Tuesday, May 22, 2018

Why EMDR Helps Recovery

Man in therapy
For many people, addiction is a co-occurring disorder with mental health issues. These conditions range from anxiety and depression to childhood trauma and PTSD.

Too often, the severity of the underlying issue prompts a greater likelihood that other disorders will present. For example, if someone was sexually abused, he or she may also have depression, social anxiety, and panic attacks. This is why substance abuse is a common self-medicating behavior to deal with the symptoms and triggers of such conditions.

Your brain has incredible resilience to handle traumatic experiences, but certain circumstances such as abuse, assault, rape, and war may overwhelm its coping capacity. Some people, according to Psychology Today, develop the ability to be more "stress resilient" over a lifetime, while others don't. The reasons for this variance are multi-faceted, and researchers continue to be fascinated by the possibilities of not only understanding resilience, but also helping the brain recover.

One possible approach for stress, trauma, and addiction recovery is Eye Movement Desensitization and Reprocessing (EMDR).

What Is EMDR?

EMDR is a psychotherapy treatment developed in 1989 by Francine Shapiro, Ph.D, an American psychologist interested in more effective techniques for addressing PTSD. She noticed a correlation between eye movements and thought patterns. She believed the body's natural physical healing processes could be applied to the brain's replay of painful experiences and memories.

Over time, trauma and chronic stress may decrease neuronal connections in the brain. For example, if you cut your finger, your body works to heal the wound. This process is usually effective unless there's a foreign object embedded in the cut. If the object isn't removed, the body is unable to repair the wound. When someone is traumatized by a situation or event, the mind replays the experience through painful dreams and flashbacks—the foreign objects preventing healing.

Research has shown an association between PTSD and functional changes in the amygdala, a part of the brain involved in the formation of emotional memories, especially fear-related memories.

Using a combination of eye and hand movements, as well as audio stimulation, patients in EMDR therapy re-engage with the trauma and essentially reprogram the brain to acknowledge, accept, and finally resolve those experiences. Much more quickly, many proponents say, than traditional talk therapy sessions might ever complete. There are numerous positive results, according to the EMDR Institute:

  • A study funded by health system Kaiser Permanente discovered that "77 percent of multi-trauma victims and 100 percent of single-trauma victims were no longer diagnosed with PTSD after only six 50-minute sessions."
  • Other studies indicate up to "90 percent of single-trauma victims no longer have post-traumatic stress disorder after only three 90-minute sessions."
  • Another study of combat veterans determined that "77 percent of them were free of PTSD after 12 sessions."

Due to this and other qualitative research, the Department of Defense, the World Health Organization, and the American Psychiatric Association are some of the organizations that recommend EMDR as effective trauma, depression, and anxiety treatment. Mental health professionals trained and certified in EMDR conduct approximately eight phases of treatment ranging from history and treatment planning to closure and evaluation. The process may also include learning new coping mechanisms.

How EMDR May Help Break the Addiction Cycle

Addiction is often associated with environmental factors and trauma, especially in early development years. This exposure at a young age establishes certain thought patterns and behaviors. While one person may experience trauma and not be affected, another individual may choose to cope with the circumstances with drugs or alcohol.

Again, aspects of brain resilience, environment, genetics, social network, and other factors play a large part in someone's mental health and the propensity for substance use disorder (SUD).

In cases where trauma is a root cause for mental health disturbances and SUD, EMDR therapy provides the opportunity to focus on this catalyst, resolve it, and move into more effective treatment and behavioral modifications. This may enable someone to embrace sobriety with clear confidence and reduce the risks for relapse.

How We Use EMDR for Progressive Treatment

At Cottonwood Tucson, we offer EMDR treatment in individual and companion trauma interventions for residents with PTSD and trauma issues in order to reduce distress, build skills, and develop stronger resources for healing. It's another component in our overall approach to help people heal emotionally, physically, mentally, and spiritually.

By Tracey L. Kelley

Wednesday, May 9, 2018

Helping a Loved One with Binge Eating Disorder

It's often difficult to determine if a loved one has a problem with binge eating. You may feel you're comparing someone's behavior to your own, passing judgement, or being critical.

Binge eating disorder (BED) has key signals that help make it easier to determine if you should be concerned. If there's a problem, it's treatable, especially with caring methods such as interpersonal therapy and cognitive behavioral therapy.

Understanding BED

Binge eating is the most common eating disorder. When a person has recurrent episodes of this behavior, the Diagnostic and Statistical Manual of Mental Disorders (DSM–5) characterizes it as:
  • "Eating, in a discrete period of time (within any two-hour period) an amount of food that is definitely larger than what most people would eat in a similar period of time under similar circumstances."
  • "A sense of lack of control over eating during the episode—a feeling that one cannot stop eating or control how much one is eating."
BED is often associated with:
  • Serious trauma
  • Childhood and adult obesity
  • Anxiety
  • Depression
These co-occurring disorders often contribute to loneliness, worry about body image and weight, and low self-esteem—possible causes of binge eating. Other potential factors may be exposure to a relative's particular eating patterns and genetic or environmental contributors.

Interestingly, many people who are obese don't have BED. However, of those diagnosed with BED, nearly two-thirds also have clinical obesity.

BED episodes may have three or more of the following behaviors:
  • Consuming large quantities of food even when not hungry
  • Eating more rapidly than usual
  • Ignoring feelings of fullness or satiety
  • Feeling guilty, depressed, or disgusted afterward
  • Eating alone due to embarrassment about the amount of food eaten
A professional may also look for signs such as someone feeling distress over the behavior or how long it's been happening. People suffering from BED usually have a recurrence at least weekly for three months or longer. Additionally, while binging is often associated with other conditions such as anorexia nervosa or bulimia nervosa, someone may have BED and not these other conditions.

Once binging behavior becomes a pattern, it's a compulsion that's hard to control—just like drug or alcohol abuse. The pattern over stimulates the brain's reward center.

Although eating disorders are often associated with women, the numbers aren't as skewed as you might think. Roughly 3.5 percent of women and 2 percent of men suffer from BED.

BED Warning Signs to Note

The National Eating Disorders Association (NEDA) outlines the significant warning signs that help you determine if someone you care about has a problem with binge eating.

  • Frequent digestive distress such as constipation, stomach cramps, and acid reflux
  • Noticeable weight fluctuations
  • Trouble concentrating
  • Feelings of low self-esteem or a lack of self-worth
  • Noticeable depression, disgust, or guilt after overeating
  • Fear of eating with others or in public
  • Withdrawal from normal activities and usual friends
  • Extreme concern over or a distorted view of shape or weight
  • Hoarding or stealing food
  • Frequent dieting or following fad diets
  • Secret, recurring episodes of binging
  • Eating too quickly at each meal
  • Developing unusual food rituals, such as not allowing foods on the plate to touch, chewing too much, or eating only a particular type of food

How to Talk to Your Loved One

If you have reason to be concerned, it's important to speak up. Yes, it might not be a pleasant conversation at first, but it's a step in the right direction toward a more healthy life.

Helpguide.org offers a number of tips for how to—and how not to—talk with your loved one about a possible binge eating disorder.

  • Choose a time that's best for both of you without distractions or limitations. Make sure the conversation is on a calm day in a quiet place.
  • Use "I" statements and caring language. Explain why you're concerned by using factual examples and ask how you can help. An "I" statement is something like, "I've noticed that eating with the family is more difficult for you lately, and you seem really down. I'd like to know how I can help."
  • Be supportive. You're just now opening a line of communication. Even if your loved one is initially resistant or in denial, remain respectful and calm.
  • Fight fire with fire. With what you’ve learned so far about BED, you now understand your loved one may be struggling with a lot of conflicts. Arguing, shaming, blaming, or criticizing weight or appearance may make the situation worse.
  • Oversimplify. Not everyone responds to "Just get over it!" or "Accept yourself for who you are." Recognized that BED is a complicated condition that can't be wished away with platitudes.
  • Extend ultimatums. If you have a minor child, you may have more control over whether he or she seeks treatment. Otherwise, you can't force someone to do it your way. They have to believe they have options for wellness.

Seeking Help for Binge Eating Disorder

NEDA stresses the importance of a proper DSM diagnosis of BED so insurance companies may assist with treatment. This assistance removes any barriers to choosing the proper care providers to improve quality of life.

At Cottonwood Tucson, we specialize in treating BED through a comprehensive program that includes nutritional, physical, and exercise evaluations. We provide a variety of clinical techniques designed to help your loved one change his or her relationship to food from addictive to healthy. Our treatment continuance of care plan may also include holistic modalities to support recovery and healing from within.

By Tracey L. Kelley

Wednesday, April 25, 2018

Debunking the 6 Top Myths About Addiction

People struggling with drug or alcohol addiction not only have to face the consequences of their actions, but also the social stigma surrounding their disease. The myths associated with addiction contribute greatly to the reasons why people may not seek effective medical treatment. If you or someone you love suffer from addiction, learn why the myths exist and how to enable better wellness with knowledge about this disease.

Myth #1: Willpower Is All You Need to "Get Over It"
Willpower is an aspect of self-control that helps us in numerous ways. When you resist the temptation to scroll through social media in order to finish work on time or choose a healthy salad instead of a fast food burger, this is a small example of willpower in action.

The American Psychological Association offers extensive research about willpower and why it's important for us to understand. On one hand, we can all improve our ability to control impulsive actions. On the other hand, a consistent barrage of challenges depletes willpower. Some studies indicate this depletion causes drops in glucose levels and changes to brain function, which affects self-control.

Yes, the initial choice to use illicit substances or drink to excess may be a slip in willpower. However, research also supports addition as a brain disease. Drugs and alcohol negatively impact the brain's neurological structure and how it works. These physiological damages compromise a person's ability to maintain self-control. 

Continued substance use will only further damage cognitive function, even if his or her actions have disastrous consequences in daily life. The American Society of Addiction Medicine (ASAM) indicates that "dysfunction in these circuits leads to characteristic biological, psychological, social, and spiritual manifestations."

Once people have proper detoxification and treatment, they can utilize techniques that boost self-control and develop greater awareness of triggers that erode willpower. 

Myth #2: Addiction Is a Moral Failing
Another constant challenge to drug and alcohol rehabilitation is the notion that addiction is somehow a moral failing. For example, someone might suggest that an addict would be able to stay sober if he or she only had a stronger demonstration of faith or didn't associate with the wrong crowd.

While it's true that spirituality can be of great support, addiction isn't a form of punishment for not believing the right way. And, it's important to acknowledge that while environmental influences, including associations with people or places, may contribute to an individual's addictive behavior, there are often deeper factors at work that result in the chemical dependency. Co-occurring psychiatric disorders, trauma, and genetic predisposition may also be underlying catalysts for addiction.

Some people can use substances and never suffer from addiction. And, throughout the United States, partaking of alcohol or marijuana isn't against the law and, thus, not against a moral 

The conscious intent of someone using alcohol or drugs, even prescription drugs, isn't to become addicted. But, as neurological changes occur with continued use, a "motivational disturbance" happens. This doesn't mean someone is weak or lacking character. It indicates that addictive behavior, driven by a brain chemical shift, will:
  • Prompt greater compulsive need
  • Trigger response reward
  • Inhibit normal decision-making ability
This same type of brain-altered compulsivity presents in other forms of addiction, such as eating disorders, gaming, sexual excessiveness, and gambling.

Myth #3: Once You're Addicted, You'll Always Be Addicted
ASAM clarifies that as society continues to understand what really happens to someone with an addiction, it's apparent that good people can do bad things. This doesn't mean they always will, but myths like this linger.

Addiction may not be curable, but it's absolutely treatable. Treatment enacted by qualified professionals is designed to help people regain whole body wellness.

Depending on the contributing factors and the state of the condition, recovery may require some effort. However, with proper treatment and support, an individual is ready to take personal responsibility for managing their illness for the long term. This creates a path of success.  

Myth #4: Rehab Doesn't Work
At some point, individuals with addictive tendencies need to realize that while they may not be responsible for their disease, they are in control of their recovery. This doesn't happen in a vacuum.

First, the safe environment of a rehabilitation center provides the security and personnel necessary to deal with the physical, emotional, and mental challenges associated with recovery.

