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Addiction is a chronic condition and relapse is common. It’s hard to know exactly how common, but the National Institute on Drug Abuse estimates that about 40 to 60 percent of people who get treatment for a substance use disorder relapse within a year.

Although relapse is common, it should be avoided if at all possible. Not only is it terribly discouraging, but it also leaves you more vulnerable to overdose, since you no longer have any tolerance. The good news is that if you do relapse, it doesn’t have to be the end of recovery. The following steps can help you get back on track.

Know That Relapse Is Not a Permanent Failure

The first step after a relapse is to sort out your thinking. One common reaction is to think something like, “Well, I’ve already ruined my recovery so I might as well go all out.” It’s normal to feel disappointed and discouraged after a relapse, but this all-or-nothing thinking doesn’t help matters. Yes, it would have been better not to relapse, and starting again will be hard.

However, instead of thinking of relapse as a permanent failure, think of starting again as the second-best option. The best thing would have been to stay sober but since that opportunity is gone, focus on the second-best option. Many people relapse several times before ultimately staying sober long-term. The sooner you decide to move on from this setback, the easier it will be.

Reach out to Someone You Trust

Once you’ve decided to stop digging a new hole, reach out to someone you trust. Good options are your 12-Step sponsor, your therapist, your group, or a supportive friend or family member. Tell them what happened and that you want to get sober again. There are several reasons for this. For instance, it moves things along if someone can help you make a plan and follow through.

Another reason is that it creates a higher level of accountability. Once you tell someone that you relapsed and that you want to get sober again, you feel a greater sense of obligation to follow through. Third, being open and honest makes a clear break from addictive behavior, which is typically evasive and deceptive. Coming clean about a mistake is a clear sign you want to make a real change.

Figure out the Best Way to Get Sober Again

Once you’ve reached out, the next step is to figure out the best way to get sober again. If you had more of a minor slip, like just drinking or using once or even a few times, you’ll probably be fine getting sober again without a medical detox. However, if the relapse was more extensive, you may need to consider whether to go through medical detox. Your doctor or addiction counselor can help you make that determination.

Analyze What Went Wrong

After you’ve addressed the emergency of drinking or using and you’ve gotten sober again, it’s time for some serious reflection. You want to understand exactly what led up to your relapse. Start by writing out a sort of narrative that includes where you were when you actually relapsed, who you were with, how you felt, what you were thinking about, and so on. Then, think about things more broadly. What was going on in your life at the time? Were you feeling depressed or anxious? Were you feeling unusually good?

When people relapse, it’s often days or weeks after they make a definite decision to relapse and they are just waiting for the opportunity. Do you remember when you made that decision? Was it around the same time the possibility first occurred to you or was it sometime later? Had you been sticking to your recovery plan? These are all important questions to ask if you want to better understand what happened. Also, don’t rely solely on your own memory. Get input from your therapist, your friends and family, and from your sober network.

Think About What You Still Have Going for You

One of the biggest challenges in getting over a relapse is the feeling that you have to start over again from scratch. In some ways, you do have to start over. You might have to detox again and you have to start again at one day sober. This matters because sobriety tends to get easier the longer you’re in recovery. You may feel like you’ve wasted a lot of time, money, effort, and will power.

However, in some important ways, you don’t have to start over. You know that you can make it through detox and stay sober for a while. You are familiar with some kind of recovery process, whether it’s participation in a professional treatment program, talking to a therapist, or going to 12-Step meetings. You may have identified and made some progress toward treating any co-occurring mental health issues. You may have something resembling a sober network already in place.

Write down an actual list of all the advantages you have this time that you didn’t have last time. Take it one step further and write down all the advantages you have in general. When you see all the things you have going for you, the prospect of “starting over” won’t seem quite as overwhelming.

Make a New Plan and Try Again

Finally, once you’ve gotten sober, analyzed your mistakes, and taken stock of your current assets, make a new recovery plan that incorporates what you’ve learned. This will be different for everyone. For example, you might realize that after a few months, you started cutting a lot of corners on your recovery plan by skipping meetings, not exercising, and so on.

Your new plan will have to focus on keeping you more engaged and less complacent, possibly by increasing your social support. Another common problem is that people have a rough time transitioning from an inpatient treatment program back to their normal lives.

‍Your revised plan might include repeating treatment but this time with a more gradual transition, such as stepping down to an outpatient program or sober living environment before heading home. Whatever the stumbling blocks were last time, and there may be several, create a plan for exactly what you will do if you encounter them again.

Relapse is unfortunately very common in addiction recovery, but it doesn’t have to be a disaster. Plenty of people relapse and go on to have a strong recovery. You don’t fail until you quit trying. At The Foundry, we know that recovery from addiction is never a straight line. We use a variety of proven methods to give our clients the tools they need to stay sober long term. For more information about our treatment options, call us at (844) 955-1066 or explore our website.

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Getting plenty of restful sleep is one of the best things you can do for yourself in recovery. A night of good sleep can mean the difference between meeting the day with energy and focus and just dragging yourself through. Even a minor sleep deficit can have a significant effect on your physical and mental health, and therefore your recovery.

‍Sleep deprivation and running a chronic sleep deficit have been shown to cause cognitive impairments such as poor concentration, poor working memory, poor long-term memory, and worse decision-making. In the long run, inadequate sleep can significantly increase your risk of anxiety disorders and major depression. Since these commonly occur along with addiction, it’s crucial to do what you can to get enough sleep.

