What is Cognitive Processeing Therapy or CPT?

There has been a lot of focus and attention on treating PTSD and trauma in the last few decades. And for good reason. PTSD can be a debilitating disorder, affecting one’s ability to function on a daily basis. People who suffer with PTSD might experience nightmare’s and flashbacks, they may isolate or avoid situations for fear of the trauma happening again. Sometimes people experience rage and use drugs and alcohol in order to cope with the symptoms of PTSD. Trauma and PTSD is a very complex condition that involves different parts of the brain that we are still learning about. Currently there are many types of therapy that professionals use to treat PTSD and trauma. However, only a few have been researched and validated as effective treatment for PTSD. Cognitive Processing Therapy (CPT), Prolonged Explosure (PE), and Eye Movement Desensitization and Reprocessing (EMDR) have all been shown to be effective in treating PTSD according to the Clinical Guidelines of the VA.

In Cognitive Processing Therapy, the therapist helps the patient look at their beliefs and thoughts about the traumatic event and it’s consequences. The theory with CPT is that the patients beliefs and thoughts about the event are leading to painful and disturbing emotions about the event which is then leading to avoidance behavior. The avoidance behavior is preventing the patient from processing through the trauma in a healthy way in order to achieve resolution. The idea with CPT is that the therapist helps the patient restructure their thoughts and beliefs about the trauma so that they can process through the trauma and achieve resolution. CPT is a very effective treatment strategy for PTSD and working through traumatic events.

Check back as I talk about other treatments for PTSD and trauma!

The Basics of Trauma Informed Care

What is Trauma Informed Care?

Being trauma informed is one of the most important skills I have learned working with women, and especially women in recovery from a substance use disorder.  Unfortunately, most women in recovery from addiction experienced a traumatic event before the addiction developed.  If a clinician or a treatment program is working with women and they are not trauma informed, they can inadvertently re-traumatize the patient.  Re-traumatizing a woman in early sobriety can lead to mood instability, increased shame and guilt and possibly relapse.  Here are the basics of trauma informed care:

1.  Safety is the most important thing

Trauma survivors need to be in an environment where they feel safe and can trust the clinicians they are working with. Safety can mean different things to different people, but generally a safe therapeutic environment means that the patient feels worthy and respected, not judged, and her thoughts, feelings, and needs are heard and valued. Additionally, safety also means autonomy. Many women who are trauma survivors have been controlled and manipulated. A safe therapeutic experience is one that allows the trauma survivor to inherently know that she is worthy and valuable.

2.  Avoid re-traumatizing your patient

This is another very important aspect of working with women and trauma survivors. Most women who have experienced trauma have experienced the traumatic event on multiple levels. The first level is the traumatic event itself, the second is family, parents, and loved ones possibly not believing or not supporting the trauma survivor when they ask for help or report the abuse. The third is the justice system itself. Many times women experience discrimination or maltreatment by the justice system when they report abuse to the authorities. Because of the many levels that women can experience a trauma, it is important to do a thorough trauma assessment in order to learn what trauma they have experienced so that you can adjust your behavior and interventions appropriately. It is extremely important to understand how their support system and the justice system handled the traumatic event. If the trauma survivor was not supported through the trauma, and was even blamed, shamed, or told it did not happen, that can shed light for you as the clinician on the type of behavior that may re-traumatize your patient.

3.  Help your patient find her power

Every woman deserves to feel strong, worthy, capable, and confident. It is my job as a therapist to continually affirm and reinforce healthy self talk for my patient. Some women and trauma survivors have never heard positive and affirming statements about themselves. They need to hear that from us, but more importantly the goal is that they start saying these positive statements to themselves. As women feel more worthy, they begin making healthy choices in other areas of their lives, such as relationships with friends, family, and partners. When your patient finds her power, this will create a ripple effect of healthy choices throughout her life. It's a beautiful thing to watch.

Struggling to put your well-being first? Check out the "Pregnancy Principle"

I stumbled upon this article by Laura McKowen, “The Pregnancy Principle”, and I thought it was genius. Think about it. When a woman is pregnant, she has no problem asking for what she needs for her baby, saying no to what isn’t good for the baby, and not feeling guilty for doing it. Most women I know who have been pregnant ALWAYS put the babies needs first. I think it’s easy for women to do this when they are pregnant because it’s FOR the baby, not always specifically for them.

What if women could be this assertive about their needs without being pregnant? This is the whole premise behind Laura’s article. Laura describes the Pregnancy Principle as including the following 4 points:

The Pregnancy Principle states the following:

1. Your well-being comes first.

2. If it doesn’t support your well-being, don’t do it. No, really. Just don’t.

3. Be unapologetically selfish with your energy and time.

4. In other, less squishy words, f*ck everything and everyone else (for a while)

Laura does a great job describing each of these points and how we can implement these ideas into our lives WITHOUT being pregnant!

When Getting Sober Reveals a Co-Occurring Disorder

What is a co-occurring disorder?  A co-occurring disorder is when someone has two mental health diagnoses.  According to www.drugabuse.org roughly half of people who develop a substance addiction have another psychiatric disorder, and vice versa.  Addiction is considered a mental health disorder, and so when combined with another mental health disorder, this is known as co-occurring disorders. 

How do I know if I have a co-occurring disorder?

