Addiction is the Legacy of Trauma

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Studies reveal that between 50 and 96% of substance abusers seeking treatment report experiencing trauma.

Up to 34% of people receiving substance abuse treatment have a co-existing PTSD diagnosis. That’s GIGANTIC! But it makes sense, doesn’t it?  If every breath you took came with unbearable thoughts of past traumas, you would likely do anything to ease that burden.

 How Does Trauma Affect You?

Trauma of any kind has the power to crack and skew the lens through which you view the world and yourself, making everything appear off. When I work with those in recovery I often hear a similar story; I went through hell and [insert drug/substance] was the only thing that I found that worked and kept me alive. As someone in recovery once told me, “it was drugs or death and I chose to live.” Now, not all in addiction have experienced trauma and use substances to escape that trauma, but it’s certainly a major factor that needs to be addressed in treatment.

What is Trauma and What Does it look like?

Trauma can be anything. It can be sexual assault, domestic violence, and war – each of which are widely discussed and shown through media. But it can also be the loss of a loved one, infidelity, or divorce. It’s any deeply distressing, disturbing or even embarrassing event/experience that causes a person to shift how they view themselves or the world around them.

When this shift has happened it’s not always obvious. You might know a few side effects like nightmares, flashbacks, and hypervigilance from movies like Saving Private Ryan or even Iron Man 3 (yes, I am a nerd, I need to put this here). What you might not see are some of the more subtle signs that someone is dealing with trauma; two of which I’m about to discuss.

If you read my previous article about signs of addiction relapse, I discussed the acronym AA (Attitudes and Actions) as a simple way of recognizing warning signs of relapse. Looking at someone’s attitudes and actions can also be a way of identifying trauma/PTSD.

Two subtle ways Trauma changes a person

Mood

Sometimes these shifts in mood can be obvious – intense irritability, fits of anger/rage, sadness, and/or anxiety– however the mood change I’d like to highlight is what I call the void. It’s an absence or minimized version of emotions. A feeling of being disconnected or numb. It might feel like the person is looking through you rather than at you – like a thousand-yard stare. If this mood change sounds familiar it’s because this void, or feeling of disconnection and/or numbness, can also be a symptom of depression.

Behavior

The next subtle sign of trauma is isolation. This can literally be a person physically removing themselves from others – their co-workers, friends, families and loved ones – but it can also mean emotional isolation. The subtle sign is the latter of the two. When someone is emotionally isolating you might feel as if you’re only connecting with a fraction of who they are, like there’s so much more to be revealed. This isn’t necessarily by choice; trauma is powerful and even if the event/experience occurred years in the past it can still occupy/impact one’s thoughts.

Why Understanding Trauma and Addiction is Important

I started this article discussing trauma in terms of how it relates and affects those in addiction. I want to end by stating that like addiction, trauma is far reaching and affects more than people than we might like to admit. Just like addiction, trauma can impact every aspect of a person’s life, from their relationships (family, friends, significant others) to occupations (careers and school). Once again, I’d like to ask you to take what you’ve learned today and share it with someone else. By doing that, we can continue to keep the conversation flowing about mental illness and in-turn break down the barriers that limit people from getting the help they need.

To schedule an appointment with Kendall Campbell, LMFT-Associate, call 512-960-3254.

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When Saying No is Actually Saying Yes.

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Saying “no” might be just what you need.

It’s impossible to have CONSTANT insight and awareness to how your emotional energy is expended throughout the day and how your reactions and responses to others will impact future days. Or have your emotional intelligence so finely tuned that you are certain how your decisions and behaviors will emotionally effect professional and personal relationships and family dynamics. If you have those things dialed in, then you've mastered the ability to set boundaries and achieve a level of self awareness that never leaves you feeling exhausted, over-committed or overwhelmed. 

Most of us are powering through our days to the best of our abilities utilizing the most efficient coping skills we have acquired along the way. As the holidays approach and the calendar seems to fill up more quickly than usual, I’m reminded that saying “yes” to everything is not necessarily a good thing. In fact, it could be actually be a bad thing- not just for me, but for my family too.

First, let’s be clear about what “saying no” means in this context; I’m not referring to the “no” you say when your kid is trying to eat a crayon or cut their sister’s hair. We’re talking about the “no” that is necessary to set boundaries. ALL kinds of boundaries— the boundaries that foster emotional well being, the boundaries that support healthy functioning in a nuclear family and the logistical boundaries that have to deal with every day commitments.

