How Our Occupational Therapists Help Trauma Patients
Most of us take for granted our ability to complete the most basic steps associated with self care and social engagement. We never really consider that brushing one’s teeth, taking a shower, or having even the briefest social interaction with a stranger may be an emotionally strenuous task for some individuals. Naturally, when a person suffering from post traumatic stress disorder (PTSD) tries to explain the difficulty they experience executing daily tasks, it is not uncommon for them to be met with objections or to have their issues dismissed and be told to simply “get over it.” This advice is in no way helpful to the firefighter who is triggered by the sound of their own children crying, after witnessing children dying in a fire while on the job. And this certainly does nothing to assist the war veteran who relives moments on the battlefield everytime they hear the sound of aircraft overhead. From the decades of research on PTSD, one thing is abundantly clear—avoidance is not a viable option. Enter occupational therapy.
What Is Occupational Therapy?
Occupational therapy is a form of treatment for individual suffering from addiction or mental health disorders that interfere with their ability to perform daily tasks associated with living a normal, healthy. Occupational therapy focuses on three main areas:
- Self Care: includes personal hygiene, grooming, and healthy eating
- Productivity: includes maintaining employment or attending school
- Leisure: includes playing sports, team activities, and personal hobbies
Occupational therapists will often try to restore a patient’s self-confidence by breaking down big tasks into smaller, more manageable subtasks for the patient. This approach prevents the patient from feeling overwhelmed and gives them a sense of achievement by proving a series of small wins that bring them incrementally closer to achieving a big goal.
Symptoms of Post-Traumatic Stress Disorder
The biggest commonality among first responders, veterans, and survivors of abuse with post-traumatic stress disorder (PTSD) is that it impairs their abilities to move forward after the traumatic event. PTSD symptoms create severe psychological limitations that promote self-destructive behaviors. Through repetition, these behaviors become habits that an individual will feel unable to control, much less stop. PTSD symptoms are usually grouped into four categories:
- Intrusive memories
- Avoidance of triggering situations and emotions
- Negative changes in thinking and mood
- Changes in physical and emotional reactions
In his book, The Evil Hours: A Biography of Post-Traumatic Stress Disorder, David J. Morris describes the aftermath of trauma as follows:
Trauma destroys the fabric of time. In normal time you move from one moment to the next, sunrise to sunset, birth to death. After trauma, you may move in circles, find yourself being sucked backwards into an eddy or bouncing like a rubber ball from now to then to back again. … In the traumatic universe the basic laws of matter are suspended: ceiling fans can be helicopters, car exhaust can be mustard gas.
Understanding Your Emotions Helps Manage Symptoms
Our emotions are an important part of our individual growth and development. They can help us with everything from situational awareness to establishing healthy relationships. Distinguishing between an appropriate emotional response and a dysfunctional one can be a challenge for individuals with post-traumatic stress disorder (PTSD). Our occupational therapists teach patients principles and skills to help them better understand their emotions:
- Your emotions can provide you with useful information or important signals.
- Emotional signals can often be useful, but they should not be treated as facts.
- Your emotions are important, but keep them out of the driver’s seat when it comes to making certain types of decisions.
- Staying connected to your emotions is essential for developing useful coping techniques. However, you must also maintain the capacity for rational analysis of your reactions to situations and be able to evaluate whether or not your reaction is appropriate.
- In some situations, the appropriate action for you to take may be the opposite of what your emotions are telling you to do—this is called “opposite to emotion action.”
The process of working with occupational therapists is both collaborative and goal oriented, making it easy for patients to track their progress.
The Wise Mind: Balancing Emotion and Reason
When we are in our emotional mind, our actions are predominately based on our emotions and how we are feeling. Our response to stress or triggering situations is extremely reactive as we abandon logic, fact, and reason when our emotional mind has taken over. An example of your emotional mind taking over is when you overreact to a situation because it triggers a negative memory of a similar situation; your fear that something similar to your memory may happen again drives your overreaction, even if it is actually extremely unlikely.
We would all like to believe that we operate from our reasonable mind, however this is not always the case. The reasonable mind is the part of us that is based solely on logic and rational information. It gathers and interprets empirical information from our observations and forms beliefs and opinions based on that information. If drives actions that are are cool, controlled, and strategic. The reasonable mind is very useful in crisis situations. Many military personnel and first responders can tell you, being able to access the reasonable mind when you need it can be the difference between life and death. The reasonable mind is excellent for planning and evaluating big life decisions, however, it is possible to overdo it and fail to recognize and consider the significance of our emotional signals. Overuse can create habits such as minimizing our feelings, and compartmentalizing events that could be pivotal to our development by diminishing our emotional connections to them. Such habits could lead to depression, burn out, or feeling numb.
The wise mind is the integration of the reasonable mind and the emotional mind. It is a functional blend of strategic thinking guided by healthy emotional awareness. It is the capacity to consider past experiences, current perceptions, and theoretical knowledge, to arrive at a constructive understanding of one’s present situation. Our occupational therapists teach our patients techniques to make the wise mind more easily accessible and available to help them manage their trauma symptoms.
Problem Solving: Barriers and Strategies
Problem solving can be difficult for the average person on any given day. It requires us to use all aspects of our mental capacity to analyze a particular set of circumstances and available choices, and then produce a solution. An ideal solution would not only satisfy our immediate need, but would also be consistent with our long-term goals. This process can be extremely difficult for individuals suffering from mental health or substance use disorders as they may not trust their own judgement and or accuracy in assessing a situation.
Barriers to Effective Problem Solving
The first step that our occupational therapists take with patients is to help them identify common barriers to solving problems quickly and effectively, including the following:
- Looking for a perfect solution
- Feeling hopeless or helpless; believing that a satisfactory solution does not exist
- Feeling depressed, distressed, or anxious to the point that one cannot focus on problem solving
- Excessive fatigue to the point that impairs cognitive ability
- Underdeveloped problem-solving skill set
Strategies for Effective Problem Solving
Occupational therapist also teach patients a range of effective problem-solving strategies that can be used in different situations, including the following:
- Algorithms: An algorithm is a iterative, step-by-step procedure that produces a better solution with each iteration. While it has a high change of producing a good solution, it can be very time consuming.
