Maureen Canning on What Really Happens in Sex Rehab

Tuesday, January 26th, 2010 | News & Announcements, Sexual Addiction |

Maureen Canning, Clinical  Consultant of The Meadows and Dakota, was recently featured in an interview on iVillage. In Tiger Woods in Sex Rehab: What Really Goes on in There, Anyway?, Canning described some indicators of a sexual addiction, and what goes on during a typical day of sex addiction treatment. Canning was also quoted in a Time.com article, What Happens in Sex Rehab?

On a related note, the work of The Meadows Senior Clinical Advisor Pia Mellody was described in an article on love addiction on Albany.com. The article outlines Mellody’s book Facing Love Addiction: Giving Yourself the Power to Change the Way You Love , and describes the symptoms, causes, and steps to overcome love addiction.

For more information on the treatment of sexual addiction, visit The Meadows,  The Meadows Dakota or Maureen Canning’s Sexual Addiction Blog.

Maureen Canning Interviewed on Good Morning America

Thursday, January 21st, 2010 | News & Announcements |

Maureen Canning, Clinical Consultant for The Meadows Addiction Treatment Center, was interviewed January 6th on Good Morning America.  In a story on the death of Johnson & Johnson heiress Casey Johnson, Canning explained the difficulties that high profile families face when their adult children have trouble with substance abuse.

To read more about the story and view the Good Morning America video, visit at abc.com.

Winter 2010 Edition of Cutting Edge Now Available

Friday, January 8th, 2010 | News & Announcements |

The newest edition of The Cutting Edge, published by The Meadows, is now available. Feature articles include  Emotional Incest and What’s Wrong about Being Special by Debra L. Kaplan, The Next Step… Life Pleasure in Advance Recovery by Steven Hoskinson, and an excerpt from The Intimacy Factor by Pia Mellody and Lawrence Freundlich.

Also included are two staff spotlights and information on a featured workshop (Sexual Recovery), additional 2010 workshops, free lectures, and other upcoming events.

The Cutting Edge is available in HTML and PDF formats.

Remembering Who We Are: Tools to Gain Clarity

Thursday, December 24th, 2009 | Best of MeadowLark |

Note: This article was originally published in the Fall 2005 issue of MeadowLark, the magazine for alumni of The Meadows.

Remembering Who We Are: Tools to Gain Clarity

Kathleen O’Brien, LCSW

“I want to change, but I don’t know how.”

How many times have you heard yourself utter these very words? Most people come to counseling knowing that their lives need to change, but they often don’t feel confident enough in their abilities to make that happen.

Confusion about what is most important can lead, at the very least, to poor choices and mildly co-dependent behavior and, in the extreme, to serious addiction problems.

It doesn’t work for us to behave in ways that go against our own values. We can suffer depression and/or anxiety when we ignore what we believe to be most important. We then “treat” our unhappiness with self-destructive behaviors, such as dysfunctional relationships, substance abuse, irresponsible spending and so forth. One poor choice leads to another, and soon we find ourselves at the bottom of a very deep hole.

That downward spiral is daunting, to say the least. My experience both personally and professionally has shown me that, in order to make a significant life change, we need to remember who we are, i.e. to have clarity about what we value most.

The truth is that most people know intuitively what is most important to them. When a client finds herself in a predicament, I ask what she would tell a son or daughter to do in the same situation. Almost without fail, she has an instant answer for the problem at hand. It is as though she can access her wisdom for someone else’s benefit (especially her child’s), but not for her own. It’s not that she doesn’t know the answer; she just doesn’t feel entitled to act on her own behalf. As a result, she usually doesn’t develop the skills necessary to get her needs met in a healthy way.

Take a few moments to ponder the following:

• If it did not matter what other people thought, what would you do differently in your life?
• If you knew for certain that you had only a limited time to live (by the way, this is always true), how would you spend that time?
• If you were to die tomorrow, how would your obituary read? Think about what you would be remembered for at this point in time. Who would mourn your passing? What would have been your greatest contribution to the world?

