We also want to thank Brad Lamm, our sponsor for this issue. His unique style of interventions empowers the person with the addiction to choose his or her own treatment, and also offers Lifestyle Intervention Engagements for six months after the initial interventions. He currently offers intervention trainings on the West and East coasts, as well as in London (http://interventionspecialists.org/intervention-training/) – we’re proud to join forces with him and support the work he does.

This month, Dr. Tian Dayton provides us several practical exercises for forgiveness, including step-by-step instructions to take your clients through. She also offers us her new app based on her book, Forgiving and Moving On – a veritable banquet of forgiveness skills.

Change takes many forms, and Larry Smith presents the four psychological skills he associates with lasting transformation in sobriety. Using equal parts 12 Step principles and his personal experience, Smith’s approach looks at long-term recovery from a different angle that is bound to resonate with many.

New contributor, Jeffrey Cohen, offers his legal experience to the subject of referrals in the addictions community. This is a must-read for any clinician, in the interest of maintaining best practices.

Charlotte Reznick returns to the pages of RecoveryView.com with eight simple, easy-to-teach and use imagery techniques for children. These coping skills are great for adults, too!

It’s no secret that trauma is often the launching point for all sorts of addictions, due to its ability to transport the addict to a less-painful place. The origin of this state of mind is actually the disassociation that very often takes place at the point of trauma. Jasmin Rogg eloquently explores this topic in her article, as well as how to find healing and reintegration of the self.

Adolescents are a notoriously difficult lot to treat. More so when alcohol or drugs is involved. New RecoveryView.com author Josh White tackles this particular challenge with wilderness therapy, a unique approach to an obstinate population that proves extremely effective.

Enjoy our Spring issue – perhaps outside near some blooming trees or flowers – and breathe deeply the spirit of hope and renewal.

Blessings,

Jim & Josie

Tian Dayton’s best-selling book, Forgiving and Moving On, is now an app, courtesy of Health Communications. Learn more here: https://itunes.apple.com/us/app/daily-affirmations-for-forgiving/id439405037?mt=8

Forgiveness is a process not an event.

Rather than an endgame, forgiveness is important and beneficial because it motivates us to work through the powerful feeling and thought patterns that block it. Hanging onto unresolved emotions throws us out of balance emotionally; it affects our emotional sobriety. Forgiveness involves willingness to work through the feelings that keep us reverberating in unresolved, painful emotions that make forgiveness seem impossible, as well as a willingness to view, as Marcel Proust said, “the same landscape through different eyes”.

Forgiving others who have hurt us can seem insurmountable. Emotions such as anger, resentment and unresolved hurt come to the surface and cloud our willingness or ability to see past them. But it is in addressing these feelings openly and honestly that we can move through them toward healing.

Forgiveness also allows us to bring our emotional worlds back into balance: When we process our emotions rather than block them or stay stuck in them, we can draw meaning and insight from them. We can grow, we have choices. The process is challenging, but the freedom, sense of purpose and inner strength that comes from facing painful emotions and working them through actually grows self. We become deeper, wiser and bigger people.

Self-Forgiveness

People sometimes struggle the hardest with self-forgiveness. Self-recrimination and shame can make us retreat into rigid positions that make intimacy and connection feel fraught with discomfort. Becoming willing to forgive the self implies a recognition that hanging onto anger toward ourselves not only hurts us, but everyone around us.

Is self-forgiveness self-indulgence? Or is self-forgiveness the best healing strategy for both those we love and ourselves? Many who have tried, come to the uncomfortable realization that self-forgiveness can be as, or sometimes even more, challenging than forgiving another person. When we contemplate self-forgiveness, we can get snagged up on all sorts of warring emotions that block our ability to release ourselves from the grip of our own self-loathing. Why do I deserve self-forgiveness? Shouldn’t I be punished for what I have done? Am I just letting myself off the hook if I forgive myself? Am I condoning my own lousy behavior? Will I just go out and do this bad thing again and again if I embrace an attitude of self-forgiveness too easily or quickly? Will others think I am not holding myself accountable if I act as if I deserve self-forgiveness even if I have done things to be ashamed of and should be held accountable for?

Hair shirts and whips didn’t come out of nowhere; they were man’s way of punishing the self in order to deserve forgiveness. But in the absence of concrete rituals of self-punishment, are we just driving our contempt further into our unconscious with all of this punishing self-talk? After all, it’s probably true that sincere penance is what underlies any form of self-forgiveness that really works. Without it, true forgiveness hasn’t really taken place. So we have to ask ourselves, is it wisdom to forgive our selves, understanding that restoring inner peace will do more to keep us from acting in harmful ways than holding onto guilt and shame? Or are we denying of the impact that our behavior is having on others?

When are we acting out of wisdom, and when are we acting out of our own need to minimize our negative behavior when it comes to self-forgiveness? These are the kinds of questions that those who enter the recovery process sincerely ask themselves and even agonize over. But it’s in that very agony that the release sometimes comes. This grappling with our own behavior in a deep and real way is messy and painful, but may well be what eventually leads us to the realization that we cannot really hate another person without hating ourselves…and that we cannot really love another person with our loving ourselves, and that if we forgive ourselves, we will be less likely to pass on the secondary pain of self-loathing to those we love.

Self-forgiveness then, if accompanied by meaningful changes in thinking, feeling and behavior, can be liberating for both ourselves and those we’re close to. If our self-forgiveness is undertaken with wisdom and commitment to improvements in our own behavior, it can be an important step toward positive and long-lasting change in our lives and relationships.

Making Amends (Working the Ninth Step)

Addictive behaviors are often attempts at running from our own inner turbulence, misguided attempts at quieting an inner storm. The storm is often about feeling hurt by others or hurting others through our own behavior. The two are intertwined, feeding and fueling off each other. Asking for or granting forgiveness offers a way out, a way to make an attempt at restitution, to restore peace and serenity. We’ve done our part to right a wrong from both sides.

Dr. Ken Hart of the Leeds Forgiveness for Addiction Treatment Study (FATS) says, “Controversy often arises because people fail to understand that forgiveness is always desirable, but attempts at reconciliation may sometimes be ill-advised.” Dr. Hart’s study is testing two different approaches to forgiveness: secular and spiritual.

The secular approach aims to speed up the growth of empathy and compassion so that addicts can better understand the imperfections and flaws of those who have hurt them. In psychodrama, we do this through role reversal by giving clients the opportunity to stand in the shoes of another person. Usually, they come to realize that the sense of “badness” they carry around from having interpreted their abuse to mean “something must be wrong with me or I wouldn’t be treated this way,” isn’t and probably was never true. They were in the wrong place at the wrong time; they got hurt because another person was projecting his own unhealed pain on them. This awareness can be a great burden lifted and allows the hurt person to see her hurt differently and to take it less personally. It can also develop some empathy since the next question is, “Well, if it wasn’t about me in the first place, then what was it about? What was inside the person who hurt me?” This is a step toward real understanding.

The second type of forgiveness tested is spiritually based, Twelve-Step-oriented forgiveness used by Project MATCH  in    in the United States. In this approach, addicts who have harmed others are encouraged to apologize for their wrongdoing, thereby making attempts at restitution. According to Hart, “Seeking forgiveness through the amends process requires incredible humility; the assistance of a Higher Power (God) helps people to transcend their ego, which normally balks when asked to admit mistakes.” He goes on to say, “We think the two treatments can help people in addiction recovery drop the burden of carrying around pain from the past.”