- Heuristics: A heuristic is a mental rule of thumb, such as an educated guess, stereotype, or generalization. Many people tend to employ this particular strategy when faced with a series of complex problems to reduce the possibilities to a more manageable number.
- Trial and error: This approach can be effective when the number of potential solutions is small and the cost of failure is low. The idea is to try solutions, learn from the results, and keep trying until a satisfactory solution is discovered.
- Insight: With this strategy, the solution to a problem may appear “all of a sudden.” Many researchers believe that insight occurs when a person recognizes features of a current problem that are similar to a problem that the person has successfully solved in the past.
Subjective Unit of Distress Scale and Coping Strategies
It can be very difficult for those suffering from substance use and mental health disorders to clearly recognized and understand how they are feeling at any given time. Occupational therapists provide patients with tangible metrics to help them the recognize, isolate, and react appropriately to negative stimuli. The Subjective Unit of Distress Scale (SUDS) works as an emotional gauge, and is a crucial part of therapy. The SUDS protects patients from their more destructive emotions by teaching them practical ways to distract themselves from what they are feeling. The objective is to turn this distraction, which may be unusual to the patient in the beginning, into their habitual response to extreme stressors.
Occupational Therapists Help Patients Get Back to Their Lives Faster and Better
Recovery from post-traumatic stress disorder is a difficult process that requires hard work and commitment from the patient. Occupational therapists help facilitate this process and allow patients to return to their normal lives more quickly, with effective coping skills, useful habits, practical knowledge, and effective problem-solving strategies.
Call Us for More Information
If you would like to learn more about the treatment programs provided by EHN Canada, enrol yourself in one of our programs, or refer someone else, please call us at one of the numbers below. Our phone lines are open 24/7—so you can call us anytime.
- 1-800-387-6198 for Bellwood Health Services in Toronto, ON
- 1-587-350-6818 for EHN Sandstone, in Calgary, AB
- 1-800-683-0111 for Edgewood Treatment Centre in Nanaimo, BC
- 1-888-488-2611 for Clinique Nouveau Depart in Montreal, QC
Integrated Treatment of Substance Use Disorders and Concurrent Post-Traumatic Stress Disorder (PTSD) Is The Most Effective Approach
Post-traumatic stress disorder (PTSD) can develop after an individual has been exposed to a traumatic event such as death, serious injury, or a threat of harm to themselves or to others. When exposed to such events, it is normal to feel intense fear, helplessness, and horror, but in most cases, these feelings are eventually resolved—but, unfortunately, not always. Some people experience long-lasting and intrusive symptoms such as disturbing flashbacks, heightened states of arousal, mood disturbances, and avoidance of memories about the event. These are the symptoms associated with PTSD.
Post-traumatic stress disorder (PTSD) is more common than you might think. An estimated 1-in-10 Canadians will experience PTSD at some point in their lives. Certain populations are at higher risk of developing PTSD because they are more likely to experience traumatic events. Members of the military are often seriously injured, witness the death or injury of others, and have their lives seriously threatened. Many veterans returning from Iraq and Afghanistan report being targets of enemy gunfire, knowing someone who was injured or killed, or even having to handle dead bodies. Such experiences can have a lasting effect on an individual’s mental and emotional well-being.
There appears to be a bi-directional causal relationship between developing post-traumatic stress disorder (PTSD) and developing a substance use disorder. People with PTSD experience persistent and disturbing psychological symptoms, which make them more likely to use alcohol or drugs as coping mechanisms. Conversely, people with substance use disorders are both more likely to experience traumatic events and less likely to be able to process them effectively.
Compared to either disorder alone, concurrent post-traumatic stress disorder (PTSD) and substance use disorders are associated with worse mental and physical functioning, and higher levels of psychological distress. When these two disorders are concurrent, the negative effects can be quite severe: they can impair a person’s ability to work, to maintain healthy relationships, and to maintain a positive outlook on life. As a result, people with concurrent PTSD and substance use disorders will often experience rapidly deteriorating physical and mental health, and should therefore get treatment as soon as possible.
There are several treatment options available for individuals with concurrent post-traumatic stress disorder (PTSD) and substance use disorders, including both medical therapy and psychotherapy. Historically, treatment focused on resolving the substance use disorder first, before proceeding to address the PTSD. However, the historical approach risks exacerbating a patient’s PTSD symptoms: when a patient with PTSD narrowly focuses on trying to resolve their substance use disorders, they are likely to be confronted with challenges and discomfort for which they are not yet adequately prepared. Today, however, most clinicians recognize that patients’ substance use is closely related to their PTSD symptoms. Hence, at EHN Canada, we believe that the most effective treatment approach is through integrated treatment programs that address both disorders together.
EHN Canada’s integrated treatment model acknowledges the fundamental interdependence between post-traumatic stress disorder (PTSD) and substance use disorders. Therefore, we address the two disorders at the same time, usually within the the same treatment program. Substance use disorders are conceptualized as tools—albeit highly dysfunctional ones—that people use to try to manage their PTSD symptoms. We educate patients and provide them with a new, healthier, and more effective set of tools, early on in their treatment programs. This reduces the likelihood that a patient’s PTSD will compromise their recovery from their substance use disorders. Our conviction that the integrated treatment model produces superior outcomes is also supported by patients’ attitudes: research has found that patients with concurrent PTSD and substance use disorders report an overwhelming preference for the integrated approach.
Post-traumatic stress disorder (PTSD) and substance use disorders have a complex interrelationship. EHN Canada treatment programs teach patients how to recognize and manage their symptoms and triggers. We also help patients create solid recovery plans that serve to guide their long-term behaviour changes. EHN Canada’s individualized treatment programs also push each patient to discover their own unique strengths and skills. We encourage and support our patients to further develop these abilities to support their successful recoveries and recovery maintenance. Patients complete EHN Canada treatment programs having developed functional and adaptive coping strategies, as well as assertiveness and effective communication skills. They walk out our doors ready to face the world, full of optimism, and eager to get back to their relationships, families, friends, and careers.
Call Us For More Information About Our Programs
If you would like to learn more about the treatment programs provided by EHN Canada, enrol yourself in one of our programs, or refer someone else, please call us at one of the numbers below. Our phone lines are open 24/7—so you can call us anytime.