The point here is to focus on remembering who you are. Pia Mellody calls this “remembering that you are precious.”

Over the years, I’ve tried many techniques to help clients clarify how they feel and what they value. I call this “accessing one’s own wisdom.” Here are some techniques I’ve found helpful:

• Write about it. Keeping a daily journal makes it next to impossible to fool yourself for long. There is nothing like hearing yourself complain day after day to get you moving. I speak from experience on this one!
• Consider the best and worst possible outcomes. If the worst happened, how would you deal with it? If you have trouble here, ask yourself what you would tell someone else to do. Sometimes people get stuck because they believe that it’s abnormal to experience pain. They think that life is supposed to be happy all the time. Part of becoming an emotionally mature adult is learning to endure the normal pains of life without resorting to addiction.
• Define what you consider to be universal values. These are the so-called “bottom line” ways of being in the world, e.g. honesty, family, health, integrity, adventure, friendship, love, success, etc. Once you have your own list, take a look to see how closely you are living according to these values. Do your actions match what your heart and mind tell you to do?
• What would other people be surprised to know about you? This is a powerful question to ask yourself – and often very revealing. The answer may offer clues about what you really value.
• Ask someone you trust to write a eulogy for you. It is interesting to get a peek into how others see you.
• Make a collage. Go through old magazines and find pictures that appeal to you; it doesn’t matter why you find them appealing. Trust that your unconscious is leading you to discover more information about yourself. When you find these pictures, rip them out and paste them onto poster board. Place the collage in a place you will see often. What does it tell you about yourself?
• Get away from your problems for a while. Distance can give us a different perspective. Rent a funny movie. Do something physical, such as walking, running, hiking, etc. Experience the nurturance available in nature. A walk on the beach or in a forest can expand perspective and lead to inner calm.
• Look at what you like to do for fun. The way you spend your free time (and your money) can tell you a lot about what you find important.
• Think about how your ideal life would look. Where would you be? What would you be doing? Who would be in your life? Ask yourself why you aren’t doing these things. Try to own the choices you’ve made. It is easy – but not particularly useful – to blame others when it comes to change. How do you want to do things differently? Who might help you?
• Try acting as if you feel confident and competent. What stops most people are negative attitudes such as futility (“nothing ever works anyway”) and fears, including the fear of failure. In reality, we are limited mostly by what we believe is possible. Expect a lot from yourself (and others, too). Define for yourself what your “best effort” would be. Are you doing that? If not, why not?
• Meditate! Use meditation to access your own spirituality. This is not about religion, but about accessing that part of you that needs to connect to your inner self. There is no single way to do this. A class can help you get started. Some medical insurance companies offer meditation classes to help improve health and general well-being.

In conclusion, remember that the way to heal yourself is to know who you are and to live according to what is true for you. When a person acts in truth, it resonates down to the cellular level. You are your own best healer!

Fall/Winter Edition of MeadowLark Now Available

Wednesday, December 16th, 2009 | Best of MeadowLark |

The Fall/Winter 2009 edition of MeadowLark, the magazine for alumni of The Meadows, has just been published. This issue contains several feature articles:

• The Intimacy Factor by Pia Mellody and Lawrence Freundlich
• Recess Revisited: A Recovery Behavior by Diane Detwiler-Zapp
• Perceptions Create Realities by Charles Atkinson

Also included this issue in are staff spotlights, alumni contributions, a featured workshop (Sexual Recovery), free lectures, and other educational opportunities.  MeadowLark is available in both HTML and PDF formats.

Science and Ancient Wisdom: Treatment Here-and-Now

Thursday, December 10th, 2009 | Best of MeadowLark |

Note: This article was originally published in the Summer 2008 issue of MeadowLark, the alumni magazine of The Meadows.