It can sometimes be difficult to determine if you have a co-occurring disorder.  One of the questions to ask yourself is whether or not you remember having anxiety or depression before you started using substances.  If you remember having anxiety or depression as a child or teenager, this can lead to using substances to cope with those feelings.  Unfortunately, many women experience traumatic experiences early in life which can lead to using substances to cope with depression, anxiety, or PTSD symptoms.  If you did experience anxiety or depression as a child or teenager and started using substances to cope with those feelings, then you may have an underlying co-occurring disorder.

If you did not experience anxiety, depression, or a traumatic experience as a child or teenager, then the answer may not be as clear.  Using substances can actually cause anxiety or depression, and for some people when they stop using substances the anxiety or depression starts to clear up.  In order to determine if anxiety or depression symptoms are substance induced or symptoms of an underling co-occurring disorder, it’s important to maintain sobriety, and continue to monitor your feelings and moods.  If you notice that after 30 days of sobriety you are still feeling anxious or depressed, I would suggest that you meet with a licensed therapist who can help you determine if you have a co-occurring disorder.  Sometimes it can take up to 6 months of being sober in order to have a clear picture of what your baseline mental health symptoms looks like. 

Some people notice more severe mental health symptoms when they get sober.  If you notice hallucinations, paranoia, delusions, not sleeping for days at a time, or severe depression or anxiety, make an appointment with a medical doctor immediately or go to a local mental health clinic.  If you notice suicidal or homicidal thoughts at any time, call 911 or go to your nearest hospital emergency room.

What should I do if I think I have a co-occurring disorder?

This first thing to do if you think you might have a co-occurring disorder is to schedule an appointment with a licensed mental health therapist or a psychiatrist.  If you schedule an appointment with a therapist, confirm that they have an addiction and mental health license because it is important that they have training in both and can evaluate your symptoms properly.  If the therapist feels that medication would be helpful, they may recommend that you schedule an appointment with a psychiatrist or addictionologist. 

What’s the difference between a therapist, a psychiatrist, and an addictionologist?

It’s also important to understand the difference between a therapist, a psychiatrist, and an addictionologist.  A therapist is a licensed mental health professional that can evaluate, diagnose and treat mental health disorders through various modalities.  A psychiatrist is a medical doctor that also treats mental health disorders and can prescribe medication. 

If you are in recovery from a substance addiction, it may be beneficial for you to see an addictionologist instead of a psychiatrist.  An addictionologist is a psychiatrist who has additional training in treating addiction and is certified by the American Society of Addiction Medicine.  Seeing an addictionologist is helpful because they know which medications to prescribe that are not addictive, and which are safe for recovery.

At Silver Lining Counseling in Charlotte, I can help you determine if you have a co-occurring disorder, and teach you the skills and tools to manage the symptoms.  I provide a safe and empowering place for you to heal. 

The Anxiety Reduction Series - Part 2: Advanced Skills to Reduce Anxiety

In Part 1 of The Anxiety Reduction Series I went over basic tips and skills for reducing anxiety.  In Part 2 I am going over more advanced skills for reducing anxiety.  These are skills that I try to teach all of my patients when helping them reduce anxiety. 

1.       Focus on the present, not the future

Most people who have chronic anxiety issues or an anxiety disorder have a lot of thoughts about the future that they cannot control.  We all think about or even worry about the future from time to time, but if this becomes a constant thought process, it can lead to chronic stress, anxiety, racing thoughts, and worry about worst case scenarios.  If you feel like this is you, it’s important to start restructuring your thoughts so that you focus more on the present, and less on what you cannot control.  A coping skill that I can teach you and help you integrate into your daily routine is called “checking the facts”.  Checking the facts challenges the brain to only focus on what you know to be true without a doubt.  When you check the facts, it distracts the brain from focusing on the future or what you cannot control. 

2.       Learn how to meditate and practice mindfulness

There have been a lot of studies done using meditation and mindfulness that show that both are definitely helpful in reducing symptoms of anxiety.  Meditation and mindfulness may sound intimidating, but they are really just about focusing on the present moment.  Meditation is a practice used to help you focus less on thoughts in your brain and more on the present moment.  Some people use it for spiritual enlightenment, but others use it as a secular practice to reduce stress and anxiety and stay focused on the present moment.  Mindfulness is a state of mind in which you intentionally focus your attention on something that anchors you to the present moment throughout your day, like washing the dishes, brushing your teeth, or folding laundry

Meditation can be challenging for people with anxiety disorders, but it gets easier with practice.  It’s usually most helpful to use an app on your phone or recorded guided meditations when you are first getting started in order to keep yourself focused.  Try meditating for 5 minutes twice a day, and then add 5 minutes each week until you get to 20 minutes twice a day.  Pick a place in your home that is comfortable, free from technology, and a place that you will not be interrupted by people or animals.  Once you feel more comfortable with meditation, try out different types to find the ones that you like the most. 

Mindfulness is less structured and is not a formal practice like meditation.  As I explained earlier, mindfulness is more of a state of mind that anchors you to the present moment throughout the day.  As you move throughout your day, try to notice what you are thinking about.  Instead of being present as you eat breakfast with your family, are you thinking about work or the deadline you have this week?  Try to bring your focus to the present moment, taking in what you see, smell, hear, and taste as you are sitting with your family at the breakfast table.  Bring awareness to the act of eating breakfast, and notice if this helps you become more present. 