These two approaches to forgiveness – gaining empathy if we’re the hurt party, and making amends if we’re the offending party – are useful cornerstones in our own practical approach to forgiveness. Twelve-Step work has long recognized the need for addicts or those who have perpetrated wrongs to do the Ninth Step: step Eight : “Made amends to those we had hurt except when to do so would harm them or others.”

This is of the Twelve Steps that form the cornerstone of Alcoholics Anonymous (AA). The Twelve Steps are also the foundation of other programs such as Al-Anon, the program for the family members of addicts; Overeaters Anonymous (OA); Narcotics Anonymous (NA); Gamblers Anonymous (GA); and Debtors Anonymous (DA).

But forgiveness cannot and should not be pushed, rushed or arrived at prematurely. Clients who have been deeply wounded need to take ample time to process all of their feelings of anger, resentment and sadness, to mourn the losses they have experienced and come to terms with them.

Generally, this process itself will bring them closer to letting go, but it can often take many years. People develop PTSD symptoms because something has terrified them, whether they are a prisoner of war, a rape victim or a child who has been sexually, physically or emotionally abused by a parent. Someone in a position of power has forced the victim to submit to his or her will. That makes them vulnerable and when they share their stories that vulnerability surfaces, along with fear, mistrust and other feelings such as anger and sadness. It can be re-traumatizing if they feel coerced into forgiving either before they are ready or by sharing material they would rather not share. They need to feel safe and supported and go at their own pace with gentle encouragement. Generally speaking, forgiveness isn’t an idea introduced by the facilitator; it arises spontaneously from someone in a group and then we talk about it or work with what might be in its way.

The following exercises are designed to point out that forgiveness is, in fact, a process. Clients seem to pass through a predictable set of stages before forgiveness occurs, much as in the grief process. I have attempted to name those stages and created exercises to address the process of forgiveness. I would remind the reader that there is no one-size-fits-all approach to anything, including forgiveness. These stages are meant only to suggest a process and make it a workable one, to provide a framework. They may be experienced in a different order, leapfrogged or some skipped entirely, depending upon the severity of the issue and the person involved. In addiction, the goal is not to get rid of feelings like anger or sadness but to experience them and integrate them into the self-system with greater understanding and insight.

The Stages of Forgiveness

1. Waking up. We realize we’re holding onto something that’s hurting us (maybe even more than the other person) or that we need to forgive ourselves for something and stop beating ourselves up on the inside.
2. Anger and Resentment. We’re hurt and angry. We resent the other person because we see them as being the cause of our pain.
3. Sadness and Hurt. We’re in pain. We feel wronged or wounded and we’re probably also worrying that we did something wrong that we don’t quite understand.
4. Integration, Reorganization. We feel and experience split-off emotions associated with internal blocks and place them into a new context. We reintegrate them into ourselves with new awareness and insight.
5. Reinvestment. The process of forgiving and working through blocked emotion frees up energy that can be reinvested into building new relationships with self, others and life, or improving those we already have.

Examining Myths about Forgiveness

Goals:

1. To provide an action format for working with issues of forgiveness or letting go.
2. To provide a way of bringing forgiveness into the recovery process that isn’t overly prescriptive.

Steps:

1. Write each myth on a separate sheet of paper and scatter them on the floor:
   • If I forgive, my relationship with the person I’m forgiving will definitely improve.
   • If I forgive, I’ll no longer feel angry at that person for what happened.
   • If I forgive, I forgo my right to hurt feelings.
   • If I forgive, it means I want to continue to have a relationship with the person I’m forgiving.
   • If I forgive, it means I’m condoning the behavior of the person I’m forgiving.
   • If I haven’t forgotten, I haven’t really forgiven.
   • I only need to forgive once.
   • I forgive for the sake of the other person
   • Other
2. Invite group members to stand near the myth they most identify with.
3. Ask group members to share about why they choose that particular myth.
4. Repeat this process for a few of the myths that people most identify with.
5. Next, invite group members to walk over to someone who said something that they particularly identify with and place their hand on that person’s shoulder.
6. Invite group members to share with the person they chose why they chose them. Allow time for the sharing of the sub-groupings that will have naturally formed.
7. Move into letter writing or return to seats for sharing.

Writing a Letter of Forgiveness

Goals:

1. To provide a contained way in which to use letter-writing as an experiential process.
2. To illustrate how to move a letter into a variety of forms or experiential work.

Steps:

1. Ask participants to decide which type of letter to write (see Variations below).
2. Ask them to begin with “Dear So and So” and end with an appropriate closing, signing their names.
3. Encourage them to write anything that comes to mind. This letter is not meant to be sent, but to release their feelings. It works best to write quickly, not thinking about how it sounds or imagining that anyone will read it. Writing letters can be a useful closure activity to finish expressing feelings that have been stirred up through psychodrama.

Variations:

The following are some examples of letters that can be written:

• A letter of forgiveness to the self
• Granting forgiveness to someone who has hurt you
• Forgiving your self
• Asking for another person’s forgiveness
• A letter you would have liked to receive from another person asking for your forgiveness
• A letter asking forgiveness from someone else
• A letter expressing anger toward someone
• A letter from someone expressing sentiments he wishes that person had expressed
• A letter to an aspect of self or the self at a particular time in life
• A letter to a substance or behavior to which a person in recovery is saying good-bye

Letter-writing can be useful as a closure technique. If a lot of feelings come up for group members during a session, they can choose people to whom they feel they have something to say and take a few minutes to write letters to them — not to send, but to use as a psychodramatic release. After they have finished, they can proceed with any of the following:

• Share the letters with the group
• Read their letter to an empty chair representing the recipient of the letter
• Choose a group member to play the person to whom the letter is written and read it to him or her.
• Form pairs or subgroups and share the letters
• Share the letters with a therapist in one-to-one work

Clients may also write letters that they wish they would receive from someone. They may then:

• Choose a group member to play that person and experience the letter being read to them
• Share the letter with the group
• Share the letter in pairs or subgroups
• Share the letter with a therapist in one-to-one work

Experiential Reading of Letters

Steps:

1. Set up two chairs facing each other and invite whoever wishes to choose one of the following options:
   • Read their letter to an empty chair representing themselves
   • Read their letter to an empty chair representing another person
   • Choose someone to represent the person or self to whom the letter is written and read their letter to that role-player
   • Ask someone else to take on the role representing themselves and read their letter to that role-player
   • Ask someone to play the role of a person from whom they wish to receive a letter and have that role-player read the letter back to them (the client) as the client listens
2. Invite group members to take turns reading, using any of the above options. Feel free to allow the protagonist to reverse roles and answer back if they feel moved to do so, though this, too, should not be forced in any way.
3. Allow all those who wish to read their letters to do so.
4. Sit in the group and share and process how that experience felt.

Forgiving another Person or Forgiving the Self through Role-Play Vignettes

Goals:

1. To concretize the relationship that involves forgiveness issues.
2. To work through issues that may be blocking forgiveness.

Steps:

1. Ask group members to think of and share about someone whom they are having trouble forgiving, including themselves if that is what is most present.
2. Invite whoever feels warmed up to self-select and choose someone to play that person or themselves, or use an empty chair to represent one or the other.
3. Allow the scene to unfold and work with it using any and all techniques that might be appropriate, including role reversal.
4. Bring the scene to closure whenever it seems to be coming toward resolution by saying, “Say the last things you need to say for now.”
5. Return to seats for sharing.