Second, a holistic facility that treats the individual, not just the condition, provides effective treatment. A specialized program is crucial to address individual medical needs and includes identifying contributing factors. This dual approach helps someone make qualitative changes in wellness in order to establish control; utilize new techniques for managing behavior and overcoming challenges; and create a life of purpose and value.

Myth #5: A Relapse Means There Is No Hope
A relapse doesn't mean rehab failed, a person is a failure, or he or she will always be addicted. The National Institute on Drug Abuse indicates that approximately 40 to 60 percent of people experience a relapse. If this happens, treatment modifications are required to help an individual advance to a more stable state of being. Qualified health professionals recognize that a relapse can be debilitating to someone's spirit, but they have the resources necessary to help him or her progress beyond it.  

Myth #6: A Support System Isn't Necessary
Another myth associated with rehabilitation is the support of family and friends doesn't matter. Again, addiction recovery requires compassion, understanding, and knowledge. A strong network constructed of people who don't believe the myths and instead, believe in the individual, is critical to recovery. This network may start in a treatment facility, then extend into the real world post-rehab.

In addition, choosing a facility such as Cottonwood Tucson with a strong family program enables everyone to learn, change, and grow. This fosters a community focused on essential healing and establishes a journey of complete wellness.

By Tracey L. Kelley

Thursday, March 29, 2018

Using Good Nutrition to Support Your Recovery

Alcohol and drug abuse can create a number of health problems, including severe nutritional deficiencies. Empty calories from alcohol fill the body up without providing the fuel it needs, and many illegal drugs act as appetite suppressants.

In the early stages of recovery, paying close attention to your diet can help you heal some of the past damage caused by substance abuse. The following tips provide a general guideline for a healthy diet, but you can also try keeping a food journal to learn more about how what you eat affects your energy level, mood, and cravings.

Stay Hydrated
The human body is 2/3 water by weight, so dehydration can cause serious problems with your nervous, circulatory, and respiratory systems. During withdrawal, staying hydrated can help reduce the severity of detox symptoms such as constipation, headaches, and stomach upset.

Ideally, you should try to drink one half to one ounce of water for each pound of body weight. For example, a 200-pound man should try to drink 100 to 200 ounces of water per day.

One problem people often have with the suggestion to drink more water is that they get bored with the taste of plain water. Infused water made from fresh fruit and herbs is a great option, as is using ice cubes made from no-sugar-added fruit juice to add a hint of flavor to your water. There are also flavored Stevia drops you can use to sweeten your drink without adding empty calories.

Eat the Rainbow
Current federal dietary recommendations suggest that you fill half your plate with fruits and vegetables at each meal. However, it's important to choose a wide variety of fruits and vegetables instead of sticking to the same basic choices.

A great way to make sure you're getting a full range of nutrients is to try to eat a rainbow of fruits and veggies each day. Every color of the rainbow offers different nutritional benefits. For example, orange and yellow citrus fruits are rich in antioxidants to support your immune system. Red fruits and vegetables, such as apples, raspberries, tomatoes, and red onions, contain lycopene and anthocyanin to improve your memory and boost heart health. Green leafy veggies like kale and spinach are a source of chlorophyll to help rid the body of harmful toxins and promote detoxification in the liver.

Fill Up with Whole Grains
Whole grains are an excellent source of insoluble fiber, which helps you control your appetite and keep your digestive system in order. Unlike refined grains that have been significantly modified from their natural composition, whole grains contain the original bran, germ, and endosperm.

Common refined grains include white brain, white rice, white flour, and regular white pasta. Examples of whole grains include whole wheat bread, brown rice, oatmeal, and air-popped popcorn, as well as more adventurous options like quinoa, bulgur, millet, and buckwheat.

Snack Smart
Snacking is important to keep your blood sugar stable, but it's smart to choose snacks that will fill in the nutritional gaps in your diet instead of reaching for candy bars, potato chips, or fast food when you get hungry in the middle of the day.