3.       Restructure negative or irrational  thoughts into positive, rational thoughts

As discussed in Part 1, chronic anxiety can cause us to worry about worst case scenarios that are normally irrational, negative, and completely out of our control.  Unfortunately, some of us take these negative and irrational thoughts as the truth and base our behavior on them.  Counseling for anxiety can help you become aware of these thoughts and learn to restructure them so that your emotions and behavior are based on the facts of the situation.  One technique that I teach a lot of my patients is how to restructure these thoughts on your own.  Take out a piece of paper and make 2 columns, one that says “Unhealthy” and another that says “Healthy”.  Write down the unhealthy thoughts in the “Unhealthy” column about a situation that is causing the feelings of anxiety.  These thoughts normally include “shoulds” that lead to unhealthy expectations of ourselves and others, negative thoughts about ourselves, and all or nothing thinking.  Some examples of unhealthy or irrational thoughts are:

·         “I’ll never” or “I never” thoughts

·         I’m not good enough thoughts

·         “What if” thoughts

·         “I should”  or “I have to” thoughts

·         “They should” or “They have to” thoughts

·         Thoughts about worst case scenarios

For every negative thought that you write down, restructure the thought into something positive and present tense.  Write down the healthy thought in the “healthy” column next to the unhealthy thought.  Healthy and rational thoughts never include “should’s”, “have to’s”, negative thoughts about yourself, or unrealistic expectations of yourself or others.  Examples of healthy and rational thoughts are:

·         I can achieve my goals with practice

·         The facts of the situation are…

·         I can choose to…

·         They can choose to…

·         I am good enough regardless of my mistakes

·         I can’t control the future but I have the skills to handle what might happen

Now you have a list of healthy, rational, positive, and present tense thoughts that you can read over when you notice yourself having negative or anxious thoughts.  Keep the list readily available in your phone, wallet or purse so that you can pull it out anytime you need a reminder of some healthy thoughts. 

4.       Start an affirmation practice

This is one of my most used techniques with patients, and it works!  A lot of people who have anxiety or depression also have negative or unhealthy thoughts about themselves.  It is really important to learn how to talk to yourself in a kind, loving way.  Try to make a list of 10 positive, true, and present tense statements about yourself.  If you’re having trouble thinking of affirmations, search the internet for affirmations for ideas.  Some examples of affirmations include:

·         “I am worthy”

·         “I am good enough just the way I am”

·         “I have skills that I can use in recovery”

·         “I am a valuable woman/man”

Once you have created a list of affirmations, pick one every day to focus on.  Say the affirmation out loud to yourself in front of the mirror at least 20 times per day.  This may feel uncomfortable at first, but I find that once my patients get comfortable with doing it, they find that it starts to make them feel better about themselves.  Try it!

5.       Find a therapist who can do EMDR

Eye Movement Desensitization and Reprocessing (EMDR) is a technique used by trained therapists to help desensitize the reactions you might have to triggers or situations that cause anxiety.  EMDR uses bilateral stimulation, usually in the form of eye movement to bring up events and situations that are associated with unhealthy belief systems in the neural network.  The bilateral stimulation desensitizes you to the triggering event, and then a more adaptive belief is integrated into the neural network.  EMDR is an evidence based technique that has been shown to be very effective for the treatment of anxiety. 

I hope Part 2 of The Anxiety Reduction Series has been helpful in giving you some additional tools and techniques to reduce anxiety.  At Silver Lining Counseling in Charlotte, I use all of these techniques to help reduce symptoms of anxiety.  If you are interested in learning more about what I can do to help you reduce anxiety, please call me or schedule a free phone consultation by clicking on the “Request an Appointment” button on the top of my webpage. 

The Anxiety Reduction Series: Part One – Learning the Basics of Anxiety Reduction

Anxiety is a common mental health issue that most people experience at some point in their life.  For some it might be a situational problem that only arises in anxiety producing situations like public speaking.  However, for others it can be a chronic mental health disorder that is life-long.  At Silver Lining Counseling in Charlotte, NC, I can help you manage your anxiety symptoms by helping you assess ways to improve emotional and physical health, learn how to breathe in a way that triggers the relaxation response, help you identify ways to manage your stress more effectively, and learn how to restructure your thinking in order to reduce anxious feelings.  Part One of The Anxiety Reduction Series addresses how to improve overall emotional and physical health which will in turn reduce anxiety.  Part Two outlines examples of more advanced skills that you can learn through counseling for anxiety. 

1.        Learn how to belly breath

This is probably the first thing I teach all of my patients.  People who have chronic anxiety tend to have shallow breathing.  What this means is that when you inhale, your chest and shoulders rise more than your belly.  Unfortunately, this type of breathing is associated with the fight/flight/freeze response in the brain and just continues the anxiety cycle.  In order to trigger the relaxation response in the brain, it’s important to practice belly breathing instead.  When belly breathing you do the following:

·         Inhale through the nose or mouth, whichever is more comfortable

·         Breath deep into the lungs so that your belly is rising when you inhale

·         Exhale completely through the mouth, making sure all of the air leaves the body; this will insure a full inhale going forward

Practice belly breathing multiple times a day in order to get more comfortable with how it feels.  If you feel short of breath, make sure you are exhaling completely.  You can even add counting to the inhale and exhale in order to keep yourself focused.  For example, count to 4 on the inhale, and count to 4-8 on the exhale. 