Unfortunately, insomnia is a common withdrawal symptom and it may persist for weeks or months into recovery, making the process harder. If you’ve been having trouble sleeping, these tips might help.

First, See Your Doctor

Before you do anything else, it’s a good idea to rule out medical causes for your insomnia. Talk to your doctor about your insomnia and be sure to share your addiction history. Many sleep medications are just benzodiazepines and you should definitely avoid those if you have a history of substance use issues.

Next, See Your Therapist

There are two main reasons to talk to your therapist about your sleep problems. The first is that insomnia is a common symptom of several mental health issues, including major depression and anxiety. It could point to an issue that hasn’t been treated or hasn’t been treated adequately. If such an issue does exist, your sleep should improve as you get it under control.

Second, your therapist can help you sleep better. There is a specific cognitive behavioral therapy protocol for insomnia called CBT-I. It includes many of the tips mentioned here but also entails examining your assumptions about sleep and what you say to yourself while lying in bed awake.

Get on a Regular Sleep Schedule

The best tip for sleeping better is one no one wants to hear: sleep at a regular time, even on the weekends. There are a lot of reasons we hate this advice--we have too much to do, we don’t like being constrained by a regular bedtime, we need to catch up on weekends, and so on. However, your circadian rhythm is complex and it doesn’t know what a weekend is.

If you keep your body guessing about what time you’re going to go to bed, you just won’t be able to fall asleep as fast or sleep as deeply. Start by setting a regular wake-up time and you will find it easier to fall asleep at night.

Turn Your Bed into a Sleep Trigger

You want a clear connection in your mind between getting into bed and falling asleep. That means your bed should only be used for sleep and sex. Don’t watch TV in bed, don’t look at your phone, don’t read or eat or do anything else in bed.

If you lie down to sleep but you don’t fall asleep for 20 minutes, get up and do something low-key until you feel tired. Otherwise, your anxiety starts going up, you think, “Here we go again,” and you start to think of your bed as a sort of torture device, where you lie exhausted but unable to sleep.

Cut out the Naps

Naps can be tempting, especially if you can’t ever seem to get a good night’s sleep but they can also throw off your rhythm. Naps are especially disruptive if you sleep for more than twenty minutes or nap later than 2 p.m. When you’re trying to conquer insomnia, it’s best to cut out naps completely. Think of it as storing up your tiredness for bedtime.

Cut down on caffeine.

For most people, a bit of caffeine is fine and moderate coffee and tea consumption appears to have some health benefits. However, caffeine also has a half-life of between four and six hours. If you drink a cup of coffee at noon, as much as a quarter of that caffeine--plus whatever is leftover from the morning--might still be in your system at midnight, depending on how fast you metabolize caffeine. Even if it doesn’t keep you awake, it can disturb the quality of your sleep. If you can’t sleep, try cutting down on caffeine or setting a strict cutoff time.

Keep Your Room Dark and Quiet

This is an obvious bit of advice that almost everyone ignores. We evolved to sleep in dark, quiet environments but most of us now live in places where it’s hardly ever dark or quiet. There are street lights, traffic, noisy neighbors, 4 a.m. garbage trucks, barking dogs, and so on. Even low levels of light and sound can disturb your sleep even if they don’t completely wake you up. If you can’t keep your room dark and quiet, consider investing in some ear plugs and a sleep mask.

Turn Down the Thermostat.

Just as we evolved to sleep in dark and quiet, we evolved to sleep in slightly cooler temperatures. However, most of us now live in temperature-controlled buildings that are theoretically the same around the clock. One important sleep adaptation is that our body temperature drops. If you can, turn down the thermostat to between 68 and 70 degrees before bed, you should sleep a bit more deeply.

Have a Good Bedtime Routine

Finally, have a good bedtime routine. A regular sequence signals your body that it’s nearly time to sleep. A good routine can also help you wind down and relax before you get into bed. Try not to work or deal with other stressful things up to the time you go to bed.

Keep in mind that watching intense movies or TV shows right before bed can have a similar effect to real-life stress. Instead, do something relaxing. Listen to some music, pray or meditate, or take a warm--but not hot--shower or bath. You’ll sleep better if you lie down while in a good mood.

Getting plenty of sleep is one of the best things you can do for your physical and mental health, especially if you are recovering from addiction. Unfortunately, insomnia is one of the most common problems people face when dealing with substance use and mental health issues. There are no guarantees that you’ll get a good night’s sleep on any given night, but if you create the right conditions, you can tip the odds in your favor. At The Foundry, we believe that wellness is one of the most important parts of a strong recovery from addiction. That’s why we emphasize overall health, including restful sleep, in our treatment programs. To learn more, call us today at (844) 955-1066.

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It’s not uncommon for people to feel lonely when starting out in addiction recovery. There are several reasons for this. If you’ve just come home from inpatient addiction treatment, where you were around people most of the time, you might suddenly find a normal amount of alone time rather stark. None of the people you are used to chatting with in the dining hall or rec room are around anymore.

Second, when you’re starting recovery, it’s a good idea to distance yourself from friends and acquaintances who use drugs and alcohol. Even if they don’t pressure you to drink or use drugs, the association might trigger a craving. Feeling this avenue of socializing is restricted in this way might make you feel lonely.

This loneliness can have real consequences for your recovery, your mental health, and even your physical health. Loneliness and boredom often trigger cravings. Feeling both bored and sad is a bad combination for recovery.

