This article includes the topic of suicide. If you or someone you know is in crisis, please call, text, or chat with the Suicide and Crisis Lifeline at 988, or contact the Crisis Text Line by texting TALK to 741741.

Suicides in the US reached an all-time high in 2022, according to new data provided by the Centers for Disease Control and Prevention (CDC). According to provisional findings from death certificates, about 49,449 people took their own lives last year, an estimated 3 percent increase compared to 2021.

KFF, an independent source for health policy research, notes that “Increases in the number of suicide deaths follow high levels of mental health symptoms during COVID, rising financial stressors, and longstanding difficulty accessing needed mental health care—particularly for some populations. Total suicide numbers may be undercounted, as some research suggests that suicides may be misclassified as drug overdose deaths since it can be difficult to determine whether drug overdoses are intentional.”

“The largest increases were seen in older adults,” reported NBC. Deaths rose nearly seven percent in people ages 45 to 64 and more than eight percent in people 65 and older. White men, in particular, have very high rates, the CDC reported. The suicide rate among males in 2021 was approximately four times higher than the rate among females. Males make up about half of the US population but nearly 80 percent of suicides.

As we reported on this blog, men are also much more prone to drug overdose deaths than women, and the fatalities are not always accidental. Another important factor is the wide availability of firearms. According to an analysis by the Johns Hopkins Bloomberg School of Public Health, “Gun suicides continued to reach all-time highs, increasing 1.6 percent from a previous record in 2021; 26,993 people died by gun suicide in 2022.”

“While the increase in gun homicides has gained public awareness, less attention has been paid to the growing epidemic of gun suicides—which historically make up the majority of gun deaths. The gun suicide rate has steadily increased, nearly uninterrupted, since 2006. In 2021 it reached the highest level since the CDC began recording such data in 1968; and this past year, in 2022, it surpassed that record,” the JHU researchers wrote.

The current epidemic of suicides by white, middle-aged men is correlated with an epidemic of loneliness. Approximately one in five American men say they do not have a close friend, according to the Survey Center on American Life's May 2021 American Perspectives Survey. “Only 30 percent of men reported having a private conversation with a close friend when they divulged personal emotions in the past week,” wrote psychiatry professor Charles Hebert in Newsweek in 2022.

Earlier this year, US Surgeon General Vivek Murthy issued an advisory on the “healing effects of social connection,” in which he warned that “about one-in-two adults in America reported experiencing loneliness” in recent years. “Loneliness is far more than just a bad feeling—it harms both individual and societal health,” Dr. Murthy wrote. “It is associated with a greater risk of cardiovascular disease, dementia, stroke, depression, anxiety, and premature death. The mortality impact of being socially disconnected is similar to that caused by smoking up to 15 cigarettes a day and even greater than that associated with obesity and physical inactivity.”

Loneliness, social disconnection, anxiety, depression, and other stressors can lead to substance misuse and, ultimately, suicide. “There is considerable evidence from population-based and clinical studies supporting a positive association between psychosocial adversity, negative affect, and chronic distress, and addiction vulnerability,” stated Rajita Sinha in a 2009 study entitled “Chronic Stress, Drug Use, and Vulnerability to Addiction.”

Addressing social isolation and chronic distress usually requires people to seek help — an act that some men see as a weakness. “Men are socialized to not ask for help or be vulnerable—and they can be penalized when they challenge this notion,” wrote David Mayer in Harvard Business Review in 2018. “An informative set of studies from 2015 finds that when male (but not female) leaders ask for help, they are viewed as less competent, capable, and confident. And when men make themselves vulnerable by disclosing a weakness at work, they are perceived to have lower status. This is problematic, as not seeking help when you need it or admitting areas for improvement inevitably leads to mistakes and less development.”

The combination of social disconnection, anxiety, depression, and substance misuse can expose individuals identifying as male to serious physical and mental health risks. Men with substance use disorder need comprehensive treatment to address all relevant concerns.

Foundry Treatment Center Steamboat operates a specialized men’s treatment program for adult males experiencing substance use and co-occurring mental health disorders. The program regularly treats men struggling with feelings of isolation, loss, trauma, and hopelessness. As previously reported by Foundry Steamboat, many of the men the program serves perceive a lack of purpose and meaning, which can contribute to relationship problems and depression.

“Living with active substance use disorder — even before someone knows that they have a problem — can cause extreme isolation and loneliness. Addiction destroys relationships and separates people from the very people best positioned to help them. Men with addiction are at especially high risk of suicidal ideation and suicide attempts for numerous reasons. We regularly use symptom rating scales to assess client depression and suicidality to ensure that they are getting the clinical and psychiatric help they need to feel better while they pursue recovery. We also build strong therapeutic relationships with clients and get to know them and their situations,” says Foundry Steamboat Chief Clinical Officer Michael Barnes, Ph.D.

“The need to assure that men feel a sense of belonging and know that they have peers with whom they can have a conversation about how they are feeling is a central reason for our alumni program and why we encourage clients to find a community-based support group that suits them. Suicide is very often preventable if people feel authentically connected and are able to self-regulate their emotions, and it is a problem directly related to addiction that requires vigilance and study.”

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Unions and the leadership responsible for protecting the health and wellness of their members can play essential roles in addressing America’s addiction epidemic and changing public perception about the disease. Since its inception, organized labor has empowered workers to negotiate better wages, insurance benefits, paid leave, and safety standards. In recent years, unions have also begun to tackle one of America’s most formidable health problems — addiction.

The National Labor Relations Act of 1935 legalized unions in the United States. Union density, the percentage of union employees, peaked at 35 percent in 1954, and more than 20 million Americans belonged to a union in 1979. Today, union workers account for just 10.1 percent of workers, representing roughly a twenty percent decline since the early 1980s.

While total union membership has waned, more people are joining, and the desire to unionize is significantly growing. According to the Economic Policy Institute, union petitions increased by 53 percent between 2021 and 2022, and more than 60 million people wanted to join unions but could not do so. It is no secret that some of America’s largest private employers oppose unionization. A May New York Times article detailed efforts by Apple, Trader Joe’s, Starbucks, and REI to stop unionization and their potential use of retaliatory practices and firings to suppress unionization support.

The Writers Guild of America strike (in its third month at the time of this writing) is using its member’s notoriety to draw attention to the stark pay inequity between the front-line workers who produce entertainment and the corporations who reap the lion’s share of the profits. What seems clear is that more people see the benefits of union membership to offset growing income inequality, slow wage growth, reduced paid leave, more costly or limited health benefits, and other workplace challenges.

Organized labor represents more than collective bargaining power. Unions offer a form of community, identity, and safety net. At a time when mental health disorders, substance use disorders, and deaths of despair are at record levels, belonging to an organization that provides a degree of fellowship, protection, and resources may seem more meaningful than ever.

Chris Carlough, a national labor leader, educator, and mental health advocate, comes from a long line of union members. To Carlough, the appeal of unions is fundamentally unchanged — greater negotiating power leads to better contracts, better wages, and a more level playing field. What is new, however, is the ability of unions to make a vital resource available to millions of Americans in need — mental and behavioral healthcare.

“Growing up, I remember my grandfather telling us, ‘Never trust a man who doesn’t drink,’ and that was a message that stuck with me during my formative years,” says Carlough. “The idea that using alcohol or other substances to cope with physical or psychological pain is deeply ingrained in some workplace cultures.” Carlough points to high rates of substance use disorder among some industries with high union representation. The Substance Abuse and Mental Health Administration reports that 17.5 percent of miners and 16.5 percent of construction workers have heavy alcohol consumption or alcohol use disorder. “There is a culture of acceptance, and it is a means of coping with the physical pain that comes with the job and emotional pain that comes from childhood or other trauma picked up along the way. These are careers in which injury is fairly common. Someone may fall from a ladder, for example, and the unspoken response from co-workers is ‘this is a no-pain zone’ or ‘rub some dirt on it’ and get back to work,” says Carlough. “This is exactly the kind of thinking and behavior that leads to substance abuse. People have been injured but feel like they would be considered weak if they saw a doctor. So, they drink, misuse prescription medicines, or take illicit drugs to cope with the pain. But they have not treated with the underlying injury, and the pain persists, and so does the substance use.”

Injury is one of many factors that can lead to substance use and mental health disorders. Many workers are exposed to various stressors, including job insecurity, fear of being replaced by technology or automation, the need to be retrained for new jobs, an inability to save adequately for retirement or to fund daily life and childcare, and more. People are even reporting more anxiety about existential issues like climate change and societal ones like political unrest. Many factors are converging to exacerbate stress and anxiety, leading more people to seek relief through substances or unhealthy behaviors.

Today, Carlough and his colleagues are working to change how union members think about mental health and substance use disorders and improve access to high-quality care. Carlough is the coordinator of the SMOHIT SMART MAP program, a mental health awareness, and peer-led action program that highlights the issues associated with all mental health issues with a particular focus on substance use disorder and suicide prevention and trains union members to help fellow members and their families in need to access those resources. Carlough travels the country, providing education and training and spending time with union leaders and members to dispel old thinking, reduce stigma, and normalize treatment. Another focus is overcoming some remnants of toxic masculinity that can still be found throughout the workforce, which can make it harder for people to admit that they are struggling and seek help. “It helps when I tell people, ‘Me too,’ as in I have struggled with mental health issues, and I share some of that vulnerability relating to my own alcoholism and addiction and how I got the help I needed, so maybe they can too.”

The SMART MAP Peer training takes trusted, respected, and empathetic union workers, from apprentices to long-standing journey-level tradespeople who want to help and enlist them into this service. “Your union brother and sister can make the difference. Part of what we do is train our members to simply ask people how they’re doing and not take someone’s first answer at face value. We want them to dig a little deeper to elicit an authentic response. If someone can feel safe and comfortable telling you that they are feeling down, are in pain, or are having other problems, that is the first step toward getting them help — help that might save their lives and the lives of their family members. We also work to ensure that everyone from peer support to company owners and union representatives are aware of all available resources and how to access them to get people into treatment. Not only can this help people feel that reaching out for help is normal, but that they are supported compassionately throughout the entire process.”

Carlough also connects unions with high-quality treatment providers and employee assistance programs (EAPs) to ensure union members receive the quality and range of services needed. “Not all treatment providers are the same, and people may need access to multiple levels and types of care. Unions control significant health plan funding, and this can be used to create beneficial relationships with the best medical providers. We want to ensure that when members feel comfortable getting help, they get the excellent, evidence-based treatment from experienced caregivers all workers deserve. We need effective treatment that addresses root causes and helps people access the continuum of services and resources they need to get the mental healthcare they need or to enter and stay in recovery.”

When Carlough wanted to increase education efforts for union members, he tapped long-time friend and Foundry Steamboat CEO Ben Cort. Cort and Carlough have collaborated to develop education and find appropriate treatment partnerships for organized labor unions nationwide. Now, Cort is interested in ensuring that Foundry Steamboat’s trauma-integrated care is available to union members who could benefit from it. “Unions are a vital part of this country’s labor force and are lifelines for millions of American families. Union members, including first responders, are at risk for witnessing or experiencing physical and psychological trauma and need appropriate treatment to be easily accessible. I want to ensure that in addition to educating unions about how to connect members to excellent treatment resources, we are doing all we can to make our unique trauma-integrated care model available and accessible to as many union members as possible.”

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Denver Mayor Mike Johnston declared a homelessness state of emergency on July 18 — his first act as the city’s new mayor. According to the U.S. Department of Housing and Urban Development, Denver ranks tenth in the nation for homelessness and third for sheltered homelessness — rates higher than Las Vegas and almost as high as San Francisco. This week, the Denver city council voted to extend the state of emergency to August 21 in light of new data indicating higher rates of homelessness than previously known. As of this writing, an estimated 9,065 people are homeless or sheltered homeless in the Denver metro area. “The homeless population has grown 31% over the year before. The number of those experiencing homelessness for the first time rose by 51%. The greatest percentage increases were among families, increasing 64%,” according to CBS News.

Homelessness and behavioral health disorders are strongly related. Addictive disorders and mental health conditions can lead people to become homeless or housing insecure, and these conditions can be the result of becoming homeless. However, evidence suggests that social determinants of health, including housing affordability and employment status, are the primary drivers of homelessness. This week's Dow Jones MarketWatch report indicates that rising rents are the leading causes of homelessness nationwide. The article cites Steve Berg, chief policy adviser at the National Alliance to End Homelessness, who says the "number of people who lose their housing and become homeless is [going] up faster than the number of people who are homeless and move back into housing." Berg goes on to say, “rent is the No. 1 issue…for 75 years, the long-term trend has been that the cost of modest rental housing has been going up faster than modest income."

The U.S. Department of Health and Human Services identifies “five domains” of social determinants of health, including economic stability, education access and quality, healthcare access and quality, neighborhood and built environment, and social and community context. Deficits in any of these domains can mean significant adverse life events for entire family systems, including medical problems, limited opportunities and upward mobility, mental and behavioral health disorders, housing insecurity, homelessness, trauma, suicidality, and more. As has been widely reported, social determinants of health, especially those linked to purposeful employment and a sense of community belonging, maybe a significant driver of the epidemic rates of suicidal ideation and deaths by affecting the nation in recent years — so-called “deaths of despair.”

As behavioral healthcare providers, we often treat clients who experience housing insecurity and homelessness, and subsequent trauma. Many experienced mental health professionals and policymakers know that traumatization resulting from financial setbacks and insecure housing can make drastically reduce the odds of rebounding.

Foundry Chief Clinical Officer Michael Barnes, Ph.D., suggests that mental health conditions and trauma can be precursors and results of homelessness, and acknowledging the role of trauma is vital to helping homeless individuals and families become safely rehoused. “As a medical community and public, we are just beginning to fully understand the profound role trauma plays in a multitude of health problems. People can become traumatized far more readily than we realize, our culture perpetuates and normalizes countless traumatic stimuli, and there is a general lack of treatment resources up to the task of treating traumatized people. When it comes to the issue of homelessness, we must understand that becoming homeless immediately reprioritizes our hierarchy of human needs and changes our patterns of behaviors and beliefs at a deep subconscious level. Homelessness is absolutely traumatizing, and trauma must be addressed, processed, and resolved before people are once again able to respond normally and restore emotional well-being.”

“Homelessness and addiction are inextricably linked. Regardless of the root cause of becoming homeless, there is almost always a mental health or substance use component involved. People who are otherwise healthy are less likely to become homeless because they oftentimes have the agency and cogency to seek available resources, though this is not always the case, and not enough resources are available. For many people, unfortunately, the experience of becoming homeless is a sea change so devastating that they feel the need to use substances to self-treat the symptoms of severe anxiety and depression. Many homeless people also use stimulants to stay awake for very long periods for fear of being victimized while asleep,” says Barnes.

Dr. Barnes believes that addressing the homelessness problem in Denver and elsewhere will benefit from trauma-oriented approaches. “We still do not have enough truly trauma-informed treatment providers for the housed patients seeking mental and behavioral healthcare. My hope is that policymakers anticipate the need for trauma-informed approaches to helping homeless people because without adequately treating their underlying trauma, other interventions are less likely to succeed, and they are more likely to end up back on the streets.”

Foundry Steamboat and other high-quality providers are beginning to assess client recovery capital to evaluate their prospects of successfully maintaining recovery and developing recovery-supportive lifestyles. The program instituted the Recovery Capital Index measure in 2022, which measures individualized social determinants of health and other extra-therapeutic factors to indicate advantages or potential areas that need to be addressed using available resources.

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While the rates of deaths and devastation wrought by ongoing addiction and mental health crises are unprecedented, these problems have always been with us.

Despite estimated one-trillion-dollar productivity losses from depression and anxiety and $215 billion productivity losses from addiction annually, treatment resources are vastly outweighed by the need. A major problem is too few people are becoming behavioral health professionals. According to the Commonwealth Fund, “In 2021, fewer than half of people with a mental illness were able to access timely care; those with substance use disorders were even less likely.” Workforce shortages are cited as the primary cause of treatment inaccessibility. The Association of American Medical Colleges reported in 2022 that the country will soon”...be short between 14,280 and 31,109 psychiatrists, psychologists, social workers, and others…”

Behavioral healthcare careers can be very challenging. Frontline workers, like psychologists, psychotherapists, and psychiatrists, experience high rates of burnout. In 2022, 46 percent of psychologists felt unable to meet the demand for care, and 45 percent felt burned out, according to the American Psychological Association. Compassion fatigue, heavy administrative paperwork requirements, compliance-related issues, insurance claim management, and even hard-to-use electronic health record systems make a tough job even harder. Almost 60 percent of therapists stay in the same job for less than two years.

High-quality treatment provider organizations, and even smaller private practices, recognize the need to support clinicians and other team members to create workplaces and teams that reduce fatigue and increase longevity. Treatment providers committed to maintaining long-term employees and building expertise are committed to developing healthy and supportive cultures and fostering safety, openness, and personal wellness. Treatment organizations also do well to remember that many healthcare workers feel a calling to this work that helps them endure its inherent challenges. Designing practices and procedures that honor and protect this sense of calling can reduce stress and create client-centered environments in which practitioners feel supported and able to do high-quality work.

Direct caregivers are one behavioral healthcare role among many. Many treatment provider organizations, but especially those operating extended care residential and intensive outpatient levels of care, require numerous positions, including managers and directors, case managers, compliance and insurance utilization specialists, outreach and admissions professionals, wellness experts, nutritionists and chefs, recovery coaches and recovery peer support specialists, and more. Every member of these teams is vital to supporting the program’s treatment mission and creating a therapeutically-centered environment conducive to client success and clinical excellence.

Foundry Treatment Center Steamboat is led by experienced professionals who have gained experience at some of the nation’s leading behavioral healthcare institutions. When acquiring the program and planning its expansion, this team knew that creating a clinically-focused and supportive environment was crucial to clinician longevity and client outcomes.

“The trauma-integrated care model developed by Dr. Barnes requires an operation completed organized around the goals of reducing retraumatization and supporting perceived safety. We must put this theory into practice for clinicians as well as clients. To be effective at treatment, we also must treat one another well,” says Chief Operating Officer Tom Walker.

“We offer very competitive pay and benefits, pay for continuing education and personal development, provide ample vacation and paid leave time, offer free access to wellness services, and generally create an open environment where our team members feel open about sharing and feeling supported,” says Human Resource Manager Amanda Lacey.

Other Foundry Steamboat team members recognize the benefits of working with colleagues who support their aspirations. Outreach & Special Projects Manager Amber King felt supported to spearhead a novel initiative rooted in a personal passion. “When Amanda and I proposed organizing treatment providers in rural communities, the team was immediately receptive and supportive. Our personal passions drive this project to bring resources to communities like the ones we grew up in, and that lack adequate care. Not many employers would be so open to allocating the time and resources, and fewer would realize that supporting this project is actually supporting and rewarding us by doing something we love.”

Access to leading experts and training is another advantage of working at Foundry Steamboat and other high-caliber providers. Foundry Steamboat provides internship opportunities for rising healthcare professionals. It is a place where leading thinkers and practitioners with decades of experience share their insights and help others learn and grow.

Behavioral healthcare is a demanding job but a deeply helpful profession. Some of the most rewarding aspects of this work are seeing individual lives saved and families salvaged, clients celebrating recovery anniversaries, and the future prospects of generations changed.

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Men were significantly more vulnerable than women to overdose deaths involving opioid and stimulant drugs in 2020–2021, according to a new study analyzing data from across the United States.

The study, published in Neuropsychopharmacology, found that men had a two to three times greater rate of overdose mortality from opioids (like fentanyl and heroin) and psychostimulants (like methamphetamine and cocaine). The study was led by researchers from the Icahn School of Medicine at Mount Sinai in New York City and the National Institute on Drug Abuse (NIDA).

While we know that men use drugs at higher rates than women, the researchers found that this alone could not explain the gap in overdose deaths, noting that biological, behavioral, and social factors likely combined to increase the mortality risk for men. From 2020 to 2021, men had a rate of overdose mortality from opioids and psychostimulants that was two to three times greater than the overdose mortality rate for women, according to a recent study.

“Though men and women are being exposed to the modern, fentanyl-contaminated drug supply, something is leading men to die at significantly higher rates,” NIDA Director Nora Volkow, MD, said in a news release. “It may be that men use drugs more frequently or in greater doses, which could increase their risk of death, or there may be protective factors among women that reduce their risk of death compared to men. Understanding the biological, behavioral, and social factors that impact drug use and our bodies’ responses is critical to develop tailored tools to protect people from fatal overdose and other harms of drug use.”  

After controlling for sex-specific rates of drug misuse, researchers found that overdose death rates by sex for the following drugs were:

Synthetic opioids, such as fentanyl: 29.0 deaths per 100,000 people for men, 11.1 for women;

Heroin: 5.5 deaths per 100,000 people for men, 2.0 for women;

Psychostimulants, such as methamphetamine: 13.0 deaths per 100,000 people for men, 5.6 for women; and

Cocaine: 10.6 deaths per 100,000 people for men, 4.2 for women.

Higher overdose death rates for men were consistent across states, even when accounting for other demographic factors. The difference in overdose mortality between men and women was significantly more significant than in reported drug misuse between men and women. For example, men had a 2.8 greater rate of cocaine overdose mortality than women while having just a 1.9 greater rate of cocaine misuse.

“These data emphasize the importance of looking at the differences between men and women in a multi-layered way,” Eduardo R. Butelman, Ph.D., assistant professor of psychiatry at the Icahn School of Medicine at Mount Sinai and a lead author on the study, said in a news release. “Moving forward, it will be important for researchers to continue to investigate how biology, social factors, and behaviors intersect with sex and gender factors, and how all of these can impact addictive drug misuse and overdose deaths.”

The authors hypothesize that it is a combination of biological factors (e.g., men may have a greater vulnerability to the toxicity of drugs than women), behavioral factors (e.g., men may use these drugs in a riskier way than women), as well as other social- and gender-related factors.

The Loneliness Crisis

One possible factor is the lack of mitigating social connections. A 2019 study found that “females find same-sex social interactions to be more rewarding than males, and females are more sensitive to the rewarding actions of oxytocin than males.” As we reported on this blog, approximately one in five American men say they do not have a close friend. “Only 30 percent of men reported having a private conversation with a close friend when they divulged personal emotions in the past week,” wrote psychiatry professor Charles Hebert in a 2022 Newsweek article.

This comes at a cost. “Loneliness increases the risk of mental illness among men,” warned Hebert. “Persistent loneliness independently predicts risk of Alzheimer's disease. Additionally, psychiatric illnesses such as major depressive disorder often go unrecognized in men due to reluctance to discuss one's symptoms.”

Persistent social isolation, depression, anxiety, and trauma are major drivers of substance misuse and addiction. “Addiction is an illness of escape. Its goal is to obliterate, medicate, or ignore reality. It is an alternative to letting oneself feel hurt, betrayal, worry, and—most painful of all—loneliness,” Patrick Carnes wrote in Facing the Shadow. “Escaping reality for even the briefest time brings some relief. When escaping becomes habitual, we have a mental illness known as addiction.”

In a famous 2016 TED Talk, Johann Hari provocatively stated that the opposite of addiction is not sobriety but human connection. Surgeon General Vivek Murthy warned in May that “widespread loneliness in the US poses health risks as deadly as smoking up to 15 cigarettes daily. About half of US adults say they’ve experienced loneliness, Dr. Murthy said in an 81-page report.

Foundry Treatment Center Steamboat operates a specialized men’s treatment program for adult males experiencing substance use and co-occurring mental health disorders. This report resonates with Clinical Compliance Director Jasmine Aranda, LPC, LAC, LAT, TTS, ADS. Aranda, who has years f experience focusing on male clients and the issues they relate that have led to the development of dual-diagnosis conditions, sees evidence that loneliness and purposelessness may play fundamental roles in this crisis.

“Cultural and socioeconomic shifts affecting all people started well before the pandemic, but the pandemic seems to have worsened and accelerated the effects of these issues. We regularly hear clients who feel financially insecure, uncertain how long they can remain gainfully employed or hold on to housing. They fear mostly for the future of loved ones. Many men we treat feel less cohesion with family, friends, and neighbors. It can be very difficult for people, especially those in rural parts of the country, to make a living as they used to or to carry on family-owned businesses. Women, men, and adolescents are affected mentally, emotionally, and physically by these problems,” says Aranda.

“Among our male residential clients, who tend to have families and careers, today’s culture is challenging their long-standing narratives. Societal sentiment and economic realities are making it harder for men to be sole breadwinners and fulfill the role of protector. Purposelessness is a major problem for many men. Fathers can feel like they don’t understand how to navigate a rapidly changing world and lack the knowledge or skills to help their children navigate it. They may feel displaced and devalued because of increased economic disparity and the inability to earn a living that affords them a good quality of life despite working hard. Even the values of ruggedness or toughness and stoicism that were prized by previous generations are seemingly being questioned as our society becomes more open to discussing hardship and mental health disorders — which is a very good thing.”

Aranda suggests that increased rates of death by overdose correlate to increased rates of despair and perceived uncertainty.

“This program focuses heavily on the resolution of trauma and the ability of people to naturally self-regulate their autonomic nervous response to stress. Many of our clients live with a constant, debilitating rate of anxiety, hypervigilance, and panic that may, in part, be the response to increased uncertainty. We can help men by making it safe and comfortable for them to seek help, increasing awareness about the rise in uncertainty and anxiety, and helping them connect and feel valued. Doing these things could go a long way in reducing the perceived severity of the issues that drive them to misuse substances to feel normal or relieved.”

Pharmaceutical innovations continue improving the quality and longevity of life, even when beneficial side effects of these medicines are discovered unexpectedly. Numerous medications created to treat specific illnesses have found new applications because they were found to be effective at addressing completely different problems. One example is Prazosin, a medication originally developed to treat hypertension. After its FDA approval for use in 1988, the drug was found to reduce nightmares associated with Post-Traumatic Stress Disorder (PTSD), and is now sometimes prescribed for this purpose.

Ozempic (semaglutide) a diabetes drug introduced in 2017, was later FDA-approved to help people with diabetes and obesity lose weight. Recent reporting suggests that the drug could help people lose more than the desire to overeat. It may also reduce people’s desire to overuse substances, making it a promising target for treating addiction.

Semaglutide is a GLP-1 receptor agonist, mimicking the action of the human incretin glucagon-like peptide-1 (GLP-1), thereby increasing insulin secretion and blood sugar disposal and improving glycemic control. Side effects include nausea, vomiting, diarrhea, abdominal pain, and constipation.

As semaglutide increased in popularity (as a weight-loss medication), patients have been sharing interesting effects beyond appetite suppression. “They have reported losing interest in a range of addictive and compulsive behaviors: drinking, smoking, shopping, biting nails, picking at skin,” wrote Sarah Zhang in The Atlantic. “Not everyone on the drug experiences these positive effects, to be clear, but enough that addiction researchers are paying attention.”

Some physicians report that the effect of reduced alcohol use is the most common thing they hear from people taking Ozempic or similar drugs. Lorenzo Leggio has been studying the phenomenon at the National Institutes of Health. His team recently published a study indicating that semaglutide can reduce alcohol drinking in rodents (this effect has not yet been studied in humans).

“GLP-1 analogs like semaglutide may influence interest in psychoactive substances such as alcohol because they have an effect not just in the gut but in the brain, Leggio told CNN. “We believe that at least one of the mechanisms of how these drugs reduce alcohol drinking is by reducing the rewarding effects of alcohol, such as those related to a neurotransmitter in our brain, which is dopamine” he said. “So these medications are likely to make alcohol less rewarding.”

Asim Shah, a professor in the Menninger Department of Psychiatry and Behavioral Sciences at Baylor University, heard similar things from people he treats. “Patients do say that they feel a benefit on their addiction, whether it’s alcohol or smoking or anything like that. People are even saying they’ve decreased their gambling,” Shah told the Houston Chronicle. “Is it true or not? We don’t have proof.”

Should that proof emerge in future research, it would yield further support for the disease model of addiction. “Discovering how the new weight loss medications alter appetite and the compulsive behavior that can be associated with it could offer new insight into the nature of pleasure and addictions,” addiction expert Maia Szalavitz wrote in The New York Times. “Adjusting brain systems that regulate desire may also affect the stigma that society pins on people with conditions that can lead to loss of control. When drugs can significantly ease weight loss or addiction recovery, it’s hard to argue that the problem is moral rather than medical.”

In her influential book Unbroken Brain, Szalavitz explained that desire comes in two flavors: the “pleasures of the hunt” and the “pleasures of the feast,” also described as “wanting” and “liking.”  Drugs such as cocaine and methamphetamines engage the wanting circuits of the brain, while heroin and alcohol are about sedation and satisfaction.

“The positive side of wanting is feeling empowered and focused on getting what you desire; the negative side, of course, is craving that goes unsatiated,” Szalavitz explained in The New York Times op-ed. “The second kind of pleasure [liking]...  is linked with the satisfaction and comfort of having achieved your goal.”

The wanting circuits tend to rely on the neurotransmitter dopamine, while liking is more associated with the brain’s natural opioids and serotonin. Having these common currencies of emotion allows our brains to modulate what we want, depending on what it perceives as our most pressing needs.

Szalavitz explains how medication-assisted treatment utilizing opioid agonists such as buprenorphine or methadone satiates “opioid craving by providing a consistent level of a drug similar to the one that is wanted, without the chaos that can prevent people with addiction from living well.”

Other medications, like naltrexone, do the opposite and prevent opioid receptor activation. These medicines, however, can reduce the experience of pleasure overall. GLP-1 drugs act differently. They modulate the motivational dopamine systems but apparently without depressing desire overall. So far, the data on using GLP-1 drugs for substance addictions are mixed. Some studies showed positive results in animals and humans, but others found no effect.

Nora Volkow, the director of the National Institute on Drug Abuse (NIDA), is funding research on these medications for drug addictions. Szalavitz quotes Dr. Volkow as saying they might work “by interfering with that urge to have more.” It will be fascinating to determine whether it is possible to alter or even create a set point that signals that “enough” drugs have been taken. People with alcohol use issues seem to lack such an off switch, while those who drink moderately report knowing when to stop.

Szalavitz hopes the research will eventually yield medications that help people “change with ease” after years of struggling. The experience with methadone—first studied as a treatment for opioid addiction in the 1950s and 60s—shows that full recovery from addiction usually takes much more than just taking a single medication.  

While medications that can help stem the desire to use substances or reduce their ellative effects can be highly effective treatment aids, experienced medical and behavioral health providers know that substance use disorders and their co-occurring mental health conditions can result from complex underlying issues that cannot be resolved with medicines alone. Essentially, reducing the effect of a substance does not necessarily address the factors leading that person to seek substance-induced relief. When considering messages promoting the promise of medications, it is important to include the fundamental concept that addictive disorders have biological, psychological, and sociological components that can lead to their development and exacerbation. Stopping people from feeling the effects of substances or being able to stop taking them does not always mean that the underlying issues causing them to misuse the substance are reduced. Creating the perception that a medication alone can comprehensively “cure” addiction should be carefully avoided.

Foundry Treatment Center Steamboat, like other experienced behavioral healthcare providers, avails clients of psychiatric medications to help control cravings and restore mental health while taking a holistic approach that considers the bigger picture affecting clients. As a program that emphasizes the outsized roles that trauma and family system issues play in developing a range of health problems, including addiction and mental illnesses, Foundry Steamboat clinicians suggest taking a judicious approach to the role of medications in personalized treatment plans.

“The problems our clients are facing are often the underlying reasons that they developed substance use disorders in the first place,” says Chief Clinical Officer Michael Barnes, Ph.D. “Medication can certainly help people feel better and help them establish a baseline from which they can deal with underlying problems, but medication is very rarely a complete answer to this very complex disease.”

Medication-assisted treatment (MAT), which has been promoted as the gold standard for addiction treatment and has been used for decades, is a case in point. While medication-assisted treatment tremendously benefits many people, others relapse and overdose, divert their medications, or change the substances they use to achieve a high. This is not because MAT is ineffective or without merit, but because many of the people prescribed medicines to reduce their ability to feel the elative effects of alcohol or opioids still face daunting problems that make them feel deeply stressed, anxious, and depressed. Problems such as family estrangement and divorce, abandonment, housing insecurity, financial instability, legal entanglements, physical health problems, and victimization are some of the many reasons that people have difficulty entering and maintaining recovery, regardless of medications they may be prescribed.

“The potential benefits of semaglutide are certainly welcomed, if studies prove its efficacy to safely reduce cravings. We need as many tools in the toolbox as we can get,” says Foundry Chief Medical Officer Dr. Jim Shuler. “But when treating addictive disorders cohesively and fully, we need to consider social determinants of health, medical and trauma histories, and lifestyle factors and treat for these. Medication, while potentially very helpful, doesn’t treat these issues. These take a different set of therapies, skills, and supports. We do not want to instill the idea that medicine is the answer because, in the vast majority of cases, the answer lies in identifying and addressing a much deeper set of issues than one’s inability to stop using substances despite wanting to. In other words, medication is just one spoke that can help keep the entire wheel of the patient round.”

“In some cases, not even the most well-tuned medication plan is going to help a person dealing with the profound effects of trauma and negative life experiences,” says Dr. Barnes. “Some problems simply cannot be medicated away. Many people simply do not have the ability to regulate their autonomic nervous response to stress naturally, and without that ability, they will either always be dependent upon medications that attempt to control it or will not experience relief. The answer, in these cases, is to teach them how to achieve homeostasis and make important lifestyle changes that moderate stressors.”

Foundry Steamboat takes a holistic approach to treating substance use and co-occurring mental health disorders, including trauma. Psychiatric prescribing, which is provided to clients in the program’s residential and intensive outpatient programs, makes a significant difference to many clients. However, the program employs thoughtful assessment, psychotherapy, fitness and nutrition support, recreation and wellness services, and specialized trauma therapies with the aim of helping clients develop recovery-supportive lifestyles and learn to reduce the potential triggers of substance use disorder.

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Many people in rural America are on their own when it comes to mental healthcare. Nearly half a million, or 14 percent of, Coloradans are affected by mental health challenges, a 2016 report from the Colorado Health Foundation revealed, and many of them lack access to care. A 2020 report by the Colorado Rural Health Center (CRHC) found that of the state’s 64counties, 22 don’t have a psychologist or psychiatrist working there. 

According to the CRHC’s2022 Snapshot, “Nine rural counties in Colorado have no pharmacy, while eleven other rural counties have only one pharmacy.” Thirty-seven of Colorado’s64 counties (all rural or frontier) do not have any ICU beds.

The region around Durango in southwestern Colorado is a good example. Although many residents suffer from substance use disorder, treatment options are sparse. “The region has no recovery homes, no medical detox, and no inpatient substance use treatment facilities,” reported the Durango Herald in May. “While treatment resources do exist, those demanding inpatient care must usually travel to the Front Range.”

Many residents of rural America feel generally isolated and left behind by the modern world. In 2015, two Princeton economists argued that middle-aged white Americans without a college degree were now facing “deaths of despair”—suicide, overdoses from drugs and alcohol, and alcohol-related liver disease. They suggested that distress caused by globalization and rapid technological change probably drove those deadly outcomes. Middle-aged whites are now more likely than their predecessors to report pain and mental health problems and are experiencing symptoms of alcoholism at a younger age.

Middle-aged white males in rural areas are often also affected by so-called “man rules.” The rugged and self-reliant frontiersman is supposed to be able to “hold his liquor” and not “go on” about his feelings. Men, in general, face different expectations than women, which can impact their mental health and substance misuse. In the 2022 CRHC Snapshot, 21 percent of adult rural Coloradans reported drinking excessively.

Foundry Steamboat Rural Community Connection Effort

The Foundry Steamboat men's residential program treats adult men experiencing substance misuse, co-occurring mental health conditions, and trauma. The program offers comprehensive, coordinated treatment, including medical care, psychiatry, psychotherapy, fitness, and wellness coupled with gender-responsive and trauma-informed approaches. Its focus, milieu, and expertise make this program especially appropriate to men for whom previous treatment episodes have been successful. Foundry Steamboat also offers a virtual intensive outpatient program for men and women in Colorado and Wyoming and operates Chrysalis Continuing Care, an in-person IOP in Denver’s RiNo neighborhood. 

Foundry Steamboat team members are experienced with the challenges facing rural Coloradans, including steep rises in suicide and untreated mental health disorders. In 2022, Foundry Steamboat outreach representatives Amber King and Amanda Buckner, who hail from rural Colorado hometowns, established monthly virtual meetings to make connections between therapists and other behavioral health stakeholders in these rural communities. 

This rural community outreach and networking effort is beginning to yield results. Therapists, case managers, and peers are identifying new resources, and more people are being referred to treatment. The group’s recent discussions indicate that therapists are seeing positive changes that could make it easier for people in some communities to seek care. 

In Vail, for example, therapists have noticed that young people are becoming more vocal about experiencing mental health conditions, such as anxiety, depression, and suicidal ideation. Vail community members are also building a peer recovery system, which can help people seeking treatment and support those living in recovery.

Vail offers an important example of how problems facing rural Americans affect communities across the socioeconomic spectrum. Although Vail is a small community of 5,000 full-time residents, the town receives more than1.3million visitors per year who ski its slopes in winter and hike its mountains in summer. Tourism makes Vail a relatively affluent community and supports a range of businesses and healthcare facilities.

Despite its resources and infrastructure, Vail struggles from a lack of mental and behavioral healthcare and experiences stigmas affecting many rural communities, some of which are stubborn remnants of longstanding rural culture. And like many so-called mountain towns that attract a high population of visiting tourists, residents can struggle with forming lasting relationships or feel isolated despite being surrounded by people.

“While life in mountain towns and agricultural communities can differ greatly, rural communities can sometimes perpetuate unhealthy cultural cues by normalizing substance use as part of daily life. It can be easy for families to inadvertently keep cycles of substance misuse going by enabling or even encouraging substance use to overcome boredom, pain, or as a social lubricant. When communities are isolated from major population centers by hundreds of miles, it’s easier for ideas and behaviors — both good and bad — to remain unchanged while these thoughts and behaviors may be changing in the broader population,” says Foundry SteamboatCommunity Relations Manager Amanda Buckner.

"As a voice in rural recovery work, collaborating with community leaders throughout the state has transformed inspiration into action and helped build the recovery community organization in our mountain town,”says Rob Shearon, Founder of Reconnected, an app that helps people recovering from mental health and addiction to connect with others. Before foundingReconnected, Shearon was a program manager for the University of ColoradoCollegiate Recovery Center.

"At Reconnected, we're not just providing peer recovery coaches through our partnership with the local hospital, we're building a supportive community through a variety of social events, from non-alcoholic happy hours to mountain bike rides with the local rec district.We're creating a network of like-minded individuals who are there for each other every step of the way in their recovery journey," says Shearon.

“The fact that Vail is starting a peer recovery support network and getting community involvement happening represents major progress,”says Buckner. “When we started these Zoom meetings, we weren’t sure how responsive people would be or if it could help to make a change. It is still very early. But when we hear colleagues like Rob telling us about these successes, or that young people are feeling more comfortable talking about their problems, that’s a big deal. It shows that change is possible and that this effort can help to make change.”

Join the Connecting Rural Community monthly calls, which take place on the second Monday of each month by emailing amanda.buckner@foundrysteamboat.com.

An inspirational article written by Foundry Steamboat Wellness and Recovery Coach is published in Steamboat Pilot & Today. This piece celebrates Mental Health Awareness Month, which is the month of May, and provides practical suggestions to support positive mental health.

Read the full article here: https://www.steamboatpilot.com/news/sarah-coleman-i-see-you-i-hear-you/

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The animal tranquilizer xylazine has become the latest scourge in the American addiction crisis. The substance often pushed under the names “Tranq” or “Tranq dope” is a non-opiate sedative, analgesic, and muscle relaxant only authorized in the United States for veterinary use, according to the federal Food and Drug Administration.

Xylazine—currently not a controlled substance—“was first noted as an adulterant in Puerto Rico in the early 2000s,” reported the Drug Enforcement Administration (DEA) in October. “Xylazine, reported as an adulterant in an increasing number of illicit drug mixtures, has also been detected in a growing number of overdose deaths. It is commonly encountered in combination with fentanyl but has also been detected in mixtures containing cocaine, heroin, and a variety of other drugs.”

“The drug causes dangerously low blood pressure, slow heart rates, blackouts, and skin wounds so severe they can lead to amputations,” reported Axios Denver on March 15. “The sedative, which makes the effects of fentanyl even deadlier, is also unresponsive to common overdose-reversal treatments, like naloxone.” The reason: naloxone (Narcan) only counteracts the effects of opioids and not of other psychoactive substances.

Tranq started to appear in Philadelphia about three years ago. The more powerful synthetic opioid fentanyl has edged out heroin in the Pennsylvania city, but the fentanyl high fades more quickly than heroin, so xylazine is being added to make the effects of fentanyl last longer. Exposure to xylazine is common among people addicted to heroin, fentanyl, and cocaine, as the tranquilizer is often added without the knowledge of the addicted user.

Misusing xylazine can have serious consequences. CNN recently reported that “the drug has side effects like ‘tranq walk,’ where people seem unaware of their surroundings, along with sores and wounds.” The sores frequently turn into horrific ulcers on the extremities and are associated with copious purulent drainage and foul smell. Necrosis of subcutaneous tissues and abscesses are common.  

Local police told Axios Denver that xylazine has now arrived in Denver. Authorities detected 18 cases in 2022 through a fentanyl-monitoring project that tests drugs. Authorities say that figure is likely higher, even though Denver has nowhere near the levels seen in the Northeast, where the drug is prevalent.

“The emergence of xylazine across the United States appears to be following the same path as fentanyl, beginning with white powder heroin markets in the Northeast before spreading to the South, and then working its way into drug markets westward,” reported the DEA. “This pattern indicates that use of xylazine as an adulterant will likely increase and be commonly encountered in the illicit fentanyl supply.”

Fentanyl and xylazine are just the latest chemical weapons in America’s seemingly endless battle with addiction. Over 110,000 people died of drug overdoses last year, according to the CDC—a new terrible record. Once again, we are largely blaming a substance (fentanyl) and its merchants (foreign cartels) while ignoring the deeper reasons why so many Americans are willing to ingest and inject dangerous, addictive substances. Once again, cities and states are pushing for much harsher sentences for people caught with the deadly substance-de-jour.

Critics are already calling “the new crackdown a ‘War on Drugs’ 2.0,” reported NPR’s Jasmine Garsd in March, but many experts warn that further criminalization is not going to fix the problem.

"There's no doubt in my mind that law enforcement should be involved. There's no doubt in my mind that the court system should be involved," Adam Scott Wandt, assistant professor of public policy at John Jay College of Criminal Justice, told NPR. "But we cannot law-enforcement our way out of this fentanyl epidemic. It's a public health epidemic. We need to concentrate and focus on public health solutions in order to help people break their habits, break their addictions."

People with addiction need compassion and treatment. They are already continuing with their self-destructive behavior despite severe punishing consequences. More punishment will achieve very little. Addiction is a complex disease, often driven by desperate attempts to self-medicate trauma, anxiety, depression, and other mental health conditions. If the resulting emotional pain is left unaddressed, criminal interdiction is unlikely to achieve much.  

Amber King, a Foundry Steamboat team member who grew up in rural Colorado, is familiar with the relationship between social determinants of health and mental health and addictive disorders. King and colleague Amanda Buckner recently started a free networking event for therapists and other mental healthcare stakeholders in rural Colorado communities. “Addiction has long been viewed as a moral failure or the result of making bad life choices. Despite public education efforts in recent years and the fact that most people today know a friend or family member affected by addiction, this is still a widely held belief. The reality is that addiction is very often the result of terrible life events and cycles of addiction and violence that affect family systems for generations. The roots of this problem, for many people, stem from feeling mitigated, isolated, oppressed, hopeless, and lacking resources to help them address these feelings and experiences. Substances come and go and change. More people are still dying from alcohol misuse every year than from all other substances. We need to acknowledge that addressing the problem of xylazine, or fentanyl, or opioids, or any substance takes more than stopping the supply — it comes from helping reduce the perceived need for people to self-medicate with substances to feel normal,” says King.

Foundry Steamboat offers a men’s residential treatment program in Steamboat Springs and virtual IOP services to adults in Colorado and Wyoming. The program’s clinicians are experienced with people who face financial, legal, and relational challenges and who feel marginalized. The program’s Trauma-Integrated Care model helps clients understand why they develop addictive disorders and how to develop recovery-supportive lifestyles and provides skills to naturally self-regulate the autonomous nervous system to reduce the need for substances.

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Since it was introduced in November, the artificial intelligence model known as ChatGPT has garnered substantial interest from the media and the general public.

ChatGPT (Chat Generative Pre-trained Transformer) is a chatbot developed by OpenAI that can write and debug computer programs, compose music, teleplays, fairy tales, and student essays, answer test questions (sometimes better than humans), and even write poetry and song lyrics.

Now, it’s also venturing forth into the realm of medical diagnosis. “ChatGPT is not the first innovation in this space,” reported Ruth Hailu, Andrew Beam, and Ateev Mehrotra on Statnews in February. “Over the last decade, various symptom checkers have emerged on websites and in smartphone apps to aid people searching for health information. Symptom checkers serve two main functions: they facilitate self-diagnosis and assist with self-triage. They typically provide the user with a list of potential diagnoses and a recommendation of how quickly they should seek care, like see a doctor right now vs. you can treat this at home.”

A StatNews team tested the capabilities of previous symptom checkers and came away decidedly unimpressed: “Our team once tested the performance of 23 symptom checkers using 45 clinical vignettes across a range of clinical severity. The results raised substantial concerns. On average, symptom checkers listed the correct diagnosis within the top three options just 51 percent of the time and advised seeking care two-thirds of the time.”

But ChatGPT seems to outperform its forerunners. “We gave ChatGPT the same 45 vignettes previously tested with symptom checkers and physicians,” reported the StatNews researchers. “It listed the correct diagnosis within the top three options in 39 of the 45 vignettes (87 percent, beating symptom checkers’ 51 percent) and provided appropriate triage recommendations for 30 vignettes (67 percent). Its performance in diagnosis already appears to be improving with updates. When we tested the same vignettes with an older version of ChatGPT, its accuracy was 82 percent.”

So far, so good. However, one of ChatGPT’s significant issues is its potential to generate inaccurate or false information. Occasionally, the chatbot seems to be making things up. “When we asked the application to give a differential diagnosis for postpartum hemorrhage, it appeared to do an expert job and even offered supporting scientific evidence. But when we looked into the sources, none of them actually existed,” reported Rushabh Doshi and Simar Bajaj on Statnews. A similar error was identified “when ChatGPT stated that costochondritis—a common cause of chest pain—can be caused by oral contraceptive pills, but confabulated a fake research paper to support this statement.”

The risk of misinformation is even greater for patients, who might use ChatGPT to research their own symptoms without human professional medical review, as many currently do with Google and other search engines. Indeed, ChatGPT managed to generate an alarmingly convincing explanation of how “crushed porcelain added to breast milk can support the infant digestive system.”

OpenAI has acknowledged that ChatGPT "sometimes writes plausible-sounding but incorrect or nonsensical answers." This behavior is common to large language models. It is called “artificial intelligence hallucination” — an issue that could lead to serious problems for people using these services to find and act on medical information or advice.

The use of large language models and generative AI is in its infancy. However, future iterations of ChatGPT could vastly expand its knowledge base and increase its accuracy across domains, including medicine. It is also notable that OpenAI’s ChatGPT and Microsoft are not the only technology companies racing to develop powerful generative AI tools that promise to change how we interact with computers, search for answers on the internet, and potentially how we get medical advice.

Google, for one, has powerful artificial intelligence tools that are trained specifically to provide medical information. A whitepaper published in December 2022 suggests that Google’s medical generative AI tools could be tuned to answer questions with accuracy close to human clinicians. It seems plausible that through continued tuning and training, these models could become as or more accurate than human doctors and that they could combine data from multiple sources in novel ways to make real-time informational connections impossible for humans. While all of this is currently conjecture, the future may hold tremendous promise for making high-quality medical information more accessible.

AI is Already Being Used to Assist in the Delivery of Mental Healthcare

While large language models like ChatGPT are all the rage and hold tremendous promise, artificial intelligence has been used in medical applications for years. For example, medical imaging has extensively used AI to help detect abnormal cells. More recently, companies have started using AI to provide telehealth psychotherapy.

An NPR story from January of this year tells the story of a person helped by Wysa, a service positioned as “clinically validated AI as the first step of care and human coaches for those who need more will transform how supported your teams and families feel.” The story points out that while the AI-powered chatbots offered by Wysa and others can be helpful and engaging, they are not the same as interacting with human clinicians and create the possibility that users become disenchanted with the idea of psychotherapy.

It seems possible, if not probable that medical AI will become increasingly advanced and capable. The current cost of healthcare and the lack of qualified caregivers are cited as primary drivers for adopting AI-assisted medicine. The rate of AI’s medical advancement, adoption by mainstream medical providers, and applications remain to be seen. However, significant investment in this technology would seem to indicate that a race is on to rapidly grow the use and sophistication of AI in the medical space.

Behavioral Healthcare Remains a Human-Centered Domain

The desire to make psychotherapy more accessible and to reduce the workloads of fatigued and stretched clinicians through the use of technology is, perhaps, understandable. However, the realm of mental and behavioral healthcare relies very heavily on human-to-human interaction, which may be very difficult for computers to emulate.

The very concept of using technology to deliver therapy flies in the face of a bedrock principle of modern psychology and psychiatry because, ultimately, it attempts to replace the essential relationship between therapist and client with a computer algorithm.

“There is consistent evidence that the quality of the therapeutic alliance is linked to the success of psychotherapeutic treatment across a broad spectrum of types of patients, treatment modalities used, presenting problems, contexts, and measurements,” wrote Dorothy Stubbe, M.D. in 2018 on Psychiatry Online. “Although scholars may differ in how the alliance is conceptualized, most theoretical definitions of the alliance have three themes in common: the collaborative nature of the relationship, the affective bond between patient and therapist, and the patient’s and therapist’s ability to agree on treatment goals and tasks.”