Square breathing is another counting technique which involves counting to 4 on the inhale, holding the inhale for 4, exhale for 4, and then holding the exhale for 4 and then repeating. 

2.       Get adequate sleep

Not getting enough sleep can also lead to mood instability and increased anxiety or depression.  If you’re having trouble sleeping, it’s a good idea to figure out the cause of your sleep problems.  The first step in sleeping more and getting better quality sleep is to make behavior changes.  Start with you habits before bed and then take a look at your bedroom and the environment you’re sleeping in.  For example, cut out use of technology an hour before bed, and have a relaxing bedtime routine.  Once you have made changes in those areas, assess and manage any stress more effectively.  If you are still having trouble sleeping, you may want to see a sleep specialist and have a sleep study done to rule out conditions like sleep apnea. 

3.       Reduce caffeine intake

Do you know how much caffeine you are consuming in a day?  Keep track of how much caffeine you are consuming by recording the number of cups of coffee or sodas in your phone or a journal.  It also helps to record if you notice increased anxiety during these times as well.  This will give you a good idea about how caffeine is affecting you.  Some people are unaware of how much caffeine they are consuming.  Caffeine is a central nervous system stimulant, and can cause increased heart rate, jitters, anxiety, and racing thoughts, decreased sleep quality, and digestive issues.   I highly recommend discontinuing caffeine intake after 12 noon in order to make sure that it does not interfere with sleep.  If you do notice that caffeine increases your anxiety, it might be wise to go without caffeine just to see if your anxiety subsides.  If you have been consuming high amounts of caffeine throughout the day, you may want to slowly decrease your consumption gradually in order to avoid severe caffeine withdrawal.

4.       Manage your stress

Stress management is one of the biggest triggers for anxiety.  We all experience stress from time to time, some more than others.  The stress response is helpful in situations in which we are in danger because it propels us into taking action to protect ourselves and our loves ones.  The problem with stress is that many of us are feeling that level of stress in situations that are not necessarily dangerous.  Current life stressors such as providing for your family, caring for kids and loved ones, managing a house hold, and expectations that we place on ourselves can lead us to feeling high levels of stress.  When we feel this stress on a consistent basis, our brain is releasing chemicals that keep us on high alert.  Being on high alert makes it difficult to relax, stop racing thoughts, manage emotions, and think rationally.  It is really important for our emotional and physical health to find ways of managing your stress so that you are not in this high alert state of mind all the time.  Find time to detach from you work and home responsibilities in order to do things that revitalize you such as exercise, meditation, being outdoors and spending time with friends. 

5.        Dietary considerations and exercise

Your diet and what you consume can also affect levels of anxiety.  High intake of refined carbs and sugar can lead to increased anxiety, and also blood sugar fluctuation.  Blood sugar fluctuation itself can lead to physical symptoms that feel similar to anxiety like jitters and shakiness.  It’s important to eat a healthy well balanced diet that follows recommended dietary guidelines.  If you are concerned about your diet or blood sugar irregularities you should consult with your physician for their recommendations. 

I mentioned exercise above as a way to manage stress.  I can’t stress how important physical exercise is to overall emotional and physical health.  Exercise not only is healthy for your physical body, but it also helps you expel built up stress and energy, and if done consistently will help you sleep better.  Exercise is an important part of building a wellness lifestyle in order to achieve optimum emotional and physical health. 

I hope Part One of the Anxiety Reduction Series was helpful!  It’s important to understand the many variables that can impact anxiety and mood stability.  I’m a strong believer that optimal emotional health is just one part of a wellness focused lifestyle.   The mind and body are very connected; therefore any positive changes you make in one area will have a positive impact on other areas.  In Part Two I will outline more advanced skills that I teach throughout counseling in order to help my patients reduce anxiety. 

10 Ways Counseling Can Help You Reduce or Stop Drinking

At Silver Lining Counseling in Charlotte, I have been helping my patients reduce or stop problematic drinking for over 10 years.  Counseling is extremely helpful because it can help you identify what is triggering your alcohol use, and can teach you healthy ways to cope with feelings and life stressors.  Here are just some of the ways counseling can help you reduce or stop drinking.

1.        Counseling can help you identify ways to reduce stress

Stress is probably the number one trigger that can lead to problematic alcohol use.  Whatever the cause of the stress, stress can increase blood pressure, heart rate, and lead you to want to drink alcohol to relieve those feelings of stress.  I can help you find healthy ways of managing your stress, whether that is setting boundaries in relationships, making changes at work, or using breathing and meditation techniques to reduce the physical feelings of stress. 

2.       Counseling can help you identify triggers that lead to drinking

Stress is not the only trigger that can cause someone to drink.  Most people who are trying to cut down or stop drinking have internal and external triggers.  Internal triggers are irrational or unhealthy thoughts or feelings that lead to drinking, and external triggers are things in our environment that trigger thoughts of drinking such as bars and restaurants, relationships, or time of day.  It’s important that I help you identify your triggers so that you can avoid what you can, or change the way you are interacting and responding to triggers.   

3.       Counseling can help you express your feelings in healthy ways

A lot of people drink in order to escape uncomfortable feelings.  However, drinking does not get rid of or resolve those feelings, it simply covers them up temporarily.  Learning how to express your feelings in healthy ways is an important part of the recovery process.   I can help you learn how to express your feelings in healthy ways so that your feelings don’t trigger you to drink.