- 1-800-387-6198 for Bellwood Health Services in Toronto, ON
- 1-587-350-6818 for EHN Sandstone, in Calgary, AB
- 1-800-683-0111 for Edgewood Treatment Centre in Nanaimo, BC
- 1-888-488-2611 for Clinique Nouveau Depart in Montreal, QC
Breathing under water: living with health, wholeness, serenity and addiction
B Y L E E H A U S M A N N M A , I C C A C
“Breathing Under Water”
I built my house by the sea.
Not on the sands, mind you;
not on the shifting sand.
And I built it of rock.
A strong house
By a strong sea.
And we got well acquainted, the sea and I.
Not that we spoke much.
We met in silences.
Respectful, keeping our distance,
but looking our thoughts across the fence of
Always, the fence of sand our barrier,
always, the sand between.
And then one day,
— and I still don’t know how it happened —
The sea came.
Without welcome, even
Not sudden and swift, but a shifting across
the sand like wine,
less like the flow of water than the flow of blood.
Slow, but coming.
Slow, but flowing like an open wound.
And I thought of flight and I thought of
drowning and I thought of death.
And while I thought the sea crept higher, till
it reached my door.
And I knew then, there was neither flight, nor
death, nor drowning.
When the sea comes calling you stop being
Well acquainted, friendly-at-a-distance,
And you give your house for a coral castle,
And you learn to breathe underwater.
~ Unpublished poem by Sr. Carol Bieleck,
It’s approximately 7:30 on a cold, clear February morning. I am standing at the floor-to-ceiling windows admiring the skyline of downtown Vancouver from our hotel room at Executive Suites. Our tentative plan is to take a side trip to Edgewood in Nanaimo and visit former clients. When travelling, I always bring my own instant coffee. I have gone from being an epicure of fine wines and hard drugs to a connoisseur of coffee. Our suite comes well equipped with an electric kettle for my morning indulgence. This suite also features a luxurious whirlpool tub which juts out into the walking space of our room. I pour the hot water into my favorite mug from home. As I am stirring, I walk towards the windows to admire the view and suddenly I am on the floor, coffee mug smashed on the marble edge of the tub, blood gushing from my hand. Nausea wellsup in my stomach as I realize what happened. I tripped over the whirlpool tub. I look at my left hand and two fingers are cut open. It doesn’t look good.
My partner calls for a taxi to take us to St. Paul’s Hospital. It’s a challenge for me to get into the cab with a smashed up hand and white bath towel soaked in blood. The driver gives me a frown of disapproval, warning me not to get blood on his seats. As we drive up to the emergency doors of the hospital, my hand is throbbing and the nausea increases. The staff at St. Paul’s is efficient and compassionate. After an agonising insertion of four needles to freeze my hand, I see the emergency doctor who quickly and competently sews up my fingers. No tendons were severed, but he suspects a nerve was sliced. This needs to be looked after when I return home.
Seven days later, I am prepped at SunnyBrooke Hospital for emergency hand surgery. I change into gowns, the standard one in front, one in the back. I am asked to lie on a hospital bed, answer a series of questions while an IV is inserted into my wrist. I ask, “What is this for?” The nurse says, “Just something to relax you.” I hadn’t expected this. The hand surgeon had said I didn’t need anything. Then without warning, the dopamine hits my brain and I’m getting ecstatic in the anticipation of mood altering drugs. I can’t believe it! I have been clean and sober for over twenty years, but when this information hits my brain I am feeling considerable anticipation and excitement. The anesthetist is standing over me in the operating room. I hear the shuffle of instruments, and then the drug hits! Ah, I’m feeling it, that first intense rush in my lower throat, then the captivation of my brain with intoxication, warmth and relaxation, like a mother’s hug. But I’m an addict, and it’s never enough. And I can’t believe what I do next. I have the audacity to say to her, “Did you know that if one dose is good, two will be better?” Through the haze, I hear her say, “Uuumm? Ok.”
“It all comes flooding back. How well
I know these rules. I teach this. I live
this. Active addiction, it’s just one
step away, one drink away, one
More. Never enough. No “Off” button. Never safely use again. Can’t stop at one. Obsession of the mind. Allergy of the body. Powerless. It all comes flooding back. How well I know these rules. I teach this. I live this. Active addiction, it’s just one step away, one drink away, one drug away.
The surgery is over and the benzodiazepines wear off. I’m prescribed Tylenol 3s. My daughter picks me up and drops me at home. I take the Tylenol as prescribed the first time, but the second time I think, “Two are good but four are better.” My addict is back, but not for long. I reach out to my partner, a good member of Al anon. He comes to take them away. A sigh of relief. The next day, I am at work and everything is back to normal, except my bandaged hand. Am I going to drink or use drugs again? No, I won’t. How can I say that with such conviction and so conclusively? It’s because I have learned to breathe under water.
Breathing under water is my ability to face a life crisis or have a brush with mood altering substances and not return to my addiction. When faced with difficult challenges and feeling like I am gasping for air, I have learned to accept the things I can’t control and let things be. I can drop into a place within myself that allows me to keep breathing without becoming consumed by external circumstances. “The New Testament called it Salvation, Buddhism calls it Enlightenment and the 12 Steps call it Recovery.” (Richard Rohr, “Breathing Under Water”)
I am a woman, a mother, a partner,a therapist, an active AA member, and I am an addict. My addiction is my treasured gift.
When I hit bottom, a timely Grace saved my life and led me to the rooms of 12 Step recovery. This crisis has been an opportunity for great spiritual growth. Using the tools laid before me through the 12 Steps, I was able transform my thinking, my belief system and my interactions with this world. I opened up to a new way of seeing, a new level of clarity, and a higher level of consciousness. I had no success until I acknowledged that all my human strength and willpower weren’t enough to fight this disease. I was going to drown. But instead, I surrendered. I was then taught to breathe under water through the “Work” of recovery. My journey began with rigorous honesty and humility. I had to admit I was at the end of my human capacity to stop my addiction and learn to surrender. In this surrender, I found a strength far greater than my own.