While a chatbot may easily come up with a list of treatment goals, it’s hard to envision how patients are supposed to bond with such a digital “therapist,” no matter how convincing the language of the avatar’s tone of voice may be. Addiction, in particular, is a complex, systemic problem, and only a careful individual assessment can determine the best treatment option. Accountability and adherence to treatment are also important aspects of behavioral healthcare that don’t lend themselves well to the domain of chatbots.

Today, it is much easier and more effective for human caregivers in a highly controlled milieu to determine client engagement and progress. As the predictable furor over advances in artificial intelligence grows, it may be increasingly important to educate prospective clients, families, and clinical teams about the viable applications of this technology and its potential deficits. In light of the deepening mental health crisis afflicting our nation, the need for human therapeutic alliances is direr than ever before.

“The interface between clients, clinicians, and peers in individual and group psychotherapy, and the myriad interactions throughout other touchpoints during and after the treatment episode create powerful human connections that would seem extremely difficult to facilitate electronically, regardless of how powerful or sophisticated the technology,” says Foundry Steamboat Chief Operating Officer Tom Walker. “Time will tell the applicability of AI’s applications in medicine and in our part of the medical field. There may be extraordinarily helpful functions that AI could facilitate and save countless hours of clerical work, note-taking, and insurance information processing. It may also usher in a new era of information transfer, where very recent peer-reviewed treatment innovations are made immediately available through interconnected systems. There are very smart people thinking of ingenious ways for this technology to make the provision of treatments of all kinds more efficient and effective,” says Walker. “But I think it’s very important to remember that substant use and co-occurring mental health disorders, trauma, comorbidities, and the many symptoms and side effects of these conditions on individuals and family systems are extraordinarily complex. Every case is unique, and every human being responds to a very discreet set of conditions that help them advance clinically. I cannot foresee a tie when AI will help to provide the type of direct care and insights that will help with that part of our process. While it may seem very tempting to want to rely upon these technologies to answer the critical need for treatment, I think we need to be very careful about how we educate the public about the need for in-person behavioral healthcare, regardless of how advanced AI may become in the future.”

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Focaccia 

Prep time: 20 minutes

Bake time: 20 minutes

Idle time: 2-14 hours

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If you have done any kind of “artisan” bread baking before then this recipe is essentially very similar. There are a few key things to try to remember while you are making an “artisan” loaf of bread; keep the dough a little sticky, develop gluten, and be patient.

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Ingredients

• 1000 grams of flour; bread flour and whole wheat (about 4 ½ cups, but weighing the ingredients is best)
• 700 grams of water
• 150 grams of sourdough starter (optional)
• 1 - 3 grams of yeast (½ - 1 teaspoon) (using less yeast slows down the rise and will make the bread have more flavor)
• 15 grams of salt (about 3 teaspoons) 
• 20 grams of olive oil (about 3 tablespoons)

**Traditional focaccia bread will use some version of a “starter” If you are interested in making your own sourdough starter, see my recipe about how to put together a starter. For this recipe a sourdough starter is not actually needed. If you do not have a starter use a higher amount of yeast and the rise times will be faster. If you want to use starter and have the time, this recipe can take as long as all to create a more interesting flavor. If you use starter and a small amount of yeast, be prepared to wait longer on your rise times. 

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Directions 

• In a large mixing bowl on top of a zeroed kitchen scale, weigh out 700 grams of warm water. *Note that zeroing your scale in between measurements makes things easier to keep track of.
• In the same bowl add in 1-3 grams of yeast (and 150 grams of sourdough starter if using) and stir to combine.
• Add 400 grams of whole wheat flour into the mixing bowl and stir to combine. (at this point you can let your mixture sit with plastic wrap or a tight fitting lid for up to 8 hours at room temperature or 12-14 hours in the refrigerator)
• Add in 20 grams of olive oil, 15 grams of salt and 600 grams of bread flour and stir until combined.
• Once all of the ingredients are combined, turn the dough out onto a floured countertop and knead by pressing the palm of your hand into the dough and stretching it then pulling it back towards you. Kneading by hand will take about 5-7 minutes or until the dough is smooth and elastic. If you have a kitchenaid mixer you can also use the dough hook, and let the machine knead it on speed 3-4 for 5 minutes. 
• Put the dough into a greased bowl and cover with plastic wrap or a tight fitting lid to let rise for 1-2 hours or until the dough has noticeably expanded (if you used yeast and starter mix it will be around 2 hours or more).
• Once the dough has expanded, take the dough out of the bowl and use the “stretch and fold” method to build gluten in the dough (take one end of dough and stretch it as far as you can without tearing it then fold it back on itself, repeat this on all 4 “sides” of dough). Now place your dough back into the greased bowl and cover again to let rise for another 1-2 hours.
• After this rise time, proceed in doing the “stretch and fold” method one more time. Let dough rise for around another 30-45 minutes (rising should speed up a little throughout the day). After this stretch and fold session, start preheating your oven to 400 degrees fahrenheit. 
• After this rise it is time to shape the dough. Turn your dough out of the bowl onto a countertop that has been coated in olive oil. Work your dough with your hands into a flattened oven shape. This is a bit like working with a large pizza dough, where it is important to get it fairly flat but do not tear it (refer to video for shaping). Transfer the flattened dough to a baking sheet lined with parchment and cover with plastic wrap or a wet towel to let rise one last time for around 30-45 minutes. 
• After the rise, coat the loaf with olive oil and poke little “pockets” into the dough where the olive oil will settle. Sprinkle salt and pepper over the top of the loaf and place in the oven for about 20 minutes or until slightly golden on top.
• Let your loaf cool on a cooling rack until completely cool before cutting, or enjoy warm.
• Focaccia will keep in the refrigerator for about 2 weeks or around 5 days on the counter if kept out of direct sunlight. 

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Notes

• Depending on the weather in your area rise times might differ, and they could be longer or they could be shorter. Be patient and do not panic. If you have the time to let it sit longer let it sit.

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People struggling with a substance use disorder (SUD) or behavioral addiction often report feeling lost or devoid of purpose. This is very similar to the way some people describe how they feel when they have lost connection with their spirituality. This kind of spirituality is not about a catalog of commandments but a sense of interconnectedness with all living beings and a personal quest for meaning.

 Spirituality can be defined as an individual's search for ultimate or sacred meaning and purpose in life. Furthermore, it can mean to seek out or search for personal growth, religious experience, belief in a supernatural realm or afterlife, or to make sense of one's own "inner dimension.”

 Spirituality can be a powerful tool in the healing process. “Patients who are spiritual may utilize their beliefs in coping with illness, pain, and life stresses. Some studies indicate that those who are spiritual tend to have a more positive outlook and a better quality of life,” wrote Christina Puchalski, MD, in her study on the role of spirituality in healthcare. According to Puchalski, specific spiritual practices have been shown to improve health outcomes. “Spiritual commitment tends to enhance recovery from illness and surgery.”

Dr. Puchalski is the founder and executive director of the Institute for Spirituality & Health (GWish) atGeorge Washington University. GWish was established in 2001 and quickly took on a leadership role in the nascent field of spirituality and health. Conducting research, educating practitioners, and impacting healthcare policy worldwide, GWish frequently collaborates with religious, spiritual, and health organizations to create more compassionate healthcare systems around the globe.

A spiritual outlook also tends to enhance recovery from addiction. The American Psychological Association reported in 2000 on a study that found that higher levels of religious faith and spirituality among people recovering from substance use disorder were associated with several positive mental health outcomes, including more optimism about life and higher resilience to stress, which may help fortify the recovery process.

Despite such results, the aspect of spirituality is often still excluded from a modern medical environment. However, recovery support groups such as Alcoholics Anonymous (AA)have long described addiction as a disease of the spirit.

“Diseases of the flesh(e.g., cardiovascular disease, diabetes, cancer) are physical in nature and are treated using the traditional medical model: a history is taken, a physical exam and laboratory or other tests are conducted, and treatment is discussed with the patient.” wrote Paul King, MD, in 2012 on psychiatrist.com.“Diseases of the Spirit, on the other hand, may result from the misuse of short-term anxiety-relieving techniques and may not be adequately addressed by the medical model. For example, drinking to relieve stress may lead to alcoholism, opiates and benzodiazepines can lead to abuse problems and chemical dependency, sexual promiscuity may become sex addiction, excessive gambling and shopping may lead to financial ruin, and pornography can lead to sex offender behavior.”

“The Spirit or soul requires sustenance and care, and neglect of the Spirit can lead to disorders,”wrote Dr. King, “just as neglect of the body leads to disease.”

In his new book The Myth of Normal, addiction expert Gabor Maté takes a similar approach: “Addiction is a complex psychological, emotional, physiological, neurobiological, social, and spiritual process.”

Maté criticizes modern medicine for separating the mind from the body, although “living people cannot be dissected into separate organs and systems.” For Maté “health and illness are not random states in a particular body or body part” but “an expression of an entire life lived.” That would also include a spiritual aspect or lack thereof.

In the 1930s, famousSwiss psychiatrist and psychoanalyst Carl Jung also weighed the impact of spirituality when he corresponded with the founder of Alcoholics Anonymous,Bill Wilson, in an attempt to discover a cure for the disease of alcoholism.Dr. Jung concluded that the misuse of alcoholic “spirits” was primarily an attempt to fill the thirst for “the spirit of God.” He asserted that the remedy was spiritual because a spiritual problem cannot be resolved with a material solution.

“You see, ‘alcohol’ inLatin is ‘spiritus,’ and you use the same word for the highest religious experience as well as for the most depraving poison,” Jung wrote to Wilson.“The helpful formula, therefore, is: spiritus contra spiritum.”

Today, many addiction professionals see the disease of addiction well beyond psychosomatic body-mind interactions. They recognize a deeper malaise at the core of addiction: the disconnection from a higher power—whatever that might be exactly, a missing sense of purpose, a failure at authentic self-actualization, the highest level in the pyramid of human needs proposed by American psychologist Abraham Maslow in 1943.

NYU psychiatry professor Marc Galanter regards spirituality as an important form of recovery capital: “Achieving an enhanced spiritual orientation can provide increased recovery capital, the enhanced ability to sustain recovery from substance use disorders(SUDs). This can be valuable in adding to the resources, such as pharmaceutical or institutional, on which such a person can draw.”

Spiritual recovery capital may also help prevent a relapse. “An approach to enhancing personally experienced spirituality, as embodied in the availability of culturally syntonic approaches, and thereby improving one’s recovery capital, may serve to yield relief from the pressure to turn to substance misuse and addictive behaviors,” wrote Galanter, Hansen, and Potenza in July.

Foundry Steamboat takes the mind, body, and spirit approach to recovery. Its curriculum and psychoeducation directly address the benefits of exploring, developing, or reconnecting with one’s spiritual aspect. Wellness programming, including fitness, recreational activities, mindfulness work, nutritional education, horticulture, and bonding experiences, have the intention of helping clients feel a connection with themselves and others. The concept of meaning plays an important role in Foundry Steamboat’s clinical approach. The Trauma-Integrated Care model developed by Chief Clinical Officer Michael Barnes helps people learn to self-regulate naturally. A major part of being able to feel centered and less stressed about one’s life is seeing oneself in a larger interconnected context. Spirituality can help clients learn to appreciate their roles within the broader frameworks of relationships, families, and communities and to find a sense of deep personal meaning that can make a crucial difference when modulating stressful situations, dealing with adversities, and working through relationship issues.

The growing Foundry Steamboat alumni community and its alumni programming also strive to help people experience a deeper sense of fellowship and spiritual connection. The Foundry Treatment Center Steamboat alumni program offers in-person gatherings for clients and family members, and regular virtual meetings that keep people in close touch with care team members and peers. Alumni events remind clients of the goals of recovery and lessons learned during treatment and foster the growth of supportive friendships.

Learn more about Foundry Treatment Center Steamboat. The program offers a residential trauma-integrated men’s program in Steamboat Springs, Colorado, and a virtual Intensive Outpatient Program for men throughout Colorado. Speak confidentially with an informed team member at (720)477-6757.

Possibly the most underrated season of all time in a mountain town is Fall. Fall is often called “shoulder season”. Of course Steamboat Springs is home to some of the best aspen groves that anyone could ask for and their leaves are truly stunning! The brisk cooler air of the fall reminds all of us the ski season is right around the corner and it’s hard not to be excited about the future powder days, but other than stunning leaves and hopes of great future powder days, what is actually going on in the season of Fall itself? Sometimes I think of Fall as the season of food. You can’t talk about Fall without talking about Thanksgiving, and let’s not forget about a good halloween chili! 

Chili is a hot topic around the Foundry right now. The annual “chili cook off” is back! Foundry’s chili cook off is a chance for staff to come together and be actively engaged with each other in a setting that isn’t just “another day at the office”. People naturally will gather around food. Just think about any event or gathering that you have been to (birthdays, weddings, sporting events, etc…), there was probably some sort of food being served. People gathering around food is probably the most human thing that we can do. Every single person needs food to survive, meaning that food is possibly the most basic thing that all humans have in common. 

Not only is food a necessity, it is often a way of life. So many people around the world spend large portions of their day dedicated to cooking and prepping food. I’m not talking about just restaurant workers, I’m talking about everyday people. In some cultures around the world it is common for people to just make their own bread or make their own tortillas, but here in America it is much more common for people to just go buy bread and tortillas at the store. Why we have gotten away from making foods probably comes down to time. Most people will say there isn’t enough time to make bread or tortillas or for some people even just any food at all. Make time!!

I say Fall is the season of food, and I mean it! Fall is a time where a lot of us find ourselves spending more time indoors due to the weather. Some of us miss the abundant outside time we can spend during the summer months. Instead of feeling down about being inside more, get excited about all that you can do inside! Cook something, bake something, prep food for the week, or spend hours trying to come up with the perfect chili! Cooking and baking is my favorite indoor activity and one day I hope it becomes your 

Garden Update!

Yes, Fall is here, so our garden season is wrapping up quickly. The green house is still chugging along as always, but we have more exciting news that is similarly related to the garden! We’ve gotten ourselves a Pig! His name is Tatter Tot and he is just adorable! We love him unconditionally.

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Recipe!

Fall is the season of pumpkin and also the season of baking! So why not put two and two together to make yourself some great pumpkin banana bread!

‍Pumpkin Banana Bread

‍Yield: 1 9x5 loaf pan

Prep time: 30 minutes

Bake time: 45-50 minutes

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Ingredients

• 1 cup whole wheat flour
• ¾ cup all purpose flour
• 1 whole egg and 1 egg yolk (room temperature) 
• ½ stick of butter (melted)
• 3 T of honey
• 4 bananas (very ripe or overripe)
• 1 teaspoon of cinnamon
• ½ teaspoon of nutmeg
• 2 teaspoon of baking powder
• ½ teaspoon baking soda
• 8 ounces of pumpkin purée 

For the honey cinnamon butter

• 1 teaspoon of cinnamon 
• 2 tablespoons of honey 
• ½ stick of unsalted butter (softened enough for mixing)
• 1 teaspoon of kosher salt

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Instructions

• Preheat the oven to 350 degrees
• In a large mixing bowl or stand mixer combine egg, egg yolk, pumpkin purée, honey, bananas and melted butter.
• Mash the bananas with a masher or fork until the egg banana mixture has turned into a paste
• Now add all of your dry ingredients; whole wheat and all purpose flour first, then baking powder, cinnamon, nutmeg, and salt.
• Once all of your dry ingredients have been added, mix until combined.
• Grease a 9x5 loaf pan with butter or a spray oil.
• Pour your batter into the pan and then place in the oven for 30-40 minutes or until a toothpick inserted into the center of the loaf comes out clean. 
• While the loaf is baking, make your honey cinnamon butter. 
• Put your softened butter, cinnamon, kosher salt, and honey into a small mixing bowl and beat together with a fork until combined. 
• Serve your pumpkin banana bread warm with the honey cinnamon butter over the top!

As always, have a safe and clean season! - Chef Henry Olson 

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**Photo credit: Andrew Olson (@_andrew__olson_)

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Could Clinical Trial Reporting Spur Illicit Substance Use?

Might the widespread publicization of oversimplified clinical study findings contribute to increased substance use? The precipitous rise of cannabis legalization, industrialization, and use may prove a powerful case in point. Some studies suggesting the efficacy of cannabis to treat various medical problems were used by cannabis proponents to support the drug’s legalization and commercialization.

In recent years, stories citing small-scale clinical trial data published in traditional and social media channels suggest that cannabis could effectively treat pain and some mental health disorders, and even replace the use of some opioids to help address the opioid epidemic.

More recent information about the effects of legal medical and recreational cannabis calls into question many of the claims made by these earlier studies and highlights the adverse knock-on effects of cannabis legalization, including sharp rises in cannabis use disorder, cannabis induce psychosis, emergency department visits, and traffic accidents.

Importantly, America’s longest-running study on substance attitudes indicates that fewer people than ever feel that cannabis poses health risks, and cannabis use among all age groups, including teens and adolescents, is up.

If it holds true that people’s beliefs about substances and consumption behaviors can be swayed by exposure to clinical trial data (no matter how preliminary and cursory), this may be one reason for recent increases in hallucinogen use.

Data from the Centers for Disease Control and Prevention (CDC) indicate that just this year, clinical trials conducted by highly trusted institutions including Johns Hopkins, Columbia University Irving Medical Center, the University of California at San Francisco, and others, show that hallucinogens like psilocybin and ketamine may reduce the symptoms of treatment-resistant depression, a major public health problem.

The findings of these studies have been circulated by esteemed publications including the New York Times, The Guardian, the BBC, National Public Radio, Stat News, and others. In fact, a Google search for “psilocybin treats depression” returns more than 5.5 million results. While research into the potential mental health benefits of hallucinogens has peaked in recent years, the study of these substances as commercial medications has been underway for decades.

A peer-reviewed study released in August by the Columbia University Mailman School of Public Health and Columbia University Irving Medical Center indicates hallucinogen use grew from 1.7 percent in the U.S. in 2002 to 2.2 percent in 2019.

Just as promising clinical trial data may have spurred increased cannabis use, so too the publication of studies indicating potential health benefits of hallucinogens may reduce perceived health risks and make people feel more comfortable about using these substances.

Part of the problem posed by news reporting about clinical trials is that people may not read beyond the headlines or think critically about the study’s findings. Many of the articles reporting on the trials of psilocybin and ketamine make it clear that trial sample sizes may be small, that additional phases of research are needed to determine if compounds found in these substances can be turned into safe and efficacious medications, and that people should not attempt to achieve the same effects by using these substances on their own.

The Nature article “Psychedelic drugs take on depression — Mind-altering drugs might provide relief for those who don’t respond to conventional therapies — but does the hype outweigh the hope?” questions the significance of some claims made by recent studies suggesting the health benefits of hallucinogens and cites an important fact — that the promising effects of hallucinogens like esketamine show modest differences when compared to placebo. Additionally, many of the clinical trials being conducted are performed under close medical supervision and often include trained psychotherapists who counsel test participants during their study experience.

Despite the fact that most clinical trial reporting contains cautionary language and suggests that further study is needed to substantiate initial findings, it is possible that many readers may simply conclude that the substances are safe or beneficial because they either skim news headlines without reading full articles or choose to make their own interpretations.

As summarized in a 2014 Washington Post article, “Americans read headlines. And not much else.” “So, roughly six in 10 people acknowledge that they have done nothing more than read news headlines in the past week. And, in truth, that number is almost certainly higher than that, since plenty of people won't want to admit to just being headline-gazers but, in fact, are.” It is possible that even fewer people read in-depth news coverage or follow-up on news stories today — seven years after this article was written.

Before internet-based news and the ubiquitous use of mobile devices, most people got their news through a relatively small number of television and radio channels, newspapers, and periodicals. The relatively high cost of producing and distributing news, and the pressure by advertisers to control the quality of editorial content, meant that most major news outlets spent significant time fact-checking stories, and fewer news stories made it into mass circulation.

Scholarly articles like clinical trial information were most likely to be found in esoteric trade publications read by members of the medical profession rather than in mainstream media. Today, we are exposed to millions of times more sources of information, many sources do not fact-check information, and still, other information channels shape news to suit political or commercial outcomes. Another major change is the algorithmic distribution of information, largely driven by social networks, that attempts to deliver news that evokes an emotional response among consumers (as has been claimed about the inner workings of Facebook).

Confirmation bias is another issue that can impact information consumers and make them more likely to draw their own conclusions when presented with facts. Confirmation bias is the tendency to use information to confirm existing beliefs. If an individual is predisposed to believing that hallucinogens, like psilocybin, are natural substances that are harmless or efficacious, reading headlines that seem to support this point of view can solidify their belief in this supposition despite the fact that this assertion may not be accurate.

Digesting news uncritically and confirmation bias has led people in some quarters to expect a “psychedelic revolution” in the treatment of substance use disorders and other mental health conditions.

“In light of popular media reports of a forthcoming ‘psychedelic revolution’ with commercialization and marketing that may further reduce the public perception of any risk, researchers, clinicians, and policymakers should increase their attention to the rising rates of unsupervised hallucinogen use among the general public,” observed Columbia University study author Deborah Hasin. “Our results highlight such use as a growing public health concern and suggest that the increasing risk of potentially unsupervised hallucinogen use warrants preventive strategies.“

LSD, psilocybin, phencyclidine (PCP), MDMA, and other dangerous hallucinogens are listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) used by psychiatrists in the United States to diagnose substance use disorders. Symptoms of LSD use can include panic attacks, psychosis, seizures, and delusions. Another condition listed in the DSM-5 is cannabis use disorder (CUD), a potentially serious condition frequently requiring treatment.

Treatment providers see the impacts of misleading or misinterpreted substance information

Clinicians at Foundry Treatment Center Steamboat, and colleagues across the country, often witness the collision between incorrect perceptions about psychoactive substances and the negative effects of their problematic use. It is common, for example, for Foundry Steamboat clinicians to find clients experiencing cannabis use disorder surprised to learn that cannabis addiction is possible. The prevailing narrative that cannabis is not habit forming is untrue, and rates of cannabis use disorder and problematic use have increased since the substance became medically and recreationally legal.

Cannabis legalization, commercialization, and use disorder may be a bellwether for the future of hallucinogens and other substances highlighted in clinical studies. The specter of changing public risk perceptions that may increase the likelihood of substance trial and use is worrisome to behavioral healthcare providers.

“When Colorado legalized recreational cannabis, many of us were worried about the results, especially for younger people. Unfortunately, these worries were justified,” says Amber King, Foundry Steamboat Outreach and Special Projects. “We are not only seeing more people finding themselves addicted to high-potency THC products, but we are also seeing other negative impacts in the community. Some of these problems, like increased traffic accidents and children accidentally accessing these products, mirror some of the problems caused by alcohol, which kills more people every year than any other substance.”

“Now we are afraid that the trend toward relaxing concerns about other substances will result in similar problems,” says King. “Widespread headlines that suggest that hallucinogens may help treat mental health conditions could lead some people to attempt to self-medicate with these substances — a choice that without proper clinical supervision and dosages could exacerbate preexisting mental health disorder symptoms instead of alleviating them. Other people may simply believe that using these substances is unlikely to be harmful. Still other people may use this information to push for legalization and commercialization, a move that has had catastrophic effects for many people negatively affected by cannabis legalization.”

The Foundry Treatment Center Steamboat Men’s Program provides comprehensive, Trauma-Integrated Care to men experiencing substance use and co-occurring mental health disorders. The program’s virtual Intensive Outpatient Program treats adults throughout Colorado. For more information call (844) 955-1066.

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This article discusses suicide. If you or someone you know is at risk of suicide, please call the Suicide and Crisis Lifeline at 988. The previous National Suicide Prevention Lifeline at 1-800-273-8255 is also still available. 

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Colorado’s Rural Communities Offer Stark Evidence of Factors Reducing the Nation’s Life Expectancy

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US life expectancy dropped for the second consecutive year in 2021, falling by nearly a year from 2020, according to government data released in August.

In 2019, someone born in America had a life expectancy of almost 79 years. In 2020, the first year of the COVID-19 pandemic, that dropped to 77 years. Last year, the life span dropped again—to 76.1 years. 

Life expectancy estimates the average number of years a baby born in a given year might expect to live, given death rates at that time. It is “the most fundamental indicator of population health in this country,” Robert Hummer, a University of North Carolina researcher focused on population health patterns, told the Associated Press. 

Officials of the Centers for Disease Control and Prevention (CDC) blamed COVID for about half the decline in 2021, a year when vaccinations became widely available, but new coronavirus variants caused waves of hospitalizations and deaths. Other longstanding problems were major contributors as well, though: drug overdoses, heart disease, suicide, and chronic liver disease. 

According to the CDC release, the decline “between 2020 and 2021 was primarily due to increases in mortality due to COVID-19 (50.0 percent of the negative contribution), unintentional injuries (15.9 percent), heart disease (4.1 percent), chronic liver disease and cirrhosis (3.0 percent), and suicide (2.1).” 

“This is the biggest two-year decline—2.7 years in total—in almost 100 years,” reported Kate Sheridan on Stat News. “The COVID-19 pandemic is the primary cause of the decline. However, increases in the number of people dying from overdoses and accidents are also a significant factor.”

A large percentage of the cases of chronic liver disease is caused by alcohol misuse and alcohol use disorder, and a lot of the unintentional injuries are really drug overdose deaths; the increase in suicides is driven by trauma, depression, anxiety, and substance misuse. 

Provisional data from CDC’s National Center for Health Statistics indicate there were an estimated 107,622 drug overdose deaths in the United States in 2021, an increase of nearly 15 percent from the 93,655 deaths estimated for 2020 which in turn amounted to a 29 percent increase over 2019. As recently as 2014, the number of overdose deaths in the US was 47,055. 

COVID-19 may have exacerbated the decline in US life expectancy in the past two years, but the downtrend started quite some time before the pandemic. For decades, US life expectancy was on the upswing. But, as the AP reported in July 2021, that trend stalled in 2015, for several years, before hitting 78 years, ten months in 2019. A person born in Canada could expect to live 82 years in 2019. The life expectancy in Japan was 84 years three years ago. 

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Deaths of Despair

Years before the emergence of the COVID pandemic, Princeton economists Anne Case and Angus Deaton suggested in a 2015 paper and a subsequent book that working-age white men and women without four-year college degrees were dying “deaths of despair” by suicide, drug overdoses, and alcohol-related liver disease at unprecedented rates. 

In a review of the book, Carlos Lozada noted, “even before the coronavirus struck, America was suffering an eviscerating epidemic. Its cause was not a virus; its spread could not be blamed on foreign travelers or college kids on spring break. No masks or gloves could slow its contagion, no vaccine could prevent new cases.”

Although Case and Deaton completed their book before the onset of the COVID pandemic, Lozada found that their diagnosis was “painfully relevant.” 

“The debate over how quickly to ease social distancing restrictions and get the economy moving again forces a reckoning: How do we balance the risk of increased coronavirus infections if we reopen the economy too soon against the risk of more deaths of despair if we do so too late?”

Some researchers observed as early as July 2020 that the unfolding COVID pandemic and the existing addiction epidemic in the US would converge into a “perfect storm”:

“Given the COVID-19 pandemic, tackling the alcohol and substance use disorder crisis may be even more problematic because, as in a perfect storm, a combination of elements serves to worsen the already complex clinical conditions of patients with these disorders. The consequences of this storm may spread long after the pandemic is resolved and may affect a large proportion of the population, beyond individuals with current alcohol and substance use disorders.”

The CDC data show that men were hit harder by this perfect storm: While the decline in life expectancy for the male population due to unintentional injuries was 19.1 percent, it was 14.8 percent for females; in chronic liver disease and cirrhosis, it was 3.4 percent for males versus 2.4 percent for females.

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Colorado’s Rural Communities Especially Hard-Hit

Colorado has some of the nation’s highest rates of substance use disorders and age-adjusted suicides, according to the Centers for Disease Control and Prevention (CDC). Research from the Colorado Health Institute suggests that untreated mental health conditions, stigma and structural racism, prevalent alcohol and marijuana use, and firearm ownership rates are some of the leading factors contributing to Colorado’s suicide and behavioral health problems. Another recent study points to financial insecurity and economic disparity, lacking infrastructure and federal support resources, and perceived breakdowns in community connectedness and family systems as leading causes of “diseases of despair” in rural and urban communities. 

In rural communities throughout Colorado, the problems represented by statistics and data points in research studies can be seen in the real lives of people suffering their effects. 

During recent visits with community workers and care providers in Cedaredge, Grand Junction, Telluride, Hotchkiss, Paonia, Delta, Ridgway, and Durango, Foundry Steamboat team members Amanda Buckner and Amber King heard harrowing reports of staggeringly high rates of substance use disorder and suicide — two neighboring towns reporting ten suicides in just one week. They were told about how many of the people in these communities feel isolated and distant from one another and have limited access to high-paying jobs and healthcare resources. Native American people in these communities, like Native American people throughout the US, continue to suffer myriad and disproportionate socioeconomic problems that contribute to addiction, mental health disorders, and suicide. 

Problematic ideas about addictive disorders also seem to be a common issue embedded in the cultures of some rural Colorado communities. “I grew up and live in a rural Colorado town, and I hear the same misperceptions perpetuated there today. The belief that using substances, especially alcohol, is fine as long as someone is able to function and has a house to live in,” says Amanda Buckner, Foundry Steamboat Community Outreach Manager. “For many families in these areas, substance use has become normalized, even encouraged, within the family system and passes for acceptable behavior. In too many cases, this leads to people self-medicating underlying mental health issues with substances instead of recognizing that they have a problem and seeking treatment."

Amber King, who also grew up in a rural Colorado town, cites the lack of access to a continuum of care in rural communities. “Most people who need help in these communities are hours away from the levels of care and specialized providers they need. They have few financial resources and lack family and peer support needed for people to feel comfortable and safe seeking help.” Challenges unique to rural communities can also prevent people from acknowledging that they are experiencing mental health problems or seeking care. “These towns can be very tight-knit communities with some families going back generations. Residents may know more about the lives of their neighbors than people who live in larger cities, and this lack of perceived anonymity can make it hard for people to feel safe getting help. This issue especially affects first responders, physicians, and other professionals who live in and serve these towns, who perceive a need to maintain a local reputation. When you believe that the people you interact with every day know what’s happening in your life, it can be hard to admit that you have a problem and ask for help,” says King. 

Foundry Steamboat is establishing close and regular ties with rural communities to facilitate connections between caregivers and make it easier for individuals and families to talk about mental and behavioral health problems. Foundry Steamboat team members are hosting ongoing virtual meetings where mental health professionals, community leaders, school officials, and others responsible for the mental health and wellbeing of rural communities can discuss needs, share resource information, and find camaraderie and understanding. Through these efforts, Foundry Steamboat hopes to play a positive role in helping to dispel the stigma surrounding mental health and substance use disorders, expand resources for rural communities, and break down the barriers that make it harder for people to seek treatment and find recovery.

If you are recovering from a substance use disorder or even just considering getting help, a good therapist should be part of your foreseeable future. Substance use issues are rarely just about drugs and alcohol. They are almost always embedded in a nest of trauma, mental health issues, dysfunctional relationships, and other unhealthy behaviors.

Just trying to abstain from drugs or alcohol without addressing these other issues is difficult and typically short-lived. If you have been through a treatment program already, finding a good therapist is an excellent way to stay on track and work on applying the lessons of treatment to real-life challenges.

Even if you don’t see your therapist regularly at some point, it’s helpful to have someone to call when things get tough. However, the task of choosing a therapist is not that simple. If you live in a mid-sized city, there are likely hundreds of options. And now that more therapists are holding remote sessions, you have even more choices. The following are some ways you can find a therapist you like.

Ask for Recommendations

Asking for recommendations is a good place to start. There are several ways to go about this. Probably the single best way is to ask a therapist. Therapists know each other, know what their colleagues specialize in, know their treatment styles and personalities and, most importantly, know who to avoid.

The best situation is if you have a friend or relative who is a therapist because they know you and can better match you to someone you might work well with. However, if that’s not an option, you probably know someone who is in therapy.

If they like their therapist, you might contact them and ask for recommendations or have your friend ask. You might even consider seeing your friend’s therapist. It doesn’t hurt to put them on the list. Keep in mind, though, that therapists have rules about conflicts of interest, so your relationship to the person will affect whether you can see the same therapist.

Another possibility is to ask your doctor for a recommendation. This has the particular advantage of allowing you to describe your needs in some detail without worrying about confidentiality. However, it’s also important to make sure your doctor’s recommendation is based on personal knowledge and they’re not just picking a name off a list. When asking for recommendations, always ask for two or three names so you have some options.

See Who Your Insurance Covers

If you’re paying out of pocket, this isn’t quite as important, but if you’re relying on insurance to pay at least some of the cost of therapy, then this will narrow down your options to some degree, depending on your insurance. If you can afford it, it might be worth it to pay out of pocket even if you do have insurance. That way, you’ll be making your decision based on who you really think is best, not based on who is willing to accept your insurer’s rates.

Look Online

There are several online listings of therapists. The most comprehensive is on the Psychology Today website. There, you can narrow down your choices by location, issues, type of therapy, insurance, and other factors.

Not everyone is listed in these directories but you can usually find several strong candidates. Their profiles often link to their professional websites so you can get more info. Do not look on Craigslist for a therapist.

Check Cut a Few Before Committing

It may be tempting to just commit to the first therapist who looks like a good fit. However, there is sometimes a huge difference between a good fit on paper and a good fit in person. Start by calling or emailing a few promising candidates.

See if you can do a 10 or 15-minute consultation. This should give you a pretty good idea if this is someone you feel comfortable talking to and has a therapeutic style you feel good about. Doing this over the phone instead of coming in for a whole session makes you feel less committed to a particular therapist.

Ask About Their Specialization and Experience

When you email, or during your initial consultation, be sure to ask about their background, their education, and their experience with your particular issues. Where they were educated is not nearly as important as their relevant experience. This is especially important because most people struggling with substance use issues will need a therapist who specializes in addiction and something else.

Most therapists will list depression and anxiety disorders among their areas of expertise, since these, by far, affect the most people. However, you should be able to get a sense of their specializations--whether they primarily treat children or adults, families or individuals, and specific issues like addiction, PTSD, sexual abuse, and so on. Beware of therapists who claim to be experts in everything.

Ask About Their Approach to Treatment

Different therapists have different treatment philosophies. Some are happy to use whatever works while others are more orthodox. Most therapists these days rely heavily on cognitive behavioral methods but there are still some practicing psychoanalysts. More therapists are now incorporating things like mediation, exercise, and healthy eating into their treatment.

Some have a more religious or spiritual bent while others pay close attention to the science. Ask open-ended questions like, “How would you describe your approach to treatment?” The more research you do beforehand, the better questions you can ask.

Ask About Price

If your insurance covers a therapist, ask about price anyway. Insurance is still very dodgy about covering mental health. Even if a therapist is in-network, you may end up having to pay for sessions exceeding a certain amount per year. In other words, in October, you might discover that your insurance has paid for all the sessions they’re going to pay for that year and you’re on your own for November and December.

Or your therapist may drop your insurance, meaning you have to pay out of pocket if you want to continue working with them. Either way, it’s best to know what it might cost you and decide accordingly. Often, therapists will work on a sliding scale, so ask about that before you decide you can’t afford to work with a particular therapist.

For some people, a good therapist is all they need to change their substance use habits. For others, a therapist can help them make the often difficult transition from treatment back to regular life. For anyone with co-occurring mental health issues, a good therapist is crucial for maintaining recovery. Ask for recommendations, do your research, ask questions, and take your time deciding. There are many good therapists out there but there might not be many good therapists for you. At The Foundry, we know that good mental health is the core of a strong recovery. That’s why we use a variety of evidence-based methods to help our clients address co-occurring mental health issues. To learn more, call us today at (844) 955-1066.

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Healthy eating is one of the key lifestyle changes that will support a strong recovery from addiction. There are many reasons healthier eating is important. One is that addiction and poor nutrition often go together, typically from neglect but also because alcohol impairs your digestive system’s ability to absorb nutrients. This malnutrition can have many negative health effects and should be corrected as soon as possible. 

Second, prolonged substance use increases your risk for a variety of medical problems, including heart disease, stroke, liver disease, diabetes, and certain kinds of cancers. Although you may not be able to fix these problems with a healthy diet, you can certainly reduce your risk. Finally, many studies have found that healthy eating reduces your risk of depression, which is a major driver of addictive behavior and affects about 20% of people with substance use disorders. 

Adopting a healthy diet can help you feel better, be healthier, and have a stronger recovery, but it’s also challenging to change long-standing eating habits. The following are some relatively easy ways you can improve your diet quickly.

1. Write Down What You Eat

First, it’s crucial to actually know what you’re eating. Our memories tend to be very selective about what we eat so spend a week or two recording everything you eat as you eat it. Either write it all down in a notebook or use an app like MyFitnessPal. The latter has the advantage of being more accurate and recording nutritional information automatically, and it’s free. You may be surprised to see what your eating habits are really like.

2. Make One Change at a Time

One mistake people often make is trying to completely overhaul their diet right away--maybe going totally whole-food plant-based or totally keto or something else. That’s a lot of work up front, you encounter a lot of friction from friends and family, and you’ll be lucky to make it a week using that strategy. 

Instead, focus on one small change at a time. There are two ways to approach this: You can either start by making an easy change and gradually make more challenging changes, which helps boost your confidence, or you can start with a change that will make the biggest difference in your health and mood. Say, for example, that after writing down everything you eat and drink, you realize you’re drinking more than two liters of Coke every day.

That’s nearly 800 empty calories and more than 42 grams of sugar, while the American Heart Association recommends no more than 36 grams of sugar a day for an adult male. Therefore, tackling that one habit is going to have huge benefits in terms of a better mood, less inflammation, and maintaining a healthy weight.

3. Make Healthy Substitutions

A common mistake people make when trying to quit any bad habit is to just try to stop doing it. This leaves a sort of void and it’s very easy to slip back into the old habit. A better approach is to replace the bad habit with a good or neutral habit. Changing food habits is no different. Leaving something off your plate is hard; replacing it with a healthier option is much easier. In the example above, maybe you habitually pour yourself a glass of Coke every time you sit down to eat.

There are many easy substitutions that are much healthier. Water or unsweetened iced tea would be ideal, but you could also go for flavored sparkling water, or even a soft drink with less sugar would be a step in the right direction. Unfortunately, fruit juice is often just as bad as soda in terms of sugar but a lot of people believe they’re choosing the healthier option. 

You can make many different kinds of easy substitutions in order to eat healthier. You can eat baked or grilled chicken instead of fried, get the vinaigrette dressing instead of ranch, and get the baked potato instead of fries. Substitutions--especially those that favor whole foods--are an easy way to eat healthier without feeling deprived.

Add One Vegetable

Another tactic that you can use by itself or in combination with substitution is to just add one vegetable to every meal. That way you’re increasing your fiber and nutrition while only adding a few calories to your meal. It works with anything. For example, which is healthier: a burger and fries or a burger and fries and a carrot? Obviously, it’s better to have meals composed entirely of healthy whole foods, but it’s also important not to let the perfect be the enemy of the good and an easy way to do that is just to add a serving of vegetables to every meal.

Learn to Cook One Easy Meal

There’s a lot of research showing that people who cook more meals at home are healthier and closer to their ideal weight. There are a number of reasons for this but perhaps the biggest is that commercial foods tend to have more sugar and fat than the equivalent foods you make at home. Unfortunately, most people don’t have a big culinary repertoire and they don’t have time to cook every meal.

Start by learning to cook one easy thing that you don’t mind eating frequently. For example, rice and beans are super easy and you can make one batch and eat it all week. Even a sandwich is fine if the ingredients are fresh and healthy. You can buy frozen vegetables and pop them in the microwave for a couple of minutes and they taste fine. Figure out a few easy go-to recipes. The more meals you make at home, the healthier you’ll be.

Follow the 80% Rule 

Finally, observe the 80% rule, which is that you should stop eating when you’re 80% full. It takes a few minutes for your stomach to signal your brain that it’s full because the hormonal signal has to diffuse through your body. As a result, by the time we feel full, we’re often overstuffed. You can eat only healthy foods and still make yourself unhealthy by eating too much of it. It’s easier to observe the 80% rule if you pause occasionally while you’re eating to let your food settle. This gives the “full” signal a chance to reach your brain.

At The Foundry, we know that healthy lifestyle changes make everything else in addiction recovery easier. That’s why we emphasize a healthy diet, as well as exercise, mindfulness, and social connection as part of our holistic approach to treatment. There are no shortcuts to living a healthy lifestyle, but we can get you off to the best possible start. To learn more, call us today at (844) 955-1066.

In a perfect world, once you realize you have a problem with drugs and alcohol and decide to quit, your friends, your family, and especially your significant other would all respect your struggle and quit drinking too, at least around you. However, reality is seldom so obliging. We live in a drinking culture where the majority of Americans and Europeans drink at least occasionally and often regularly.

For people who are capable of drinking moderately, that’s not a big deal but for you, it can be terribly frustrating trying to stay sober when the people around you are drinking. It can be especially challenging if your significant other continues drinking in your presence, especially early on. However, you will often find that in recovery you have to make the best of an imperfect situation and this is no different. If you are trying to stay sober and your partner still drinks, here are some tips for making the best of it.

Communicate

It’s crucial to communicate and not every couple is good or even competent at this. There are several reasons for this. First of all, you can hardly expect your partner to help you out if they don’t know what you need. Maybe you’ve said, “Hey, would you mind not drinking around me for, say, the next six months while I’m just getting started?” And they said, “Sorry, no,” and that was the end of it.

Maybe you just assumed they would quit drinking too but the thought never crossed their mind. Even if you did raise the issue and they said they wouldn’t quit drinking, there may be other ways they are willing to accommodate you but you have to learn to communicate to work these things out. You may even need couples therapy to work on communication in general.

The second reason communication is important is that poor communication leads to more conflicts, and frequently arguing with your significant other is one of the biggest ways to ratchet up your stress--one of the most powerful triggers of cravings. Learning to communicate better reduces stress and reduces cravings.

Know Your Triggers

It’s always important to know your triggers--the people, places, and things that cause drug and alcohol cravings. While there are some general things that tend to trigger cravings for most people--stress, for example--other cravings can be very specific, such as a friend you always used to drink with, a favorite bar, or even a particular holiday or anniversary.

The good news is that the more aware you are of your own specific cravings, the more information you can give your partner and the better you can work out effective compromises. Maybe one particular restaurant triggers cravings but another similar restaurant doesn’t. Maybe the smell of tequila triggers cravings but the smell of gin puts you off entirely. The more you are aware of these things, the more you can work around them.

Maintain Healthy Boundaries

As with communication, maintaining healthy boundaries is always important in a relationship and it’s especially important when you’re recovering from addiction. Simply put, healthy boundaries are when you respect your partner’s values and autonomy and they respect yours. So while it’s important to express your needs and ask them to help, it’s also important to realize that you ultimately can’t control what they do.

It’s also important to assert your own values and independence. It’s fairly common for people with substance use issues to get involved in codependent relationships, in which one person forsakes their own needs and desire to care for the other, which is bad for both partners. If boundaries are a problem for you, you may need couples therapy or you may even need to consider separating. 

Involve Them in Recovery

As noted above, it’s often a good idea to participate in couples therapy when communication or boundaries become a problem. Often, family therapy is even an integral part of addiction treatment programs. However, involving your significant other in recovery goes far beyond that. Many programs offer education sessions to help family members better assist their loved one’s recovery. Just having a better understanding of how addiction works and the roles family play can make them feel more engaged in the process and better able to help. They may also benefit from participating in a group like Al-Anon or Nar-Anon, which can help them better understand what you’re going through while also offering them some emotional support.

Move Things Around

One major challenge in having a partner who still drinks is if they want to keep alcohol in the house. While it’s better to keep alcohol and drugs out of the house entirely, you may be able to reach an acceptable compromise. For example, maybe they can keep their beer in a different fridge, perhaps in a room you don’t go into very often, so you aren’t confronted with a case of beer every time you want to make a sandwich.

Maybe they can drink something you’re not especially fond of, rather than your go-to drink. Perhaps there are other triggering items in the house that you could get rid of, put in storage, or put somewhere you’re less likely to see them. As discussed above, it all comes down to knowing your triggers and being able to communicate.

Make a Plan for Socializing

Home arrangements aren’t the only challenge. If you’re going out, especially with friends, you may have to strategize on how best to avoid triggers and temptations. For example, you might take separate cars, in case you want to leave early. You may prefer certain friends to others. You may decide that for some occasions, it would be better if you stayed home or did something else while your partner goes out. When you do go out together, it may be a good idea to remind your partner that they shouldn’t let you drink. Get them to promise, if necessary.

Remember That You’re Ultimately Responsible 

It would be great if your partner was completely committed to helping you stay sober and willing to do whatever it takes. Unfortunately, that’s not always the case, and even supportive partners don’t always know the right thing to do in every situation. The important thing to remember is that although support is nice, you are ultimately responsible for your own recovery. 

Life is often messy and sometimes you just have to weigh up all your competing motivations and make the best choice you can. It’s possible that your partner won’t stop drinking but is still, on balance, good for you and good for your recovery. Communicate your needs as well as you can, maintain healthy boundaries, and make strategic compromises, and most of the time, you should be able to stay sober, even if your partner drinks.

At The Foundry, we know that no one recovers from addiction alone. Having a strong sober network as well as a supportive partner are among the greatest assets you can have. Our program aims to involve the family in recovery as much as possible, providing both emotional support and educational opportunities for the people closest to our clients. For more information, call us today at (844) 955-1066. 

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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Hypnosis has been around for hundreds of years, and during that time, its reputation has periodically risen, fallen, and risen again. It has been used for everything from entertainment to battlefield surgery and some attribute to it near-magical abilities while others believe it’s pure nonsense. Using hypnosis to treat anything is generally based on the idea that if you can directly affect your subconscious mind in some way, you can dramatically change your experience of reality, whether you’re on stage believing you’re a chicken or undergoing surgery without pain. 

The idea that you could use this power to overcome addiction is tantalizing. Wouldn’t it be great, for example, if someone set a glass of beer in front of you and instead of feeling a powerful desire to chug it, you only felt bland indifference? This is the dream that has been sold to many people trying to overcome various substance use issues. As with many treatment methods, hypnosis appears to be a bit of a mixed bag. Here are some of the things hypnosis can and can’t do.

What Hypnosis Isn’t

First of all, hypnosis isn’t some kind of magic power. There’s no animal magnetism, as Franz Anton Mesmer--where the word “mesmerize” comes from--believed. There may not even be anything physically identifiable as a hypnotic state. No one can hypnotize you to do anything you don’t want to do, contrary to many Hollywood storylines.

Although the relaxed state you typically achieve in hypnosis may make it easier for you to recall certain memories, it’s not like opening a file on your computer. In fact, hypnotically retrieved memories are no longer admissible in court, following a disastrous spate of false accusations in the 1990s. Most importantly for our purposes, it’s very unlikely that hypnosis is like flipping a switch for major behavioral change, such as overcoming addiction.

What Hypnosis Is

Experts actually disagree about what exactly hypnosis is. As noted above, various studies have failed to identify a specific hypnotic state in the brain. To the extent that hypnosis works, it is typically by a combination of deep relaxation and subtle reframing. So, for example, the hypnotist may ask you to relax and just notice the weight of your body against the couch, which, of course, you can feel.

And don’t you also notice a warm feeling in your chest? Sure you do. And now it’s expanding outward. And your arms and hands, which are feeling warm and also heavy, and so on. In the context of a medical procedure, the hypnotist may describe an incision as a feeling of slight pressure, drawing your attention to the feeling as it is, rather than the frightful thought of your skin being cut. Much of hypnosis is just allowing yourself to be led into a certain way of thinking.

Some Studies Show Promise in Treating Addiction

We’re currently on an upswing in scientific interest in hypnosis and a number of studies have found some promising results in using hypnosis to treat addiction. For example, one small study found that treatment that included hypnosis for alcohol use disorder led to an impressive 77 percent sobriety rate after one year.  Another small study of people with opioid use disorder found that hypnosis helped all participants remain abstinent from all drugs for six months and 56 percent remained abstinent from heroin for two years. These were small preliminary studies but they suggest hypnosis may be a useful tool for addiction treatment.

Hypnosis May Enhance the Effect of Other Treatment Methods

In addition to treating addiction directly, hypnosis may be useful in addressing some of the factors that contribute to addiction. These typically include mental health issues, such as major depression, anxiety, bipolar disorder, and others, trauma, and dysfunctional relationships--in addition to genetic factors, which, unfortunately, we’re stuck with for the moment. Insofar as hypnosis can help improve these issues, it can help your chances of long-term recovery success too.

Hypnosis Can Help With Mental Health Issues

At least half of people with substance use issues also have some kind of co-occurring mental health issue. Addiction and mental illness each make the other worse and they must be treated simultaneously. Hypnosis may be useful in conjunction with other therapeutic methods. As noted above, hypnosis is really a skillful way of managing your attention through subtle suggestion and reframing.

In a way, this is what your therapist is trying to accomplish anyway. For example, a therapist using CBT might help you reframe a situation by bringing to your attention your irrational beliefs about the situation. Hypnosis can be used as an extension of this process.

Hypnosis May Help You Manage Pain

Many people develop substance use issues because they are taking opioids for chronic pain. This puts them in a bind because they are afraid quitting opioids will leave them defenseless against the pain. However, there are other ways of treating chronic pain, and hypnosis may play a part. Pain feels real and undeniable, but it’s actually complex and somewhat ephemeral.

It depends to some extent on our expectations and how we think about pain. In this regard, hypnosis can be helpful. As noted above, hypnosis has been used in battlefield medicine and its use for surgery is pretty well established. If it can help you through surgery, it can help with chronic pain. Just relieving some of your distress about pain can make the pain less intense and make it easier to give up your reliance on pain medication.

Not Everyone Is Equally Susceptible to Hypnosis

Finally, it’s important to note that not everyone is equally susceptible to hypnosis. We all fall somewhere on a spectrum from highly-hypnotizable to not at all hypnotizable, and so far, researchers have no idea why some people can be hypnotized and others can’t. This clearly will affect whether hypnosis can play a part in your recovery.