Variations:

Several vignettes or monodramas can be done one right after the other, and the sharing can happen after several are finished. In this case, group members can share with whomever they identified and role-players can de-role.

Asking for another Person’s Forgiveness

Goals:

1. To get square with the self so that clients can stop carrying unspoken shame and guilt.
2. To concretize a forgiveness issue and work through the blocks within the self that may be keeping a client from making amends.

Steps:

1. Ask group members to think of someone from whom they want forgiveness or someone they feel a need to make an amends to.
2. Ask them to share about this person.
3. Invite whoever feels warmed up to self-select and choose someone to represent this person or use an empty chair.
4. Allow the protagonist to begin the scene in which they are asking for someone’s forgiveness. Let the scene progress and use role reversal and whatever other techniques feel appropriate.
5. When the scene seems to be coming to natural closure say, “Say the last things you’d like to say for now.”
6. Allow others to follow with more vignettes and then share after several, or return to seats for sharing.

Variation:

This scene can be done asking forgiveness from more than one person, if necessary.

Excerpted from Relationship Trauma Repair: An Experiential Model for Healing PTSD and The Living Stage: A Step by Step Guide to Psychodrama, Sociometry and Experiential Group Therapy, Dayton, HCI

When it comes to addiction, the progression of transformation starts with denial or a stage known as “unconscious incompetence.” Eventually, the process evolves to having had a Spiritual Awakening in the “conscious competence” stage of learning how to live clean and sober.

There is a level beyond the God Consciousness of a Spiritual Awakening. There is an unconscious state of competence that equates to being on autopilot in God’s world. This degree of vigilance requires a willingness to relinquish everything except God’s will; this takes a great amount of effort – until it takes no effort at all.

The word “unconscious” in this context means: Awake – but not aware. Competence equates to manageability over one’s life.

Remember, these four levels of transformation apply to many facets of the human experience.

The Four Levels of Transformation:

1. Unconscious Incompetence
2. Conscious Incompetence
3. Conscious Competence
4. Unconscious Competence
   

Level 1 – Unconscious Incompetence:

The definition of unconscious incompetence is the human state in which there is something wrong with a person, and they are unconsciously aware of its existence. Usually this is the result of denial. Untreated addicts and alcoholics, in the midst of chaos, fall into this level.

*****

This person’s life is truly unmanageable, and they don’t even know it. Denial, the brain’s defense mechanism, prevents this person from feeling the pain associated with reality and truth.

If you ask this person if alcohol or drugs are affecting the quality of his life, he will most likely answer “no!” And follow up with statements such as, ”It’s my spouse that has a problem” or “My job sucks – that’s the real problem”.

Some forms of denial related to Unconscious Incompetence include:

• Avoidance: “There is no wrong”
• Deflection: blame others
• Reflection: blame the accuser
• Minimizing: “I’m not that bad”
• Rationalization: “If you were me”
• Uniqueness: “I am different”

Eventually, the consequences of denial, unconscious incompetence, become too devastating and the person becomes conscious of his problem. However, a person with a true dual-diagnosis personality disorder may have a more difficult time becoming honest enough to get past this stage.

To enable movement into the next level, people may experience moments of clarity. These people are not ready to take action; they are simply no longer oblivious to the problem.

Level 2 – Conscious Incompetence:

This is the initial conscious awareness that some facets of life have become unmanageable. Not possessing true clarity at this point in time, the person is still behaving incompetently. It’s the recognition of being lost in the woods without a clue of which direction to walk.               

*****

This is when the negative consequences of a person’s behavior really start to surface. Health issues start to arise, along with loss of self-esteem and integrity. The downward slide seems to pick up momentum once the person climbs on the elevator to go down:

The elevator going down usually looks something like this:

Ground Floor = Extreme lows and highs. The ego speaking firsts and loudest. Planning the next high, or cleaning up the wreckage of the last intoxicating event takes priority over living in the present. “Look out below!”

1^st Floor Down = Family: The family knows there’s a problem with the person they love (or used to love). It has become the proverbial elephant in the room. Once the family actually recognizes the problem, they will usually take one of two courses of action (neither are correct):

1. They do nothing hoping that the problem will just go away. They fear discussing the elephant in the room.
2. They nag, which always makes things worse. It causes more stress with the abuser and adds on the already low self-esteem. In order to numb this pain, the abuser will drink or use.

They haven’t a clue how to deal with the person becoming insane right in front of their eyes. The person abusing drugs and/or alcohol is now conscious that there is a problem at home, although most will rarely admit that they are the source.

2^nd Floor Down = Friends: Healthy friends distance themselves from the chemical abuser, and the unhealthy friends are attracted to the abuser. The addicted person seeks “lower companionship” or they totally isolate. Sane acquaintances want nothing to do with them.

3^rd Floor Down = Finances:It’s expensive being addicted. The cost of the booze and drugs alone should be alarming. The cost of missed opportunities also comes into play. The poor financial decisions due to the compulsive behaviors result in financial turmoil. The cost of legal consequences soon arises for most.

4^th Floor Down = Legal: Speeding tickets, stop sign violations, reckless driving, driving under the influence and accidents repeatedly place addicted people in front of a judge. Throw in some domestic violence and trespassing and even the previously squeaky-clean citizen finds himself making trips to the courthouse. Courtrooms are full of druggies and boozers.

5^th Floor Down = Career: This is the turning point for many, especially people who worked hard to get their career. Addicted people tend to be really good at faking it, so for many of them, it takes a legal problem to jeopardize a person’s career. Despite an active company Employee Assistance Program (EAP), I chose to avoid “those people” at all costs. After my arrest for possession, and facing the loss of my aviation career, “those EAP people” became one of my favorite resources.

6^th Floor Down = Jails and Institutions: These fine facilities are full of people with “untreated” or “unwilling to be treated” alcoholism and drug addiction. For some, this loss of freedom is worse than death.

7^th Floor Down = Death: I ask my patients to picture themselves in a casket. I ask them to think about what will be said at their funeral. I asked them if they think they will die if they don’t accept help. More than 80 percent raise their hands.

My personal bout with conscious incompetence brought me to believe I was hopeless, and I was simply going to die an addict. My blind uniqueness told me that: “No rehab would work for me” and “AA was for quitters!” I can totally relate to an addict or alcoholic who truly believes that they just can’t stop. Many die rather than move on to the next phase. A person may be stuck on this level for a long time.

The old saying applies: The choices are being: locked up, covered up or sobered up.

Level 3 – Conscious Competence:

Becoming aware that we have choices is instrumental in conscious competence. We recognize the need for change; we become consciously aware that we are not alone on life’s journey. We find satisfaction in helping others. We take responsibility for our thoughts and actions.

*****

People experiencing conscious competence are not only aware of their addictions, they remind themselves every day of their addictions. People new to a 12-Step program and people completing treatment who have become honest, open-minded and willing are firmly planted in this stage.

Many of these folks love how they feel with their newfound appreciation for life, as God intended. Certain promises start to come true usually around completing Step -9 of the twelve steps:

The Promises, can be found on page 83-84, of the Big Book, Alcoholics Anonymous.