4.       Counseling can help you learn to think in more positive, healthy ways

Another really important part of substance abuse counseling is identifying irrational or unhealthy thought patterns that trigger uncomfortable feelings like shame or depression.  I can help you identify unhealthy thoughts and then help you restructure them into healthy thoughts that lead to more reasonable and healthy feelings.  This technique is known as cognitive behavioral therapy, and is one of the most well-known and well-studied counseling theories.

5.       Counseling can help you learn coping skills to prevent drinking or drinking too much

Another part of substance abuse counseling that is very important, is developing coping skills that you can use in specific situations in order to prevent drinking or drinking too much.  Many people have to be in situations where they are around alcohol, and this can be stressful and uncomfortable, especially if they are trying not to drink.  I can help you identify ways to handle the situation in order to reduce the likelihood of drinking or drinking too much.

6.       Counseling can help you identify if your drinking behavior is substance abuse or addiction

Addiction is a medical disease that develops after someone has been abusing substances and the brain starts to depend on the substance to feel normal.  If you are unsure if you have addiction, I can help you evaluate your substance use behavior and help you identify if you have any symptoms of addiction.  If you think you might have an addiction, it’s important to have an evaluation by a Licensed Addictions Specialist, like myself. 

7.       Counseling can help you examine your family history to see if there is any genetic predisposition to addiction

We now know that addiction is a genetic disease.  People that have addiction in their family have a much higher chance of developing addiction, especially if one of their parents has struggled with addiction.  Understanding your genetic predisposition gives you knowledge and power in making healthy decisions about your own substance use. 

8.       Counseling can help you identify other untreated mental health symptoms that might be underlying the addiction

Many people who are abusing substances or who have addiction also have a co-occurring mental health disorder like anxiety, depression, or bipolar disorder.  Having another mental health disorder can make it difficult to cut down or stop drinking because the symptoms of the other disorder can trigger substance use.  If you think you may have symptoms of another mental health disorder, it’s important to see a therapist who can treat both the mental health and substance abuse or addiction issues.  I can help you manage the symptoms of mental health disorders, while also cutting down your drinking or stopping altogether. 

9.       Counseling can help you increase your self-worth and self-esteem

One of the most important things I do for my patients is help them increase their self-worth and self-esteem.  Everyone deserves to feel valuable and worthy, regardless of the mistakes they have made.  Not feeling worthy or good enough can lead you to turn to drinking again and again.  I can help you increase your self-worth and self-esteem so that you can start to believe in yourself and know that you can meet your goals and live the life you want.   

10.   Counseling can help you increase your motivation and provide accountability

Research shows that it is important to have accountability if you are trying to cut down or stop drinking.  I can help you find the motivation you need in order to meet your goals, and I can also provide accountability by following up with you each session on how you are progressing toward your goals.  You are in charge of your goals and treatment plan, I am here to support you in meeting those goals. 

I hope this article has been helpful in outlining the many ways that counseling can help you reduce or stop drinking.  At Silver Lining Counseling in Charlotte, I address all of these 10 items and more in helping my patients reduce or stop drinking. 

To schedule an appointment with Kristin, click on the home page and then click the Request Appointment button.

"When Getting Sober Reveals an Underlying Illness" - Great article from Liv's Recovery Kitchen

I really like this article, “When Getting Sober Reveals an Underlying Illness” from Liv’s Recovery Kitchen. Liv describes how adverse childhood experiences can increase the likelihood for chronic illnesses, substance abuse and addiction, injury, and many others.

She also discusses the famous ACES study which is one of the most famous studies done that outlines how our childhood can positively or negatively affect us based on the types of experiences we had as a child. Here’s the link to the study in case you want to read more: https://harmreductiontherapy.org/wp-content/uploads/2014/11/Origins-of-Addiction-ACE-Study.pdf

"The Heart and Science of Kindness" - Article from Harvard Medical School

I’m a firm believer in karma and the notion that you get back what you put out into the world. Being kind to others is something that we know makes us feel good, but research shows that when we are kind to others or watch kind acts by others, it makes us happier.

“The Heart and Science of Kindness” is an article by Brodrick for Harvard Medical School. Brodrick explains the ways in which we can practice kindness to others, but also to our selves. She points out that when we are kind to ourselves we are kinder to the people around us as well. Just like any new behavior, remembering to be kind to ourselves and others takes practice. Brodrick discusses how feeling compassion towards others can help lead to acts of kindness.

How to Increase Self-Worth in Addiction Recovery

So, you’ve made the decision to get sober. You’ve gone to detox or treatment, or stopped using on your own and now you’re trying to get a hang of living life sober. You feel like you’re doing everything right, but you have this nagging self-talk that is critical and judgemental about your every move. This type of self talk is actually pretty common in early addiction recovery, but it doesn’t have to be this way. You can change your self talk and increase your self worth and confidence. Here are a few tips for how to increase self-worth in addiction recovery:

1. Surround yourself with positive healthy people that support your recovery

   It’s really important when you’re getting sober to surround yourself with healthy, positive support people. Seek out family and friends who will affirm your choice to get sober and are willing and happy to do sober activities with you. If you don’t have any family or friends who are supportive of your recovery, attend sober support groups such as AA or NA and start to form a group of sober friends that affirm and support you.

