Treatment

As stated in a book titled: Beyond Addiction: How Science and Kindness Help People Change, written by Jeffrey Foote, Carrie Wilkens, and Nicole Kosanke with Stephanie Higgs, “Recognizing that for most people change is more like learning to read than getting hit on the head with an apple, you’ll be less likely to blame a loved one for being ‘bad at it’ in the beginning or despair when he has bad days later on…. Change isn’t magic. It does not take a miracle. Change takes thought, planning, and work, and reasons to do something different. You can help make it worth it for your loved one, by helping to create an environment in which positive behavior is rewarded by your affection, presence, collaboration, and other forms of reinforcement, while negative behavior is shut out in the cold.” Living with someone who has an addiction can be challenging, especially if we do not know what to expect or how to handle the situation. Doing research and seeking help are important to do both before your loved one moves in and after they’ve moved in. Candance Plattor, registered clinical counselor who has recovered from addiction to opioids, marijuana, and alcohol, notes 5 key things that need to happen to love yourself and the person with the addiction:

Most of us know of someone with an addiction; some of us have been asked for money or other resources to help our friend or family member. When this happens, our loved one always seems to have an upsetting story or sad reason for why they need support, but they may never seek treatment. We want to help them and at first, we may even give them everything we are able to offer – but our loved one continues to ask for more and more, and eventually we become exhausted of our time, money, resources, mental and physical energy.   Setting limits is very important when living with someone who has an addiction. By setting boundaries, you are protecting yourself and your well-being while also ensuring your loved one facing the natural consequences of their own actions. For example, you may wish to inform your loved one that if they are using, you refuse to loan them money or pay their bills. If you feel that your loved one is not going to seek treatment on their own, you may wish to stage an intervention. Planning, gathering information, forming an intervention team, deciding on specific consequences, making notes on what to say, holding an intervention meeting, and following up are all important steps to reach out to your loved one. There are several reasons for why your loved one may not wish to seek treatment: 1) they don’t want everyone to know that “had to seek help” because of their addiction, 2) they believe treatment is too expensive, 3) they feel life is too hard being sober, 4) they believe they don’t really have a problem, and/or 5) they haven’t hit rock bottom yet. Educating yourself about addiction is one of the best ways you can prepare yourself to better understand your loved one and what they are going through. Educating yourself, setting limits, staging an intervention, and taking care of yourself are all steps needed when your loved one isn’t taking steps towards their treatment and recovery.

An excerpt from Tom Shachtman’s book titled, To Be or Not To Be Amish: Once the young ladies hit the cars, and the cars have pulled away from the homestead, appearances and behaviors begin to change. While riding along, each Amish girl performs at least one of many actions that have been forbidden to her throughout her childhood: lights up a cigarette, grabs a beer, switches on the rock and rap music on the car radio or CD player, converses loudly and in a flirtatious manner with members of the opposite sex. Leanne, a character from “Orange is the New Black”, grew up in an Amish community and started using meth during her Rumspringa. Outside of her character, this issue is a major concern in the United States today. According to Amish America, Rumspringa or “running around” is “a term used to describe the period of adolescence Amish experience starting at around age 16. Rumspringa seems to have caused an epidemic of addiction among the Amish community; last year, approximately 70 people – many of them youth – were arrested at an Amish party. Fox 59 reported more than 1000 people were expected to attend from Ohio and the Interstate before the party was shut down. Addiction does not discriminate. Individuals of the Amish community face the same demons the rest of us face, including addiction. According to NPR.org, Rumspringa is a time where adolescents of the Amish community can “test” out the modern world to determine if they would like to continue their path within the community. At age 16, the adolescents have not yet been baptized, so they are not officially considered members of the church yet. Many youths are encouraged to explore movie theatres, driving, malls and more – but some, with this feeling of freedom, take part in unhealthy behaviors that lead to addiction. Alcoholism, meth, heroin, and opioid addiction all impact the Amish community, just like any other community. The dangers are ever more real to Amish youth because, with this form of freedom, they are likely to take drastic action in a similar fashion people first entering college might take. At any age and in any community, addiction can occur.

