Breakingthecycles.com – Changing the Conversations

by Lisa Frederiksen

U.S. Department of Health and Human Services Substance Abuse and Mental Health Services Agency (SAMHSA) is committed to promoting evidence-based and promising practices in serving persons with mental illnesses and/or substance use disorders. They’ve produced a new series, The Evidence-Based Practice (EBP) Knowledge Informing Transformation (KIT) series, with  materials that provide innovative, engaging, and effective learning tools that help shape mental health services toward recovery.

One I’d like to especially draw your attention to is titled, “Co-Occurring Disorders: Integrated Dual Disorders Treatment.” With over half of persons who have an alcohol misuse problem also having a mental illness, known as a dual diagnosis (aka, a co-occurring disorder), it is important to learn more about this new evidence-based treatment practice. This treatment approach helps people recover because it offers both mental health and substance abuse services at the same time and in one setting.

Click here for details, downloads and ordering.

by Lisa Frederiksen

This article, Depressed Parent’s Negative Effects on Kids are Combatable,” appeared in the Sunday, March 14, Los Angeles Times. It points to the impacts of a parent’s undiagnosed, untreated (and not discussed in an effective, straightforward manner) depression on their children. Impacts include the consequences of the parents’ inconsistent expectations and discipline, role reversals (children comforting parent or trying to be strong for parent) and parental withdrawal. The impacts, themselves, included depression and anxiety disorders, poor coping skills, learned helplessness and poor social relations. BUT, the good news is that the effects of parental depression can be reversed in two key ways: 1) the parent getting the help they need, and 2) the family openly and honestly talking about what is going on and what is being done to fix it.

I bring this article to your attention because it parallels what happens to children as a result of a parent’s undiagnosed, untreated (and not discussed in an effective, straightforward manner) alcohol misuse. Those negative impacts are very similar to the ones described above, and they, too, can be reversed if: a) the parent seeks help, and b) the family starts opening and honestly talking about it.

The “talk” does not have to be complicated nor deep nor all-encompassing; nor do you have to have all of the answers at once. In fact, talking in spurts and often is better with children. Equally important will be to let your children talk to you — to let them tell you their feelings without having those feelings corrected, fixed or explained. The Lucile Packard Foundation for Children’s Health website has some terrific resources that can help.

This is a guest post from my good friend, The Discovering Alcoholic, who writes a top rated recovery blog, www.discoveringalcoholic.com, covering alcoholism, substance abuse, treatment and recovery issues.

Straight from the Hiroshima train station, the public streetcar pushes into the crowded city center following a narrow channel through a blaring landscape of music, horns, and hawkers. Much unlike the corner inset of the tourist map, the actual guide keys to this area are a garish display of commercial signage that both overwhelm and yet substitute for the minimal municipal markers. Everything may not be bright and clean, but there can be no doubt that this city is fervently alive. After just a few stops, I see my destination. Now I am walking through an epitome of order where even the natural wildness of the river and the trees are tamed harmoniously with cut stone and planned lines. Children gallivant, couples bump shoulders, and teenagers carry out hidden agendas while those old enough, wise enough, or perhaps just unlucky enough ponder why and what happened here.

Near the Miyuki Bridge, there was a police box. Most of the victims who had gathered there were junior high school girls from the Hiroshima Girls Business School and the Hiroshima Junior High School No.1. They had been mobilized to evacuate buildings and they were outside when the bomb fell. Having been directly exposed to the heat rays, they were covered with blisters, the size of balls, on their backs, their faces, their shoulders and their arms. The blisters were starting to burst open and their skin hung down like rugs. Some of the children even have burns on the soles of their feet. They’d lost their shoes and run barefoot through the burning fire.

Even today, I clearly remember how the view finder was clouded over with my tears.