It’s important to remember that loneliness isn’t just the absence of companionship; it’s the presence of psychological stress. Studies have shown that loneliness is linked to a greater likelihood of high blood pressure, diabetes, depression, and psychological distress. If you’re feeling lonely in recovery, here are some suggestions for what to do about it.

Accept That What You’re Feeling Is Normal

First of all, accept that it’s normal to feel lonely sometimes. We’re a social species and we depend on each other for survival. From an evolutionary perspective, to be isolated is to be vulnerable. Part of coping with loneliness entails acknowledging the feeling, accepting that it’s ok, and knowing that it will eventually pass. Just labeling the feeling can help you feel a bit better. So, if you’re alone and feeling restless, bored, or sad, think, “Ah, that’s loneliness; it won’t last though.”

Go to Meetings Regularly

The best way to beat loneliness is obviously to have regular social connections. For people in recovery, that often means attending regular 1Step or other mutual-aid meetings. This is a time to connect to other sober people and it may also be a good time to discuss your feelings of loneliness. Most of the other members will know what you’re talking about.

Some people may even make themselves available if you feel like you need someone to talk to. Going to meetings regularly also gives structure to your day so that if you do feel lonely, you have a definite idea of when that might end. Keep in mind, especially if you’re relatively new, that engagement is key. While it might help just to be around other people, you still might feel lonely if you just sneak into a meeting and sit in the back.

At the moment, we’re all under quarantine from the coronavirus and that might put a damper on meetings in your area. If that’s the case, you may be able to connect with your group digitally. A lot of meetings are now being held on Zoom, Google Hangouts, and other platforms. Not only is this safer, but it also gives you a chance to get some different perspectives from different groups.

Work on Repairing Damaged Relationships

Another reason you may be feeling lonely is that you may have alienated some of your friends and family when you were actively addicted. If you’re feeling lonely, that may be an indication that it’s time to start mending those relationships. This may be a long-term project but it has to start somewhere. Reach out to the people you’ve wronged and who you want back in your life.

You may have already done this to some extent while working the 12 steps. If so, great. Try reaching out to some of those people. Relationships are typically built through frequent, low-intensity contact. If you still haven’t apologized and made amends to some people, now might be a good time to do that. An apology and making amends won’t fix your relationship right away but it’s a good place to start.

Get Involved in New Activities

People are often surprised how much harder it is to make friends as an adult. When you’re younger, you’re around other people your age every day in school and other activities. When you’re an adult, you’re around other people at work--sometimes. However, people at work have their own lives and concerns and you may or may not have any points of connection.

One solution is to get involved in some new activities. Join a cooking class or a yoga class. Find a running or biking group. Join a recreational sports league. Volunteer for a worthy cause. These are great ways to see the same people regularly and meet people who share your interests. Beyond that, these all aid your recovery by giving you a challenge and a sense of purpose.

Reframe Loneliness

Another important thing to remember about loneliness is that it’s really just in your head. Just because you’re alone doesn’t mean you are necessarily lonely. Loneliness only happens when you are alone and craving company. Being alone can also be an opportunity to do some things you can’t do when other people are around. It may be a chance for you to read, write, meditate, create, listen to music, and think about your values and priorities.

Many of these things require deep, uninterrupted focus, which makes alone time perfect for working on them. Under the current quarantine, we’ve all been reminded several times that Shakespeare wrote King Lear while under quarantine from one plague and Newton invented calculus while exiled from another plague. While we all need to socialize to various degrees to be healthy and happy, we can also use alone time to think, focus, and work.

Loneliness is a common challenge early in recovery but it gets better. You can build a sober network pretty quickly if you make a regular effort and stay engaged in meetings. You may also be able to salvage some old relationships. In the meantime, it’s important to accept that what you’re feeling is normal and that it will pass, and to make what use you can of your alone time. At The Foundry, we understand that a strong recovery is about treating the whole person—mind, body, and spirit. We incorporate many different proven treatment methodologies to help you stay sober long term. To learn more about our programs, call us today at (844) 955-1066.

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EMDR stands for eye movement desensitization and reprocessing. It’s a form of psychotherapy developed specifically to help clients process and overcome trauma. EMDR is a targeted form of therapy that uses bilateral movements, such as side-to-side eye movements, to mute the intensity of traumatic memories.

For cases of simple trauma in adulthood, this can often be accomplished in only a few sessions, compared to months or years of traditional therapy. A course of EMDR therapy usually takes between six and 12 sessions, with clients attending one or two sessions per week.

Why EMDR Is a Great Tool for Addiction Treatment

EMDR was originally developed to treat post-traumatic stress disorder, or PTSD, and it is still primarily used for that purpose. Trauma is a factor common to many, perhaps even most, people who struggle with substance use issues. There have been many studies examining the connection between PTSD and substance use disorders and these have found that among people seeking treatment for substance use disorders, between 20 and 50 percent also have a lifetime diagnosis of PTSD and between 15 and 40 percent met the criteria for PTSD in the past year.

Childhood trauma is an especially large risk factor for developing substance use issues as an adult. Adverse childhood experiences, or ACEs, include things like being abused or neglected, witnessing domestic violence, having a parent get arrested, and other experiences that make a child feel threatened or unsafe. The more ACEs someone has, the greater their risk of negative outcomes such as substance use and mental health issues as adults.

According to an article published in the North Carolina Medical Journal, each ACE increases your risk of developing a substance use disorder by two to four times and as many as two-thirds of people who struggle with addiction can trace their problems to ACEs. For these reasons, identifying and treating trauma should be a top priority for any addiction treatment program and EMDR is a targeting way of doing that. What’s more, it delivers quick results, making it perfectly suited to the context of an intensive addiction treatment program.

