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Drug abuse and alcoholism are caused by many factors including mental health disorders, self medication, or unresolved past trauma.  There is a growing number of addicts who are compelled to abuse substances and these individuals tend to have problems with impulse control in other areas of life. Impulse control means that we make decisions without putting too much thought into it and we do not think about the consequences of our actions prior to acting on the behavior.  We all make decisions that we might regret later on such as taking on a new job or moving to a different home.  This does not mean that we are impulsive.  It means that all of us at some point make decisions that maybe we not in our best interest at the time. Impulse control and addiction means that at some point in our addiction, it was difficult to say no.  We may have tried our first drink or took our first drug with a group of friends where it might have been challenging to resist or say no. Impulse control also affects our ability to stay sober.  When an impulse to use takes over, we have a hard time saying no.   Over time, if our impulsiveness continues and we find it increasingly difficult to say no to drugs or alcohol, we might become addicted.  Research supports this idea and it is particularly common with college students.  Once we are headed down this path of addiction, we behave impulsively as we do not think about the consequences of our behavior and we make decisions without much thought. With treatment, we can learn to suppress our impulses and make good choices.  One technique that is commonly used is mindfulness.  Learning to have focus and awareness of our feelings, other people, and unhealthy situations can stop the impulse to drink or use drugs.  We also need to have a solid grasp on our thoughts and be able to stop, listen, and act, which can be learned in treatment.

There are many individuals who have committed illegal activities to support their drug or alcohol use.  In 12-step recovery, the checklist of whether one is an addict includes mention of illegal activity to finance the addiction.  The degree of illegal activity will range by the person and the addiction.  There is a picture that one conjures up of a drug deal in a dark alley or a person robbing a convenience store to get money to buy drugs.  These types of situations usually get media attention.  There are others who commit white collar crimes and get no media attention.  The issue at hand is more one of why addicts commit illegal activities in the first place and what can be done during recovery to overcome these problems. The addict can sometimes face problems obtaining money to finance their addiction.  Many resort to illegal activity because of desperation.  The addiction is very powerful and can play a role in one’s ability to know right from wrong.  There is a physical and psychological need to drink or take drugs and this need overshadows doing what is right.  Illegal activity becomes an option when the addict or alcoholic has run out of choices.  There are no friends or family members left to ask and your employer will not advance you any further money.  Credit cards are non-existent or maxed out.  At this point, the addict might consider illegal activity to get money. The type of illegal activity chosen is a personal matter or could be a group effort.  It might be easier and less threatening to take money out of your spouse’s wallet then to steal a wallet from a stranger.  It might be easier to embezzle money from your employer than to rob a store.  The point of these examples is to illustrate the desperation associated with an addict’s need to use drugs or drink.  There is also an increase of those who commit white collar crimes to finance a drug or alcohol problem. During recovery, if illegal activities were committed, they will need to be addressed.  Some problems will need to be addressed through the justice system and some can be addressed through 12-step meetings or through therapy.  There is a point when the addict needs to review these illegal activities in a safe space and learn to live with the negative things done to fuel the addiction.

In today’s world, the Internet is everywhere.  We have apps on our phones and links to websites on our computers. Access to information is 24/7/365.  Most individuals in recovery attend 12-step meetings in person.  This allows for personal sharing of recovery through the relationships that are formed and the fellowship that is shared in the meetings.  Attending a 12-step meeting online might have benefits; however, there are both positive and negatives associated with this type of meeting attendance.