Suspended receiver Josh Gordon of the Cleveland Browns has struggled with addiction for several years, missing many games and nearly all a season in 2015 due to substance abuse. On a video released, Gordon stated, “I’ve used alcohol on many, many occasions. Xanax on many occasions, cocaine several occasions, marijuana most of my life, codeine, cough syrup. Methazine is very prevalent where I'm from. It's what I grew up using." When Gordon left in mid to late October of 2016, he moved to Gainesville, Florida and got into “probably the best shape of my life.” A candid interview with GQ showed Gordon’s true thoughts about himself, addiction, and his recovery. When asked how he felt about recovery now compared to previous attempts, Gordon stated that before, he was thinking to himself, “If I plan on having any type of career, I’ll stop”, but now he is thinking to himself, “If I want any type of a life, if I wanted to live, I’ll stop.” Gordon exclaimed that his perspective changed when he started realizing the reality: that his addiction was leading him to his death and that if he truly wanted to life, he needed to do something about it. Dr. Stephen Diamond, licensed clinical and forensic psychologist, told Psychology Today, “in some ways, addiction is an extreme example of an existential challenge we all wrestle with every day: accepting reality as it is.” Josh Gordon’s previous beliefs of himself and his addiction may have held him back from truly changing his life; it wasn’t until he faced his reality that he had a clearer view of what he needed to do next. ESPN noted that Gordon had been given a year-long suspension for the 2015 season because he had four drinks on a plane. Gordon stated in a video, “I’ve been enabled most of my life, honestly. I’ve been enabled by coaches, teachers, professors, everybody pretty much gave me a second chance because of my ability.” Psych Central defines enabling as “removing the natural consequences to the addict of his or her behavior.” Enabling perpetuates addiction and shows the person there is nothing wrong or their behavior is “okay”. Many people, especially athletes and other highly-recognized individuals, may become enabled because their friends, family, and authority figures do not feel comfortable “standing up to” or “confronting” the person, although this is what they really need.

Many of us have friends, family, or extended family who have gone through addiction. According to the National Survey on Drug Use and Health, 23.5 million Americans aged 12 or older needed treatment for an illicit drug or alcohol abuse problem. When family members have an addiction, their attitude and behavior changes. This, in turn, changes the equilibrium within the household – whether it is spoken or unspoken. Psychology Today notes that patterns of interactions between family members may include how feelings are expressed (or not), how conflict is managed (or avoided), how family issues are communicated in the world outside of the family system, what roles each family member is assigned to, and more. These patterns impact every member of the family, leading some to adopt negative patterns of behavior, continuing the negative cycle of addiction. Luckily, this doesn’t have to be true. The National Association for Children of Addiction states that recovery and even abstinence is possible – you can break the cycle. Tim Sanford of boundless.org, author and licensed professional counselor with over 20 years of experience as a clinician, has provided several key steps to breaking the family cycle of addiction, or even dysfunction.

Many of us have heard horror stories on the news or seen terrible events occur on television shows such as “Law and Order: SVU”. Much of society and pop culture labels the perpetrator as a “psychopath”, and this term has stuck for years. While the term “psychopath” has gained popularity, and is used quite casually even do describe people we don’t particularly like, it’s used far off kilter. Psychology Today notes that psychopathy is one of the most difficult disorders to recognize, mainly because the characteristics of a person with psychopathy seem “normal” – even likable. By understanding the reality of what “psychopath” really means, perhaps we can discuss crime and people more appropriately. Terms such as “psychopath” and “sociopath” are often used interchangeably, but there are key notable differences. Psychopathic traits are more innate, and sociopathic traits are centered more around antisocial tendencies as they pertain to social and environmental factors. Many individuals classified as psychopaths tend to be charming, self-centered, dishonest and undependable, and may engage in reckless behavior for the sheer fun of it. Those with psychopathy often don’t feel guilt, empathy or love, and routinely offer excuses or place the blame on others for their dangerous decisions. The Scientific American notes, however, that most people classified as psychopaths are not violent, and most violent people are not psychopaths. They provide an example of the 2007 killer Seung-Hui Cho being classified in the newspaper as a “psychopath”, but those who knew him said he was markedly shy, withdrawn, and peculiar. These characteristics contradict that of a psychopath is defined as. Another common misconception is that psychopaths are psychotic.  Psychotic disorders, such as schizophrenia, often involve people losing touch with reality – people who are considered psychopaths often do not lose touch with reality, however. They are very rational, and often recognize their actions are viewed as wrong in the eyes of society, but they do not care. There are conflicting beliefs about whether psychopathy can be cured. According to Yale University, “There is no pill that can instill empathy, no vaccine that can prevent murder, and no amount of psychotherapy that can change an uncaring mind.” Psychology Today claims that psychopathy lies on a spectrum, and some researchers believe that psychotherapy (talk therapy) has benefits for those with psychopathy. While we may not understand the acts of someone with psychopathy, we can learn to use the term in it’s appropriate context.