How It Works

The big idea behind EMDR is that the mind will heal itself, given the chance. Just as your body will heal a cut or a broken bone on its own, your mind has its own way of healing from trauma. This becomes apparent when you consider that PTSD is actually surprisingly rare. According to the US Department of Veteran’s Affairs, about 60 percent of men and 50 percent of women will experience trauma in their lives but only about four percent of men and 10 percent of women will develop PTSD.  

That indicates that trauma is necessary but not sufficient for developing PTSD. Something is preventing the mind from healing itself in the normal way. Often, this happens when the brain is still developing at the time of the trauma or the trauma is repeated.

The idea behind EMDR is to help the client change the way the trauma is stored in the brain so it can be processed in the normal, healthy way. The exact mechanism by which this works is not exactly clear but we know from many clinical trials that it does work. Part of it has to do with re-experiencing the trauma in a safe, controlled environment. Often, people with PTSD are unable to access certain aspects of the experience and part of EMDR therapy is to bring those into conscious awareness.

There is also a hypothesis that the bilateral stimulation, such as eye movements, mimic the process your brain uses during REM sleep to consolidate new memories. The effect is that you change the way you think of the traumatic memory at a deep level. Some people describe it as forgetting to let the traumatic memory – or things related to it – bother you.

What to Expect From EMDR Therapy

EMDR is delivered in an eight-phase process. How long this process takes varies by individual and depends on factors like whether you’re treating a single trauma or complex trauma, when you experienced the trauma, and how severe it was.

In phase one of treatment, the therapist will take your history, decide whether EMDR is a treatment approach that makes sense, and develop a treatment plan. You will work with the therapist to identify possible targets for processing. These may be traumatic memories from your past or even recurring situations you are currently dealing with.

During phase two, you will work with your therapist to develop interim strategies for coping with emotional stress. Since the process will take at least a few weeks to work, it’s important to have ways of coping with stress in the intervals between sessions. These might include imagery or relaxation techniques.

Phases three through six are when you identify and process target memories. You will start by identifying three things: an image related to the memory, a negative belief about yourself, and emotions and bodily sensations related to the memory. You will also develop a positive belief.

During the processing phase, you will be asked to focus on the negative image, thought, and emotions, while simultaneously engaging in the bilateral stimulation. You might be asked to follow the therapist’s hand side to side with your eyes, follow a light, or tap with your fingers. The therapist will then ask you to notice whatever spontaneously happens. When you no longer have negative emotions associated with the memory, your therapist will ask you to recall your positive belief.

In phase seven, you will be asked to keep a log for a week to remind you of the calming techniques you used in phase two and to note any additional issues that come up. Phase eight is about evaluating the progress you’ve made so far.

EMDR is becoming increasingly popular because it is a focused, time-limited, and effective way to process traumatic memories. Instead of changing your thoughts or beliefs around a trauma, you change the way that trauma is stored in your brain. At The Foundry, we understand that trauma is the driving force behind most addictions and we use a number of methods, including EMDR, to help our clients heal. To learn more about our methods and programs, explore our website or call us today at (844) 955-1066.

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Different people think of different attributes when it comes to addiction recovery. Some people may think of discipline or self-control. Others may think of social connection or spirituality.

One attribute that is critical for everyone involved--treatment professionals, family and friends, and people with substance use disorders--is compassion. Compassion plays a vital role at every stage of recovery for the following reasons.

Addiction Is Fueled by Pain

The most important thing to understand about addiction is that most of the time, it’s fueled by pain. Most people who struggle with substance use have some kind of trauma in their past, whether it was childhood abuse, neglect, domestic abuse, sexual assault, or some other traumatic event. The pain of trauma can last years, perhaps even your whole life. Many people use drugs and alcohol as a way to escape the pain in their own heads.

Typically, addiction treatment professionals are well aware of this, often from firsthand experience. Their compassion for people feeling that pain is what inspired them to work in this field. However, it’s also critical for family and friends to understand this. Seeing the pain behind addiction can be hard at times, especially since addictive behavior negatively affects family and friends.

For example, it can be hard to have compassion for someone when you feel like that person is manipulating, deceiving, or otherwise taking advantage of you. Addictive behavior can seem like the height of self-involvement, especially when the pain is buried beneath aggressive or secretive behavior. As challenging as it might be at times, family and friends have to remember their loved one is acting that way because they are hurting. Compassion, not criticism or judgment, is typically what helps the most in the end.

Compassion for Yourself Is Critical

It’s also crucial for anyone with a substance use disorder to develop compassion for themselves. People with substance use issues can often be extremely compassionate towards others and extremely harsh on themselves. This is especially true for people with co-occurring conditions like major depression and anxiety disorders. If you struggle with addiction, you are probably no stranger to self-critical thoughts.

You may think things like, “Why am I like this? Why can’t I stop? What’s wrong with me?” Often, the self-criticism goes much deeper than that and precedes substance use by years. You may feel a deep sense of shame or worthlessness. If you pay attention, you’ll probably notice that you say all kinds of nasty things to yourself, probably things other people have said to you and you accepted as true.

Perhaps worst of all, you may feel like flagellating yourself in this way will inspire you to be better. Unfortunately, that’s not how it works. It’s almost impossible to make positive changes from a place of shame and hopelessness. A much better approach is to work on being more compassionate and supportive toward yourself. Try talking to yourself the way you would talk to your best friend. Accept that we all make mistakes and know that even your really bad blunders don’t make you a failure or a horrible person; they just make you human.