While this seems like a clear strike against hypnosis as a treatment methodology, it’s important to understand that the same applies to pretty much every treatment method. SSRI medications, for example, only work for about 40 to 60 percent of people with depression, but they remain an effective tool in the kit, and perhaps something similar is true of hypnosis.

Hypnosis isn’t magic and it won’t cause major behavioral changes overnight, but it is an adjunct treatment method with some scientific backing. If you’re interested in trying hypnosis as part of therapy or addiction treatment, look for a therapist or addiction counselor with real training in hypnotherapy, ideally, one certified by the American Society of Clinical Hypnosis, or ASCH.

At The Foundry, we understand that addiction is a complex problem that requires individualized solutions. We bring a number of evidence-based practices to the table to help our clients. These include CBT, DBT, EMDR, family therapy, lifestyle changes, and more. For more information about our approach to addiction treatment, call us at (844) 955-1066. 

Exercise is one of the most important lifestyle habits to adopt when you’re recovering from addiction. There’s a lot of research showing that regular exercise reduces stress and anxiety, improves mood, and reduces relapse risk. Exercise also helps reduce some of the physical health risks of excessive drinking and drug use. Adopting even a moderate exercise regimen, such as walking for 20 minutes a day should definitely be part of your recovery plan.

However, some people find that exercise makes them feel worse--typically more anxious but sometimes depressed as well. If you’ve tried adopting an exercise habit and find that you feel worse, here are some possible reasons.

You’re Relying Only on Exercise

With all the media coverage of the wonderful ways exercise benefits your mental health, a lot of people get the idea that exercise is all you need to deal with a mental health issue. However, mental health is about more than mood. Your thinking, your external circumstances, and even your brain chemistry all play a role as well.

You’re not likely to have any kind of strong recovery if you don’t look at the whole picture. That’s why exercise should be just one part of a recovery plan that includes therapy and possibly medication and other lifestyle changes.

You’re Prone to Panic Attacks

If you have a panic disorder, exercise is a bit of a gambit. On the one hand, exercise is probably the best thing you can do for yourself. It reduces your reactivity to stress and improves your mood. It’s also a great way to desensitize yourself to the physical sensations of panic.

When you exercise, you feel physiological stress similar to anxiety, but you know it’s just a normal response to exertion. However, if you push too hard, you may actually trigger a panic attack because your heart is beating too fast, you’re having trouble catching your breath, and so on. Typically, the best thing to do is back off and just push yourself a little bit at a time.

Get your heart rate up for a few minutes, then take a break for a few minutes. Remind yourself that what you’re feeling is normal. It might help to have some soothing music handy to calm you down during the rest intervals. Gradually build the challenge by pushing yourself a little bit, then resting and calming down. 

You’re Going Too Hard

Most people getting into exercise for the first time tend to overdo it. They’ve seen too many training montages and Nike commercials and they think they have to exhaust themselves during every workout. Excessively-long endurance workouts are especially bad for raising the stress hormone cortisol and they may actually disrupt your sleep, further compounding your anxiety.

At the other end, you may be overdoing high-intensity exercise such as heavy lifting or high-intensity interval training--HIIT--by cramming too many workouts into a week. These kinds of workouts take more time to recover from and you may end up feeling worn down, depressed, or anxious. There is a saying in fitness circles: Volume, frequency, intensity--pick one. 

More to the point, you don’t have to exhaust yourself every workout. In fact, when you’re first starting out, it’s far more important to create the habit, which means making your workout as easy as possible. Once you’re in the habit of exercising most days, you can gradually make it harder.

Also, you can get a lot of benefits from even moderate exercise, such as walking 20 or 30 minutes a day. Instead of trying to train like a pro, take the opposite approach and ask yourself how little you can do and still get some benefit. As you get in better shape, that minimum will gradually increase.

You Need to Give It More Time

A lot of people, especially in January, start exercising, then give up after a week or two. They don’t see results and they just feel tired all the time. As discussed above, the first thing is to make sure you’re not going too hard, but rather focusing on establishing a regular and sustainable habit. The second thing is to give it a bit of time. Every change is uncomfortable at first.

You have to squeeze a new activity into your day, you have to use more energy than you’re used to, and you’ll probably feel a bit sore for the first week or so. Many people notice an improvement in their mood and sleep pretty quickly, but if you don’t, try to stick with exercising for at least a month before you give it up.

You’re Exercising at the Wrong Time of Day

Time of day can make a big difference. For example, if your body doesn’t regulate blood sugar well, working out before breakfast may be especially miserable. At the other end, exercising too close to bedtime may increase your cortisol and make it harder to sleep, which increases your anxiety. Everyone is different so the important thing is to try some different things and figure out what time of day works best for you. 

You’re Doing the Wrong Exercise

Most research on exercise and mental health has focused on moderate aerobic exercise. The typical recommendation is at least 20 minutes of moderately intense aerobic exercise, such as running, biking, or swimming. Weightlifting typically doesn’t have quite as strong an effect on mental health, although several studies show it does help.

However, as noted, we’re all different and we all respond differently to different kinds of exercise. Research may show that aerobic exercise is best, but plenty of people have put many miles on their running shoes to no avail. Then they give it up and start lifting instead and feel like someone flipped a switch on their mood. Listen to your body. If one kind of exercise makes you feel more anxious and another kind calms you down, do the latter. There’s no right or wrong here.

You’re Exercising in the Wrong Environment

Finally, consider the environment where you exercise. If you run along a busy and dangerous street, you’re going to feel more anxious about it than if you run on a treadmill or in a nice park. If you feel like people are staring at you and judging you every time you walk into the gym, you are likely to feel self-conscious and anxious.

Typically, no one in the gym is worried about what you’re doing so make sure you don’t have distorted beliefs about the situation but it is important that you’re exercising in an environment where you feel safe and accepted.

Exercise is one of the best things you can do for your physical and mental health and some level of regular exercise should be part of every addiction recovery plan. When exercise makes you anxious or depressed, the most common issue is overdoing it. It’s also important to listen to your body and make exercise decisions based on your own needs.

At The Foundry, we know that exercise is one of the most important lifestyle changes you can make when you’re recovering from a substance use disorder. We help you make exercise a regular part of your life in a way that’s fun and promotes social connection. To learn more, call us today at (844) 955-1066.

Season’s greetings from the Foundry clinical team! In a recent conversation with a friend, he asked me to pick my favorite holiday. I quickly responded, “New Year’s Day!” My answer comes from my annual practice of taking time to reflect on the past twelve months. Within that process, I stop to take stock of our program's wins, losses, and lessons learned.

What jumps out at me is how much our program has evolved and grown since the start of the year. Every aspect of our program has been assessed and updated:

• We have clarified our developmental model that more consistently allows clients to focus on addiction recovery, while simultaneously addressing issues of safety, autonomic nervous system dysregulation, and resolution of active trauma symptoms. Within this process, clients focus on connecting to others, trust, and attunement to needs that enhance their likelihood of embracing the fellowship of 12 step and other social support networks.
• We have expanded our trauma awareness and clinical focus to include work across the trauma continuum. This expansion allows us to help clients who are struggling with PTSD, Developmental/Complex Trauma, and the Primary and Secondary trauma that is experienced by family members.
• We have expanded our use of EMDR to include the DeTUR model for reducing the impact of addiction triggers and cravings. We have also introduced Brainspotting, somatic psychotherapy, and John Bruna’s Mindfulness in Recovery program.
• We made improvements to our Partial-Hospital (PHP), which has grown to include an 8 bed, community-based sober living unit, where participants live in a townhouse in Steamboat Springs and receive clinical services at the Ranch. Each participant is able to maintain their relationship with their primary therapist and continue to work on developmentally appropriate treatment plan objectives.
• We also improved the Equine Therapy Program so that it is now fully on-sight and provided to all participants in our Residential and PHP levels of care.

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2020 will be another year of growth and development for the Foundry clinical program. We are currently developing a 90-day trauma integrated addiction program and a new multidisciplinary family program. The 90 days program will provide participants with increased integration as they move through various levels of care and into increased community participation. The family program will incorporate onsite service, in conjunction with remote educational and clinical activities that will be provided via computer. This integrated family program will allow us to promote family healing for the families of all of our clients, whether they are in Steamboat Springs, the Front Range, or across the country!

We want to thank all of our friends and referral resources for their support and the confidence that you have shown in our staff and clinical program throughout 2019! We hope that 2020 is a great year for you and for everyone who gives so much to the clients and families that we serve!

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

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

Before We Even Have the Conversation

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

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

Time to Have a Hard Talk

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

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

Listen to what they are saying.

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

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

Come to a Solution

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

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

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

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We’ve all heard clichés like “alcohol kills brain cells” or “drugs fry your brain.” Watching someone who’s under the influence of drugs and alcohol, few of us are inclined to doubt it. However, the idea that a period of heavy substance use can leave you mentally damaged for life is also terribly discouraging. If you’ve struggled with drugs and alcohol, the following can give you some idea of how that might have affected your brain.

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Most effects are temporary.

First of all, the vast majority of effects from most drugs only last as long as the drugs are in your system. If you drink too much, you can sleep it off. The next day or two might be rough, but you’ll be okay before long. Our bodies are pretty good at maintaining equilibrium, so individual episodes of drinking or drug use typically won’t have lasting effects except perhaps in extreme circumstances, like an overdose. It turns out that the anti-drug scare tactics of the 1980s and 1990s largely backfired, so it’s not a good idea to overstate the dangers of isolated drinking or drug use. It’s worth noting, however, that substance use does have a larger effect on the developing brain and people who experiment with drugs and alcohol at a younger age are more likely to have substance use issues later in life.

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It may take months for your brain chemistry to rebalance.

A bigger concern than isolated use is developing a tolerance, which is another way of saying developing a dependence. This is when your body is so used to the presence of drugs and alcohol that it compensates in order to bring you back to equilibrium. Once you’ve developed a dependence, you need drugs or alcohol in your system to feel normal — and when you quit, you will probably notice some emotional and cognitive effects.

Exactly what those are depends on what substance you’ve recently quit. If you’ve quit drinking, you’re likely to experience irritability and insomnia. If you’ve quit cocaine, you’re likely to feel lethargic and unable to focus. While the effects of the drugs themselves might wear off pretty quickly, the effects of withdrawal might hang around for a while. Acute withdrawal typically only lasts about a week or two, but many people experience post-acute withdrawal syndrome, or PAWS. Symptoms of PAWS often include emotional numbness, depression, trouble concentrating, and lack of motivation. These are thought to be caused by changes in your brain’s dopamine system, which is related to motivation, reward, and goal-seeking behavior. This typically lasts a few months, but some people report symptoms lasting up to 18 months.

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The long-term effects of addiction aren’t entirely clear.

There’s still quite a bit of discussion in the scientific community over whether addiction permanently changes your brain. We know that addiction does appear to cause some structural changes in your brain. As noted above, some of the most important changes have to do with the dopamine system. The dopamine system is designed to reward behaviors that keep us alive and help the species propagate. However, drugs and alcohol can throw this system into overdrive — especially among people with the right genetic predisposition.

This overclocking of the dopamine system has downstream effects, too. In your prefrontal cortex, there’s a region that becomes sensitized to stimuli that might lead to substance use. We call these stimuli “triggers,” and they are a direct result of the dopamine system realigning your brain’s priorities.

There is also a region of the prefrontal cortex that is primarily in charge of inhibiting behaviors — a sort of mental brake — and this region becomes weaker as addiction progresses. The result is that after a certain period of addiction, you have a brain that is completely bored with anything other than substance use, is extremely sensitive to the possibility of substance use, and is less able to inhibit behavior related to substance use.

Much of the debate around this subject relates to whether this structural change can go back to normal. It’s possible that some people’s brains were never “normal” to begin with. As noted above, there’s research showing that some brains are just wired to respond more strongly to drugs and alcohol. However, we do know that the dopamine system will gradually respond more normally to other stimuli over time and that the prefrontal cortex can change its structure in a matter of weeks using techniques like mindfulness meditation. In other words, we don’t know for sure whether your brain can ever return to some pristine, pre-addiction state, but it can certainly get much better.

Damage from long-term, heavy use may be permanent.

There are a few cases where brain damage from substance use may be permanent. Inhalants, for example, are extremely damaging to the brain. There’s also a condition called stimulant psychosis, which is usually temporary but may be permanent in a small percentage of cases. Korsakoff syndrome, also called “wet brain,” is typically caused by decades of heavy drinking and results in severe memory impairment, confabulation, and apathy. Probably the most common concern in terms of mental impairment is early-onset dementia. A large study¹ of more than a million patients in France found that alcohol use disorder was the single biggest cause of early-onset dementia.

Brains are more resilient than we used to think.

The good news for anyone recovering from addiction is that our brains are extremely adaptable and resilient. Even people who have had strokes that would have been debilitating 20 years ago are able to regain much of their original function. As recently as ten years ago, most neuroscientists believed the adult brain didn’t create new neurons, but now we know it does and that exercise promotes this function. In general, our brains will typically figure out a way to do what we repeatedly ask them to do and new methods and technologies can help them heal even faster.

It’s normal to worry that maybe you’ve abused your brain so much that it will never work quite right again. In some cases, your brain might have undergone some permanent changes, but our brains change anyway, whether we’ve struggled with substance use or not. The important thing to know is that brains are adaptable and they can always get better. At The Foundry, we use a variety of evidence-based methods to help our clients heal and create better lives. To learn more, explore our website or call us today at 1-844-955-1066.

In recent decades, meditation — especially mindfulness meditation — has gone from a sort of fringe practice to the mainstream. Workers practice mindfulness to boost their productivity and reduce stress, and mental health professionals regularly incorporate it into their treatment methodologies. Mindfulness is an integral part of dialectical behavioral therapy, or DBT, a method of therapy used to treat tough conditions like borderline personality disorder, eating disorders, and suicidal depression. Mindfulness can help people cope with physical pain and emotional distress.

It can give them insight into their thinking and behavior. While mindfulness is frequently in the media, there are many persistent misconceptions about it. This is partly due to conflicting information and partly due to people conflating mindfulness with other forms of meditation. Here are some popular misconceptions about mindfulness.

“Mindfulness means having no thoughts.”

Perhaps the biggest misconception about mindfulness and meditation in general is that the goal is to empty your mind entirely. This may even sound pretty appealing. If you struggle with any mental health issue, you may feel like your thoughts are constantly attacking you and you would welcome even a temporary break from your own mental chatter. Unfortunately, mindfulness doesn’t work that way. For one thing, stopping your thoughts is nearly impossible. Thinking is what your brain does.

For another thing, flipping the “off” switch is not necessarily the best way to deal with painful thoughts and emotions. On the contrary, sometimes the best thing you can do for yourself is to become more aware of your thoughts and emotions. This way, you can better distinguish between challenging emotions and you have more insight into how thoughts and emotions are connected. Our most challenging emotions are often caused by irrational thoughts. Seeing your mental life more clearly is a big asset in therapy.

Finally, while mindfulness meditation doesn’t stop your thoughts, it does change your relationship to your thoughts. We tend to take our own thoughts far too seriously. In reality, thoughts are sort of like guesses about the world. Instead of reacting to them as if they are all true, we should ask whether they are true. Mindfulness helps you take a more realistic view of your own thoughts.

“Mindfulness means blissing out.”

While there are forms of meditation that are intended to help you cultivate certain states of mind — including bliss — mindfulness is not one of them. The problem with blissing out is that at some point, you have to come back. In that way, you would be substituting the escapism of drugs and alcohol with the escapism of mediation.

Mindfulness is rather about cultivating awareness and acceptance. Research shows that people who are more accepting of their negative emotions are less likely to suffer difficulties like depression as a result of emotional stress.  

“Mindfulness makes you passive.”

One criticism of mindfulness you often hear is that it makes you passive. Since the whole point is to let go of attachments, be less judgmental of yourself and others, and be more accepting of situations beyond your control, it’s easy to make the mistake of thinking that you might become inert or willing to accept bad things that you might be able to change.

However, that’s not quite how mindfulness works. There’s a difference, for example, between being judgmental and having judgment. The former is a sort of ego-reinforcing exercise and the latter is a form of discernment. Often, our behavior and emotional reactions result from years of habit and conditioning and we aren’t even aware of it.

This is perhaps nowhere more obvious than in addiction. Mindfulness allows you to distinguish between what you really want for yourself and others instead of allowing yourself to keep going on autopilot, which is really far more passive.

“Mindfulness is just a way to relax.”

If you look at a group of people practicing mindfulness meditation, it probably seems very peaceful. They’re all sitting there quietly, relaxed, perhaps with their eyes closed. Indeed, mindfulness meditation can be quite relaxing and practice even begins with some deliberate relaxation. Even if mindfulness meditation were just a way of relaxing for 30 minutes a day, you would probably still get a lot of benefit from it.

However, there is far more to it than that. As discussed above, mindfulness is more about becoming aware and accepting whatever is going on in your mind. This is quite often the opposite of relaxing and can be quite intense. When your defenses are relaxed, troubling thoughts, emotions, and memories might come up, in which case, the last thing you are thinking about is relaxing.

This is a space where you can experience these things and learn not to be afraid of them. This is also why it’s typically a good idea to learn mindfulness meditation under the guidance of a trained instructor or therapist, who can help you out when troubling emotions and memories arise.

Mindfulness is just something to do when you feel like it.

Finally, a lot of people seem to have the idea that mindfulness meditation is something you do intermittently as needed, the way you might take the occasional mental health day off work or bathe your dog. To get the most out of mindfulness meditation, you need to practice every day, even if it’s just for a few minutes. Our brains are highly adaptable, but they only change through persistent effort.

Occasional meditation might be a nice thing to do on a hike or after a stressful week, but it won’t change your relation to your thoughts. The real value of mindfulness is being more aware and less reactive, and that takes consistent effort, especially on the days when you don’t feel like it.

Mindfulness is everywhere these days, but it is often mischaracterized and therefore generally misunderstood by the public. Mindfulness isn’t thoughtless, blissing out, or passivity. Nor is it a panacea for everything wrong in your life. It can help you become more aware of what’s going on around you and inside your own head, making it great for addiction recovery because it can improve your relationships and make you more aware of the connections between your thoughts, feelings, and behaviors. At The Foundry, mindfulness is one of several modalities we use to help our clients break their dependence on drugs and alcohol. To learn more about our program, call us today at (844) 955-1066 or explore our website.

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Opioids and prescriptions are taking over the streets and suburbs. Prescription pill dependency is at an all-time high everywhere, with suburban areas being hit hardest in recent years. Opioid overdoses are also increasing, with a high rate of deaths amongst young adults and women. These demographics were less prevalent in the past years, concerning overdoses.

Still, these populations are hit harder than ever with increased rates of prescription medications flooding the marketplace (and homes). Understanding why prescription pill dependency hits the suburbs hardest and how to support a loved one who may be struggling with a substance use disorder can save a life.

Poverty and Substance Use

There has always been a consensus, historically, that poverty drives substance use. People in poverty are more likely to become addicted, for various reasons. Prescription pill use does not discriminate. Across all demographics, people have struggled with opioid substance use.

There are areas and pockets of poverty that struggle more than people in suburban areas, but it is also better hidden. People in financially robust regions and in more affluent neighborhoods are more likely to be functionally addicted. Poverty does not have as much to do with how many people become addicted as it does any other aspect of someone’s life like career or hobbies.

People from all walks of life are getting addicted to substances and need help. Effective substance use programs are the best at supporting people as they walk through treatment and seek help for a substance use disorder. To better understand the geography of growing substance use and overdoses, it is essential to look at all factors and assess the best ways to address the crisis.

Suburban Versus Rural Crisis

One of the reasons substance abuse has hit suburbia so hard is that it remained hidden for a long time. Suburban counties in the metro area have seen a rise in people addicted to prescriptions. Economically struggling places are still being ravaged by the opioid crisis, but there is a reason the conversation has highlighted economic distress and instability as a factor driving “deaths of despair.”

Among high-poverty counties, there has been an increased rate of people dying from overdoses. Counties that are poor, or remain poor, are seeing higher than average overdose deaths in their areas. Counties that have lower poverty rates are also seeing an uptick in people dying from overdoses. Not everyone is going to die from a substance overdose. In fact, many people remain addicted to prescriptions for a long time and never experience an overdose.

The vast majority of counties have no registered substance use nonprofits, including areas where poverty is higher. Rural areas are going to be less resourced in general as people have been moving to cities and suburbs for many years. The suburbs have not been immune to the ravages of the substance crisis.

Putting it All Together

Widespread substance use in these communities has led to more discussion about how the intersection of substance use disorders and suburban life has unfolded. The impact it has on community structure, individuals, and families is shocking. The need to find services to address this issue is widely noted and is appearing in the news more frequently.

In suburban areas, mothers, wives, daughters, husbands, and sons are all struggling under the weight of prescription addiction. There is nobody immune to the effects. Those struggling with substance use disorders feel they have nowhere to go. Often, high-functioning substance use disorders are harder to give up because people struggle to admit they need help.

They are afraid of what it might look like to give up the substance use disorder. Substance use service providers working in rural and suburban areas rely on different services and things to help them connect to recovery programs. The key is to find supportive networks that will help them navigate resources so they can stay healthy and clean for a long time to come.

Combating Substance Use

The best way to combat substance use in suburban areas is to ask for help. Families of loved ones need to be educated on what is available, what to ask for, and how to ask for help. Unless families and loved ones step out in faith to ask for help, it will continue to be an issue that hides in plain sight. Medical doctors are wary now of over-prescribing prescriptions, so they are creating a space for people to use other medications where needed.

National efforts help stem the flow of substances that are taking lives across the United States. Networks of families and friends affected are meeting to connect over their grief, loss, pain, and struggle while offering hope to others. The best way to move forward from this substance use disorder crisis is to seek supportive services in the area. Ask for help from loved ones and find the right treatment center, which includes treatment, detox, and recovery services long after treatment ends.

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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I'm Taking a Walk

"I'm taking a walk. I'm going outside.” John Prine

I learned the value of taking a walk at a young age. As a teenager, when I was having a hard time, I would climb the small hill behind our house and sit on a rock. The view from up there shifted my perspective. Everything looked different, smaller — the houses, the cars, the animals, the people, and most of all, my problems. Impossible situations that weighed heavy on my mind just a few moments earlier seemed to shrink in comparison to a much bigger picture. The further I walked, the more distant the chatter of my mind became, and like the music playing on the stereo of a passing car, the noise faded further and further away.  

"A walk in nature walks the soul back home."  Mary Davis

It's still the same. Today, when I go for a walk, the fog in my head clears, and I began to notice other things, like the sound of my feet crunching the ice crystals as I walk on the frozen ground. I hear myself exhale as I breathe deeper and release the tension I didn't realize I was holding. I feel my heart as it beats against my chest and pumps blood throughout my body, bringing a new awareness to some of the everyday miracles that I take for granted. What starts as a simple walk suddenly transforms into a treasure hunt filled with tiny details — an experience that awakens all of the senses.

Taking a walk is not a matter of exercise, although that is a side benefit. For me, taking a walk is about being kind to my body and my mind. It's giving myself a gift loaded with meaning — something different, something fun, something better. I walk to discover, and the world outside never disappoints. The rewards are bountiful — an inward sense of peace, a fresh perspective, an idea, or a sign assuring me that I am not alone. I always come back feeling better about life. After all, Mother Earth is the essence of abundance.  

Most days, when I return, my partner asks, "What did you find?" Once, I came home with a story about the stump from a fallen tree. It looked just like a water bowl. My Great Pyrenees, Snow, thought so too. She lapped up the clear water as if it had been left there just for her. Another time, I found two giant Lion's Mane mushrooms, which still amazes me. I took them home and made delicious faux crab cakes. Sometimes I find a feather, or a rock, or the bones of an animal. Recently, out of the corner of my eye, I caught the brief glimpse of an owl flying between trees. Owls have specialized feathers that enable near-silent flight. Today I saw a buzzard. It was just what I needed to see, a timely message to let me know everything is okay. A buzzard is a type of vulture. It cleans things up. As old habits and beliefs come to the surface in my life, I realize it's time to get rid of the things that no longer serve me, the old decaying stuff. Sometimes I stand for a few minutes and soak in the warmth of the sun or listen to the sound of rain gently falling through the trees. Taking a walk infuses my life with meaning in more ways than I can count.

"In every walk with nature, one receives far more than he seeks."  John Muir

The ever-changing world of nature is a teacher that reminds me to be amazed and to notice — the earth I walk on, the expansiveness of the sky where the stars, the moon, and the sun exist, where the birds and airplanes fly, and the trees reach. It also reminds me that we are all connected, and every living thing plays an integral part, including me.

"When we reconnect with Nature there are measurable positive impacts on our physical, psychological, and spiritual health. Cultivating reverence for Nature and our place in it can profoundly change our lives."  Dr. Peter Borton

Perspective is everything. Taking a walk offers a different view, like stepping out from behind the curtain and realizing there is an even bigger show going on outside. These days, I have an agreement with myself to watch the sunrise and sunset every day. Unless I climb to the top of the hill, the trees around my house are too tall for a clear view of the sunrise, so instead, I look west and watch as the sun softly illuminates the land. I also try to pause a moment and look up whenever I walk out the door or get out of the car (I don't want to miss something extraordinary because I was too busy looking down at my phone.) Stop, look, and listen. Those words I learned as a child before crossing the street are still relevant today.

"I hope you still feel small when you stand beside the ocean."  

from I Hope You Dance written by Mark D. Sanders and Tia Sillers

Most of all, when I take a walk, I feel smaller, like a tiny pebble in the stream. I have a renewed sense of gratitude, knowing that I don't have to do this thing called life alone. I am supported, nourished, and nurtured by a world that is alive. Nature also grants me a sense of wholeness and belonging — knowing I am a part of something much bigger and infinite. Some days, I want to stay in that sacred space forever, but I know that I can't, I have things to do. However, if there is one thing I am sure of, taking a walk does wonders for my mental health. It makes me feel better, and life doesn't seem to be as hard.

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Trisha Leone Sandora

http://www.trishaleone.com/

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In recent years, the media has paid a lot more attention to issues related to addiction and treatment because of the opioid crisis. Despite this increase in attention, many myths and misconceptions about addiction, treatment, and recovery persist. These misconceptions can stand in the way of people getting the help they need. The following are some of the more common misconceptions around addiction treatment.

“You have to hit rock bottom before treatment will work.”

One of the most persistent myths about treatment and recovery is that you have to hit rock bottom before you can recover from a substance use disorder. The biggest problem with this myth is that there’s no guarantee someone will hit bottom before they die of an accident or overdose. In 2018, more than 67,000 people died from drug overdoses, and each year, about 88,000 people die from alcohol-related causes.

While a rock-bottom moment may help convince someone to get treatment, it’s not the only thing that can. For example, about 120,000 people go through drug courts each year and those who do are far less likely to reoffend than people who just go to jail; indicating that treatment can be effective even if you don’t really want to go. What’s more, interventions are typically successful at getting people into treatment if they’re led by experienced interventionists. The truth is that most people who enter treatment are ambivalent about getting sober and they typically feel more motivated as treatment progresses.

“Treatment is for rich people.”

With so many news stories about celebrities going to rehab, it’s easy to associate addiction treatment — especially residential treatment — with the rich and famous. In reality, even inpatient treatment is more affordable than most people realize. In fact, the less luxurious treatment centers often offer better value, since more of your money goes to treatment rather than amenities.

Beyond that, there is a spectrum of care for addiction, starting with counseling or other outpatient services on one end and inpatient treatment on the other. Most people can afford some level of treatment, especially now that there are more ways than ever to pay for treatment. Most insurance companies will pay for at least a portion of treatment, and the recent SUPPORT Act has made more federal money available for treatment. Before you assume treatment is out of reach, call a few programs and see if they can help you pay for it.

“All you really need is detox.”

Since detox is the first really big barrier many people see standing between them and sobriety, they assume that if they could just get past that, then the rest of recovery will be easy. However, that’s typically not the case. Most people’s addictive behavior is driven by something else, such as a mental health issue or trauma. Until these are resolved or brought under control, any attempt at recovery is likely to be difficult and short.

A strong recovery typically entails addressing any mental health issues, creating healthy lifestyle changes, and connecting with a strong sober network. A good treatment program can help you get a good start on these tasks in a short time.

“If treatment didn’t work the first time, it won’t work the second — or third — time.”

Addiction is a chronic condition, and it often takes years of trying before recovery finally sticks. According to the National Institute on Drug Abuse, between 40 and 60 percent of people who get treatment for a substance use disorder relapse within the first year. However, just because treatment didn’t stick in the past doesn’t mean it won’t in the future.

While it may feel like you have to start over after a relapse, you’re actually starting from a better position than you did the first time. You are already familiar with the recovery process, you probably have some kind of sober network, and you have some new mistakes to learn from.

What’s more, not all treatment programs are the same. If you didn’t succeed with treatment in the past, it could be the program wasn’t great or it wasn’t well suited to your needs. You might do better in a different program. Or, if you liked the program, you might benefit from spending more time there. You have not failed until you give up.

“You can’t get treatment when you have a job or family to worry about.”

A lot of people feel like they can’t get addiction treatment because they have family or work obligations and they can’t just drop everything. While you do have to put life on hold to some extent to enter inpatient treatment, it is worth it for some people. If that’s just not possible, there are treatment options that allow you to live at home and work while still getting treatment — there are mutual-aid programs like AA and NA, you can talk to a therapist, you can get outpatient services, or you can enter an intensive outpatient program. Most treatment options don’t actually require you to go live in the facility for 30 to 90 days. Find a treatment option that works for you.

“After treatment, your addiction is cured.”

Too often, people assume that once they go through treatment, they’re set for life. Unfortunately, it doesn’t work that way. As noted above, addiction is a chronic condition that most people will have to manage for life. Treatment is a great way to get away from an unhealthy situation, learn some crucial recovery skills, start treating any mental health issues, begin creating some healthy lifestyle habits, and forming social connections.

The first challenge comes after you leave, since many people have trouble making the transition back to regular life. This is why follow-up care, stepping down in treatment intensity, finding a local 12-Step meeting, and possibly even arranging a sober-living situation are often helpful for making the progress you made during treatment carry over into regular life.

There are many misconceptions about addiction treatment; those mentioned above are among the most common. Overcoming addiction is complicated and personal. There is no one-size-fits-all, and it often takes years of persistent effort for recovery to last. At The Foundry, we know that a lot goes into a strong recovery. We use multiple modalities to provide individualized care. For more information about our treatment options, call us today at (844) 955-1066 or explore our website.

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Trauma is one of the most common drivers of addictive behavior. Although identifying trauma can be complicated--as we’ll see--research suggests it plays a major role in developing substance use disorders. For example, one study found that 66% of women with an opioid use disorder also reported sexual abuse and various studies have found that between 20% and 50% of people seeking help for a substance use disorder also have symptoms of PTSD.

That’s why identifying and treating trauma is crucial for a strong recovery from a substance use disorder. Unfortunately, there are many misconceptions about trauma that contribute to the stigma and prevent people from getting the help they need. The following are some common misconceptions about trauma.

1. “Trauma Is Life-Threatening”

We tend to think of trauma as something that might kill us--combat, a serious car accident, an armed robbery, and so on. However, trauma is fairly subjective. Consider two potentially traumatic events: a serious car accident and a divorce. The car accident is typically more life-threatening but a divorce can deprive you of your family, your sense of belonging, a lot of your money and security, and even your sense of self-worth. All of this might have more profound long-term consequences for your life and sense of well-being. Therefore, it’s not necessarily true that just because you haven’t been shot at, beaten, or otherwise physically threatened, that you haven’t experienced trauma.

2. “People Who Experience Trauma Usually Get PTSD”

Awareness of PTSD has gradually spread following the Vietnam War. The US Department of Veterans Affairs estimates that about 30% of Vietnam War veterans developed PTSD at some point in their lives--a really astronomical number, considering the number is estimated to be less than 20% even for Iraq War veterans. However, conditions for Vietnam veterans were especially bad.

Draftees were disproportionately drawn from disadvantaged backgrounds, sometimes choosing military service to avoid prison time, they were often ordered to harm civilians or were required to harm civilians in self-defense, and they received little support upon their return home. All of these factors have been shown to increase the risk of developing PTSD. 

Among the general public, the odds that trauma will develop into PTSD are much lower. Although about 60% of men and 50% of women will experience trauma at some point in their lives, fewer than eight percent of Americans will ever develop PTSD. The severity of the trauma, a history of abuse or mental health issues, and lack of social support all increase your risk of developing PTSD following a traumatic event.

3. “Trauma Only Affects the Weak”

Given that trauma develops into PTSD only rarely, one might draw the conclusion that trauma only affects the weak. While some people are more vulnerable to trauma than others, “weakness” is not the right word for that vulnerability. As noted above, the severity of the trauma, history of mental health issues, and social support are all important factors, none of which you have much control over. A severe enough trauma will affect pretty much anyone and you have no control over a history of mental health issues. 

Research suggests that high trait neuroticism might also increase your risk of developing PTSD, as well as other mental health issues. You might even say it takes more strength for someone with high neuroticism to weather adversity and seek help than it does for someone who just isn’t too bothered by anything. Besides, the history books are full of people who did heroic things and later suffered from PTSD. Audie Murphy, for example, won literally every US military award for heroism during WWII but struggled with PTSD and alcohol use for the rest of his life. 

Furthermore, the fact that social support is a strong mitigating factor shows that we all need help sometimes, whether it’s from a therapist or from supportive friends, family, and colleagues. Your environment makes a big difference and what separates a “strong” and a “weak” person might be nothing more than the social support they enjoy. 

4. “Trauma Is Inherently Bad”

We tend to think of trauma as a bad thing. No one wants to be threatened, raped, beaten, shot at, divorced, or nearly killed in an accident. We avoid these things whenever possible. The immediate effects of these kinds of incidents are almost always bad--pain, shame, anxiety, depression, and so on. However, in the long term, it is possible to bounce back from trauma better than before.

While post-traumatic stress disorder gets most of the attention, there is also such a thing as post-traumatic growth. Just surviving a traumatic experience can be a source of strength because you feel like if you can survive that, you can survive anything. For example, many Civil Rights leaders survived assassination attempts, which only strengthened their determination.

It’s easy to imagine giving up in the face of credible death threats, but in these cases, the result was the opposite. That kind of growth is available to anyone who has experienced trauma. If you are able to learn from it, to gain a sense of purpose, to strengthen your connection to the people who are most important to you, and so on, trauma can be put to good use.

5. “You Will Suffer from Trauma for the Rest of Your Life”

The usual model of trauma is that we imagine being damaged physically or psychologically and carrying that damage the rest of our lives. It’s true that some kinds of trauma will change your life permanently, that some events leave scars. However, it doesn’t mean that you have to live less of a life. Even people who experienced childhood trauma or severe trauma can overcome it and even grow when they get the right help. There has been a lot of progress treating trauma in recent decades, which means trauma isn’t typically something that you have to suffer with for the rest of your life. 

At The Foundry, we understand that trauma plays a major role in substance use disorders. That’s why we use many different approaches to help our clients heal from trauma as part of our comprehensive approach to addiction treatment. Our methods include cognitive behavioral therapy, or CBT, dialectical behavioral therapy, or DBT, eye movement desensitization and reprocessing therapy, or EMDR, Alpha-Stim, family therapy, and others. To learn more, call us at (844) 955-1066.

There is a common pattern you may have noticed in people who have recently quit drinking: They start eating a lot of sugary snacks. They’re always munching on chocolate, candy, or pastries. Although it’s common for people to lose weight when they quit drinking, people who pick up this habit might actually gain weight instead. Here’s a brief look at why this happens, why it’s bad, and what you can do about it.

Why It Happens:

1. Hypoglycemia

Many people aren’t aware that hypoglycemia--or low blood sugar--is extremely common among people with alcohol use disorder. Symptoms of hypoglycemia include irregular or fast heartbeat, pale skin, shakiness, anxiety, sweating, hunger, and irritability. Severe hypoglycemia may cause confusion, abnormal behavior, blurry vision, seizures, and loss of consciousness. Some of these may look familiar since they are also symptoms of alcohol withdrawal and hypoglycemia may easily be mistaken for protracted withdrawal symptoms.

There appear to be several reasons why heavy drinking causes hypoglycemia. First, the liver plays an important role in regulating blood sugar by storing and releasing glycogen. Alcohol impairs the liver’s ability to release glycogen, so this method of regulation becomes less effective. Simultaneously, alcohol changes the patterns of blood flow in the pancreas, increasing insulin production, which lowers blood sugar. These complementary effects are compounded by the high sugar content of many alcoholic drinks--particularly beer, which people often forget has a lot of sugar--which also causes an increase in insulin. 

People suffering from low blood sugar typically try to fix it in the quickest way possible: eating sweets. They aren’t always aware of what they’re doing. Often, they just learn unconsciously that sweet snacks relieve their symptoms and it soon becomes a habit.

2. Low Dopamine

Another reason many people develop a sugar habit after they quit drinking is that it can replace some of the dopamine boost they lost when they quit drinking. Our dopamine system exists in order to reinforce survival behaviors like eating and having sex but drugs and alcohol overclock that system so that it mainly seeks drugs and alcohol. Normal sorts of stimulating behavior become dull by comparison.

However, sugary foods give you a little more dopamine bang for your buck than other foods. People who experience protracted depression or emotional numbness in the early days of sobriety might find a bit of relief from eating sweets. 

Why It’s Bad:

In one sense, swapping alcohol for sweets sounds like a pretty good bargain. Sweets can make you fat and ruin your teeth but alcohol can ruin your life. While that’s true to a certain degree, there are some good reasons why replacing alcohol with candy is not a sustainable strategy.

1. Inflammation

First, refined sugar is a highly inflammatory food and inflammation is gaining attention as a major cause of a variety of problems, including mental health issues, medical problems, and even addiction itself. Inflammation is the body’s natural response to injury or infection. It helps destroy pathogens that make us sick. It also triggers other adaptations that are designed to aid the body in fighting infection and prevent spreading disease. These adaptations include pain to immobilize an injured area, lethargy to help us conserve energy, fever to kill microbes, and social isolation to prevent it from spreading. 

You may recognize lethargy and isolation as symptoms of depression, and in fact, recent research has found that as many as half of depression cases can be attributed to chronic inflammation. Depression is also a common driver of addictive behavior and must be treated and managed for recovery to last. Research also shows that a diet low in sugar and other inflammatory foods like processed meats and vegetable oils also reduce your risk of depression. 

2. Health Risks

As noted above, inflammation is increasingly being identified as a mechanism behind many health problems. For example, why should it be the case that obesity increases your risk of heart disease? Part of the answer appears to be that fat cells release inflammatory compounds and chronic inflammation leads to problems such as heart disease. That means two things: First, inflammatory foods such as sugar can directly increase your health risks, even if you otherwise lead a relatively healthy lifestyle and aren’t overweight.

Second, excessive sugar consumption can lead to obesity, which can cause health problems. A lot of the health risks of prolonged heavy drinking--heart disease, high blood pressure, increased risk of stroke, diabetes, some cancers, and so on--are compounded by obesity. While making the switch from alcohol to sweets certainly buys you time, some of your long-term health risks will be similar.

What to Do:

1. See Your Doctor

If you think your blood sugar is out of whack, the first thing to do is see your doctor. Your body and especially your brain need sugar to function so hypoglycemia is a serious matter. You want to be sure there isn’t some underlying medical issue causing your low blood sugar. 

2. Fix Your Diet

Most of the time, low blood sugar or blood sugar swings are caused by poor diet. You feel a bit faint so you eat a candy bar, which boosts your blood sugar temporarily, but then you crash again and need more sugar, so you’re always on this blood sugar rollercoaster. 

You can normally sort this out by reducing your sugar intake as much as possible--it’s nearly impossible to eliminate sugar completely, unless you make all of your own meals from scratch--and eating foods that are high in fiber and protein, such as vegetables, whole grains, nuts, beans, and legumes. These slow your digestion and ensure a more steady supply of carbs to your system.

If you must have something sweet, choose fruit. The fiber will fill you up and slow the absorption of sugar. Also, keep in mind that it may take a while for your body to adapt to the absence of alcohol in your system but you should start feeling better after a relatively short time on a healthy diet. 

At The Foundry, we understand that healthy eating is one of the best lifestyle changes you can make to support a strong recovery. Our program emphasizes good nutrition and an active lifestyle, which boosts your energy and mood, as well as healing your body. To learn more about our program, call us today at (844) 955-1066.

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

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

You see you’re not alone.

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

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

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

Groups provide social support.

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

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

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

You get different perspectives.

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

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

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

Group is a better approximation of life.

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

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

You improve your social skills.

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

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

It’s more cost-effective.

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

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

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

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When people with an alcohol use disorder decide to quit drinking, there’s usually one big reason. Maybe they lost their job because of their drinking, their spouse threatened to leave and take the kids, or they ended up in a drug court with a choice between getting help or going to prison.

Even if you do have one big reason for quitting, there are many less important — but still pretty nice — benefits that come with it. Whether you have a serious problem with alcohol or you feel like you could just use a break from alcohol, the following are some of the good things that happen once you quit.

You sleep better.

A lot of people assume alcohol helps you sleep better, but really the opposite is true. Alcohol helps you fall asleep more easily, but it also prevents you from reaching deep, restorative sleep.

When you’ve been drinking, you spend more time in the shallow parts of the sleep cycle, especially REM sleep, which is why you tend to remember your dreams more. After the first few hours, your sleep becomes disrupted as the alcohol is metabolized and your body starts to experience the rebound effect, which typically results in increased anxiety.

Typically, people find they sleep better pretty quickly after they stop drinking. They feel more rested because they sleep more deeply and sleep all night instead of waking up frequently in the early morning hours. If you’re getting sober after a serious addiction, it may take weeks or months for your sleep patterns to return to normal, but it will happen eventually.

You feel better.

If you drink a lot, it might be that you only feel good or even normal for a short period when you’ve had a certain amount to drink. The rest of the time, you may be hungover, sleep deprived, or in the early stages of withdrawal.

If you’re a very heavy drinker, you may be feeling some health effects such as lack of energy from malnutrition, frequent illnesses, or even problems resulting from heart or liver disease.

When you quit drinking, you may temporarily feel worse while you’re going through withdrawal, but then you’ll start to feel much better in general. You won’t be hungover or starting withdrawal and you’ll have more energy because you’re digesting your food better and sleeping more deeply.

You think better.

Obviously, no one is mentally sharp while drunk but the cognitive effects of drinking tend to persist even when you’re not drinking. One reason is alcohol’s effect on sleep.

When you’re not sleeping deeply and running a chronic sleep deficit, your brain doesn’t work as well. Research shows that sleep deprivation and sleep deficit lead to cognitive impairments, including poorer working memory, poorer concentration, poorer long-term memory, and worse decision making.

Poor sleep also interferes with memory consolidation, so if you’re in school or trying to learn new skills, drinking will make it harder. When you quit drinking, you will probably notice your head feels clearer even if it takes a while for your sleep to get back to normal.

You lose weight.

Most people find they lose weight pretty quickly once they stop drinking. Alcohol has a lot of empty calories, which add up fast, even if you’re only having a few drinks a night.

For example, a can of beer has about 150 calories, so you could easily drink an extra 600 calories a night — about a quarter of the daily caloric needs for an average male — without even reaching the threshold for binge drinking. Not only that, but alcohol boosts estrogen production in both men and women, making it harder to metabolize fat.

As a result, many people are surprised to find that they lose weight when they stop drinking, even if they aren’t trying. It should be noted though, that some people actually gain weight. It’s not uncommon for people to start eating a lot of sweets when they quit drinking, which quickly leads to weight gain.

You look younger.

You’re probably aware that alcohol is a diuretic, meaning it extracts water from your body. That’s why you pee so much when you drink — you actually discharge more liquid than you consume. This has a number of effects, but the most apparent is its effect on your skin.

When your skin dries out, it becomes less elastic. As a result, you might look older and more wrinkled after just one night of heavy drinking.

If you drink often, the effect is compounded. However, once you quit drinking, you start looking younger pretty quickly. Your body wants to be adequately hydrated, so it will hold on to that water once you stop messing with your system.

You have more free time.

Most people are not aware of how much time drinking consumes until they quit. Heavy drinkers often block off time specifically to drink, which means they aren’t doing other things with that time.

Alcohol also distorts your perception of time, especially when you start missing chunks due to blacking out. What’s more, alcohol often makes people and activities seem more interesting than they really are. When people quit drinking, they suddenly find they have a lot of free time on their hands they can use to spend time with people they care about, engage in new hobbies, read, get things done, or whatever else they want to do.

A lot of good things happen when you quit drinking. The benefits described above are only the ones you might notice pretty quickly and don’t even include many of the health or relationship benefits that will become apparent with time. At The Foundry, we know that recovering from drug and alcohol addiction is about far more than just abstinence; it’s about becoming free to live the life you want to live. To learn more about our treatment programs, call us today at 1-844-955-1066 or explore our website.

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What fills your cup?!

I recently read an article about getting rid of toxic things in your life.  It made me think about what ACTUALLY fills my cup. And, on the flip side, what drains it.  A few things that have filled my cup recently:  sunshine, tea date with Aloha, trying a new Pilates class, ice cream with Theo, the gang back together, my sister’s smile, watching Kara get her first muscle-up, a side country hike with the boys, an extra workout with Jaime.  And the list goes on…

People ask me ALL the time why I do CrossFit.  There are more than one hundred reasons why but the single unparalleled authentic reason, is the family, the community, the squad.  This is what keeps everyone coming back for more.  Sure, you look fantastic, you feel amazing, you can pull cars off of small children, you can do hundreds of push-ups and pull-ups, you accomplish new things every day, youPR, you try new things, you become better at the things you do outside the gym, and you have one hell of family that would do just about anything for you.

So, my challenge to YOU this month is to search high and low for what fills YOUR cup, big or small.  It could be a morning meditation or an afternoon dog walk.  It could be a random act of kindness or a phone call to your mother.  I suggest surrounding yourself with like-minded people and get rid of the ones that drain you.  Replace the negative with positive.  And, by filling your cup first, you can be abetter person, friend, spouse, co-worker, parent to those around you.

Here are a few tips to help you fill your cup, and in turn, fill someone else’s:

1.      Take care of yourself-Eat well, sweat daily, get good sleep, and have a glass of water every once in a while.  Find the things that make YOU feel healthy and do them!  This will allow to show up better in your every day.

2.   Say no-Stop saying yes will when you REALLY mean no.  Go with your gut instinct and stick to your decision.

3.   Try something new-You will be amazed at how great you feel by the challenge, the accomplishment, and the “good” hurt.  Plus, change is good, right?!

4.   Meet up with a friend and have a genuine face-to-face conversation-I can’t begin to tell you how simple this seems and how hard it is to schedule. Just do it.  Make the time.  It is WAY worth it.

5.   Get outside-It is a funky time of year no doubt but make yourself get at least a few moments of fresh airEVERYDAY.  It is like a breath of fresh air…. HA!    You will feel instantly full.

Stop and smell the roses. Don’t worry be happy.  Stay present.  Say thank you.  Look around you, find the simple joys in life, and remember that if it doesn’t fill your cup, dump it.  Happy Spring.

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Alpha-Stim is a powerful treatment tool to help individuals achieve recovery and relieve pain, anxiety, depression and insomnia - all without the use of medication.

These challenging symptoms, which present additional obstacles to those entering recovery, are  controlled by the the billions of different cells that comprise the body’s central nervous system. With every sensation, these cells communicate by conducting electrochemical signals between the your body and brain.

A clinically proven medical device, Alpha-Stim treats the body at the electron level by changing the electrical and chemical activity of certain nerve cells in the brainstem. By transmitting a unique electrical waveform to modulate the cells’ signals, cells are returned to baseline, normal functioning. No pain or discomfort is experienced while using Alpha-Stim.

In essence, the Alpha-Stim focuses on achieving equilibrium in the “alpha” state of your brain, which can be measured and monitored on an electroencephalogram recording.

In a healthy alpha state, stress-effects are reduced, as well as agitation. A patient’s mood is more stabilized, and the ability to regulation sensation and perception of particular types of pain are improved.

When treating anxiety, insomnia, and depression, a current is applied with easy-to-use clips attached to the ear lobes for at least 20 minutes several times per week, or on an as-needed basis. Anxiety is reduced immediately while insomnia and depression may require up to three weeks to see a significant change.

When treating pain with the Alpha-Stim, two wands or attachable electrodes are placed directly at the site of the pain. A microcurrent waveform signals the cells to immediately and significantly reduce the sensation of pain. Results can be felt instantaneously.

Whether you are treating anxiety, depression, insomnia or pain, a pleasant and relaxed feeling of well-being will be experienced. I have seen Alpha-Stim help countless people reduce the discomfort and pain that is common in the first stages of recovery. This treatment is available to all participants during a residential treatment stay.

Rudy Spector is a Registered Nurse at The Foundry Treatment Center Steamboat, a rehab and substance abuse treatment center in Colorado. She takes pride in helping those achieve recovery and is a firm believer in the healthy benefits of outdoor activities. She has been a resident of Steamboat Springs since 2000 and enjoys spending time with her husband and 4-year-old daughter.

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Addiction recovery isn’t just about abstaining from drugs and alcohol; it’s much bigger than that. Recovery is about living a healthier, more fulfilling life. It’s about creating a general sense of well-being so you don’t want to use drugs or alcohol. That’s why healthy lifestyle changes are such a crucial part of treatment and recovery. The body and mind are one unit and what’s good for one is good for the other.

Among many positive lifestyle changes you will make in recovery, one of the best may be spending more time in nature. Our modern lifestyles keep us safe and comfortable indoors but we’ve lost a lot in the bargain. Nature can be a source of calm, joy, and wonder. Spending more time outdoors can benefit your recovery in the following ways.

Nature Is Good for Your Mental Health

Mental health is part of the equation for most people recovering from a substance use disorder. According to the National Institute on Drug Abuse, at least half of people with a substance use disorder also have a co-occurring mental health issue, such as major depression, anxiety, bipolar disorder, borderline personality disorder, and others. While these issues require professional therapy, spending time outdoors can help tip the odds in your favor.

Many studies have found that spending time in nature benefits your mental health, but one large Danish study is especially noteworthy. Because the Danish health system tracks the health of all of its residents from birth, this particular study was able to gather a huge sample of mental health data--in fact, they gathered mental health data from every citizen born between 1985 and 2003. The researchers then compared this data to satellite images that showed which citizens lived in greener areas.

