Blog & Announcements

Therapy is an integral part of addiction treatment and most people will continue therapy, at least intermittently, throughout recovery. In an ideal situation, your therapist is your partner in mental health.

You work together to figure out what’s not working in your life and what to do about it. However, as with any relationship, your relationship with your therapist might not be very good or it may start out good and later fall apart. Here are some times you should consider finding a new therapist.

You’re Moving

Obviously, if you’re moving, you may have to find a new therapist. Consistency is important in therapy and if you have to drive an hour or more to appointments, it will probably wear you down eventually. However, geography is becoming less of a barrier to treatment these days.

Many therapists were already expanding to remote sessions and that number has probably increased dramatically, since, at the moment, we’re all under quarantine to slow the spread of the coronavirus. So if you like your therapist and you’re moving, see if remote therapy is an option. Otherwise, consider asking your therapist for a recommendation for someone who can see you remotely or who works in the area you’re moving to.

Unprofessional Conduct

Unprofessional conduct is definitely a sign you should consider switching therapists. It depends to some extent on how bad the conduct is. For example, breaching confidentiality or making sexual advances should make you dump your therapist right away. These behaviors are pretty rare, given that the vast majority of therapists genuinely want to help people and they depend greatly on their professional reputation.

Other forms of unprofessional conduct might include missing appointments, showing up late, or canceling appointments last minute. Sometimes these things are unavoidable, so it shouldn’t be considered unprofessional unless it becomes a pattern. Behaviors, like looking at their phone during your session, eating, or otherwise not paying attention, are also not encouraging. If you generally like your therapist but you’re bothered by these behaviors, it might be worth a discussion before moving on to someone else.

You Feel Like You’re Not Making Progress

You may get to the point in therapy where you feel like you’re not making any progress. Ideally, you will have set out some goals for therapy and some benchmarks so you can tell how you’re progressing, so it should be fairly obvious when you’re stuck. Another way you can tell you're stuck is if you feel like every session is the same.

You come in and complain about the same things for 50 minutes, then leave and nothing seems to change. Therapy can start to feel like a chore if you’re not getting anything out of it. If this happens, discuss it with your therapist. Perhaps you can change strategies or re-examine your goals.

Your Needs Change

Sometimes people find that they make a lot of progress in therapy at first and then somehow they get stuck. This is often because your needs change as you go. For example, maybe when you first started in therapy, your biggest challenge was coping with drug and alcohol cravings but as you got those under control, you found the biggest problem in your life was your relationships.

Yet your therapist keeps focusing on managing cravings and so you feel bored and stuck. Typically, your therapist will check in from time to time and make sure your needs are being met, but they are not mind readers. If your goals have shifted, you need to let them know. Usually, you will be able to refocus and work on your new priorities.

However, therapists, like everyone else, are better at some things than others. It’s possible your therapist was great at helping you deal with cravings but not so good at helping you improve your relationships. If that turns out to be the case, it may be time to look for a therapist whose strengths better match your needs.

You Feel Like You Can’t Speak Freely

If there’s one thing that’s essential in a therapist-client relationship, it’s that you should be able to speak freely. This is why confidentiality is so critical. You can’t be worried about whether your therapist is going to testify against you in court or blab all your secrets to their barber if you’re going to share what’s really bothering you.

However, confidentiality isn’t the whole issue. If you feel like your therapist is judgmental or critical, it can be just as hard to speak openly, as if doubting their discretion.One skill every therapist should have is non-judgmental listening. As a client, you should feel heard and validated.

That doesn’t mean your therapist has to approve of everything you say or do, just that you shouldn’t be made to feel like a bad person. However, we all have our prejudices and sore spots. It’s not always possible for your therapist to refrain from judgment. If you raise the issue and it doesn’t improve, it might indicate that your therapist isn’t the best person to help you with your particular issues.

Your Therapist Has Boundary Issues

Healthy boundaries means you protect what’s important to you and you respect what’s important to others. A good therapist might give you suggestions but they shouldn’t try to control you, tell you what to do, or otherwise violate your autonomy.