During recovery we meet many individuals who are also in recovery.  We can meet people in these meetings and some might even become friendships.  While friendships are encouraged due to the support and connection provided, getting romantically involved during recovery might not be a good idea.  There are men and women who attend these meetings and we might find ourselves wanting to form a relationship with a person that is more than friendly. Forming a new intimate relationship during recovery is not unethical; however, it could jeopardize your recovery particularly if you are new to recovery.  Some people who have been attending 12-step meetings for a long time state that forming a new relationship is not an ideal situation until one has been clean and sober for one year.  Regardless of whether one meets someone through meetings or elsewhere, there are reasons for not getting into an intimate relationship during recovery.  It should be noted that recovery is a lifelong process.  It is not realistic to state that one should never begin a new romantic relationship during this process. Recovering from drug and alcohol abuse in the beginning is a difficult time for many, both emotionally and socially.  Starting a relationship at this early stage can cause problems as the persons involved may want to focus more on the relationship and less on recovery.  There is also an emotional consideration.  When quitting drugs or alcohol, there are many emotions a person might experience.  These emotions include depression, anxiety, or feeling overwhelmed. Starting a relationship can take the focus off of working through these emotions, which is important for recovery. Another reason to avoid forming an intimate relationship in early recovery, is the possibility of relapse.  If a person meets someone at a 12-step meeting and becomes involved with this individual and a relapse occurs, there could be the opportunity for the other person to relapse as well. There is some truth to not starting a relationship for one year at the start of recovery.  This first year should be a period of selfishness and working on recovery no matter what.  It would be a good thing to focus on yourself and develop relationships that are more friendly.  Having this friendship in recovery can assist in developing a good support system and having a friend to talk through emotional crises or bad days.

Our relationships with others will change during recovery.  These relationships can include family members, other relatives, spouses, boyfriends, girlfriends, friends, and people we work or go to school with.  As one begins recovery from alcohol or drug abuse, there may be relationships that end.  One reason for this is that some of the people we associated with are still using drugs or drinking alcohol.  It is good practice to venture away from these friends, as they can jeopardize recovery.  If there are family members using drugs or alcohol, it would be a good idea to limit contact with them. Recovery should never be at risk. Addictions and even recovery can break up marriages or relationships.  There might be a spouse or significant other who continues to use drugs or alcohol, while the other wants to maintain sobriety.  This typically does not work well until such time as the person using drugs or alcohol decides to stop and begin a recovery program.  Work or school relationships can change as well.  Maybe work friends like to go out after work for happy hour or there are friends who meet after school. Recovery involves lifestyle changes including developing relationships with others that are positive and which support your recovery.  Sometimes it can be difficult to sever friendships during recovery; however, you will have opportunities to develop new relationships.  You may meet someone at a 12-step meeting or discover that a friend at work is also recovering from drug or alcohol abuse. An important part of recovery is understanding that friends and family members might have issues with trusting you. Some relationships may end simply because of the hurt experienced by the family member or friend.  Trust is usually the first thing to be affected in a relationship, and the last to get back.  If you have friends or family members that you want to have in your life during recovery, remember that trust is not easily restored.  Over time and with continued recovery, family members will slowly begin to trust again but it will take patience.

Borderline Personality Disorder (BPD) is a disorder so complex that it comes in many different forms. This mental disorder comes with unstable moods, behaviors, and relationships. It will come with efforts to avoid abandonment, impulsivity, emotional instability, identity disturbances, and feelings of emptiness. BPD can be diagnosed more in early adulthood than in childhood since children and teens are constantly growing and changing who they are as people. 1.6% and 5.9% of the general population are affected by this disorder. The intensity of the symptoms could be decreased with age mostly in their 40s or 50s. In order to understand the complexity of BPD, it is best to explore the extreme symptoms that come with this disorder. One symptom is committing frantic efforts to avoid real or imagined abandonment. Those with BPD can be sensitive to what is happening around them. Constantly having fears of abandonment and unleashing their anger inappropriately is a result. BPD patients can be angry at the smallest change in plans such as a meeting being canceled or being a few minutes late. If someone abandons them, then that person will be seen as bad. In order to avoid abandonment, BPD patients can commit acts of manipulation to get what they want by either hurting themselves or attempting suicide. Another symptom is having unstable and intense relationships. When meeting someone for the first or second time, these caregivers or lovers could one minute appear to look like the greatest people in the world that BPD patients want to spend time with. Then, if the ones they love do something to upset them, BPD patients can switch their mood from idealizing them to devaluing them. These individuals are able to empathize and be nurturing to others but only if their demands are met. Identity disturbance is another symptom where goals, values and career aspirations suddenly shift. Changes in opinions and plans about sexual identity, career, values, and friends can occur. These individuals can either beg for help or can be an avenger for past mistreatment. There are even feelings buried deep inside them that they did not even know they had. This can happen when the BPD patient feels they are not getting enough support, nurturing, or meaningful relationships.