The results were striking. The team looked at 16 different mental health issues and found that people who grew up in greener areas had a lower risk of 14 of the 16 conditions. Children who grew up in more urban settings had between 15 and 55 percent higher risk of developing mental health issues, depending on the specific issue.

Nature Promotes Exercise

One positive aspect of spending more time in nature is that it promotes exercise. Exercise is another crucial aspect of living a healthier lifestyle. Its many benefits include reduced stress, better mood, improved memory, better concentration, better cardiovascular health, healthier body weight, and better overall health. There is even relatively new research suggesting that exercise helps reduce relapse rates among people with substance use issues.

Unfortunately, not everyone loves exercise, especially in its modern form. Too often, we think of exercise as grinding away useless miles on a treadmill or stationary bike or pumping out reps on some sweaty weight machine. It’s no wonder the prospect of making exercise part of your day is less than thrilling.

However, exercising in nature is different; it was what we evolved to do. For example, hiking across varied terrain through changing scenery is both healthier and more enjoyable than mechanical forms of exercise. What’s more, there are so many ways to be active in nature--hiking, rowing, rock climbing, biking, and pretty much anything else you can think of. Whether you just want a calming walk or something more adventurous, there is an outdoor activity to suit your taste.

Nature Reduces Stress

One mechanism researchers frequently cite to explain nature’s positive effects on physical and mental health is its tendency to reduce stress. Chronic stress has many corrosive effects, including cardiovascular damage, digestive issues, poor immune function, anxiety, and depression and anything you do to relax between bouts of stress gives your body a chance to repair itself.

As discussed above, spending time in nature promotes physical activity--since you’re probably walking or biking, rather than driving--and that certainly helps reduce stress, but studies suggest that exercising in nature has an even greater stress-reducing effect. In a study conducted by Stanford researchers, participants were divided into two groups.

One group walked for 90 minutes in a park with trees, shrubs, and grass, while the other group walked for 90 minutes along a busy street. Both groups were given a series of tests including physical tests, brain scans, and questionnaires before and after the walk.

As it turned out, the group that had walked in the park had less activity in a part of the brain associated with rumination, the habit of obsessing over problems. Rumination has been linked to a greater risk of anxiety and depression. For some reason, walking in nature quiets the part of the brain that likes to stir up emotional trouble.

Nature Promotes Prosocial Behavior

Perhaps the most surprising effect of nature is that it can promote prosocial behavior. That may seem obvious if you’re camping with friends or doing other activities that require teamwork but spending time alone in nature can also make you more altruistic. This is because nature provides opportunities to experience awe--the sense of feeling overwhelmed by being in the presence of something greater than yourself.

A number of studies have found that experiences of awe, such as looking down from a mountain top or hiking through a redwood forest, can make us more sociable, less aggressive, more likely to help others, more likely to donate money, and more likely to behave ethically. These kinds of behaviors make you happier in general and they also help you find a sense of social connection, which is a crucial element of a strong recovery.

Spending time in nature can do us a lot of good. In addition to the benefits proven by scientific research, there is also something that is both soothing and restoring about the outdoors. At The Foundry, we understand the healing power of nature and we integrate many outdoor activities into our holistic treatment programs. To learn more about our treatment options, call us at (844) 955-1066.

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When you have a loved one with a substance use disorder, sometimes you get to a point where you’ve done all you can to encourage them to get help and all that’s left is to stage an intervention before it’s too late. If you do decide to stage an intervention, it’s essential to do it with the help of an intervention specialist, someone who has training and experience in running interventions.

There’s a lot more to it than just getting everyone together in a room and asking the person to get help and the specialist can help with the planning and facilitation. Everyone participating in the intervention will be asked to read an intervention letter. There are several reasons it’s important to write a letter rather than just making it up as you go.

First, an intervention is a form of public speaking with pretty high stakes and you don’t want to get stage fright and forget what you intended to say. On the other end of the spectrum, you also don’t want to start going off on tangents and taking up everyone else’s time. You want your remarks to be focused and effective. Finally, an intervention is an emotionally charged situation. You want to say what you have to say without getting drawn into arguments that might sabotage the whole process. The following are some tips to help make your intervention letter as effective as possible.‍

Start From a Place of Love and Support‍

First, make it clear that the reason you’re participating in the intervention is that you love the person, you’re worried about them, and you want to help them. None of you would be there if that weren’t true, but your loved one might not see it that way. Their defenses will probably be up and you’ll want to do what you can to establish that you’re on the same side. It’s often a good idea to share a happy memory of the person or describe something about them or something they did for you that you’re genuinely grateful for.

Say That Addiction Is a Disease and Treatment Is Possible

The next thing is to make it clear that you see a clear difference between the way your loved one is really and how they act while in the grip of addiction. Make it clear that you understand addiction is a disease, that it’s not their fault, and that treatment is possible.

Describe Specific Times When Drugs and Alcohol Caused Problems

The main event of an intervention, the part we’re all familiar with, is when you describe the negative consequences drugs and alcohol have had on your loved one and the people they care about. This can easily turn into a laundry list but there are several important factors to keep in mind if you want your letter to make an impact. First, only describe events that you have firsthand knowledge of.

These should be things that affected you directly or that you personally witnessed. This helps to avoid credibility issues that may arise if you relied on secondhand accounts or rumors. Second, there is a room full of people waiting their turn to speak and they’ll probably cover those other incidents themselves. 

Next, be sure to stick to facts. Avoid generalizations, value judgments, and attributing motives to your loved one. Again, these all open the door to arguments and rationalizations. The idea of an intervention is that the accumulation of hard facts gradually becomes overwhelming and undeniable. Avoid statements like, “You’re always getting drunk and yelling at me and the kids.”

Instead, say something like, “The police have been called on us three times this year and all of those times, you had been drinking.” You might want to start by brainstorming all the ways drugs and alcohol have hurt your loved one and then narrow it down to three to five of the most potent incidents to include in your letter.

Ask Them to Accept Help

After you have described exactly what addiction has done to your loved one, as well as their friends and family, reiterate that you believe addiction is a disease, one that experience shows they can’t deal with alone and ask them to accept help. Affirm that they can’t keep going on like this but that life can get better with treatment.

State the Consequences of Not Accepting Help

An ultimatum is only advisable in a small percentage of cases. Your intervention specialist will determine whether you should include consequences for your loved one refusing help. However, if you do include an ultimatum, you have to be prepared to follow through.

If you’re telling your child, “If you don’t get help, I’m not going to keep paying for college and I’m not going to support you financially,” then you have to follow through, or else it will undermine any future efforts you make to persuade them to accept help. They’ll know your threats are empty and they can do what they want.

Get Feedback and Make Revisions

Finally, don’t be satisfied with the first draft of your letter. To paraphrase Hemingway, the first draft of everything is, well, not good. After you’ve written your first draft, put it away for a day or two, if possible, then read it aloud to yourself. This will make any mistakes or awkward phrases jump out at you. This is especially important because the ultimate purpose of the letter is for you to read it out loud, so make it easy on yourself. 

Next, show it to some people whose judgment you respect and see if they have any feedback. Don’t take criticism personally; keep in mind you’re all working together to try to help your loved one. Finally, make sure to get some feedback from your intervention specialist. Ideally, you will do a full rehearsal so you can all read your letters and get feedback, but at the very least, they should be able to read it over and give you suggestions. Keep in mind that this person has a lot of experience in interventions and has most likely been the subject of an intervention themself, so their feedback is especially valuable. 

An intervention led by an experienced specialist has a good chance of getting your loved one into treatment. You can do your part by writing a compelling letter and being a team player. Always write from a place of love and support and when discussing the consequences of your loved one’s substance use, stick to undeniable facts. 

It’s always hard to see a loved one struggle with a substance use disorder but life can get better. At The Foundry, we know that evidence-based treatment, healthy lifestyle changes, and family support are keys to a sustainable recovery from addiction. To learn more about our approach to treatment, call us at (844) 955-1066.

Ingredients

• 1 cup of peanut butter
• ¼ cup chopped dried fruits (raisins, apricots, dates, mangos, etc.)
• 1 cup of rolled oats
• ¼ cup dry coconut flakes 
• 1 Tablespoons of chia seeds
• 1 Tablespoon of flax seeds
• ¼ cup honey
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Instructions‍

These are super easy to make! You might have to add more or less oats to make the balls stick together!

• Start by mixing the peanut butter and honey together.
• Add the rest of the ingredients.
• Feel the mixture with your hands and see if it all sticks together, if the mixture does not stick together try adding more honey or peanut butter. If the mixture is too runny try adding more oats. 
• Once mixture is the right consistency, make it into bombs and put in the fridge.
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Notes

• Add whatever combination of dried fruits and nuts that you want!
• Add some chocolate chips!
• Add some cocoa powder to make Chocolate Bombs! 

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Self-awareness is the degree to which you are aware of your own tendencies, your strengths and weaknesses, your values, your interests, and how you respond to various situations. Self-awareness is the foundation of addiction recovery and good mental health in general. It is a key skill of emotional intelligence and is the basis for the other skills of self-regulation, motivation, empathy, and social skills. 

However, self-awareness is also deceptively difficult. We all assume we know ourselves well because we have unique access to our own thoughts, emotions, and personal history. While that is true, we are also constrained by biases, blindspots, and cognitive distortions. What’s more, it’s hard to understand ourselves when we don’t really know what it’s like to be anyone else. Despite these challenges, we can all improve our self-awareness and reap the benefits in addiction recovery and in life. Here’s how.

Therapy

The most direct route to greater self-awareness is therapy, both group and individual. Both can help you become more aware of your blind spots and biases. Individual therapy can help you dive deep into your personal history and explore your cognitive distortions. For example, if you have a habit of focusing on the negative or discounting the positive things about yourself, you may have an unfairly negative view of yourself and your abilities. Or perhaps you have unfair expectations of other people or the world in general. You may never even consider these possibilities without expert guidance. 

Group therapy can be especially helpful for increasing self-awareness since you can get many different perspectives on your problems. Perhaps most importantly, in group therapy, you learn to give and receive feedback and generally improve your communication skills. These can help improve your self-awareness outside of the therapeutic setting as well.

Asking for Feedback

As noted above, getting feedback from different people is a great way to improve your self-awareness. In the context of therapy, this is relatively easy since much of your therapist’s job is to help you in this regard and create a healthy environment for sharing in group therapy. However, outside of a therapeutic environment, soliciting feedback becomes more challenging.

The people who know us well and spend a lot of time around us, whether they are friends, relatives, coworkers, or romantic partners are often reluctant to be completely honest. It’s uncomfortable to hurt someone’s feelings--even with the best of intentions--and then have to live or work together. 

To get around this obstacle, you have to find ways to give them permission to be honest. This might start with choosing the right medium. For example, people typically find it easier to be honest over text or email than face-to-face. Also, make it clear that you are seeking honest feedback and not just testing them. You might also give them an opportunity to say something nice about you to offset the constructive feedback, something like, “What would you say is my greatest strength?

What is my greatest weakness?” Or, in a work environment, you might ask something like, “What’s one thing I could work on to most improve my performance?” People tend to feel more comfortable answering specific questions rather than making a judgment on you as a person. Just be sure you aren’t deliberately shielding yourself from the feedback you don’t want to hear.

Mindfulness Meditation

One way to improve your self-awareness on your own is to practice mindfulness meditation. This is a simple practice; just set aside 20 or 30 minutes a day, and during that time, try to remain present. You typically do this by paying attention to your breath, listening to ambient sounds, or feeling for sensations in your body.

Inevitably, thoughts and emotions will arise on their own and you can use these opportunities to practice observing them without judgment. So, for example, an unpleasant memory may suddenly come to mind. Instead of trying to ignore it or think of something else, you might try tracing the chain of associations that led to that memory.

Or you might pay attention to the emotions the memory evokes and ask yourself why you respond that way. The more you learn to accept your own thoughts and emotions, the more you will be aware of what's going on in your own mind.

Journaling

Journaling is another great way to improve self-awareness on your own. Part of the reason is that writing about what happens and how you feel about it helps you make connections that you might not notice otherwise. Just the act of writing about your feelings can change your brain in ways that make you more aware of your emotions. However, journaling can go far beyond that.

For example, just keeping an accurate and relatively detailed record of what you do all day can yield surprising insights into your behavior. If you’re skeptical, try estimating how much time you’ve spent on your phone today and then check it against your actual screen time in your phone’s settings. Writing is a way of keeping ourselves honest about what we’ve actually done, thought, and said.

Writing about what happens and how you feel about it will reveal a lot of patterns. Even if you never go back and read what you’ve written, you’ll probably notice you spend a lot of time worrying about your work situation or complaining about your parents, or whatever else.

Self-awareness is an ongoing project. Not only is it a big challenge in itself, but we are always changing and growing. Knowing yourself better requires that you make a consistent effort, keep an open mind, and learn to accept constructive criticism with equanimity. 

At The Foundry, we know that overcoming addiction isn’t just a matter of abstaining from drugs and alcohol; it’s a journey of self-discovery. We use proven methods such as dialectical behavioral therapy, group therapy, and mindfulness meditation to help our clients better understand themselves and live a fuller life. For more information, call us at (844) 955-1066.

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

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

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

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

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

12-Step Facilitation

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

Cognitive Behavioral Therapy

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

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

Motivational Interviewing

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

Family Behavior Therapy

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

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

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

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Borderline personality disorder (BPD) is a condition that massively increases your risk of addiction. One study estimates that about 78% of people with BPD will develop a substance use disorder at some point in their lives, compared to only about 8% of the general population. However, BPD is a fairly obscure disorder. Major depression and anxiety disorders, for example, are far more common and although there are many misconceptions related to those conditions, people generally understand what they’re about and probably know at least one person who has struggled with them. On the other hand, a condition like schizophrenia is far less common but the sometimes extraordinary symptoms attract a lot of attention. BPD, by contrast, is less well-known and the name doesn’t offer much insight either. Insofar as people know about it at all, they often assume it’s similar to bipolar disorder, which isn’t really accurate. The following is a brief look at BPD, what it is, how it affects your life, and how it’s treated.

Who Does BPD Affect?

Roughly 2.7% of adults have BPD. Although it is often associated with women--perhaps because of stereotypes involving hyperemotionality--BPD affects men and women about equally. The perception that BPD mainly affects women has likely led to it being under-diagnosed in men so it’s important to be aware that men have about equal risk. Symptoms also appear to be more severe in younger adults and often get milder with age.

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Risk Factors

BPD is currently not well understood but it appears that many of the risk factors that are relevant for other mental health issues are relevant for BPD as well. For example, there appears to be a genetic component, so if a close family member such as a parent or sibling has BPD, you are more likely to develop it at some point. Childhood environment appears to be another major risk factor as well, particularly any history of abuse or neglect. One central characteristic of BPD is an intense fear of abandonment, so any childhood trauma related to abandonment or neglect--either physical or emotional--may be particularly relevant.

Symptoms

The symptoms of BPD are mainly characterized by two factors: the intensity of emotions and all-or-nothing thinking. In other words, people with BPD tend to feel overwhelmed by their emotions, both positive and negative, and they have trouble coping with the complex gradations that characterize much of our emotional lives. This affects how they relate to themselves and others.

Unstable Sense of Identity

First, the difficulty dealing with emotional complexity, as discussed above, along with other factors make it hard for someone with BPD to form a stable and coherent sense of identity. Much of our identity comes from our relationships to others and if these associations are always fluctuating wildly, it’s hard to know where you stand. Your judgments of yourself are also subject to these kinds of fluctuations. And finally, if your emotional reactions to people, values, and ideas are always drastically changing, it’s hard to form a coherent sense of yourself and this can sometimes be extremely disorienting. 

Fear of Abandonment

As noted above, BPD is typically characterized by an extreme fear of abandonment. They may go to great lengths to avoid abandonment, either real or imagined. For example, they may escalate a relationship quickly or completely cut off contact suddenly if they are afraid they might be pushed away. However, like most people, those with BPD want to have stable, intimate, and meaningful relationships. The desire for close relationships and the fear of abandonment can create a lot of emotional stress.

Volatile Emotions

As discussed above, BPD is characterized both by very intense emotions and by all-or-nothing thinking. Therefore, to someone with BPD, someone or something may be either amazing or terrible, with little in between and these judgments may change from one day to the next. They often experience intense anger that they have trouble controlling. They may experience moods that are both intense and changeable and these moods may last hours or days. This is one reason BPD is sometimes mistaken for bipolar disorder, although bipolar episodes typically last something more on the order of weeks. 

Relationship Problems

Predictably, emotional volatility, intense anger, fear of abandonment, and an unstable sense of self often lead to relationship problems. Because people with BPD typically fear abandonment, they may adore someone one day and despise them the next for no apparent reason. Obviously, this can be confusing and stressful for the people in their lives. It also tends to confirm the worst fears of the person with BPD when the people they care about start to distance themselves because of this behavior.

Risky Behavior

Impulsiveness and risky behavior is another common characteristic of BPD, and it is especially common in those with a co-occurring substance use disorder. This might include excessive drug and alcohol use, unsafe sex, reckless driving, or spending sprees. This is another behavior that sometimes leads to BPD being confused with bipolar disorder since reckless behavior is also a common feature of manic episodes. Clearly, the mix of substance use with frequent feelings of intense anger and alienation puts someone at high risk for developing a substance use disorder.

Treatment

Treating BPD can be difficult. Not only is the condition poorly understood, but successful psychotherapy depends on a good therapeutic relationship, which is one of the central problems of BPD. However, dialectical behavioral therapy, or DBT, has been shown to be pretty successful in treating BPD. DBT is based on the more common cognitive behavioral therapy (CBT), but it’s more intensive and places more emphasis on accepting and regulating challenging emotions as well as developing interpersonal skills to improve relationships. To those ends, DBT has both individual and group therapy components, as well as more frequent contact with the therapist between sessions.

BPD is one of the less well-understood mental health issues and it affects a relatively small percentage of people. However, for those it does affect, it is practically the perfect storm for creating a substance use disorder. It undermines relationships and causes a deep sense of alienation, it causes intense and rapidly changing emotions, including anger, and it often leads to impulsive behavior. If you or someone you love shows symptoms of borderline personality disorder, it’s crucial to seek help as soon as possible, whether or not substance use is also a problem. 

At Foundry, we know that substance use is usually only the most visible part of a bigger problem. Most people who struggle with addiction have a co-occurring mental health issue and BPD is one of the most challenging. We offer DBT as well as a range of other therapeutic options as part of our comprehensive approach to treating addiction. To learn more, call us today at (844) 955-1066.

Someone who is dearly loved can fall deep into harmful substance use behaviors. Enabling their behavior only makes it worse. It is hard to identify the signs of enabling behavior because it seems closely related to “helping” them figure things out or alleviating discomfort. Spending lots of time and energy on a loved one like this is only going to end in heartache. Eventually, it ends up with the person resenting the entire process and feeling stuck in the cycle with the loved suffering from a substance abuse disorder. Find some tips on how to identify what is going on and how to quit enabling behaviors for good.

Defining Enabling Behavior

Enabling is complicated. Most people don’t even realize they are engaging in enabling behavior. The line is an essential one to draw, and it is vital people understand the ways enabling behavior can keep everyone locked inside a substance use disorder. Enabling occurs when a behavior keeps someone from experiencing consequences or the truth of their behavior, and they may not ever experience the pain of their reality. Some common ways people enable loved ones with substance use disorders include:

• Secretive behavior, sneaking substances to them or “covering” for them.
• Making ultimatums but not following-through with any consequences.
• Providing care-taking for a person with a substance use disorder when their ability to provide self-care is impaired.
• Ignoring or dismissing undesirable or dangerous behavior.
• Prioritizing their needs above those of others in the family possibly creating conflict.
• Bailing that person out of jail, financial trouble, or any bind that they could correct themselves.

The enabling behavior continues because they love them so much, but love is not enough to fix the challenges. Those with substance use disorders who struggle must be accountable for their choices if they want to change. It may be a hard lesson to learn for both the enabler and the person dealing with addiction, but responsibility for self shouldn’t be compromised.

Enabling From Fear

One of the key ways people continue to enable is from fear. They worry if they don’t care for their loved ones, something bad will happen. A caring mother may offer a home to the child because it seems safer than living on the streets. Fear is not a good motivator for loved ones of those with a substance use disorder. Many loved ones want to shield the person from pain rather than let them face harsh consequences. They don’t realize it also encourages them to continue doing what they’re doing. It proves to the person with substance use disorder that this way of living is acceptable and encourages them to manipulate others to get what they want.

Become Educated

The more a person learns about substance use disorders, the better they become at dealing with it. The more objective the person can be in support of a loved one, the better off they will be. There are many myths surrounding substance use disorders, including that helping them is healing. They are not going to help if they are enabled to keep using substances or drinking. Education means learning the true nature of substances and alcohol and how it affects everyone. Recovery is beneficial when family and loved ones are all involved in the process. Every person plays a role in reinforcing substance use behavior. Recovery is more beneficial when everyone knows how to play a part in doing better.

Seek Support

Don’t try to help the loved one alone. Peer support groups like Al-Anon, Nar-Anon, and others provide resources for loved ones struggling with substance use disorders. The meetings are helpful, and they provide support for those who need it most. Participation is not required all the time, but people can show up as they please and feel supported. Talking about the issues can help find solutions they may not have thought about and find healing for their issues, along with a loved one’s substance use disorder.

Create Space Financially

One way that families often enable loved ones is by taking care of them financially. They may pay their bills for them, give them credit cards to use, or offer bank account information. There is a good chance a loved one is taking advantage of this opportunity. Consider ways to stop the financial issues in their tracks. Set limits by refusing to bail them out of consequences, require rent payments, and limit the money you give your loved one. Don’t freely give if it is funding drugs or alcohol, because this keeps them in the cycle. Cutting them off helps them feel the consequences and forces them to try and seek other means of getting help.

Seek Help

Interventions, treatment programs, and family support groups are key to healing. An intervention most often is successful when set up by a professional. Every person needs to participate that is impacted by the substance use behavior to be effective. Be sure to be ready for whatever outcome arises. They will not quit until they are ready to quit, but the support of loved ones in a healthy way is essential to the journey of 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 1-844-955-1066.

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Detox is the first major hurdle in addiction recovery. Fear of withdrawal keeps many people drinking and using long after they stopped having fun. Withdrawal is often miserable but unfortunately, there’s no way around it. Many treatment programs, particularly residential programs, have medical detox built-in. There are also facilities you can go to specifically to detox before going into a treatment program or just trying to stay sober on your own.

A lot of people feel like they can detox on their own, perhaps following instructions from the Internet. That might work for some people--although you should consult a doctor before detoxing at home--but others should definitely consider detoxing in a facility. The following considerations can help you decide which is best for you.

When You Shouldn’t

You Have a Long-Standing Addiction

Withdrawal symptoms happen because your body has adapted to the presence of drugs and alcohol and it won’t function normally without them. The severity of withdrawal varies a lot from person to person but your level of drug and alcohol use and how long you have been physically dependent play a major role. They are the primary factors that determine how far your system has deviated and therefore how big of a shock it will be to suddenly have no drugs or alcohol in your system.

The timeline may not be as long as you would expect--better to think in terms of months, not years. For example, a man who averages 12 drinks per day for two months will have about a 50% risk for major withdrawal symptoms.

You Drink Heavily

Alcohol is an especially tricky substance to detox from because DTs can come on suddenly after two or three milder days, seizures may happen with even moderate withdrawal, and DTs can be fatal in a small percentage of cases. As noted above, drinking consistently over a long period of time increases your risk, but the more you drink, the shorter your timeframe for serious withdrawal. 

For example, a man who consumes 25 servings of alcohol per day has a 50% chance of serious withdrawal after only three days of continuous drinking. The catch is, of course, that if you’re drinking 25 drinks per day, you’ve probably been drinking heavily for a while already, alcohol poisoning would probably be the more pressing issue. The moral of the story is that DTs are nothing to mess around with.

At the very least, you should discuss your options with your doctor before you quit cold turkey after many days of consecutive drinking. Given how quickly you can go downhill and how much pain you can save with early intervention, detoxing in a facility is often the best choice for heavy drinkers.

You’ve Tried Before and Given Up

Every stage of recovery has its own challenges but withdrawal is an especially high wall to climb. People often try to sober up on their own and do well for two or three days, only to give up and go back to using when withdrawal symptoms get too severe. This is especially common when detoxing from opioids, since withdrawal symptoms are so miserable and for alcohol, since people are often aware that  DTs can be dangerous.

When you detox in a facility, you have extra assurance that you’re detoxing in the safest way possible and therefore are less likely to fall back on the health excuse. Being in a facility can also increase your level of commitment and accountability, making you more likely to persevere through a tough detox.

You’ve Had a Rough Detox Before

It’s hard to predict how bad detox will be. As discussed above, severity and length of substance use are relevant factors, but perhaps the best predictor is if you’ve had a rough detox before. If your symptoms were severe or you had medical complications, it’s a pretty good sign that your next attempt will be similar and you would be better off detoxing in a facility. 

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You Have Co-Occurring Issues

Finally, withdrawal symptoms can put a lot of stress on your body, so if you have any co-occurring conditions, it’s much safer to detox under medical supervision. Relevant co-occurring issues might include high blood pressure, cardiovascular disease, or pregnancy. It may also be a good idea to detox in a facility if you have co-occurring mental health issues like depression, any anxiety disorder, or other conditions that might compound an already stressful ordeal.

When It Might Be OK

You Don’t Have a Long Addiction History

As discussed above, the longer and more heavily you’ve been drinking and using drugs, the greater your risk for a severe withdrawal, and consistency is nearly as important as volume. For example, if you have unhealthy drinking patterns but you’re mostly bingeing on weekends, you probably won’t have serious problems with detox--unless you’re drinking 25 drinks per day, which, again, is another issue entirely.

Younger people also tend to have less severe withdrawal symptoms, partly because they’re more physically resilient and partly because they haven’t been drinking or using for as long. If you’ve been staying below about five drinks per day on average, you are fairly unlikely to have a severe detox, but everyone is different. 

Your Doctor Is Helping You Taper

As noted above, if you’re considering detoxing at home, it’s always good to consult your doctor first. Sometimes a long taper is possible or even necessary. For benzodiazepines, for example, you typically have to taper down over a period of weeks or months to avoid dangerous withdrawal symptoms. People often taper down from prescription opioids so they can have a month or two of unpleasantness rather than a week of abject misery. The challenge with a taper is staying on track and not backsliding, so you will need some form of accountability.

You Have Someone at Home to Help

Finally, if you’re going to try to detox on your own, it’s much easier with help. It can be someone who lives with you, is willing to stay with you, or is willing to check on you frequently. Part of it is accountability--to keep you from running out to the liquor store, or whatever--but part of it is safety. For example, DTs can come on quickly, leading to confusion and loss of coordination.

You may not be able to call for help when you need it. Even if you are facing a less life-threatening detox, it can be hard to take care of yourself when you’re experiencing something that’s like the worst flu you’ve ever had. Having someone reliable to watch out for you while you detox makes the process more comfortable and likely to succeed.

At The Foundry, we know that detox is often the one thing people fear most about getting sober. We offer detox that begins with a full medical evaluation and an individualized plan that ensures detox will be as safe and comfortable as possible. We want you to be as healthy as possible as you move from detox to recovery. To learn more about our approach to addiction treatment, call us today at (844) 955-1066.

If you look at most approaches to addiction treatment, from AA to residential programs, you’ll notice that social connection plays a big role--perhaps the most important role. While treatment programs typically include individual therapy and lifestyle changes, they also focus heavily on group therapy, family therapy, and group bonding activities. This isn’t to promote a summer-camp atmosphere; it’s the serious work of recovery. The following are some of the main reasons why social connection is so important for addiction recovery.

Connection Is a Basic Human Need

First, it’s important to understand that having family and friends you trust, that you feel comfortable talking to, and whom you can rely on is not just a luxury, it’s a real human necessity. While chatting with your friends or complaining to a sympathetic ear may seem frivolous in the scheme of things, they are the type of interactions that hold communities together and make you feel like you belong.

Although we tend to value self-reliance--especially men, and especially in the US--we all understand instinctively that our safety and wellbeing ultimately depend on cooperation. In our ancestral past, exile likely meant death, so feeling socially alienated is a major source of stress. In modern society, financial transactions have replaced many of our social transactions but in the end, we all need some sense of connection to feel happy.

Using Drugs to “Fill a Void” May Be Literally True

We’ve known for a long time that feeling unable to connect to others is a common theme among people who struggle with substance use. Whenever you get to know someone with a history of addiction, you will typically find they also have a history of trauma, abuse, or neglect. These kinds of experiences, especially in childhood, impair your ability to form trusting and meaningful relationships later in life.

People often say they use drugs to “fill the void.” Recent research suggests that may literally be true. In one fascinating experiment, researchers gave some participants a placebo for four days and gave other participants naltrexone, an opioid antagonist that prevents opioids from binding to receptors in the brain. The participants were then asked to rate their social interactions in terms of their feelings of social connection.

On the final day, they were given a task specifically designed to elicit feelings of social connection, such as reading statements of gratitude written by people close to them. After a 10-day clearing period to get the naltrexone out of the participants’ system, the placebo group was given naltrexone and vice versa. The researchers found that while taking naltrexone, participants reported significantly lower feelings of social connection.

Interestingly, other sources of pleasure appeared to remain unaffected. That suggests that our opioid receptors may be specifically related to the pleasure we derive from social connection. When those needs aren’t being met by healthy social interaction, the void may literally be filled by synthetic opioid molecules. The study also suggests that naltrexone injections, which are sometimes court-ordered for drug offenders, may actually inhibit authentic recovery.

Connection Reduces Stress

People recovering from addiction typically cite stress as their number one trigger for cravings. The type of stress doesn’t really matter, although we are all more vulnerable to certain kinds of stress. The feeling of being overwhelmed, feeling helpless, or feeling worthless makes you want to escape the situation. You feel like you can’t deal with it anyway, so you might as well go back to drugs and alcohol. 

Social connection is one of the best buffers against stress. There are several reasons for this. One is that, as discussed above, socializing fills a basic human need. Just as you feel stressed when you’re hungry, you feel stressed when you are deprived of social interaction. The coronavirus pandemic illustrates just how strong this need is. People are willing to risk their lives and the lives of their family members to hang out in groups. Just as eating relieves the stress of hunger, social interaction relieves the stress of isolation.

Second, when you’re more socially connected, you have more resources available to solve problems. This is the underlying cause of the effect discussed above but it works on the rational level too. For example, being short on rent is much less stressful when you know a friend will lend you some money or a relative will let you stay with them if necessary. Often, just knowing these resources are available to you makes you feel more able to cope with stress, even if you never have to ask for help.

Connection Improves Your Health

Social connection isn’t just good for your mental health; it’s good for your physical health too. Research has linked chronic loneliness to a variety of health problems, including high blood pressure, heart disease, obesity, and poor immune function--all common health problems caused by substance use, especially alcohol. In other words, if you feel chronically lonely in recovery, not only are you fighting an uphill battle to stay sober, but you may also be compounding already elevated health risks.

On the other hand, feeling connected reduces stress--and therefore stress-related illnesses--and increases the likelihood that you will continue other positive lifestyle changes and have access to medical care when you need it.

Connection Keeps You Focused on Recovery

Finally, having a strong sober network keeps you focused on recovery. There are always ups and downs in recovery. Sometimes you will feel very motivated and sometimes even the easiest part of your recovery plan will feel like an insufferable chore. Being part of a recovery-focused group will help keep you going even when your motivation is low or when you are distracted by other concerns.

You have frequent reminders of what you need to be doing in recovery, inspiring examples of what is possible if you stick with it, and possibly some cautionary examples reminding you of what’s at stake if you backslide. Furthermore, the dread of walking into a meeting and admitting you slipped is an extra incentive to stay strong in moments of temptation. 

Social connection isn't the only factor in a strong recovery. Research also shows that genes play a major part in addiction risk. Furthermore, if your past experiences have impaired your ability to form social connections, you will probably need therapy to fix the problem. Just being more social won’t be enough on its own. However, having the right kind of sober support, reliable friends, and a good family environment can make a huge difference.

At The Foundry, we understand the importance of social connection in addiction recovery. We involve family in the recovery process to facilitate support, communication, and healthy boundaries. We also emphasize connection among our clients through group therapy and group activities. To learn more about our approach to treatment, call us today at (844) 955-1066.

Resilience is the ability to bounce back from adversity and perhaps even become happier, smarter, stronger, and healthier than you were before. There is no shortage of adversity in addiction recovery. You may have your own demons to slay, you may have family and friends who actively try to undermine your efforts, and you may slip up or fully relapse several times.

The good news is that none of these setbacks have to be permanent. Like all of recovery, resilience comprises a variety of skills that you can improve with practice and persistence. The following are some tips for becoming more resilient in addiction recovery.

Expect Challenges

It may sound counterintuitive, but the first way to improve your resilience is to expect challenges. Too many people think they’re going to enter treatment or their loved one will enter treatment and everything will turn around right away. In reality, every phase of recovery presents new challenges. If you expect too much too soon, you’re likely to be discouraged.

Life will improve when you’re sober but it will take consistent effort. When you inevitably encounter challenges, if you are expecting them, you know that’s normal and you may even have a plan ready.

Have a Team

Social support is one of the most important parts of recovery in general. It helps you feel connected, it increases your feeling of accountability, and it makes you more resilient in the face of challenges. Your sober network can be a source of moral support, practical support, and good advice from people who have been in your place. Remember that no one succeeds alone. Even if there’s only one person you can confide in, whether it’s your best friend or your therapist, it lightens your load considerably. 

Banish Black-and-White Thinking

Watching out for distorted thinking is one of the most important ways of regulating your emotions, which is why learning to identify and challenge cognitive errors plays a central role in cognitive behavioral therapy and dialectical behavioral therapy. One common cognitive distortion that can torpedo your resilience is black-and-white or all-or-nothing thinking. This is the belief that if something is not a total success then it’s a total failure.

Nearly everything you do will actually be somewhere in the middle. Watching out for black-and-white thinking is especially important after you’ve had a slip. A lot of people will slip up and have a drink or something and then think, “Well, I’ve already blown it, so I might as well go all the way.” Instead of trashing your whole recovery over a small mistake, keep in mind that there’s still a lot to gain by minimizing the damage and getting back on course.

Look for the Silver Lining

When something bad happens, it’s natural to fixate on the negative consequences. Most of us are naturally wired to spot threats. That’s great for keeping you alive on the savanna but it can also blind you to a lot of good possibilities.

Few situations are completely bad--see above--but when we fixate on the bad aspects, it’s easy to feel hopeless. Whenever something bad happens, even something small, challenge yourself to find something good about it, even if it seems slightly absurd. 

Figure Out What You Can Control

Often, what’s most demoralizing about a challenging situation is that you feel like you have no control over what happens. It’s often true that you have little control--like when you get laid off or your house floods, for example--but it’s rarely true that you have no control at all. Finding something you can control--anything at all to improve your situation even a little bit--can be a way to both reduce stress and get yourself into a situation where there are more options.

Even when you can’t see the whole solution, doing what you can with what you have is the first step in finding your way out of trouble. It also affirms that you haven’t given up.

Affirm Your Values

Feeling connected to your values is often a key factor in persisting in the face of setbacks. This is called self-affirmation and research shows that it helps you better cope with negative feedback and make healthier decisions in general.

You can do this by taking a few minutes to write about your core values and why they matter. For example, a lot of people decide to get sober because they realize their family’s happiness is at stake. Regularly connecting to that value of family can help you persevere in the face of setbacks.

Take Care of Yourself

When challenges arise, they are always easier to deal with if you are healthy and rested. That’s why self-care is so important for resilience. Sleep is particularly important because sleep deprivation or chronic sleep deficit erodes your resilience on two fronts--the parts of your brain responsible for identifying threats become overactive and the parts of your brain responsible for emotional regulation, attention, and problem-solving become underactive.

In other words, when you are sleep deprived, you are more likely to see any given situation as threatening and less able to come up with solutions for actual problems. It’s also important to exercise regularly since that reduces your reactivity to stress while increasing blood flow to the areas of the brain responsible for planning, self-control, and emotional regulation.

Stay Present

Finally, when facing a tough situation, it’s crucial to stay present. Typically, people have two kinds of unhelpful reactions to a crisis--they either try to ignore it and pretend it’s not happening, or they catastrophize and imagine all the horrible consequences it will have for their lives. Neither is helpful. You can only act in the present, which means you need to pay attention to what’s going on.

Also, you can’t shoulder the responsibilities for whatever will happen in the future. Thinking about that will only overwhelm you, which is why they say in AA “One day at a time.” This is especially true with anything having to do with recovery since it’s a challenge you have to deal with every day. If you think too far ahead, you’ll only feel discouraged. Do today’s work today, then rest, then do tomorrow’s work tomorrow. 

Some people just seem to be more resilient than others, but most of the time it’s because those people have faced adversity that you don’t know about. Bouncing back takes practice and the more you practice the better you get. 

At The Foundry, we know that emotional resilience is at the core of a strong recovery from addiction. That’s why we’ve designed our holistic program around building and nurturing our clients’ resilience through evidence-based therapeutic techniques as well as positive lifestyle changes such as exercise, mindfulness meditation, and social connection. To learn more, call us today at (844) 955-1066.

When you’re recovering from addiction, it’s a great idea to pick up a new interest, hobby, or activity. These do several good things for you. Perhaps most importantly, especially early on, they give you something to do.

Too much boredom and restlessness are not good for recovery, and having a new pursuit gives you something to do. Also, if it’s something you enjoy — which it should be — it gives you something to look forward to every day; a sense of direction or focus. Finally, when you learn new skills and see them improve day by day, it increases your sense of self-efficacy: the feeling that you are in control of your life.

There are many possible challenges to take on in addiction recovery. The important thing is to find something you enjoy and something that connects with your values. You may have to try out a few things to find what you like. Here are some suggestions to get you started.

Learn to play an instrument.

Any kind of expression is good for recovery and music has some attributes that make it especially good for some people. First of all, music therapy is an alternative form of therapy that involves many different ways of engaging with music.

It often helps people who aren’t helped much by more conventional modes of therapy. A number of studies have found that it can be particularly effective for treating trauma and depression. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5500733

However, the benefits don’t stop with therapy. Several studies have found that the act of making music in itself can improve your mental health. For example, researchers at Oxford¹ have found that singing in a choir can have many benefits, including increasing your feelings of happiness and wellbeing, reducing pain, and even improving your immune system.

Music is good for you because it is a complex activity that promotes social cohesion. Music requires cooperation between many parts of your brain in both hemispheres. It is one of the best workouts you can give your brain and some studies suggest practicing music can even stave off dementia.

Get fit.

No matter what, a certain level of fitness should be part of your recovery plan. Few things are as good for your physical and mental health as daily exercise and emerging research even suggests that it may help prevent relapse.

However, a basic level of self-care is not the same as making sports or fitness a particular interest in recovery. All you really need to be healthy is to walk about 30 minutes a day, but that won’t provide as much of a challenge or motivation as an activity.

For that, you need something that gives you plenty of room to grow — something that requires strength, skill, and stamina. Team sports are a great place to start, because they not only require skill and keep you active, but they also add a social element that holds you more accountable and helps you feel more socially connected — one of the most powerful aspects of a strong recovery².

Even if you never thought of yourself as a sports person (perhaps especially if you never thought of yourself as a sports person), learning a new sport can be a huge boost for your mood and confidence.

Make art.

As with music, art is a great recovery activity because it emphasizes self-expression. Much of what you go through in life may be hard to put into words, but you still need some way to express it.

Drawing, like dreaming, can be an expression of your inner world. Most of us were encouraged to draw when we were kids, but creativity is discouraged as we get older.

Making art, whether it’s drawing, painting, sculpting, knitting, collaging, or anything else, is often a great way to get back into contact with the parts of your mind that can’t easily express themselves in words.

Learn a new language.

Most people only learn new languages for the sake of practicality. It takes a special kind of person to do it for fun.

However, if you’re that kind of person, learning a new language can be a great recovery activity. For one, it opens up a whole new world that wasn’t available when you were limited to English.

The change of perspective when you can suddenly read a newspaper from Mexico City or Berlin is startling. Perhaps more importantly, a new language connects you to new people.

Language is fundamentally social and even the process of learning a new language can help you build new relationships. Like music, language learning is also great exercise for your brain.

Write.

If you’ve been through an addiction treatment program or worked with a therapist, there’s a good chance you’ve already done quite a bit of writing as part of recovery. However, there’s no reason to stop there. Like art and music, creative writing, such as poetry and fiction, can be a way of exploring thoughts and feelings you can’t quite articulate directly.

What’s more, writing is a great way to process what you’ve been through and find meaning in it. Think of all the people who have been through horrible things and then redeemed those experiences by writing about them — from Victor Frankl and Malcolm X to the many excellent recovery memoirs that have come out in the past 10 years or so.

Writing your story is a way to own what you’ve been through and create a story where you’re the hero rather than the victim.

There’s essentially no limit to possible activities to engage in during recovery. The great thing about recovery is that your future is no longer about drugs and alcohol; it can be about anything you want. The more you challenge yourself, the more you’ll grow. At The Foundry, we know that recovery isn’t just about abstinence; it’s about living better. For more information about our treatment programs, call us today at 1-844-955-1066 or explore our website.

1. Launay, J. (2015). Choir singing improves health, happiness – and is the perfect icebreaker. The Conversation.

Twark, C. (2018). Can exercise help conquer addiction? Harvard Health Publishing.

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Well it is finally happening! Spring has sprung! The short days of winter are almost behind us, and the activity filled days of summer are right around the corner! The most exciting thing of all is that our greenhouse is actually green now! 

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I know! How exciting! Soon we will be actually putting these plants right into our meals. A big part of my food philosophy is sustainability, which is driven largely from the farm to table (or garden to table) cooking that we are able to do at the Ranch! 

Oftentimes I am asked why cooking farm to table is actually more sustainable than globalized food sourcing. Well there are so many reasons, but I will only share one here. One big reason is that we know everything that we put into our garden/greenhouse at the ranch. Kim Brooks, our gardener, is so thoughtful about how all the plants in our garden can work together instead of forcing things to grow with fertilizers and pesticides. Since larger factory farms in America use human produced fertilizers and pesticides, the average acre of corn grown in America in 2006 needed about 50 gallons of oil to grow! This is mainly due to the amount of energy needed to make the fertilizers and then transport them. 

The best meals are the meals in which you have a connection to every ingredient on the plate. Whether you planted, harvested, or foraged all of the ingredients, you can take pride in the thought that your meal is making a positive impact!

With all of the excitement of farm to table summer cooking on the horizon, I still make everything I can from scratch with seasonal ingredients. Last month I shared my famous homemade bread recipe, and this month I want to share another staple recipe! A classic granola recipe! This granola is perfect for a breakfast parfait or just plain granola and milk! It is also great for a midday snack!

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**Side note!!**

Do you want more content from the Foundry kitchen? Or from Foundry altogether? Look us up on Instagram (@foundrysteamboat), Facebook (Foundry Steamboat), or Twitter (@foundryrehab)! 

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Mixed nut Granola!

(Makes about 1 gallons' worth)

Ingredients

• 5-6 cups rolled oats
• 2 cups unsalted mixed nuts (almonds, cashews, walnuts, really whatever nuts you want!)
• 1 Tablespoon salt
• 1 teaspoon cinnamon
• 1 teaspoon nutmeg
• ⅛ cup sunflower, coconut or canola oil*
• ¼ cup honey 
• ~1 cup of dried fruits (optional)

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Directions

• Preheat oven to 350 degrees 
• In a small saucepan over medium heat heat the honey until warm and runny, then take off the heat for later
• In a large mixing bowl or stand mixer combine the rolled oats, mixed nuts, salt, cinnamon, and nutmeg. Mix until combined Add in whatever oil you are using and stir until the oil coats all of the mixture
• Stir in the honey and make sure it is well mixed
• Dump granola mixture onto a large baking sheet, and press with a spatula until all the granola is leveled on the sheet
• Bake for 8 minutes in the oven, then take out of the oven and stir the granola on the pan. After stirring press the granola until level again and place back in the oven. After another 8 minutes take the granola out of the oven and stir/press granola one more time. Then place in the oven for the final 5-8 minutes until golden brown
• After taking the granola out of the oven press it with a spatula one more time, let the granola cool until it is cool to the touch. 
• Once fully cooled, break up the granola with a spatula. The granola should be nice and crunchy! 
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Have a fun and clean month everyone!
- Chef Henry
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*Big thank you to Andrew Olson (@_andrew_olson_) for taking some awesome food styling pictures with us!

*Also big thank you to Siena Atkins with @sienas_studio for providing us with great handmade plates to put our creations on!

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Beneath everything else, recovery from addiction is not about abstaining from drugs and alcohol but rather about improving the way you relate to yourself and the world. There are many ways in which our own minds can cause us problems. We have intrusive thoughts, we worry too much, we have inaccurate beliefs about the world, and we have unrealistic expectations of ourselves. One very common way we make ourselves miserable and limit our own progress is by having a fixed mindset instead of a growth mindset.

Growth vs. Fixed Mindset

A fixed versus growth mindset is a concept developed and popularized by Carol Dweck. In her research, she noticed that some children were more tenacious in solving problems and she discovered that the main thing that differentiated these children from those who gave up easily was that they had what she termed a “growth mindset” while the children who gave up quickly had a “fixed mindset.” 

The difference between these two mindsets is simple: If you have a fixed mindset, you believe that you’re basically born with certain talents and capacities, such as intelligence or social skills or athletic skills and so on, and there’s not much you can do to improve your performance in any given area if you’re not especially talented in that area. A growth mindset, on the other hand, is the belief that with a bit of effort, you can improve your skills and grow as a person.

The reality is, of course, somewhere between these two. Talent is certainly a real thing. Few people will reach the heights of Lebron James or Elon Musk no matter how hard they work. On the other hand, many--perhaps most--of us have too little confidence in our ability to make meaningful changes in our lives. In other words, most of us would be much better off if we made an effort to adopt a growth mindset. That’s especially true for anyone recovering from addiction.

A Growth Mindset Reduces Resistance to Change

Resistance to treatment is a common problem. Many people have what AA people call “terminal uniqueness.” This is sort of the idea that “I’m not like everyone else here, so I don’t have to engage with treatment the way they do.” This typically stems from a need to protect your sense of identity. Everyone else is an “addict” while you are basically a decent person who hit a rough patch. To participate fully in treatment is like admitting that you got lost somehow and you can’t find your way back. 

To a person with a fixed mindset, this is a serious threat. It implies that this edifice of self you have constructed has a faulty foundation. You want to reject any evidence to the contrary. However, to someone with a growth mindset, the idea that you might need help is much more palatable. You’re not broken on some fundamental level; you just have some weak points you need to strengthen and you know that you can get stronger with persistent effort.

A Growth Mindset Opens Up New Possibilities

When you’re first considering the possibility of treatment or just starting out in recovery, it can be very hard to imagine a better life. You are probably at a low point, or else you wouldn’t be considering a major life change. All of your future possibilities are colored by your present circumstances. This is especially true if you have a fixed mindset. That’s because when you try to imagine living a happier, more fulfilling life, you’re trying to imagine living that life as the person you currently are.

You may think, “How am I supposed to live a good life when I can barely get out of bed, when I can’t get through the day without drugs and alcohol, when I’m constantly tormented by anxiety, and so on?” It’s a perfectly reasonable question to ask when you don’t believe in the possibility of growth.

If you have a growth mindset, it’s easier to imagine that a better life is possible, even if you aren’t yet sure how. You may still be aware of all the obstacles in your way but perhaps you can also remember overcoming other obstacles that once seemed insurmountable. You may not be able to imagine living a better life as the person you are now, but you can imagine living a better life as the person you can become.

A Growth Mindset Turns Challenges into Opportunities

Perhaps the greatest advantage of a growth mindset is that it turns challenges into opportunities. There is no shortage of challenges in addiction recovery. In fact, every stage of recovery--detox, treatment, therapy, transitioning home, continuing with your recovery plan, and so on--offers a different set of challenges. 

If you have a fixed mindset, every challenge is just an opportunity to fail. You have your little set of skills and qualities and if those don’t equip you for the challenges you face, then you’re just out of luck. People will see that you, as a person, just don’t measure up. 

However, if you have a growth mindset, your model of challenges is completely different. Instead of seeing them as the rocks that sink your ship, you see them as weights that make you stronger. A challenge is an opportunity to learn something about yourself. It’s a chance to learn new skills and expand your ability to persevere. Every new challenge recovery presents is an opportunity for growth and will prepare you to overcome even bigger challenges down the road.

Adopting a growth mindset is one of the best ways to become more robust to the challenges that you will face in addiction recovery. It makes you less afraid of change, it makes you better able to imagine a happier life without drugs and alcohol, and it makes every new challenge into a chance to grow. 

At The Foundry, we know that getting sober and staying sober is probably the hardest thing you will ever have to do. We also believe that abstinence from drugs and alcohol is only one outcome of a process that will increase your overall quality of life, including your mental and physical health, and your relationships. For more information about our treatment program, call us at (844) 955-1066.

We typically think of grief as the result of losing someone close to us--a relative, a friend, or even a pet. However, grief is really a reaction to any loss and can be part of many of life’s challenges--a breakup or divorce, losing a job or business, losing a house, or even giving up drugs and alcohol. Grief can be intense and pose a major challenge to addiction recovery.

We typically have little or no control over the situations that cause us grief and life doesn’t care whether or not your recovery is strong enough to withstand a major loss. As difficult as grief can be, it doesn’t have to undermine your recovery. The following tips can help you stay sober while you process your grief.

Accept Your Feelings

First of all, it’s crucial not to suppress or avoid grief. When confronted with a loss, grief is a normal reaction, and trying to suppress, avoid, or numb it will only cause you problems in the long run. Research shows that accepting challenging emotions, particularly in stressful situations, leads to fewer mental health challenges, such as major depression. Of course, allowing yourself to feel painful emotions is inherently challenging.