THE PROMISES

If we are painstaking about this phase of our development, we will be amazed before we are halfway through. We are going to know a new freedom and a new happiness. We will not regret the past nor wish to shut the door on it. We will comprehend the word serenity and we will know peace. No matter how far down the scale we have gone, we will see how our experience can benefit others. That feeling of uselessness and self-pity will disappear. We will lose interest in selfish things and gain interest in our fellows. Self-seeking will slip away. Our whole attitude and outlook upon life will change. Fear of people and of economic insecurity will leave us. We will intuitively know how to handle situations which used to baffle us. We will suddenly realize that God is doing for us what we could not do for ourselves.

These promises are integral in recognizing the results of our commitment to sobriety. However, there is still plenty of room for growth after the promises start coming true.

I am very protective of the 12-Step Process. Nevertheless, one of the complaints posed by Licensed Mental Health Professionals and Cognitive Behavioral Therapist about 12-step programs is that after achieving long-term sobriety, many Twelve Steppers tend to dwell on how sick they are. This criticism has some merit.

Some people in recovery may be permanently stuck in this phase of their development. And that is not a totally bad thing – it beats living chemically addicted. On the other hand, others continue to move forward in their recovery. They are able to gain self-esteem and still maintain humility. These folks rarely use negative self-talk when sharing their experience, strength and hope. These are the people who have what I want.

An example of being stuck in this phase is when a person with more than 20 years of sobriety states they are still powerless over alcohol. They seem to be comfortable living in the problem. There is a tendency to place too much emphasis on “drunk-a-logs and on how pitifully sick we are,” as opposed to how well we become while living in the solution.

People who stall in Level 3 conscious competence make recovery more work than necessary. They truly believe they are still living in the throes of Step 1. They will argue that the first step implies that we never recover from being powerless. To me, this is an effective defensive tactic if you like low-scoring games.

At this point in recovery, I prefer to be on the offense. I like high-scoring games and I wish to experience all the grace that comes my way in recovery.

There are many great teachers in twelve-step programs. I am not drawn to those who claim they know the answers, but instead, I am drawn to those seeking truth. The truth-seekers tend to read, pray, meditate and journal more than others. Whether they know it or not, they aspire to become unconsciously competent.

Level 4 – Unconscious Competence:

Every person achieving unconscious competence spent a great deal of time in the conscious competence phase. We can only find ourselves in Level 4 by experiencing the repetition required in Level 3 to maintain sobriety. Like miracles, unconscious competence comes to us – we don’t go to it.

As stated in the introduction of this article:

“There is an unconscious state of competence that means we are on autopilot in God’s world. This degree of vigilance requires a willingness to relinquish everything except God’s will; this takes a great amount of effort – until it takes no effort at all.”

People who live their lives in the flow of doing what is right, without consciously thinking about it, experience unconscious competence. For these people prayer, mediation and being of service is all part of daily life. The reward is in the service. They tend not to take things personally nor do they cave in to the weight of their egos. This is spiritual recovery in the highest form.

*****

 Living life on this level may be the result of any of the following:

1. Having had a Spiritual Awakening as a result of the 12 Steps
2. A profound spiritual experience such as a near-death experience
3. A massive shift in personal values
4. Remission from a terminal disease
5. Years of living clean and sober

The person who has thoroughly experienced the 12 Steps and has had a spiritual awakening, referred to in Step 12, will most likely agree with the premises:

• Today, alcohol and drugs have no power in my life, in fact, I rarely think about drinking or using. I have a God of my understanding, the fellowship of a 12-Step program and I work daily on the maintenance of my spiritual wellbeing. I am unconsciously competent about avoiding people, places and things that are not on my spiritual path.

• I no longer allow my ego to challenge God’s will for me by accepting only One Voice to speak to me.

• I recognize steps like these are simplified ways for humans to digest God’s will slowly. God’s accomplishments are not gradual, nor do they ever change. With God, time is meaningless because it is eternal.

• As half-measures avail us of nothing when it comes to recovery from addiction, half-measures also avail us of nothing when it comes to willingness of accepting God’s will for us.

• Intuitively knowing how to handle situations that used to baffle us correlates to the state of unconscious competence discussed here.

Here are my suggestions for maintaining unconscious competence (I strive practice these simple steps each morning when I awake):

1. Read something of a spiritual nature.
2. Talk myself into a self-guided meditation on the lesson I choose to receive from my spiritual reading.
3. Journal on the experience of the meditation.

The time allotted for each step varies. At times, I only read a paragraph, other times I read a chapter. I find it helpful rereading the same spiritual message over and over before I meditate. I also find that journaling is much easier after meditation.

It may not sound like it, but we are very present in the moment when experiencing unconscious competence. This is because our minds are free of the fear and anxiety created by our egos.

The big federal law involved in the issue, the Anti Kickback Statute (“AKS”) (42 CFR 1320a-7b(b)) basically forbids paying anyone for referring patients whose care is compensated in any way by any state or federal healthcare program (e.g. Medicare, Medicaid, CHAMPUS or TriCare). The law enforcement arm of that law, the Department of Health and Human Services Office of the Inspector General (OIG), has been clear that such commission-based sales arrangements implicate the AKS and has identified some core suspect indicators, including:

• Compensation set on a percentage-of-sales basis

• Direct billing of any federal healthcare program by the seller for an item sold by the contractor

• A direct contract between the contractor and a physician in a position to order or refer

• A direct contract between the contractor and federal healthcare program beneficiaries

The AKS has both criminal and civil monetary consequences and is one of the government’s favorite tools. Recovery service providers are well advised to become familiar with not only the AKS, but also the law’s exceptions, so called “Safe Harbors,” which describe arrangements that don’t violate the AKS. The “personal services arrangement” Safe Harbor has particular application in the area of marketing, as does the AKS exception for “bona fide employment arrangements,” which apply to W-2 employees, but not independent contractor relationships. Though the AKS arguably applies to just about every arrangement, at least these are some good examples of what’s OK.

Many recovery service providers do not interact with federal or state healthcare programs of any kind. That’s great. For them, the AKS may not seem to be an issue, since the law only applies when services are reimbursable by a state or federal healthcare program. But states are equally unkind in enacting laws that essentially require providers to comply with the AKS even when no state or federal healthcare program dollars are involved. For instance, Florida’s Patient Brokering Act (“PBA”) mirrors the AKS in many ways and carries with it criminal consequences. Even more damaging is the fact that many insurers use the PBA to deny payment for claims.

Recovery service providers have to be careful about how federal and state laws apply to marketing arrangements. Though doing so is a little like playing Whack a Mole, it’s totally doable with the right guidance.

For in our 21st Century, growing up is more difficult than ever. Children continue to be exposed to unprecedented pressures and they are not always coping well. As never before, children need to be equipped with internal strength and resources. And for parents and caretakers, raising happy, healthy, well-adjusted children often seems an overwhelming task. They deserve to know what works.

In my therapeutic practice with children over the past 25 years, I have found that many of the answers to life’s challenges lie within each child – that children can create pictures from their mind’s eye to heal their troubles. Through learning and practicing visualization, kids can develop emotional self-care skills to help themselves with a variety of everyday, practical concerns. If parents could easily and successfully teach their kids effective imagery techniques to solve their own problems, their world might be transformed. If teachers could help children access their highest learning potential, education could flourish and test scores would surely go up.