~ Testimony of Yoshito Matsushige cameraman for the Chugoku Newspaper

This is the Hiroshima Peace Memorial where the twisted, tattered remains of the old Prefectural Products Exhibition Hall now commonly called the Atomic Bomb Dome are preserved, an edificial testimony to the devastation of the world’s first nuclear weapon target. It is an ugly scar among 30 acres of pristine monuments dedicated to remembrance and peace; without it one could walk the grounds never realizing the absolute destruction of the first ground zero. Looking around, it seemed that many do just that… isn’t that what recovery is all about?

At the Hiroshima Peace Memorial the utter destruction, painful memories, and the slow rebuilding process have all been documented and molded into a recovery program. At least here, the lessons of the war are not forgotten. No anger, resentment, or revenge is displayed- just a message, a peaceful reminder to others that they should not repeat the mistakes of the past and suffer such dire consequences. In fact, as you exit the onsite museum you get exactly that- an audio presentation, a speaker’s meeting of the survivors like Toshiko Saeki who lived through the blast.

I could not help but think of Hiroshima as a recovery Mecca, ideal for the pilgrimage of recovering alcoholics. A vibrant city that was scoured down to the rock bottom by nuclear fires only to be built up again bigger and better under no pretenses of victimization or singular blame, just pure acceptance and a vow to honor the past, enjoy the present, and to protect the future.

If you need a spiritual reminder of what real recovery is all about, I suggest you make the trip to the Hiroshima Peace Memorial.

Top 7 Best Alcoholics Anonymous Alternatives List
In several blog posts over the past two years, we have examined Alcoholics Anonymous (AA) and a lively discussion has followed those posts. AA is a group that many have very strong feelings about – both positive and negative. For some, AA has truly been a life-saver and allowed them to manage their addictions, while for others, the experience has not been as positive. Based on that feedback, we wanted to take a moment and provide information on the top 7 alternatives that we’ve found on the internet for addiction support. We hope these will be helpful to those out there that are looking for a new (or additional) support group solution to managing addictive behaviors. Read more…

I Know My Child is Drinking
If your child has been caught using alcohol or diagnosed with an alcohol abuse problem, there are steps you can take at home to help prevent continued underage drinking: Read more…

by Lisa Frederiksen

As you’ve read in various posts on this blog and elsewhere, I’m sure, mental illness is one of the risk factors for developing the disease of alcoholism and/or alcohol misuse problems. Mental illness (ADHD, bipolar, depression, anxiety) is also present in just over half of those with alcoholism and/or alcohol abuse problems in what is known as a dual diagnosis. For these reasons, I wanted to use today’s post to draw your attention to Victoria Costello’s post, “The Dangerous ‘Upside’ of Denying Mental Illness,” posted on Psychology Today’s website, March 10. To give you a sense of her article, please find the following excerpt:

I’ve been disturbed of late by a print media trend towards what looks an awful lot like a reactionary bandwagon on mental illness. A prime example was the NY Times Magazine story of 2.28.10 titled, “Depression’s Upside.”

If the reader can get past the feeling of revulsion that depression need have an “upside,” there’s plenty more in this story to anger anyone who’s ever battled this disease or dealt with it in a family member.

This block quote sums up Jonathan Leher’s main point… “The depression might be worth it if it helps you better understand social relationships. Maybe you need to be less rigid or more loving.”

In light of the direct connection between depression and suicide (60 percent of the 33,000 Americans who die by suicide each year suffer from clinical depression), if Lehrer can’t think of another less dangerous way of improving social relationships, I pity anyone who consults with him about their depression. But I’m also very concerned about his message, and how it appears to be part of a trend (back) towards the denial of mental illness, especially the debilitating disease of depression.

Click here to finish…

by Lisa Frederiksen

One of the key messages I share in a number of my talks is the role early childhood trauma plays as one of the risk factors for developing the disease of alcoholism and/or an ongoing problem with alcohol abuse. And here is why.