Hope replaced the hopelessness. The idea of faith was presented to me, but one that was expansive and inclusive. I then made a decision to turn my will and life over to the care of this power. Once I had built a foundation of faith, I was able to summon the courage to do a fearless, moral inventory. I needed to examine my life and my actions and take responsibility for harm I had done to myself and others. “The unexamined life is not worth living,” stated Socrates. Working through the Steps helped me to identify unhealthy patterns of behaviour. In my case, pride, ego, self-righteous anger, gossip, people-pleasing, and judging and controlling were all qualities that needed to be addressed. It required humility to realize my limitations while acknowledging my strengths. The paradox of humility is that I am both great and small. Continued daily mindfulness and reflection helps address issues in the moment, stopping them from growing into resentments or tensions. Self searching has become a habit and helps me to achieve and maintain emotional sobriety. I am able to sustain this through a meditation practice and service to others.
“In my case, pride, ego, self-righteous
anger, gossip, people-pleasing, and
judging and controlling were all
qualities that needed to be addressed.
It required humility to realize my
limitations while acknowledging my
strengths. The paradox of humility is
that I am both great and small.“
Breathing under water isn’t always easy. Some days I wonder, “Am I going to drown?” No, I am not. I have built a foundation for living that I step into with ease. When the waves of life threaten to disrupt my serenity, my work in recovery has taught me to drop into my centre and draw from the internal resources of faith, strength and love. I am then able to breathe under water. Inspiration for this article is taken from Richard Rohr’s book, Breathing Under Water, Spirituality and the Twelve Steps.
Lee Hausmann MA, ICCAC joined Bellwood Health Services in 2011 as a therapist focusing on individual and group therapy and has been involved in the field of addictions for over 20 years.
Lee holds a Master of Arts Degree in Addiction Counselling from the Hazelden Graduate School of Addiction Studies in
Minnesota. During her post-graduate specialization, she also completed her clinical training which included new patient
assessments, chemical dependency diagnosis, treatment planning, and aftercare recommendations. Lee is also a member of the Canadian Addiction Counsellors Certification Federation and holds an ICCAC certification.
In addition to her work at Bellwood, Lee maintains a private practice helping both men and women address their chemical dependency. She founded Women of Substance — an organization that supports women in recovery and their spiritual growth.
How Do You Know If Someone Is Addicted to Drugs or Alcohol?
“I drank too much the other night, that won’t happen again!” “I just need one more hit. I’m fine!” You may have often heard people you care about say these phrases and not think twice about them- until recently. Perhaps, there have been changes in their behaviour that have you concerned.
Changes in behaviour can be a sign of mental illness or addiction. Unfortunately, many people don’t understand what addiction is or how it develops. Addiction is not something that happens overnight. It’s not something you decide to try as you would decide to try Starbuck’s latest Frappuccino.
The World Health Organization (WHO) states that addiction and mental illness affects approximately 10% of the population at any point in time. WHO also reveals that one in four families has at least one member currently struggling with addiction or mental illness. Addiction has no boundaries.
At Bellwood, we’ve seen all walks of life enter our doors and all of them share the same disease. Many of them have lost, or are on the brink of losing so much because their drinking or substance use has spiraled out of control. How do you define addiction? How do you know if someone’s drinking or drug abuse has become a larger problem than previously believed?
Addiction is the inability to stop using a substance despite the negative consequences experienced. People have many different reasons why they become addicted but there is one thing they do share in common. That is the desire to change the way they feel or in some cases, numb the pain. The feelings they get from using alcohol or drugs are what can lead to substance abuse and eventually result in physical and psychological dependence.
Individuals struggling with addiction may:
- Experience physical or psychological withdrawal when he or she tries to stop drinking or using drugs
- Be unable to control how much he or she consumes
- Continue to drink or use drugs despite experiencing consequences at work, physically and/ or in relationships with other people
Other common characteristics of addiction include disconnection and isolation. Trauma or previous experiences in a person’s life may have been the reason why the person turned to substances to medicate unpleasant emotions. As a person plummets deeper into the disease of addiction, isolation becomes more apparent.
Do these behaviours sound familiar? If you’re concerned about a loved one’s drug or alcohol use, or perhaps it is yourself that you’re concerned about, Bellwood has an online quiz for alcohol and drug abuse. Responses to these questions may indicate that you need to talk to an addiction counsellor.
- Do you ever get drunk or high alone?
- Has drinking or using drugs stopped being enjoyable?
- Do you find that your choices of friends are selected based on your alcohol/ drug use?
- Do you drink or use drugs to cope with your feelings?
- Is it difficult for you to imagine a life without drinking alcohol or using drugs?
- Do you plan your life around your use of drugs or alcohol?
- Do you drink or use drugs to avoid dealing with the problems in your life?
- Are you ever not completely honest about your use of drugs or alcohol?
- Have relatives or friends every complained that your use of drugs or alcohol is damaging your relationship with them?
- Has your use of drugs or alcohol caused problems with motivation, concentration, memory, and relationships, at work or with your health?
- Have you failed to keep promises you made about cutting down or controlling your use of drugs?
- Do you feel anxious or concerned about how to obtain more drugs or alcoholic beverages when your supply is near empty?
Addiction is a disease that affects many people and is often described as a family disease. It’s important that you consult with a professional to get a better understanding of what’s happening with your family member or with someone you care about. Bellwood Health Services is an addiction treatment centre that provides support and treatment options for individuals, family members and employers.
Talking to someone is an important step towards addiction recovery. Give us a call at 1-800-387-6198 or email us at [email protected] to learn how we can get you started on your path of recovery.
Intensive Outpatient Program For Addiction Begins At EHN Montreal
The newest clinic in the Edgewood Health Network is now offering our Intensive Outpatient Program. On February 1st, EHN Montreal began running the program designed for those who want to participate in intensive addiction treatment while continuing to maintain their day-to-day lives. Inpatient treatment is not suitable or possible for everyone seeking help, and so we’ve created a high-quality outpatient program that meets the needs of those clients.
The Intensive Outpatient Program (IOP) includes over 90 hours of psycho-social education, group therapy and individual therapy. Clients are able to explore the underlying causes of their addiction and address them in a safe and supportive environment.