So many of you are acquainted with my work and have heard stories about the dear children I have had the pleasure to know over the years. Here is a concise summary – as a reminder and as a guide – of eight imagery tools that I have found most useful in assisting children in their emotional and intellectual growth. You can easily share these with your child clients, parents, educators and other professionals.

TOOL #1: THE BALLOON BREATH

What it is: A simple technique of breathing slowly and deeply into the belly while focusing attention about two inches below the navel. This type of diaphragmatic breathing centers and calms children.

How kids use it: Fifteen-year-old Terrance, who was frequently upset, was able to calm himself and reduce his stress from an 8 to a 2 (on a 0 to 10 scale) by practicing his balloon breath several times a day. He found it made him feel especially peaceful when he focused his attention on his heart.

TOOL # 2: DISCOVERING YOUR SPECIAL PLACE

What it is: A safe, special place inside children’s imagination where they can retreat, relax, regroup or even “space out” in a healthy way. It’s a place to pose endless questions about life issues, and create numerous positive, possible solutions.

How kids use it: Six-year-old Fanny had such extreme test anxiety that she cried uncontrollably, threw up and had to be removed from class when faced with a spelling test. She learned to create a comforting special place for herself and her best friend to safely study: a lovely place with rainbows and fluffy white clouds, a shiny sun, flowers in lime green and hot pink, and a star-filled desk.

TOOL # 3: ANIMAL GUIDES AND OTHER CREATURES

What it is: An inner imaginary guide – kind, loving and having a child’s best interest at heart – to help children tap into their wisdom. It’s often safer and easier for animal friends to offer solutions to problems in creative ways, than expecting logic and linear thinking to do the work.

How kids use it: Seven-year-old Sally’s unicorn, Sapphire, lives on top of the cloud in her rainbow special place and comes “every single, pingle, wingle, tingle night” to help her with her problem of not sleeping by sprinkling white powder on her head and slowly saying “falling asleep” as she drifts off to her favorite dream.

TOOL # 4: PERSONAL WIZARDS

What it is: Wizards come into play when animal friends “just won’t do.” They are valuable tools when something stronger and more magical is needed – at least in a child’s eyes.

How kids use it: Eight-year-old Bree was understandably distraught when her beloved grandmother passed away. An old and ancient wizard – wearing blue and silver robes with white stars – came to her. He carried a gray and white feather “all about love, hope and kindness” and when he waved it around, “made the bad all better.”

TOOL # 5: RECEIVING GIFTS

What it is: Gifts from imaginary helpers can come in many forms for different situations. Gifts are often metaphors, symbolic and exactly what the child needs in the moment. Gifts can be obvious or require further explanation by the animal friend or wizard. Sometimes gifts are hidden and need to be uncovered or dug up – sometimes they are right in front and unwrapped.

How kids use it: Twelve-year-old Dara, who a year earlier had expressed little desire to live because of peer rejection, now received a blue box wrapped with red ribbon demonstrating her strides in self-worth. Inside were five gifts for her blossoming life: a yin-yang symbol showing balancing friendship with her best friend, a yellow smiley-face necklace reminding her of the happiness she now feels, a heart-shaped candle continuing to bring love into her life, a diamond-shaped crystal creating clarity for herself, and a flower making life “even more beautiful.”

TOOL # 6: CHECKING IN WITH YOUR HEART AND BELLY

What it is: This tool is comparable to suggestions of “listen to your heart” and “pay attention to your gut feelings.” Children are encouraged to take a few minutes each morning to “check in” with their heart and their belly, and to notice what messages are there for them as they start their day.

How kids use it: Seven-year-old Sally’s jealousy of her younger brother was causing a lot of angry tears at home. She discovered her “good love feelings” for her brother were in her heart, while her “bad hateful” feelings were in her belly. When she asked, her heart told her she needed more time with her mother, and even though her mom was so busy, she could find that time by helping her mom with the baby.

TOOL # 7: TALKING TO TOES AND OTHER BODY PARTS

What it is: Here, children discover where and how they hold different feelings in their body – worry is often in the gut, sadness sometimes in the eyes. There is no exact location or description; each is distinctive. Kids then find they can dialogue between emotions and/or symptoms to find answers to their concerns.

How kids use it: Eight-year-old Robbie started to panic every day 30 minutes before school ended; he was afraid his mother was not going to pick him up. Turns out “fear and worry” were renting space in his stomach and by talking to these menacing partners he was able to strike a deal where they agreed to move out if he practiced his balloon breath every day.

TOOL # 8: USING COLOR FOR HEALING

What it is: Color has been especially helpful in healing pain. Feelings and symptoms often have different colors associated with them. They can be unique to each individual and change over time. One day happiness may be perceived as sunny “yellow” and anger as roaring “red,” while on another, happiness can be exciting “red” and anger depressing “black.” By learning where and how colors live in their body, children can use them for their healing advantage.

How kids use it: Eleven-year-old Nancy was referred by her pediatrician for recurring, painful stomachaches. Her parents were on the verge of an unspoken divorce and her body was suffering from their constant arguing. She asked her stomach what color she needed to breathe in to help her feel better – her stomach wisely created the image of a swirling rainbow to ease her distress. She was able to vastly reduce her pain by breathing in a rainbow of healing light. Imagery practitioners, you are now armed with eight simple, efficient and totally free options to mix and match – depending on the situation and the child’s favorite – to use on your own and with the families you reach. If a child learns one tool today, life tomorrow may be richer and easier.

Many blessings,
Dr. Charlotte

Originally published in Kid Konnects in:
The Journal of Imagery International (ImagiNews), December 2005

 “I feel disgustingly helpless and dirty – it dominates everything.”

“The courageous, carefree, happy, funny part of me was lost that day. I am defiant.”

 “I hate myself – can’t forgive myself for having been so stupid.”

“Please save me, but leave me alone.”

“I was incested and thrown in a closet from the age of 3. I was unforgivable and didn’t forgive anyone. I went to psychotherapy for years. In AA they told me, ’Let us love you until you can love yourself.’ Eventually the ache in my heart went away.”

“I didn’t deserve what happened to me when I was 5, but I took that and punished other people for it – and that’s my part in it.”

“You have to master dissociation.”

It’s almost impossible to talk about it. Nobody wants to hear about it. Collectively, we uphold the taboo. We act as if such things never happen. As far as the victims are concerned, everybody is in cahoots, but they themselves prefer to deny it, too. It is simply too disturbing and depressing.

It’s not necessarily easy to be human. We do some learning and experiencing. We mature, develop convictions and beliefs, and end up taking them for the truth. On the basis of a healthy genetic makeup and a gentle and nurturing childhood, a functional whole develops, where thoughts, moods, feelings, attitudes, characteristics, and behaviors are integrated. Human behavior happens on the foundation created in childhood – by experiencing and watching adults, and then behaving just like these role models.

An estimated 85 percent of addicts are survivors of abuse in childhood. The same percentage (about 85 percent) of prison inmates were abused as children.  One in four (or three) girls is sexually abused before the age of 18. One in six (or five) boys is sexually abused before the age of 18. For the survivor of sexual child abuse, life becomes most painful and confusing. He grew up with betrayal and suffering – severely traumatized and without good enough role models for handling life.

