The biology of addiction

Evidence is piling up that there is a genetic component to alcoholism and addiction. Michael Ferguson, a professional associated with the California treatment center Sober Living By The Sea, puts it this way:

"Genetics load the gun, and environment pulls the trigger.”

Research is showing that people with a certain gene have a tendency towards being unable to quit once they have started drinking or using drugs. However, if an individual has a great support system of family and friends, a good education and the understanding of a family history where addiction has been threading its way through the genrations, then addiction is certainly preventable.

For more on addiction and genes, here is a video worth watching.

What is a good psychotherapist?

You should have the sense that the pyschotherapist “gets” who you are and what difficulties you are experiencing.

The good therapist should be able to offer you hope that your difficulty is able to be addressed and solved — perhaps not immediately but with time and attention.

A good therapist should be attentive and able to listen well, provide support and validation while also able to be honest with you about your challenges and blind spots.

He or she should be informed about community resources and able to offer you additional information (books, videos, Web sites, support groups and other sources within the community) that may be helpful.

If your problem is outside of the experience and the scope of the therapist’s practice, he or she should be able to refer you to a competant professional who should be able to help you.

A few words about sex addiction and "cures"

Yesterday’s request of Racine’s former mayor to attend treatment center for compulsive sexual behavior and trauma are bringing his legal charges – and discussions about sex addiction – back into the public eye.

Many people are asking if individuals who are attracted to unhealthy and destructive forms of sexual activity can be "cured.”

This is a complicated question. An answer about a “cure” – or lack of same – would be very easy to answer if all offenders fit an identical profile.

However, there are many profiles of a person who acts compulsively with regard to sexual activity – just as there are many profiles with individuals who are caught up with compulsive use of alcohol, drugs, spending, gambling and other high-risk behaviors. Here, it is important to have a thorough assessment by professionals who are able to determine long-term behavior patterns and the true level of the illness. Sometimes the illness is contributes to activities that break the law -- for instance, an alcoholic who has a car accident when driving while intoxicated is acountable for that accident and injuries or deaths that result. In most areas, it is not against the law to gamble, but legal authorities will be calling if you embezzle money from your employer. With respect to sex addiction, individuals may find themselves in legal trouble if their actions violate a law; a pedophile is defined ins psychological terms one who is attracted to children, 13 years of age and younger, and there are other laws as well. Addictions of all kinds affect the brain, and the person’s brain can be retrained to respond to triggers differently and to learn and practice healthy behaviors. Addictions cannot be "cured." But they can be treated, and a recovering person can learn how to abstain from destructive behavior and respond with healthy choices with awareness, motivation and support. Many good programs are available for in-depth treatment which often includes treatment for depression and anxiety; The Keystone treatment center employs a variety of standard and innovative treatment modalities, including psychodrama, a powerful action method that is often used in psychotherapeutic settings.

Keystone's Web site provides a good overall view of how sexual acting-out behaviors can damage people, marriages, jobs and families – just as alcohol and drugs do. There is an excellent article by Susan J. Campling, Psy.D., the center’s director, that should answer many common questions. She says:

“Today we understand the powerlessness the addicted person feels and have begun to recognize that the pleasure of addiction, the “high” can result from substances outside and inside of the person. Behaviors can trigger the release of internally produced chemicals that create the pleasure high and at least temporarily, alter mood. Sex, gambling, exercise and shopping are only a few of the behaviors that can alter a person’s mood. When the addicted person continues to engage in these behaviors despite negative consequences, we see the footprints of addiction.

I must challenge views that inpatient treatment is “ineffective.”

When I worked as a psychotherapist at Caron Treatment Centers, an inpatient treatment center for chemically addicted persons and their families in Wernersville, Pa., we often referred to other centers for specialized treatment, such as eating disorders, sex addiction and the like. Keystone, located in a nearby county, was one of several referral options.

Inpatient treatment at a quality treatment center gives the individual the opportunity to fully focus on addressing the illness without distractions that daily life presents. It is a real chance to make significant changes, if the person is motivated to learn and grow. Part of the learning is to identify healthy risks that lead to help and healing rather than unhealthy risks that lead to secrecy and shame.

It’s also important that a person, once discharged, is willing to follow recommendations of continuing care. Such recommendations might involve ongoing outpatient therapy, participation at self-help meetings, abstinence from mood-altering chemicals and other lifestyle alterations.

Another important resource is Sex and Love Addicts Anonymous, a 12-step group that offers a simple and yet very effective program for individuals who are motivated to recover. Its name refers to both to individuals who are addicted to some sort of sexual activity, as well as those who have a chronic and compulsive preoccupation with romance, intrigue or fantasy. Others have found help at a similar group, Sex Addicts Anonymous.

SLAA and SAA are structured self-help programs based on the original steps of Alcoholics Anonymous – which has literally helped millions of people to recover from compulsive use of alcohol and birthed many other helpful groups, including Narcotics Anonymous, Overeaters Anonymous, Gamblers Anonymous and Nicotine Anonymous and programs for family members of those addicted.

As Susan Campling says:

“Today, it is no longer socially acceptable to laugh at the pain of alcoholism. Today we continue to glorify the sexual conquests of TV stars and pass judgment upon the "moral failings” of persons unable to stop their sexual acting out. We freely use words like “pervert,” “nympho” and lecher. Perhaps it is our fear that diseases can happen to anyone and that we are all vulnerable that is intolerable. Instead of drunks or perverts, persons suffering from addiction, might be something else. They might be people worthy of our understanding and compassion. They might be us.”

See her complete essay, “As We Raise Our Head from Shame to Grace,” here.

For more information, see SLAA’s site here and SLA's site here with additional helpful links here. Professionals can learn more about psychodrama and sex addiction at my blog for professionals here.

Massage therapy school has its own blog

The professional massage therapy school at the Wisconsin Institute of Natural Wellness now has its own blog! It's still brand new, but you can find some basics of the school -- now taking applications for the September 2009 school year -- as well as massage therapy links, massage news and links of alumni, including Lake House's own Helene Hellesen and Judy Warner. Check it out here.

Why yoga and psychotherapy make a great fit

As a psychotherapist, coach and educator -- and sometime yoga practitioner -- I have repeatedly observed that yoga is an excellent adjunct to psychotherapy. Actually, it's an excellent adjunct for any kind of path of growth, personal or professional, because it helps stabilize us and helps us take in learning, accelerate change and advance spiritually.

Contemporary psychotherapy has become more interested in neurobiology -- the interaction of the many hormones and other chemicals within sections of our brains -- which affect our emotions and behaviors. We know that the chemicals can be shifted and changed in a variety of ways: by medication, by certain experiential therapies, and by yoga.

I have found that many people benefit from yoga, often in surprising ways: a teen-ager who denies the effects of marijuana on her body learns that she cannot breathe very well during a posture; an overwhelmed care-taking mother learns to slow down and take time for herself; a business man who is experiencing high blood pressure begins to relax and feel more in control of his body. A study published in a recent issue of Psychology of Women Quarterly reported that mind-body exercise, such as yoga, is associated with greater body satisfaction and fewer symptoms of eating disorders than traditional aerobic exercise like jogging or using cardio machines. Yoga practitioners reported less self-objectification, greater satisfaction with physical appearance, and fewer disordered eating attitudes compared to non-yoga practitioners.

Here are ways that yoga is helpful:

Sometimes we think too much and we need to clean our brains. Our thoughts fill our heads and seem to control our entire reality with "When…" and "What if…" Yoga, as a method of uniting mind, body and spirit, seems to bring the thoughts in the body. When you are focusing a posture with a good stretch, mindful of hand and feet placement and taking a breath, there is little time to ruminate and worry.

Yoga postures also aid in releasing emotions in a healthy way. If it is stress, your boyfriend or your job making your emotions go wild, the postures help contain the emotions and release them in a safe and appropriate way. No one is embarrassed or confronted with angry outbursts, and

Yoga reduces stress and helps us slow down in this fast, fast world. When we are calm, we are able to make decisions, large and small, more clearly. Sleeping better, and therefore feeling more rested, also contributes to optimism and energy rather than exhaustion and irritability.

Yoga helps reduce pain and physical discomfort. It is hard to be cheerful and optimistic when you are in physical pain. For many people, the pain and the limitations that it causes in each person's personal life creates depression.

Yoga is self caring. Many people who have few self-care habits can begin to appreciate their bodies and what their bodies can accomplish. Motivation and dedication, rather than expensive equipment, increases a person's ability to care for self, and some of the benefits can be experienced almost immediately.

Yoga offers a comforting philosophy that complements psychological principles. It gives attention to the body while also identifying the importance of the mind, the spirit and numerous lifestyle choices.