Nor should they be too familiar. While you should feel like you can be open with your therapist, your therapist is not your friend. If they share too much about their personal life or try to have a relationship outside of therapy, it signals a lack of boundaries and you may want to find someone else.

It’s important to keep in mind that it can take a little while for a therapeutic relationship to develop. It may take several months for you to feel comfortable opening up and it may take that long for your therapist to get a clear picture of your background and needs. For those reasons, it’s always better to talk it over first if you are not happy with the way therapy is going. It’s usually better to fix a problem if it can be fixed rather than start over with someone new. However, some problems just can’t be fixed, at which point, you should just move on. At The Foundry, we know that mental health is a key aspect of a strong recovery and we use evidence-based methods to treat substance use disorders and co-occurring mental health issues. To learn more, call us today at (844) 955-1066.

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Anxiety is a common problem for anyone struggling with or recovering from addiction. The National Epidemiological Survey on Alcohol and Related Conditions surveyed more than 43,000 people and found that among people who had experienced an anxiety disorder in the past year, about 15 percent had at least one substance use disorder--about twice the rate of addiction as in the general population. And that didn’t include post-traumatic stress disorder, or PTSD, which is an even greater risk factor for substance use than generalized anxiety disorder or social anxiety disorder.

At the moment, most of us in the US and elsewhere are under lockdown to help slow the spread of the coronavirus, or COVID-19. If you are already struggling with anxiety, this only adds to the challenge, compounding uncertainty with boredom and isolation. Unfortunately, our own thinking is typically the biggest source of anxiety. The following errors in thinking may be making you more anxious than you need to be.

Trying to Eliminate Anxiety

The first thing to realize is that anxiety is a normal and useful emotion. You can’t eliminate it entirely, nor would you want to. Anxiety alerts us to danger and spurs us to prepare for upcoming challenges. People who never felt anxious left the gene pool a long time ago, which is why everyone feels anxious occasionally and as many as 30 percent of American adults experience an anxiety disorder at some point in their lives.

Trying to eliminate or avoid anxiety, ironically, just ends up making you more anxious. What does make sense is to think about anxiety--and things that make you anxious--rationally. When you do feel anxious, recognize that it’s just the ancient parts of your brain trying to protect you. Accept your anxiety for what it is--a feeling, a sort of warning signal. Then, try to figure out if the thing you are anxious about is really a threat or if you’re making it worse with faulty thinking.

Jumping to Conclusions or Predicting the Future

Worrying about the future is always an issue for people with anxiety issues because the core thinking of anxiety is always something along the lines of “Something awful is going to happen and I won’t be able to do anything about it.” At the moment, that kind of worry is both more concrete and widespread than normal. Right now, a lot of people have the same few worries--will they be able to keep working?

How long can they go without income? How long will we be quarantined? Will I or someone I care about catch the virus? And so on. It’s likely that most of us will face a challenge on one or more of these fronts but attempting to predict the future only makes you worry unnecessarily. No one knows what’s going to happen but when you think about it, the same has been true every day of your life.

When you have trouble with anxiety, you tend to imagine the worst possible outcome and assume that it is inevitable. In reality, the future is fundamentally unpredictable. All we can do is make sensible preparations right now and trust that we will find ways to meet challenges in the future.

Should Thoughts

Should thoughts come from a belief that you, other people, or the world should be different somehow and that it’s awful that they aren’t. When you apply should thoughts to yourself, the result is often depression, whereas applying should thoughts to other people and the world tends to increase stress, anger, and anxiety.

So, at the moment, a lot of people are thinking this quarantine is unfair, that they should be able to go to work, go out with friends, play sports, and so on. However, should is just a wall for you to beat your head against. It would be lovely if the world and other people conformed to our wishes but most of the time they don’t. Insisting they should, in the face of overwhelming evidence to the contrary, only makes you more miserable.

Black-and-White Thinking

Black-and-white thinking, sometimes called all-or-nothing thinking, is the idea that if an outcome isn’t exactly what you want, you shouldn’t bother. This is also sometimes called letting the perfect be the enemy of the good.