Programming in English has already begun with a French IOP following in May. Intensive Outpatient treatment has already been extremely beneficial to many clients in our other locations. Brent Lloyd, clinical manager of EHN Calgary, says that the program is popular even though it’s difficult. “Participants have asked for extensions on their three month program because of the growth they’re experiencing. They are interested thriving and not just surviving. It is not for the faint of heart, however, the dynamics that transpire when you treat people with respect and invite them to be part of community is inspiring to watch. The gratitude they express is humbling. ‘I feel heard, loved, seen and shame and guilt is not driving my life.’ We also hear ‘this stuff is hard.’ We remind them, yes, but not as hard as living in active addiction.”
Ivy Tolchinsky is EHN Montreal’s Clinical manager. Ivy is passionate about recovery and has dedicated over 12 years of her work experience to the field of addiction as a counsellor, supervisor and group facilitator. During that time she
has dealt with a wide range of individuals at various stages in their recovery process; from newcomers to those struggling with issues in later recovery. She empowers people to use their lifestyle transition as a learning process to find new and fulfilling directions while maintaining sobriety.
If you or someone you know would like more information about the IOP in Montreal, please call 514-521-9023 or visit edgewoodhealthnetwork.com/montreal to learn more about the various services offered at EHN Montreal.
Five Things You Need To Know About Interventions
How do you get someone who is so immersed in their addiction to listen up and realize that they need treatment? There are many reasons why someone suffering from a substance use disorder may not want to go to treatment. Some don’t believe they have a problem, some may think they can get well on their own.
And yet, there has been much research done on the psychological or physical conditions a person needs to get well. Some organizations believe in the idea of ‘rock bottom’ – hitting an absolute low allows the person to realize they need help. Others believe that a person must be individually motivated to get well in order for therapy to work. Because of this, families are often at a loss as to how to help their loved one.
For some families, an intervention can be an option. When performed properly by a licensed clinician, interventions can help individuals to see their behavior more clearly and motivate them to seek treatment. There is very little scientific data about the effectiveness of interventions because experts have had trouble agreeing on the definition effectiveness. A clinical study was conducted on a sample of 331 people by the State University of New York determined that the Johnson Intervention was very effective at engaging and maintaining clients in residential treatment. Approximately, 86% and 90% of those who had undergone an intervention were admitted to treatment. Out of those individuals, 83% graduated from treatment.
We spoke with Andrew Galloway, Edgewood Health Network’s National Director, an International Certified Alcohol and Drug Counselor as well as one of TV’s Intervention Canada lead interventionists on the power of interventions. In Andrew’s experience, most interventions are successful. He believes interventions are a loving way to motivate a person to get help for their addiction. Family members, friends, and employers come together to express their concern for the addict, share how the addiction is affecting them, and ask their loved one to enter a treatment program.
There are key aspects that come with carrying out an intervention that you should be aware of if you think it may be right for your family. Remember that interventions should never be carried out without an experienced clinician.
- Educate yourself on the disease of addiction: Have everyone involved in the intervention speak to an addiction specialist ahead of time to learn how and why this disease happens. It’s important for loved ones to understand that it’s not their fault. You may contact CAMH, The Drug and Alcohol Helpline or Edgewood Health Network to provide you with information and support.
- Understand that the individual doesn’t know the impact their addiction is having on your family: People that are caught in the cycle of addiction are in denial and they don’t always understand the damage that their addiction has caused. An intervention can help them gain that understanding.
- It’s crucial that you express compassion and sincere concern for the person’s welfare: For an intervention, participants are asked to write a letter about their concerns and examples of how the person’s addiction is affecting them. Avoid sounding judgmental and confrontational. An interventionist will help you set boundaries around your relationship with the individual if they decide not to get help.
- The addict can reject help and refuse to go to treatment. This doesn’t mean the intervention has failed. By carrying out an intervention, the family has actually started their own path of recovery. Interventions can also be therapeutic for family members to know that they’ve done everything they could to help. On the other hand, interventions can work and it’s important to have an action plan if the person agrees to treatment. Select a person to take the lead to make arrangements ahead of time to get someone admitted into treatment.
- Interventions are highly intense and can be an emotional rollercoaster for everyone involved. Have a certified interventionist, a doctor or a certified addiction counsellor lead your intervention. This can help with the whole process to ensure the intervention is conducted appropriately in a non-threatening, respectful and supportive manner. The interventionist can also help family and friends prepare, rehearse and stay on point with what is shared during the intervention.
While interventions can be highly effective in persuading a loved one to enter treatment for drugs, alcohol, gambling or sex addiction– one should first educate themselves on the disease of addiction. Andrew says, “Family members, friends and employers must be aware that rejection may be a part of the intervention process, but is certainly very rare. There is no such thing as a failed intervention. It isn’t over until the addict either goes to treatment or the family gives up on their bottom lines and return to old behaviours.”
Interventions are not for everyone and it’s typically a family’s last resort. Consult an interventionist to help you determine if an intervention is appropriate for your loved one. They will provide you with the support and direction on how to start a journey of recovery for everyone.
To speak to someone about getting help for a loved one who is struggling with an addiction, please contact us. You can also speak to Andrew Galloway, Interventionist at the Edgewood Health Network by calling 647-748-5501.
Can You Be Too Old To Start Recovery?
More research has been showing an increase in the number of older people, including baby boomers, overdosing or abusing drugs and alcohol. Perhaps you thought addiction only affected young people or the wealthy? Studies are revealing that substance abuse in seniors is becoming an urgent matter in geriatric medicine. Some seniors are becoming addicted to painkillers or alcohol, and they need help.
At the Edgewood Health Network (EHN), our addiction treatment centres in Canada see people from all walks of life. However, recently we have been seeing a steady increase in older people seeking help for addiction. Some of you may be asking, “Can you be too old to start recovery?”
The Pressures of Life
I sat down with one of the first addiction counsellors at Bellwood Health Services, DR, an incredibly honest and compassionate person who always tells it like it is to clients coming into treatment. DR has worked in several capacities at Bellwood. From marketing, outreach to admissions – he’s done it all. As a person who’s been in recovery for almost 40 years, DR has seen the way factors such as technology, education, and the family unit have changed and perhaps placed enormous pressure on people to “keep up” or get left behind.