We can’t help to look at other people. What they have, who they are, their accomplishments – most of these is displayed very eloquently on social media networks such as Facebook or Instagram. When we view these, sometimes we may be so excited for someone we love and care about, but other times we may experience feelings of jealousy, envy, sadness, and even hatred. Our judgments don’t just stop at social media, however. First impressions cause us to judge someone, and those judgments aren’t always correct. The Scientific American states that we judge based on two qualities in first-interactions: warmth (whether the person is friendly and well intentioned) and competence (whether the person can deliver on their intentions). It’s not a debate that we judge others, but why do we do that? Maria Moraca, writer for Tiny Buddha, states that our judgments are often an extension of our own self-criticizing. When our internal dialogue is critical and demanding, we become critical and demanding of others. Are we supposed to stop judging others altogether? That is impossible. As Dr. Marwa Azab tells Psychology Today, we have two components of the brain: our logical, conscious system and our reflexive, non-conscious one. Our logical system is controlled, intentional, voluntary, and what we are actively aware of. Our reflexive system is involuntary and outside of our awareness – much of the thoughts that occur here are reactive and irrational. Tiny Buddha has noted three main causes for judgment on others:

According to the National Alliance on Mental Illness (NAMI), cognitive behavioral therapy (CBT) focuses on exploring relationships among a person’s thoughts, feelings, and behaviors. By addressing these patterns, the client and therapist can develop tools to replace those unhealthy thoughts with more positive, productive ones. Previous research has shown that CBT has been an effective treatment for depression, anxiety disorders, bipolar disorder, eating disorders, schizophrenia, and more. Anyone can use CBT, and there are many techniques that you can easily do at home:

As humans, we create our own perceptual definition of “the wrong path” but philosophically, there are simply choices being made. As a society, we have a clear distinction regarding morals; there is a right and wrong, good and evil. The nature of morality may vary depending on the person and circumstance. For example, a common philosophical question of morality is this: We typically state that stealing is wrong. If stealing is wrong, then a person should suffer the consequences, which often means that the person goes to jail. However, what if a person has no money, no family, is homeless, and is starving? Should someone go to jail for stealing a loaf of bread at the store? This question could be debated and argued from several different viewpoints; we now have food shelters so that people don’t have to make “risky” decisions such as stealing. When it comes to other viewpoints of “right and wrong” and “good and evil” common societal belief is that “right” and “good” means happy, healthy, and making choices that coincide with success, value, and goodwill. Choices that are considered “wrong” and “evil” are often choices that harms oneself and others, declines a person’s happiness and health, and doesn’t assist with the success, value, and goodwill of a person and population. Many times, if someone falls into harmful habits of addiction or is negatively affected by characteristics of mental illness, they may be viewed as “going down the wrong path”. However, as humans, we are bound to come across maladies and issues, and “the wrong path” could easily become “the right path” should a person have proper support and is able to take steps towards overcoming what is troubling them. The issue with stating that someone has “taken the wrong path” is an implied notion that the person is staying on the wrong path, never to return. This can be limiting, as being human is a series of ups, downs, and everything in between. If we can change our perspective to the fact that we are all human with maladies and flaws, we all suffer from pain, we all make choices, and we all learn from those choices, we can better help lift one another up to overcome our struggles. We all have diverse backgrounds and experiences, feelings and thoughts – therefore we all suffer from different things. The best way to “stay on the right path” is to eliminate the pressure behind being right and what that means to be on the “right path”, and just take a path. See what works and what doesn’t, learn and grow from our experiences and strive to lead a life of which we can be proud of.

