Laughter as Medicine: Learning to Meditate and Laugh Together

It sounds peculiar to laugh and meditate at the same time, especially when the general perception of meditation is to sit quietly and be still. But a few daily lighthearted chuckles and chuffs often stimulate changes in helpful "feel good" brain chemicals such as endorphins, serotonin, and dopamine. Laughing, like meditation, can reduce symptoms of anxiety, depression, and stress.

Laughter Meditation: Part of Laughter Yoga

Sometimes jokingly referred to as "The Art of Hahaha," laughter meditation exercises come from the practice of laughter yoga. There are many sources of this style, but one of the most frequently cited is Dr. Madan Kataria, or the "The Laughter Guru" and founder of Laughter Yoga International in 1995. He uses a combination of exercises and yogic breathing techniques to help people grin, snicker, and chortle their way to better health.

As a medical doctor, Kataria relies on clinical studies to prove his point that laughter—often without the use of comedy, jokes, or other humorous prompts—provides a number of benefits, including:

• Stimulates oxygen throughout the brain and body
• Releases endorphins, dopamine, and serotonin
• Reduces cortisol, which helps alleviate stress
• Lowers blood pressure
• Strengthens the immune system
• Eases digestion
• Promotes relaxation

What's more, Kataria notes your body apparently can't tell the difference between real laughter and fake laughter, but will still experience the residual effects. So initially, you may have to work yourself into a giggle fit, but eventually, your natural response takes over.

The scientific community continues to be intrigued by the effects of laughter on wellness. The term gelotology relates to the study of laughter and its effect on the body. For example:

• The Cancer Treatment Centers of America uses laughter therapy as a physical exercise with patients as part of its Mind-Body Medicine program. Often conducted in a group setting, what starts as a deliberate "hee hee" or "ha ha" builds into big hoots around the room as people laugh—well, at everybody else!
• Many researchers have articles detailing laughter as a wellness aid and how regular laughter improves the health of senior citizens.
• The Mayo Clinic reports "data is mounting about the positive things laughter can do," including relieving pain, connecting with others, and decreasing negative thoughts.
• For nearly 30 years, Dr. Lee Berk studied the effects of laughter on the brain and body. Of note, he examined how laughing generates gamma frequencies in the same way meditation does, which helps synchronize neuronal activity. This may be particularly helpful for people in recovery.
• Laughter Online University offers a free PDF as to the benefits of this type of therapy and why it works.

Primarily, researchers agree that when we laugh, even if we have to jumpstart a chuckle to get a full belly laugh going, we end up in a happy place. Here's an interesting TEDx Talk from laughing yoga instructor Ida Abdalkhani, indicating that within about two minutes, fake laughter becomes real.

Laughter Meditation Exercises

To start practicing more mindful laughing, sometimes it's as easy as a smile. Not as a forced response to someone telling you to smile, but simply as a response to something that makes you feel joyful. Then, you can continue to smile more as you encounter people and feel more natural about it. No one is saying you must smile, but you're creating a conscious path to do so more frequently.

Now, start working with laughter meditation exercises. Here are a few to try:

• Dr. Kataria offers a gentle giggling exercise.
• Stephanie Nash leads a session in the Chopra Well.
• Here's a 10-minute "laugh along" video led by Robert Rivest.
• This is a longer laughter wellness session, about 15 minutes or so, from Sebastian Gentry, that includes movement.
• Laughter yoga teacher Bianca Spears invites you to laugh with her in a variety of ways.

Feel silly yet? Good! That's the point. Laughter meditation isn't designed to make light of what you may experience in life, but to help you find ways to add more joy to your day. There's the balance. Encouraging your body and mind to have more positive responses helps you continue to move forward with your health.

If you'd rather not watch a video, consider this solo practice from The Chopra Center. After the 10-minute session, capture your experience in a meditation journal for future reference.

Holistic Wellness at Cottonwood

When residents receive addiction and mental health treatment at Cottonwood Tucson, there's a combined approach to the philosophy of care. Mental, emotional, physical, and spiritual aspects are all addressed in order to create whole being wellness. From advanced nutrition to equine therapy, EMDR, and yoga, there are many complementary techniques to enhance healing. Learn more about this holistic treatment approach.




By Tracey L. Kelley

Addiction Detox: Nothing to Fear

When you realize it's time to get treatment for a drug or alcohol problem, there are many unknowns. One common fear people have is what happens during detoxification.

There's no question that substance abuse changes not only brain chemistry, but also a person's physiology. Stopping suddenly or without proper supervision are probably the worst actions someone can take when they're ready to be healthy. The mind and body are too reliant on the artificial effects produced by the substances.