Science and Ancient Wisdom: Treatment Here-and-Now

Before reading further, take 20 to 30 seconds to do this exercise: Let your gaze leave this article and let your eyes look around wherever, and at whatever, they want – just 20 seconds or so. (Really, try it, and then come back to reading.) People in my Somatic Experiencing® (SE) Trauma Treatment courses who try this are surprised that, in a very short time, they feel noticeably more relaxed, peaceful, and in the “here-and-now.” Some say they should do this all the time!

Thanks to the forward-thinking people at The Meadows, the connection between trauma and addiction is better understood and more effectively treated. Part of this treatment at The Meadows’ extended-care facilities consists of working with the trauma-resolution skills of Peter Levine’s Somatic Experiencing®. The relationship between trauma and the exercise you just tried is that, according to Bessel van der Kolk, post-traumatic stress is fundamentally a disorder in the ability to be in the here-and-now. This means that the state of- the-art in trauma therapy is no longer intense regressive or cathartic therapy. Instead, state-of-the-art therapy is the process of becoming alive to the moment.

For those I train in SE, like those at The Meadows, working in the here-and-now is a cornerstone of clinical theory and practice. When doing his dissertation decades ago, Peter Levine met Stephen Porges and explored his research. Porges’ “Polyvagal Theory” (Porges, 2001) shows how one pathway of the nervous system engages freeze and another relates to social engagement. Levine discovered how to work with the transition of the nervous system through these phases (freeze and engagement), as well as the phases of fight and flight. This is SE. This article’s focus is on the engagement phase, which must be integrated into all other nervous system phases.

While Porges’ emphasis is based on single linear phase transitions, in SE we work with non-linear and rapid cycling states, for instance, freeze and fight, or flight and orientation. Traumatic symptomology such as intrusion of fight, flight and freeze means that the past has become the present. Flashbacks are the classic example of such disorientation—innocuous cues can trigger an all-out response. In other words, the person temporarily experiences a state that is disconnected from the actual here-and-now environment. One of the antidotes to this traumatic recollection is orientation. I provisionally define orientation as “connecting to the environment through the senses” — in other words, coming back to our senses. This is a broader understanding of engagement than social engagement, per se. For clients whose early life experiences were marked by trauma and abuse, social engagement is actually a trigger for fight, flight and freeze. In this process of orientation, rather than being inundated with a cycle of feelings, thoughts, and sensations associated with unresolved trauma, the client’s attention can be directed to the reality of the environment that is available through the senses. Typically we see decreased blood pressure and decreased heart rate, as well as the subjective experience of greater relaxation and interest. In other words, it is the difference between stopping to smell the roses and reliving getting stuck by a thorn!

With many severely disoriented clients, much of the initial therapeutic work (in addition to establishing rapport) consists of the stabilization that comes from establishing better cognitive pathways or habits of here-and-now sensory attention. In attending to the sensory experiences of the external world, physiological mechanisms for assessing safety are allowed to occur without undue influence from traumatic memory. The mechanisms of this assessment are far too important, in a survival sense, for the slow processing of linear thought or conscious effort. Porges aptly names this subconscious process of safety assessment “neuroception” (Porges, 2004). Thus, a natural orientation to the external environment via the senses facilitates the neuroception of safety.

This approach is receiving increasing scientific and popular attention (Time Magazine: Mind & Body Special Issue, January 27, 2007, pp. 55ff). Whether incorporated into CBT, DBT or meditation, the role of the observer is crucial. The process of orientation is fundamental to this cognitive activity. However, many traditions that recommend observation may not adequately reinforce with clients the importance of orientation to the outer versus the inner environment. For those with significant disorientation, it is nearly impossible to track the interior landscape without being involuntarily drawn into what SE terms the “Trauma Vortex.” The involuntary and repetitive attraction to this “vortex” is the disruption of the approach-avoidance system, and it is one of the dynamics that underlies addiction and compulsive behaviors in general. Although somatically informed therapists draw from Levine’s work, they often make the mistake of inviting clients’ attention to the inward sensate experience, without consideration to the vital criteria that indicate whether a client can negotiate such attention without reactivating and reinforcing trauma states. For instance, one of the most common beginner’s mistakes is when a therapist asks an anxious client to focus on that sensation in the body. For some clients, this can work well and provide a sense of relief and transition to a more relaxed state; for others, this can lead to further discomfort and other states of disintegration. It is vital for the therapist to immediately and accurately assess the client’s capacity in order to determine the appropriate intervention. Without such assessment skill, the safer route is to begin with external orientation, which can stimulate the innate orienting response and build stability.