A healthy snack would be one that combines several different food groups. For example, you can try making your own homemade trail mix by combining almonds, walnuts, or sunflower seeds with your favorite dried fruit and whole grain granola. Portion 1/4 cup serving sizes into plastic sandwich bags or reusable containers so you always have a healthy snack ready to go. A mixture of honey and almond butter or natural peanut butter is another easy-to-prepare snack option that makes a great dip for fresh fruits and veggies, as well as a topping for bagels, rice cakes, and whole grain crackers.

If you're concerned about nutritional deficiencies, it may seem like taking dietary supplements would be an easy way to give your body a boost. However, it's always preferable to get the fuel your body needs through a balanced diet. The vitamins and minerals in supplements are synthetically created and thus harder for the body to absorb than what's found naturally in food. Some supplements may also interact with certain prescription medications.

Talk to your doctor about any specific nutritional concerns you may have before deciding to use dietary supplements. If your doctor believes a supplement may be appropriate, he or she can help you choose one that best fits your needs.

By Dana Hinders

Many Hands Sustainability Center

Wednesday, March 21, 2018

Can the Seasons and Weather Affect Your Sobriety?

The saying goes, “As the seasons change, so do we,” and this proverb may have added meaning when it comes to addiction recovery. Although the determination to stay sober is your own, the changing of the seasons and weather can have an impact on your sobriety.

As we in the United States transition into spring and Daylight Saving Time, we should take the time to examine the effects that these changes may have on recovery.

Seasonal Affective Disorder
Typically, we associate sustained low mood and/or depression with winter weather. This condition is called Seasonal Affective Disorder (SAD) and is caused by your body’s reaction to a decrease in natural light.

However, those who live in warmer, sunnier regions may also experience “Summer SAD,” a condition that results in feelings of depression, oppression and agitation possibly brought on by too much sun, which can also affect melatonin production and cause disruption to the body’s circadian rhythms. Reduced levels of melatonin and poor sleep can become triggers for stress and ultimately substance use. 

SAD can affect addiction and addiction recovery just as clinical depression and other mental health disorders do. A Finnish study of alcohol use disorder (AUD) showed a significant correlation between SAD and an increase in alcohol consumption among the 4,554 individuals surveyed (Morales-Muñoz, Koskinen, & Partonen, 2017).

Right now, spring and Daylight Saving Time are literally and figuratively bringing more light to our lives. As the days lengthen, notice whether your moods change. If you’re feeling unusually anxious, sad, or manic, consider talking with your doctor about whether you might have seasonal affective disorder. 

If the extra sun and heat are driving you indoors, take advantage of supplements like Vitamin D and SAD lamps, which can simulate the effects of natural light on your mind and body. Socialization, exercise, medication, and other mood-boosters that can reduce the effects of depression are also effective in treating SAD.

Social Drug and Alcohol Use
Social influences of the warmer months can also impact substance use habits. Upcoming spring and summer holidays in the United States, such as St. Patrick’s Day, Cinco de Mayo, Memorial Day, and the Fourth of July, culturally encourage binge drinking.

Bloch, Shin, and Labin’s (2004) study of drinking habits in California shows a significant increase in alcohol-involved car accidents during certain holidays. Among the holidays most associated with alcohol-related accidents were the Fourth of July (#3), Super Bowl Sunday (#4), Memorial Day (#6), and Cinco de Mayo (#7).

While the warm month holidays do not pose as great a threat to sobriety as the winter holidays (e.g., New Year’s and Christmas), they are nevertheless responsible for statistically significant spikes in substance abuse. For instance, in underage males, drinking-related hospitalizations double over the Fourth of July. Similarly, Cho, Johnson, and Fendrich (2000) found that, of 57,758 American adults surveyed about their alcohol consumption in the previous month, participants were more likely to report episodic binge drinking in the month of July than in any other month.

Knowing and avoiding your triggers is a necessary part of staying on the path to recovery during these times of year. And remember that the strategies you used to keep sober over the winter holidays still apply. 

By Emily Fogel Conway

Cottonwood Tucson is an inpatient holistic behavioral health treatment center and addiction rehab. For more information, call us today at (800) 877-4520.

CARF - Commission on Accreditation of Rehabilitation FacilitiesNATSAP | National Association of Therapeutic Schools and ProgramsNBCCNAADAC