He experiences PTSD (Post-Traumatic Stress Disorder) in the form of flashbacks, anxiety, panic attacks, rage, insomnia, depression and psychosomatic complaints. On a behavioral level there is lack of openness; violent, unprovoked rage attacks; and repetitive self/destructive behaviors, including all addictions and eating disorders. There can be excessively cautious and inhibited behaviors, or the opposite: re-enactment of victimization and deliberate exposure to danger.

Persisting agitation and hyper-vigilance, along with unresolved grief, seemingly require ongoing dissociation from high-intensity emotions and unacceptable experiences. Such factors predispose a person for a life where relief and pleasure must be sought, and pain must be numbed and self-medicated at any price – or memories and impulses would remain intolerable.

A variety of confusing and self-defeating thought patterns persistently present. The survivor may be hopeless, fearful, resentful, jaded and cynical, often with sadistic and vengeful fantasies, as well as an array of self-destructive habits, which tend to complicate matters and cause more problems. He may also sexualize feelings (such as interest, curiosity, admiration, respect, affection or attraction), thereby causing trust issues in all relationships.

Once integration has been compromised in such a way, psychic wholeness and comfortable inter-relatedness of thoughts, memories and feelings is interrupted. Staying present becomes utterly undesirable and difficult, or seemingly impossible. It’s as though the inner melody of the soul has been rendered dissonant and the alcoholic is running from himself, in search of a better music outside of self. Missing comfort, flooded with adrenaline, tempted by impulsivity, filled with negative and conflicting thought contents, it does not appear doable to “just say no” to food, sex, alcohol, drugs, or other thrills and forbidden pleasures. Hedonism is not negotiable when your mind is screeching and tension relief is sorely missing.

He may also compartmentalize reality, keeping events and groups of people separate. He may present a different side of himself to people, lie (directly or by omission), manipulate and deceive others in an effort to direct their reaction and control the outcome. Lacking continuous attention to reality, his life doesn’t feel real. It doesn’t make sense. He gets lost in the process of covering up and his sense of identity remains vague. He has to keep his distance to hide that he feels broken. He doesn’t understand others and it’s next to impossible to speak for himself. Torn by ambivalence, he can never be content about a choice. He may present himself with fierce arrogance and hostility to mute the voice that yells demeaning things inside his head. He wants to be loved and understood – aching for someone to see and hear how he really is, but he must conceal such a vulnerability… a tough exterior protects from further exploitation. Fear of intimacy can also be handled by hypersexual activities. Sexual behaviors can be compulsive, perverse, promiscuous and inhibited. Despair about life and death are camouflaged by life-threatening bravado. Tortured by shame and guilt, seemingly indifferent and defiant, he can’t show up for himself or for others, and abandons everything that’s good in his life.

Thich Nhat Hanh speaks of the creation of mental constructs, which crystallize in internal formations. This happens in response to trauma and also through instant chemical relief — often the only relief known to the victim.

In psychoanalysis, cathexis is defined as the process of investing mental or emotional energy in a person, object or idea. Victims of sexual abuse tend to take on the responsibility for the traumatic events they were not capable of fighting, remaining stuck in toxic shame, disconnected from their own soul and incapable of accessing self-love. Instead they may remain forever energetically connected to the experience and the perpetrator. Traumatic bonding is a powerful form of cathexis, where the victim becomes energetically connected to the perpetrator, resulting in persisting fear, anger, rage and resentment. This can even produce the odd result of the so-called Stockholm Syndrome where the victim identifies with the aggressor in a loving or compassionate way, while remaining blind to compassion for himself.

Such a process serves to keep the energy firmly connected to pain and suffering, and also to the past. Consequently, the victim remains stuck indefinitely — vague and indifferent to his own identity, lacking interest or hope for himself, his own fate, or the lives of others. Usually there is an ongoing undercurrent of sorrow or anger, and a desperate and inconsolable loneliness.

Recovery must offer hope via a solution for the psyche to become whole (again), a complete transformation where trauma and shame can be healed. Consequently, attachment ceases to be felt like holding on to barbed wire for fear of going under. The process must include release of the ties of cathexis – as though he severs a rubber band that had tied him to the perpetrator through the energy of fear and anger. The solution is of a spiritual nature. Forgiveness is to be found through a liberating act of ”calling his spirit back” from attachment to the perpetrator, where he ultimately lets go of the anger-bond in favor of self-love. It is about (re)establishing a friendly inner world on a daily basis. The process of psychotherapy and the practice of mindfulness reveal the path, one step at a time. Without such mental hygiene, his emotional landscape reverses to a treacherous swamp.

Forgiveness is an overriding principle for recovery from emotional trauma, but when the victim had to endure unforgiveable acts, he might reject that concept altogether. In such cases discernment is important – to differentiate the personal versus the legal aspect – legal action can still be taken, while forgiveness is enabled on an intra-psychic level for healing to occur. It doesn’t mean to minimize or justify what has happened, rather it is about taking one’s spirit back from an ongoing internal dialogue of accusation and sadistic fantasies of punishment and vengeance. Only then can the victim’s life energy be fully employed for achieving wholeness from internal fragmentation. Healing is about becoming whole again from disowning parts of self during dissociation and fragmentation. Such ego defense mechanisms were aids to survival in childhood, but remain shackles for the adult survivor.

Mircea Eliade calls it “rape of the soul”, suggesting “soul retrieval” like in Shamanistic rituals. He states, “Each of us must take the responsibility for healing our own traumatic injuries.” Retrieving souls is about restoring wholeness. Shamanistic rituals employ the community to support the healing process.

In her wonderful book Why People Don’t Heal, Carolyn Myss speaks of “woundology” when people integrate victimization into their self-image, where it becomes part of their identity, thereby interfering with the healing process.

She relates the story of David Paladin, a Navajo Marine, used by the U.S. Army as “Wind-talker” for his native language as an unbreakable radio cypher during WWII. Captured by the Germans at the age of 18, he was taken to the concentration camp of Dachau. He was tortured as a POW where his feet were nailed to the floor for three days. The wounds developed into gangrene.

After his liberation he was emaciated near death and spent two years in a coma. When he returned home to his tribe at the age of 21, his legs in braces, they exclaimed, “What happened to you?”

He proceeded to answer, “The Germans…”

They stopped him, “No, what happened to you?”

Again, he wanted to explain, “The Germans…” and again they replied, “No, what happened to you?” and he tried to recount his experience, whereupon they told him this: “Your spirit is not with you. A man cannot live without his spirit. You must get your spirit back.” They threw him in the river and instructed him to swim and get his spirit back.

Through forgiveness work in psychotherapy and spiritual practice, a metamorphosis can occur, where liberation from the prison of past experiences becomes possible. The victim’s life energies become transformed and cease to poison the soul. The energetic tie to the perpetrator can be severed. Consequently, emotional energy is released and becomes usable for the good. The practice of mindfulness in meditation helps to undo these knots – survivors can experience transformation and healing, while also downward-regulating emotional intensity.

Of course, a survivor of childhood trauma would much prefer to ease himself into recovery – he can’t bear the prospect of adding more displeasure to his misery. This is why he must immediately be offered hope that happiness is within reach, in spite of everything. He must be shown that he is, in fact, loveable and deserves to be saved. He must be guided on the path of letting go and see that life can be good. He must be given clarification, that it’s been an error all along. That he was an absolutely innocent child who needed love and guidance. That he never deserved to be treated this way. That he doesn’t really want oblivion and intoxication, but rather healing and ultimately relief from suffering. Only then will he embrace recovery.