Once relative stability is attained, a balance of interior and exterior attention can be facilitated. Then a more neutral and practiced observation of the range of experiences can be enjoyed, as the attention can shift naturally between affective experiences, both positive and negative. (This fundamental process at the heart of SE is known as “pendulation,” which I discussed briefly in the Summer 2006 edition of The Cutting Edge) This natural swing between polarities is the normal condition of the balanced nervous system. And interestingly, the resulting integration that comes from this innate oscillation is a broader and more nuanced life in the here-and-now. The experience brings awareness, presence, and a greater ability to experience life on its own terms, without undue constriction or elation. Obtained after significant work of attending, this resulting state can yield an expanse of awareness with an increasing ease of relation and a connectedness to everything that is. This state, known among meditative adepts, is simply our human mind freed of its overlay of conditioning hewn by survival networks related to approach-avoidance. Freed from the dominance of an ill-conditioned approachavoidance paradigm, one enjoys engagement with what is now, new and alive. And so, as clinicians, we can orient to the fact that we live in a time of opportunity, when mind and body are becoming reacquainted, and when science can shake hands with ancient wisdom.

References
Hoskinson, S. (2006) “SE’s Systemic View of Functional Reward Systems.” The Cutting Edge, Summer 2006. See TheMeadows.com.
Porges S. W. (2001) “The polyvagal theory: phylogenetic substrates of a social nervous system.” International Journal of Psychophysiology, 42, 123-146.
Porges, S. (2004) “Neuroception: A subconscious system for detecting threats and safety.” Zero to Three [Online] National Center for Infants, Toddlers and Families. No. 5, May. See zerotothree.org.
Stengel, R. (Ed.). (2007). The brain: A user’s guide [Mind and body special issue]. TIME, 169 (5).

ABOUT THE AUTHOR
STEVEN HOSKINSON, MA, MAT
Under the auspices of Hoskinson Consulting in Encinitas, California, Steven Hoskinson, MA, MAT, is an international consultant and trainer for clinicians and trauma treatment providers. Steven is a Senior International Instructor for the Foundation for Human Enrichment and has done research in creativity, myth and spirituality. His perspectives include evolutionary, developmental, cognitive-behavioral and systems approaches within a mindfulness framework. Other major influences include personal mentoring with Peter Levine, PhD, more than 20 years of experience in the contemplative arts, and a decade as a practicing aikidoist. www.HoskinsonConsulting.org

John Bradshaw Featured in Ethics Viewpoint Roundup

Monday, November 30th, 2009 | News & Announcements |

John Bradshaw, MA, Fellow of The Meadows, was mentioned in a recent article in the Sudbury Star. In “Different Views on Ethics”, librarian Kaija Maillloux rounds up eight books with unique perspectives on ethics. From the article:

“Reclaiming Virtue: How We can Develop the Moral Intelligence to do the Right Thing at the Right Time for the Right Reason, by John Bradshaw, shows that each of us has what he calls an inborn moral intelligence, an inner guidance system that can lead us — if we know how to cultivate it in ourselves and others. His fascinating discussion ranges from the ancient Greek philosophers to modern explorations of emotional development, from provocative historical insights to the recent discoveries of neuroscience.”

To learn more about Reclaiming Virtue, see this interview with John Bradshaw from earlier this year. For more information about Bradshaw and The Meadows, visit www.themeadows.org.