How do I know if I need to say “No?”

Ever feel like you're losing control of your own emotions? Or that others are dictating how your day goes?  It’s time to say no. Recently, a client shared a story about her mother’s constant criticism and judgment of her parenting; her mother is always weighing in with an opinion about how something could be done better. My client was losing herself in self-doubt and fear that she was making decisions that would be detrimental to her children. It was time for her to say no. “No, you cannot project your own regrets and fears about your own identity as a mother onto me. No, I am a good mother and I won’t hear you anymore.” She set an emotional boundary that no longer allowed someone else’s feedback to rule her emotions despite her own ability to validate her role as a mom. If you are feeling overwhelmed, stressed and anxious - chances are good you need to check in with yourself and see if you're emotionally exhausted or over-committed. If you are feeling like you have no choice or no say in your relationships or schedule or interactions - its time to slow down for a moment and re-access.

What you're saying "yes" to when you say "no."

 Saying “No” means— I am taking care of myself, so I can take care of others. I value my own mental health. I know my limits.

While some people will take your ability to say no as a personal insult, its important to reinforce (not just to others, but also to yourself) the need to care of yourself. We live in a relational culture that emphasizes or puts a high value on active lifestyles, community and efficiency. If you're not taking of care of yourself first, it can be difficult to authentically and satisfyingly   participate in family and community. Setting emotional boundaries with the toxic friend is ok, not over-committing yourself and your kids to parties and activities so you can spend extra nights at home together is ok, deciding not to spend an hour on Facebook comparing your relationship to someone else’s is ok. In fact, it is necessary to do all of the above from time to time!

Why it can feel great to say "No."

Saying no can feel empowering, like you have control of your emotions and your time, like you have a choice. Saying no will feel different for everyone; it might feel the opposite of overwhelmed, exhausted and stressed.  It’s not just freeing your evening up from a holiday party, it is creating space for and activity or experience that feeds your energy. Saying No is independence. Saying no is permission to be you and make your own choices, free from the influence of others. Saying no is choosing you.

As the holidays approach there were be many extra curricular activities for kiddos, holiday parties and more extended family time than usual. Take some time to check in with yourself, your partner or your family. Do you need to say “no” more? 

To schedule an appointment with Caroline Harris, LMFT-Associate, call 512-915-3063.

The Practice ATX

512-861-4131

What The Harvey Weinstein Saga Can Teach ALL of Us.

Well hello, Harvey.  I keep trying to forget about you and what you represent, but for all of us, I can’t.

I’ve been reading the articles about Harvey Weinstein.  It makes me remember my early days as a woman in the good ol’ boys club of law firms and courtrooms.  Not the first time for a #MeToo, but more obvious and no attempt to be hidden.   Now, as a therapist, I am more attuned to aspects of male privilege that may be subtler, but which are still harmful.

I have competing thoughts.  I’m not surprised.  In fact, I thought I knew this about Weinstein.  I thought it was abundantly clear, as it seemed to be for many people who knew him or worked with him.  And I have to confront that it was an unspoken assumption on my part.  An assumption based on innuendo and perhaps common sense.  And it hits me (as it always does), I take part in supporting this type of male privilege.

Can we talk about equality?

Image by  Nick Step /CC2.0

Image by Nick Step/CC2.0

At the same time, I feel anger and outrage deep in my belly.  I know this feeling.  I started noticing it as a young girl driving around with my dad.  He told me I could do anything, but I wondered about the advertisements surrounding me—they made me so uncomfortable.  It starts at such a young age—seeing the highly sexualized view of women and that we are here to serve.  It made that little girl question, where did my value lie?  That confusion and the experiences between now and then (more #MeToo’s) are not about my singular world; they are about the world we live in, the systems in place that perpetuate them, and how, yes, I unknowingly and unwittingly participate in them.  I do.  There, I said it.  And it is okay.

What is privilege?

Just so we are on the same page: male privilege is a set of social, economic, and political advantages that are made available to men solely based on their sex. And these advantages lead to devastating conclusions that men are more worthy and powerful.

Do males have privilege? Absolutely, without a doubt.  Do we all need to stand up and say, “No.  I will not live like this anymore?” You bet.  But what irritates me is that we think we need to do this only for women.  Something men need to do for us. The truth is it’s for all of us, for our collective humanity, and not “just” to support women.  Let’s be clear: addressing male privilege is for every last single one of us.  And as a society we need people supporting people.  Can I speak more about my experiences of male privilege than my husband can?  Absolutely.  But that does not make it less valuable for my husband to equally participate in and address the problem.  It is not just for me or our daughter, it is also to improve his and our son’s lives. 

So, what are some ways that each of us can work more diligently to begin to peel the layers of male privilege back?

·      TALK ABOUT IT.  Talk about bias.  We all have it.  We have all, in different ways, been trained.  No one is immune.  If we can’t talk about it, how do we confront it?  We need to think about our assumptions, be able to question them and it be okay. 

·      ASK QUESTIONS.  When things don’t make sense or something seems off, get curious.  Not to assign blame, but to truly engage in conversation.  What does blame get us?  Yes-Weinstein and other offenders like him need to be held accountable.  But in our day-to-day lives there are much smaller moments that lead to the Harvey Weinsteins and the systems of male entitlement that are unchecked.  These subtler manifestations of male entitlement understandably don’t garner the same attention that Weinstein’s egregious behavior does, but we need to discuss them.

·      ASSUME RESPONSIBILITY.  This is not up to men.  It’s not about all “those bad men.”  It’s about you and me, our co-workers, our educators, our executives, and our children.  As long as we expect change to happen elsewhere, it won’t.

On a lighter note, the other day I had to laugh.  My 10-year-old son came home complaining he was made fun of based on his gender.  After a quick check-in, I realized an old friend of his had said to him “boys drool, girls rule.”  Well, we’ve been talking…and he is thinking.  And we talked again, so I could clarify a few things, but it is a start.

Practice Conversation. Practice Accountability. Practice Change.

To schedule an appointment with Robyn Strelitz, LMFT, call 512-434-0868.

The Practice ATX

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3 Things You Can do Right Now to Encourage Your Child's Resilience

Nguyen Nguyen/CC0

Nguyen Nguyen/CC0

Resilience is when we maintain healthy development despite our adversity. A quick google search of the definition brings up phrases like “elasticity,” “recover quickly from difficulties,” “return to previous form.” Perhaps those definitions are true to some degree, but when it comes to children and adolescents many adapt to their environment to sustain themselves, often engaging in unhealthy behaviors that allow them to survive in less than optimal conditions. One thing is for sure though, children never return to their previous form; they grow, evolve, learn and condition themselves to navigate life’s emotional difficulties.

The behavioral tools and coping skills they pick up along the way are a combination of healthy and unhealthy, effective and maladaptive, isolating and engaging, the list goes on. Our children are learning these behaviors from the vast expanse of their environments; peers, parents, siblings, social media, tv, video games, the person in the restaurant at the next table over.

True resiliency in children means they are able to weather the emotional ups and downs of life and continue to developmentally thrive. Resilient children do not always choose healthy ways of managing their emotions or anxieties, but they ARE managing them. As parents, caretakers and adults with vested interest in the emotional safety and well being of children we can all do three things right now to support and foster resiliency and emotional stability for children.

How to Build a Child's Resilience

1. Put your phone down.

Kids need to know that they are the priority over a work email or Facebook. They are taking their emotional cues from you, when you choose the phone over an interaction with them you miss an opportunity to remind them they are the most important thing in the room. Technology isn't going away, BUT YOUR KIDS EVENTUALLY WILL.

They will learn from everyone else in the world that cell phones and computers are important, your role as a parent is to ensure that your support will be given when they bring worries, concerns and questions from outside into the home. Stability supports resiliency.  BE the stable relationship in your child’s life that allows them to navigate their emotional landscape.

2. Provide consistency.

Consistency creates routine and predictability. Whether it’s the nighttime routine before bed, or the guaranteed Saturday afternoon with dad playing basketball, consistency creates a space for children to depend on. It is far easy for a child to handle the stress of a tough week at school when she knows on Thursday she will get some one on one time with her mom to talk about it. Consistency allows children and adolescents to “turn into the family” when they are having a hard time or needing support, as opposed to looking to outside influences to mitigate their stress and anxiety. Eat with your kids. Research shows it supports healthy eating patterns.