Mindfulness can help but it works best if you’ve already been practicing mindfulness meditation consistently. If not, you might still benefit from just allowing yourself to feel grief, understanding that it’s normal, noticing how it feels in your body, and noticing how it comes and goes and changes over time.

Connect with Others

One of the worst parts of grief, especially after losing someone close to you, is that you feel alone. Perhaps you’ve lost a confidant or someone you depended on in some way. You can’t imagine anyone else filling that gap and you can’t imagine that anyone else really understands what you’re going through. However, that feeling is an illusion. Others probably feel the loss keenly as well and the people around you want to help you, so let them. It’s especially important to resist the temptation to isolate yourself. Isolation increases your risk of both depression and relapse. Stay in touch with friends and family.

Talk to a Therapist

People don’t always need therapy to cope with grief, but if you’re recovering from addiction while trying to cope with grief, it’s best to have professional help. You may be confronted with a flood of overwhelming and conflicting emotions and you may feel tempted to escape with drugs or alcohol. A therapist can help you sort all this out, lend a sympathetic ear, and help you make a plan for staying sober as you deal with your grief. And if you have a history of depression, grief is just the kind of thing that might trigger another episode so it’s important to do everything you can to look after your mental health.

Keep Going to Meetings

A major loss can severely disrupt your life and as a result, you may feel like it’s fine to skip meetings for a while. That’s typically a bad idea. This is the time when you need that structure and support the most. There are almost certainly some people in your group who have had to deal with grief in recovery and they can provide support and advice.

As discussed above, it’s also important to stay connected and avoid isolating yourself and going to meetings--perhaps even going to extra meetings--is a great way to ensure extra support and keep from feeling isolated. Also remember that even if you have to travel for a funeral, there are probably meetings wherever you’re going. 

Beware of the Anniversary Effect

As time goes on, you will gradually feel better. You might start to feel almost normal again after a few months but then it’s time for that person’s birthday or it’s the first holiday without them and suddenly you come apart again. This is the anniversary effect and it often blindsides people. It typically happens around birthdays, holidays, and, of course, anniversaries--including marriage anniversaries and the anniversary of the person’s death.

Sometimes seasonal cues can trigger a return of grief. The best thing to do is to be aware of it and perhaps even deliberately mark the occasion with other friends and family members so that it becomes an occasion for remembering the best things about the person.

Be There for Others

Keep in mind that when you’re grieving, you’re probably not the only one. If a loved one has died, there are probably other people who are hurting too. While that doesn’t invalidate your own grief in any way, being aware of that fact and being there for others can be a way of connecting and sharing the load. Having compassion for others’ grief can make you feel a bit better, and if not, it can at least give you a sense of purpose that can carry you through and help you stay sober.

Take Care of Yourself

As noted, grief is often disruptive but you should still make an effort to take care of yourself as much as you can. Try to get enough sleep and eat healthy meals. Get some exercise if possible; that will boost your mood and help you cope with stress. The more you are able to stick to your regular routine, the less chaotic your life will feel.

Get Creative

Expressing your feelings about loss can be hard. You may be overwhelmed with conflicting feelings and find yourself at a loss for words when trying to talk to friends or even your therapist. You may have more luck with more creative pursuits--painting, drawing, poetry, music, or whatever you like to do. These modes of expression don’t require you to be very specific or accurate and can allow you to grapple with feelings there aren’t really words for. 

Grief can be a serious challenge for addiction recovery because it can be traumatic and destabilizing, just the sort of emotions people typically rely on drugs and alcohol to cope with. Acceptance, social connection, and self-care are the major keys to staying on track when faced with grief. 

At The Foundry, we know that life can throw some major challenges your way whether you’re ready for them or not. That’s why we emphasize skills for emotional resilience, as well as involving family in the process. To learn more about our approach to treatment, call us today at (844) 955-1066.

As the chef at The Foundry and someone who has overcome addiction to celebrate four years of sobriety, I have seen why nutrition is such an important topic for those in recovery. When in the throes of addiction, we usually don’t care about the negative effects our substance abuse has on the mind and body.  My intention is to help educate, inform, and explore how we can improve our lives through nutrition in recovery.

The first topic to address is one everyone is familiar with: cravings. Whether it be for chocolate, nicotine, salty snacks or alcohol we all have experienced cravings in our lives. The difficulty about handling these cravings in sobriety is that we as addicts need instant gratification. Cravings are a signal from your body telling you that it needs something, and your brain recognizes these needs in the way you usually fulfill them. If you always eat candy bars, when you experience a sugar craving your brain will think of candy bars first. If you start satisfying that sugar craving a banana or green smoothie, your brain will begin craving these healthier options when your blood sugar drops. This is part of a lifestyle change. The goal is to live healthier and as your brain chemistry changes, your health will change as well.  

Another option is to practice moderation and upgrade your favorite snacks to healthier options. Going back to our candy bar example, instead of eating processed refined sugars, corn syrup and chemicals, snack on a few bites of fair trade organic dark chocolate for a “healthier” treat.  Chocolate is still chocolate, so if you can opt for fresh fruit instead, that would be even better. You don’t need to starve yourself of your favorite snacks, just try to find the most natural, whole food version of what you are craving and maintain portion control. This will help with satiation and give your body the nutrients  it needs. If you can learn how to make the snacks you prefer, even better. Not only will you impress your friends, you’ll learn in the process.

If your cabinets are filled with cookies and chips, this can seem overwhelming. To help you, I have provided a food craving roadmap to help you understand what your body is actually asking for during a craving.

At The Foundry, we incorporate all of this information into our meal planning and nutrition education at our residential treatment center in Colorado. It’s important to us that we help you as much as possible on your recovery journey, and for some that can include cooking lessons and being introduced to new foods. As they say, if you teach a man to fish...

Hopefully this blog has helped to answer any questions you had in regards to what cravings mean and what healthy options are in terms of satisfying them. Remember to practice self-control, and moderation and you will be on your way to a healthier lifestyle.

-Eric Powers, Chef of The Foundry

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We’re living in the age of bingeable TV. Not only are there a lot of great shows available to stream in their entirety, Netflix and other platforms automatically play the next episode before you even have time to go to the bathroom. Therefore, we have a lot of little incentives encouraging us to sit on the couch watching one show for hours at a time. While we all have days--especially when we’re sick--when sitting on the couch and binging a TV show is all we can manage, we have to wonder: Is binge-watching good for you?

This question is especially pressing for anyone recovering from a substance use disorder, a mental health issue, or both. In fact, most people who struggle with a substance use disorder will also have a co-occurring mental health issue and a strong recovery entails looking after your mental health. While there are specific ways you should be doing this, such as seeing a therapist and possibly taking medication, lifestyle factors--including how much time you spend binge-watching TV--also play a major role. Let’s look at some ways binge-watching might affect your mental health.

Binge-Watching May Increase Anxiety, Depression, and Loneliness

Since binge-watching is a relatively new phenomenon, ballooning over the past five years or so, there hasn’t been a lot of research into how it affects mental health. However, what research there is should give you pause. One study by researchers from the University of Texas at Austin found a high correlation between binge-watching, depression, and loneliness.

‍Other studies have found negative effects including increased fatigue, mood disturbances, and insomnia. Many of these studies show correlation, rather than causation and it’s easy to imagine that someone who is already depressed or anxious might spend more time binge-watching TV. However, there are also a number of reasons to believe that binge-watching may negatively affect your mental health.

Binge-watching Can Disturb Your Sleep

At least one study has found that people who binge-watch more have more insomnia and poorer quality sleep. While this may also be a matter of correlation to some extent, “pre-sleep arousal” also appears to play a significant role. Pre-sleep arousal includes both biological and psychological factors. Biologically, a number of studies have found that the bright light from screens, especially in the blue spectrum, mimics daylight.

If you are exposed to this kind of light before bed, it may disrupt your circadian rhythm, making it harder to sleep. Psychologically, a show may get you wound up, perhaps for hours, when you should be winding down for sleep. We enjoy the drama, tension, suspense, and action of good TV shows, but these also increase your heart rate, blood pressure, and adrenaline. When you finally go to bed, you may feel like you’ve just been through a stressful or even mildly traumatic experience, which is not conducive to sleep. 

This sleep disruption can take a toll on your mental health. A number of studies have found that a chronic sleep deficit can quickly impair mental faculties such as attention, working memory, and emotional regulation. In the long run, insomnia has been linked to a higher risk of major depression and anxiety disorders.

Binge Watching Makes You Less Physically Active

Perhaps the biggest single problem with binge-watching is that it has a high opportunity cost. That is, every hour you spend watching TV is an hour you’re not spending doing something else--not even moving. This affects both your mental and physical health. Too much sitting--and snacking--increases your risk of obesity and related conditions such as diabetes and heart disease.  Recent research has found that obesity significantly increases your risk of depression and vice versa. 

Perhaps more significantly, if you have a history of depression or anxiety, getting regular exercise is a critical part of a comprehensive treatment plan. Many studies have found that exercise improves mood by increasing levels of endorphins, serotonin, and BDNF, a neurotransmitter that grows neurons in certain parts of the brain. Exercise also causes structural changes in the brain that make you less vulnerable to stress and anxiety. If you have struggled with depression or anxiety, spending hours sitting on the couch is the last thing you should be doing.

We Tend to Binge-Watch Alone

Or alone together. Watching TV is an activity that mainly entails getting absorbed into the world of the show. No company is necessary or even desirable. If you are binge-watching with someone, it’s unlikely you are simultaneously having a stimulating discussion or otherwise connecting in any meaningful way. You’re both just watching the show.

Binge-watching may just be a symptom of loneliness, but it may also make you less likely to accept an invitation, reach out to friends, or even just leave the house, all of which perpetuates loneliness. However, it’s worth noting that many people cite social motivations for binge-watching. In other words, they want to be able to talk about a show with friends or colleagues. So in this limited way, binge-watching may have a prosocial silver lining. 

You May Feel Let Down When a Show Is Over

Finally, you may feel better while binge-watching a show, but it will inevitably end, at which point, you may feel a significant letdown. At some level, we respond to TV characters as if they are real friends and acquaintances and we miss them when they’re gone. We get invested in the meaning created by the storylines, the exciting events of the show, and the interesting worlds in which it all happens. When it’s all over, you’re left facing dull reality and it’s not great for your mood. 

The explosion of quality TV shows in recent years has been amazing, but like most things in life, moderation is key. Binging is bad for you, whether it’s alcohol, cake, or TV, even if it’s good TV. What’s more, binging has become a phenomenon largely through behavioral manipulation by media giants. It’s in your own interest to decide how to use your time and to use it in ways that maximize your health and happiness.

At The Foundry, we know that abstinence from drugs and alcohol is only one aspect of a strong recovery. Long-term success depends on making healthy lifestyle changes and generally taking control of your own life, rather than falling prey to destructive habits. To learn more about our approach to addiction treatment, call us today at (844) 955-1066.

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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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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Learning to set and maintain healthy boundaries is an important part of addiction recovery. Maintaining healthy boundaries means that you respect other people’s values and autonomy and you expect them to do the same for you. Unhealthy boundaries are typical in dysfunctional relationships and these are often one of the factors driving addictive behavior. 

For example, a physically abusive relationship is a situation where one person uses violence to control the other. This violates their right to personal safety and their right to make their own decisions. What’s more, physical abuse often leads to depression and substance use. If you are in an abusive relationship, the best thing to do is usually just to leave and get as far away from your abuser as possible. This is a very clear boundary, using physical distance. However, other relationships may be more complicated, and learning to maintain boundaries is a healthy behavior to learn in general. Here are some tips.

Know Your Values and Priorities

First of all, if you are going to set boundaries, it helps to know why. Start by identifying your core values, whether they’re family, integrity, honesty, learning, kindness, or whatever else. It might help to take some online tests to help you clarify your values or you may spend some time writing about it. Perhaps look back through the major decisions you’ve made in your life and see what your guiding principles have been.

For example, maybe you turned down a job that paid well because you felt you were being asked to do something dishonest. That indicates that you value honesty above money. That’s good to know and it indicates honesty is a value you are willing to protect. Knowing what’s really important to you can help you figure out where to draw the line and give you a boost in courage when you need it most. 

Listen to Your Gut

Another way to identify your values and to recognize when someone might be violating your boundaries is to listen to your gut. We often react emotionally before we fully understand a situation rationally. That doesn’t mean your gut is always right, just that if you feel weird about something, pay attention to the feeling and don’t dismiss it without consideration.

For example, if you feel confused by what someone is telling you, it could be they are trying to manipulate you--a clear violation of your boundaries. Take a step back and don’t make any decisions until you are seeing things more clearly. Or perhaps you just have a bad feeling about a situation. That might indicate that you should move away from that situation. Our instincts have evolved to keep us safe so give them some credit.

Communicate Clearly

No relationship is perfect and there will be plenty of times when you just disagree. Boundary issues don’t always imply sinister intent; often people just go along with things and the other person has no idea they don’t want to do them. This happens every day in big and small ways. It’s your responsibility to be clear about what you want and don’t want.

That means learning to communicate clearly. No matter how well the other person knows you, they aren’t psychic and they may not know what you want unless you tell them. The key is to do it politely. Not every disagreement has to lead to an argument. In fact, most disagreements can be worked out pretty easily if both parties are willing to listen.

Keep in mind that this goes both ways. It’s important to communicate clearly about what you want and it’s also important to listen to the other person and respect their values and autonomy. 

Learn to Say No

In many situations, especially when you’re recovering from addiction, learning to say no is a skill in itself and it’s one of the first skills you should learn. When you leave treatment, people may offer you all sorts of things. Since drinking is so common in American culture, there’s virtually no chance you won’t be offered a drink from time to time, usually by people with good intentions. That’s why a polite but firm no is a crucial skill to master quickly. 

Work With a Therapist

So far, we’ve discussed some important considerations in setting boundaries, but there may be deep-seated psychological reasons why setting boundaries is difficult for you. If you grew up in an abusive household, for example, or if you’re currently in a codependent relationship. Sometimes people lose touch with their own needs and desires entirely and sometimes they feel like setting boundaries is just impossible for them. If that’s how you feel, you need to talk to a therapist. They can help you figure out what you want and need and help you develop the skills to assert yourself. 

Family therapy is also great for this since it focuses specifically on family dynamics, clear communication, and healthy boundaries. Getting the relevant people to work through their relationship issues can make a huge difference. However, not everyone has to participate in order for family therapy to be effective. Just changing the behavior of one or two family members can change the whole family dynamic.

Get Reassurance from Your Support System

Finally, it’s always harder to set and maintain boundaries when you feel isolated. This is especially true when you’re first trying out a new behavior that you’re not really sure about. It feels like a big risk. However, if you have a strong support system behind you, you don’t feel quite so alone, even if your support system doesn’t happen to be with you at the moment.

This is one reason going to 12-Step meetings is helpful, even after you’ve completed a professional treatment program. You may also want to consider attending Al-Anon or Nar-Anon meetings, for family members of people with substance use disorders, since you may fall into that category too. If you do have a family member or close friend with substance use issues, these meetings can give you a different perspective on setting boundaries with them.

Boundaries are crucial not only for recovery but for being your own person and directing your own life according to your core values. Setting and maintaining boundaries means knowing what your values are, listening to your gut, and learning to communicate clearly and respectfully. It’s also important to keep in mind that maintaining values requires practice. You’ll get better the longer you keep at it.

At The Foundry, we know that much of recovery from addiction is about learning practical skills to improve your relationships and manage your behavior. Great relationships are especially important for a strong recovery. We use a variety of evidence-based practices, including CBT, DBT, and family therapy to help you improve your communication and relationship skills. For more information, call us at (844) 955-1066.

Depression is one of the most commonly co-occurring issues with a substance use disorder and treating depression effectively is essential to long-term sobriety. One study found that among people with a mood disorder such as major depression or bipolar, a staggering 32% also had a substance use disorder. A relapse of depression may also lead to a relapse of drinking or drug use, so it’s important to try to prevent recurring episodes if possible.

Unfortunately, there’s a high probability that depression will recur. About half of people who have had one episode and about 80% of people who have had two episodes of depression will have another. The good news is that if you spot the signs early, you can reduce the severity of another episode or possibly avoid it entirely. Here are some tips.

1. Seasonal Changes

First, it helps to know your patterns and some possible causes of depressive episodes. Seasonal changes are one such cause. Moving from fall into winter triggers an episode for many people, most likely because the shorter days disrupt the circadian rhythm, which has been linked to depression. This is known as seasonal affective disorder, or SAD and is typically treated with lightbox therapy to recalibrate your internal rhythm.

Summer SAD can also trigger a depressive episode but the symptoms are typically slightly different. Whereas winter SAD usually causes increased appetite, excess sleep, and low energy, summer SAD more often causes decreased appetite, disturbed sleep, and agitation. Summer SAD may also trigger manic symptoms in people with bipolar disorder.

2. Anniversaries

The anniversary effect is when some holiday or anniversary triggers a mood change. It’s especially common in connection with the death of someone close. For example, you may suddenly feel depressed as the person’s birthday approaches or when you have to celebrate a holiday without them. However, the same might happen for something related to any traumatic event, such as a breakup, an accident, or an assault. If you are aware of the anniversary effect and any upcoming anniversaries, you can prepare yourself and feel less ambushed by it.

3. Triggers

It’s also important to be aware of any other triggers that might be specific to you. Stress is always a possible trigger of depression. It could be work stress, the death of a loved one, or a divorce, or it could even be something more positive, such as buying a new house or having a baby. While it’s always good to manage stress, you may want to seek out additional therapy or social support whenever you start to feel overwhelmed.

4. Early Symptoms

It’s always good to know your patterns so you prepare for problems but if you’ve had a couple episodes of depression already, they may just recur more or less randomly. This often occurs at roughly 18-month intervals but that’s never exact. The following symptoms may indicate another episode is approaching. Obviously, any symptom of depression, though less severe, may be a warning sign of relapse.

Common symptoms include depressed mood, thoughts of suicide or death, feeling worthless or helpless, sleeping badly, appetite and weight changes, lethargy, lack of motivation, slow movements, poor concentration, and physical pains. However, the following signs are either lesser known or they are usually the first symptoms to appear.

5. Low Mood

For most people, a bad mood is just a bad mood, but if you have a history of depression, a bad mood might spiral down into a depressive episode. If you do have a bad mood, it will usually pass but if it doesn’t, don’t stress about it. Instead, find a reliable way of interrupting the mood--a technique called behavioral activation. This has been shown to be an effective way to treat depression and it’s even more effective when you’re not yet in the grip of a full episode. Watch some funny videos, go out with friends, take a walk, or listen to some music--anything to lift your spirits, especially if you don’t feel like it.

6. Restlessness

When you’re in a full episode of depression, nothing is enjoyable. This is called anhedonia. Things you normally like just lose their appeal. In its milder form, anhedonia is more like boredom or restlessness. You do something you normally enjoy and you still feel flat so you try something else but that doesn’t work either. Sometimes this is a sign that you need to rethink your priorities or try something new but sometimes it’s an early sign of depression.

7. Isolation

Isolation is a classic sign of depression. You don’t feel like going out or seeing anyone. Maybe you even skip 12-step meetings. You decline invitations, cancel plans, or just don’t show up. You don’t return texts or calls. The more you isolate yourself, the worse you feel, so it’s important to push against this tendency as soon as you notice it. Accept invitations and actually show up. Reach out to friends and family, even if it’s just a periodic text or call. Stay connected in any way you can manage.

8. Irritability

Irritability is one of the most commonly ignored symptoms of depression. Most people with depression experience irritability but they often don’t connect the two. However, it may be one of the earliest symptoms. If everyone suddenly seems to be on your nerves or mundane tasks are suddenly incredibly frustrating, it may be an early sign of depression.

9. Sleep Disturbances

People typically associate depression with sleeping too much or not being able to get out of bed. If you’re doing that, it’s certainly cause for concern. However, sleep disturbances are just as common and people less often connect them to depression. If you find yourself waking up at three or four in the morning and being unable to go back to sleep, it may be an early warning sign of a relapse of depression.

10. Concentration Problems

Poor concentration can be terribly frustrating. You keep spacing off or if you do stay focused, it can feel really hard to make sense of whatever you’re doing. Sometimes this may just be situational. Perhaps it’s the end of a long day or you didn’t get enough sleep last night. However, if it seems to happen a lot, it could be a symptom of depression. It’s not just the body that slows down with depression, it’s your cognitive abilities too. If you’re having trouble with focus, working memory, or formulating a coherent plan, it may be an early symptom of depression.

Many of the items on this list are not enough on their own to indicate a relapse of depression but two or three together should be cause for concern. If you think you might be heading for a relapse of depression, make sure you’re still following your treatment plan, get in touch with your therapist, and try to stay socially connected. It’s much easier to avoid another episode than to climb out of the pit once you’ve fallen in.

At The Foundry, we know that addiction isn’t just a matter of drugs and alcohol--it’s about the whole system, including family, lifestyle, and mental health. We use proven methods to treat co-occurring conditions and teach our clients the emotional resilience skills they need for a long recovery. To learn more, call us at (844) 955-1066.

No part of treatment or recovery is exactly easy. Each phase of the process has its own unique challenges. For example, it can take quite an effort to convince your loved one they have a problem at all and it might be just as difficult to convince them to accept professional help. Once they’ve agreed to accept help, getting them physically into treatment is sometimes a project in itself. There’s no point at which you should assume that recovery or even treatment is a done deal. You will probably have to put some energy into it throughout the process. There will be times when your loved one is scared or when they just don’t have the ability to help themselves. This is when you, as a friend or relative, have to do what you can to help. Once your loved one has expressed willingness to get help for a substance use disorder, the following are some things you can do to help make sure it actually happens.

Help with a treatment plan.

There are a dizzying number of options for addiction treatment. There are more than 14,000 addiction treatment centers in the US alone and that doesn’t count other elements of treatment such as consulting with counselors, therapists, or doctors. With all these options, it’s hard to narrow down the best one, and it may be next to impossible for someone with a serious substance use issue, especially if there is a co-occurring issue like major depression to consider.

Choosing a good treatment program is beyond the scope of this post, but start by getting recommendations from your doctor, therapist, or people you know who have gone through a program and have a strong recovery. Also, look for accreditation and credentialed staff. When making a final choice, a good program will want to know a lot about any potential client to make sure they are a good fit. Be wary of a program that accepts anyone. This is quite a bit of work and it’s likely you will be much more motivated than your loved one to make the effort.

Pack a bag.

One common route to getting a loved one into treatment is to hold an intervention. Most people are familiar with this concept. A group of people, typically family and maybe a close friend or two, get together and explain calmly and clearly why the person has a problem and needs to accept help. One element of an effective intervention is that there can be no space between someone agreeing to accept help and actually leaving for treatment. Otherwise, they start having second thoughts, come up with excuses for why they don’t need treatment or why they want to go later, or maybe just disappear.

By the time you have the intervention, everything should be ready for them to enter treatment. That means they should have a place booked in a treatment program, travel arrangements to get there, and a bag full of necessary items packed and ready to go. Each treatment center has its own list of items to bring and this list can typically be found on its website. These items typically include a credit card for medications and other expenses, current medications, insurance card, photo ID, family and emergency contacts, a small amount of cash, casual clothes, sleepwear – assume they will have a roommate – gym clothes, toiletries, a journal, and recovery-related books. Items that typically aren’t allowed include clothing with drug or alcohol references on them, excessively revealing clothes, anything – including toiletries – with alcohol in it, weapons, valuables, food or drink, electrical devices, and books not related to recovery.

Escort them to the facility.

A lot can go wrong between intervention and walking into the treatment center. Your loved one’s motivation is already fragile and it might collapse at any point, especially if the treatment center is far away. Also, keep in mind that you might be dealing with someone whose mind may not be that sharp outside of drug-seeking behavior. Sometimes people intend to enter treatment only to get lost or distracted on the way. You should have a plan either to accompany them or to have someone accompany them to treatment.

Some treatment centers provide this service and there are also third-party services that will escort your loved one to treatment. As noted, travel arrangements need to be made ahead of time so you’re not working out details while your loved one has time to reconsider.

Encourage them to complete treatment.

Your loved one will likely have some fears about treatment. These typically revolve around being out of control, being vulnerable, being lonely, letting everyone down, or fear of change in general. Again, this is beyond the scope of this post, but do your best to assure your loved one that it’s going to be fine, that everyone has their best interests at heart, and that they will be happy they saw it through.

It’s not uncommon for people to spend a week or two in treatment and sort of panic, often feeling like they don’t belong there or that they’ve gone through detox and can handle the rest on their own. Sometimes they feel like staff members are out to get them. This is especially common among people with bipolar disorder, schizophrenia, or borderline personality disorder. If those are considerations in your loved one’s treatment, they should be in a program that is equipped to handle those co-occurring conditions. As for their promise to complete the program before they leave and if they call wanting to come home, remind them of their commitment and encourage them to stay.

Sending a loved one to treatment for a substance use disorder is never easy, for you or for them. They have no idea what to expect or how their life might change. They may feel like they are being treated unfairly. You don’t know what to expect either. Your time, money, and hope may not amount to anything. On the other hand, you might save your loved one’s life.

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

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People often complain about brain fog in their first year of recovery. This is the feeling that you can’t focus on anything, even simple tasks, you can’t remember things you should be able to remember, you don’t feel motivated, you can’t form a plan and follow it through, or maybe you feel sort of emotionally numb. Your brain has a lot of adjusting to do during this early period and it’s normal to feel a bit off. People who have recently quit stimulants may have an especially hard time with brain fog since stimulants unnaturally enhance the faculties mentioned above. Brain fog can be a major challenge for recovery because it makes you have doubts like, “Will I feel this way forever?” and “How am I supposed to function like this?” Brain fog usually goes away on its own as your brain slowly adapts to functioning without drugs and alcohol. The following tips may also help.‍

1.) Go to the Doctor

If it’s been a while since you detoxed--several months, at least--and you feel like your cognitive symptoms haven’t abated, it’s a good idea to talk to your doctor. Malnutrition is a common problem for people with substance use disorders. Medical detox and treatment programs typically try to address this issue, but if you didn’t go that route or if you’ve fallen back into old lifestyle habits, you may have some nutritional deficiencies. Deficiencies in omega-3s, magnesium, B vitamins, and other nutrients may be causing your symptoms and your doctor can figure this out with a simple blood test. These are also usually easy to correct. 

It’s also a good idea to rule out possible medical causes. Sleep apnea, thyroid problems, autoimmune disorders, and traumatic brain injuries are all possible causes of brain fog that you’ll want to rule out. You may also be on medications that are messing with your cognition and you’ll certainly want to discuss any change in medication with your doctor.

2.) Talk to Your Therapist

If there are no medical causes of your brain fog, talk to your therapist, if you haven’t already. Brain fog may have a psychological cause. Depression is the most likely. People often don’t realize that impaired concentration, slow thoughts, and poor memory are all common symptoms of depression. Lack of motivation and energy and emotional numbness are more well-known symptoms. Your symptoms may also be related to stress and anxiety. Psychotherapy, possibly with the assistance of medication, can help get these under control and that should improve your symptoms. However, some medications like beta-blockers have cognitive side effects, so you may want to avoid those.

3.) Dial-In Your Sleep

As for the things you have the most control over, sleep is the most common culprit when it comes to cognitive issues. Even a relatively modest sleep deficit can significantly affect your cognition, impairing your concentration, working memory, recall, planning, and self-control. Most studies suggest that we need at least seven hours of sleep a night to function optimally and for many people, even seven hours will be too little. The National Sleep Foundation recommends between seven and nine hours of sleep a night and the optimum amount will vary by individual and by any extra recovery needs, such as recovering from physical exertion or illness. 

If you’re getting less than seven hours a night, there’s a good chance that’s causing at least some of your cognitive problems. While too little sleep is by far the more common issue, it’s also important to be aware that too much sleep can also cause cognitive impairment. So if you’re sleeping more than nine hours a night on average, you might want to shorten it a bit. It’s also important to sleep regular hours. That will make it easier to fall asleep and to wake up and you will feel less tired with the same amount of sleep.‍

4.) Experiment With Your Diet

As noted above, nutritional deficits can affect your cognition, so eating a variety of whole foods, especially nutrient-rich fruits and vegetables, will help fill some of those gaps. It may also help to eliminate certain foods. Inflammatory foods have been found to be especially bad for mood and cognition since they essentially trigger the same immune response you experience when you’re sick. Try reducing your intake of sugar, high-fructose corn syrup, refined wheat, fried food, and processed meats. Alcohol is also highly inflammatory and impairs cognition, but if you’re in recovery, you should be avoiding alcohol already. 

5.) Get More Exercise

Exercise is just as good for your brain as it is for your body. It increases blood flow to every part of the brain, it makes you less sensitive to stress, it improves your mood, and it helps grow new brain cells. Most research indicates that moderate-intensity aerobic exercise has the most cognitive and mental health benefits and one large study published in The Lancet Psychiatry found that team sports are the single best exercise you can do for mental health. If your head is foggy, a game of basketball, a jog, bike ride, or walk may be just the thing you need. ‍

6.)Practice Concentrating

Most of the items on this list are about removing the impediments to healthy cognition, but it may also help to challenge your brain more as well. Some of the cognitive impairment you feel after quitting drugs and alcohol comes from lack of use. It’s very easy to concentrate on things related to drugs and alcohol but everything else takes a back seat. You can start building up your focus and other cognitive skills by using them more frequently. Meditation is a great way to do this deliberately, but there are other ways to do this as well. Playing an instrument, for example, uses the whole brain and requires a lot of focus and coordination. High-skilled sports and possibly even some video games may also help.

7.) Be Patient

Finally, it’s important to be patient with yourself. It can be hard to go through your days in a fog, struggling to complete even the simplest tasks, but it will get better. Your brain has to heal from possibly a long time of drug and alcohol use and that just takes time. It’s also important to remember that whenever you feel challenged or frustrated trying to focus, your brain is actually adapting. Alternate periods of work and rest. After a time of trying to focus and remember, give yourself a real break, where you don’t do anything at all and be sure to get enough sleep. This gives your brain more opportunity to make the changes you require of it.

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Recovery from addiction is a process and sometimes it feels way too slow. At The Foundry, we know that one of the biggest challenges of recovery is persisting day after day when progress isn’t always obvious. We’re here to support you and your family through treatment and beyond, to give you the best chance of success. To learn more about our approach to treatment, call us at (844) 955-1066.

Meditation can be an excellent part of an addiction recovery plan. In recent decades, there has been a lot of research showing practical benefits of meditation including stress reduction, increased productivity, better sleep, better relationships, and a greater sense of well-being. These can all serve you well in recovery. Because of the popularity of meditation in recent years, there has been a flood of information about it. Unfortunately, much of it is well-intentioned but misleading and if you follow it, you might easily miss out on many of the benefits of meditation or conclude that meditation just isn’t for you. The following tips can help make your meditation practice a more effective part of your recovery plan. ‍

1.) Know Your Needs

First, meditation has become part of the current zeitgeist. It’s in the media all the time and you often hear people talking about their meditation practices. It’s almost expected that if you’re living a healthy, balanced life, then, of course, you’re meditating. However, it’s important to have some idea of what you actually want from the practice. Do you want to reduce stress? Do you want to have more compassion for yourself and others? Do you want to improve your concentration? Do you want to become enlightened? There are no wrong answers, but your individual needs will guide your approach to meditation.‍

2.) Find a Style that Works for You

Next, it’s important to understand that meditation isn’t just one thing. There are many different styles, traditions, and techniques. Currently, mindfulness meditation is the most popular and well studied and it will be a good place for many people to start. However, it’s not the only game in town. You may want to try a different style of meditation based on what you want from your practice. For example, if you want to reduce stress, mindfulness or a relaxation-response style of meditation may be the best for you. If you want to cultivate compassion then loving-kindness meditation (metta meditation) is the way to go. If you want to improve your concentration then a meditation that builds focus on an object, such as the breath, may be the most helpful.

3.) Find a Teacher

As noted, there is a flood of information on meditation out there and much of it is second-hand, perhaps a copy of a copy of a copy. The fastest way to get into a meditation practice and figure out if it’s right for you is to find a teacher. Depending on where you live and your particular situation, this may be easy or it may be hard. If your options are limited, the best strategy might be to work with the best teacher you can find. Even if it’s not exactly the style you want to do, they can show you the basics and help you figure out where to go next. If there is no teacher available in your area, look into online options. You can take a mindfulness-based stress reduction course online, which lasts eight weeks and has been shown to be pretty effective. There are also many good teachers on YouTube who do guided meditations for beginners. Look for videos by qualified teachers such as Thich Nhat Hanh, Yongey Mingyur Rinpoche, Jack Kornfield, Jon Kabat-Zinn, Joseph Goldstein, and Sharon Salzberg.‍

4.) Be Consistent

One of the biggest mistakes people make when they decide to try meditation is that they only do it when they feel like they need it. Perhaps they feel stressed or unable to relax, so they decide to light some incense and sit on the floor for a while and be peaceful. While that’s not the worst thing you can do, it’s about like exercising once in a while or practicing the piano once in a while. You really only get the benefits from regular practice. Meditation is a way of training your mind and you won’t see lasting changes unless your practice is consistent. It’s much better to practice 10 minutes every day than to practice for an hour at random intervals.

5.) Stick With One Approach for a While

Once you start learning about all the different approaches to meditation, you may be tempted to try them all. However, as discussed above, consistency is important. Spend at least a month with one practice and see what happens. If you don’t feel like it’s a good fit for you or your priorities change, try something else. 

6.) Don’t Try So Hard

Another common mistake people make is that they try too hard. A common misconception about meditation is that the goal is to clear your mind, which isn’t very practical. Some meditation styles advocate single-pointed concentration. However, most people try to achieve this through intense mental effort, which often backfires. Typically, it’s more effective to relax and approach your thoughts in the role of an observer rather than a bouncer. If you get caught up in trying too hard and constantly judging your meditation, it’s going to be counterproductive.‍

7.) Focus On the Process

There’s a paradox when it comes to meditation: There’s something you want from meditation or else you wouldn’t bother doing it, but the more you focus on the result you want, the less effective the meditation is. The reason is that you can’t simultaneously focus on the present, accepting your thoughts and emotions, and think about how great life will be in the future when your thoughts and emotions aren’t so irritating. The way out of this paradox is to focus on the process. Make meditation a regular part of your day, like brushing your teeth. When you do the practice, just do it and see what happens. Whether your experience that day is good or bad, it still counts.

Meditation isn’t a silver bullet but it is a practice that can enhance your recovery in many ways. For example, mindfulness meditation practice helps people be more aware of their emotions, less reactive to stress, and deal better with cravings. It’s a sort of safety valve for your mind. It relieves some of the tension so you can think a little more clearly and make better decisions. Having an experienced teacher is the best way to learn meditation. Consistency, patience, and being gentle with yourself are also crucial for getting the most out of your practice. 

At Foundry, we incorporate mindfulness meditation and yoga into our treatment program because we know treatment is only effective if we treat the whole person--mind, body, and spirit. Meditation is one aspect of our overall approach to wellness. Long-term success in recovery means creating a life that feels purposeful and connected, with no need for drugs or alcohol. To learn more about our addiction treatment program, call us today at (844) 955-1066.

Therapy is a central feature of any addiction treatment program. The majority of people with substance use disorders have co-occurring mental health issues such as anxiety disorders, major depression, personality disorders, PTSD, ADHD, schizophrenia, and others. Even those without a co-occurring disorder can benefit from discussing their thoughts around substance use and stress as well as learning new behavioral and coping strategies. Getting emotionally healthy is indispensable for a strong recovery. The following tips can help you make the most of your therapy sessions.

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1.) Find the Right Therapist

If you are entering an addiction treatment program, there are probably only a few therapists but they should all have experience treating co-occurring addiction and whatever your particular challenge is. If you are choosing your own therapist out in the world, you have to be a bit more selective. Find someone near you--ideally within half an hour travel time--to make it easier to attend appointments consistently. Find someone with experience treating the issues you struggle with. Most therapists have some experience with depression and anxiety but fewer specialize in addiction. When you have narrowed down the field to maybe three candidates, see if you can talk over the phone or have a sort of trial session with each of them to see who you connect with most easily.

2.) Understand That Therapy Is a Collaboration

When you’ve found a good therapist, keep in mind that therapy is a sort of collaboration. Your therapist is like a professional consultant. They need a lot of cooperation from you. It’s not the case that you can walk in, tell them what’s wrong, and expect them to fix you. In fact, it’s a bad sign if your therapist does too much of your work for you--telling you exactly what to do, dictating your goals for therapy, and so on. 

3.) Have Some Idea of What You Want to Accomplish

When you go to therapy, it’s a good idea to start out with some idea of what you want to accomplish. What’s bothering you that you decided to seek help? For most people, substance use is only a symptom of other problems but reducing or eliminating your substance use is a good objective to start with. You can work with your therapist to come up with other, more measurable objectives. You want to have some idea of whether you’re making progress in therapy and progress will look different for everyone.

4.) Don’t Censor Yourself

In normal conversation, we hold things back. Sometimes we don’t want to be too honest about our feelings or reveal too much about our past. Sometimes we just don’t want to say something that’s not relevant to the conversation. However, in therapy, it’s typically better just to say whatever is on your mind, even if you think it might be embarrassing or irrelevant. Honesty is essential, and it’s hard for your therapist to figure out what’s going on with you if you’re always being polite and curating your own thoughts and emotions. Furthermore, those odd, seemingly irrelevant thoughts that pop into your head may be more relevant than you think. Don’t worry about your therapist judging you; they’ve heard things you probably couldn’t imagine. And unless you make a credible threat against yourself or others, they are legally prohibited from sharing anything you say in a session.

5.) Ask Questions

Related to the point above, it’s good to ask questions. Indulge your curiosity. Ask questions about therapy, ask questions about psychology, ask questions about your therapist's experience with certain problems, ask questions about whether other people have the same problems as you, and so on. If there’s something your therapist isn’t allowed to reveal--such as information about other clients--they will make that determination. There’s no harm in asking if you’re curious.

6.) Talk About Therapy‍

It’s also good to talk about the process of therapy in your sessions. There may be times when you feel like you’re not making progress, you’re not really connecting with your therapist, or perhaps your priorities have shifted. It’s good to talk about these issues as soon as possible. They are often easy to fix. It takes a while to create a good therapeutic relationship, both in terms of sharing information and building trust, so if you’re in a situation where therapy was going well for a while but now it’s not, it’s certainly worth a conversation before quitting therapy or changing therapists.

7.) Do Your Homework

Your therapist will often ask you to do something between sessions. It may be a practical assignment like asking you to do at least one thing that makes you slightly anxious. Or it could be a written assignment, such as keeping track of times you feel angry during the week and what caused it. It’s important to take these assignments seriously since they are the bridge between your sessions and your life. If your therapist doesn’t give you homework, it’s still a good idea to keep a therapy journal. Write down briefly what you talked about, how you feel about it, and any thoughts or questions you have for next time.

8.) Keep an Open Mind

We all assume we know ourselves better than anyone else. That’s true in some ways, but we all have biases, blind spots, and patterns we’re not aware of. Much of therapy is about becoming more aware of your own behavior. This task is much harder when you cling to preconceived ideas about who you are, how other people see you, and how a person should act. Be open to at least considering suggestions that initially seem off base. Never forget that your best thinking is what got you into this mess to begin with.

9.) Set Boundaries

Finally, it’s usually a good idea to set boundaries around therapy. Some people in your life may be a little too interested in what you discuss in your sessions. They may be afraid they’ll get blamed for some of your problems or they may just be eager to give their own advice. Neither is really helpful. Be careful who you discuss your therapy sessions with. What goes on there is for you alone.

Therapy is central to addiction recovery because so much of addictive behavior is driven by challenging emotions that arise because of mental health issues. Although 12-Step meetings like AA and NA have helped many people, they aren’t designed to treat mental health issues, and so their benefit will be limited for many people. When participating in therapy, the most important thing to remember is that engagement is key. Your therapist may be best thought of as a sort of guide. They can help you get where you want to go, but you have to tell them where you want to go and you have to do the walking. 

At Foundry, we know that mental and physical health form the solid foundation of recovery from addiction. We use cognitive behavioral therapy, or CBT, dialectical behavioral therapy, or DBT, family therapy, group therapy, and other methods to treat co-occurring mental health issues. We also emphasize healthy lifestyle changes as a way to support mental health and addiction recovery. To learn more about our comprehensive approach to treatment, call us today at (844) 955-1066.

Most people vastly overestimate the role of willpower in addiction recovery. They assume that staying sober is just a matter of gritting your teeth and pushing through. In reality, addiction is typically caused by a combination of factors including genes, childhood environment, trauma, and mental health issues. The root causes of addiction have to be addressed for recovery to succeed. Saying willpower is all you need to recover from addiction is like saying willpower is all you need to recover from diabetes.

However, willpower does play a role. You need a bit of willpower to use your cognitive therapy skills, go to meetings when you really don’t feel like it, and do the other things in your recovery plan. While treatment and a recovery plan are what really help you recover, willpower can help you stay engaged. The following are some tips to give you a bit of extra willpower when you need it.

Exercise your willpower muscle.

For a while, there was an idea going around that willpower is a finite resource that you have to conserve throughout your day. While this is true in the short term — just as you might be tired after climbing a few flights of stairs — in the long term, the more you use your willpower, the stronger it gets. Just like how taking the stairs will get you into better physical shape in the long run, working your willpower muscle will increase your self-control.

For example, one study asked smokers to engage in activities that required some degree of willpower — either refraining from eating sweets or squeezing a hand gripper — for two weeks, while a control group was assigned tasks that didn’t require willpower. It turned out that the group that had performed tasks requiring willpower were more successful at quitting smoking.

You can easily apply this principle to your own life by making it a point to do small, slightly irritating tasks. You might give up sweets, like in the smoking study. Alternatively, you might make it a point to improve your posture or brush your teeth with your non-dominant hand. The point is to practice doing things that are slightly uncomfortable and that you would rather not do. Be sure to give yourself a bit of rest between tasks that require willpower, so you have time to recover.

Clean your house.

Cleaning your house is surprisingly good for boosting willpower. First, it’s an excellent way to strengthen your willpower muscle, since no one ever really feels like taking out the trash or washing the dishes. Keeping a clean house provides many small and useful ways to build your willpower.

However, a cleaner environment also appears to boost your willpower even if you weren’t the one to clean it. One study² put some participants in an orderly environment and others in a messy environment, then asked them to make various choices. The participants who were in a more orderly environment were more likely to choose healthy snacks and donate money. Having a clean house might give you the extra bit of willpower you need to exercise or eat a bit healthier.

Get in touch with your values.

Nietzsche famously said that whoever has a why can endure any how. One of the biggest challenges to our willpower is when we face a choice that appears not to have any stakes. For example, you know that one cookie won’t really make a difference in the scheme of things, and since it doesn’t matter, you might as well eat it. Skipping one 12-Step meeting is probably not going to sink your recovery.

However, these things add up. That’s why it’s important to identify your most important values and connect your daily activities to those values. So, for example, a lot of people decide to get sober for the sake of their families. If that has been part of your motivation, as well, keeping “family” in mind can help you overcome whatever resistance you’re feeling when you’re trying to decide whether or not to attend your 12-Step meeting today.

Use your willpower where it will do the most good.

In addition to strengthening your willpower through exercise and other things that can give it a boost, be sure you’re using your willpower to your best advantage. For example, it’s much easier to use your willpower to take a different route to work every day than it is to pass by the bar and not stop. It’s easier to go past the bar than it is to go in but not order a drink, and so on. Use some foresight and strategy so you can avoid the need for herculean displays of willpower.

Create healthy habits.

Often, what looks like willpower is just a matter of good habits. Most of our behavior is habitual to some degree, so use that to your advantage. When creating a new habit, it’s important to link it to an existing habit, start small, and only create one new habit at a time. So, for example, if you want to start exercising regularly, start by tying it to something you already do every day, like waking up or coming home from work.

Say you come home from work, change into your exercise clothes, and walk for five minutes. After a month or two, this will become automatic and you won’t have to use any willpower to get your daily exercise.

Spend time with the right people.

You can only expect to do so much on your own. Your motivation and willpower are always stronger at some times and weaker at others. Having the right people around you can get you through rough spots by keeping you focused on the right things and holding you accountable. In the context of recovery, for example, the camaraderie of your 12-Step group can help keep you engaged even when you have other things on your mind. It’s essentially a way of outsourcing your willpower to get you through tough times.

No one recovering from addiction should be relying entirely on willpower, but it certainly can help you stick to your recovery plan. Your beliefs about willpower matter too; if you believe your willpower will run out, then you won’t have as much. Otherwise, it’s important to build your willpower in small ways, remember why you’re exercising your willpower to begin with, create healthy habits, and find supportive people. At The Foundry, we know that addiction is complex and that overcoming it is about creating a healthier, more fulfilling life. To learn more about our treatment options, explore our website or call us today at (844) 955-1066.

Happy New Year everyone!

Don’t you just love this time of year? A time for new beginnings, a time to dream, to make goals, and turn words into action. A time to let go of the past and to look toward the future! The beginning of the year always feels so fresh and exciting to me, and this year is no exception. Fun things are on the horizon here at Foundry Steamboat, and I can’t wait to share with you what we have planned! To kick off the year, here is what the Wellness Program has been up to in January!

Healthy Habits

This month our Healthy Habits group focused on Sleep Hygiene. Sleep is so important for not only our physical health, but our mental health as well. Getting quality sleep every night can set the foundation for your day. A good night’s sleep can boost your mood, improve memory, strengthen your heart, bolster your immune system, increase your exercise performance, and improve your productivity and your overall quality of life.

           We can all agree sleep is vital to our health, so then what the heck is Sleep Hygiene?! Sleep Hygiene is defined as various practices and habits necessary to have good nighttime sleep quality and full daytime alertness. You might not have good sleep habits if you have frequent sleep disturbances, daytime sleepiness, or it takes you too long to fall asleep.

           If you are struggling with Sleep Hygiene, here are a few things you can implement to help you get quality sleep:

∙      Limit daytime naps to 30 min (or avoid them altogether, if you can)

∙      Avoid stimulants such as nicotine or caffeine close to bedtime

            ➣  You may even need to limit caffeine to before noon in some cases

∙      Exercise!

             ➣  As little as 10 min of aerobic exercise can improve nighttime sleep quality

∙      Avoid food that can cause indigestion right before sleep

∙      Get adequate exposure to natural light

              ➣  Exposure to sun during the day and darkness at night helps with a healthy sleep/wake cycle

∙      Establish a relaxing bedtime routine

              ➣  This helps the body recognize it is time for sleep

              ➣  Your routine can include warm shower or bath, reading a book, or light stretches

∙      Avoid blue light from phone or TV right before bed (zero screen time 30 min before)

              ➣  Blue light can make it difficult to fall asleep because it suppresses melatonin production in the body, tricking your brain into thinking it is daytime

∙      Make your sleep space pleasant and relaxing!

              ➣  Comfy pillows and mattress

              ➣  Temp between 60-67 degrees for optimal sleep

              ➣  Can include a noise machine, fan, ear plugs, eye mask, or blackout curtains to create a pleasant sleeping space

∙      Only use bed for sleep and intimacy!

              ➣  Reading, watching tv, or working from your bed, can make your brain associate your bed with a place of wakefulness, instead of a place to sleep!

Try a few of these tips to see if they improve your quality of sleep. To track their effectiveness, make note of how many nights a week you utilize these tools to see which ones work best for you. Keep in mind, the more you practice them, the better they work! For more information about sleep hygiene visit www.sleepfoundation.org.Happy sleeping!

January Wellness Activity Highlight

           This month we took advantage of the sunshine and got outside on our snowshoes around the ranch! At the time of the activity, we had recently had a snowstorm which made the perfect canvas for us to think outside the box and make some art with our snowshoes. The residents and staff got creative out in the hayfield and did a collaborative Snowshoe drawing. This activity was perfect for mindful movement and cardio! The end result was so cool, and we even got aerial photos and a video, thanks to one of our staff members with a drone! You can check out our aerial video by going to our YouTube channel or our social media platforms. We have big plans for our next snowstorm, we can’t wait!

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Fitness

In the fitness aspect of theWellness Program, we focus on functional movement; movements that mimic everyday life. Functional Fitness is a classification of training that prepares the body for real-life movements and activities. It trains your muscles to work together and prepares them for daily tasks by simulating common movements you might do at home, at work, or in sports. While using various muscles in the upper and lower body at the same time, functional fitness exercises also emphasize core stability. Movements such as squatting, reaching, pulling, and lifting will be made easier with functional fitness integrated into your exercise routine.

           Some of the benefits of functional fitness include increasing ease of everyday movements; increases flexibility, coordination, balance and posture; helps reduce joint pain; reduces the risk of injury; can be tailored to any ability; and builds muscle. Here at Foundry Steamboat, we incorporate three functional fitness workouts a week.

Below is one of the full body workouts we did this month:

For 12 min, do as many rounds as possible of:

-      5 pull ups (modifications: assisted pull ups, ring rows, or bent over rows)

-      10 push-ups (modification: elevated push-ups)

-      15 air squats

-      20 sit ups (modification: crunches)

-      3 – 5 burpees

That’s a wrap on January for the Wellness Program! Stay tuned for what we have going on in February!

Cait Mowris, Wellness Director, Foundry Steamboat

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One stereotype about addiction that may actually have some truth to it is that people in recovery smoke and drink a lot of coffee. A study of nearly 300 AA members in Nashville found that nearly 57 percent smoked cigarettes, compared to just 14 percent of Americans overall, and nearly 89 percent drank coffee, compared to about 64 percent of Americans overall.

Smoking is clearly bad for you and your recovery, as discussed in another post, but what about coffee? As you might expect, the picture with coffee, and caffeine in general, is more complicated.

The Source Is Important

First, it makes a huge difference whether you’re getting caffeine from coffee or tea or from energy drinks. Health experts are pretty much unanimous that energy drinks should be avoided. Part of the problem is that you never quite know what you’re getting. Some energy drinks have extravagant levels of caffeine. Others contain exotic ingredients, the effects of which are poorly understood, especially in combination with other ingredients.

