmful, and potentially alcohol-dependent drinking." In this same survey, 28% of the respondents reported depression, 19% reported anxiety, and 23% reported significant levels of stress in the work environment. Issues associated with addiction and mental health struggles have implications that go beyond the attorney’s wellbeing. Attorney impairment is not a mitigating circumstance for failing to provide clients with appropriate representation (9).

All of these issues are not directly associated with working with traumatized clients, but the importance of these growing concerns should be carefully considered!

Recommendations for law firms and County, State and Federal courts: 1. Accept the reality that trauma and frequent interaction with traumatized clients can harm outcomes, reduce work performance and job satisfaction of employees, and create emotional and behavioral consequences for employees and the organization as a whole. 2. Work with a consultant to assess the impact of trauma, compassion fatigue, and organizational trauma on the overall health of the organization. 3. Develop trauma-informed policies and procedures for working with all clients. 4. Provide training for all employees on trauma, best practices for working with traumatized clients, and prevention of compassion fatigue, burnout, and secondary trauma. 5. Provide resources for employees who are struggling with compassion fatigue, burnout, or secondary trauma, addiction and other mental health issues. These resources should include coaching, therapy, treatment and access to an Employee Assistance Program. It is also important to provide preventative opportunities for self-care, consistent utilization of PTO, etc.

Recommendations for Law Schools: 1. Provide training in trauma, best practices for working with traumatized clients, preventing and addressing compassion fatigue, burnout, and secondary trauma for all students. 2. This training should be mandatory for all students regardless of the student's stated areas of interest.

Recommendations for addiction professionals and other mental health professionals: 1. It is critical to remember that working with attorneys and other legal professionals should include a thorough trauma assessment, assessment of compassion fatigue, and burnout. 2. It is important to remember that Trauma-Integrated Legal Practice is relatively new concept in most legal practices, courts, and governmental legal environments. Trauma education, including education on compassion fatigue (i.e., burnout and secondary trauma) is critical for attorneys to accept the serious impact of trauma in their work environment. 3. From this perspective, all addiction and mental health treatment should be trauma-informed and trauma-integrated. Working with attorneys and legal professionals should be seen from the same perspective of working with other helping professionals (i.e., medical professionals, first responders, therapists, etc.).

Special Thanks to Patrick Barnes, Esq. for providing input and feedback on this blog post. · For more information on Trauma-Informed Legal Practice, go to Wave of Change Coaching and Consulting, LLC (www.waveofchangecoaching.com).

Footnotes 1 Figley, C. R. (1995). Compassion Fatigue: Coping with Secondary Traumatic Stress Disorder In Those Who Treat the Traumatized. Brunner/Mazel. New York: NY. 2 https://www.waveofchangecoach.com/ 3 https://www.lawcare.org.uk/news/lawyers-and-vicarious-trauma 4 https://www.lsc-sf.org/wp-content/uploads/2015/10/Article_Establishing-a-Trauma-Informed-Lawyer- Client-Relationship.pdf 5 https://www.aals.org/wp-content/uploads/2015/06/Katz-Haldar.pdf 6 https://www.attorneyatwork.com/confronting-lawyer-turnover-in-law-firms/ 7 http://www.abajournal.com/magazine/article/after_the_jd_study_shows_many_leave_law_practice 8 Krill, P. R., Johnson, B. R., & Albert, L. (2016). The Prevalence of Substance Use and Other Mental Health Concerns Among American Attorneys. Journal of Addiction Medicine. January/February 2016, 10(1), 46-52. 9 https://www.lawpracticetoday.org/article/evaluating-impaired-attorneys/

Dr. Mike Barnes is the Chief Clinical Officer at the Foundry Treatment Center Steamboat, a rehab and substance use disorder treatment center located in Steamboat Springs, Colorado.

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Contact Foundry

Call today to get started on your journey or if you have any questions.

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(844) 955 1066