“The pace of the world we live in is causing people to create high expectations for themselves and everyone around them. A university graduate versus a trades person is perceived differently now than it was decades ago. The number of people and their concern to stay connected virtually, the immediacy that is expected from others to respond immediately, or the race to enroll your children in everyone else’s kids’ sports or hobbies are examples of stress that people are now experiencing that didn’t exist before. More stress leads people to want to stop the world and just get off. Some people try to relax through yoga or meditation. But there are others who will say it’s too much of a hassle to drive there or that they have no time. So what do they do? They use chemicals. It’s something to help them escape. And they can use it whenever, wherever.”
Nothing Changes if Nothing Changes
Of course, life changes as you get older. Financial circumstances may change, your family can grow or perhaps it gets a bit smaller with the loss of a loved one. If you haven’t reached out and received help for your alcohol or prescription drug abuse, chances are your life has spiraled out of control; you haven’t been handling the changes in your life in a healthy manner and you are still using after several years. DR acknowledges that confronting his disease and getting treatment for alcohol addiction was what he had to do to change his life.
“I think about how blessed I am not to use chemicals or alcohol anymore to escape or handle my problems. We learn through 12 step program, old-timers, and others that you must confront each situation and resolve it rather drug or drink it away, as it will just come back. Recovery modalities have changed and there are many more options since I undertook my alcohol recovery. You still have to work at it ONE DAY AT A TIME and remember to call someone if you need help. Yes, I still do the occasional meeting; not every month or every day, but I drop in and listen. It validates once again that my three bosses back in the beer industry did a great thing by not putting their heads in the sand, but instead confronting me about my disease. I thank God they did. Relapse is always close at hand. If we get away from our program it can be easy to slide down that slippery slope.”
It also helps to be a part of team at an addiction treatment centre when you’re in recovery. “Working in this facility is like going to an AA meeting as it validates that the road of recovery that I chose many years ago was the right one. It cements the choices I have made. Yes, it is wonderful to see the graduates leave. They usually leave somewhat anxious, but if they use the tool kit filled with information and techniques we gave them, it will certainly assist them.”
Some Wise Words About Early Recovery
Early recovery can be a challenge for most people who have just finished treatment. Some say it’s where “the real work begins.” DR recommends avoiding certain places, have an exit plan if need be, and don’t forget to visit your regular support group.
“Avoid places in early recovery that are triggers for you. Examples might be baseball games or dressing rooms from beer league hockey where you might feel pressured to drink to be one of the boys again. There is nothing wrong with saying you are in recovery. Some see it as a very strong point and are proud of you for the accomplishment. If you go to a function early in recovery where alcohol is present, a wedding for example, have a plan to leave. Share it with someone else before you arrive. Let them know that if you are struggling and need to leave, you will give them a sign that you need their support to leave. It could be your spouse, a friend, a business associate, a son or daughter. HAVE A PLAN and follow it. Go to meetings. They are wonderful and a place where you can be thankful for your sobriety. Participate in aftercare, wherever form that might take. It can take place at the doctor’s office, AA meetings, with a therapist, at an addiction centre, etc. I attended the YMCA for 25 years as part of my recovery plan.”
Getting Help if You Are a Senior for Substance Abuse
We asked DR if it was possible to be too old to start recovery.
“The first pearls of wisdom would be to mention a story of a graduate from the Credit Valley Alcohol and Drug program who attended AA. I was invited to his birthday party for his recovery. He was celebrating one year sober – 91 years young! You are never too old to be sober. One of my uncles by marriage could not stay sober and attended AA late in his life. He passed away sober. That was all his children ever wanted. He was three years sober. I believe the oldest graduate at Bellwood Health Services was roughly 83.”
If you suspect an older loved one or patient may be abusing drugs or alcohol, Bellwood Health Services can provide a complimentary assessment and provide early intervention. Give us a call or email us to learn more about how we can help.
The Importance Of Aftercare In Recovery
For those suffering from addiction, the consequences can be devastating. People lose their jobs, damage their relationships with friends and family, and face financial hardship. It becomes cyclical; substance abuse creates these personal difficulties and in turn, they can cause stress and trigger the individual to use more frequently. In other words, abusing substances becomes the individuals primary means of coping with life’s difficulties. When this happens, the environment becomes so toxic that admission into a residential addiction treatment center may be necessary to give the individual a chance at recovery.
Residential treatment offers a safe environment to begin to repair the damage caused by addiction. At this stage, people are very vulnerable and treatment provides a safe place away from triggering situations in which they might relapse. They can focus on healing and recovery. Clients are taught more constructive coping strategies, relapse prevention and grounding techniques. They can then begin to practice and refine these skills without the outside pressure of their environmental stressors.
While residential treatment is a necessary first step, recovery really consists of using coping, grounding and communication tools in “real life” situations. Without prior experience practicing these newly acquired tools, the recovering addict is susceptible to return to past behaviours and may relapse. Therefore, early recovery is a time of transition and one where aftercare support becomes vital to long term behaviour change. Continuing care is an active way the individual can build on the foundation of recovery that he/she has established in residential treatment.
There are many support systems available to individuals in early recovery. Aftercare supports can consist of self-help groups such as Alcoholics Anonymous, individual counselling, or outpatient groups run by addiction treatment organizations. Furthermore, these meetings take place throughout the day and into the evening, making them easier to attend. Also, with the latest technology trends there a variety of aftercare meetings available online.
Attending aftercare benefits the participants by giving them the ability to share their experiences using active coping skills in real life situations. Individuals may receive feedback on how they can improve these skills going forward or receive reinforcement that they are progressing well. Another benefit is the opportunity for the individual to belong to a community that they can relate to – one that is supportive, but will also hold each other accountable when needed. For example, aftercare can help individuals come to a realization that they may be on a risky path of returning to their previous behaviours. These groups also provide members with the opportunity to pass knowledge onto others who are beginning their journey of recovery. Imparting knowledge and experiences onto newcomers can help reinforce an individual’s commitment to abstinence and a life of wellness.
Research has also demonstrated the importance of aftercare. Studies have found that regular aftercare participation is one of the best predictors of success following treatment. For example, a long-term follow-up study spanning 40-years, found that those who were able to maintain longer periods of abstinence were attending 20 times as many meetings as those who were not able to maintain abstinence. Bellwood’s own outcome research has demonstrated that 83% of those who engaged in two or more regular aftercare supports were high recovery (continuously abstinent or achieved at least 95% reduction in substance use) at six-months follow-up from residential treatment.