Dropped Stitches

Thursday, November 26th, 2009 | Best of The Cutting Edge |

Note: This article originally appeared in the Spring/Summer 2009 edition of MeadowLark, the magazine for alumni of The Meadows.

Dropped Stitches
By Judith S. Freilich, MD

I am a psychiatrist thinking about knitting – about dropped stitches, in particular. Knitters know that a dropped stitch weakens the whole cloth, disrupts the garment’s integrity and leaves a hole that may not even show until there is a stretch or stress on it. Then, the fabric is likely to begin unraveling from the hole, no matter how carefully the rest is knitted.

I wonder about this in my life. In the fabric of my life, there were many dropped stitches – emotions suppressed, voices blocked, roads not taken, losses not grieved before moving on, trauma endured. Life.

My way was to keep moving forward with determination, compassion and courage. I loved, worked hard, accomplished, learned and helped others along my way. On the surface, my efforts seemed of strong cloth. As time went on, those invisible holes – the dropped stitches – began to show and unravel.

“The body is the mind’s subconscious,” says respected neuroscientist Candace Pert, PhD. That which our minds can’t absorb is held for us in our bodies. Dropped stitches remain in our garment, a part of us. They do not just disappear.

What to do about my dropped stitches? Do I leave the past untouched and continue pressing forward? What would that mean for the whole cloth? Does it end up in the trash that way? Do I choose the difficult task of repairing my garment, so it has more integrity for the future?

When a knitter discovers a dropped stitch, she repairs it. She unknits back to it, picks up the dropped stitch and then knits forward again. Knitters call this “tinking” – “tink” being “knit” spelled backwards.

I think I will “tink.” Many of my dropped stitches are losses not fully grieved. There are trauma-made holes, too. The largest is from when my daughters died in a tragic car accident in 1985. Then, I had no ability to grieve. I might have died or gone crazy had I not become frozen and dissociated.

I did not consciously make a decision to freeze. Perhaps my soul did, in order to preserve my life. And by doing so, the memories and grief were frozen and stored in my body – until the time came to unfreeze and release them. And, yes, it left dropped stitches. I think this was preferable to having no garment at all.

There are many ways to “tink.” Each begins with recognizing a hole. We can complete a grief left undone. We may reconnect with an attenuated relationship. There is repair that is spiritual in nature, such as gratitude and forgiveness in their many forms.

There is trauma work. Effective trauma release is “tinking” at its best. Sometimes it involves finding memory pictures, then developing them to bring buried treasure to light or frozen emotions to life. Sometimes, tracking body sensations is the way to find and release them. Or we might return to an old physical environment, restoring an emotional state that was left behind before it was time.

The purpose is to transform trauma. It helps to think about chemistry and alchemy. Like knitting, these are transformational processes. They turn one thing into another. If a single step in the process is missed, the whole thing won’t go to completion. It just doesn’t work.

Tinking is precise, too. It begins with intention – and some resistance, as undoing is unpleasant. The knitted strand is carefully pulled apart, all the way back to the hole. The yarn is neither lost nor cut. It remains an integral part of the garment. When reknitted forward, it becomes part of a stronger garment.

Knitting creates links. A bridge is a link. To pick up a dropped stitch is to build a new bridge, make a strong link where one was weak or not even there. Building a strong bridge requires first building good foundations at each end of the span.

Not long after my girls died, a friend talked to me of bridges. She said that when your child dies, the foundation of your life collapses. For a while, you must go forward, building a new foundation. At some point, you then can build a bridge back to the past. Healing happens then. Connecting past and future makes a stronger whole.

With thanks to Descartes: “I ‘tink,’ therefore I am.”

— Judith S. Freilich, MD, is a psychiatrist at The Meadows who is board-certified in psychiatry and neurology.