Compassion Brings People Together

Finding a sense of social connection is an important part of addiction recovery. It gives you a sense of purpose and accountability, whereas loneliness, isolation, and alienation typically lead to depression, anxiety, and hopelessness. Connection makes you feel better about life and keeps you focused on recovery. Few attributes are as good for fostering social connection as compassion.

People like to know that you care if they are hurting and want to help. When you have compassion, you listen and try to understand rather than make judgments or just wait for your turn to talk. When you are part of a group that values compassion, you know you can talk to each other and rely on each other.

Compassion for others makes you happier.

One thing people are often surprised to discover about compassion is that it makes you happier. Too often, we get caught up chasing our own happiness and, as a result, end up feeling dissatisfied and miserable.

We may think of caring for others as an obligation or a burden, but in fact, it’s one of the best ways to boost your own happiness. There are even a number of scientific studies showing that participants who work on increasing their feeling of compassion through metta, or loving-kindness, meditation, report a long-term increase in positive emotions.

How to Develop Compassion

Nearly all of us have some baseline of compassion already. We wince when we see someone get hurt, we want to protect small animals, and we feel bad when we hurt people we care about. The main thing is to build on the compassion you already feel. Remind yourself periodically that you want the people close to you to be happy and safe and help when you can.

However, the real challenge is feeling compassion for people we don’t get along with or particularly dislike. Inevitably, there will be some of these people in your family, at work, in your therapy group, or at your 12-Step meeting. The key here is to recognize what you have in common. You both want to be happy and feel like you matter.

You both have suffered pain and disappointments. Perhaps the most important thing to remember is that behavior that seems obnoxious to you is usually caused by some kind of pain or insecurity. Being able to understand that pain and wanting to relieve it is what compassion is all about.

Compassion is critical at every phase of addiction recovery. No one recovers alone; everyone needs love and support. Compassion for yourself is always the place to start and sometimes this is the hardest to nurture. Compassion for others builds strong social connections.

At The Foundry, compassion is one of our guiding principles. We know that recovery from addiction is first and foremost a process of healing and our caring staff uses a variety of evidence based treatments to help our clients heal. To learn more about our treatment programs, call us today at (844) 955-1066.

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Cognitive behavioral therapy, or CBT, and dialectical behavioral therapy, or DBT, are both forms of psychotherapy frequently used as part of a comprehensive addiction treatment program. Both have been proven effective for treating substance use disorders as well as many commonly co-occurring mental health issues. As the names suggest, CBT and DBT have much in common. In fact, you could say that DBT is a specialized form of CBT. Which is best for you depends on your particular situation. The following is a look at the important differences between CBT and DBT.

CBT Came First

As noted above, DBT is a specialized form of CBT. CBT was developed in the 1960s by psychologist Aaron Beck, based in part on the rational-emotive behavioral therapy, or REBT, of Albert Ellis. Beck was trained as a psychoanalyst but wanted some way of giving his clients more tangible results in less time. The core insight of CBT is that the things that happen to us don’t directly cause our emotions.

Our emotions are a result of our thinking about what happens to us. What’s more, many of our thoughts, beliefs, and assumptions are distorted in such a way that we suffer more than is necessary when things don’t go how we would like. Much of CBT is about identifying and challenging these faulty beliefs and thereby changing our emotional reactions.

Behavior is another important element of CBT. Imagine thoughts, emotions, and behaviors as sides of a triangle. Any change in one has some effect on the others. So, for example, you can change your emotions by changing your thoughts or by changing your behaviors. Therefore, CBT also emphasizes strategies for behavioral change that don’t necessarily require you to feel like doing something. More than anything, CBT represents a fairly large toolkit--skills that therapists can teach their clients to help them better control their emotions and behavior.

DBT Was Developed to Help With Borderline Personality Disorder

DBT was developed in the 1980s by psychologist Marsha Linehan to treat clients with borderline personality disorder, or BPD. BPD is a condition characterized by volatile and intense emotional reactions and frequent relationship problems. For example, someone with BPD might adore a particular friend one day, then feel like that friend has betrayed them--often based on little or no evidence--and switch to hating that person the next day. The friend, understandably, would be confused by this behavior and consequently, close relationships are fraught for someone with BPD. Linehan found that her BPD patients were often resistant to typical CBT.

The main issue was that CBT emphasizes changing challenging emotions by changing faulty thinking. Patients often felt this approach failed to validate their feelings. As a result, Linehan developed an approach to therapy that attempted to balance change and acceptance, and this is where “dialectical” became part of the method. Treatment becomes more of a discussion about which feelings are more valid and which might be constructively altered.

While DBT was originally developed for people with BPD, it has since been adapted for treating other conditions. It has been proven effective for substance use disorders, as well as commonly co-occurring conditions like eating disorders, self-harm, PTSD, and suicidal depression.

DBT Emphasizes Distress Tolerance and Social Skills

In addition to more emphasis on acceptance, DBT also focuses on distress tolerance and social skills. These are particular areas where people with BPD typically struggle the most. CBT focuses on managing challenging emotions by managing thoughts. The volatility and intensity of emotions common in BPD can make this challenging and the patient’s desire for validation may make them less likely to employ cognitive strategies.

Therefore, DBT adds an element of distress tolerance. These are skills include mindfulness and acceptance skills, as well as short-term survival skills like distraction and self-soothing. The idea is that the patient will inevitably feel unpleasant and strong emotions but they can develop the skills to keep them from causing problems in life.