“The road to freedom is through the doorway of forgiveness. We may not know how to forgive, and we may not want to forgive; but if we are willing to forgive, we may begin the healing process. It is imperative for our own healing that we release the past and forgive everyone.” – Louise Hay, author, Hay House Publishing

“In the doctor’s judgment he was utterly hopeless … alcoholics have had what are called vital spiritual experiences. To me these occurrences are phenomena. They appear to be in the nature of huge emotional displacements and rearrangements. Ideas, emotions and attitudes, which were once the guiding forces of the lives of these men are suddenly cast to one side, and a completely new set of conceptions and motives begins to dominate them.” –Big Book of Alcoholics Anonymous, p. 26

These issues are not effectively treated by making life “easier” for these young adults in the hopes they will “see the light.” Coddling and enabling these individuals just makes them more likely to continue the behavior. Conversely, being overly harsh with them isn’t the way, either – yelling and screaming and stamping feet just results in them tuning out. Parents often resort to 30-Day Primary Rehab, which can definitely be effective, but often isn’t a radical enough intervention. Some young adults cooperate while in Primary, then lapse back into their old behaviors soon after they return home.

Most clinical professionals agree that radical interventions are necessary to treat radical behavioral issues. Wilderness therapy is one such intervention. Completely removed from the stressors, routines and triggers of everyday life, clients have the opportunity to connect deeply with themselves and others within the framework of a radical shift in environment. Studies have shown that the frequent relapses and recidivism rates that often occur following traditional treatment are significantly reduced when a client goes through a wilderness experience beforehand. As a prequel to extended care, or a stand-alone treatment episode, a wilderness therapy experience is the most impactful intervention a young adult can experience.

The wilderness setting, where a young adult has no access to drugs, alcohol or the Internet, provides a golden opportunity to begin the journey of recovery. Being away from distractions provides an opportunity for clients to understand the “payoffs” they get from their addictions, and to help them see that they’re losing more than they’re gaining from the addictive behavior. If the program features an immersion in the 12 Steps, clients can learn practical tools for staying sober now and forever. The potency of the wilderness experience makes it a viable, and often preferable, alternative to more traditional treatment methods.

At the WinGate Wilderness Therapy Young Adult Program, we connect the “steps” clients are taking on the trail with the “Steps” they are taking in their recovery. For example, accepting Step One – powerlessness and unmanageability – is much easier when a young adult is in the middle of nowhere. We ask, “If your life is manageable, why are you out here in the wilderness?” Often there is no answer while sitting amid the wilderness as opposed to a nice, warm treatment center (or on mom and dad’s couch), where that question might be easier to dodge or avoid.

Step Two, coming to believe in a power greater than oneself, is also very accessible in the wilderness. Most programs take place in very beautiful environments, such as the Grand Staircase-Escalante National Monument, where WinGate operates. In this beautiful setting, often atheists or agnostics come to see that there is more to life and the world than his or her resentments, ambitions, frustrations and addictive thinking.

On the trail, we also do experiential exercises, such as having clients write their resentments on stones and carry the resentments with them, noticing how their packs get heavier and heavier as they add resentment. This experiential approach to Step Four helps our clients connect in a very real way their level of resentment with the “heaviness” they feel in their hearts, bodies and minds.

Step Five, in which resentments are shared and (hopefully) released, is also very powerful in a wilderness setting. We have clients “sling” their resentment rocks into the wilderness. They then pick up their packs and see how much lighter they’ve become. The tangible experience of releasing resentments in this way impacts the clients in a very deep way.

From an experiential perspective, steps Eight and Nine are also very powerful in the wilderness. These steps, which are about making amends, have a more powerful impact when clients not only list the people they’ve harmed and apologize to them, but also make leather bracelets while on the trail, which they offer to those they have harmed as a physical representation of their living amends.

WinGate operates on the principles of Arbinger, a philosophy springing from the work of Martin Buber, that advocates for personal agency and empowerment. We believe our clients doesn’t need to be punished if they do something “wrong” – they need to experience natural consequences and understand the relationship between the choices they make and the outcomes that ensue. They need not be forced to cooperate, but rather we must seek to understand their motivations and draw those toward behaviors and actions that will work better for them. The land itself is a powerful ally in this respect; it allows clients the time and space to reflect on their behaviors and outcomes, free from TV, the telephone, the Internet or any other way to “numb out” and avoid how they’re feeling.

This strengths-based approach helps clients make healthier choices because they want to, not because someone is forcing them to. Again, the wilderness is a powerful ally in this process; the peace and tranquility our clients experience allows them to awaken to their spirits in ways never before possible. As clients deepen their connections with nature and deeper truths, their urges to use are greatly reduced. The Step-work and walking the trail help them learn to step outside themselves, which opens them to the Arbinger concept of seeing other people as people just like them. This is particularly helpful for young adult addicts in early recovery, who often have a hard time creating relationships because they see others as objects, vehicles or obstacles.

Being completely removed from distractions and the usual day-to-day routines provides a radically powerful context in which young adults can connect with themselves, one another, nature and spirituality. As the Steps are worked while on the trail, the clients’ steps become lighter as they find their true selves, release their resentments and non-working behavior and leave behind their old ways.

Starting off our issue, as always, is Dr. Tian Dayton. She continues to elaborate on the many issues an adult child of an alcoholic (ACOA) may face as a result of growing up in an alcoholic home; in this case, trauma syndrome. With clarity and personal insight, Dr. Dayton explains the process through which ACOAs develop trauma and how it can haunt them well into their adult years, providing us with a richer and more compassionate understanding of the experience of these walking wounded.

Jasmin Rogg lends a literary flair to this issue with her touching and insightful poem, The ism or Geriatric Children. Here, she relays different stories of addiction in deeply intimate and beautifully heartbreaking fashion, allowing a direct lens into the mind and heart struggles of using and trying to get and stay clean.

Frequent contributor, Stephen Grinstead, gives us private access into his personal experience with chronic pain, and the passion it ignited in his home and work life. His story reminds us that the most important part to heal in any addiction is our thoughts and beliefs around our situation.

Dr. Lisa Firestone takes on that hurtful and often self-defeating critical inner voice with the concept of Voice Therapy. A step-by-step technique to identify and effectively counteract the negative effects of that critical inner voice, Voice Therapy provides a useful tool to add to the successful recovery toolbox.

The speciality of that critical inner voice is mongering fear, a subject with which Marcia Ullett is all too familiar. Fortunately, she learned to understand and overcome her fears by discovering an entirely new way to look at and relate with them. It’s an important life lesson for anyone – with or without addictions.

Herb Kaighan waxes eloquent on the subjects of love, yearning and fulfilment. It’s equal parts inspiration and meditation – an existential cool drink of water that soothes and refreshes.

When relapse is considered by many to be inevitable, discouragement quickly follows for anyone facing a life without using. Fortunately, Dr. Kristina Diener provides us with 10 tips to increase the odds for a successful recovery, including an important reminder to be patient and have compassion along the way.

While this issue is widely varied in its content, the common thread of hope and renewal is undeniably woven throughout. Hope, renewal, love and joy … we’d say this winter is turning out to be very beautiful indeed.