Perhaps most importantly, energy drinks tend to have a lot of sugar. The average energy drink has about 23 grams of sugar. The American Heart Association recommends consuming no more than 36 grams of sugar per day total for men and no more than 25 grams of sugar per day for women. The energy drink with the most sugar is Rockstar Xdurance, with a stunning 69 grams.

Excess sugar consumption is bad for your health in general and has been linked to obesity, diabetes, heart disease, chronic inflammation, and fatty liver disease. For people recovering from substance use disorders, these outcomes are especially bad. Someone recovering from alcohol use disorder, for example, is already at greater risk for diabetes, heart disease, and liver disease. 

Sugar can take a toll on your mental health as well, putting you at greater risk for relapse. Several studies have found that high-sugar diets and obesity increase your risk of depression. Inflammation has also recently been implicated in some forms of depression. In short, if you’re recovering from addiction and drinking energy drinks, you would be far better off consuming an equal amount of caffeine in the form of coffee.

Pros

There Appear to Be Some Mild Health Benefits

As for whether you should drink coffee or tea, it’s a mixed bag and it largely depends on your situation. There do appear to be some mild health benefits associated with coffee and tea. The case for tea is pretty straightforward. It’s loaded with antioxidants and numerous studies have shown that heavy tea drinkers have a slightly lower risk of various cancers. The only real downside is burning your mouth when drinking it too hot. 

Coffee is a bit harder to pin down since contradictory studies emerge every few years. For example, some older studies found a slight increase in bladder and pancreatic cancer risk but those have been largely discredited. It does appear that coffee raises your blood pressure and that unfiltered coffee can raise your cholesterol. 

However, a number of studies have identified a number of health benefits from moderate--that is, about four cups a day or less--coffee consumption. These include a lower risk of cardiovascular disease and stroke, type 2 diabetes, liver cancer, liver cirrhosis, and gout--all risks that are heightened by excessive alcohol consumption. These positive effects aren’t huge, but if you’re already drinking a few cups of coffee a day, they’re a nice bonus.

Caffeine Can Improve Your Mood

Caffeine can also have some positive effects on your mental health. Coffee’s effects on mental health have been pretty well documented and they include increased alertness--obviously--more energy, better cognitive function, and better mood, as well as fewer depressive symptoms and lower risk of suicide. These effects can give you an edge in dealing with the sluggishness and irritability common early in recovery.

Drinking coffee might be considered a form of self-medicating, but for most people, the negative effects of moderate coffee consumption will be preferable to those of even well-tolerated SSRIs. The only caveat is that you shouldn’t use caffeine as a substitute for therapy for a mental health issue.

Cons

Caffeine Can Aggravate Anxiety

The biggest drawback for many people in recovery will be caffeine’s tendency to aggravate anxiety. Caffeine stimulates the sympathetic nervous system, which feels the same as anxiety or even panic. If you’re not prone to anxiety, moderate consumption is probably fine but if you have issues with anxiety, even a little caffeine may make them worse. According to one study, nearly 18 percent of people with a substance use disorder had problems with anxiety in the past year. That means there’s a decent chance you should be trying to manage your anxiety levels, which might include cutting down on caffeine.

Caffeine Can Disturb Your Sleep

The other major concern about caffeine for people in recovery is its effect on sleep. Insomnia is a common withdrawal symptom and it may persist for weeks or months into recovery. If you’re guzzling coffee all day, that’s not likely to help you sleep any better. Caffeine has a half-life of about four to six hours, depending on your metabolism. That means that even if you quit drinking coffee at noon, there may still be quite a bit of caffeine in your system at bedtime. That may keep you up or it might just cause you to sleep less deeply. 

Insomnia and chronic sleep deficit have been linked to a number of mental health issues. In the short term, these include poor concentration, poor working memory, and poor emotional regulation. In the long term, it significantly increases your risk of anxiety disorders and major depression. Since both of these are common factors in developing substance use disorder and relapsing to substance use, it’s important to get enough quality sleep, which may entail reducing or eliminating your caffeine intake. 

Everyone’s situation in recovery is different. Some people are more sensitive to caffeine and some people metabolize it very quickly. Some people can’t sleep after drinking a cup of coffee in the afternoon, others can sleep fine if they have a cup right before bed. Some people have anxiety issues and some don’t. It’s important to be aware of your own vulnerabilities and act accordingly.

At The Foundry, we understand that recovery from addiction is highly individual, which is why we work with clients to come up with a treatment plan that best suits their specific needs. We also know that a strong recovery depends on making healthy lifestyle changes, including diet. We incorporate all of these things into our holistic addiction treatment. To learn more, call us at (844) 955-1066.

Boredom during addiction recovery is both common and dangerous. There are several reasons boredom is more common when you’re starting recovery. First, you may discover that you suddenly have a lot of extra time on your hands and you’re not sure what to do with it. Most people don’t realize how much time drugs and alcohol can devour. You may also be trying to distance yourself from friends who use drugs and alcohol, so your social activity may be temporarily diminished. 

Boredom is also amplified by what’s going on in your brain when you first get sober. When you use drugs and alcohol, you’re essentially overclocking your dopamine system and this may go on for years or decades. When you quit, your brain is underwhelmed by things that might normally be interesting and enjoyable. Your brain is only sensitive to things related to drugs and alcohol. As a result, a lot of things will seem boring during the time it takes your brain to recalibrate. 

This can be dangerous because boredom is stressful and during active addiction, it’s a problem you likely solved with drugs or alcohol. Therefore, it’s important to learn to deal with boredom in addiction recovery. Here are some tips.

There Is No Quick Fix

These days, most of us immediately reach for our phones when we feel the slightest bit bored but this is really only a superficial solution. It turns down your boredom from a distressing eight to a tolerable six. As a result, you may end up wasting hours doing a moderately boring activity like scrolling through Facebook or Reddit rather than doing something that might actually be fulfilling or productive. These kinds of time-wasters are fairly mind-numbing and will probably only make you feel more agitated in the long run.

What Is Boredom?

Keep in mind that your boredom may be trying to tell you something. Your problem is usually not that you have nothing to do, but rather that no available option seems appealing, engaging, or satisfying. Your brain may be trying to tell you something. Perhaps your usual activities don’t promote ends you really care about or perhaps your values or priorities have changed in ways you haven’t acknowledged. Boredom is an opportunity to think these things over and possibly consider new directions. Just be careful that you don’t fall into negative rumination.

Examine Your Thinking About Boredom

Boredom is not fundamentally different from any other challenging emotion. It’s typically some mix of restlessness, dissatisfaction, and lethargy. You want to do something but you’re not sure what. You can cope with boredom and the distress caused by boredom using the same techniques you would use to cope with other challenging emotions like anger or anxiety. If you have been through an addiction treatment program, you probably learned quite a few of these techniques while participating in cognitive behavioral therapy or dialectical behavioral therapy. 

One common approach is to examine your underlying assumptions. For example, you might have trouble engaging with an activity if you’re thinking something like, “I’ll never get better at this,” or “there’s no point in doing this anyway.” Or perhaps you’re feeling distressed because of how you think about boredom, maybe something like, “It’s unfair that I feel bored; I shouldn’t feel this way,” when in reality, everyone feels bored occasionally. Spotting these faulty beliefs and challenging them can help you feel less bored or at least less bothered by boredom.

Do Something Boring

This one seems paradoxical, but if you try it, you might find it helpful. Part of the reason boredom is irritating is that we do something with the expectation that it will be fun and interesting but then it doesn’t deliver. However, when you vacuum the living room or put away your laundry, you don’t expect it to be fun; you just want the result. If you’re bored and nothing seems to engage your attention, pick something on your to-do list and do it. You may still find it boring but you’re bored anyway and this way, you’ll at least get something done. What’s more, you may find that doing something--anything--gets you out of your rut.

Rearrange Your Schedule

Occasional boredom is unavoidable. Maybe you’re stuck in another pointless meeting at work or your dentist is running behind schedule. However, if you’re frequently bored, you may not have enough to do. See if there’s something you can add to your schedule to keep you a little more busy--a 12-Step meeting, a standing coffee date, a workout, an art class, whatever. The trick is to structure your days so that you have enough to do that you’re not bored but not so much to do that you feel stressed and overwhelmed.

Set a Timer

Finally, when nothing seems satisfying, try setting a timer for 10 minutes or so and sticking with an activity for the whole time, even if it feels tedious and pointless at first. Many activities, especially complex and productive activities, take a certain amount of effort and focus for them to be engaging. It may take a few minutes to get into a novel you’re reading or to remember where you left off on a project.

If you give up after a couple of minutes of feeling disinterested, you’ll never get into it. Sometimes you just have to persist until you overcome that initial resistance. Try picking something you want to do and sticking with it for a certain length of time no matter what. If you’re still not into it after 10 or 15 minutes, try something else.

Boredom is a real problem in recovery, but it’s no different from other challenging emotions. Remember that, like other emotions, boredom is just information. It’s an opportunity to think things over and it doesn’t have to be distressing. It can also be an opportunity to do something useful and to practice overcoming inertia.

At The Foundry, we understand that recovery from addiction isn’t just about abstinence from drugs and alcohol; it’s about living a happier, more fulfilling life. We use a variety of proven methods to help our clients tolerate and manage stressful emotions as part of a holistic treatment program. To learn more, call us at (844) 955-1066.

Easter time! Easter is of course a big holiday and with it comes big expectations of being around family and friends. There’s also an expectation of eating great food and having a “feast”, but sometimes gathering in large groups becomes overwhelming especially if you are the one hosting! If you are anything like me, you love gathering with friends or family to enjoy some great food and have good conversations, but there is a lot of pressure to make all the food yourself AND provide the entertainment. 

I think the best entertainment actually just is the cooking! So how do you get everyone involved in the cooking process? That is a great question, and one that I try to ask myself every time I have a cooking class or people over. I like to refer to a good group of people cooking together as “community cooking”! 

Where to start with community cooking? Well I think about meals that get multiple people either; using a cutting board, rolling dough, or doing some sort of other prep.

Easter Sunday at the Ranch was a great community cooking day! All of the clients got in on the feast that we had at the ranch, and what says Easter more than a good Easter brunch with hot cross buns! Our “community meal” was a potato veggie hash with eggs and bacon. Enough veggies for everyone to be able to lend a helping hand! Plus we always have some great conversations when everyone is involved in the cooking process. Yes there was even time to make some great lemon raspberry cake!

So the next time you are hosting a group of people at your house, or just having a casual get together with friends, think of ways that they can cook with you! You never know what great things you will talk about!

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Greenhouse update!

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Yes!! We are eating food from the greenhouse! Our farm to table cooking is back! We are now harvesting enough mixed greens just from our greenhouse that we don’t need to buy anymore greens from the store!! How exciting!

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As always if you are looking for more Foundry content check out our website, or look for us on social media; instagram (@foundrysteamboat), Facebook (Foundry Steamboat), or Twitter (@foundryrehab)! 

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Recipe time!

Hot Cross Buns

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Makes about 15 buns

Prep time: 15 minutes

Cook time: 25 minutes 

Rising/down time: ~1.5 hours

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Ingredients

• 2 ½ cups of warm water
• 2 teaspoons of yeast
• 1 ½ teaspoons of salt
• 1 cup of dried cranberries 
• ½ of a stick of melted butter
• 1 cup of whole wheat flour
• About 3-4 cups of bread flour

For the icing

• ¼ cup of milk
• 2 cups of powdered sugar (or add powdered sugar to texture)

Directions 

• In a large mixing bowl or stand mixer add the warm water and yeast. Let the yeast dissolve for about 1 minute.
• Add in 1 cup of whole wheat flour and stir to combine. Let the mixture sit until you see bubbles start to form or about 5 minutes.
• After the five minutes are up, add in the bread flour, melted butter, dried cranberries, and salt. Stir/mix to combine. If you are using a stand mixer, mix until the dough starts to pull away from the sides of the bowl (you may need to add a little bit more flour depending on what flour you are using). 
• Once the dough pulls away from the sides of the bowl; “knead” the dough until smooth and elastic. If using a stand mixer, the kneading process will only involve turning up the mixer to speed 3-4. If you are mixing by hand, turn the dough out onto a floured surface and push the palms of your hands into the dough and stretch it. Repeat this motion until the dough is smooth/elastic.
• Once kneaded, put your dough back in the mixing bowl and wrap it with plastic wrap or put a wet towel over it. 
• Let your dough rise/ferment for about 45 minutes or until the dough has doubled in size. 
• After the dough doubles in size, divide it into 4 ounce balls by weight (or about the size of two golf balls).
• Roll your “dough babies” into nice round balls then place on a baking sheet lined with parchment paper. Lay a wet towel over your dough after shaping. After you have rolled all of your dough, preheat the oven to 400 degrees.
• Let your dough sit again for about 30 minutes or until doubled in size again.
• When the dough has doubled, place it in the oven for about 15-18 minutes or until the crust is golden brown. 
• While the buns are baking, work on making the icing! Icing is super easy to make, just combine the milk and the powdered sugar. If your icing is too runny, add some more powdered sugar. If your icing is too thick, add some more milk. 
• When the buns are done, take them out of the oven and place on a cooling rack. Eat them hot with the icing or allow them to cool completely and then make a “cross” with the icing on top!

Have a fun and clean month everyone!

• Chef Henry

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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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Contrary to popular belief, there is no such thing as an addictive personality. Substance use disorders afflict the outgoing and the shy, the kind and the mean, the curious and the conservative. However, there is one personality pattern that research shows is more common among people with substance use disorders: high neuroticism and low conscientiousness. These are two of the big five personality traits most commonly used by psychologists, the other traits being extraversion, openness, and agreeableness.

Neuroticism is the tendency to experience negative emotions and it’s highly correlated with mental health challenges and substance use issues. 
Conscientiousness involves things like being goal-oriented, organized, responsible, and law-abiding. Even people who are high in neuroticism are less prone to substance use issues if they are also high in conscientiousness.

As fundamental personality traits, these are both slow to change, but since conscientiousness is the trait most directly related to behavior, it’s the trait you have the most control over. The following tips can help you be more conscientious and thus strengthen your recovery from addiction.

Avoid Black-and-White Thinking

If you’re a creative person, a non-conformist who likes to find your own way, you no doubt hear things like “law-abiding, organized, achievement-oriented,” and so on and think, “No thanks.” You may imagine turning into some kind of conformist, validation-seeking automaton. That belief can be a major barrier to positive change.

Don’t worry, no matter how hard you try, that will never be you. In being more conscientious, we’re not talking about overhauling your personality; we’re talking about turning up one particular dial from about two to about four. The idea is to boost your conscientiousness just enough that you’re not so vulnerable to your own destructive impulses.

Get Clear on Your Priorities

One major characteristic of conscientious people is that they’re highly organized. They have a schedule and a to-do list and they stick to them. If you’re currently low on conscientiousness, you probably won’t have much luck trying to jump straight to a schedule broken down into 15 or 30-minute blocks. Instead, start by organizing your day according to your priorities.

Each day, or even the night before, identify the things you must accomplish and then prioritize them. So maybe you have a 12-step meeting, a therapy session, and work as your top three. There are probably some other things you could do, and perhaps some things you want to do and you may get to those or you may not.

Before you do anything else, schedule your priorities and work everything else in around them. That way, you won’t get distracted by “urgent” things that won’t really improve your quality of life.

Set Relevant Goals

Another common characteristic of the highly conscientious is that they are goal-oriented. Setting goals and working toward them consistently is often difficult for the conscientiously challenged. Goals feel constrictive. You have to work on them even when you don’t feel like it and besides that, you may set a goal today that you don’t care about tomorrow. Sometimes just setting a goal ignites a determination deep within you to do the exact opposite. So how do you deal with it? 

One solution is to set process goals. Instead of setting a goal that’s SMART--specific, measurable, achievable, relevant, and time-bound--identify the direction you want to go and work on developing behaviors that take you in that direction. For example, if you want to be a rockstar, make sure you practice your instrument at least 30 minutes every day. If you want to stay sober, identify the behaviors that will lead to that result, and make them part of your life. 

It’s especially helpful if you can associate your long-term goals with your core values. For example, “I want to stay sober because I care about my family’s happiness.” Then, whenever you have a decision to make, you can ask yourself, “Does this take me closer or farther from my goals and values?” If it takes you closer, then go for it.

Create a Healthy Routine

Related to the points above, creating a healthy routine will significantly boost your conscientiousness. Routines have two major advantages: First, any routine, even a terrible one, will reduce uncertainty. Uncertainty is a major source of stress and anxiety in life and if you kind of know what to expect from day-to-day, you manage those feelings a little more easily.

Second, a healthy routine is an easy way to automate healthy behaviors. Instead of having to decide all the time if you’re going to have a healthy breakfast, if you’re going to exercise, if you’re going to attend your 12-step meeting and so on, you make them regular parts of your day so that you just sort of do them on autopilot. You don’t have to exert much willpower once those routines are set. 

Creating a healthy routine is another challenge altogether. Start with your top priorities for the day, as noted above. If you’re recovering from addiction, these should be elements from your recovery plan. You may already have a head start on some of them if you’ve completed an inpatient treatment program. Otherwise, start with one or two anchor points.

For example, you might get up at the same time every day and you might go to a 12-step meeting at the same time every day. Then you can start building other things around these two. So maybe you get up and exercise right away, perhaps walking for a few minutes until you’ve formed a solid habit. Then start adding other elements directly following previously established anchors. The idea is that you want to go from one thing to the next, like stepping stones. 

Since conscientiousness is a personality trait, it is slow to change. While a low-conscientiousness person will never magically turn into the most goal-oriented, focused, and responsible person around, they can gain more control over their lives. The keys are to keep your values in mind and make consistent efforts. You will also have a bit of a tailwind since conscientiousness tends to increase slightly with age.

At The Foundry, we know that recovery from addiction isn’t just about abstaining from drugs and alcohol, but rather about making the kinds of changes that allow you to take charge of your own life and live in a more connected, meaningful way. That’s why our holistic program focuses on growth in every area of life. To learn more, call us today at (844) 955-1066.

It’s often said that recovery from addiction is a marathon, not a sprint. As in a marathon, there are plenty of opportunities to give up in recovery and the people who do well aren’t necessarily the ones who come blasting off the start line, but the ones who can keep themselves going when they feel totally exhausted. There is no easy trick to staying motivated, but some of the following strategies might help.

Understand that Motivation Is Variable

First, understand that motivation is not some intrinsic quality and it’s not something you can do equally well every day. Motivation is a skill and sometimes you can do it well and other times you just have to be content to make it through the day. The good news is, that like any skill, the more you practice motivating yourself and creating the right conditions for motivation, the easier it gets. 

Identify Your Core Values

When you’re trying to keep yourself motivated, it helps to have a clear vision of why you’re doing what you’re doing. Otherwise, you don’t have much incentive to persist through tough times. While it may be hard to picture your perfect sober life, you can certainly identify some of your core values and how staying sober relates to those values. 

For example, many people decide to get sober when they realize what their drinking and drug use is doing to their family. For these people, it’s important to keep the value of family clearly in front of them. You can do this in various ways. You might keep pictures of your family around you, where you can see them easily. You might periodically write about why family is important to you. Studies have found that this practice--called self-affirmation--can help you make healthier decisions and improve your relationships.  

Create Good Habits 

As discussed above, motivation goes up and down. Therefore, it’s important to create structures in your life to hedge against the risk of relapse on low motivation days. Part of that structure is made of healthy habits and routines. It typically takes about two months for a new behavior to become automatic, but after that, the healthy behavior is on autopilot.

This may be one reason people new to recovery are often advised to attend 90 12-Step meetings in 90 days. If you commit to that, then going to your meeting should be automatic by the end of the 90 days. That’s a major piece of your recovery plan that you won’t have to put any thought or effort into--you just go. The more healthy habits you create, the more the odds are stacked in your favor.

Build a Great Sober Network

Another big part of creating a structure that will keep you on track is creating a great sober network. This includes sober friends, supportive family members and friends, and fellow 12-Step members as well as your therapist, your doctor, your sponsor, and anyone else that has a special interest in your recovery. A sober network helps you in many ways.

It helps reduce stress because there are people who will listen without judgment and who can offer advice and support. You have more resources to deal with any problems that arise and you feel a greater sense of accountability. The last thing you’ll want to do is go to your 12-Step meeting and admit that you slipped up. That can be a powerful incentive to stay sober even when you don’t feel like it.

Find Ways to Cope with Doubt

Learning to deal with doubt is crucial for staying motivated because nothing kills your motivation faster than listening to that little voice that asks you, “Why are you putting yourself through this? You’re just going to fail anyway.” In order to stay motivated, you have to have a reasonable expectation of success. The problem is that it’s hard to judge what’s reasonable, especially when you’re just starting out. 

The other strategies described here can help you cope with doubt. Having a strong sober network is especially helpful since you’ll meet people who have succeeded despite significant challenges. It’s also important to learn ways to push back against irrational thoughts. For example, if you think things like, “You’ll fail at this because you fail at everything,” you might recognize this as an overgeneralization and push back with a thought like, “Really? Everything?” and think of some evidence to contradict your overgeneralization. 

Take One Day at a Time

This may sound cliche, but it’s a cliche because it works. If you think that you have to motivate yourself to keep going forever, it will feel exhausting. However, if you only think that you have to make it through the day or even through the hour, that typically feels more manageable. You can only act in the present moment, so if you can motivate yourself to not drink, to go to your meeting, to call your therapist, or whatever else you need to do right now, that’s really all you have to worry about. If you can do it today, you can do it tomorrow too.

Play the Tape

Finally, in an emergency, you can always play the tape. This is where you think through the consequences of drinking or using again. Typically, when you have a craving, you’re only imagining the immediate gratification of drinking or using again. Unfortunately, that gratification only lasts a short time and then you have to deal with the consequences of relapse. Instead of focusing on the relapse itself, think through the entire thing--the next hour, the next day, the next week, and so on.

Imagine how you’ll feel about relapsing after so much hard work, how disappointed your family will be, how hard it will be to tell your 12-Step group, and so on. Think about how bad things were in active addiction when you finally decided to get help. Picturing all of this clearly can make the momentary gratification of relapse seem small by comparison.

Motivation is a single thing, but rather learning to select and use a range of skills appropriate to the situation. Identify your core values, create good habits and routines, create a good support system, and learn to play the mental game.

At The Foundry, we believe that recovery from addiction entails a set of skills that anyone can learn. We use a variety of methods, including dialectical behavioral therapy, mindfulness meditation, yoga, and lifestyle changes to help our clients learn recovery skills and build a sense of self-efficacy that will serve them long after they graduate from our program. To learn more, call us at (844) 955-1066.

Most people with a substance use disorder know about shame. It may be the central feature of their emotional lives. If you struggle with substance use, you likely feel shame on several levels. There may be shame resulting from physical, emotional, or sexual abuse, whether as a child or as an adult. Research continually shows that abuse, trauma, and PTSD are incredibly common among people with substance use disorders. Many people carry shame from those situations, even though they weren’t to blame. 

Substance use disorders can also lead to shame in themselves. Addiction can override your moral judgment to the point where you’re willing to manipulate or deceive your loved ones to get what you want. You may act impulsively and recklessly while drunk or high, causing harm to yourself and others.

You may feel shame because of the stigma of substance use and you may feel shame about having to ask for help. Shame is common and it’s also one of the most corrosive emotions. Like any wound kept hidden, it only gets worse with time. The following are some suggestions for coping with and healing shame.

Acknowledge Shame

The first step in dealing with shame is to acknowledge what you’re feeling. It’s not always obvious that what you’re feeling is shame. Sometimes you experience it as anger, irritability, defensiveness, procrastination, or depression. It may take some introspection to realize shame is behind some persistent challenging emotions. You can dig down into these emotions by asking why. Why do you get angry when a loved one suggests you talk to a therapist? Why do you get defensive when certain topics are raised? 

Shame likes to hide. There’s a good reason people often say after telling an embarrassing story, “I wanted to crawl in a hole.” You want to protect yourself from those who would deride you. Unfortunately, when you feel shame, you are the one deriding yourself and so shame takes on different forms. 

Observe Shame Nonjudgmentally

When you are able to identify shame, try observing it without judgment. This can be incredibly hard because no one likes how it feels. Your natural reflex is to push it away or think of something else. However, that only makes the feeling stronger because you continue to fear it. Instead, allow yourself to feel it. Where do you feel it in your body? Does it feel like fear? Disgust? What thoughts are associated with it? Make sure you’re not feeding the shame with self-criticism; just experience it as it is. 

Is It Shame or Guilt?

It’s also important to distinguish shame from guilt. Guilt is a useful emotion. It’s our conscience letting us know we’ve let ourselves down in some way. Feeling guilt prods us into fixing our mistakes and improving our behavior. The important distinction is that guilt applies to our actions and shame applies to our inherent value.

When you make a mistake, perhaps you’ve made a rude comment to a friend, guilt says, “That was badly done; I’ll have to apologize and be more careful in the future,” but shame says, “I’m a horrible person and I’m always going around hurting people.” 

The irony is that shame actually makes you less able to improve your behavior. It implies that you’re permanently, inherently bad, rather than affirming that you’re capable of growth. If there is something you feel ashamed of, something you perhaps did as a result of addiction, try transferring it to the guilt category.

For example, instead of thinking “I’m an awful person for stealing from my parents,” change it to “It was wrong to steal from my parents and I’m determined never to do that kind of thing again.” 

Is It Something Else?

Shame has other functions as well. For example, an overt display of shame can signal remorse to the people around you. If you’re beating yourself up, they feel more inclined to let you off the hook. In this case, shame performs a social function, preserving your connection to the community after you’ve done something bad. Of course, after a certain point, this no longer helps. 

Shame may also be a way of keeping yourself stuck. You may feel like you don’t deserve to be happy because you’re so rotten. Conveniently, this also spares you the effort of trying to make positive changes in your life. After all, you can’t fail if you don’t try. The thought of failure or really any kind of change may be so frightening that even living with shame seems preferable.

Develop Compassion for Yourself

To move past shame, start by developing some compassion for yourself. We are often much harder on ourselves than we are on anyone else. In fact, if we treated others the way we treat ourselves, we’d probably be ostracized or locked up.

When you have identified some source of shame, take a step back and try to regard yourself the way you would a friend. Imagine a friend telling you they were ashamed of whatever it was that you did, or whatever happened to you. Imagine reacting with compassion, knowing that although your friend isn’t perfect, they deserve to be happy. Try extending that same feeling to yourself.

Try Opening Up

Finally, try opening up about shame. This is what really allows you to heal. As noted above, shame wants to hide but that only makes it worse. If you don’t yet feel like you can open up to someone you trust and care about, consider opening up in therapy.

Your therapist has probably heard it all and anything you say is confidential by law. Often, just saying it out loud to someone helps, but your therapist can also help you work through your feelings. Group therapy is also a great place to open up because you will probably discover that some other members of the group have had similar experiences and you will no longer feel alone.

If you’re not quite ready to talk about your feelings of shame with anyone, try writing about them. Just acknowledging them and exploring them in some detail will probably make you feel better, and perhaps prepare you to discuss it with a therapist.

Shame is a destructive emotion because it convinces us that we’re bad, that we’re weak, that we’re unlovable, and that we don’t deserve anything good in life. The good news is that shame can’t live in the daylight. The more you are able to acknowledge and share feelings of shame in appropriate circumstances, the less it will control your life. 

At The Foundry, we know that trauma and shame are often at the core of a substance use disorder. That’s why our program focuses on treating trauma with proven methods, including dialectical behavioral therapy, or DBT, EMDR, mindfulness meditation, trauma-informed yoga, and other methods. To learn more, call us today at (844) 955-1066.

No one likes to believe their loved one has a substance use disorder. Not only that, it’s a fairly serious thing to confront someone about unless you’re pretty sure. This is bad for two reasons. First, if your loved one does have a substance use issue or other addiction, they will use your attentional blindness and uncertainty against you. They can easily leverage your doubts into making you apologize and drop the subject. Second, the longer you wait for clearer evidence, the worse their addiction will get. Addiction is a progressive disease and it will never be easier to overcome in the future, so time is valuable. 

Some signs of addiction are fairly obvious. Someone may use drugs or alcohol excessively in your presence, even in appropriate situations. They may cancel plans or neglect other responsibilities so they can drink or use drugs. They may show withdrawal symptoms when they quit drinking or using drugs for a few days. They may seem incapable of drinking in moderation. Or they may promise to quit or even try to quit but then continue using or drinking anyway. 

However, the signs of addiction are not always so evident or decisive. Addiction affects people from all walks of life and often people who are capable and resourceful in their careers and other areas of their lives bring those same talents to hiding their addictions. 

Working Late

No matter how skilled someone is at hiding their addiction, there are two things addiction always requires: time and money. Therefore, someone with a substance use disorder or other addiction will always need ways to account for missing time. The closer they are to you, the harder it is. One excuse that is convenient for many people, especially high achievers, is that they’re working late.

Typically, working late on its own is not definitive proof--which is really true for any item on this list--but it’s one piece of evidence. If your loved one is suddenly working longer hours, it could be a sign of addiction--perhaps even to work--or it could be a sign they’re hiding something else like an affair or planning a surprise party. Or they might actually be working. It’s just one piece of the puzzle.

Traveling a Lot

Another way of reserving time for an addiction is to travel more. This gives you time alone and you’re less likely to run into people you know. People who are especially concerned about their reputations, for either personal or professional reasons, often prefer to buy drugs and engage in other addictions farther from where they live so they are less likely to run into people they know. Traveling more for work or to visit relatives and insisting on going alone may be another sign of addiction.

Running More Errands

It’s tricky to hide an addiction from someone you live with. Even if you can duck into the garage or the laundry room for a drink or whatever, you still risk being discovered or having your stash discovered. It’s much safer to drink or use in another space. But what if you’re at home and the craving suddenly hits you? Well, maybe you get called into work unexpectedly or you left something important at the office.

Maybe you need to run out to the store or someone your spouse never talks to is having some kind of crisis. These kinds of errands that seem to come up more often may be cover for addictive behavior.

Money Schemes

As noted above, every addiction requires time and money. We’ve looked at some ways of accounting for missing time but the money is perhaps the more decisive factor. This is true whether it’s a substance addiction, like drugs or alcohol, or a process addiction like gambling, shopping, or sex. Missing money is always cause for concern. You might notice cash missing, a sudden drop in your checking account or a savings account, or new debts.

Sometimes, this is very hard to catch. For example, your spouse may have taken a lot of money out of their retirement account and you would have no way of knowing. Or they may say they want to transfer some savings into another investment that doesn’t really exist. Any kind of scheme to move money around or borrow, steal, or scam money should be a big red flag, especially combined with other evidence.

Frequent Illnesses

It’s possible to keep up appearances, maintain your relationships, and perform well at work despite a substance use disorder for a while, but eventually, cracks will start to show and illnesses are among the more difficult cracks to paper over. Illness might be an excuse for being hungover or otherwise impaired or it may be genuine. Many substances, especially alcohol and opioids leave you more vulnerable to illness and infection.

You may even develop fairly serious medical issues like liver disease, heart disease, and cancer. Fatty liver can develop even with relatively few other signs of alcohol use disorder.

Mysterious Injuries

As with more frequent illnesses, more frequent injuries are often a sign of substance use issues. Alcohol and other drugs often impair balance, coordination, and judgment. What’s more, they can impair your pain perception and your memory, so you might not even be aware that you were injured or know how it happened. If your loved one has injuries but they don't know where they got them or they lie about where they got them, it could be a sign of substance use.

Incidents

If your loved one gets a DUI or gets arrested for fighting while drunk, they will probably give you some kind of story like, “The one time I have a few drinks before driving home and I get busted!” That’s possible, but it’s very unlikely. If your loved one gets into some kind of trouble while drunk or high, it more likely indicates a pattern of behavior, even if it was a pattern that you were completely unaware of. 

It’s a pretty serious thing to confront someone about a substance use disorder or other addiction and it’s also a lot to deal with if they do have a problem. Keep in mind that it’s not an accusation, it’s a conversation. Maybe mention you’ve noticed they’ve been behaving differently lately and ask if they’re ok and how you can help. Ask open-ended questions and listen attentively. You’re not trying to trap them; you’re trying to figure out if there’s a serious problem they need help with. The best approach is always non-judgment and compassion.

At The Foundry, we know that it’s not easy to face the possibility that your loved one has a substance use disorder. It’s much easier to give them the benefit of the doubt and hope everything turns out ok. However, addiction is a progressive disease and if you look the other way for too long, you might find your life unraveling. We provide comprehensive addiction treatment for mind, body, and spirit. We also involve the family throughout the process because we know that social connection and a supportive environment can make all the difference in recovery. To learn more, call us at (844) 955-1066.

For most people, whether they’re entering an inpatient treatment program or slipping into their first 12-Step meeting, beginning recovery from addiction is an uncertain time. You aren’t sure whether you are doing the right things or if you have any chance of success in the long-term. When we aren’t sure what to do, we instinctively look around to see what other people are doing.

While this might get you through your first few meetings without making too many faux pas, comparing what you’re doing to what others are doing is not a great approach to recovery. Here’s why.

Comparison Makes You Unhappy

First of all, comparing yourself to others is perhaps the fastest way to wreck your mood. There have been quite a few studies on the psychology of social comparisons and they all agree that it’s bad for your mental health. One study found that people who made more frequent social comparisons were more likely to experience guilt, envy, regret, and defensiveness.

They were also more likely to lie, blame others, and have unmet cravings. All of these are counterproductive for anyone trying to stay sober. Lying, guilt, envy, resentment, and cravings are all typical elements of addictive behavior and you want to move away from those as much as possible. 

It’s important to keep in mind that comparisons don’t just make you feel bad when you come up short. One study of participants' tendencies to make comparisons on Facebook found that participants who made more comparisons experienced more depressive symptoms, even when they felt like they were better than the other person. Something about the comparison itself makes us unhappy.

Perhaps it promotes self-consciousness or self-criticism, even when the scale tips in our favor. This is an important point, given that the early weeks and months of recovery are already emotionally challenging and many people who struggle with substance use issues have mental health issues such as depression, anxiety, and personality disorders as well.

Comparisons Are Always Misleading

If the primary purpose of comparing yourself to others is to orient yourself or measure your progress, then comparisons aren’t very useful anyway. First of all, your needs in treatment and recovery will be different from everyone else’s. You have different strengths, weaknesses, personal history, addiction history, values, and goals. You have different medical and psychological needs. Some people will have a lot of family support and others won’t. In the end, you’re never really comparing apples to apples. 

Second, you only know what others want you to know. It’s entirely possible to seem like you have everything together but still be struggling on the inside. If you doubt it, just consider how long you were able to keep your substance use issues secret. Someone who seems to be doing great may or may not actually be doing great. You just have to be comfortable with the fact that you can never really know where you rank among your sober peers and that such a rank would be so qualified as to be useless anyway. You just have to accept some degree of ambiguity.

Everyone Has Different Needs and Goals in Recovery

Since everyone’s situation in recovery is different, everyone will have different needs and therefore different goals. Your recovery plan should reflect your individual goals and values. One person may be invested more in repairing family relationships while another may be more focused on dealing with a mental health issue.

Your goals and therefore your recovery plan will, therefore, look different from anyone else’s. You’re going to get off track if you start feeling the need to start competing in areas that aren’t central to your own recovery. It’s much better to keep your eyes on your own particular prize.

Comparisons Create a Competitive Environment

Finally, you don’t want to feel like you’re competing against your peers in recovery. There may be some limited space for friendly competition in recovery--for example, if you and a friend are challenging each other to stick to a healthy diet or exercise regimen--but overall, you want to encourage feelings of mutual support. Making constant comparisons creates a mindset of competition.

You feel like when someone else succeeds, then you lose. In reality, the opposite is true: When one person succeeds, you’re all a little better off. Instead of comparing yourself to your peers in recovery, try to be happy for them when they do well, and support them when they struggle.

How Can You Break the Habit?

Comparison can be a tough habit to break. The first step is to just accept that comparison won’t do you any good. You’re all sort of on separate journeys together. Second, be conscious of when you’re actually making comparisons. Notice what it feels like to need that kind of reassurance and notice how that feeling of grasping makes you feel worse.

It may be a good idea to limit your social media use since social media use tends to promote social comparison and defensiveness. In fact, comparison is what most studies have focused on as the reason social media use exacerbates feelings of depression and loneliness. 

Finally, instead of comparing your progress to others’, figure out more relevant ways to track your own progress. This might be by setting goals and subgoals related to recovery, such as attending 90 meetings in 90 days or it might be tracking your progress according to goalposts you came up with along with your therapist for measuring your progress. What matters is that you set your own goals and stay engaged in the process. 

At The Foundry, we know that recovery from a substance use disorder is always an individual journey. No two clients are the same and we work with you individually to create a recovery plan that will promote your long-term success. That’s why we use a variety of proven methods to help you overcome the diversity of challenges you’re likely to face along the way. To learn more about our approach to treatment, call us at (844) 955-1066. 

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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Optimism is a good quality to have in addiction recovery and in life. Studies have shown that more optimistic people have better relationships, earn more money, and enjoy better health. If you’re recovering from a substance use disorder, a bit of optimism in challenging times can make the difference between pushing through and throwing up your hands and pouring a drink.

Unfortunately, optimism doesn’t come naturally to everyone, especially to anyone who is at a low point in life. There is even some evidence that optimism has a genetic element. Even if you’re not a naturally optimistic person, you can learn to be more optimistic. Try the following if you want a more positive outlook.

Imagine the Best Outcome

Most of us spend a lot of time thinking about what we don’t want. We don’t want to be in pain, we don’t want to be poor, we don’t want to be unhappy, and so on. However, when we fixate on what we don’t want, our focus is essentially negative. Not only are we preoccupied with the fear of a certain outcome, we unconsciously move toward it. For example, you have probably had the experience while driving, riding a bike, or even walking of being distracted by something by the side of the road and then realized you veered in that direction without even noticing. The same can happen with more abstract things.

Instead, focus on what you do want. Don’t try to avoid getting dumped; focus on making your relationship good. This leads to better outcomes and makes you more optimistic. There are a number of ways you can do this. One is to wake up in the morning and ask yourself, “What would this day look like if everything went perfectly?” That will make it much easier to get out of bed. A more in-depth exercise is to spend a few minutes once a week writing about what your ideal life would look like in five or 10 years.

Record the Positives

Whereas imagining the best outcome looks to the future, writing down the positives looks to the past. We are mostly hardwired to notice threats and other unpleasant things because that helps keep us alive. Unfortunately, it also makes us unnecessarily gloomy. One way to push back against that tendency is to write down good things that happened during the day or week.

There are two similar exercises that can help with this. The first is the “three good things” exercise. Each night, before you go to bed, write down three things that went well and why they went well. The other exercise is the gratitude journal. Write down some things you were grateful for that day, either grateful to someone in particular or just in general. They can be big or small. Doing this regularly will make you more attuned to the good things in your life and the people who support you.

Look for the Silver Lining

In a sense, all of optimism is about finding the good in any situation. This is often challenging, especially if you’re prone to depression or anxiety and especially if you are under stress. One trick you can use is to tell yourself, “This situation is completely terrible, but if I had to find something good in it, it would be this.”

For example, most of us are currently in lockdown to slow the spread of the coronavirus. Thousands of people have already died from it, many more have lost their jobs, and all of our lives have been disrupted. This situation is completely terrible, but if you had to find something good about it, you might say that it gives you time to work on some projects you’ve been putting off for a while, it gives you more time to spend with your family, it helps to clarify your priorities, it brings out the best in people trying to help, and so on. This is not an exercise in ignoring the bad; it’s acknowledging the good as well.

Notice Your Thinking Style

Much of our pessimism is caused by faulty thinking. For example, you may think you know for sure that something will have a bad outcome, when in fact, no one really knows what will happen. Or you might think that since you failed at something in the past, then you will fail at it in the future when, in reality, most of us get better with practice and increase our chances of succeeding in the future.

Research on optimism has discovered a common thinking pattern among more optimistic people: they tend to believe their failures are temporary and based on external circumstances while believing their successes are permanent and based on their intrinsic qualities. Pessimists tend to believe the opposite.

In reality, all of our successes and failures are partly down to our own talents and partly down to external circumstances but since we can never know for sure to what extent each of those contribute, it’s more useful to assume that your failures are circumstantial and your successes are because of you.

Make Friends with Positive People

Finally, make friends with positive people. We tend to pick up on the habits of the people we spend the most time with. If your friends are optimistic, you will likely become more optimistic. That’s not to say you should ostracize anyone who complains. We all have bad days. However, if you have a friend who always complains, plays the victim, and expects the worst possible outcome, this might be a good time to socially distance yourself from that person.

It’s important to remember that optimism isn’t the naive belief that everything is great; it’s the awareness that even when things are really bad, they are almost never comprehensively bad and it’s possible, and even likely, they will get better. A pessimist will give up right away but an optimist will try. Even if they don’t achieve a perfect outcome, they will often achieve a better outcome. At The Foundry, we believe that true recovery from addiction is about living a happier, more fulfilling life. We use evidence-based methods to give our clients the skills they need for a long recovery. To learn more, call us today at (844) 955-1066.

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A wise woman once told me that we only listen in order to respond, anxiously waiting our turn to speak.  How, then, can we really ever understand, have compassion, or actually hear what a person is saying?  Here are a few tips from a girl’s best friend, the ever loyal, ever compassionate, best floppy ears out there,Fido!  I cannot take full credit for this novel idea and must give some credit to the book, How to Listen Like a Dog.  

Here is how:

-Make eye contact:  Ever notice when you talk to the dog, he can’t take his eyes of you. He hangs on every word hoping you drop a small piece of food or scratch behind his ears.  Try this the next time someone tells you a story.  Dedicate your focus to their face and really take in the whole story thru their eyes.  Try to maintain this for the duration of the story without letting your eyes wonder to other things.  You will be amazed at how much more you absorb!  

-Listen without judgment:  That sweet dog of yours never judges you or compares you to other people.  What a great idea.  The next time a friend needs an open ear and mind, try to listen without judgment. Take it all in without mentioning yourself, anyone else, or the better behaved dog next door.

-Don’t interrupt:  This might be the most important one of all.  Just listen.  Don’t talk. Just listen.   Then, listen a little more.  Try not to interrupt until the conversation asks for it.  Just try it!  I mean, if the dog can do it, why can’t you?!

-Give positive reinforcement: We all need a little encouragement no matter what.  Try positive feedback without talking.  Nodding your head, wagging your tail, smiling.  It can really enhance the listening experience and, even better, the speaker’s experience.

-Don’t multitask:  This is a tough one.  We pride ourselves on being able to do many things at once.  I challenge you to try one thing at a time especially when listing. Just listen.  Don’t text, don’t talk to someone else, just listen.  See if it carries over into other aspects of your life.  A dog really only has a once track mind.  Eat, sleep, pee, repeat.  Can it really be that simple?!

PS… Keep this little tidbit in mind, when the dog nudges you to go outside and play, maybe listen a little extra, and get out there and do something AWESOME with your furry friend!

Happy listening.

“There is no doubt that the ability to listen—to really, authentically listen—is one of the most important qualities of an effective leader, good friend, and successful family member.”

SarahColeman

Health and Wellness Director, The Foundry

PersonalTrainer, CrossFitter and Coach, SteamboatCrossFit

Food connoisseur, My kitchen and yours

OutdoorEnthusiast, Everywhere

Owner, A Weight LiftedFitness Camp

Managing Partner, InspiredLife Network

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Fear is one of the biggest barriers to seeking help for addiction--fear of withdrawal, fear of loneliness, fear of vulnerability, fear of failure, and more. Underlying many of these fears is a general fear of change. Getting sober is perhaps the biggest change you’ll ever make in your life and it requires other changes, including how you relate to others, what you do for fun, who you spend time with, and how you take care of yourself.

That can feel pretty daunting and fear can slow your progress in recovery. The following suggestions can help be less afraid of change, and perhaps even embrace it.

Why Change is Scary

First, it helps to understand why change scares us. It may seem irrational to fear change. For example, you may look at what drugs and alcohol have done to your life and think that any change has to be better, and, in fact, that’s what motivates many people to seek help. However, you may still resist change, even when you rationally know it will be better for you.

Why? Well, however bad your life is right now, at least you know you can survive it. You know what to expect and you know how to deal with the challenges that come with your current way of life. Even if it’s bad, at least it’s familiar. If you make a change, who knows what will happen?

You may face some situations that you don’t know how to deal with. Even if you know, rationally, that getting sober won’t threaten your life--and will likely save it--we instinctively fear the unknown. You don’t know quite how to imagine sober life and at the very least, that can undermine your resolve.

Do Your Research

One way to reduce your fear of change is to understand it better. The clearer your idea of your destination, the less threatening it will seem. For example, in the days before the Internet, if you wanted to book a hotel room or rent an apartment in another city, you pretty much had to cross your fingers and hope for the best. Now you can look at pictures, explore the neighborhood with Google street view, and get step-by-step directions to the front door. The whole process is much less scary. 

Similarly, if you’re trying to make a big change in life, whether it’s getting sober, moving to another area, or changing careers, knowing what you’re getting into helps minimize your fears. If you’re trying to recover from addiction, that means reading memoirs about recovery, listening to others at 12-step meetings and group therapy sessions, and talking to people who have been where you want to go. This helps replace simplistic and distorted ideas of what that change means with more accurate and inspiring possibilities and it also alerts you to possible challenges along the way.

Approach Change With Curiosity

However much research you do, you won’t be able to predict the future. There will always be unexpected challenges and every individual has a different journey. These unknowables can be a significant source of anxiety. 

One way to cope is to approach the change with curiosity, rather than trepidation. Fear and excitement are physiologically the same--your heart rate and breathing speed up, your senses are sharpened, and so on--and you can choose how to interpret those physiological signals. That means you can feel afraid and choose to be excited. Being excited about the unknown is another name for curiosity.

Think of recovery as a film, in which you can’t wait to see what happens. This applies to big and small changes alike. Is your therapist asking you to do something that stretches your comfort zone a bit? Think of it as an experiment and be curious about the result. 

Confront Your Fear of Failure

As discussed above, we often prefer the familiar to the unknown, even if the familiar is pretty miserable. The reason is that in the primitive parts of our brains, we believe the unknown can be fatal. While death is not a likely outcome of getting sober, failure is certainly possible. Recovery takes a lot of time and effort.

You and your loved ones may have high hopes and the thought of letting everyone down can be frightening. Or you may be afraid that once you’re sober, you’ll no longer have an excuse for failure in other areas of your life, such as work or relationships. In short, you’re afraid that trying to get sober will somehow expose you as inadequate. 

That’s a normal fear but it’s also a kind of illusion. Say, for example, that you do relapse. That’s certainly a setback, but it’s not a permanent failure. Plenty of people relapse several times and still eventually get sober. Everything worthwhile takes practice and perseverance. You will inevitably have setbacks and disappointments but they don’t have to be permanent failures. 

Focus on the Process

Part of the fear of change is that you see a clear dividing line between the person you are now and the person you want to become. That idea of transformation can be simultaneously exciting and terrifying. The problem is that the person you are changing into only exists in the future, in your imagination.

If you could somehow snap your fingers and turn into that person, it would feel strange and alienating. All you can really do is focus on the present and the process of recovery. Recovery is really a matter of practicing new skills, learning new things about yourself, and making small changes in your habits, and eventually, you will move from being able to abstain from drugs and alcohol to preferring to live without them. There is no point at which you change into a different person but at some point, you’ll look back and realize life is different now.

It’s normal to fear change. Most of us are hardwired to prefer the familiar. However, fear of change can keep you stuck, and sometimes it can even threaten your life. The keys to overcoming change are to know what to expect, be curious about the process, be aware of your fear of failure, and focus on the process in the present moment. 

At The Foundry, we know that making any big change in life is scary but we also know that treatment helps people live happier, more fulfilling lives. We use proven therapeutic techniques and provide a great support system to help you make one of the best changes in your life. For more information, call us at (844) 955-1066.

Anxiety is one of the most common co-occurring disorders with addiction. Nearly 18% of people with substance use disorders experienced the symptoms of an anxiety disorder within the past year, and that figure doesn’t include post-traumatic stress disorder, or PTSD, which may affect as many as half of people with a substance use disorder. 

Anxiety disorders, as a group, are the most common mental illnesses in the US. Anxiety disorders include generalized anxiety disorder, panic disorder, phobias, PTSD, social anxiety disorder, and obsessive-compulsive disorder. According to the National Institute of Mental Health, more than 30% of Americans will experience an anxiety disorder at some point in their lives.

However, nearly everyone experiences anxiety to some degree, and in many situations, it would be unusual if you didn’t feel anxious. What’s more, it’s hard to compare your own experience to anyone else’s to know whether you experience an excessive amount of anxiety. How can you tell if your anxiety is really an anxiety disorder?

You Feel Anxious for No Apparent Reason

The first thing to remember about anxiety is that it plays an important role in our survival. That’s why there are far more people who experience too much anxiety than people who experience hardly any. Anxiety is meant to warn you of danger and spur you into taking action. However, if you have an anxiety disorder, your brain or other parts of your physiology might decide to become anxious for no apparent reason. One minute, you’re sitting at home, minding your own business, and the next minute you’re overcome by worry or fear. If you find you’re anxious for no apparent reason, there may be some system in your brain or body that’s not properly regulating your state of mind.

Your Anxiety Continues After the Stressor

Sometimes you may have a good reason for anxiety--perhaps you have a job interview or you just narrowly avoided getting hit by a car. In cases like those, it’s normal to respond with some level of anxiety. However, after the danger has passed, your brain should send the “all clear” signal so you can wind down. However, if you get stuck in a loop, you may keep thinking about the inciting incident and your anxiety will stay pretty high. You try to stop but you just keep thinking about it. If this happens frequently, you may have an anxiety disorder. 

You Feel Anxiety Out of Proportion to the Situation

As noted, there are plenty of times when some amount of anxiety is appropriate, but you always seem to feel much more anxious than the situation warrants. For example, someone has a birthday at the office and you get together with your coworkers for cake only to feel intense social anxiety. They’re all people you know, having an informal gathering with no stakes--why are you nervous? Unfortunately, this kind of reaction is not that uncommon and the anxiety can persist even if you know, rationally, that it’s excessive.