There are many ways black-and-white thinking can lead to anxiety. In our current situation, if you’re trying to figure out how to cope with being under quarantine, you may not bother with measures that can make you feel better if they aren’t perfect solutions. For example, many people have started doing therapy sessions and 12-Step meetings over Zoom and other online platforms. These are clearly not as good as in-person meetings, but they are considerably better than nothing.

Mental Filtering

Mental filtering is the habit of only seeing the bad things that happen. It’s a special case of the larger phenomenon of confirmation bias, which is when you only look for evidence that supports your current beliefs. When you do mental filtering, you’re only seeing evidence that supports your belief that something bad is going to happen or is already happening.

In times of crisis, it’s far too easy to focus on the negative, especially now, since all we see on the news is the rising death toll and the shortage of medical supplies to treat new patients. However, if you look for them, there are positive things too. As Mr. Rogers said, look for the helpers.

In addition to medical workers and people supplying critical goods and services, there are a lot of communities coming together to help each other and find ways to adapt. If you’re stuck at home, it might be a great opportunity to read, make art, or learn new skills.

Emotional Reasoning

Emotional reasoning is the belief that something is true because it feels true. It’s easy to fall into this trap when thinking about the future because ultimately, we don’t have much evidence to rely on. The central belief of anxiety--“Something bad is going to happen and I can’t do anything about it”--relies entirely on emotional reasoning. In reality, no one knows what’s going to happen; everything is a guess.

However, you may be able to refute the second part to some extent. Most of us have survived trying experiences. One thing you can do is to look back on those times and think, “If I made it through that, I can make it through this other thing I’m worried about--if it even happens.”

Anxiety is a common challenge for people recovering from addiction and right now is an especially trying time. Anxiety is normal and healthy, but our thinking often makes anxiety far worse than it needs to be. Learning to identify and change this faulty thinking is one of the main priorities of cognitive behavioral therapy, or CBT, and dialectical behavioral therapy, or DBT. It can be very hard to recognize your distorted thinking on your own and a good therapist will speed up the process. At The Foundry, we use CBT, DBT, and several other evidence-based methods to help our clients recover from substance use and co-occurring mental health issues. To learn more, call us at (844) 955-1066.

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If you, or someone you care about, has finally realized drugs or alcohol have become a problem and it’s time to get help, congratulations, you’ve taken the first big step toward a better life. However, the next step--figuring out where to get help--can be incredibly challenging. According to the National Institute on Drug Abuse, there are more than 14,000 addiction treatment facilities in the US alone.

Some of them are excellent, many are mediocre, and a few are terrible. Treatment is a big commitment of time, money, and effort, so it pays to do your research before you commit. The following will at least help you narrow down the field of treatment options.

First, Assess Your Needs

Start by figuring out exactly what you need from treatment. It’s a good idea to start by talking to your doctor and therapist, if you have one. There are also independent consulting services that help people identify good treatment options. You may also ask for recommendations from your doctor, therapist, or people you know who have been through treatment. As noted above, be sure to research those recommendations thoroughly before committing.

Accreditation

One thing you definitely want to look for is accreditation. The two main accrediting agencies are The Joint Commission and The Commission on Accreditation of Rehabilitation Facilities. These are non-profit organizations that base accreditation on industry standards, client outcomes, and value. Typically, treatment centers will display these accreditations somewhere on their homepage.

Evidence-Based Methods

Evidence-based methods are the next big thing to look for. That means there is actually scientific evidence for the treatments provided. Just as you expect that any treatment administered by your doctor has been shown to be effective in clinical trials, you should expect that addiction treatment has some evidence supporting its effectiveness. Unfortunately, evidence-based practices are the exception rather than the rule among addiction treatment providers.

Some common evidence-based methods include cognitive behavioral therapy, or CBT, dialectical behavioral therapy, or DBT, family therapy, eye movement desensitization and reprocessing therapy, or EMDR, and motivational interviewing. There is also substantial evidence that wellness practices, such as a healthy diet and regular exercise significantly strengthen recovery.