Social skills are another important aspect of DBT. These are typically incidental in CBT. For example, you may have social anxiety resulting from an unfounded belief that others are judging you harshly. Since relationship problems are such a central feature of BPD, it makes sense to give special attention to developing social skills--called interpersonal effectiveness. These include skills like expressing your needs, saying no, and resolving conflict.

DBT Is More Structured

In a way, DBT is more intensive than CBT and it is also more structured--both in terms of time and content. In terms of time, people in DBT typically meet individually with a therapist once a week to work on specific issues and skills. They also have a group session each week, which typically lasts two-and-a-half hours. In between sessions, patients will typically check in with the therapist over the phone.

There are also four specific modules in DBT. Distress tolerance and interpersonal effectiveness are two of them and have been discussed above. The other two include mindfulness and emotional regulation. Mindfulness is especially helpful in distress tolerance. It emphasizes observing emotions and events nonjudgmentally. Emotional regulation includes skills like recognizing and labeling emotions, increasing positive emotions, and applying distress-tolerance techniques.

DBT Has a Group Component

As noted above, DBT typically includes both individual and group therapy. CBT can be used with either or both but doesn’t specifically incorporate both. The purpose of including group sessions in DBT is to give patients an opportunity to practice their new interpersonal and emotional regulation skills in a safe, supervised environment.

Neither CBT nor DBT is necessarily better than the other. It really depends on your specific needs. If you do struggle with borderline personality disorder, major depression, an eating disorder, or PTSD, it’s likely you will need DBT. Each of these conditions carries a very high risk of a co-occurring substance use disorder and if you have both, you need treatment for both. Substance use and mental health issues each make the other worse so it’s crucial to treat them in an integrated way. At The Foundry, we know that everyone seeking help for a substance use disorder has different needs. We offer many options for individualized treatment, including CBT and DBT. To learn more about our treatment options, call us today at (844) 955-1066.

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Getting plenty of quality sleep is one of the best things you can do for your physical and mental health. This is especially important if you’re recovering from a substance use disorder. Many studies have linked sleep deprivation with both short-term and long-term problems. Short-term problems include increased anxiety, poor concentration, poor working memory, and less self-control.

Long-term problems include increased risk of anxiety disorders and depression. One meta-analysis of more than 170,000 participants found that insomnia significantly increases your risk for depression. If you’re recovering from a substance use disorder, there’s a high probability that you already have issues with depression, anxiety, or other mental health challenges.

Therefore, it’s especially important to look after your mental health by getting enough sleep.Unfortunately, getting enough sleep is not always so easy. Insomnia is often a symptom of mental health issues as well as a cause. What’s more, insomnia is a typical withdrawal symptom and it may persist for weeks or months into recovery. If you’ve been having trouble getting enough sleep, here are some tips that might help.

Talk to Your Doctor

First, if you can’t sleep or if you feel like you’re getting at least eight hours of sleep every night but you somehow still feel tired all the time, talk to your doctor. If you’re experiencing insomnia or sleep apnea, there may be medical causes and medical solutions.

You will want to eliminate physiological causes first. When you talk to your doctor, be sure to share your addiction history. Many sleep aids are basically just benzodiazepines and you don’t want your doctor to prescribe something that will just cause you more problems.

Talk to Your Therapist

If there is no medical cause of your sleep problems, talk to your therapist about it. There are primarily two reasons for this. First, your sleep problems may be a symptom of a mental health issue that isn’t being adequately addressed. For example, most people think of sleeping too much as a symptom of depression, which it is, but insomnia or disturbed sleep are also extremely common, especially for men with depression.

Insomnia may also be a symptom of ADHD, anxiety disorders, or bipolar disorder. The bottom line is that it could be an important psychological symptom and co-occurring mental health issues must be addressed for your sobriety to last.The second reason to discuss sleep problems with your therapist is that there is a form of cognitive behavioral therapy, called CBT-I, specifically tailored to deal with sleep problems.

It includes some of the things mentioned here, such as sleeping on a regular schedule and practicing good sleep hygiene. Your therapist may also help you identify and challenge unhelpful beliefs about sleep. For example, when you can’t sleep, you may think something like, “Oh no, not this again, I’m going to be exhausted all day tomorrow,” and so on. A more helpful way to think is something like, “Hmm, can’t sleep.

That’s ok, I’ll just rest. I’ll probably fall asleep before I even realize.” In other words, many of the cognitive distortions that can disturb us during the day can also disturb us when we’re trying to sleep. Your therapist can help you sort these out.

Get on a Regular Sleep Schedule

As noted above, one of the most important things is to sleep on a regular schedule, even on the weekends. Sleep is a complicated process, involving changes in neurotransmitters, hormones, and body temperature. These are much more efficient when they happen on a regular schedule. This is why people who do shift work tend to have a lot more sleep problems.

Try to be in bed by a certain time no matter what. Block off plenty of time to sleep--most people need at least eight hours--and be sure to include a few extra minutes for the time it will take you to drift off and wake up. Then, get up at the same time every morning. It may also help to work with your body’s natural rhythms by waking up with the sun.

One study found that spending a weekend camping significantly improved participants’ circadian rhythms, helping them sleep and wake more easily. So, if you’re having trouble getting on a regular sleep schedule, a few days of camping might be just what you need, even if you only camp in the back yard.