Holistic health focuses on the whole person; not just physical health.  In holistic health, practitioners use a mind/body/spirit approach to treatment.  Does this type of approach have a place in clinical treatment?  If we truly want to heal what ails us, clinical treatment should encompass the whole of the person including the mind and the spirit. Treatment for substance abuse typically focuses on a person’s physical and psychological dependence on drugs or alcohol.  The goal of treatment is to treat the addiction.  People will learn new coping skills in how to live a life without drugs or alcohol.  They may form social relationships through the fellowship of 12-step meetings.  They may also gain insight into their patterns of behavior or psychological issues surrounding the addiction. Holistic health is relatively new to the substance abuse field as professionals are understanding more about the mind/body/spirit connection.  There are many parts to substance abuse recovery.  The body is affected by chemicals, but so is the mind and the human spirit.  Holistic health should be an option in substance abuse treatment. When one stops to think about all of the people hurt by addiction, the loss of the self, the denial of spirituality, the lack of control in the mind, the pending stress associated with sobriety, holistic health needs to be focus on treatment.  Through holistic health, addicts in recovery can learn how to properly take care of themselves from a whole body approach.  It would be beneficial for addicts to learn how to care for their bodies through good nutrition and exercise.  Taking walks is also a good way to cleanse the mind.  Walking has both physical and mental benefits.  Teaching addicts to meditate and progressively relax the mind through deep breathing, has tremendous benefit on the mind and spirit. Once the addict leaves treatment, they will need to have the skills to cope with life.  These skills can be taught in treatment and include stress reduction techniques, understanding triggers that can cause relapse, job skills, financial skills, social skills, asking for help, and finding spiritual peace.  The addict is a whole person with varying degrees of need.  If only the physical needs of the person are addressed in treatment, then treatment is not supporting the person holistically.  It would be far more effective to teach the skills that not only guide them through the first stages of treatment, but to provide them with the skills that will last a lifetime.

Step 4 of the twelve steps involves making a fearless and moral inventory of ourselves.  Sounds simple enough. However, Step 4 asks the recovering addict or alcoholic to take a hard look at themselves and their addiction.  Many do not want to do this, at least not right away.  In recovery, one needs to take this deep dive into themselves as it is the way to understand the addiction and prepare for a new life without drugs or alcohol.  The important thing to remember about Step 4 is it is as individual as the person in recovery.  Not all people will view Step 4 the same way nor will all people complete this step the same way.  For your recovery, find your own way to complete this step and make it work for you Fearless means without fear.  In looking at ourselves during recovery, we may uncover truths about ourselves and the people our addiction affected.  We might not like what we uncover.  It takes courage to do this, as one can think about all the negative things they did or said when under the influence of drugs or alcohol.  The importance of a fearless inventory means that you are honest in spite of all the negativity surrounding your addiction.  A fearless inventory can also mean that you find the strength to move forward.  You may be able to work out the pain you caused others and work through it.  You can embrace the negativity and give it purpose.  Many addicts or alcoholics discover that they have a lot of good qualities, which were hidden by the addiction.  Taking a fearless inventory means that you will look at yourself before the addiction, during the addiction, and what you can gain from staying sober. Morality has to do with knowing the difference between good and bad behavior and acting accordingly.  In completing a moral inventory, one might focus on the bad decisions they made while abusing drugs or alcohol.  In order to work through this, taking an inventory of the people hurt or affected by drug or alcohol abuse can help recovery.  Not only will you address those hurt in Step 4 but you will also take a moral inventory of who you are as a person.  It is a good idea to note all the qualities that make you who you are, good or bad.  This will help with knowing who you are and what needs work during recovery and what is okay and needs reinforcement.