Qualified Staff

The best available treatment methods don’t mean much unless there is a competent, experienced staff to administer them. Ideally, a program will have a doctor certified in addiction medicine as well as qualified nursing staff. There should be therapists with graduate degrees in psychology or social work, as well as qualified counselors. Common certifications for addiction counselors include LADC, LPC, CAC, and CCDP. There should also be experts in other areas, such as exercise and nutrition.

Works with Insurance

Most people entering addiction treatment will rely on insurance to help them pay for it. However, even if you’re paying out of pocket, you want to be sure that a facility works with insurers. Insurance companies want to know their money is well spent and typically don’t cover programs with poor outcomes. Good programs typically work with several different insurers.

Clean, Comfortable Facilities

Some programs try to sell you on their luxury facilities but that’s typically not what you want. It suggests that your money is going to amenities rather than treatment. Neither do you want facilities that are excessively spartan. That suggests low regard for clients and perhaps even cutting corners. You certainly don’t want facilities that are dirty or shabby. Look for the middle path--something clean and comfortable but not too fancy.

Individualized Treatment

Everyone has different needs in treatment and it’s crucial to find a program that tailors its treatment to the individual. There is no one-size-fits-all in addiction treatment. Patented methods and miracle cures rarely work. You want a program with flexibility, that can use a diversity of methods to meet your specific needs.

Equipped for Co-Occurring Disorders

Most people seeking help for addiction will have some kind of co-occurring disorder. At least half of people have a co-occurring mental health issue, such as depression, an anxiety disorder, ADHD, borderline personality disorder, and others that must be treated concurrently for recovery to last. Many people will also have medical issues, perhaps related to their substance use that will require special care. Be sure to ask in detail about a facility’s capacity to provide care for these issues.

Watch Out for Red Flags:

Lack of Rigor

As noted above, addiction treatment should be individualized. Even programs that provide individualized care know that not everyone is suited for their program. Quality treatment programs will want to be sure you or your loved one are a good candidate, that they can meet your needs and that you will do well in their specific environment.

Therefore, they should ask lots of questions about your addiction and medical history, ask to see your medical records and contact your therapist. Treatment centers are bound by the same privacy rules as hospitals, so don’t worry about sharing this information. However, if a program seems to take anyone who calls, it might be a sign that they don’t really care whether you are a good fit for their program.

Guarantees of Success

Addiction is a chronic condition and therefore inherently difficult to treat. According to the National Institute on Drug Abuse, between 40 and 60 percent of people relapse in the first year after treatment. Therefore, if a program guarantees a high success rate like 80 or 90 percent, you should probably be skeptical.

Some programs offer a guarantee in that you can return for free if you relapse after completing the program and that’s fine since they’re acknowledging the ongoing nature of addiction recovery. As with anything in life, beware of miracle cures.

Unsolicited Referrals

Finally, beware of generic addiction treatment services that don’t seem to have a physical location. These are often referral services who claim they will match you to an appropriate treatment provider but will really sell you to the highest bidder. You want to be doing your own research and making your own decisions as much as possible.

Choosing an addiction treatment program is one of the most important decisions you'll ever make. Treat it with the gravity it deserves. Don’t be afraid to ask questions. If you feel weird about a program or you feel like someone is being evasive, move on. There are plenty of fish in this particular sea and you should feel good about your final decision. At The Foundry, we know what a big decision this is and we want to help you make a good one. Call us today at (844) 955-1066 to ask us anything you want to know.

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If you have a loved one struggling with a substance use disorder, you may feel incredibly frustrated that they won’t get help. Can they not see what drugs and alcohol are doing to them? Don’t they want to be happy? What’s important to understand is that your loved one may be miserable but they’re also afraid.

That may not be obvious since many people cope with their fear by becoming aggressive or disengaged but the fear is there. If you understand their fear, it can help you be more patient and supportive and you may ultimately have more success getting them into treatment. Here are some of the reasons people are afraid to enter addiction treatment.

They’re Afraid to Admit Having a Problem

It may be obvious to you and everyone else that your loved one has a problem with drugs and alcohol and you may believe it’s obvious to them, but denial can be powerful. Keep in mind that there’s no clear line when addiction begins. It’s a gradual process with a lot of gray area. That is to say, it looks very different from their perspective.

There is still a lot of stigma attached to addiction and when you admit to having a problem, you feel like you’re accepting membership in a rather dubious club. When you admit to having a problem, you also have to confront the possibility that you might need help, which leads to a bunch of new anxieties.

They’re Afraid to Give Up Control

One of those anxieties is giving up control. Often, people with substance use issues will accept that they have a problem but then insist on dealing with it on their own. They insist they are still in control, even though the most common symptoms of addiction include trying to quit but being unable to and not being able to drink or use drugs in moderation.

When you insist on doing it your own way, that’s usually an attempt to avoid the hard but inevitable aspects of recovery. They want things to change but they don’t want to be uncomfortable, which is really true of everyone. And in addiction recovery, there are plenty of opportunities to be uncomfortable.

They’re Afraid to Be Alone

When people imagine entering an addiction treatment program, they often picture some remote facility, not unlike a prison, where they’ll have to spend 30 to 90 days among strangers. In other words, they feel like they’re going to have to endure this ordeal alone.

While it’s typically true that people entering treatment don’t know anyone there, the loneliness will only last a few days at the most. The staff wants you to feel welcome and you may have a roommate.

Most importantly, good treatment programs know how important it is for clients to feel connected and supported and they facilitate that connection through group activities and group therapy. People often say they met their best friends in addiction treatment because it is a place where most of the people have experienced similar struggles.

They’re Afraid to Open up

Most people know that if they enter addiction treatment, they’ll have to talk to a therapist and participate in group therapy. This can be a frightening prospect. Men appear to be especially reluctant to seek help for mental health issues and talk about their feelings, but it can be hard for anyone.

Not only does it entail revisiting painful memories and emotions, but many of these experiences have been buried deep down for years or decades. Feelings of shame or a general reluctance to open up and be vulnerable can make someone want to avoid therapy entirely.

However, a good therapist won’t push a client to talk about anything before they’re ready. That often ends up being counterproductive. Eventually, most people discover that keeping things bottled up is more trouble than it’s worth. It’s often a tremendous relief for people to discover that their deepest, darkest secrets are not that uncommon and they no longer have to feel ashamed.

They’re Afraid of Living Without a Coping Mechanism

One of the most important things to understand about substance use disorders is that people typically start using drugs and alcohol for a reason and they continue to use them because they get something out of it. For example, at least half of people with substance use disorders have a co-occurring mental health issue, although they may not know it. Childhood trauma, abuse, and neglect are very common among people with substance use issues.

Although drugs and alcohol are a bad way to cope with emotional pain, they are the only coping mechanism many people have. When you say to someone, “You need to get sober,” they may be hearing you say that you want to deprive them of the one thing that makes life tolerable, even if it does cause other problems.

to replace unhealthy coping mechanisms with healthy--and more effective--ones. One reason therapy is such a central component of treatment is that it helps resolve many of the issues that drive substance use and teaches clients skills to cope with challenging emotions.

They’re Afraid to Disappoint You

Finally, many people resist entering treatment for addiction because they’re afraid of failure. Recovery can seem like an overwhelming challenge. They may have failed at it before, perhaps even several times. Failure is bad enough in itself but it’s even worse when other people are depending on us. What’s more, a lot of time, money, and effort goes into quality addiction treatment.

That adds up to a lot of pressure to succeed at a time when most people don’t feel equal to even the most mundane challenges. It’s important for them to know that sobriety is worth the risk of failure--even repeated failure, if necessary. Recovery never goes perfectly for anyone. There are always challenges and setbacks but you don’t fail until you quit trying.

There is plenty to fear when embarking on addiction recovery, but there’s even more to fear from not trying at all. People lose their money, their jobs, their families, and their lives to addiction, but they don’t have to. Some fears--such as the fear of being uncomfortable--are valid, but also an inevitable part of the process. The key to overcoming those is to realize the payoff is worth the price. Other fears, like being alone or having to live without a reliable coping mechanism are largely illusory. At The Foundry, we understand that getting help for addiction is a hard decision but we also know that quality addiction treatment changes lives. To learn more about our programs, call us at (844) 955-1066.

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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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