There are many different forms of aftercare, but it is important to remember that attending any form of aftercare is an improvement over leaving the treatment center overconfident. Recovery requires continuous work on the skills learned in treatment and is a lifelong process. As the Chinese philosopher Laozi once said ‘a journey of a thousand miles begins with a single step’ and each week of successful engagement in support, is a successful step on the road of recovery and lifelong wellness.
Substance Use and Addiction: What Does Work Have to Do With It?
Could your job be encouraging a substance use disorder?
Addiction can affect anyone, regardless of their job. But there are certain fields where substance abuse and addiction are more common, and they tend to have a few things in common. Research shows that high stress, low job satisfaction, long hours or irregular shifts, fatigue, repetitious duties, boredom, isolation, irregular supervision and easy access to substances can all contribute to the problem. But what groups are most affected?. We know that employees in the arts and entertainment, mining and food services are more likely to report heavy drinking in the past month compared to other employment groups. On the other hand, employees working in healthcare and education are the least likely to report heavy alcohol use.
Risk Factors Explained:
There are several factors associated with different types of jobs that may lead to an increased likelihood of problematic substance use. Low employee visibility and isolation can be high risk for substance use and misuse. Jobs that involve a substantial amount of travel, and therefore less direct supervision such as some sales jobs, construction or contracting jobs, can lead to increased substance use. In addition, social and workplace norms around drinking and drug use can also contribute to the problem. Some work environments are more permissive that others and it has been found that perceived acceptability of drinking by coworkers is one of the strongest predictors of drinking behaviour. In some industries such as the food and beverage service industry, alcohol is easy to acquire right on the job, making it easier to consume. Therefore the normative belief that it’s okay to have a drink while at work, coupled with the easy access to alcohol can make it extremely likely that an employee in a bar or restaurant will consume alcohol while on the job. If the employee works every day, it can become a daily habit that can ultimately lead to it’s misuse and possibly abuse.
Another important contributing factor is the issue of employee stress. Stress can come from various sources including physical hazards or heavy workloads, tight deadlines, low job security and workplace conflict. These factors can lead to an employee feeling little or no control over what happens at work. Jobs that offer very little control, combined with increasing demands, can place the employee at risk for substance use as the alcohol or drugs may be the employee’s form of coping with the demands and stress of the work environment. Therefore employers should be aware of possible stressful situations and should emphasize work/life balance with employees.
What to do?
It is important to note that not all employees working in high risk occupations will go on to develop an addiction. Instead, it is likely that a combination of several causes, including individual factors such as genetics, social, cultural, and mental health issues, places an employee at greater risk for developing a substance use problem. In order to minimize this risk, it helps if employers are aware of the common signs of substance abuse and receive adequate training in how to approach an employee that might need help.
It is also important to establish clear organizational policies about substance use in the workplace. Employees need to have clear expectations about workplace rules and repercussions that would follow should an employee choose to break those rules. Employers should also be aware of how the work environment or job features may lead to maladaptive coping or other unwanted behaviours such as drinking alcohol or using drugs. This knowledge could shape the workplace culture such that employees feel empowered to approach a supervisor when concerned or taking some time to rest and recover when feeling stressed or overwhelmed.
So pay attention to the signs. Try to minimize stress, isolation and fatigue. Work on creating a culture where health and self-care are more important than drinking and using.
Mindfulness: From Distraction to Stillness
Stillness. The calm surface of a lake at dawn. The silence of an empty chapel. The soft quiet of a night full of stars. How we wish at times for our minds to settle, and just be still. For the pointless worries to stop, that ceaseless chatter. What we should have done, what we should be doing, what we should be preparing for. The tyranny of the shoulds. Our minds are constantly doing, always trying to fix things, change things, make things better. Trying to close the gap between where we are, and where we think we should be. From the second we get up in the morning, to the time we fall asleep at night. What should I have said to her on the phone last weekend? What can I do about my weight? All big questions, to be sure, but do they never stop? Why can’t we shut our minds off? It’s something I hear in the office all the time. I can’t focus, doc. I can’t turn my brain off. It won’t let me sleep. It must be ADHD. Isn’t there a pill you can give me?
Modern society doesn’t help. There’s always another distraction out there. Something else to do. Cellphones, Facebook, Twitter, Google. More channels on TV. More ads. Faster cars. Better hair. Whiter teeth. Another thrill, another sensation. Don’t stop, or you might miss something. A constant need for ‘more’. It isn’t hard to see where addiction fits in.
What’s the answer? How does one stop ‘doing, doing, doing’, and just ‘be’? How do we learn to control our minds, and not have them running in circles, taking us with them? For a few, the diagnosis really is ADHD, and treatment for this can help. For most of us though, the problem isn’t that we can’t pay attention, but that we’ve forgotten how to. This is where the gentle practice of mindfulness can help. Mindfulness is the awareness that emerges through paying attention, in the present moment, to things as they are. It’s what happens when you start to notice what’s going on, both outside you, and on the inside, in your thoughts and feelings. Noticing what it’s like to eat an apple and enjoy it, rather than ‘scarfing’ down lunch so fast you can’t remember 10 minutes later what you just ate. Noticing what your thoughts are, but then remembering that they’re just thoughts, and that you don’t have to react to them.
A simple way to begin being mindful is to take a minute and just focus on your breathing. Try it. Let your breath be your ‘anchor’. Notice how each breath in fills you with energy, and how each outward breath lets go of tension. Sit with your breathing for a moment, and notice what happens. Let whatever happens happen. You might notice how the soles of your feet feel on the floor. You might become aware of all the sounds around you. Notice it, and then come back to being aware of your breathing. A thought might cross your mind. Just notice it, like it’s a cloud crossing the sky. Then gently let it go, and come back to your breathing. You don’t have to react to every thought. Thoughts and feelings come and go all the time, like bags coming down the baggage chute at the airport. If you choose, you can sit with them and let yourself experience them. On the other hand, you can let them go, and just come back to your breathing. You can control what you pay attention to, and for how long. You can learn to control your mind, rather than letting your thoughts and impulses run away with you. It’s a skill, which means it takes practice, but it’s a skill worth learning. And the payoff, ultimately, is stillness.