2. Practice positive self talk and affirmations

   Addiction can lead to painful consequences and broken relationships. Some people feel a lot of guilt and shame when they get sober because of what might have happened while they were using. Some people had negative core beliefs about themselves before they started using, and used substances to escape these negative beliefs. It’s really important to begin to talk to yourself in healthy and positive ways when you stop using in order to build positive self -worth and reduce the risk of relapse. Begin by choosing an affirmation every day that is present tense and true. Some examples are: “I am worthy”, “I deserve recovery”, or “I am good enough just the way I am”. Say the affirmation to yourself out loud at least 20 times per day while looking at yourself in the mirror. It might seem uncomfortable at first, but it gets easier every day, and can have a big impact on how you feel about yourself. Another important part of building self-worth is noticing critical and judgemental self talk and replacing it with healthy self-talk. A helpful strategy is writing down the negative statements and then writing out healthier statements in order to practice restructuring your thoughts.

3. Engage in behavior that makes you feel good about yourself

   Another effective way of increasing self worth is to engage in behavior that makes you feel good about yourself. For example, waking up early and getting to work on time contributes to more positive thoughts about yourself then if you had slept through your alarm and were late to work. Make a list of all of the behaviors or things you do that make you feel good about yourself and try to practice some of these each day. Everyone has their own unique list of behaviors that make them feel good about themselves in healthy ways, but here are some common examples: Stay sober, go to a meeting, exercise, call sponsor, pray or meditate. Practicing behaviors that make you feel good about yourself will help you build self-worth and self confidence over time.

   I hope this article gives you some ideas on how to increase your self worth in addiction recovery. If you have tried some of my suggestions but you are still struggling with negative self-talk, it might be helpful for you to see a therapist who can help guide you through the process.

"7 Tips to Sleep Better Naturally" - Great article by Laura McKowen

When getting sober, a lot of people struggle with insomnia or other problems sleeping such as difficulty getting to sleep or staying asleep. Sleep is SO important in early recovery. The brain is trying to heal and balance itself out after addiction, and it needs that time to regenerate during sleep. Sleep also helps us balance out our emotions during the day, and so not getting enough sleep in early sobriety can cause some people to relapse.

Check out this article by Laura McKowen, “7 Tips to Sleep Better Naturally”. She is a sober woman who uses these techniques to help her sleep. I really like the 7 tips that she discusses, especially making your bedroom a sanctuary and getting a weighted blanket. I’ve used various weighted blankets as well, and they are great for calming anxiety before bed, but you can really use them anytime.

Check out this article and try out some of these tips tonight!

"Can Exercise Help Conquer Addiction" - Interesting article from Harvard Medical School

We know that exercise is a part of healthy lifestyle and has also been shown to help combat anxiety and depression as well. It appears that exercise may help treat addiction as well. According to this article “Can Exercise Help Conquer Addiction” by Claire Twark for Harvard Medical School, there is some research that shows promising results that exercise may help treat addiction.

In her article, Twark outlines some recent studies involving animals and humans that show promising results. She also discusses how there are now organizations popping up throughout the country that promote physical activity for people in recovery.

I personally feel that exercise is an important part of a recovery program for a number of reasons. Exercise can help new sober people create a healthy schedule and routine. Exercise and sports can help sober people connect socially in healthy ways, and also helps the body and the brain start to heal after addiction. While exercise is an important part of recovery, I do think it’s important to remember that a recovery program combines many forms of treatment modalities like exercise, meditation, psychotherapy, self help support groups and medication assisted treatment if appropriate.

"The Summer Party Survival Guide for People in Recovery" - Great article by Anne De Santis Lopez for Shatterproof

The summer months are usually associated with cookouts, outdoor activities and parties. So what does this mean for people in recovery from addiction? It definitely can make things challenging, especially if you are newly sober.

Anne De Santis Lopez for Shatterproof wrote a great article “The Summer Party Survival Guide for People in Recovery” that outlines 10 ways to survive these summer activities and parties sober. She outlines great tips if you CHOOSE to go to an event, I do think it’s important to remember that you DO NOT have to go if you feel like the situation will be risky for your recovery.

Some of the tips she mentions are:

• Get the Scoop Ahead of Time - get useful information before hand from the hosts like number of people, activities at the party, and who will be going

• Ask for Support - Reach out to people who will be at the party for support. Talk to the host if you feel comfortable

• Have an Exit Strategy - Always drive yourself and decide in advance what the right time will be to leave. Plan a 12-step meeting to attend right after to help get yourself grounded again if need be

If you have a party or event coming up check out this article to make sure you feel comfortable and keep your recovery safe!

5 Signs You Might Be Codependent

Codependency is not a clinical diagnosis, but it’s a word that’s been around for decades.  Made most famous by Melody Beattie’s Codependent No More, codependency is now a term that we hear a lot, but what does it mean?  How do we know if we are codependent?  What’s wrong with being codependent? There are plenty of times in life when we do nice things for others or take responsibility for certain aspects of a relationship.  For example, in a parent child relationship, the parent is obviously responsible for making sure the child’s basic needs are met. 

However, in a relationship with another adult the dynamic is very different.  Both adults are equals in the relationship and are responsible for their own thoughts, feelings, and behavior.  The problem comes when one person in the relationship takes on the role of being responsible for the other person’s feelings or behavior.  An extreme example of this is in an alcoholic family system.  One family member normally becomes the chief enabler in order to try to control the alcoholics behavior, prevent consequences, and “keep the peace” in the home.  The problem with codependency is that it prevents the codependent person from taking care of themselves.  Many codependent people have spent years taking care of others and not addressing their own emotional, spiritual, and physical needs.