We are born with approximately 100 billion brain cells but only a fraction are “wired.” It takes neurons (brain cells) talking to neurons — or “wiring” — for us to do whatever it is we do. Dr. Norman Doidge uses the phrase, “Neurons that fire together, wire together,” in his book, The Brain That Changes Itself. This “firing together, wiring together” causes the brain to form “brain maps” for everything we think, do, feel or say. For example, the act of my typing this blog post involves my fingers, my eyes, my mind recalling research, my body and its posture — all working seamlessly together in a manner I don’t even think about. It just happens; happens thanks to neural networks wiring together because they fired together to form the brain map for how I “write.”

Now, read this quote that I received in a newsletter from SAMHSA informing readers that  National Children’s Mental Health Awareness Day is on May 6, 2010.

“Research has found that core brain development, 85 percent of which occurs in the first three years of life, shows differences in brain structures and function based on the child’s experiences in relationships with others and with their social context.” Shonkoff, J. & Phillips, D. A. (Eds.). (2000). From Neurons to Neighborhoods. Washington, DC: National Academy of Science

It makes sense when you think about it. For although we are born with approximately 100 billion brain cells, at birth about all we can do is sleep, eat, poop and urinate, cry and breath.  If our neurons were all wired at birth, we’d come out running, laughing, reading, talking and doing calculus. Now read Shonkoff’s quote again.

Because the brain continues to form brain maps and input gets more advanced and complicated (think school, sports, music, relationships…), in the first decade of life, trillions of neural networks are formed. So here is where childhood trauma comes in.

If a child is being raised in a home with undiagnosed/ untreated alcohol misuse, their neural networks for how to see, process and cope with the world are all being influenced by how their family members interact. For a better understanding of what I’m saying here, please read this excellent piece on Huffington Post by Dr. Tian Dayton, “Diane Schuler, The Heartbreak of Denial.”

Bottom line… long before the age at which we start to have a memory of our lives, our neural networks are being formed in response to what is going on around us. And that “what is going on around us” has a profound impact on how our neural networks wire. All of this to say, here is another reason to address alcohol misuse — whether it is the person drinking too much or the person reacting to it — for our children’s sake.

by Lisa Frederiksen

One of the things that can keep family members and alcohol misusers stuck is the debate about how much is too much and what makes a person an alcoholic and does not being an alcoholic make excessive drinking okay. In a recent post, “Controlled Drinking Can’t Work for an Alcoholic,” I discussed what makes a person an alcoholic, and why a person who is not an alcoholic can perhaps learn to drink in moderation.

Recently I found this website, Moderation Management. They offer suggestions for how to drink in moderation, as well as face-to-face and online support meetings. They provide the following answers on their website to these two questions:  “Why is a moderation program needed?” and “What is Moderation Management?”

Why is a Moderation Program needed?
According to the NIAAA and many other independent researchers, there are four times as many problem drinkers as alcoholics in this country. Yet there are very few programs that specifically address the needs of beginning stage problem drinkers, while there are literally thousands of programs for the smaller population who are seriously alcohol dependent.

By the time people reach serious stages of alcohol dependency, changing drinking becomes more difficult, and treatment is usually costly. MM believes that this situation needs to be remedied in the interest of public health and human kindness with early intervention and harm reduction programs. Moderation programs are less costly, shorter in duration, less intensive, and have higher success rates than traditional abstinence-only approaches.

Nine out of ten problem drinkers today actively and purposefully avoid traditional treatment approaches. This is because they know that most traditional programs will label them as “alcoholic”,  probably force attendance at 12 step and abstinence based meetings, and prescribe lifetime abstinence as the only acceptable change in drinking.

They may also have real concerns about how their participation in these programs will affect their jobs and ability to attain future medical and life insurance. MM is seen as a less threatening first step, and one that problem drinkers are more likely to attempt before their problems become nearly intractable.

Not surprisingly,  approximately 30% of MM members go on to abstinence-based programs.  This is consistent with research findings from professional moderation training programs. Traditional approaches that are based on the disease model of alcohol  dependence and its reliance on the concept of powerlessness can be particularly counterproductive for women and minorities, who often already feel like victims and powerless.