Partial hospitalization typically involves the most intensive care available outside of nonresidential programs, and it could be just want you need. It is often used for people who suffer from addiction and abuse, mental health disorders, and/or behavioral health disorders. People who have already completed residential treatment and want to transition to more independent living may benefit from this form of hospitalization, and people whose needs do not require residential treatment may also use partial hospitalization. According to the Association for Ambulatory Behavioral Healthcare (AABH), partial hospitalization can be beneficial because it costs less than full residential facilitation, and those who participate in this program often need less treatment afterwards because of the intensive care they received during that time. Participating in partial hospitalization could mean that you receive the care that you need while maintaining outside responsibilities and transitioning to full, independent living. Partial hospitalization may include medical attention as well as individual or group therapy, just as they would in residential facilities. The program typically requires 6 or more hours each week, and you would continue to learn about your addiction or mental illness and even discuss your concerns with others. Here, family is even given an opportunity to attend therapy and work with you as well. However, where you would live and receive food in a residential treatment center, partial hospitalization means that you would return home each day, able to take care of your children or other home responsibilities. However, this form of treatment is not appropriate for those who suffer from severe addiction and behavioral issues, or those who are just beginning their journey to recovery and need full support. Partial hospitalization is not beneficial for those who need round-the-clock care, and if you are suffering severely from behavioral issues or other concerns, this may not be an appropriate option for you. If you have indicated initial stability in your residential program but may not be fully ready for outpatient programs, partial hospitalization may be a wonderful choice. If you are considering participating in partial hospitalization, please speak with a health care professional now. If you are currently in a rehabilitation facility, speaking with a leader in your program could be beneficial because they will be able to work with you to determine a plan of action that fits your needs.

Family therapy is beneficial for a variety of reasons – it helps people understand one another, it helps families work through issues, it helps family members support a person suffering from an addiction or mental illness, and more. Family therapy often gives people a chance to work through issues that otherwise would be difficult to work through on their own – a supervised, neutral setting with an experience psychologist to help guide individuals through a respectful discussion can prove transformative. According to Desert Hope, “Family therapy concentrates on determining and adjusting how the overall structure, patterns of communication, aspects of relationships, power structure, and other aspects of the family system are affected by whatever issue is being addressed.” In family therapy, the therapist typically meets with individuals as well as other family members. After a few meetings with the family members, a therapist can often tell which form of treatment will work best. Family therapy has been shown to help people work through depression, obesity, alcoholism and drug abuse, although that list is not exhaustive. Dr. Nichols mentioned on Good Therapy that at the beginning of the sessions, she will provide information on confidentiality, who needs to attend ongoing sessions, the rules, her role, and expectations for everyone. This helps all family members to know what to expect and what is required of them. A variety of techniques may be used by a family therapist, and family members are expected to be respectful, honest, and take responsibility for themselves. One newly popular technique studied in Contemporary Family Therapy is Outdoor Behavioral Healthcare (OBH), or wilderness therapy, and involves family members partaking in outdoor activities to help them relieve stress and to use nature as both reality and metaphorical for their therapy needs. Of course, traditional therapeutic methods are also widely used.   Narrative therapy was also mentioned as a contributing beneficiary to therapy by allowing family members to externalize their situations, deconstruct problematic narratives by asking questions, identify unique outcomes or times when someone was not oppressed by an issue, link unique outcomes to future alternatives, invite members of a social network to witness the new narrative, and document new knowledge that has taken place. The techniques mentioned above are just 2 of many, but typically involves families working individually and together with a therapist to overcome family concerns. Family therapy could be a great tool for you to use if you wish to resolve family issues and bring the family closer together. If you are considering using this, speak with a therapist today to determine the right fit for you and your family.

When you make the decision to seek help for your mental illness, addiction, or dual diagnosis, you are taking a courageous step. Recovery is multi-faceted and incorporates all aspects of daily life, primarily because it forces us to change for the better. Our typical routine may have been different when we were engaged in actively-addictive behaviors, but once we enter recovery, our mornings change. The people whom we spend our time with may change, and the way in which we handle situations may improve. The Substance Abuse and Mental Services Administration notes four main components that support a life in recovery: