Psychiatric treatment and psychotherapy. These are broad, general terms that refer to a general approach many many different emotional and mental problems. Effective substance use disorder treatment is a specific and specialized approach to a medical condition. The brain does not process chemical intoxicants correctly and it leads to severe dysfunctions in behavior. That is- compulsive use of said intoxicants. Based in the brain. We can SEE the malfunctioning parts of the brain. This compulsive unwanted desire, NEED to use sometimes leads to incomprehensible ethical and moral deviation in a person.
Effectively treat a substance use disorder and you will effectively treat a broad array of psychiatric conditions in the process.
Effective treatment of a psychiatric condition has no effect on a substance use disorder; in fact, it will often enable that substance use disorder to fester, hide and lead the patient to rationalize the need to keep using the very fuel for a very bad fire that is killing them. Often a slow and ugly death that destroys many lives in its way.
Specialized substance use disorder is VITAL; especially when a less intensive, though vital, intervention such as AA has not been effective to stop that fire. Most people w the disorder can get abstinent and healthy within AA. Some folks, a smaller percentage, require stronger treatment using specialized medical and psychiatric care.
More to come. If interested in such discussion, follow my site at recovery101. Its getting refreshed Jan 2018!
Saturday, December 30, 2017
Saturday, September 19, 2015
Forgiving
Forgiveness is a state of mind. It is a state of one's spirit. Forgiveness is hard. Most days, I am sure I really don't understand it at all.
Forgiveness is the choice I make every day of my life. It does not come naturally to me, especially if one has not corrected their ways. Over decision to stop using my tongue to mess with that aching tooth. I prefer to just have it (the wound, the violation, the memory burnt into my mind, heart, soul) all eradicated from my memory. But that is not going to occur.
I used to believe that forgiveness was something I chose to do and then it would exist, or occur. Almost like a light switch. 'Ok, jody, time to forgive that person'.
Often I have the belief that the human brain is very close to a lizard's, with minimal evolutionary progress beyond reptilian. There are people, of course, that have evolved beyond the rest of us. But, it's not really their brain, is it? Perhaps it's really their soul. Or their grit? Or, is it just courage? Perhaps I am having a slight crisis of faith in the strength and courage of human beings.
Perhaps forgiveness is more similar to tracks in a ditch. The more times I spin my wheels on the tracks in a ditch, the deeper they set. Stop going over the tracks, eventually the tracks will fade.
I am thinking more of acceptance, perhaps. Maybe forgiveness is first dependent on acceptance, and there comes the rub for me. And my ego may not always allow me to accept my weakness, my vulnerability, my innocence. My ignorance, foolishness and arrogance.
Today is about waking each day and making the active choice to actively forgive my trespasses. And I do need to start there every morning. Don't replay the pain; occurrence. Free my spirit from resentments.
Forgiveness is the choice I make every day of my life. It does not come naturally to me, especially if one has not corrected their ways. Over decision to stop using my tongue to mess with that aching tooth. I prefer to just have it (the wound, the violation, the memory burnt into my mind, heart, soul) all eradicated from my memory. But that is not going to occur.
I used to believe that forgiveness was something I chose to do and then it would exist, or occur. Almost like a light switch. 'Ok, jody, time to forgive that person'.
Often I have the belief that the human brain is very close to a lizard's, with minimal evolutionary progress beyond reptilian. There are people, of course, that have evolved beyond the rest of us. But, it's not really their brain, is it? Perhaps it's really their soul. Or their grit? Or, is it just courage? Perhaps I am having a slight crisis of faith in the strength and courage of human beings.
Perhaps forgiveness is more similar to tracks in a ditch. The more times I spin my wheels on the tracks in a ditch, the deeper they set. Stop going over the tracks, eventually the tracks will fade.
I am thinking more of acceptance, perhaps. Maybe forgiveness is first dependent on acceptance, and there comes the rub for me. And my ego may not always allow me to accept my weakness, my vulnerability, my innocence. My ignorance, foolishness and arrogance.
Today is about waking each day and making the active choice to actively forgive my trespasses. And I do need to start there every morning. Don't replay the pain; occurrence. Free my spirit from resentments.
Tuesday, September 9, 2014
Power of No
I have been thinking about the power of no. Been on my mind all week. So, I googled it. I love when nouns become verbs...
Being a people pleaser can be easier in the short term. Be agreeable and going along. Learning balance and listening to your inner truth. Sometimes my truth is hard to come to; sometimes 'the easier softer way' is my truth. But, that is ok. It is NOT ok to base my decisions on it. And, at times, I do.