Outcome studies indicate that professional programs which offer both moderation and abstinence have higher success rates than those that offer abstinence only.  Clients tend to self-select the behavior change options which will work best for them.

What is Moderation Management?
Moderation Management (MM) is a behavioral change program and national support group network for people concerned about their drinking and who desire to make positive lifestyle changes. MM empowers individuals to accept personal responsibility for choosing and maintaining their own path, whether moderation or abstinence. MM promotes early self-recognition of risky drinking behavior, when moderate drinking is a more easily achievable goal.

Please note: Neither BreakingTheCycles, www.breakingthecycles.com, nor Lisa Frederiksen endorses any specific treatment program over another, nor any particular method for stopping, controlling or changing drinking patterns, rather strives to bring the latest information on various treatment options to readers’ attention.

Tackling the Mysteries of Alcohol Dependence
Why does drinking alcohol have such profound effects on people’s behavior? Why does alcohol dependence develop and persist in some people but not in others?
Scientists attempt to answer these questions by studying the brain, where alcohol intoxication and dependence begin. During the past decade, advances in technology have helped us better understand how alcohol changes the brain and how those changes influence alcohol-related behaviors. In the coming decade, this knowledge will help researchers develop drug and other interventions that can reduce the high social, personal and economic costs of alcohol-related problems. Read more…

If Your Kids Are Drinkng ‘Alcopops,’ Be Worried
The alcohol industry has found ways to make its products attractive to kids, and parents may not realize what it is their children are drinking. So-called “alcopops” taste like fruit juice but can contain as much booze, or more, than some beers. Girls, in particular, are said to love the sweet malt punch. Other beverages are packaged to look like popular energy drinks, but contain liquor. Read more…

The following is a guest post by Bill White, M.S., a counselor, author, mentor, blogger and speaker specializing in depression, anxiety and general mental health issues. He hosts a blog, http://chipur.com, and does a lot of E.R. psychiatric emergency work in Chicago’s suburbs where he also spends time with his two teenage children.

“S.A.I.L.” Stop-Assess-Interpret-Logic

Here’s a technique I came up with that’ll be easy to etch upon your mind, allowing it to be there for you at a moment’s notice. The next time you begin to sense the tiptoeing of a panic attack in your immediate vicinity…stop everything. Now, slowly take a few refreshing abdominal breaths and begin whispering to yourself, “S.A.I.L.”…”S.A.I.L.”…”S.A.I.L.” And as you’re saying it, imagine feeling warm and gentle breezes of relief upon your skin. And here’s the magic of the acronym…

STOP everything in your life right now.

ASSESS exactly what’s going on within, and outside of, you.

INTERPRET if the situation is truly threatening and merits alarmed reaction.

LOGIC your way to an appropriate emotional and behavioral response.

Of course, I could go on and on with more details on the technique; however, newsletter constraints won’t allow it. But I think you get the idea. Give it a go, and if you want to learn more about S.A.I.L. and tons of other panic and anxiety tidbits of relief, check out Panic! …and Poetic Justice.

by Lisa Frederiksen

What do you say when someone you care deeply about keeps telling you time and again they’re sorry.

They’re sorry, but they were drunk; or they’re sorry, but they must have blacked out; or they’re sorry, but they don’t remember; or they do remember and they’re so very, very  sorry for…

- vomiting in your car (”Ah man… I don’t feel so good…”)
- peeing in your closet (”Hey… I thought it was the bathroom.”)
- picking a fight with your sister at your mother’s birthday dinner (She started it…it was none of her business whether I was having another beer, and what about you? You went along with her.”)
- trashing your house (”What do you mean I did this. What happened?”)
- trying to pick up your best friend  (”Hey, she kept coming onto me,  and that’s the last I remember.”)

I don’t have any answers, other than to say, as long as a person drinks more than their brains and body can process, there will always be a next time, sometime, and once again, they’ll be sorry, but…