Practice Good Sleep Hygiene

In addition to keeping a regular sleep schedule, practice good sleep hygiene. This starts during the day by not taking naps--at least for a while. At some point, you can take naps again, but not after 2 p.m. and not longer than 20 minutes. At night, have a bedtime routine to signal it’s almost time to sleep. Don’t use the bed for anything except sleep and sex. You want a strong association between getting into bed and falling asleep.

Don’t watch TV or look at your phone in bed. Try to keep your bedroom cool, between 68 and 70 degrees. Also, keep your room as dark and quiet as possible. If that’s an issue, get a sleep mask and ear plugs. Even if light and sounds don’t wake you up at night, they can still disturb the quality of your sleep.

Cut Down on Caffeine

For most people, moderate caffeine intake is not a problem and some studies suggest coffee and tea have some mild health benefits. However, it’s important to realize that caffeine has a half-life of between four and six hours.

That means if you have a cup of coffee at noon, about a quarter of that caffeine will still be in your system at bedtime. You may feel tired but still be unable to sleep or you may sleep but not as deeply. If you’ve been having trouble with insomnia, try cutting down on caffeine.

Exercise

Finally, try to get regular exercise during the day. Research shows that even moderate exercise, such as a 30-minute walk, can help you sleep better the very same night. We don’t quite know why this works but it’s likely that exercise reduces stress and anxiety, which helps you sleep better. Just don’t exercise too close to bedtime. Getting your heart rate up within two hours of bedtime can make it harder to fall asleep.Getting enough quality sleep is a crucial aspect of wellness.

Not only does it make you mentally sharper, improve your self-control, and reduce your risk of anxiety and depression, but it also improves your physical health, reducing your risk of obesity, diabetes, and cardiovascular disease. In short, it’s an important part of your recovery to get right.

At The Foundry, we recognize that wellness is a key component to sobriety and it is integrated into our programs at every level. To learn more about our treatment options, call us today at (844) 955-1066.

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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.

At the moment, Americans and people around the world are currently advised to stay home to help prevent the spread of Covid-19, or the coronavirus. While this is a sensible precaution to protect public health, it may seriously test many people’s mental health, especially anyone with a history of anxiety or depression. No one knows how long the quarantine might last but the current estimate is at least eight weeks. On top of that, people aren’t sure how this virus might affect their jobs or the economy overall.

Then, of course, there is the possibility that you or someone you care about might get sick. Compounding all this uncertainty, we are denied major sources of comfort such as spending time with family and friends, religious and spiritual gatherings, and 12-Step meetings. If the quarantine has got you on edge, here are some suggestions for managing your mental health.

Don’t Obsess Over the News

It’s tempting to spend your day refreshing Twitter or watching cable news, trying to keep up on new developments with the virus. That’s especially true since this is--we hope--a once-in-a-lifetime event. We want to know if we should be doing anything, if there have been new cases or cures, how many cases there are in our area, what the government is doing, and when this whole thing might be over.

However, obsessing over the news, now more than ever, is only going to make you feel worse. While a lot of the media coverage has been uncharacteristically measured, it can still give you the feeling that we’re all living in a disaster movie. Try to limit your news consumption to once a day. Check the CDC website for information and updates, and otherwise keep calm and carry on.

Stay In Touch With Your Therapist

If you’ve had issues with anxiety, depression, or substance use, you may have a regular therapist. You may or may not be able to keep your regular appointments, depending on where you live. Be sure to contact your therapist and make some kind of backup plan. A lot of therapists are now offering HIPAA-compliant video sessions, so that may be an option.

Other people have been doing phone sessions or Skype sessions. If you don’t have a regular therapist or if you can’t get in touch with your therapist and you or someone you care about is feeling overwhelmed, sad, depressed, anxious, or possibly a danger to yourself or others, call 911 or call SAMHSA’s Disaster Distress Helpline at 1-800-985-5990.

Eat Healthy

Since the quarantine feels like something between a sick day and a holiday, you might feel tempted to splurge on junk food. However, it’s important to keep two things in mind. First, this might go on for a while and you don’t want your cheat day eating to become a habit. Second, what you eat has a pretty direct effect on your mental health. This effect appears to be especially strong for depression.

Try to eat meals that are mainly composed of whole foods, especially fruits, vegetables, whole grains, nuts, beans, legumes, and lean meats, especially fish. As much as possible, avoid processed foods, especially processed meats, which are highly inflammatory, sugar, and fried food. If you’re recovering from addiction, it should go without saying that you should avoid alcohol as well.

Try to Get Some Exercise

Exercise is one of the best ways to boost your mood and lower stress. It releases mood-boosting endorphins and serotonin as well as BDNF, which grows neurons in the hippocampus, a part of the brain that helps consolidate memories. Exercise also increases blood flow to the brain, especially the prefrontal cortex, which is responsible for executive functions such as planning, emotional regulation, foresight, and self-control--all of which are great to have in a crisis.

At the moment, it’s still considered safe to walk, run, or bike outside, since the risk of transmission is low in outdoor environments. There are also plenty of workouts and yoga routines you can do in a small space at home. Check out YouTube for some options that appeal to you.

Reframe How You Think About the Quarantine

The funny thing about the quarantine is that up until a few weeks ago, there seemed to be no end of complaints about how Americans never properly socialize anymore. We all just stay home and play video games and watch Netflix.

When we do go out, we spend all our time looking at our phones. Now that we have to stay home, it seems like a huge burden. Instead of feeling constrained, choose to focus on all the stuff you can do at home. Catch up on reading, cleaning, TV shows, or other projects that you seem to always put off.