Think of how a car reacts when brakes are applied with a quick and forceful motion. Sure, it may slow down or even stop, but not without severe jolting and systems locking up. Your biological system needs a gradual, controlled release from toxicity in order to recover. It may take only a few hours after not using drugs or alcohol for someone to experience severe or even life-threatening withdrawal symptoms. There's no reason to suffer through this.

Because addiction is a brain disease and affects each individual in different ways, not everyone requires the same type of detoxification. A medically-managed detox administered by credentialed addiction specialists makes the process safe, comfortable, and effective.

So, there's nothing to fear: detox may just be the first step in your eventual healing.

Understand What's Happened to You

Medical experts agree that once people require alcohol or drugs to function day-to-day, they have physical and mental dependencies. This means you currently may suffer or eventually will have complications with the following:

• Imbalances in or damage to the autonomic nervous system, which regulates numerous processes in the body, including breathing and heart rate; control over digestion, waste elimination, circulation, and pain response; and production of important fluids
• Compromises to brain chemical and neurotransmitter function, which in turn prohibits proper cognitive ability and behavioral responses; and feeds the compulsion to use illicit substances
• An increased risk of pancreatitis, liver failure, respiratory arrest, stroke, or heart attack
• A greater chance of organ damage, hemorrhagic stroke, coronary heart disease, obesity, and cancer, especially for women

If medical professionals at your treatment facility determine substance use has caused you mental or physiological impairment, the first step of wellness is to evaluate the need for detox and if so, to what degree. Physical stabilization helps prepare the body and mind for gradual, effective recovery.

When Detox Is Necessary

A team of experts examines each person for certain characteristics that determine if medically-supervised detoxification is necessary. While it may not be, you'll probably need it if there's evidence of:

• Abuse of multiple substances, such as opioids and alcohol
• Co-occurring conditions, such as binge eating disorder, depression, anxiety, or PTSD
• Chronic or acute health conditions that either aren't managed well or may be life-threatening
• Extensive or long-term substance abuse
• Relapse from previous rehabilitation

What to Expect During Detox

Understandably, the difficulties of physical withdrawal are top-of-mind with many people considering treatment. Pop culture is riddled with terrifying stories about what a person may go through purging chemicals from his or her system. But what happens during a medically-guided detox, while initially uncomfortable, doesn't have to be frightening when you know what to expect.

The discomfort you may feel while going through physical detoxification depends on three factors:

• Types of substances used
• Length of addiction
• Intensity of addiction

You may or may not experience the following during detox:

• Body aches, headaches, and fever
• Wakefulness and/or fatigue
• Persistent nausea and vomiting
• Welts, acne, or rashes
• Muscle spasms or shakiness
• Increased appetite
• Moodiness and irritability
• Anxiety or depression
• Delirium tremens, often referred to as DTs, that make someone experience misinterpretation and confusion
• Hallucinations or paranoia

The timeframe for detoxification varies by individual. Some people discover they feel better after two or three days. Other people may need up to three weeks for their bodies to eliminate toxins and return to a general state of ease.

A medically-managed detoxification process means you'll have doctors and nurses supervising your experience, and perhaps advising a medication protocol to help alleviate symptoms. These professionals may also help with other health complications. Proper nutrition and hydration are critical components to the process as well.

Once your body feels better, and you're not experiencing intense cravings, you'll begin the next phase of healing: emotional and mental stabilization. For true recovery, it's critical to determine the root causes contributing to addiction and find healthy ways to maintain your sobriety.

Your treatment should also include what's known as a continuum of care plan. This is the recommended course of action for emotional and psychological rehabilitation after toxins are removed from your body. Your care plan may include group and individual therapy, EMDR, 12-Step meetings, and other applications that support your sobriety.

Excessive Use Requires More Recovery Time

Here's a vital fact to understand: the greater the intensity of substance abuse, the longer it takes to detoxify. Initial inpatient treatment may effectively start the process. But if your substance abuse included extreme alcoholism or the use of narcotics, it could take up to two years before you stop experiencing withdrawal symptoms.

This is nothing to be ashamed of—you simply have to prepare for a different health journey, and continue to uncover new layers of resiliency. Use the tools of your care plan, along with exercise, a clean diet, and a strong support system, to help your progress. Remember: this is your plan for life. Each step forward you take matters.

Cottonwood's Health Services

No one should ever attempt to detoxify from mood-altering substances without the assistance of qualified professionals. At Cottonwood Tucson, we have an expert staff to help you stay comfortable and understand what's happening at every point in the process. Our compassionate care approach supports you and your journey to wellness.

Learn more about how we can help you begin a satisfying life of sobriety.

By Tracey L. Kelley

Do 12-Step Programs Really Work?

As addiction science continues to advance, many people wonder about the effectiveness of 12-Step programs and how they impact an individual's recovery from substance abuse or process disorders.