Here are 5 signs that you might be codependent:

·         You’re a people pleaser

Have you been told you are a people pleaser?  Are you constantly trying to make other people happy?  Being a people pleaser is an exhausting role to play.  You are constantly having to read people and their behavior in order to try to “guess” what they are thinking or feeling.  People pleasing once in a while is not a problem, but if you are always trying to read others and what they might be feeling in order to please them or control their feelings or behavior, you’re fighting an uphill battle.  It’s impossible to know exactly what others are thinking or feeling, and no one has the power to make someone feel a certain way, we just aren’t that powerful. 

·         You put other’s needs before your own

Do you think other people’s needs are more important than your own?  Do you sacrifice your own needs so that loved ones can get their needs met?  You may not be doing this consciously, but some people are so used to putting other’s needs before their own that they do it automatically.  In some extreme situations like an alcoholic home, the stress that the alcoholic creates in the home can be extremely overwhelming and the other family members feel they have no choice but to do what is necessary to control the alcoholic’s behavior in order to prevent consequences.  This normally means the family members end up sacrificing their own needs because all of their time spent is directed towards the alcoholics needs. 

·         You take responsibility for other people’s emotions or behavior

Are you only happy if your loved ones are happy?  Do you think that you can control other people feelings or behaviors?  Do you think you can make someone feel happy or joyful?  Do you feel you can take away someone’s sadness, anger or depression?  Taking responsibility for other people’s emotions or behavior is a trait that most codependent people have.  Codependent people mistakenly think that they can control the way people feel or behave. 

·         You don’t set boundaries

Do you stay quiet when someone hurts your feelings?  Do you feel like its “mean” to tell someone how their behavior has affected you?  Do you avoid conflict at all costs?  If you answered YES to any of these questions, it might be beneficial for you to start to set some boundaries with people around you.  If you are not setting boundaries because you are afraid of how the other person might respond, this is usually a sign of codependency because you are taking responsibility for how the other person might react.  The truth is that you cannot control other people’s feelings or behaviors.  If you choose to set a boundary in a healthy and respectful way, you are not responsible for how the other person chooses, yes chooses, to respond.  Notice how I emphasized that other people choose how they respond, you do not make them respond in a certain way. 

·         You harbor resentment towards others

Deep down do you feel resentful towards others because of how they treat you?  Do you react in passive aggressive ways in order to try and get what you want in your relationships?  If you answered YES to either of these questions, it could be that you are not speaking up for yourself in your relationships and it is leading to you building resentment towards people whom you have not set boundaries or have not been assertive with.  One of the consequences of not setting boundaries or standing up for yourself is not feeling heard or getting your needs met.  If this is the reason you are feeling resentment towards others it might be helpful to seek the help of a counselor or therapist to help you start to set boundaries and practice assertive communication. 

I hope this post has been helpful in determining if you might be codependent.  If you think you might have a problem with codependency, it might be helpful to schedule an appointment with a therapist to discuss how to begin to set boundaries in your relationships. 

What is the "Sober Curious" Movement?

I’ve been hearing the term “Sober Curious” for a while now. What does it mean and how did this movement get started?

Ruby Warrington wrote the book “Sober Curious: The Blissful Sleep, Greater Focus, Limitless Presence, and Deep Connection Awaiting Us All on the Other side of Alcohol” which is what the Sober Curious movement is based on.

It seems that the “Sober Curious” movement is trying to challenge our societies current state in which alcohol is woven into every aspect of life. In our society it’s nearly impossible to attend any event where alcohol is not served. Since Warrington’s book came out, the movement has spurred the start up of sober bars and hangouts in major cities. As a substance abuse counselor, I am hopeful that this movement will make it easier for people with substance abuse problems to come forward and get help.

However, an article from the Guardian talks about how this movement could actually minimize the seriousness of substance abuse and addiction, and the fact that addiction is a chronic medical condition that requires treatment. Treatment for substance abuse and addiction is a lot more than just choosing to be “sober curious”. For many with addiction, getting treatment is a life or death situation and requires interventions such as medical detox, residential treatment, outpatient treatment, sober living, etc.

As with any new movement or trend, there are things we can gain, but also things we need to be cautious about. The Sober Curious movement can help our society see that living sober can be rewarding, satisfying, and enjoyable, and it may prevent underage drinkers from choosing to drink at all. The movement can also help those in the beginning stages of substance abuse feel more comfortable choosing sobriety or getting help due to sobriety becoming more accepted in our society. However, we have to be careful not to minimize the seriousness of addiction and that for some, intensive treatment will be needed for them to achieve and maintain sobriety.

If you are concerned about your own substance use but are not sure if you can stop on your own, it’s a good idea to get an assessment from a Licensed Addictions Specialist.

Do I Have a Drinking Problem?

Do you often wonder if you have a drinking problem?  If so, below are 4 questions you can ask yourself to better determine if you have a drinking problem.  These questions come from the Cage Questionnaire.

Have you ever felt that you should cut down on your drinking?