Stick to Your Regular Routine as Much as Possible

Part of the stress of being quarantined is that it feels like the whole world has suddenly changed. Change is always a bit stressful, especially changes you can’t control. Part of the solution in this case is to take control of the things you can control and stick to your normal routine as much as you can while still complying with public health recommendations.

Keep getting up at your regular time and taking a shower, even if you don’t have to be anywhere. Eat your regular meals, do the things you normally do, and go to bed at your regular time. If you are recovering from addiction or a mental health issue, there are probably things you normally do at home as part of your recovery plan and there’s no reason why you can’t keep up with those.

Stay in Communication With Friends and Family

We have more ways to communicate than any people in history. Don’t get so much into your reading or binge watching that you don’t keep in touch with friends and family.

Remember, We’re All in the Same Boat

If you’re sitting home alone during the quarantine, it’s easy to feel like you are alone in the world. However, there are millions, perhaps hundreds of millions who are having very similar experiences at the moment. So first, consider that whatever discomfort you’re feeling as a result of the quarantine is a small sacrifice that you’re making willingly to help protect the most vulnerable people in our society.

Second, consider the welfare of other people under quarantine. Approaching the situation with compassion helps you feel less alone and you may think of some small way to help your neighbors too.

You never know what kinds of challenges you may face when recovering from a mental health issue or a substance use disorder. While we typically prepare ourselves to cope with more mundane sorts of stress, the same principles basically apply for outlier events like a pandemic. At The Foundry, we know that recovery from addiction is really about giving you the skills to lead a happier, more fulfilling life. To learn more about our treatment programs, explore our website or call us today at (844) 955-1066.

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Flow can be a tricky state to conceptualize. For something that is different for everyone, it can be hard to say when someone has reached true “flow.” For the psychologist Mihály Csíkszentmihályi, he described flow as “being completely involved in an activity for its own sake. The ego falls away. Time flies. Every action, movement, and thought follows inevitably from the previous one, like playing jazz.

Your whole being is involved, and you’re using your skills to the utmost.” For some, flow can come during sports, for others, during a hobby. Whatever you love to do, you can try to channel flow through that activity. Flow can be described as when runners feel like they have a “high” while running. They don’t feel tired, and it’s almost like they’re floating. Csíkszentmihályi says that there are 10 components to flow:

1. Clear goals that, while challenging, are still attainable
2. Strong concentration and focused attention
3. The activity is intrinsically rewarding
4. Feelings of serenity; a loss of feelings of self-consciousness
5. Timelessness; a distorted sense of time; feeling so focused on the present that you lose track of time passing
6. Immediate feedback
7. Knowing that the task is doable; a balance between skill level and the challenge presented
8. Feelings of personal control over the situation and the outcome
9. Lack of awareness of physical needs
10. Complete focus on the activity itself

Not all of these components must be present to experience flow, but the more you have, the more likely flow will be. There are also some ways you can try to achieve a sense of flow. These are things that can help produce flow:

• Find a challenge

Pick something that you enjoy doing, but that is slightly difficult. If you’re a marathon runner, you won’t reach the flow state with a jog around the block. Make sure you love what you’re doing, but also make sure that you’re pushing yourself a little bit.

• Develop your skills that relate to the challenge

Because your challenge is challenging, you’re going to need to develop the skills necessary to complete the task. Don’t let yourself get bored or let your mind wander — this is toxic for flow. Don’t allow yourself to be overwhelmed either. That’s the opposite end of the spectrum.

• Set goals

Without goals, you won’t be achieving anything. You want to set clear, SMART goals. SMART goals are specific, measurable, attainable, relevant, and timely. If you want to reach the flow state while running, this might be your goal: run 3 miles every day for 3 weeks, then reassess where you’re at.

• Focus completely on what you’re doing

You can not expect yourself to reach the flow state if you are half paying attention to what you are doing. Don’t allow your mind to wander. Concentration is key for flow.

• Give yourself enough time

Flow takes time, too. Don’t get discouraged if it takes a while to get into the flow state. Once you are in the flow state, don’t rush it or wish it away. Make the most of it.

• Monitor your emotional state

If you’re struggling with getting into the flow state but you’ve done the above steps, monitor your emotional state. You might need to help calm yourself down if you’re too anxious or pick yourself up if you’re lacking energy.

From Csíkszentmihályi: “Flow also happens when a person’s skills are fully involved in overcoming a challenge that is just about manageable, so it acts as a magnet for learning new skills and increasing challenges. If challenges are too low, one gets back to flow by increasing them. If challenges are too great, one can return to the flow state by learning new skills.”

Flow is a process. It doesn’t just come to you when you least expect it. You have to practice your skills that will get you to that space of flow. You must push yourself to be the best version of yourself. Here are the states of flow:

• Struggle phase

During this phase, you must be willing to step out of your comfort zone. The struggle doesn’t really feel good, and most people are not willing to push themselves and struggle to reach flow.

• Release phase

After a struggle and once you have accepted it, the release phase comes. You become to do the activity without realizing that you are struggling anymore.

• Flow state

The flow state is what some people call being “in the zone.” This is where you are productive and do things with the flow.

• Brain rewiring and memory consolidation phase

After the activity has ended, you have a space to evaluate what just happened. This evaluation helps to further your future flow states.

Flow is like when a baseball player hits the fastball on the sweet spot of the bat. Some have said that they don’t even feel the ball hitting the bat on home runs. This is flow. Give yourself the time and space to experience flow for whatever activity you’re doing. Flow can be extremely beneficial for your recovery.

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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