Treatment is a journey that not all individuals experience with similar thoughts, feelings, or behaviors.  In order to plan the best course of treatment for an individual, how a person processes thoughts, expresses emotions, or views, recovery needs to be taken into consideration.  In addition, personal histories, family dynamics, and support networks should be considered when designing an individual treatment plan.  These vary according to the individual. Individualized treatment plans allow the individual to recover in a way that is the best fit for them emotionally, socially, and cognitively.  There may be some overlap in treatment such as attendance at 12-step meetings or group therapy; however, the treatment plan should encompass the unique situation of each person.  This may include individualized therapy plans with a therapist that can address specific psychological or behavioral issues.   When a person enters treatment, there may be overwhelming feelings associated with shame or guilt and these will need to be addressed on an individual therapeutic basis.  There may be individuals who require a more comprehensive treatment approach in terms of medical evaluations.  Physical issues should be assessed on an individual basis and treated accordingly based on severity of need. Therapists will assess and review the possibility of needing a physician’s intervention to ensure psychological issues do not have a biological component.  Some individuals may need to be treated through pharmacological measures and others may need more intense interventions such as detoxification. These would require physical intervention from a physician.  If an individual has been ordered to complete treatment by the courts, there may be a need to address any corresponding feelings of helplessness, anger, or resentment.  If not addressed, these can lead to an escalation of non-compliant behavior while in treatment.   These emotional, physical,social, or psychological issues are as individual as the person who enters treatment; therefore, it is not only important but also necessary to develop treatment plans that complement the individual and their unique recovery needs.  The goal of treatment is sustained recovery and learning new ways in which to manage life and corresponding stressors and even though the goal might be the same, how one reaches this goal will vary depending on individual need.

A growing amount of research is suggesting that mood and happiness could be linked to your stomach. Your gut produces bacteria to break down food. Bacteria can either be good or bad. Nobody is in a good mood when their stomach is upset. The science is similar. When the gut microbiome is upset because of trying to process unhealthy foods, it puts the brain in a bad mood. Good bacteria, on the other hand, which makes the tummy happy, makes the brain happy as well. Foods rich in probiotics are often fermented foods like kimchi and sauerkraut. Probiotics can also be found in yogurt or food that has had probiotics put into it.

Honesty is being free of insincerity and deceit. Sometimes, when we think we are really being honest with others, we are not being sincere with ourselves. Other times, when we think we are being clear with ourselves, we are deceiving others. What we consider to be honesty might be an exaggeration, elaboration, or total evasion of the truth. We want to give others the honest truth but we don’t want to be honest with ourselves. Before we can be honest with others in order to stick up for ourselves, set a boundary, or define our needs and wants, we have to be honest with ourselves. Where are we coming from? What are we triggered by? What do we honestly need? Are we honestly aware of what we need or what we want? We have to first get a gauge on what is going on within us before we can start responding to what is going on outside of us.

Mental health disorders can be considered fatal. For example, anorexia nervosa is considered the “deadliest” mental health disorder. Substance use disorders are also considered deadly as they are relapsing and remitting diseases which include the use of chemical substances which can cause overdose death. Treatment for mental health disorders has to be effective in order to save lives. The question is not so much why is art therapy used by why isn’t it used more often? Any kind of therapy type that can reduce stress, provide release, offer a break from traditional therapy, and make the recovery/treatment process more enjoyable is a critical therapy to include in treatment programming. Art therapy is used in treatment because it is proven to have a positive effect on the mental well being of clients in a treatment program. Through the use of various media, meaning supplies, and structured activities, art therapy can help clients unlock what is beneath the surface and hidden away from words. Creating images, using colors, and navigating meditative art processes helps the brain release new information without having to verbally confront what might be difficult thoughts to process. In a different position than a primary therapist, an art therapist has a unique opportunity to guide the psyche of a client through the creative process of expression. Art therapy often lends primary therapists insight into what is coming up for the client, giving them more structure as to where to take their treatment. Art therapy is also a welcome break in the traditional therapy cycle. Group therapy and individual therapy sessions often include a lot of verbal talking, listening, and processing. Art therapy is a time to get quiet and engage in the creative process, often a much anticipated relief. During art therapy, the brain gets used in a different way, which doesn’t include so much processing and analyzing. Free to express through creativity, clients avoid developing ‘burnout’ on treatment, which can become detrimental to the treatment process as a whole.