This is an important question.  If you answer YES to this question, this means that you are starting to feel concerned about your drinking.  For example, let’s say you go out with some friends and only plan on having 2 drinks, but you end up getting drunk and needing to take an Uber home.  The next morning you wake up feeling concerned that you drank too much and maybe cutting down would be a good idea.  This is an example of feeling concerned about your ability to control how much you drink. 

Have you become annoyed when people criticize your drinking?

If you have felt annoyed when others have criticized your drinking, this means that others are noticing your drinking behavior and they are concerned.  This is also a sign that your drinking may be starting to affect your relationships.  If someone has criticized your drinking, it might be a good idea to take a look at how your drinking might be affecting others.  Is your drinking causing you to get in fights with family or friends?  Is your drinking causing you to miss important events with friends and family because you’re too hungover to attend?  These are just two examples of why others may be concerned about your drinking. 

Have you ever felt guilty because of your drinking?  

Most people who are concerned they have a drinking problem have felt guilty at some point.  The reason for this is that if your drinking is a problem it is going to cause you negative consequences.  These negative consequences might surface in your relationships with family and loved ones, at work, or legal problems such as a DUI.  You are experiencing guilt because you know that your behavior is affecting you and others in a negative way.  If you are feeling guilty about your drinking, it’s important to take a look at how your drinking is negatively affecting your life. 

Have you ever drank in the morning to get rid of a hangover? 

If you answer YES to this question, what this means is that you have developed a tolerance and possibly physical dependence to alcohol.  This definitely suggests that there is a drinking problem present, and most likely alcoholism. 

If you answer YES to 2 or more questions, there is a possibility that you might have alcoholism and it is important to have an assessment with a licensed substance abuse counselor.  However, if you answer YES to even 1 of these questions it’s time to take a hard look at your drinking.  Normal social drinking does not result in you or others being concerned, feeling guilty, or morning drinking.  If you are unsure if you have a problem with alcohol, it definitely won’t hurt to schedule an appointment with a licensed substance abuse counselor and see what they have to say.  The most important thing you can do is be completely honest with yourself and others.  It might be easy or convenient to try and convince yourself that your drinking isn’t that bad.  However, if you are not honest with yourself and there is a problem, it will only progress and continue to cause you negative consequences.  I hope this article is useful in helping you determine if you might have a drinking problem. 

"Creating Recovery-Friendly Workplaces" - Great article published by Harvard Medical School

I found this article recently and thought it was a great way for employers to get more education on how to support their employees in recovery. Employees in recovery have their own unique needs, and historically most work environments have not acknowledged or addressed these needs. It is also important for employers to understand that some industries are more prone to employees having addiction, such as the construction industry. Not only would it be helpful and supportive for their employees to create a recovery friendly workplace, but it would also increase productivity. The article outlines a number of great ideas such as having peer support group meetings in the workplace, and also offering flexible schedules so that employees can get to therapy or treatment appointments.

Check it out!

https://www.health.harvard.edu/blog/creating-recovery-friendly-workplaces-2018120615520

Hope Runs For Recovery 5k - Charlotte - This is a great way to support addiction recovery!

The Hope Runs For Recovery 5k is in Charlotte on Saturday September 28th. The proceeds will benefit The Herren Project and the Emerald School of Excellence. This is an awesome way to support addiction recovery!

Check it out!

https://runsignup.com/Race/NC/Charlotte/HopeRunsForRecoveryCharlotte

The Blanchard Institute's Family System Workshop - July 26th-28th in Charlotte! Free for the whole family!

The Blanchard Institute’s Family System Workshop is a fantastic resource for those in recovery and their families. I have attended the workshop myself and can speak to how powerful and informative it is!

It’s coming up in a few weeks, July 26th-July28th and is free for families! Take advantage of this wonderful opportunity!

https://theblanchardinstitute.com/events/family-system-workshop-a-recovery-healing-experience-for-the-entire-family-5/

3 TOOLS I USE TO FEEL LESS ANXIOUS →

Anxiety is a common feeling that most of us experience throughout life.  However, for some, anxiety can be more pervasive and debilitating.  As someone with an anxiety disorder, I have learned and practiced many tools to help me relax and reduce my anxiety.  Here are just a few that I use on a daily basis:

1.       Count your breaths

If you’re feeling anxious, a simple but very effective way to calm anxiety and your nervous system down is to count your breaths.  You can do this in a number of different ways, you can count your inhales until you reach 10, and then start over again.  Or you can practice counting your breath in cycles of 4:  Count to 4 on the inhale, hold for 4, exhale for 4, and then hold for 4, then repeat.  Counting your breaths brings your focus to your breathing and off of the thoughts running through your mind that might be causing you to feel anxious.

2.       Focus on your 5 senses

Another way to calm yourself down when feeling anxious is to focus on yours 5 senses.  Focus on what you are seeing, what you could touch, what you are hearing and smelling, and what you are tasting in that moment.  Bringing your attention to what you notice through your 5 senses helps you to not focus on the thoughts in your mind that might contributing to your anxiety.

3.       Focus on facts NOT fears

If you know for a fact that it is the thoughts you are having that are causing the anxiety, a helpful tip is to write down the facts of the situation.  Too often when we’re anxious, we are actually thinking about the future and worse case scenarios that probably won’t happen.  Writing down the facts of the situation can bring your rational brain back on line and help challenge the anxious thoughts and fears you are having. 

I hope these tools help you as much as they have helped me!