The most famous 12-Step program is Alcoholics Anonymous (AA), established in 1935, designed to foster "an international fellowship of men and women who have a drinking problem." The 12-Steps are considered a roadmap to recovery by helping participants:

• Observe aspects of accountability through acknowledgement of a problem; attendance in public or private meetings to encourage mutual support; and recognition of how addiction may have impacted other people
• Develop readily-accessible coping mechanisms for handling recovery challenges in daily life
• Offer solace and guidance in times of desperation, need, or compulsivity

AA's directives are outlined in what's known as the Big Book.

Since AA's founding, dozens of organizations adopted the 12-Step philosophy and structure to address other compulsive and addictive behaviors, including:

• Al-Anon Family Groups
• Cocaine Anonymous
• Debtors Anonymous
• Gamblers Anonymous
• Narcotics Anonymous
• Overeaters Anonymous

Experts at in-patient rehabilitation facilities often introduce 12-Step programs during treatment and as part of an aftercare plan. For example, at Cottonwood Tucson, residents have the opportunity to use 12-Step recovery material in individual or group therapy sessions; attend 12-Step meetings on campus; and access community resources for meetings and programs for when they return home.

How a 12-Step Program May Help You

In an article for the American Society of Addiction Medicine, addiction psychiatrist Dr. Michael Miller defined recovery as "a concept that implies not only improvement, but potentially remission…a process as well as a destination." He stressed that "recovery activities" such as 12-Step programs are not professional treatments, but can "promote recovery just as professional treatment can." He indicated if there's an endpoint to addiction, "it's to change one’s life for the better, to gain stability in one’s life, and to become more functional in one’s family and in one’s community."

In this way, a 12-Step program provides many people with a foundation toward achieving this new sense of balance and engagement. Too often, individuals suffering from substance abuse disorders associate with others who travel that same road. The simple first step of changing the company you keep to be with people who understand your challenges and now have similar goals of recovery is why many believe in the success of 12-Step processes—placing much of program's importance on fellowship.

Other advantages include:

• Taking a "moral inventory" of past actions and present life, with or without the influence of spirituality
• Allowing for better examination of personal values
• Providing reliable structure and necessary responsibility
• Offering a no- or low-cost way to uphold abstinence

What Some Scientists Say About 12-Step Effectiveness

While most of the controversy surrounding 12-Step programs involves the concept of spirituality, there's also a concern that some people with substance abuse problems rely on a program as a form of treatment.

"Most people can't deal with their addiction, which is deeply driven, by just being in a brotherhood," said Dr. Lance Dodes, when interviewed by NPR about his book, The Sober Truth, released in 2014. Dodes cited evidence that indicates the success rate of AA and other 12-Step programs is approximately 5–10 percent.

Conversely, in 2011, Scientific American reported studies that stress the recovery rate is much higher among people who attend 12-Step programs while also seeing a therapy professional. Nearly 60 percent of respondents reported long-term sobriety when they did both.

This continuing quest for effective post-residential treatment support is why some medical professionals offer alternatives to 12-Step processes. One such option is SMART Recovery. Founded in 1994 by mental health experts and based on psychological approaches, the secular organization states its mission is "to empower people to achieve independence from addiction problems with our science-based 4-Point Program."

The four points center on self-directed approaches such as:

• Improving motivation
• Refusing to act on the compulsion to use
• Developing problem-solving skills without substances
• Creating a healthy and balanced lifestyle

This method addresses a number of substance abuse and process disorders.

In 2018, VeryWell Mind shared some additional details about SMART recovery, as well as how it compares to 12-Step programs. Because the process isn't as widespread or as well-known as various 12-Step options, its overall effectiveness is hard to quantify. Although online meetings make proximity less of an issue, this convenience may also make it more difficult for some people to develop a sense of accountability and belonging.

Stay Open-Minded

In addiction recovery, nothing is more important than individualized treatment. There are numerous techniques that provide an initial approach to quality care. But as the true causation for addiction is revealed through dedicated processes, options for sustaining wellness often vary considerably between each person.

The best way to determine what aftercare program might be beneficial for your needs is to try various options, including different meeting times and locations, to see what you respond to. Keep in mind—a "one and done" approach may not provide all the information necessary to make a quality assessment. You may need to immerse yourself in a program for a couple of months to gain an authentic understanding of the approach and whether it serves you.

Talk with your continuing care provider about the most effective approach for your stages of progress.

By Tracey L. Kelley

Local media addresses the growing meth crisis

While much of the country has been focused on putting a stop to the opioid crisis, many people with addiction problems have turned to methamphetamine. Cottonwood’s clinical director Kathleen Parrish recently spoke with News4 about the dangers of the meth and the long-term damage it has on users. 

See the full story on News4 at N4T Investigators: Meth menace grows in shadow of opioid crisis.

To learn more about the addiction treatment programs at Cottonwood, click here or call us at 888-727-0441.