The Meadows’ Peter Levine on Grief & Crying

Monday, November 16th, 2009 | News & Announcements |

Peter A. Levine, Clinical Consultant for The Meadows, was recently quoted in the Psychology Today blog Let’s Connect. In a post entitled “Enjoying Your Emotions“,  Thomas Scheff explores the psychological aspects of grief and fear, and suggests that too often, we are told to learn to control our emotions, instead of learning to enjoy them. For instance, grief can be a painful emotion to a person who does not feel safe to grieve.

“We have “good cries” when we are able to rapidly move in and out of the grief. Peter Levine (1997) called it pendulation. Without this movement, we either don’t feel at all, repression, or feel so much that we get lost in it (a “bad cry”).”

Scheff concludes that critics of catharsis haven’t considered pendulation, but ought to.

For more information on Peter Levine’s works, please visit the Meadows Addiction Treatment Center website.

The Triggering Effect

Thursday, November 12th, 2009 | Best of MeadowLark |

Note: This article originally appeared in the Spring/Summer 2009 edition of MeadowLark, the magazine for alumni of The Meadows.

The Triggering Effect
By Claudia Black, PhD, MSW

Article excerpted from newly released CD Triggers and DVD The Triggering Effect.

Triggers are specific memories, behaviors, thoughts and situations that jeopardize recovery – signals you are entering a stage that brings you closer to a relapse. The process is much like riding a roller coaster that loops over itself. Once the roller coaster car gets to a certain spot in the track, a threshold is met, there is no turning back, and it starts the downward loop.

t is very likely you have heard your husband, wife, partner, mother, father, boss, a friend, attorney or even a judge say, “What were you thinking?” The answer is: you weren’t thinking.

The inability to recognize the impact of your behavior, the willingness to risk what is significant in your life, and in this case, the quick lapse into old behaviors in spite of good intentions appear to be connected to brain chemistry. Addiction hijacks the brain. The reward/pleasure center holds captive the thinking center.

The good news is that the brain has plasticity. That means, in treatment and recovery practices, you can learn skills to calm the brain’s emotional responses and reactivity area. You can learn to avoid triggers that activate the emotional area, and you can learn to enhance the decision-making area so you can rationally think through decisions, rather than respond impulsively and from such a strong emotional basis. But it takes time for the brain to be rewired, and it gets rewired with the repetition of new skills and new ways of thinking; hence, we strongly urge ongoing involvement in aftercare and other support systems.

Willpower alone is not a defense against relapse. Recovery is achieved, maintained and enjoyed through a series of actions. Learn to identify your triggers and, with each, identify a plan that anticipates and de-escalates the power of the trigger. With that, your reward is another day of sobriety with endless possibilities.

Five common triggers are:

1. Romanticizing the Behaviors
Romanticizing involves a tunnel focus on the positive feelings you associate with the behavior; it involves glamorizing using behaviors and, in the moment, totally forgetting about the negative consequences.

Getting overwhelmed at times is to be expected, but it’s very easy to slip into romanticizing without any insight as to how you got there. At that moment, you enter a slippery zone, touching the trigger. While romanticizing is itself a trigger, it often occurs in tandem with an external trigger such as noises, sights, sounds or even tastes. You could be watching a movie and the next thing you know it is depicting the power of alcohol, drugs and sex in a positive way, and you are romanticizing. Or you’re listening to the radio and an advertisement for a drug comes on, and you think about your pain pills as the commercial goes on to tell you how much better you’ll feel, and off you go. Or you’re watching a ball game on TV and can almost smell the popcorn and peanuts, and you see the spectators drinking large cups of beer and everyone is smiling like it’s only a good time.

Take a few moments to think about how you romanticize your addictive behavior. What do you find yourself thinking about? What is the romanticizing covering up? What are you forgetting to take into account?

2. Feelings
Addicts have used their behaviors and substances for years to separate from their emotional states. And there is so much to feel — guilt for how your behavior has hurt others, sadness for your losses, anger with yourself, fear of what is in front of you, shame for thinking you are inadequate, not worthy. You can act out in response to every feeling imaginable.