If you practice in a group, you have a ready-made support group. Your teacher and fellow students will be glad to see you -- or they should be glad to see you in a good and well-run yoga class! -- and you will widen your support network. Community helps us feel more connected and less isolated; research studies have shown that people who enjoy a wide social network appear to be more healthy and live longer.

Having written this, I also will say that there are times when yoga is not suitable for someone in the therapeutic process, either at a specific moment in time or in general. I can remember one woman that I worked with who experienced difficulty and stress. The woman -- who was a survivor of sexual abuse perpetrated by her sadistic mother -- had been referred by her psychotherapist to one of the best yoga instructors in the community. The idea was that the yoga would help her feel more connected to her body.

The woman felt uneasy with the class, which took place in a partially lighted room, and she experienced strong triggers when the instructor moved from student to student to correct postures. Despite the gentleness the instructor, the class was simply too threatening. The woman later found relief and growth with a male bodyworker who worked with her in one-to-one sessions with other modalities where she felt more safe and comfortable.

Nevertheless, yoga is a very good thing for most people. A good instructor should hear your concerns and adapt instruction to fit your needs. I am always looking to refer people to yoga.

Top 6 health trends for 2009

We're just into the beginnings of 2009, the time when experts are looking forward with predictions for headlines for the year.

One of the areas that is often neglected -- despite its growing interest by public and professionals alike -- is that of alternative and complementary heath. These trends surely will affect businesses, both large and small, as well as the way that health care is sought and delivered in our communities. Here is my list of top health trends:

Interest in alternative treatments will experience a second surge. As more mainstream medications, from Aleve to Prozac to Vioxx, are showing seriously dangerous side effects, we'll be looking for new solutions to minimize health conditions. Even though interest in alternative treatments is already high, more people, practitioners and patients will be willing to experiment with new remedies, activities and lifestyle changes to avoid these kinds of medications. Yoga, tai chi, qigong, Feldenkrais, imagery, acupuncture and other exercises and modalities will continue to gain attention due to their ability to calm, soothe and attend to medical situations such as chronic pain, hypertension, obesity and stress.

Along with the growth of interest in alternative medicine, there will be a growth in the interest of alternative psychotherapy and personal and business coaching. "Alternatives" don't just come down to herbs, massage and yoga, as valuable as they are. People can experience significant growth and change -- often in short amounts of time -- with activities that use drama, guided imagery, music therapy, art therapy, sand tray therapy and other modalities that speak to people's whole selves, not just symptoms.

In our buy-buy culture and go-go lives, we'll step up the need for personal satisfaction rather than external achievement. This may well mean a "diet" on activities, trimming our schedule of overextended lifestyles and creating routines and opportunities for our overstressed bodies and minds. Products and services, including personal coaching, will assist in helping us focus on what is really satisfying and comforting.

As insurance costs bump up, a greater push to keep students and employees healthy. This will mean a closer examination of cafeteria food in schools and vending machines in work places, including information on how eating patterns create stress, obesity and health and behavior problems. Food processing companies and vendors are upgrading their searches to develop and market products that are not only healthy but actually promote health.

Special interest treatments will be developed for special interest groups. Studies are showing that various groups, whether ethnic or otherwise, are at higher risk for certain health concerns. Just one for-instance: a research study is showing showing high rates of smoking in the LGBT (Gay, Lesbian, Bisexual and Transgender) community. In some parts of the country, LGBT smoking rates can be as much as 50 percent higher than their heterosexual counterparts, making nicotine an emerging public health priority for LGBT individuals.

Nicotine treatment programs will gradually become more varied and incorporate alternative methods of treatment, care and support. These alternative methods may include acupuncture, non-traditional psychotherapy, online support groups, herbal therapy, dietary changes or a combination of unique interventions designed to fit the individual's needs. More insurance companies are offering help with nicotine cessation, too, as it becomes apparent that nicotine use hurts health and contributes to many illnesses and conditions. The fact is that smoking kills more people each year than HIV/AIDS, car accidents and drug and alcohol use combined.

What to do when your kid provokes you

Here’s an easy-to-read article from one of my favorite sites, www.slate.com, about parenting:

The article, by Alan Kazdin, Ph.D and Carlo Rotella, offers thoughts to guide parents to a more helpful and calming response to children who are defiant or acting out.

The article describes various ways of responding to the defiant act and predicts both the immediate and long-term results of such responses. “The Parking Ticket” turns out the best solution. Read more here, plus the sidebar here.