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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.

When you have an entire world between your ears, constantly buzzing around, it is hard to find some silence. Silence is daunting. Stillness is frightening. Silent and still, you have to confront all of that noise swirling around your head. It makes you uncomfortable, but you’ve learned to live with it because that is the way that you are, that is the way that your brain is. As a result, you’re busy. You’re busy in the brain and you’re busy in the body. You keep yourself busy to keep yourself away from the silence. At some point, you aren’t sure which would be more insufferable, the silence or the business of your life. You aren’t alone in this struggle. Modern life is busy and most people are struggling to find time to sit still, in silence, because of both their busy lives and their busy minds. In times of being busy, they’re wishing they could sit still. In times of sitting still, they’re thinking about busy things. Silence and stillness are precious commodities. An increasing amount of research is indicating that you need time for silent stillness and still silence in order to fully thrive in life. Stress is a leading cause of disease and illness physically. Mentally, stress which is caused by unrelenting busy-ness can trigger mental illness symptoms causing them to become more severe. For example, in drug and alcohol use disorders, chronic stress without any pause for manageability, can cause cravings.

Cognitive behavioral therapy is rapidly becoming the “wonder therapy” of the treatment world. Mental disorders, physical disorders, even social disorders are being helped by regular cognitive behavioral therapy. The therapy method is so effective that programmers have “taught” AI “bots” to teach CBT to people through their Facebook messengers. Teletherapy programs have adopted CBT methods. Studies ranging from depression and anxiety to chronic pain, irritable bowel syndrome, and other medical conditions have focused on the efficacy of cognitive behavioral therapy. In studies across the board, cognitive behavioral therapy is proven to be effective and efficient in helping people find relief as well as wellness in their lives. Only one other therapy method has been proven to be as effective as cognitive behavioral therapy. A recent study found that group mindfulness practices might be as effective as individual therapy. However, the one study’s findings pale in comparison to the countless studies which have been done on cognitive behavioral therapy.

Discussions of anxiety and depression often go hand in hand. For example, symptoms of post traumatic stress disorder can include depression and anxiety. Bipolar disorder is characterized by alternating moods of depression, a bipolar-specific depression, and mania, which can include anxiety. Withdrawal from drugs and alcohol can include symptoms of both depression and anxiety. Signs and symptoms of any mental health disorder usually includes talks of either depression or anxiety, or both. Even more complicated is the fact that anxiety can be a symptom of depression and however closely related or closely discussed anxiety and depression might be, they are two completely different mental health disorders, symptomatic experiences, and diagnoses.

It can be difficult to understand addictions outside of the scope of chemical addictions. Chemical addictions are easier to understand in some ways. Though chemical addictions don’t always make sense, they can at least be attributed to a specific chemical as opposed to something that might make less sense, like shopping. Is it really possible to get addicted to something that isn’t a chemical substance? Currently, the only process addiction listed in the Diagnostic and Statistical Manual V is gambling disorder. However, that doesn’t delegitimize the very real experience that people have in their other process addictions, like sex addiction, love addiction, and even shopping addiction. Addiction is a word that helps put these disordered behaviors into an order we can understand. As a term, addiction can be defined as the “compulsive need for and use of a habit-forming substance...characterized by tolerance and by well-defined physiological symptoms upon withdrawal.” Addiction is also defined as a “persistent compulsive use of a substance known by the user to be harmful.” Should shopping addiction be considered harmful or something that could present physiological symptoms? People who develop process addictions, do experience physiological symptoms of withdrawal. They might experience insomnia, an inability to sleep, because their thoughts are racing with obsessions about shopping, for example. When they are near a shopping opportunity at a favorite store they might feel a racing heartbeat, shaking, sweating, or even feelings of nausea- all attempts on the part of the brain to get the body so uncomfortable, it has to act on the shopping urges. This is what makes shopping addiction compulsive, which identifies with the definition of addiction. Shopping addiction can be harmful. Will it cause an overdose or potentially injure someone else? Not physically. The sentiment “shop till you drop” is not exactly the reality for shopping addicts. Someone who compulsively shops beyond eating and sleeping would be the most extreme form of the addiction- spending waking hours in stores and sleeping hours online shopping, without eating or sleeping. Most often, the known harmful threat of shopping addiction takes place in the bank. Creditors mount, credit cards max, loans max out, and there’s looming financial insecurity deepening with every purchase. Despite the financial trouble, someone addicted to shopping continues to shop and spend, unable to help themselves.