You lessen or get rid of feelings when you own them, talk about them or, in some cases, engage in problem solving. It is when you try to divert, ignore, and numb that you get into trouble. Feelings are a part of the human condition and you can’t escape them. Recovery is the ability to tolerate your feelings without the need to medicate or engage in self-destructive or self-defeating behaviors and thoughts.

Recognize the gifts that come with feelings. Feelings are cues and indicators telling you what you need. Loneliness tells you, in your humanness, you need connection; fear can offer you protection, sadness offers growth, guilt is your conscience, offering direction for amends. It is critical for you to have this insight and, more importantly, to start to take ownership of the feelings when you have them.

3. Loss
Coupled with the trigger of feelings is the fact that those feelings are often associated with loss. By the time you get to recovery, you have had multiple losses in your life, often related to childhood, many times due to being raised with abuse, addiction, mental illness, etc. While you may have experienced trauma within your original family, pain of loss may be from a specific situation.

You may have experienced the loss of relationship with your parents or children, the death of friends or family, abortions, or career or work opportunities missed. As an addict, you are likely to have experienced losses related to health issues. Perhaps you have Hepatitis C, HIV, or injuries due to accidents.

It is not that you are suddenly thinking about these losses, but there may be a trigger. Perhaps you are in treatment and you see other people’s children come to visit, and you have three kids and you don’t even know where they live. Your daughter tells you that your ex-husband has just moved in with someone else. The goal is not to dwell on your losses, to not live in the pain and anguish. This is what happens when you don’t acknowledge them and what they mean, triggering you back to your using behavior. With some losses, you can only grieve and ultimately come to find some meaning from your experience; with others, in time, you can attempt to repair damaged relationships.

4. Resentments
Resentment is also a feeling, but I think it warrants its own place as a significant trigger. Resentments are like burrs in a saddle blanket; if you do not get rid of them, they fester into an infection. Resentments are often built on assumptions, i.e., “When you don’t look at me, I assume you think you are better than me.” “When you don’t include me in a social gathering, I am assuming you think I am not good enough to be with you and your friends.” Resentments are also built on entitlement, which is a form of unrealistic expectations and impatience.

Unrealistic expectations + impatience = resentments.

Move from resentments. When assuming, check it out. Put yourself in someone else’s shoes (it may allow expectations to be more realistic). Identify and own the feelings the resentment is covering (often it’s a cover for feelings of inadequacy and/or fear). Be willing to live and let live.

5. Slippery people, places or situations
You need to identify specific triggers – the people, places, and situations that are high-risk. Slippery people could be your ex-lover, certain family members, or past using/party buddies. A slippery place might be a bar you used to frequent, a casino, or an area in your community where you cruised – in essence, any place that triggers a positive association about the use of your drug of choice. Slippery situations could be an emotionally charged social gathering, such as a wedding, family event, or vacation.

Medication may be a trigger for which you need to be accountable. While there are situations when medication is needed, you are at high risk to abuse. You need to be proactive in how you are going to cope with this situation, because it is likely that your brain is going to remember a good feeling, saying more is better. Again, there are situations when medications are necessary, but self-diagnosis and/or self-prescribing only create a recipe for disaster.

What are the people, places or situations that are potential triggers? What provides safety for you to not be triggered? What triggers can you avoid? While some decisions around triggers are absolute, others are not necessarily in place for the rest of your life. Know your triggers and plan accordingly. In the face of a trigger, what do you need to do? What do you need to tell yourself? To whom can you reach out for support and/or problem solving?

Today in recovery:

1. Practice staying in the present; don’t sit in the past or project into the future.
2. Validate the gifts of recovery for the day – practice gratitude daily.
3. Identify, build and use a support system – you need to stay connected. History and experience have proven time and time again that recovery is not a solitary process and cannot be sustained in isolation.
4. Trust that your Higher Power is on your side.