3. Talk to kids about how they feel.

Feeling is natural. No matter what, your kids will feel. But knowing how to put those feelings into words is a learned skill. Most children and adolescents walk, talk and act far more mature than their actual age. We need to remind ourselves that they are master imitators. Most children are not cognitively developed enough to fully understand and process their emotions. While it might seem that they understand what they are saying, they likely need help matching the correct words with their emotions. Anger is the easiest and most often expressed emotion in teens, it’s the most socially acceptable and accessible.

Anger is primal. It is about survival.  Anger goes hand in hand with many other emotions, and when given the language, space and opportunity to explore the other emotions can be very empowering. A safe environment for exploring emotions fosters self awareness, intrinsic validation and resiliency.

To schedule an appointment with Caroline Harris, LMFT-Associate, call 512-915-3063.

The Practice ATX

512-861-4131

How to Identify the Signs of Addiction Relapse.

Pixabay/CC0

Pixabay/CC0

Relapse is the eye of the addiction storm.

Addiction can be a heavy-handed topic, and it’s not always a pleasant conversation to have. But if you’re struggling with reading about it, imagine what it might be like to live with it. Help me spread the word; help others understand it, and help those with it so we can end it. We need to continue to better understand addiction so we know how to stay connected and supportive of those battling it.

In order to further your understanding I’m going to talk about relapse, and even more importantly, I’m going to talk about how to identify several warning signs of relapse.

What is relapse? And when does relapse occur?

Relapse is a process, not a single event. 

It's an addict’s return to the addiction cycle or worse.  Clinically, relapse is the physical act of someone in recovery putting alcohol/drugs into their body. That length of sobriety could have been one day or fifty years but when that substance enters their body the sobriety clock resets. As I said though, relapse is a process and just as anyone in addiction will tell you they didn’t wake up one day and choose to be an addict. No one in recovery just stops and says “today’s the day I return to rock bottom.”  The process can be short and in earlier sobriety it might only be a month or a few weeks but more often it’s slow with several elements occurring subtly over time.

What are the relapse warning signs?

There are several different warning signs but in order to make them easy to remember I want you think of AA. Alcoholics anonymous is most known for its’ ties with helping those in addiction fight for recovery so it’s perfect that the warning signs of future relapse can be broken down into two categories; Attitudes and Actions (AA).

1. Attitudes

One of biggest warning signs I see – especially in early sobriety – is overconfidence. It’s the string of thoughts and sometimes outright statements that imply “I know everything I need to know” and “I can do this on my own.” Don’t get me wrong, having a sense of confidence and pride in what you’ve learned in treatment and/or meetings is powerful (and needed). However, when someone in recovery stops being willing to accept the support, advice or accountability of others there should be some red flags and alarms going off.

Another major warning sign of relapse is when someone in recovery becomes emotionally overloaded. More often than not this occurs as a reaction to an event like a job loss, afamily member passing away or a relationship ending, however medication changes and existing mental illness (like depression or bipolar) can also be a cause. These intense emotional moments will look like an exaggerated departure from the person in recovery’s normal emotional state. This could look like anxiety turning into panic, sadness shifting to grief or anger becoming rage.

2. Actions

One of the biggest warning signs at any point in recovery is Isolation. For any number of reasons, many in addiction put distance between those around them before relapse; this includes family, friends, loved ones, etc. This could be subtle like missing/skipping scheduled meetings or events like lunch dates, support group meetings, or work. It might also be more confrontational like lashing out or manipulating conversation in a manner that makes you feel as if you want/need to leave.

The last major warning sign relates more to inaction than action and can best be described as a general lack of self-care. A few examples of this could be eating poorly, exercising less or not at all, and/or maintaining unhealthy sleeping patterns. You might also notice that the person in recovery has a decreased interest in engaging in the activities or hobbies that you know they enjoy. This is especially important to notice because in addition to being a warning sign of future relapse it could also be an early sign of depression.

What do I do once I've seen the signs of addiction relapse?

Whether you’ve just seen one of them or all of them, you simply reach out. There are several ways to treat addiction but each of them starts with a conversation where you offer your ear and your heart. They might not be ready to share their thoughts or feelings with you at the moment but by keeping the conversation and the support open-ended, they will know they are loved and that someone else is willing to fight Addiction alongside them.

To schedule an appointment with Kendall Campbell, LMFT-Associate, Call 512-920-3654.

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The Practice ATX

512-861-4131