Returning to Work After Rehab

There are many "firsts" to look forward to when you complete an inpatient or extensive outpatient rehabilitation program. For a lot of people, the opportunity to return to work is a big accomplishment.

As you approach this sobriety milestone, it may be necessary to create a detailed plan of action regarding a number of factors, including:

• Knowing your employment rights and employer expectations
• Establishing clear boundaries
• Recognizing and handling work-related triggers
• Pacing your workload to minimize stress
• Creating a network of support both in the workplace and outside of it

Regardless of the type of position you once held, you'll now be approaching it from a completely different perspective. Use what you've learned in treatment to make the process easier.

Know Your Rights

The U.S. Department of Labor (DOL) is quite clear about employer obligations for employees completing substance abuse treatment and returning to your job. For example, the Americans with Disabilities Act (ADA) considers drug abuse and alcoholism disabilities. This means you're protected from discrimination by law due to treatment and past use—but not current use.

Your employer must allow you time off for necessary functions required by your healthcare provider or treatment facility continuing care plan. These may include doctor's visits, therapy, support meetings, and other vital components of your recovery.

Federal and state laws also outline that you're under no obligation to tell anyone in the workplace—including your direct management—why you were gone. Your company's human resources (HR) representative is your liaison to effectively going back to work.

This is all what your employer should do for you. In return, you're required to uphold employment standards. Make sure to talk with the HR representative so you have a clear understanding of the following expectations.

• Your employer has the right to administer random and/or scheduled drug tests; prohibit alcohol or drugs in the workplace or at work functions; and require the same conduct and job performance of someone in recovery as all other employees.
• In addition, the DOL indicates your employer can “discipline, discharge, or deny employment to an individual with alcoholism whose use of the substance adversely affects job performance or conduct to the extent he or she is not qualified.”

Finally, the DOL advises companies and returning employees to develop a right-to-work agreement. This is beneficial for all parties involved, as it once again provides clear expectations. In order to return to work, you must be cleared by a healthcare professional. Then, he or she may partner with you and your company's HR representative to establish guidelines for your return, workplace and job duty requirements, and other factors.

This helpful article from Workforce describes the process in more detail, and here's a sample of a right-to-work agreement.

Establish Clear Boundaries

As stated previously, you don't have to explain your stay in rehab to anyone in the workplace—unless you want to. It's a professional environment, and your private life doesn't need to be a part of it.

In order to establish clear boundaries regarding your recovery, you may find it necessary to determine what's most important:

• Telling no one and letting everyone think whatever they like.
• Sharing your addiction story with a select group of co-workers and management.
• Being open about your treatment journey to help other people understand and reduce myths and stigmas involving addiction.

The choice is yours. Work with your recovery team to determine the best course of action.

Deal with Triggers

Work can trigger a number of negative reactions in people, regardless of whether they have substance abuse disorder. But for individuals in recovery, staying mindful of what prompts compulsivity is crucial to continued good health.

Ask yourself:

• Does this work support my sobriety?
• Are there people or situations that contribute to my anxiety, depression, or negative feelings of self-worth?
• Do the behaviors of individuals in the workplace present too many challenges to my recovery?

Remember: while you may need employment, you need to also be secure in your journey to long-lasting wellness. Make a point to frequently touch base with your support network and continuing care counselor if you feel threatened in any way.

Use Stress-Relieving Techniques

When you first return to the workplace, it may be helpful to ease into the full routine gradually. Maybe start part time initially, plan for a four-day workweek, or participate in a job-share program. These alternative schedule options can be part of your right-to-work negotiations.

As you become more accustomed to the daily rigors of the job, you'll need to rely on stress-relieving techniques that bolster your energy, health, and outlook just like everyone else. This is a valid concern, as the American Psychological Association reports that chronic work stress affects approximately 65 percent of people in the United States.

For some people in recovery, triggers and stressors may be the same. But more often than not, work stress likely develops because of:

• Heavy workloads
• Lack of opportunity for promotion or growth
• Low pay
• Boredom
• No control over direction or purpose of tasks
• Inadequate recognition or acknowledgment of effort
• Conflicts in the workplace

Just as you learned to identify key substance abuse triggers, recognize what may add to your stress level and manage your response with a healthy balance of:

• Proper diet and exercise
• Time to relax and recharge
• Firm work boundaries, such as not being available 24/7
• Clear communication regarding goals, objectives, and expectations
  

Use Your Support Network

Returning to work is an important first step to shaping your new life. You don't have to do it alone. Whether it's regular therapy, a sobriety support group, or a strong collective of friends, family, and coworkers, anchor yourself in reassurance, guidance, and reassurance.

Cottonwood Tucson also helps all patients develop a relapse prevention plan that provides a stabilizing force. Here's what may help you.

By Tracey L. Kelley