You Experience Panic

While anxiety, in appropriate amounts in appropriate situations, has a useful purpose, panic is never useful. Panic is runaway anxiety that keeps you from doing anything or even thinking clearly. Symptoms of a panic attack include a sense of impending doom, pounding or rapid heartbeat, sweating, shortness of breath, tightness in the chest or throat, shaking, dizziness, or feelings of unreality or depersonalization.

People having a panic attack often mistake it for a heart attack. Panic attacks often start with an inciting incident, something that might normally cause anxiety, but then it gets out of control. After you’ve had one panic attack, just fearing another panic attack can trigger a panic attack. If these symptoms are familiar, you may have a panic disorder. 

You Feel Anxious Most of the Time

In addition to feeling anxious at inappropriate times, you may just have a low level of anxiety most of the time--when you get up in the morning, when you’re out with friends, when you lie down to sleep, and so on. Anxiety is just the background noise of your life. This may be a sign of generalized anxiety disorder. You may think of yourself as a worrier or your friends may say you worry too much. If you’re always fixated on possible problems, even if they are unlikely, it may indicate an anxiety disorder. 

You Have Physical Symptoms

Anxiety isn’t just a state of mind; it affects your body too. When you anticipate a threat, your body undergoes many adaptations, including faster heart rate and breathing, withdrawing blood from the extremities, and ramping up your immune system to protect against possible injuries, stopping digestion and other processes unrelated to fight or flight, and others.

While these are sometimes helpful in the moment, they are meant to be very short-term. If you feel anxious all the time, you are more prone to physical symptoms such as digestive problems like nausea or diarrhea, headaches, muscle tension, and even long-term problems like obesity and heart disease. Digestive symptoms and headaches with no apparent medical cause are often a red flag for an anxiety disorder.

You Have Trouble Sleeping

Insomnia and disturbed sleep are among the most common symptoms of anxiety disorders. You lie down and all you can do is worry. Since your defenses are down while you’re asleep, worry can get a jump on you, even if it’s totally irrational. Therefore, you might find yourself waking up in the early hours of the morning unable to go back to sleep. This is also a common symptom of depression, which often overlaps with anxiety disorders.

You Avoid Certain Situations

Finally, avoidance is a common symptom of an anxiety disorder. In a sense, it’s one of the defining symptoms, since it’s a practical way that anxiety limits your life. Maybe you avoid social situations or things you have a specific phobia of or things that remind you of a trauma. Unfortunately, avoidant behavior tends to grow and it can end up being fairly debilitating, whether it causes you to avoid social interactions, high-stakes situations, or even leaving the house. 

Anxiety disorders are too often dismissed as not “real” mental health issues--just a case of being too tightly wound or overly nervous. However, anxiety disorders can seriously affect your life, limiting your scope, and even driving substance use.

At The Foundry, we know that mental health is one of the keys to a strong recovery, which is why we emphasize the diagnosis and treatment of co-occurring mental health issues as part of our holistic treatment program. We know that trauma is especially common and we use a variety of trauma-focused therapies to help our clients heal. To learn more, call us today at (844) 955-1066.

Serves: 4-6

Prep time: 30 minutes 

Cook time: 50 minutes

Total time: 1hr 20 minutes 

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Sunday brunch is the best! Brunch is great for those mornings when it is rainy and colder outside, or great for days when it is sunny and nice to enjoy brunch outside! Either way brunch is a very underrated meal! This brunch hash is very simple, it basically boils down to (pun intended) putting some great veggies together and topping them with eggs!

Ingredients

• 3 pounds tri colored potatoes (purple, Yukon and red)
• One bundle asparagus 
• One yellow onion 
• 3-4 large carrots
• 1 pound of bacon
• 6-8 eggs scrambled
• Salt as needed
• Olive oil as needed
• 1 tablespoon of ground sage
• 1 tablespoon dry parsley
• 1 ½ teaspoon cracked black pepper
• ½ cup parmesan cheese for topping

Instructions 

• Preheat oven to 420 degrees 
• Prepare the onions, carrots, and asparagus.
• Cut carrots into circles or “coins”.Dice your onion into small cubes. Cut onion in half then peel the dead layer of skin off. Make incisions horizontally and vertically. Now your onion should be “diced” but if it isn’t just chop it until it is all in small pieces!
• Cut the asparagus into one inch segments. 
• Lay the bacon out on a parchment lined baking sheet and set aside for later.
• The potatoes will be boiled whole, and then roasted. So fill a large pot with enough water to cover the potatoes, and salt the water heavily or until the water tastes like “sea water” . Boil potatoes on the stove until they are fork tender (about 25 minutes). Now strain off water and cut potatoes into one inch cubes. Place them on a large baking sheet and coat with olive oil. Sprinkle with salt and pepper to taste. Put the potatoes in the preheated oven. Cook until crispy or about 25 minutes. 
• When you put the potatoes in the oven, place the bacon in the oven as well and cook until the crispness of your liking. 
• While potatoes are cooking; sauté the onions, carrots and asparagus together. In a large skillet, heat enough olive oil to coat the bottom. When oil is hot, put the onions into the skillet and cook until translucent. Then add the asparagus and carrots. Continue to stir and cook until carrots and asparagus are tender. 
• Stir in spices; 1 tablespoon sage, 1 tablespoon parsley, and 1 ½ teaspoon cracked black pepper.
• Transfer the veggies to a large bowl and set aside in a warm place.
• In the hot skillet that was used for the veggies, add some more oil if needed and cook the scrambled eggs.
• Now check on the potatoes and bacon. Once both the potatoes and bacon are done it is time to eat! On your plate mix the potatoes, veggies, and eggs. Then lay some bacon over the top! (option to sprinkle parmesan cheese on top too!)

Notes 

• The picture has a hot crossed bun! The hot crossed bun recipe is going to come out in the April kitchen blog! So go check out the Foundry’s website!

This week we would like to spend a little bit of time talking about self care. This has been a wild month and last week gave us a glimpse into what the new normal might look like for the foreseeable future. As we find ourselves with kids at home who should be at school, a stressful workplace, alarming news around every corner and restrictions around the ways we socialize a few posts about taking care of ourselves felt right.

Today we are addressing those of you who work in the treatment or therapeutic world, in helping professions. As we have wrestled with decisions this week one of the questions we keep coming back to is simply, are we doing what is best for those in treatment?

One of the lenses we try to view this question through is how safe our clients/patients feel. As Dr. Barnes often reminds us, without a save environment people can’t do the work they need to do in treatment.

With this in mind it is important to ask how WE are doing. If we, the staff, are bringing our stress and worries into work with us those we are treating will absolutely feel and react to that stress. Remember, they are in an unfamiliar place with new people trying to do one of the most difficult things they will ever do, get sober.  In order to give them the most we can in our short time with them it is crucial that we fully show up for them.

This is a tall order and doesn’t happen on its own, we need to be in as healthy a place as possible and that requires work.

 I’ve been talking to friends in this field all week to learn what they are doing to help their staff stay grounded and while I haven’t heard a silver bullet I have heard lots of good ideas. In addition to discussing this subject frequently and openly we have done a few things to help encourage our staff to stay mentally and spiritually healthy in this time of increased stress.

All of us find peace in different ways so what follows isn’t comprehensive, just a few suggestions to help you stay healthy in order to promote the healing of those we serve.

Exercise

While going to the gym likely isn’t an option, exercise doesn’t have to be forgotten. No matter how small a space you are in there are ways to get your body moving that will help. From simple body weight exercises (pushups, sit-ups, planks, etc.) to online yoga and fitness classes you can still be active inside! You can also walk/run/bike outside, just keep some space from others.

Prayer and Meditation

Our lives are so busy in normal times that this practice is often one of the first to be forgotten, but now you likely have some free time! People often balk at taking this time because they think it has to be some huge commitment, they don’t want to spend 60 minutes listening to spa music and sitting still. If that’s you try not making it so hard, especially at first. Start with a minute or two of sitting quietly and see where it goes from there.

Social Interaction

Just because we aren’t getting together to watch a game doesn’t mean we can’t still connect. I have had some awesome conversations with friends and family this past week on the phone and via FaceTime. All of those calls that we don’t get to because we’re running around are things that we can find time for. They are also often safe places for us to talk through how we are feeling and doing and to get advice.

Professional Services

Almost all of the therapists I know are still offering virtual or telephone sessions. If this is a part of your life let me encourage you to keep it so. If it isn’t, maybe now is a good time to start!

For those of you looking for ideas about how to help your staff,  I'll share a few things that we’re doing. I also hope that you take a minute to share what you’re doing here, we could use more ideas!

We have opened up our fitness facilities for staff outside of normal programming hours so they can still access the gym.

We have figured out a way to hire a few more support staff to make it easier for people to take off or call in if they aren’t feeling well.

We created a specific place to post updates about changes we are making and for everyone to ask questions and offer feedback.

Our amazing admissions director, Becca Zimble, is doing a yoga class just for staff and has made sure that they all feel welcome to participate in the classes on campus.

We brought in an outside therapist to hold group sessions online, and individual if requested, with our staff to help them process everything that is going on out there in a safe place.

This is way too long for a social media post so I’ll close out with this; I think it’s our responsibility to be as healthy and present as we possibly can for our clients/patients and encourage you to do what it takes to get and stay that way.

From a safe distance,

Ben Cort CEO

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

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

Below is the recipe for Sweet Potato Pancakes - One of the many healthy meals served to clients at the Foundry Treatment Center Steamboat.

INGREDIENTS:

• 1 1/2 cup mashed sweet potato (the flesh from 3 medium-small cooked sweet potato)
• 6 eggs
• coconut oil (for cooking)
• 2 1/4 teaspoon ground cinnamon
• pinch of salt

INSTRUCTIONS:

• Whisk together the sweet potato and eggs until well-combined. Add seasonings, if desired, and stir. Heat oil over medium-low heat.
• Drop the sweet potato mixture by the tablespoon and cook for 3-5 minutes.
• Flip each cake and cook for an additional 3-5 minutes, until lightly golden brown on the outside and cooked through. Lower heat works better, and don’t try to flip them before totally cooked on one side.
• Optional topping ideas: yogurt, nut butter, fresh fruit, or maple syrup. They are also good plain! OR go savory and try avocado and sliced turkey. Enjoy

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

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A slightly anxious, markedly skeptical Veronica stepped into the horse arena wondering how equine therapy could help in her fight for recovery. Within an hour of the first session, searing insights started emerging for her in spades.

A nursing journal article once defined healing as an incremental awakening to a deeper sense of self in ways that foster profound change. Equine-assisted psychotherapy is yet another forum for Foundry participants to explore their individual array of underpinnings that can drive addictive behavior.

So why horses?  

They are prey animals that are hard-wired to instantly interpret and respond to the emotional states of those around them with moment-to-moment acuity. Horses tend to mirror human behavior, which makes them ideal for this kind of work. Therapy horses can help people work through their emotional struggles in real-time as they can serve as powerful metaphors for problematic perceptions, relationship patterns, and obstacles.

Veronica, her real name withheld to protect her privacy, said her experiences with the horses has led to her redefining her perspectives on confidence, vulnerability, and success.

On confidence

“When we were first trying to get the horses to do these exercises, I would use bribes and other forms of manipulation. The horses didn’t respond to that at all. You can’t hide what you are on the inside from them. It’s like they can see right through you. The horses only respond to authenticity. Only when I absolutely believed I could get the horse to do what I wanted and demonstrated it with my actions, only then did he respond. The immediate feedback taught me to recognize what true confidence feels like on the inside. The horse taught me to connect with that confidence which is huge because one of the reasons I would drink is because I felt I wasn’t good enough.”

On vulnerability

In one of the group exercises, Veronica was asked to stand blindfolded in front of the horse. “I felt like that was a forced vulnerability which was a bit scary for me. The horse picked up on my fear so he allowed me to pet him for support. In most all of my relationships, I’m the caretaker. I focus all of my time and energy on tending to the needs of others without giving any consideration to my own needs. For those moments with that horse, I felt like we were in a partnership. I surrendered my caretaking self and allowed for him to support me and that was really enriching. It showed me the value of a true partnership as opposed to just caretaking.”

On frustration

At one point during a session, the horse Veronica was working with decided to lay down on the ground and not get up. “I was so frustrated with that because I knew the horse trainer could do something and the horse would get up for her instantly. I tried to get the horse to get up, but he wasn’t having it. That’s when the equine therapist and horse trainer explained the horse’s behavior and that made me look at it in a completely different light. The trainer explained there is no way the horse would have taken such a completely vulnerable posture if he didn't feel an unusual level of comfort and safety in the presence of the group. My agenda for the horse suddenly wasn’t so important anymore. With that new understanding came new perspective. Before this, I would look at success and failure as two distinct things. Now I understand that failure can lead to success and to not put so much pressure on myself to make it happen all of the time. My experiences with the horses was amazing.”

At The Foundry we offer an equine therapy program that includes sessions with horses and a certified equine therapist, all held over a three-day period. Participants are encouraged to explore the healing process by connecting, interacting and observing these kind, gentle animals. Equine therapy sessions are available to all residential Foundry participants.

Nicole Roberts, MA, LAC, LPC is a Clinical Residential Therapist at The Foundry, a rehab and substance abuse treatment center in Colorado. She has worked in substance abuse treatment for five years and supports an integrative and individualistic approach to recovery.

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Because of the opioid crisis, the public has been more well-informed in recent years about addiction. Most of us know someone who has been affected by opioids in some way, and that tends to force us to examine our assumptions about addiction and who becomes addicted. Despite this progress, there is still a long way to go. For example, a 2018 poll found that while a slim majority of Americans now believe that addiction is a disease that requires treatment, many people still hold inaccurate views about addiction and biases against people who struggle with substance use disorders.

For example, 44 percent of respondents said they believe opioid addiction results from a lack of willpower or discipline and fewer than 20 percent said they would be willing to closely associate with someone with a substance use disorder. Clearly, the stigma of addiction is real, and it is often a factor that makes people reluctant to seek treatment. The following are some things you can do to help reduce the stigma of addiction.

Educate yourself about addiction.

You can’t help others if your own beliefs are wrong or outdated. There are many resources available online, including information from the Centers for Disease Control and Prevention, the National Institute of Public Health, and the National Institute on Drug Abuse. Organizations such as AA, NA, and SMART Recovery also offer a lot of free literature online and at meetings. Additionally, there are many excellent books about addiction, including In the Land of Hungry Ghosts, by Gabor Mate, High Price, by Carl Hart, and Unbroken Brain by Maia Szalavitz.

Addiction science is relatively new and experts disagree, even on certain fundamental details. Therefore, it’s a good idea to get some different perspectives. However, most experts agree on several points about addiction. First, it seems clear that genes account for about half your addiction risk, so if you have a parent or a sibling with a substance use disorder, you are at greater risk.

Second, addiction is far more common — between two and five times as common — among people with mental health issues. Third, trauma and adverse childhood experiences significantly increase your risk of addiction. The more you know about addiction, the more you can help circulate accurate information and prevent the spread of misinformation.

Beware of stigmatizing language.

It’s important to pay attention to how you communicate about addiction both in speech and writing. You want to especially be on guard against stigmatizing and dehumanizing language. Never use words like “crackhead” or “junkie.” It’s also important to beware of more subtle stigmatizing language. Just calling someone an “addict” is stigmatizing and it’s still fairly common in media coverage, even sympathetic media coverage. Similarly, “substance use disorder” is preferable to “substance abuse.” Stigmatizing language reduces someone to a label rather than recognizing that a real person is struggling with a real problem.

When you talk about addiction or someone with a substance use disorder, imagine that it’s your friend, sibling, parent, or child and don’t say anything you wouldn’t say about them or to them. It’s possible that even in a small group of friends, someone in your company might have a substance use issue that you don’t know about. Remember that addiction is a tragedy, it happens for reasons that are mostly beyond your control, and it can happen to anyone.

Correct misinformation when you hear it.

While paying attention to your own language is a good start, it’s also helpful to correct misinformation when you hear it. If someone uses stigmatizing language or repeats false information, correct them. Most of the time, people just don’t know any better and they’re just repeating what they heard somewhere. When you contest wrong information, you might change the mind of the speaker, and you will certainly reach the listeners, as well. They might not otherwise know about alternative viewpoints.

Don’t just limit yourself to correcting misinformation you hear in person. When you see stigmatizing language or stories in the media, either in news stories or fictional representations, say something. Often, these sources prefer to be fair and simply aren’t aware of their mistakes.

Support treatment over punishment.

One of the biggest ways addiction stigma matters is that public opinion affects public policy. If people believe that individuals with substance use disorders are dangerous criminals who chose addiction, they are likely to favor punishment over treatment and resent public money being used for harm reduction and treatment.

However, people who are more informed know that the scientific evidence supports treatment and harm reduction. For example, drug courts give people the choice of treatment or jail and those who choose treatment — which is most — have much better outcomes.

Since so many people have now been personally affected by the opioid crisis, most politicians are pretty reasonable in their attitudes toward addiction these days, but there are still some who hold to the old punitive view. Support politicians at every level who advocate for treatment over those who promote punishment, and make sure your representatives know your views on addiction.

Share your experiences with addiction when appropriate.

Finally, when appropriate, consider sharing your own experiences with addiction and recovery. Addiction largely remains an invisible problem and people often don’t even realize when a close friend or relative is struggling. This allows many negative stereotypes to persist. Sharing your own experience can put a real face on addiction and it might encourage someone to seek help if they know they aren’t alone.

The stigma of addiction remains a real problem. Not only does it discourage people from getting help, but it makes people feel less than; it makes them feel more ashamed when they are already struggling. By educating yourself, correcting errors when you hear them, and being open when possible, you can do your part to fight the stigma of addiction. At The Foundry, we know that addiction is something you go through, not something that defines you. We give our clients the tools they need to be resilient and live more fulfilling lives. To learn more, call us today at (844) 955-1066 or explore our website.

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One of the most important ideas in modern psychology is that our thoughts are largely responsible for our emotional reactions. This is a central concept in cognitive behavioral therapy, or CBT, dialectical behavioral therapy, or DBT, and other cognitive therapies. For example, someone cuts you off in traffic and you become angry.

However, the other driver didn’t directly cause you to be angry. What made you angry were your own beliefs about the situation, perhaps something like, “That guy shouldn’t have done that,” or “That was a deliberate insult.” Most of the time, these things are just accidental, the result of momentary inattention. If you can think about them in that way, they don’t upset you very much. 

A lot of cognitive therapy is focused on identifying and challenging these distorted beliefs. In another post, we looked at how inaccurate thinking can contribute indirectly to addiction by worsening anxiety. Here, we are going to look at some ways that inaccurate thinking can more directly keep you from seeking help for addiction and sticking to your recovery plan.

1. All-or-Nothing Thinking

One of the worst offenders is all-or-nothing or black-and-white thinking. In this way of thinking, something is either a total success or a total failure. The problem is that pretty much everything in life is a mixed bag and if you’re only happy with total victories, you are not going to be very happy and you’re not going to try many things.

There are several ways all-or-nothing thinking can hold back your recovery from addiction. The first is if you’re waiting for the perfect time to act--because there will never be a perfect time. There will always be some excuse--you’re busy with work, you’re not feeling well, you have to feed your cat, and so on. Since addiction is a progressive disease, getting help will always be harder in the future, so it’s better not to wait for the perfect time.

Second, there are a lot of treatment options, all requiring different levels of commitment in terms of time and money. Sometimes you just can’t get the level of treatment you feel you need but that doesn’t mean you shouldn’t try to get some kind of help. For example, you may feel like you need inpatient treatment to help you deal with cravings and avoid toxic influences, but it’s just not possible right now for whatever reason. It’s still worth your time to try something, whether it’s an outpatient program, seeing a therapist, or going to 12-step meetings. Look for ways to improve your situation, even if they’re not perfect solutions.

Third, it’s pretty common for people to slip in recovery. It’s also pretty common, when this happens, to think, “Well, I’ve already ruined my recovery, so I might as well go all the way.” In reality, a slip and a full relapse are not even close to the same. A slip is a setback but it’s also easy to fix. If you keep going, you put yourself at risk for an overdose and when you finally do decide to get sober again, you may have to go through withdrawal again. It’s better to limit the damage when you can.

2. Overgeneralization

Overgeneralization is another extremely common error. It can take two forms. It’s typically either, “I did badly in this one particular thing, and therefore I’m no good at anything,” or “I failed on my first try and therefore I’ll never succeed.” Both of these are objectively false and they make recovery harder. For the first one, overgeneralizing horizontally, as it were, you will probably find some aspects of recovery harder than others.

Maybe group therapy is a challenge or maybe you’re trying to make some healthy lifestyle changes and they just don’t seem to stick. That can be terribly frustrating but it also doesn’t mean you’re comprehensively screwing up your recovery. There may be other aspects that are going really well, perhaps individual therapy or improving communication with your family. Give yourself credit for those things as you continue to work on the more challenging aspects. 

Similarly, you may have tried to get sober once or twice, slid back into drinking and using drugs, and decided, “I’m just never going to be able to stay sober.” You’re taking that very limited data to be decisive. In reality, plenty of people have to try several times to stay sober. People slip up, they have full relapses, but they keep at it and eventually have a long recovery. Persistence will eventually pay off.

3. Telescoping

Telescoping is when you focus on the bad aspects of a situation to the point where you can’t even see the good. For example, you might enter treatment feeling ambivalent about being there and immediately start looking for reasons to leave. You become laser-focused on every little thing that’s wrong with your treatment program or facility.

Maybe a counselor misspoke and called something by the wrong name, so you decide the staff doesn’t know what they’re doing--also an example of overgeneralization--or maybe your room isn’t quite as nice as you would like it to be so you complain about the facilities being awful, and so on. You may be so focused on these things that you really believe they prove the program is no good. 

However, you may also be missing out on a lot of benefits by being too focused on the negative aspects of your experience. Maybe you’ve met some pretty great people or your therapist is really astute or you discovered that you really love hiking. When you feel like you’re too focused on the negatives, try broadening your scope. See if you identify some positive things too. It will not only improve your treatment experience, but it will make you happier overall.

4. Fundamental Attribution Error

The fundamental attribution error is not typically identified as a cognitive distortion in CBT but it is relevant for anyone in recovery. It’s the belief that your own actions are the result of specific circumstances but other people’s actions are a result of their basic character. Going back to the traffic example, when you cut someone off, it was because you just didn’t see them or you weren’t aware the lane ended, or something, and you’re usually a very courteous driver but when they cut you off, they’re a reckless jerk. In the context of recovery, a very similar thing is common.

You go to a 12-step meeting or you enter a treatment program and talk to other people a little bit and you suddenly feel like you don’t belong there. You’ve just been under a lot of stress at work or your friends have been partying a lot lately so you’ve been drinking or using drugs more than you probably should, but all the other people there are addicts. 

This can be a big impediment to engaging with treatment because you feel like what applies to other people doesn’t apply to you. In AA, they call this “terminal uniqueness.” What’s important is not to yoke yourself with the addict label but rather to realize that everyone around you is also there because of specific circumstances.

Everyone has been feeling stressed, or coping with traumatic memories, or struggling with depression, and so on, and everyone there--including you--needs a bit of help with their substance use. Accepting that everyone there has a story, helps you overcome terminal uniqueness, allowing you to be more engaged in treatment and feel a genuine connection to the people around you.

There are many ways your mind can play tricks on you when it comes to addiction. The thinking mistakes discussed above can apply to pretty much anything but they are particularly relevant for people seeking and engaging with treatment. Being aware of them is the first step in overcoming them.

At The Foundry, we know that everyone has a different story and different needs from treatment. We believe that treatment for addiction should always be individualized but that everyone benefits by making the journey together. We also use evidence-based therapeutic methods including CBT and DBT to help clients untie the knots that are holding them back. To learn more, call us today at (844) 955-1066.

Gun violence, political unrest, climate change, the affordability of healthcare, the global COVID pandemic, and its repercussions, racism, terrorism, and the cost of living—Americans are deeply concerned about many things these days. And the onslaught of problematic issues seems to have impacted the nation's mental health.

"Our country faces an unprecedented mental health crisis among people of all ages," stated a White House fact sheet in March. "Two out of five adults report symptoms of anxiety or depression… Even before the pandemic, rates of depression and anxiety were inching higher. But the grief, trauma, and physical isolation of the last two years have driven Americans to a breaking point."

The White House fact sheet notes that America's youth has been particularly impacted "as losses from COVID and disruptions in routines and relationships have led to increased social isolation, anxiety, and learning loss. More than half of parents express concern over their children's mental well-being." Surgeon General Vivek Murthy issued a similar warning in December.

Derek Thompson described it as "an extreme teenage mental-health crisis" in an April article in The Atlantic. Between 2009 and 2021, the share of high-school students who say they feel "persistent feelings of sadness or hopelessness" increased from 26 percent to 44 percent, according to a recent study by the Centers for Disease Control and Prevention (CDC)—it is the highest level of teenage sadness ever recorded in the United States.

Feelings of sadness, emptiness, or hopelessness are primary symptoms of depression, but America's youth is also anxious. From 2013 to 2019, one in 11 children aged 3–17 was affected by anxiety, according to the CDC. Although there is some variation, "the big picture is the same across all categories: Almost every measure of mental health is getting worse, for every teenage demographic, and it's happening all across the country," Thompson reported.

Pervasive feelings of sadness, hopelessness, or anxiety at any age can result from traumatic experiences—with long-lasting consequences. "The effects of unresolved trauma can be devastating," wrote psychologist Peter Levine in Healing Trauma. "It can affect our habits and outlook on life, leading to addictions and poor decision-making. It can take a toll on our family life and interpersonal relationships. It can trigger real physical pain, symptoms, and disease. It can lead to a range of self-destructive behaviors."

Trauma is an emotional response to an intense event that threatens or causes harm, such as being in an accident or witnessing a violent crime. It is often the result of overwhelming stress that exceeds one's ability to cope with or accept the emotions involved with that experience.

Some people develop post-traumatic stress disorder (PTSD) after experiencing such a shocking or dangerous event. It is natural to feel afraid during and after a traumatic situation. Fear is a part of the body's normal "fight-or-flight" response, which helps us avoid or respond to potential danger. People may experience a range of reactions after trauma, and most will recover from their symptoms over time. Those who continue to experience symptoms may be diagnosed with PTSD.

Trauma (and PTSD) may also result from adverse childhood experiences (ACEs), such as experiencing violence, abuse, or neglect, witnessing violence in the home or community, or having a family member attempt or die by suicide. About 61 percent of adults surveyed across 25 states reported having experienced at least one type of ACE before age 18, and nearly 1 in 6 reported having experienced four or more ACEs.

Trauma is prevalent in the United States. "The CDC statistics on abuse and violence in the United States are sobering," wrote Monique Tello, MD, MPH, on the Harvard Health Blog in 2018. "They report that one in four children experiences some sort of maltreatment (physical, sexual, or emotional abuse). One in four women has experienced domestic violence. In addition, one in five women and one in 71 men have experienced rape at some point in their lives—12 percent of these women and 30 percent of these men were younger than 10 years old when they were raped. This means a very large number of people have experienced serious trauma at some point in their lives."

"Trauma is a pernicious, silent, and progressive mental health threat that dramatically increases the risks of depression, anxiety, hypervigilance, suicidality, and further violence if not treated," explained Michael Barnes, the chief clinical officer at the Foundry Treatment Center in Steamboat Springs, Colorado.

"Unfortunately, it can take the devastating impacts of large-scale traumatic events like the Robb Elementary School shooting to bring America's mental health and traumatic experience epidemic into public view. However, for many reasons, including accidents and injury, domestic violence, loss and grief, adverse life events, intense stress, exposure to the side effects of substance use disorders, and other untreated mental health disorders, an estimated 89.7 percent of Americans are exposed to traumatic events, and 12 million adults—that's six percent of the population—suffer from post-traumatic stress disorder at any given time. For every person experiencing PTSD, there are untold numbers of family members, friends, and colleagues whose lives are directly or indirectly affected by PTSD's side effects."

The human trauma response is complicated. In addition to the familiar negative effects of the classic "fight-or-flight" stress response, the polyvagal theory introduced by Stephen Porges in the 1990s added "a second defense system with features not of mobilization as manifest in fight/flight reactions, but of immobilization, behavioral shutdown, and dissociation."  

Watch "Trauma and the Nervous System: A Polyvagal Perspective"

Trauma-informed Addiction Treatment

Trauma, depression, anxiety, and other mental health conditions are major drivers of addiction. "Trauma and addiction go hand-in-hand," wrote Tian Dayton in Trauma and Addiction. "What starts out as an attempt to manage pain evolves into a new source of it…. The cycle of trauma and addiction is endless."

Even before the highly stressful COVID-19 pandemic, Princeton economists Anne Case and Angus Deaton suggested in a 2015 paper (and a subsequent 2021 book) that working-age white men and women without four-year college degrees were dying "deaths of despair" by suicide, drug overdoses, and alcohol-related liver disease at unprecedented rates. The pandemic appears to have exacerbated that trend.

In May, the CDC reported that more than 107,000 Americans died of drug overdoses in 2021, setting another tragic record in the nation's continually escalating addiction epidemic. The provisional 2021 total translated to roughly one US overdose death every five minutes and marked a 15 percent increase from the previous year's record.

These numbers have now significantly contributed to a decline in life expectancy. A new study by the University of Colorado Boulder, Virginia Commonwealth University, and the Urban Institute found that life expectancy in the United States plunged by nearly two years between 2018 and 2020, with the COVID-19 pandemic exacerbating a troubling trend dating back more than a decade. The overall US decline was 8.5 times greater than the average decline among 16 other high-income countries during the same period.

Since trauma is frequently the driver behind a substance use disorder, any traumatic history of the patient and any resulting mental health issues need to be addressed in addiction treatment concurrent with the substance misuse.

"Giving words to trauma begins to heal it. Hiding it or pretending it isn't there creates a cauldron of pain that eventually boils over. That's where addiction comes in," wrote Tian Dayton.  

Foundry Steamboat Chief Clinical Officer, Michael Barnes, is a Licensed Addiction Counselor, Licensed Professional Counselor, and Diplomate in the American Academy of Experts in Traumatic Stress. During his forty-year career, Dr. Barnes has developed a new model for treating addictive and co-occurring mental health disorders that centers around the identification and understanding of trauma, the resolution of trauma, and learning to naturally self-regulate emotion. The Trauma-Integrated Care model practiced at Foundry Treatment Center Steamboat helps clients and family members learn about the role of trauma in individual and family system dysfunction, reduces the likelihood of re-triggering traumatic responses during treatment, and teaches skills to reduce the chances of repeating traumatizing behaviors after treatment. The program also helps clients learn how to promote recovery-supportive lifestyles.

Addiction is often described as a family disease. "The effects of a substance use disorder (SUD) are felt by the whole family," wrote Lander, Howsare, and Byrne in a 2013 study. "The family context holds information about how SUDs develop, are maintained, and what can positively or negatively influence the treatment of the disorder."

The Michael Barnes Family Institute, launched in 2021, makes Trauma-Integrated approaches available to any family with members experiencing behavioral health conditions — even if no family member is receiving treatment. The ability to engage families at any stage of their recovery journey can make it easier to enter treatment and can increase a family's ability to safely and effectively communicate to reduce the causes of stress, alienation, and traumatic stimuli that can perpetuate dysfunction.

Participating in family programming improves treatment outcomes and encourages lasting positive changes in the entire family system. The Michael Barnes Family Institute offers two levels of programming to Foundry clients or any family in need of care:

● 101 provides psychoeducation, coaching, and connection to treatment resources to help families begin to establish a safe and supportive home environment for loved ones in recovery and to acknowledge the ways in which living with active addiction and traumatic experiences has affected their own lives.

● 102 provides in-depth analysis of family dysfunction root causes, in-depth coaching, counseling, and connection to treatment and support resources to help families identify and address deeper issues to improve the well-being and mental health of all participating family members and to restore family system function.  

Located in a beautiful mountain setting in Colorado, Foundry Steamboat takes a holistic approach to treating trauma and addiction. Our programs are designed to treat the entire person, meeting their physical, mental, and spiritual needs. Learn more about the program at www.forgingnewlives.com.

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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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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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Inflammation has been getting a lot of attention in recent years, as research has connected it to a lengthening list of physical and mental health issues. As it turns out, inflammation is relevant to addiction in several ways.

It can worsen medical issues associated with excessive drug and alcohol use, it can worsen mental health issues associated with addiction and relapse risk, and some research even suggests that inflammation can directly increase addiction risk. The following is a brief look at inflammation and how it affects addiction and recovery.

What Is Inflammation?

First, it may help to understand a bit about inflammation, since it’s often used in a vague way. Inflammation is your body’s natural reaction to injury or infection. If you’ve ever had a sore throat or cut your finger, you’ve experienced inflammation. The body’s healing process is complex, but basically what you experience when something becomes inflamed is that your blood vessels expand, allowing more blood to reach the affected tissue. This allows the blood to carry more immune cells to the tissue and facilitate healing. 

When you have an injury or an infection, this process is helpful. Not only does it speed antibodies to the site of an infection, but it also causes pain to make you protect the area, and it causes you to feel lethargic in order to save energy for healing. The problem is that we sometimes have an inflammatory response without an infection or injury, such as when we have an autoimmune disorder or we’re exposed to certain other conditions. Then, the result is chronic inflammation, which serves no purpose and causes other problems.

How Does Inflammation Affect Recovery?

As noted above, inflammation may directly increase your risk of addiction and relapse. However, it can also exacerbate medical issues related to addiction and mental health issues that commonly occur with addiction.

Medical Issues

Excessive drug and alcohol use can lead to a number of medical problems, depending on which substances you use most frequently. For example, excessive drinking increases your risk of heart disease, stroke, liver disease, type 2 diabetes, and several kinds of cancer. Research suggests that inflammation plays a significant role in all of those diseases, and since alcohol itself is an inflammatory substance, chronic inflammation may even be one way alcohol causes these health problems. If you’re recovering from addiction, especially early on, your risk is higher for these conditions, and inflammation will only make them worse.

Depression

The link between inflammation and mental health has only come to light in the past few years. Before then, it was thought that the brain and the immune system didn’t interact much. However, now we know that inflammation is associated with a number of mental health issues including major depression, bipolar disorder, personality disorders, and schizophrenia. 

Of these, the link between depression and inflammation seems to be the strongest. Various studies have subjected participants to pro-inflammatory compounds and found behavioral effects very similar to depression. These effects included decreased motivation, anxiety, anhedonia, and suicidal thoughts.

Other research has found that an anti-inflammatory diet can help reduce the symptoms of depression. It’s important to note, however, that inflammation is only one possible cause of depression and about half of people with depression don’t have markers of increased inflammation. 

The link between depression and inflammation is significant because depression is a major risk factor for addiction and relapse. One study found that 16.5% of people with major depression had an alcohol use disorder and 18% had a drug use disorder--both significantly higher than the average for the general population. 

How to Reduce Inflammation

See Your Doctor

If you are experiencing the symptoms of inflammation, which may include pain, swelling, heat, or loss of function--or depressive symptoms, as discussed above--the first thing to do is see your doctor. If you do have depression, a blood test can determine whether inflammation is a factor. Also, inflammation is a symptom of a number of other conditions, including some serious autoimmune diseases so you’ll want to find out what you’re dealing with as soon as possible.

Diet

An anti-inflammatory diet is both about what you eat and what you don’t eat and, in fact, what you don’t eat may be more important. Inflammatory foods include sugar, high fructose corn syrup, vegetable and seed oils, fried foods, processed meats, refined grains, and alcohol. Eliminating these foods should go a long way toward reducing inflammation.

Replace them with anti-inflammatory foods including green leafy vegetables, whole grains, fruit, especially berries and cherries, nuts, beans, olive oil, and fatty fish. In general, whole foods are better than packaged and processed foods.

Exercise

Exercise is good for your mental and physical health for many reasons, and one of those appears to be that it helps reduce inflammation. We don’t understand exactly how this happens but it may be that your body releases anti-inflammatory compounds in response to the mild physiological stress caused by exercise.

We also know that mental health and inflammation can go both ways; in other words, just as inflammation can cause depression, depression can cause inflammation. Therefore, the reduced stress and improved mood from exercise may also have a secondary effect of reducing inflammation.

Maintain a Healthy Weight

If you’re eating a healthy diet and getting regular exercise, you should be moving in the direction of a healthier body weight. This is also important for reducing inflammation because a number of studies have connected excess body fat to increased inflammation, as fat tissue produces inflammatory cytokines.

This may be one reason exercise helps reduce inflammation. It also appears likely that increased inflammation is one reason obesity increases your risk for a number of health issues, including heart disease, diabetes, and cancer. 

Inflammation appears to be a major player in many different physical and mental health problems, including those related to substance use disorders. Reducing inflammation through diet, exercise, therapy, and possible medical treatment will make you healthier, make you feel better, and increase your chances of a strong recovery from addiction.

At The Foundry, we understand that living a better life free from drugs and alcohol is about holistic change. It means living a healthier, more active lifestyle, feeling connected to supportive people, and having a sense of purpose in life. To learn more about our approach to treatment, call us today at (844) 955-1066.

Addiction is a battle for anyone who experiences it, but the next daunting task for anyone who wants achieve recovery is the detoxification process. The thought of having to stop the substance of choice is the first step to finding sobriety and peace.

Everyone is different, and the detox period can last anywhere from 24 hours to weeks. Here is a brief outline that can be used as to what may be expected during the detox process. The most important thing overall is to go into it with a willing attitude, and a positive thought process that you can do this! The first step to freedom!

Alcohol Detox:

Alcohol detoxification can be broken down into three stages depending on the severity of alcohol consumption. The first stage involves anxiety, insomnia, nausea, and abdominal pain. These symptoms can be expected 8 hours after the last drink. Next, the body may experience increased blood pressure, increased body temperature and respiration, irregular heart rate, mental confusion, sweating, irritability, and heightened mood disturbances which comes 24-72 hours after the last drink. The last stage involves possibility or hallucinations, fever, seizure, and agitation which tends to begin 72+ hours after the last drink. Alcohol detoxification can be life threatening, so it is recommended that it be done in a supervised setting.

Heroin Detox:

Heroin withdrawal symptoms typically begin about 12 hours after the last use, and can peak around day 1-3 and gradually subside between 5-7 days after the initial onset.  The symptoms of heroin detox can be described as “super flu” with some of the symptoms including cold sweats, depression and anxiety, loss of appetite, unstable moods, muscle cramping, nausea and vomiting, diarrhea and seizures. The distress during this process can be debilitating, sometimes leading people back to use. In this case the next use can be lethal, especially if the user takes too much of the drug in order to compensate for the withdrawal effects.

Methamphetamine Detox:

Methamphetamine, referred to as “meth”, is referred to as “the most dangerous drug on earth” due to its wide range of availability. Detoxing from meth is not pleasant, however it is not one of the more dangerous drugs to detox from. Symptoms include deep, dark depression, decreased energy, increased sleeping, teeth grinding, night sweats, emotional instability, irritability, resumption of eating leading to weight gain, anxiety, cravings, suicidal ideations or suicide.

It is recommended that whenever someone chooses to come off of substance use, it be done in a supervised detox center or treatment center. Asking for help is the first step, but also knowing what to expect can be helpful. Withdrawal is a challenging process, and no matter how quick or long it is, it is hard not to create expectations that it is not going to be enjoyable.

With strength and hope, anyone struggling with addiction can make this important step in the right direction. Always remember the detoxification process is only the first step. Once clean, long term treatment center will be the next destination. Aftercare can provide the tools to help maintain sobriety and find healthy coping mechanisms.

Sonia Kulberg is an Addiction Tech at Foundry Treatment Center Steamboat, a rehab and substance abuse treatment center in Colorado, and provides support to those in recovery throughout their stay in residential treatment.

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You’ve probably heard the AA aphorism, “One day at a time.” The idea is that thinking about staying sober for the rest of your life is too much to think about. It’s too overwhelming. You get caught up in thinking “What if this or that happens?” “How am I going to stay sober for the rest of my life?” and so on. “One day at a time” is a mantra that has helped many people through hard days. 

Sometimes “One day at a time” becomes “one hour at a time” or even “one minute at a time.” That’s fine. In fact, the more you narrow that time horizon, the closer you come to that classic dictum of happiness, “Live in the present moment.” This is good advice for anyone, but especially anyone with a substance use issue. Ruminating about past mistakes or worrying about possible problems are typical features of major depression and anxiety disorders, respectively. Living in the present spares you from having to carry the weight of the past and future but it can be hard to do. The following tips can make living in the present easier.

Focus on the Process

For many people, the biggest obstacle to living in the present is that we feel the need to plan for possible problems. This is especially true of people who tend to be anxious. Prying your attention from your worries feels a bit like taking your eyes off the road when you’re driving. 

To overcome this resistance, focus on the process rather than the end result. Living in the present doesn’t mean you give up on the idea of progress but rather understanding that progress can only happen if you act on the present. So, for example, you can be engaged in writing down some recovery goals and some steps to get there. You’re planning for the future, but you’re actively engaged in that particular activity. 

Write Things Down

One reason we often don’t live in the present is that we have something we feel is important that we have to remember. Maybe you have a meeting after lunch or you’re supposed to call your mom, or you have a great idea for your friend’s birthday present, and so on. If you have to devote mental energy to remembering those things, they will take away your focus.

Instead, just write them down. If it’s an appointment, writing it down on a calendar or planner is always a good idea, but just writing a reminder on a sticky note is usually enough to get it off your mind.

Practice Mindfulness Meditation

Mindfulness meditation simply means setting aside a certain amount of time every day to deliberately practice being in the present moment. It could be as little as five minutes or it could be as long as you want. The exercise is about accepting whatever you experience in the moment without judgment and without your mind wandering off to the past or future.

Your mind will inevitably wander off, especially at first. When this happens, just notice that it happened. Just noticing brings you back to the present because you become aware of what your mind is doing. 

Use a Grounding Technique

A grounding technique is when you deliberately notice sensations in order to ground yourself in the present. You can do this as part of mindfulness meditation or just any time during the day when you find yourself preoccupied with worries or otherwise unable to concentrate. A common grounding technique is the 5-4-3-2-1 technique. You notice five things you can see, four things you can touch, three things you can hear, two things you can smell, and one thing you can taste.

This engages all of your senses and the mild complexity of the task keeps you cognitively engaged. However, you don’t have to go through this whole exercise to ground yourself. You can engage with any sensation. For example, you might notice the sensations in just your feet or you might notice the sensations of your breathing. 

Forget About the Clock

Anyone who has ever had a job knows that the last 10 or 15 minutes of the workday are the longest. When you’re busy, you forget about time and focus on what you’re doing. When you start looking at the clock, you get restless. Time creeps by. You wish it were 20 minutes in the future and you were on your way home.

The same thing happens any time you’re too focused on the time. Part of your brain is always pulling you away from your task at hand to check the time. Try forgetting about the clock. If you have to do something at a certain time and you’re afraid you’ll get carried away and miss it, set an alarm. 

Accept Your Emotions

Another major challenge to staying present is when the present feels pretty bad. Either you’re in physical pain or discomfort or you are experiencing challenging emotions. It’s normal to want to escape that situation, even if you’re just imagining how nice it would be if you didn’t feel so miserable. 

Ironically, pushing away negative feelings only makes them stronger. The purpose of pain is to let you know that something is wrong. If you try to ignore it, it keeps tapping you on the shoulder. However, if you accept your discomfort and can be present with it without judgment, it typically becomes more tolerable.

This is especially important for anyone recovering from a substance use disorder because drugs and alcohol often serve as an avoidance mechanism. If you can look challenging emotions straight in the face and accept them for what they are, they have less control over you.

Living in the moment improves the quality of your recovery and your life in many ways. You’re more engaged in what you’re doing and you’re less bothered by rumination and worry when you live in the present. However, it does take practice. Focusing on the process rather than the outcome you want, practicing mindfulness, and periodically grounding yourself through your senses are great ways to spend more time living in the present.

At The Foundry, we know that recovery from addiction is about treating the whole person. That’s why we incorporate mindfulness meditation and trauma-informed yoga into our treatment program, along with evidence-based therapeutic methods and positive lifestyle changes. For more information, call us at 844-955-1066. 

One of the country’s premier, trauma-integrated men’s treatment facilities, Foundry Treatment Center Steamboat, announces a partnership with accomplished recovery professional Ben Cort of Cort Consulting. This long-term strategic partnership will allow Foundry to leverage Cort’s extensive experience in the field of treatment and recovery, ultimately providing a higher standard of patient care. In his new role, Cort will focus on back-end operations, helping Foundry’s administration team flourish.

“We’re thrilled to have Ben join the Foundry Steamboat team,” says Founder and CEO Scott Borden. “His industry experience and overall business acumen adds unquantifiable value to our organization. Perhaps most importantly, he shares the Foundry philosophy of providing the highest level of care. Ben joins the rest of our staff in making the greatest impact we can each day carrying a message of hope.”  

Cort has consulted for various programs, sports leagues and organized labor. Most recently, he led the marketing, business development and admissions teams at the Center for Dependency, Addiction & Rehabilitation (CeDAR), a subdivision of the University of Colorado Hospital. He was also an original board member and the first full-time employee at Phoenix Multisport, where he built sober communities through sport and health-related programs and helped to design the organization from its inception.

Cort has become a thought leader in the treatment world, working to improve the standards and education in marketing and admissions. He has also spearheaded an effort to better understand today’s cannabis industry and its effects on substance use disorder. In addition, Cort has spent time working with professional and collegiate athletes, coaching staffs, leagues, players unions and administrations to increase awareness of substance use disorder and mental health; assisting them in crafting appropriate and effective treatment plans for athletes. As a program that emphasizes physical wellness in concert with the emotional and clinical growth of participants, Foundry will greatly benefit from Cort’s prior experience.  

“I have had the chance to work inside some amazing organizations and had never considered putting roots down with one of them until I got to know Foundry,” says Cort. “The commitment they have to patient care by retaining such amazing talent speaks for itself. Having the opportunity to work alongside and learn from Dr. Michael Barnes, a former colleague, is a dream come true, not to mention that the former Medical Director from CeDAR, Dr. Laura Martin, is also part of the team. Foundry is treatment at its best and only getting better, I am exceedingly proud to be a part of this team.”

Cort sits on several boards and is most proud of his work with the National Association of Lesbian, Gay, Bisexual, Transgender Addiction Professionals and Their Allies and Smart Approaches to Marijuana, who work respectively to advance treatment for LGTBQ+ patients, and to push back on the move toward the commercialization of THC, a compound found in cannabis. His book, “Weed Inc.” can be found in major bookstores as well as on Amazon and his TED talk “What commercialization is doing to Cannabis” has been seen over 2 million times. Cort is a frequent speaker and industry expert advocating for recovery.

About Foundry Steamboat

Foundry Steamboat is a substance abuse treatment center based in Steamboat Springs, Colorado, focused on providing complete addiction treatment to help male participants regain happy and productive lives. Guided by a team of professionals, participants experience a comprehensive program centered around medical treatments, clinical therapy, wellness, and family therapy. Fully accredited by the Joint Commission, Foundry Steamboat is committed to providing the highest quality addiction treatment across a long-term continuum of care. For more information, call 844.955.1066, visit ForgingNewLives.com or connect with us on Facebook, Twitter, Instagram or LinkedIn.

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Neuroticism used to be a fairly broad term used to describe certain kinds of psychological disturbances. These days, it’s mostly limited to one of the big five personality traits, which include openness, conscientiousness, extraversion, agreeableness, and neuroticism, which you can easily remember with the acronym OCEAN. Neuroticism is the tendency to experience negative emotions and more intense emotional reactions to threatening or frustrating situations. 

While research suggests scoring high-ish on the other personality traits tends to result in better outcomes, including better relationships, more positive emotions, and even higher income, higher neuroticism tends to result in greater risk of mental and physical health issues and addiction. This is especially true when high neuroticism is paired with low conscientiousness. Given that high neuroticism increases your risk of addiction and makes you less happy overall, you might wonder if there is anything you can do about it if you happen to have high neuroticism.

As a basic personality trait, neuroticism is hard to change but it can be changed a bit. You are not likely to go from being in the ninetieth percentile to the tenth percentile of neuroticism--a huge change--but with persistent effort, you can probably dial it down a bit. It also helps that neuroticism tends to decline slightly as you age. The following are some ways you can reduce your neuroticism and thereby promote your recovery from addiction.

Go to Therapy

The most direct way to reduce neuroticism is to enter therapy. Your therapist can help you address it in a comprehensive way, including thought patterns, relationships, lifestyle factors, and perhaps medication. There is typically a biological component to neuroticism, meaning that some people are just physiologically more sensitive to stress, so it’s important not to think of neuroticism as a weakness or personal failing. Often, it also has a lot to do with early childhood environment and learned behaviors, and addressing those issues typically requires professional help.

Change How You Talk to Yourself

Although our ideas about neuroticism have changed a lot since Freud’s day, at least one thing is still similar: Negative feelings are, to a large extent, caused by our beliefs and assumptions, many of which we may not even be aware of. Although people who score high on neuroticism are often aware of their self-defeating behaviors, they feel powerless to actually change them. This is why a therapist can be especially helpful. One way of combating neurotic tendencies is to identify your underlying assumptions, challenge them, and replace them with more accurate and helpful thoughts. 

For example, if you’ve had an argument with your spouse, you might think something like, “I’m always ruining my relationships,” a thought which characterizes yourself as comprehensively and permanently inept at relating to other people. This is an example of overgeneralization. 

Instead, focus on the matter at hand. Did you listen to your spouse? Can you see things from their perspective? Were you making unreasonable demands? How might you best resolve the issue in a way that will make you both happy? More broadly, you probably have other relationships that go pretty well or you might even get along with your spouse pretty well most of the time. All of these ways of thinking can help you dismantle the cognitive distortions that worsen your challenging emotions. 

Exercise

As noted above, neuroticism is the tendency to feel more negative emotions and to feel them more intensely. Exercise combats both of these tendencies. First, exercise promotes the release of several neurotransmitters that improve your mood, including serotonin and endorphins. It also increases levels of BDNF, a neurotransmitter that grows neurons in the hippocampus, a brain region involved with memory formation that also helps regulate emotions. 