I was thinking about little children- 3-4 years old. What is the response when a little boy says no. How do the adults around respond? what messages do they give that child? Now think about when a little girl says no. How to the adults react?
Often in life, just saying yes can open up an entire new world to us. Definitely.
Being a people pleaser can be easier in the short term. Be agreeable and going along. Learning balance and listening to your inner truth. Sometimes my truth is hard to come to; sometimes 'the easier softer way' is my truth. But, that is ok. It is NOT ok to base my decisions on it. And, at times, I do.
One struggle for me, "it's easier if I do it myself". Self centeredness.
Sunday, September 7, 2014
Psychotherapy- what it is good for?
Someone I respect a great deal recently told me that he thought psychotherapy was mostly bull[pucky]. That therapists all used the similar obtuse non sensical language (no single meaning for the word boundaries or self care, or co dependency or depression) language and that it was very unscientific, and pretty much useless. I have to admit, I agree with this in many ways.
I think we have sold ourselves as the solution to everything from relationship problems, to trauma, to depression, to child rearing. Problem is- first we were very good at selling this myth, and second- that it is simply bullpucky. And, psychotherapy is NOT good, and this is backed by most all good outcome studies, at helping folks with a substance use disorder- stop using, and to stay stopped.
Another problem is that there are no standards for outcomes. And, when there is- say in depression or substance use (decreased depressive sx, or stopping use) if the treatment does not 'work' the patient is always to blame. And frankly, it does not work more than it does. How do you charge for something that rarely works? A therapist will say- I charge for my time and skills, not for outcomes. Sort of like your stock broker. It's risky investment. Strange profession.
Maybe we should say- people get better, not well! Better than what? Than when they came in. It's advice, take it or leave it? We are simply not honest about what we can and cannot do. Especially in regards to substance use disorders. Individual psychotherapy is NOT EFFECTIVE at treating substance use disorders. Some individual treatment can augment and improve outcomes when added to 12 step and groups treatments. And there are now a number of effective medical interventions that help a great deal.
So, we are left w two questions: What works for the individual with a substance use problem, and second- what IS psychotherapy good for?
I'll tell you my thoughts in the next week or so...
I think we have sold ourselves as the solution to everything from relationship problems, to trauma, to depression, to child rearing. Problem is- first we were very good at selling this myth, and second- that it is simply bullpucky. And, psychotherapy is NOT good, and this is backed by most all good outcome studies, at helping folks with a substance use disorder- stop using, and to stay stopped.
Another problem is that there are no standards for outcomes. And, when there is- say in depression or substance use (decreased depressive sx, or stopping use) if the treatment does not 'work' the patient is always to blame. And frankly, it does not work more than it does. How do you charge for something that rarely works? A therapist will say- I charge for my time and skills, not for outcomes. Sort of like your stock broker. It's risky investment. Strange profession.
Maybe we should say- people get better, not well! Better than what? Than when they came in. It's advice, take it or leave it? We are simply not honest about what we can and cannot do. Especially in regards to substance use disorders. Individual psychotherapy is NOT EFFECTIVE at treating substance use disorders. Some individual treatment can augment and improve outcomes when added to 12 step and groups treatments. And there are now a number of effective medical interventions that help a great deal.
So, we are left w two questions: What works for the individual with a substance use problem, and second- what IS psychotherapy good for?
I'll tell you my thoughts in the next week or so...
Sunday, August 31, 2014
Rigorous Honesty
I did not realize, when first read this line, that it meant that I had to learn to be more honest with myself. That it meant learning how to dig deeper, to peal away the layers of lies I have told myself and my loves. I had long lost that skin that separates you from me. I lost myself long ago. I could reframe, deny or simply ignore what stared me straight in the face every day.
I really thought that it meant that I had to not lie to you. I could do that, when I needed to. I knew when I lied, just figured it was none of your business. Lying to others is really not that big a problem. It is lying to myself that is the problem.
So, here are a few things I have learned along the way. These are what I believe are the basics to recovery. Recovery from mental illness and recovery from dependency. Most of it I have learned through the grace of my wonderful, courageous and generous patients. And, some of it I earned from my own pain and egregious ego, and from those few moments of enlightenment.
I really thought that it meant that I had to not lie to you. I could do that, when I needed to. I knew when I lied, just figured it was none of your business. Lying to others is really not that big a problem. It is lying to myself that is the problem.
So, here are a few things I have learned along the way. These are what I believe are the basics to recovery. Recovery from mental illness and recovery from dependency. Most of it I have learned through the grace of my wonderful, courageous and generous patients. And, some of it I earned from my own pain and egregious ego, and from those few moments of enlightenment.
Saturday, August 30, 2014
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