Success and blessings to all,

Jim and Josie

Old pain that gets imported into new relationships is the hallmark of the ACoA trauma syndrome. The past we thought we’d neatly left behind once we got tall enough, old enough or smart enough intrudes onto our present and we are returned, in the blink of an eye, to childhood states of emotion and along with them floods of feelings and images that we “forgot” were there.

Confronted with an angry spouse, a critical boss or a tantrumy child, the ACoA may overreact to a present-day circumstance that somehow mirrors one from the past. Unaware that hidden childhood wounds may be causing us to react more intensely than is right-sized for what’s going on, we get caught in a mind/body combustion in which pain from the past is potentizing pain in the present. We get tight guts, we hold our breath and we wait “for the other shoe to drop.” We brace ourselves and wait for something bad to happen, just the way we did when we were kids. But we don’t know that’s what’s happening. Then we swing into defensive strategies, we explode or implode, we get aggressive and defensive or we disappear and withdraw. We stand at our full adult height, but on the inside, we’re that freaked out little kid all over again. In this manner, pain from the past bleeds into the present. Seamlessly old hurt, anger and fear move from one generation to the next, because unresolved pain, anger and confusion don’t really disappear; they live within us, in a quivering silence that longs to make itself heard and known.

Where does it all begin?

Picture the child in the alcoholic home. There is a fundamental power imbalance. The child is small, the parent is big. The parent is the one who holds the keys to the house, the car, the refrigerator and the bank account. And everyone knows it. The parent has the authority. If a parent is yelling at a child, telling him that he is the problem, that if he would only change everything would be better, the child tends to believe him. Children look into their parent’s eyes to see a reflection of themselves, of who they are and whether or not they matter. When the parent is the one who is causing the stress, it’s a double whammy for the child. Not only is the child scared and hurt, but the person they would normally go to for comfort and solace is the one who is scaring and hurting them. They are disempowered by the very nature of their youth and dependency.

Kids are trapped in a world run and paid for by their parents.

If their parents are drunk or preoccupied with hiding ever-growing problems from themselves and the rest of the world, home can become a real pot boiler of emotions that are hard to untangle. The emphasis on the family moves from cooperation to hunkering down and staying safe. When the yelling comes, the child knows that if he fights back, he risks getting the family problems, that are running rampant through the house, focused onto him, or getting sent to his room, grounded, hit, punished or having his allowance taken away. Then he will be more trapped. So kids often take the path of least resistance: They comply, withdraw or shut down. Or they stand there and take it, but on the inside they flee, they dissociate, they disappear. Because the child is limited in their ability to access outside support, they have no one to tell them that they are after all not a terrible and troublemaking little person or to reassure them that everything will be all right and return to normal soon. Rather, they have to rely on their own, often immature ability to create meaning, but all too often, the meaning that they create casts themselves in a negative light. Their ability to understand, process and manage this situation is dictated by their very dependency and their limited intellectual equipment at any given point of development. The combination of these factors, the power imbalance, length of time spent in a dissociated state, the inability escape and their lack of mature, intellectual development, are factors that can contribute to childhood trauma having long impact. Years after ACoAs  leave home, they may carry anxieties about themselves and relationships that they do not fully understand. This is how ACoAs import their past into their present. And because of the way the brain processes frightening or overwhelming experiences, none of this gets talked about. Or even thought about.

Our natural response when experiencing frightening or overwhelming situations is to self-protect. We do this by running away, retaliating in some way or, when neither is possible, by shutting down, by becoming “invisible”. Fight, flight, freeze. As children or adults, these defensive strategies can result in our warding off or hiding from the very pain we need to face in order to remain aware of what is happening around us. If, when a frightening situation like being yelled at by a drunk parent occurs, we process it with someone who cares and make intellectual sense of it, we can return to normal or even learn a little something and be more resilient when problems come again. We get better at handling or avoiding them. But when this doesn’t happen – as is so often the case with stress and trauma in the home, that is being caused by parents’ erratic or irresponsible behavior – that pain goes underground, it sinks down inside, forming a little pool of unprocessed emotion that sits in our inner world. But out of sight is not out of mind. Unprocessed pain does not disappear; it lays dormant, waiting for some similar memory cue to return it to the surface waiting, in other words, to be remembered. Even loud voices, a raised eyebrow or a change in mood can send the ACoA sailing back into a place inside of them where they shiver inside and wait, just as they did as kids, for something bad to happen.

When We’re Very, Very Scared…

The thinking or language part of the brain shuts down so that the human organism has no interference in its powerful urge to either fight and defend itself or flee from danger. Therefore, it’s our most frightening experiences that oftentimes don’t get translated into words, thought about and put into a context. They live instead within us as fragmented and un-integrated pieces of personal experience, they dance on the edges of our conscious awareness or they lay below the surface, submerged in the deep waters of our unconscious. Even loving and well-meaning parents can be frightening to a small child who is tracing every movement of their face for signs of anger. Kids are so small vis a vis their parents, so subject to the mood of the household and the state of mind of those in charge of their young lives. Add parental alcohol or drug abuse, depression or anxiety to this family equation and you have a potent cocktail for kids feeling scared and even traumatized by what’s going on in the home.

Some of the factors that sear trauma in place and make it more likely that a child of addiction (or family dysfunction) will develop PTSD are:

• Whether or not escape is possible. Can the kids get away from stressful, painful family scenes?

• Whether or not there is a power imbalance (which of course, there is).

• Did the child have access to outside support? Were there caring, concerned adults who could provide “safe haven” or a place the child could feel, if only momentarily, out of harm’s way? A place that could provide a “reality check” or model a different way of being in a family?

• The length of time that the COA spends in a numbed-out or dissociated state. Trauma in the home tends to be cumulative – it occurs incrementally and over a significant period of time.

• The developmental level of the child. How old were they when trauma in the home occurred and what age-related capacities did they have to make sense of confusing, painful or frightening experiences?

• Whether or not it’s the parents, who they would normally go to for comfort and reassurance about who is causing the stress?

These are some of the factors that give trauma in the home such traction. Intense feeling states get wired into kids, and rather than absorb skills of emotional calm and regulation from their homes, they absorb states of emotional chaos and extremes. (You might say they get skilled at over- or under-reacting.) Then as adults when they are in the midst of intense emotions, which are, after all, simply a part of life and relationships for anyone, they have trouble keeping their emotional reactions right-sized. And oftentimes they feel somehow defective in their reactions, so they try to hide them and put on a false face to others and even to themselves.

But this sort of beginning need not be a life sentence. No one needs to feel alone or crazy because their past pain is leaking into their present. Twelve-step programs such as Alanon, CODA and ACOA meetings are filled to the brim with people “who know because they’ve been there” and will quietly nod their heads in recognition and identification as these stories unfold and are told. Twelve-step programs are essentially free and by their tradition are not connected with any sort of commercial enterprise. Many who enter “program” feel that they “no longer regret or wish to close the door on their past” because they have found such positive support and life direction by joining with others on a healing journey. The ACoA trauma syndrome, in other words, can as easily open a door to the soul as close it.

As a member of my group recently said, “I saw you do your psychodrama tonight. I saw you struggle to let yourself feel, to let yourself say what you wanted to say. I saw you start to feel. It was like a door inside you opened up. I remembered that moment when I started group and had that feeling. When it came to me… when that door… I mean, I had been waiting so long for something to happen… when that door inside me opened and I finally realized… I saw… that the person who was holding it closed all along, was me.”

For more info click: http://emotionexplorer.com/acoa