By: Dr. Charlie Whelton, M.D., FRCP(C), ASAM Certified
How Sugar Affects the Brain: Video Highlights Similar Effects Between Drugs & Sugar
Food is one of our primary sources of pleasure, and critical to our survival. In a healthy reward pathway of the brain, food is a natural stimulus that produces feelings of pleasure from the release of dopamine. This gratifying feeling makes this activity worthy of repeating, as we want to experience it again. However, not all foods have the same effect on the brains’ reward system. So why do certain foods activate the brains’ reward system more than others? Sugar, salt and fat are three substances that ‘hijack’ the brains’ reward system, by releasing a burst of dopamine, similar to the effects of drugs and alcohol. As more research emerges, we gain knowledge about how a diet of large portions of refined and processed foods affect the way our brain responds to food. Some individuals develop a dependence on these foods to feel happy and satisfied, and eventually develop a tolerance by needing more of these ‘addictive’ foods to experience feelings of pleasure. Dependence and tolerance are fused with the fundamentals of addiction, reinforcing the link between food and addiction. This video from the TED Talks series highlights how foods high in sugar can have a similar effect on the brain as drugs, alcohol and other addictive behaviours.
WHO Report Declares Alcohol Kills 1 Person Every 10 Seconds
Addiction has become one of the most critical health problems facing our species.
A new study released last month from the World Health Organization (WHO) reveals that alcohol kills 1 person every 10 seconds. The study states that alcohol was the reason that 3.3 million deaths occurred in the world in 2012 and that 16% of people who drink alcohol alcohol binge drink. In addition, not only does risky alcohol consumption lead to addiction, it also puts people at a higher risk for developing more than 200 different disorders. Shekhar Saxena, head of the WHO’s Mental Health and Substance Abuse department, has stated that these numbers actually translate into 1 death every 10 seconds.
Several people who work in the addictions field were probably thinking the same thing I was. Well, that’s no surprise. What was alarming to me was the number of deaths that were accounted for alcohol only! Many of you may be discovering in your practice or in the workplace that the odds of finding someone with merely an alcohol problem is becoming quite rare.
Individuals are dabbling into prescription drugs and street drugs as well as developing other dangerous compulsive behaviours such as sex addiction, eating disorders and problem gambling. Finding the proper treatment for individuals who are facing concurrent disorders has become one of the major and important missions for healthcare professionals across the world.
What does this data tell us?
The WHO continues to be an authority for health within the United Nations system. The purpose of WHO is to provide guidance and direction on global health matters, set health standards, communicate evidence-based policy options, as well as monitor and assess health trends. In essence, they are a legitimate source of statistical data and have the resources to clinically confirm how countries are responding to global health problems.
The fact that the WHO’s report states that 3.3 million people died in 2012 because of alcohol, means 3.3 million people drank excessively and severely to the point of causing bodily harm to themselves or to others. No one sets out to develop heart disease, cancer or addiction. Yet, the reality is addiction has become one of the most critical and detrimental health problems facing our species.
How did this happen? Why didn’t we save more lives?
Addiction is a Primary Healthcare Problem
I believe there are a number of people who don’t think addiction is still a serious problem in today’s world. Several healthcare authorities and associations do tremendous work to help prevent our youth from developing addictions, from binge drinking, and to prevent individuals from driving while under the influence. So why would these problems still exist and at such a prevalent rate? The reason is because numerous individuals do not view addiction as a primary health care issue. It is still viewed as a social and economic issue.
What is the definition of primary health care? According to Health Canada, “primary health care refers to an approach to health and a spectrum of services beyond the traditional health care system. Primary Care is the element within primary health care that focuses on health care services, including health promotion, illness and injury prevention, and the diagnosis and treatment of illness and injury.”
Addiction is an illness and it’s been acknowledged by medical authorities across the globe. It has been and continues to be a primary health care problem that affects everyone. Yet, primary healthcare professionals struggle to find treatment for their patients because many countries have failed to provide its citizens one of the major components to primary healthcare- and that is proper treatment of addiction as an illness.
The Major Gap – Building Awareness to Providing Treatment
As I mentioned earlier, several preventative and awareness campaigns are published frequently every year on the dangers of alcohol abuse and drugs which are fantastic for those who have no history of abuse, no trauma, no major health problems, no financial issues, and has a dependable support network, as well as has a great foundation for handling life stresses.
Some individuals may have the knowledge and be blessed to not have such issues, have the right people in their life, as well as be open to discussing their problems. Yet, several individuals unfortunately face or have faced such challenges and do not know how to manage and pull through. These individuals thus turn to unhealthy behaviours or substances to cope with the pain, despite the negative consequences, and thus are beyond the awareness campaign. These people are in need of medical and psychological treatment.
What You Can Do
If you know someone who may have an alcohol problem or any other behavioural problem and are struggling, the most important thing you can do is acknowledge the problem and offer a helping hand. We need to stop creating campaigns that accusingly point finger at individuals who clearly have the disease of addiction and change the words we use to stop the stigma that has been around for decades. We need to show these individuals through our actions and words that it is understood that addiction is an illness and that it is important to seek treatment for it. Just as you would seek Chemo for cancer or get insulin for your diabetes, people who need addiction recovery need professional treatment to treat their disease.
The sooner we acknowledge addiction treatment and the several benefits of it on the economy, the workplace, the family unit, and the judicial system, the closer the world will be at achieving the WHO’s voluntary global target to reduce harmful alcohol use by 10% by 2025.
Health Canada. (2012) About Primary Health Care. Retrieved from: https://www.hc-sc.gc.ca/hcs-sss/prim/about-apropos-eng.php
Thomspon Reuters (2014). The Knowledge Effect: World Alcohol Consumption. Retrieved from https://blog.thomsonreuters.com/index.php/world-alcohol-consumption-graphic-of-the-day/
World Health Organization. (2014) Global Status Report on Alcohol and Health 2014. Retrieved from https://apps.who.int/iris/bitstream/10665/112736/1/9789240692763_eng.pdf?ua=1
Time Magazine (2014). Alcohol Kills 1 Person Every 10 Seconds, Report Says. Retrieved from: https://time.com/96082/alcohol-consumption-who/