Second, exercise causes structural changes in the brain that actually make your brain less sensitive to stress. A structure called the hypothalamic-pituitary-adrenal (HPA) axis is plugged into several areas of the brain that are responsible for identifying and responding to threats. Regular exercise appears to help turn down the volume a bit on the HPA axis. Most studies suggest that at least 20 minutes a day of moderate-intensity aerobic exercises, such as brisk walking, jogging, biking, or swimming, is all you need to get the benefits. 

Eat a Healthy Diet

More and more experts are becoming aware of just how important diet is for mental health. There are now quite a few studies showing that diet plays an especially large role in depression. One large meta-analysis of the research found that participants who adopted healthier diets--typically consisting of more nutrient-rich whole foods--had significantly fewer symptoms of depression. 

This study found no effect of diet on anxiety symptoms--which are at least as common as depressive symptoms among people with high neuroticism. However, other research suggests that magnesium--specifically magnesium deficiency--may play an important role in anxiety disorders, making people more sensitive to stress. You can boost your magnesium levels by eating more magnesium-rich foods, many of which you should be eating anyway. These include nuts, beans, legumes, dark leafy greens, pumpkin seeds, avocados, and dark chocolate. If you decide to take magnesium supplements, consult with your doctor first since excess magnesium can cause problems.

Practice Mindfulness

Finally, you can reduce neuroticism by practicing mindfulness. One study of graduate students found that participating in a seven-week mindfulness course reduced neuroticism over a six-year follow-up period. Participants who completed the mindfulness course reported decreased psychological stress, due at least in part to personality changes. 

There are several ways mindfulness can help reduce neuroticism. Perhaps the most important is that it’s a way of practicing acceptance of challenging emotions. Instead of trying to avoid or suppress them, you learn to sit with them and see they’re only feelings or thoughts and they can’t hurt you. Mindfulness also helps support other healthy lifestyle changes such as reducing emotional eating and improves your relationships by helping you be more attentive to the people around you. There are mindfulness classes available for free in many areas and online and you can practice in just a few minutes a day.

Personality traits change slowly and you should be looking for progress over months or years, not days or weeks. For that reason, it helps to make some of these changes habitual and to enlist the support of positive people. However, with persistent effort, you can reduce the intensity and frequency of negative emotions and make recovery from addiction a little easier.

At The Foundry, we know that recovery from addiction is really about reorienting your life. It’s not just about abstaining from drugs and alcohol, but about feeling more connected, purposeful, and comfortable in your own skin. That’s why we employ a variety of methods, including cognitive behavioral therapy and dialectical behavioral therapy to help you relate better to challenging emotions. To learn more, call us today at (844) 955-1066.

Is there really a difference between helping and enabling? What is enabling? What are the causes and effects of this behavior on both the “enabler” and the person being “helped”? Helping is doing something for someone else that they are unable to do for themselves. Enabling is doing things for someone else that they can and should be doing for themselves. So, why is there so much confusion between the two?

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We have many opportunities in our lives to help someone else, whether it be amongst those of our own families, close friends or complete strangers. Perhaps someone you know has become ill, and you help them by arranging and bringing meals to them until they are well enough to do it for themselves again. A friend’s car may be in the shop getting fixed and you help them by driving them to and from work until their car is in good running order again. Maybe someone you know has run into a bit of bad luck and is in need of temporary financial help to tide them over for awhile until their situation improves. Did you notice the optimal word, “until”? Providing temporary help to someone in need exemplifies kindness and consideration towards the receiver of help, but it also makes us feel wonderful inside when we are able to do so. But it is still temporary. What then is enabling?

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Enabling is entirely a different matter, but oftentimes gets confused as “help” by well-intentioned family members, friends and even neighbors. Remember, enabling is doing things for someone else that they CAN and SHOULD be doing for themselves. Many people think of enabling strictly in regards to alcoholics or drug addicts, whose family and friends make excuses for unacceptable behaviors, thus creating an atmosphere of comfort and ease for the situation to continue long-term.
Enabling vs. helping has a much broader meaning, encompassing many areas of life, including raising children to become independent adults rather than contributing to the increasing phenomenon of grown children returning home to live with their parents. When we enable addicts, children, friends or family, we are preventing them from experiencing the consequences of their own actions. We are not only preventing them from realizing they have a problem, but we are also depriving them of fully reaching their own potential.

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CO-dependent behavior early warning signs:

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- Repeatedly bailing them out—of financial problems, extending deadlines, other “tight spots” they get themselves into
-  Giving them “one more chance”–. . .then another. . .then another. . .then another
-  Ignoring the problem—because they get defensive when you bring it up and you want to “keep the peace” or your hope that is will magically go away.
-  Joining them in blaming others or in making excuses—it’s never their fault, they have problems, their life has been “rough”.
-  Accepting their justifications, excuses and rationalizations “I’m depressed” “I have a rough life (childhood, work schedule. Etc., etc.)
- Avoiding Problems—Again to keep the peace, or to avoid “upsetting” them
-  Doing for them what they should be able to do for themselves—Yes—even when it’s faster, easier, simpler to just do it for them.
- Softening or removing the natural consequences-After all they shouldn’t have to suffer
- Trying to “fix” their problem for them.
- Repeatedly coming to the “Rescue”
- Trying to control them or their problem—Getting angry, frustrated, or hurt when they don’t “take your advice” or accept your help.

If even one or two of the above apply to a relationship over a weeks, months, or beyond; this is a sign that the relationship has become a co-dependent, enabling type of relationship.
The Best Of Intentions Often Back-fire
Helping someone in need is truly admirable, until. Enabling someone is not so admirable, fraught with complications that can last indefinitely. Society often sends confusing messages about what it means to be a good family member or friend. However “unselfishness” must have limits – everyone needs to have limits in relationships.

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Being an enabler has its own payoff, with a false sense of control over the lives of others. Well-intentioned parents, friends and even strangers can often find themselves feeling frustrated, resentful and used, but lack the will to stop the enabling. The “help” provided to those lacking the motivation and determination to stand on their own two feet has become a long-term expectation and outright demand by many. Are you an enabler?

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Turning Enabling Behaviors Into Positive Potential-Friends, family, neighbors, co-workers etc must learn to redirect their “helping” efforts with Tough Love, allowing persons to recognize and accept the responsibilities and consequences of their own choices, rather than enabling the continuance of unacceptable behaviors to the detriment of everyone involved. Take responsibility for any enabling behaviors, which is considered by some experts to be akin to abuse, realizing that creating positive change in someone being “helped” will not only have a positive impact on them but on you as well. There really is a difference between helping and enabling, but it is up to you to choose whether to continue on this path or to put a stop to it now.

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Written by:

Alyssa Baker

Foundry Treatment Center

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Also, check out her blog!! You can find it here - http://spacelyss.wordpress.com/

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Photo Credit: Stacy S. w/ Foundry Treatment Center

If you look at any quality addiction treatment program, you’ll notice several things many of them have in common and one of those things is exercise. It’s becoming much more common for regular exercise to be an integral part of addiction treatment. Experts also frequently recommend that your post-treatment recovery plan includes regular exercise.

However, this can be challenging for many people, especially those who are busy or don’t really think of themselves as athletic. The following is a look at why exercise is one of the most important lifestyle changes for recovery and how to more easily make exercise part of your daily life.

Why Exercise Is Important

First, if you want to motivate yourself to exercise more, it helps to understand why you’re doing it. Otherwise, it just feels like a chore. There is now quite a bit of research supporting the role of exercise in recovery, both in terms of physical and mental health.

Physical Health

Heavy substance use is hard on your body. Its exact effects depend largely on which substances you use the most, but overall, you may suffer from malnutrition, increased cardiovascular risks, and more frequent illnesses due to poor immune function. If you want to recover your health as quickly as possible, it’s important to eat a healthy diet and get regular exercise. 

Exercise--especially aerobic exercise like walking, running, swimming, and biking--improves your cardiovascular health pretty quickly. It also helps you maintain a healthy weight and reduces your risk of type two diabetes, as well as reducing your risk of infections and cancer. Exercise may not totally offset the physical damage of substance use, but it gets you going in the right direction.

Mental Health

Perhaps more importantly, exercise boosts your mental health. It improves your mood by increasing levels of endorphins, serotonin, and BDNF, a neurotransmitter that grows neurons. It also causes structural changes that help you react better to stress. It’s thought to be this change, along with improved sleep, that is most responsible, for the health benefits of exercise.

The improvements in mood reduce your risk of depression and anxiety symptoms, which in turn reduces your risk of relapse. Given that most people with substance use disorders also have co-occurring mental health issues, it’s hard to overstate this particular benefit of exercise for anyone trying to stay sober.

How to Build an Exercise Habit

It’s one thing to know that exercise is good for you and it’s another thing entirely to actually do it. The following are some tips for going from “not an exercise person” to someone who exercises daily without really thinking about it.

Find Something You Like

First, find something you actually enjoy. According to research, the best exercise for mental health is a moderate-intensity aerobic exercise that lasts for at least 20 minutes, at least three times a week. However, that doesn’t matter at all if you aren’t willing to do it. It’s crucial not to let the perfect be the enemy of the good. You will get some benefit from staying active, even if it’s not the scientifically validated “best” exercise. Walking is great. So are gardening, boxing, yoga, dancing, and fencing. 

There are two divergent strategies that work pretty well: Either pick something you don’t mind doing and can just participate in mechanically or perhaps even socially, like walking; or pick something that really fires your interest and is complex enough to keep you engaged, like high-skilled sports or martial arts. 

Pick a Regular Time

The next thing is to pick a regular time and stick to it. Instead of picking a regular clock time, though, attach your exercise to an activity you already do every day or almost every day. So, for example, you get out of bed every day--ideally--so you can connect your exercise habit to that. The goal is to have one daily activity lead directly into the next so that you don’t have to exert any willpower to do it. Be patient though, it will probably take a month or two for the new behavior to become automatic.

Start Small

One of the most common mistakes people make when they decide to start exercising is that they go hard right away like they’re in a training montage. You actually want to do the opposite. You want to start out easy so you don’t resist building the habit. In the beginning, building a habit is the most important thing. At first, you may just want to put on your exercise clothes and leave it at that.

Or you may walk for five minutes. You want to have the feeling that exercise is just something you have to cross off your list, not something you have to brace yourself for and grind your way through. You can build the intensity later.

Build Gradually

When the habit is pretty well established, then you can begin to increase the volume or intensity. You may start to do this automatically just out of boredom. Five minutes may feel too easy so you start walking for 10 minutes. Building gradually accomplishes two things: You are less likely to get exhausted and burned out and quit after a few weeks or a month, the way 90 percent of people give up on new year’s resolutions.

Second, it keeps you from getting injured, which interrupts both your fitness progress and your habit formation. Also, being injured is painful. There’s no rush and, over the course of months and years, consistency beats intensity every time.

Reward Yourself

Finally, set up some kind of reward for doing your exercise, even if it's just patting yourself on the back. This is especially important to remember on bad days. So, for example, you intended to run a mile but you felt terrible and ended up walking most of it. That’s fine. We all have bad days. The important thing is to congratulate yourself for showing up and doing the work rather than chastising yourself for not doing it as well as you would have liked.

It may also help to schedule some rewarding activities after your exercise. For example, you might tell yourself, “Ok, after I exercise, I can have dinner, or watch TV, or go hang out with my friends.” This gives you something to look forward to and immediately associates something positive with exercise.

At The Foundry, we know that lifestyle changes like social support, a healthy diet, and regular exercise are the foundation of a long recovery and a healthy life. That’s why these are incorporated into our holistic treatment plan along with meditation, yoga, and outdoor activities. To learn more about our approach to addiction treatment, call us at (844) 955-1066.

Recovery from addiction is complicated. You have to learn new coping skills, make new friends, make lifestyle changes, and other big changes in a relatively short period of time. There are plenty of chances to make mistakes, especially early on. The good news is that these mistakes don’t have to derail your recovery.

You can avoid many of them, if you know to watch out for them. If you do make mistakes, you can usually get back on track if you catch them early enough. The following are some of the more common mistakes people make in addiction recovery.

Thinking You Can Do It Alone

Perhaps the hardest step is admitting you have a problem, but it’s also hard to ask for help. Many people admit they have a problem with drugs or alcohol, but they want to deal with it on their own. This is usually a bad idea. The thinking that got you into addiction is unlikely to get you out. At the very least, you would benefit from social support like what you would find at 12-Step or other mutual-aid meetings. Additionally, many people need much more support and guidance, such as from a therapist or an addiction treatment program.

Not Treating Mental Health Issues

When most people decide to get help for a substance use issue, the first thing they think of is going to a 12-Step meeting. This is a great first step, and groups like AA and NA have helped millions of people get sober over the decades. However, it’s also important to be aware that most people with substance use disorders also have co-occurring mental health issues such as major depression, anxiety disorders, personality disorders, PTSD, and others. If you try to get sober without addressing these issues, it’s going to be much, much harder.

Expecting Too Much Too Soon

Recovery from addiction is possible — and even likely, with the right help — and life will certainly get better when you’re sober, but it won’t happen all at once. It takes time to form new habits and get used to different ways of thinking. It also takes time for your brain chemistry and body to adapt to life without drugs and alcohol. The early months are typically challenging, and often uncomfortable.

If you expect life to turn around right away, you’ll likely be disappointed. You should probably expect to notice a difference by the end of the first year of sobriety, and then again at five years. In the meantime, you just have to commit to the process.

Comparing Your Progress to Others

It’s normal to want to know how your recovery is progressing, but comparing your progress to others is counterproductive. First and foremost, these comparisons are never accurate. Everyone in recovery is facing different challenges and you only know what others allow you to know. Also, recovery is a cooperative effort. Everyone benefits when they support each other, but making comparisons turns it into a competition. It’s hard to celebrate other people’s successes when you feel like they come at your expense.

There’s plenty of sobriety to go around. Finally, something about the act of comparison itself makes you less happy. It’s far better to judge your progress based on your own goals and values, as well as whether you did better today than yesterday.

Dating Too Soon

Most experts typically recommend that you have a solid year of recovery before you think about dating again. This can be challenging, since substance use issues typically first appear in early adulthood, when people are dating most actively. However, there are good reasons to hold off. First, it distracts from recovery.

Dating can be stressful and time consuming, and if you meet someone you like, you are likely to prioritize that person over recovery. That may be fine as long as things are going well, but it can be a huge liability if the relationship starts having problems. What’s more, people often fall back into unhealthy relationship patterns if they start dating again too soon. A year seems like a long time, but it’s really not.

Thinking You’re Cured

It’s easy to get complacent after a while if recovery seems to be going well. You might start to cut corners like skipping meetings or neglecting other parts of your recovery plan. You might even start to think it would be ok to have a drink every once in a while.

This is much like when people stop taking their medication for a mental health issue because they feel good. You feel good because you’re taking care of yourself, so it’s important to keep doing what you’re doing. Addiction is a chronic condition, and you’ve got to stick with your recovery plan.

Drinking

If you’re recovering from alcohol use disorder, drinking is an obvious blunder, but many people in recovery don’t see alcohol as a serious problem. They may have issues with cocaine or opioids and see alcohol as more or less incidental. However, alcohol is often a powerful trigger, since most people combine drugs and alcohol. Not only that, alcohol impairs your judgment and self-control, making you more vulnerable to relapse. If you’re recovering from a drug use disorder, it’s important to stay away from alcohol, too.

Hanging Out With the Same People

We are all more vulnerable to peer pressure than we like to think. Even if your friends who drink and use drugs don’t pressure you to use, just being in that environment can trigger cravings and make it easier to relapse. People often struggle with loneliness early in recovery, which is why they hang out with old friends when they know they shouldn’t. The important thing is to create a sober network as soon as possible. Typically, attending regular 12-Step meetings is a good place to start.

Thinking Recovery Ends With Treatment

Finally, a lot of people assume that they can go into a treatment program, have their addiction problem fixed, and not have to worry about it too much after that. In reality, addiction is a chronic condition, and it takes about a year for your relapse risk to fall to 50 percent, on average. It’s especially important that you make a smooth transition from treatment back to normal life, perhaps by stepping down to an intensive outpatient program after you finish inpatient treatment, or by spending some time in a sober living environment. A strong recovery is really about changing your approach to life and not just about abstaining from drugs and alcohol.

Recovery from addiction is hard and everyone makes mistakes. The good news is that mistakes, even serious mistakes and relapses, don’t have to be final. You can learn from your mistakes and try again. At The Foundry, we use a variety of modalities to help our clients address co-occurring issues and make lasting change. For more information about our treatment programs, call us today at (844) 955-1066 or explore our website.

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We’ve all heard a lot about mindfulness in recent years. It has gone from a fringe practice to a common, even obligatory wellness practice. It has even been incorporated into mainstream treatments for addiction and other mental health issues. Treatment modalities such as mindfulness-based cognitive therapy, or MBCT, and dialectical behavioral therapy, or DBT, use mindfulness to help clients become more aware of their thoughts and emotions in general and better tolerate challenging emotions. Mindfulness meditation is often incorporated into addiction treatment programs, too. There are a number of reasons mindfulness is such a powerful addition to any recovery program, including the following.

Mindfulness reduces stress and anxiety.

One of the most publicized benefits of mindfulness practice is that it can reduce stress and anxiety. This is crucial for two reasons. First, having an anxiety disorder such as generalized anxiety, panic disorder, social anxiety disorder, or PTSD, significantly increases your risk of addiction. If you want to have a long recovery, you must find effective ways to manage your anxiety. Second, most people identify stress as their biggest trigger of cravings. Therefore, learning effective ways to manage stress will also reduce the number and severity of drug and alcohol cravings.

One of the first clinical uses of mindfulness meditation was to reduce stress. Programs like Herbert Benson’s relaxation response and Jon Kabat-Zinn’s mindfulness-based stress reduction, or MBSR, are perhaps the two most prominent examples. If mindfulness were only about spending 20 or 30 minutes a day sitting quietly and relaxing, that in itself would help reduce stress. However, there’s more to mindfulness meditation. Perhaps the most important effect in terms of stress and anxiety is that mindfulness trains you to stay in the present moment, rather than worrying about things that might happen. This effect will eventually extend into your regular life, not just when you’re deliberately practicing mindfulness.

Mindfulness improves metacognitive awareness.

Another useful aspect of mindfulness meditation is that it builds metacognitive awareness — or being aware of what you’re thinking about. This doesn’t seem like a big deal, but it is. Much of the time, our thoughts, beliefs, assumptions, and even emotions, lie beneath the level of conscious awareness. Other times, we get so swept up in some train of thought that we’re not even aware of what’s going on. Both of these can be barriers to insight and recovery.

Most treatment programs and therapists use techniques from cognitive behavioral therapy, the premise of which is that our thinking, rather than external events, is what causes disturbing emotions. If you adjust your thinking to be more objective, you will naturally suffer less, emotionally. The problem is that thoughts can be evasive and slippery. Practicing mindfulness will make you more aware of what you’re thinking and how it affects your emotions. This makes therapy much more effective.

Mindfulness improves behavioral awareness.

Part of the challenge of overcoming addiction — and bad habits, more broadly — is that a lot of our behavior happens on autopilot. If you’ve ever tried to quit smoking or quit biting your fingernails, you’ve probably noticed your body seems to engage in these behaviors without your consent or awareness. This automatic behavior happens on an even deeper level with addiction.

It’s hard to change your behavior when you’re not even aware of what your behavior is. Mindfulness helps you bring more attention to what you’re doing at any given moment. You are more aware of what you’re doing and also how you feel about it. For example, smokers who are asked to smoke mindfully are often surprised to discover that they don’t like the taste or smell of cigarettes or the feeling of smoke in their lungs. Getting off of autopilot through mindful attention gives you more control over your behavior.

Mindfulness changes patterns of avoidance.

Substance use is often a symptom of avoidant behavior. That is, you may use drugs or alcohol as a way of avoiding some kind of emotional stress rather than deal with it. While this offers temporary relief, it makes the problem worse in the long run and causes new problems to go with it.

Mindfulness is really the opposite of avoidance. Instead of trying to ignore or suppress a challenging emotion, you accept it and observe it without judgment. You notice what the emotion is like, what thoughts arise with it, where you feel it in your body, how it changes over time, and so on. Several studies have found that people who are more accepting of their emotions suffer less distress and fewer negative outcomes, such as depression when they’re under stress. This isn’t only limited to emotions like anxiety or pain from traumatic memories, but it can help you get through cravings, as well. This is sometimes called “surfing” a craving.

Mindfulness can improve your relationships.

Having strong relationships is one of the most important parts of addiction recovery. Social connection reduces stress, gives you a sense of purpose, and helps keep you accountable. Mindfulness helps improve your relationships in several ways. First, from a practical perspective, it helps you pay attention when someone is talking. We’re often too distracted by our phones or by our own thoughts to listen properly. Just making an effort to give someone your full attention will improve your relationship.

Second, one of the challenges of communicating is that we are often too reactive. We get angry, defensive, or critical and a conversation quickly devolves into an argument. When you learn to be more mindful, you’re aware of these emotional reactions within you but you don’t necessarily take them too seriously. You can entertain different interpretations and consider things from the other person’s point of view before you respond.

Mindfulness is not a replacement for therapy or treatment, but it can be a powerful addition to any recovery program. It reduces stress, helps you to be more aware of your inner life and outer behavior, and improves your relationships. At The Foundry, mindfulness meditation is one of many modalities we use to treat substance use disorders. For more information about our programs, explore our website or call us today at 1-844-955-1066.

Depression is both widespread and one of the most common risk factors for addiction. One study found that among people with a mood disorder such as major depression or bipolar disorder, 32% had a substance use disorder, while in the general population, only about 8% of people had a substance use disorder. Substance use helps people cope with the symptoms of depression in the short term, but in the long run, drugs and alcohol only make depression worse. An effective addiction treatment plan must include treatment for any mental health issues, including depression. Depression has gotten a lot more media attention in recent years but unfortunately, there are still a lot of misconceptions about depression. These misconceptions can prevent people from recognizing, acknowledging, and seeking help for depression.‍

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1.) Depression Mostly Affects Women

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It’s true that depression appears to affect women at a higher rate than men but the difference is largely overstated. For example, in 2017, about 8.7% of women had a depressive episode compared to about 5.3% of men. By comparison, only about 0.54% of men get schizophrenia, 2.9% of men develop bipolar disorder--which is also considered a depressive disorder--and about 4% of men develop post-traumatic stress disorder (PTSD). That is to say, that even if men are slightly less likely than women to experience depression, depression is still one of the most common mental health issues men are likely to face. 

2.) Depression Is All-Or-Nothing

You may have an image in your mind of what depression looks like--perhaps someone who can’t get out of bed, can’t hold a job, doesn’t shower, has attempted suicide, and so on. This can be a fairly accurate picture of severe depression but depression can vary widely in both symptoms and severity. Most depression is mild or moderate. The problem with fixating on severe depression is that someone with moderate symptoms that are causing significant impairment might think, “Well, I’m not that bad, so maybe I should just stop complaining.” It’s important to keep in mind that just because someone has it worse, that doesn’t invalidate your own experience. If depression is affecting your life and your recovery from addiction, it needs to be addressed.

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3. If Someone Has Depression, It’s Obvious

As noted above, depression comes in all shapes and sizes. Certainly, there are cases of people who can’t function but the truth is that most people with depression still manage to get by. Often, you wouldn’t even know they’re depressed by looking at them. Many people with depression are good at keeping up a front, either because they fear being stigmatized or they feel like there’s no point in letting others know how miserable they are. High profile cases of suicide, like Robin Williams and Anthony Bourdain, are clear examples of how well some people can hide their pain.

4.) Depression Is a Kind of Prolonged Sadness

Another myth that keeps people from recognizing the symptoms of depression is the belief that depression is mainly just intense or prolonged sadness. Depressed mood is a symptom but it is not the only symptom and it may not be the most prominent symptom. You have to have at least five symptoms, including depressed mood and inability to feel pleasure, for a clinical diagnosis of depression. However, you may more often feel irritable or hopeless, wake up in the middle of the night and have trouble going back to sleep, feel unable to concentrate, or feel unusually fatigued. If you have these kinds of symptoms but wouldn’t exactly say you feel sad, you may be depressed and not realize it.

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5.) Depression Is All in Your Head

Similar to the misconception above, many people think depression is all in your head, that if you could just think a little more positively, you would feel better. While it’s true that fixing cognitive distortions is often a useful part of treatment for depression, recent research suggests that depression may be more of a physical problem than previously believed. In particular, inflammation has been implicated in about half of depression cases. In other words, people with depression often have some of the same markers of inflammation you would find in someone with an infection or autoimmune disorder, suggesting that the immune system may have a significant effect on the mind.

6.) You Need a Good Reason to Be Depressed

As discussed above, you can’t always tell who is struggling with depression, and part of the reason is that some people just don’t seem to have a good reason to be depressed, such as the death of a loved one, losing a job, or getting divorced. However, you don’t need an immediate or obvious reason to be depressed, and sometimes you don’t need a reason at all. Childhood abuse or neglect can increase your risk of depression, years later, for example, and people who have had two or more episodes of depression may have recurring episodes for no reason.

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7.) Everyone Gets Depressed Sometimes

Everyone gets sad sometimes but not everyone gets depressed. About one in five people will experience an episode of depression at some point in their lives, which makes depression one of the most common mental health issues worldwide, but it also means 80% of people won’t experience it. It’s fairly common--even among people with depression--to assume that people with depression are just not handling normal emotions very well. This assumption can be frustrating for people with depression and their families who don’t quite understand the condition.

Depression is one of the most common mental health issues in the world and it is a major risk factor for developing a substance use disorder. Getting addiction under control requires integrated treatment for depression. Unfortunately, common misconceptions about depression, especially about who can get it and what the symptoms are like can prevent people from recognizing they’re depressed and prevent them from seeking help. Depression can be treated effectively in most people and even when it can’t be eliminated completely, the symptoms can be reduced. 

At Foundry, we know that mental health is the key to a strong recovery and a happier life. We use a variety of methods including cognitive behavioral therapy, or CBT, dialectical behavioral therapy, or DBT, family therapy, Alpha-Stim, as well as healthy lifestyle changes including diet, exercise, yoga, and meditation as part of a comprehensive approach to mental health and wellness. For more information, call us today at (844) 955-1066.

People want pets for many reasons. They’re cute, they’re friendly, and they can keep you company. If you are in your first year or so of recovery, there may be ways that having a pet can actually help you out and make your recovery stronger. However, it’s not a decision to be taken lightly. If you’re not in a good place, a pet may be an unnecessary liability. It may be better to wait. Here are some things to consider if you’re thinking about getting a pet.

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How a Pet Can Help

Pets Are Good Companions

One of the most common reasons people want a pet, especially a dog or a cat, is that a pet is a good companion. They don’t judge, they’re affectionate, and they’re always around. Loneliness is a common problem early in addiction recovery because people often cut ties with old friends who drink and use drugs. However, making new friends can take time and meanwhile, people often feel lonely. Loneliness isn’t just unpleasant; it can worsen issues like depression, anxiety, and other mental health issues that commonly occur with addiction. Finding ways to feel connected is essential to recovery success and having a pet around is one such way. It’s not a substitute for human companionship, but it’s certainly an improvement over isolation.

Pets Can Make You More Conscientious

We typically don’t think of responsibility as a selling point but for people recovering from a substance use disorder, it can be. Conscientiousness is a personality trait that appears to protect against substance use disorders. Conscientiousness includes things like being responsible, being organized, following rules, following a regular routine, and so on. While personality traits are inherently difficult to change, conscientiousness is more related to action than other personality traits are, which means you can become more conscientious by behaving more conscientiously.

Having a pet exercises your conscientiousness muscles in mainly two ways. First, having a pet is quite a bit of responsibility. You have to feed it, make sure it gets plenty of exercise, and make sure it has basic things like toys, a carrier, and somewhere to sleep. You have to make sure your pet is vaccinated and you have to take it to the vet when it’s sick. You’re responsible for the well-being of another living thing, which means you will get plenty of practice doing mildly annoying and unpleasant things. While this doesn’t seem very appealing, learning to care for a pet can help you cultivate compassion and get you outside of your own head, which may not always be a nice place to be.

The second way a pet will help you be more conscientious is that it will help you have a more regular routine. You have to feed a pet regularly and a cat, dog, or bird will even wake you up when it’s ready to eat. You are aware that you have to be home at night to feed your pet, so you’re less likely to stay out late or stay over with friends. This routine can help with other things like having a more regular sleep schedule and generally keep you tethered to the normal rhythm of the world.

Pets Are a Way to Connect With Others

Having a pet means you have an easy conversation topic most of the time. Everyone wants to talk about their pets because they love them, it’s rarely a controversial topic, and it’s more interesting than the weather. Having a dog is especially good for promoting social connection because you have to walk them and you are much more likely to meet and talk to your neighbors. Even people without dogs will be more likely to strike up a conversation. While most of these interactions will be superficial, it’s good to have more points of contact, especially with the people who live around you. As noted above, loneliness is a common problem in early recovery, and having a sense of social connection is one of the best ways to ensure your recovery lasts.

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Pets Encourage You to Be Active

This is mainly true of dogs, who have to be walked. Some dogs need a great deal of exercise, which means you’ll get plenty of exercise, whether it’s walking them, running with them, playing fetch, and so on. Having a dog usually means you get more activity spread throughout the day and it means you will be less likely to skip exercise if the weather isn’t perfect. While a short walk with the dog doesn’t seem like a big deal, many short walks throughout the week add up to quite a bit of exercise. Not only is that good for your health, but it’s also good for your recovery. Many studies have linked regular exercise to less stress, lower anxiety, better mood, and even longer periods of sobriety.

When You Might Want to Wait

Pets Can Be Expensive

Pets are a lot more expensive than you think. There are sometimes adoption fees, vaccinations, accessories like beds, carriers, toys, grooming items, and so on, vet bills, and food. A lot of people aren’t in the best shape financially when they start recovery and the financial stress of taking care of a pet certainly won’t help. 

Pets Entail Responsibility

As discussed above, responsibility can be a good thing for recovery, but it can also be too much. Keep in mind that if you drop the ball, it’s your pet who will suffer. It’s also possible that the responsibility of caring for a pet will be too much stress too soon. Stress is a major cause of cravings, so it makes sense to only increase your responsibilities gradually to avoid feeling overwhelmed.

Pets Can Be an Emotional Liability

The emotions involved in having a pet aren’t always positive. Animals have much shorter lifespans than people. They get sick and they have accidents. If you’re attached to a pet, its death can be devastating. If you feel like that’s not an emotional shock you’re prepared to handle--meaning you’re not sure you could stay sober if your pet dies--then it might be better to wait until you’re in a more stable point in your recovery.

Pets can be great companions. They can help us learn to be more compassionate and responsible, both of which improve your recovery and make you happier and more fulfilled in life more generally. However, once you adopt a pet, you’re responsible for its welfare. If you think there’s any chance that you will forget about it, neglect, or not be able to afford to care for it, it’s better to wait. You can always get a pet later. It’s also important to remember that as emotionally rewarding as caring for a pet can be, it creates an emotional vulnerability as well. Getting a pet is just one of many life choices that will affect your recovery from addiction and your overall well-being. 

At Foundry, we know that drug and alcohol use is just the tip of the iceberg when it comes to addiction. Mental health issues, trauma, stress, and isolation are often the real driving forces. That’s why we emphasize a comprehensive approach to recovery, one that doesn’t just emphasize abstaining from drugs and alcohol, but also addresses the root causes of addiction and gives clients the skills they need to live happier, more fulfilling lives. To learn more about our addiction treatment program, call us today at (844) 955-1066.

Many people assume college students are too young to be recovering from addiction, but the fact is that the age of the typical full-time college student coincides with that age at which drugs and alcohol typically become a problem. It’s also sometimes the case that substance use issues force people to delay their life plans, including education. Therefore, many people find themselves attending college after getting sober. College can be a challenging place for sober people, since drinking is typically considered integral to the college experience, especially in the US. More than half of college students report drinking at least once in the past month and more than a third report binge drinking in the past month. However, that also implies that at least half of college students drink moderately or not at all. What’s more, being sober will give you a significant advantage when it comes to your studies and extracurricular activities. The following are some tips for staying sober in college.

1.) Stay Near Your Support System If Possible

First, try to stay connected to your existing sober support system, whether that’s friends, family, 12-Step group, or whatever else. Social support and connection are some of the most important parts of a strong recovery. People who move away to go to college often face the difficult combination of loneliness and the stresses of school and generally being in a new place. If you can stay where you are, you retain your emotional support system and minimize new stress. To this end, it may be better to attend a college or community college in your area or even comm

ute if it’s not too long of a drive. That assumes there is a college near you and that it’s a reasonable option. If you can stay where you are, at least for the first semester, it will make the transition to college life much safer.

2.) Choose Your Residence Wisely

If or when you do decide to move to attend college, it’s important to choose your residence well. Certainly, avoid living in a frat or sorority house or even in the same neighborhood. Although some groups are certainly better than others, it’s going to be hard for you to avoid drugs and alcohol. Off-campus student housing areas are often just as bad.

The best options for sober housing will usually be either stay on campus or live in a part of town without many students. Most dorms prohibit drugs and alcohol, although how strictly that is enforced varies widely among institutions. Generally speaking, a dorm will probably have less drinking if it’s not exclusively male or not exclusively first-year students. Also, many universities have family housing available. These are typically small apartments occupied mostly by graduate students and foreign students. Therefore, family housing is typically pretty quiet and affordable. 

Whatever housing option you choose, it’s also a good idea to find a sober roommate. University housing services may be able to help you with that or you might have to find someone through a service like MySoberRoommate.com. Or perhaps you know someone through your 12-Step meetings or elsewhere who also needs a roommate. 

3.) Find a Local Support System

Whether or not you remain living at home while attending college, it helps to have social support on campus. This may or may not be a group of sober people but it will certainly be a group focused on something other than drugs or alcohol. For example, you might find a 12-Step group near campus or you might get involved with activities that support your recovery. For example, most colleges and universities have tons of opportunities to get involved in volunteering, which, in addition to being a positive activity and a great way to meet friends, is one of the 12 steps. 

However, campuses have groups of all kinds--languages, games, academic disciplines, sports, activism, and more. These are all great opportunities to make new friends around activities that are more constructive than drinking.

4.) Manage Your Course Schedule

One of the biggest challenges for anyone recovering from addiction is managing stress, which is typically a major trigger of cravings. Managing stress is a whole topic in itself but in the context of college, one of the best ways to manage stress is to manage your schedule. New college students are often surprised by how much they have to study when they first start college. Also, high fees often make students try to pack as many courses as they can into every semester. Unfortunately, that’s a great way to feel stressed, overwhelmed, and helpless. It’s much better to keep your schedule as light as you can within the constraints of academic and scholarship requirements. 

Keep in mind that class time is only the tip of the iceberg. Many classes, especially in your first year, will also have study sections and labs, both of which may assign their own homework. Then, there’s just the regular studying you’ll have to do for each class. You’ll typically get more mileage from putting more effort into mastering a few core subjects than by trying to take a huge variety of classes and you’ll feel less stressed that way too.

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‍5.) Practice Self-Care

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College students aren’t known for their self-care. Rather, they tend to be known to eat a lot of pizza and stay up late. These kinds of habits are bad for both your grades and your recovery. As much as possible, try to maintain any healthy lifestyle changes you’ve made as part of addiction recovery. Try to eat a diet mostly composed of nutritious whole foods with a minimum of sugar and fried food. Get regular exercise, even if it’s just walking a lot. 

Most importantly, don’t skimp on sleep. Sleep is when new skills and information are consolidated into long-term memory, so staying up late to study is really counterproductive. Sleep deprivation also impairs your concentration and short-term and working memory. If you’re tempted to stay up all night studying for a test, the reality is that you’ll probably benefit more from a good night’s sleep. Most importantly, consistently getting enough sleep is crucial for emotional stability, so resist the urge to cut corners by cutting sleep.

Although college is known for parties and drinking, that’s only a small part of the college experience. When you consider all the opportunities college offers--not only for classroom education, but also for gaining broader cultural knowledge, meeting interesting people, volunteering, and getting involved in new activities--using the opportunity just to drink seems like a waste of time. Staying sober starts with creating the right conditions, such as where you choose to live, and associating with the right people. There is a fairly strong inverse correlation between grades and drinking, meaning that more serious students tend to drink less. There are always exceptions, of course, but by associating with other people who want to learn as much as they can, you are likely to end up around relatively sober peers.

 At The Foundry, we know that recovery from addiction is a process of continuous learning. We also know that the best reason for getting sober is so you can live the kind of life you want to live, which may involve higher education. To learn more about our comprehensive approach to addiction recovery, call us at (844) 955-1066.

Many people starting out in recovery face a dilemma when it comes to friends: They want to distance themselves from their old associates who are drinking and using drugs but then they struggle with loneliness, which, in some ways, is almost as bad. Having a strong support network gives you a feeling of belonging and reduces stress.

It’s one of the most important factors in a strong recovery. However, few people actually have much practice making new friends as adults. The following tips can help you make the kind of friends that will help you stay sober.

Have the Right Attitude

First, you have to have the right attitude. Mainly that means being willing to take some risks in terms of going into unfamiliar situations and reaching out to others. If you’re naturally outgoing, this is not a big deal, but if you’re reading a post about making friends, you may need to prepare yourself to step outside your comfort zone. Keep in mind that if someone isn’t interested in being your friend, you shouldn’t take it personally.

We all have our reasons or lack thereof for who we’re friends with. Think of it this way: If you talk to enough people, you will eventually make some good friends. Also, keep in mind that you don’t necessarily need your new friends to be sober; you just need them to respect and support your sobriety.

Find Good Situations

The other part of the new-friends equation is to put yourself in circumstances where you are more likely to make friends. The best circumstances are those where you are in frequent contact with the same people and you all share a common interest or value. Frequent contact allows you to build familiarity and trust, while sharing an interest gives you something to talk about and possibly collaborate on. The following are examples that typically provide both of those elements.

Treatment

People often say they meet their best friends in treatment and that shouldn’t be surprising. You spend a lot of time with those people and you all share certain core experiences around addiction and trauma. Being open about these struggles is cathartic and it’s often a bonding experience. The only thing is that people often travel to attend treatment so you may have to make an effort to keep the friendship alive after you all leave and go back home, but it’s well worth the effort.

12-Step Meetings

The next logical place to make sober friends is at a 12-Step meeting. These aren’t quite as intense as treatment since you typically won’t be living in the same space as your group members, but you do share similar experiences and a commitment to staying sober, just like in treatment. The more regularly you go to meetings, the more quickly you will get to know people, and the sooner you will make new friends.

People just starting out in recovery often go to a meeting every day, or even several meetings a day. The environment is typically welcoming and supportive, making it one of the easiest places to make new friends.

Try a Meetup

If you want to meet people who share your interests, try looking for things that interest you on meetup.com. This is a site that lists special interest groups in your area by subject. There are groups for art, music, film, sports, wellness, finance, languages, travel, dance, careers, and so on. These groups often meet regularly and they aren’t too big so it’s not hard to talk to people.

Join a League

There are many reasons to be physically active in addiction recovery. Regular exercise is one of the best things you do for your physical and mental health and it can also be a great way to make friends. Joining a recreational sports league is one of the most fun ways to exercise and it’s a great way to get to know people without a lot of awkward conversations and even more awkward silences.

If you’re not a team sports kind of person, there are other ways to be social with exercise. You can join a running or biking group. Exercise classes are also great, whether you’re into spin, yoga, or boxing. 

Take Some Classes

Most people didn’t find it too hard to make friends in school since you see the same people every day for years and most of them are near your own age. The closest experience most of us have as adults is work. While, for some people, work might qualify as a shared interest, for most people it doesn’t.

Furthermore, most of your coworkers, even your “work friends” have their own lives and families to worry about and may not be interested in making new friends. However, you can take classes as an adult. And unlike when you’re a kid, you don’t have to take a class in anything that doesn’t interest you.

You can take an exercise class, as noted above, a cooking class, an art class, and so on. You see the same people for weeks or months, you share at least one interest, and you may get to work on a project together. It's a great recipe for making new friends.

Use Your Existing Network

Finally, make sure you’re using all the resources that are right in front of you. Your friends and relatives probably know people you would hit it off with but it may not occur to them unless you ask. Making friends through common acquaintances is good because those people have already been vetted, in a way, and you already know someone who can introduce you.

This is especially helpful if you are living in an unfamiliar area--say, for example, if you are staying in a sober home after attending treatment out of state. You can ask the people you live with and your friends and family back home if they happen to know anyone in the area. Most won’t, but you might get lucky.

Making friends in recovery takes some initiative and perseverance but it’s mainly a matter of talking to a lot of people and putting yourself in the right position. If you find situations where you see the same people a lot and you share interests, it should only be a matter of time before you make some good friends. The main thing is to be patient; friendships have to develop on their own schedule.

At The Foundry, we know that no one recovers from addiction alone. Connection is the key to a long recovery. We promote social connection and healthy relationship skills through group therapy, family therapy, dialectical behavioral therapy, and various activities. To learn more, call us today at (844) 955-1066.

It’s hard living with a loved one with a substance use disorder. You may have put up with years’ worth of bad behavior, including lying, stealing, violent behavior, manipulation, and general unreliability. You may find that even when your loved one gets sober that you still have trouble forgiving them for everything they put you through when they were actively addicted.

If you want to repair and preserve the relationship, it’s necessary to forgive them at some point, so you can move on, but that can be a huge challenge. It’s hard to let go of the hurt. The following tips can help you forgive a loved one for their sake and yours.

Remember That Forgiveness Is Not Approval

One reason people find it hard to forgive is that they feel like forgiving someone is the same as condoning their behavior, that it’s like saying that they really didn’t do anything wrong after all. That’s not what forgiveness is about.

Forgiveness is nearly the opposite. It’s saying, “You certainly did something wrong but I’m not going to continue being angry about it.” Forgiveness is not approval and it’s not forgetting. You should certainly retain the lessons you learned from your loved one’s addiction, but in forgiving them, you let go of your resentment.

Remember That Forgiveness Is for You as Much as Them

Your loved one may want your forgiveness and even ask for it but that doesn’t mean forgiveness is only for them. In fact, forgiveness is primarily for you. Holding on to anger and resentment is bad for you. It’s a form of chronic stress that impairs your immune system, disturbs your sleep, and generally makes you less happy.

Resentment also means you are continually reaffirming your status as a victim in this situation since you still feel harmed by the person’s past actions. Forgiveness means taking responsibility for your own mental state, leading to greater freedom and well-being.

Try to Understand Addiction

If you’ve never experienced addiction for yourself, it can be very hard to understand from the outside. Every bad thing your loved one does seems like a choice--something they deliberately do to you. It’s easy to take their actions personally and hard to forgive. However, as you learn more about addiction, the role of choice in addictive behavior appears to shrink significantly.

Addiction often causes structural changes in the brain that optimize your thinking for drug or alcohol-seeking behavior while ignoring collateral damage. The roots of addiction are also complex, involving genes, childhood environment, and mental health issues. Being angry at someone for a substance use disorder is like being angry at someone for having diabetes. It’s not something anyone chooses.

Listen

In addition to understanding addiction better in general, it’s important to understand your loved one’s particular experience. For that, listening is important. Becoming a better listener is a whole skill in itself but the basics include giving your loved one your full attention, reflecting back what they say, “So, what you’re saying is...” and trying to put yourself in their place.

That means suspending judgment at least temporarily and trying to imagine what it must have been like for them to struggle with substance use and related behaviors. Often, you’ll find that their experience has been far worse than yours, which will engage your compassionate instincts.

Talk to a Therapist

Forgiveness isn’t something you have to work through on your own; you can always enlist the help of a therapist. Your therapist can help you untangle the difficult emotions you feel related to your loved one--love, hurt, anger, sadness, fear, concern, compassion, resentment, and so on. You may be having trouble with your own feelings including guilt, shame, and anger towards someone you’re supposed to love and care for.

Validating these feelings is just as important as understanding what your loved one has been through. It may also help to participate in family therapy as part of your loved one’s treatment. Many programs like to involve the families in treatment as much as possible. It helps untangle unhealthy family dynamics, improve communication, and educate families on the recovery process.

Seek Social Support

If therapy isn’t an option for you, or even if it is, you may consider attending a group like Al-Anon or Nar-Anon for families of people with substance use disorders. Forgiveness is a common theme of these groups and you can talk things over with people who have had many of the same experiences as you’ve had.

Maintain Healthy Boundaries

As noted above, forgiving doesn’t mean forgetting. In fact, remembering how bad things got can give you ancentive to maintain healthy boundaries with your loved one. Part of the ongoing resentment is the fear that you’ll be hurt again. If you are able to insulate yourself from the consequences of your loved one’s substance use, you will be better able to forgive their past behavior.

Be Patient With Yourself

Finally, be patient with yourself. Often, the anger and resentment you feel towards a loved one with a substance use disorder is a habit of mind built over years of pain and disappointment. You can’t expect to let it all go overnight. The point of forgiveness is to allow yourself to be free from that anger and resentment but if you criticize yourself for being slow to forgive, you only add to your own pain. Give yourself time. The important things are that you want to forgive and that you’re actively working on it. 

Forgiveness can be hard. It feels like you’re condoning your loved one’s past behavior or leaving yourself vulnerable to being hurt again. In reality, you’re letting go of an unnecessary burden, even if you have to do it one brick at a time.

At The Foundry, we know that recovery is stronger when you have the support of friends and family. That’s why we promote family involvement and building a strong recovery community as well as addressing the underlying causes of addiction. To learn more, contact us today at (844) 955-1066.

Compassion Fatigue and the Need for Trauma-Informed Legal Practice

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Much of your addiction risk is influenced by your family history. Genes and the environment both play a significant role in how addiction is passed down in families. Research has identified many gene variations that appear to be related to substance use disorders.

These aren’t “addiction genes” per se but rather they affect different aspects of your physiology. For example, genes related to how well you metabolize alcohol and its intermediate products, how your dopamine system responds to alcohol, and how active your brain’s fear centers are may all contribute to your risk of developing an alcohol use disorder. 

However, there is also a saying that genes load the gun but the environment pulls the trigger. In other words, having a genetic predisposition to substance use issues doesn’t necessarily mean you’ll develop an addiction. Your odds are significantly higher if you grow up in an environment where you feel unsafe or neglected, where you’ve experienced trauma, or where your parent or guardian had substance use issues.

Children are especially sensitive to trauma and chaos and they often learn substance use behaviors from their parents. As a result, if you have a parent or sibling with a substance use disorder, you are at much greater risk for developing a substance use issue yourself. The following tips can help limit your risk.

Ask About Your Family History

Addiction, even now, is a largely invisible disease. Families want to protect their loved ones’ reputations and people with substance use are often very good at hiding it. However, if your relatives have struggled with substance use, you need to know about it. Ask your relatives about your family history. Be curious about that aunt that no one ever seems to hear from, what your parents were like before you came along, or that grandparent who died at a suspiciously young age. 

Limit Your Exposure to Drugs and Alcohol

If you’re concerned about your own addiction risk, the safest bet is just not to drink or use drugs. If you do drink, set strict limits for yourself. What those limits are, depends on your situation and how worried you are about your risk.

If both of your parents had an alcohol use disorder, you might not want to drink at all but if you had an uncle with a drinking problem and your other risk factors are low, perhaps you’ll feel safe having a drink with dinner now and then. When in doubt, err on the side of caution. It’s much easier to avoid addiction than to recover from it.

Know the Red Flags

It’s also important to know the red flags of addiction. This is true even if you have decided to abstain completely. Depending on your risk factors, you may also be vulnerable to process addictions, such as gambling, shopping, sex, or eating, so being aware of addiction red flags, in general, is a good idea. The trouble is that really clear signs tend to come too late. These are things like getting a DUI, losing your job, having serious relationship issues as a result of addiction, and so on. 

Addiction typically creeps up on you slowly and by the time you realize what’s happening, it’s already hard to get clear of it. If you pay attention, you might notice addictive behavior before it becomes very hard to change course. For example, you might notice that you’re drinking every day, even if you’re only having one or two drinks.

That might be fine for most people but if you have an elevated risk, it might be time to take a break. If you feel like you need drugs or alcohol to relax, that’s another pretty clear sign because it indicates you may have begun to develop a physical dependence. 

Needing more to feel any effect is another sign of dependence, as is feeling achy, jittery, shaky, or irritable when you go for a few days without drugs or alcohol. Also, beware if you find yourself lying or being deceptive about your drug or alcohol use. If you notice any of these signs, take action immediately, whether it’s talking to a therapist, addiction counselor, or doctor, or going to a 12-step meeting.

Talk to a Therapist

One of the best ways to preempt a substance use disorder is to talk to a therapist, even if you’re not sure if you need therapy. As noted above, genes are only part of the equation. Most people seeking help for addiction also have a co-occurring mental health issue, such as major depression, anxiety disorder, PTSD, bipolar disorder, ADHD, and others.

Substance use often begins as a way of self-medicating these conditions. If you did grow up in a house with addiction, it’s likely that you have some issues stemming from that experience and it’s better to address them on your own terms rather than wait for addiction to derail your life. If you don’t know what to tell your therapist, just say that your parents struggled with addiction and you don’t want to fall into the same trap. You certainly won’t be the first.

Make Your Doctor Aware of Your Concerns

Unfortunately, much of the opioid crisis in the US is a result of people using prescriptions as directed by their doctors. They would get these prescriptions for chronic pain or pain following a medical procedure, use them for far too long, and end up addicted, often switching to street drugs like heroin.

Doctors are typically far more cautious about prescribing opioids these days but it’s still important to make your doctor aware of any family history of addiction, just as you would make your doctor aware of any family history of cancer or heart disease. There are often non-addictive treatment alternatives and at the very least, you can take precautions against overusing potentially addictive medication. 

Talk to Your Kids When They’re Ready

Finally, make sure your own kids know about the family history of addiction when they’re ready. This should be part of an overall approach to teaching your kids about drugs and alcohol from a young age. For example, when you give a young child cold medicine, you can remind them that they should only take medicine from you or a doctor, and scale up the lessons as they age.

At a certain point, they will need to know if they have a genetic vulnerability to addiction. This point may come much sooner than you realize since early experimentation with drugs and alcohol is another major factor in addiction risk.