Meadows Senior Fellows Featured at U.S. Journal Training Conference

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Mental Health conference

For behavioral health professionals, The U.S. Journal Training Conferences are some of most highly anticipated events of the year. Each even in their conference series gathers internationally-renowned experts and thought leaders to share their latest discoveries and insights into the human mind.

This year’s 4th Annual National Conference on TRAUMA, Addiction, and Intimacy Disorders in Nashville, Tenn., is certainly no exception. We are proud to be sponsors of this year’s conference and honored to have three of our Senior Fellows among the distinguished presenters.

Dr. Bessel van der Kolk

On Wednesday, May 3, Dr. Bessel van der Kolk will open the conference with his keynote, “Trauma, Body, and the Brain: Restoring the Capacity for Synchronicity and Imagination.” He will explain how recovery from trauma involves learning how to restore a sense of visceral safety and reclaiming a loving relationship with one’s self, one’s entire organism.

Dr. Kevin McCauley

On Thursday, May 4, Dr. Kevin McCauley will present “The Brain and Recovery: An Update on the Neuroscience of Addiction.” This lecture will summarize the most current neuroscientific research about addiction—research that explains how the brain constructs pleasurable experiences, what happens when this process goes wrong, and why this can have a dramatic impact on our ability to make proper choices.

Dr. Shelley Uram

Also on Thursday, May 4, Dr. Shelley Uram will present “Essential Living: A Guide to Having Happiness and Peace by Reclaiming Your Essential Self.” Her presentation will explore ways that we can find who we are at our very essence, how our ancient survival brain areas pull our attention away from this essence at a very young age, and how to get it back.

These three Senior Fellows help train our staff at The Meadows to be some of the best therapists, counselors, psychologists, and psychiatrists working in the field today. We’re confident that those who attend their presentations will walk away with new insights, and new approaches to apply in their practices and in their own lives.

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Dr. Shelley Uram Featured on The Dr. Drew Podcast

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Dr. Shelley Uram, a triple board-certified psychiatrist and Senior Fellow at The Meadows, was recently a guest on The Dr. Drew podcast.

The podcast is hosted by Dr. Drew Pinsky, a board-certified internist and addiction medicine specialist who is well known for his work both as a physician and as a TV and radio personality. On The Dr. Drew podcast, he takes listener calls and talks to experts on a variety of topics relating to health, relationships, sex, and addiction.

He and Dr. Uram had a fascinating and in-depth conversation about the ubiquity of relational trauma in today’s society, how trauma impacts the brain and body, and treatment modalities like mindfulness, yoga, EMDR, and Somatic Experiencing, and 12-step frameworks.

Here are a few highlights from the show:

On The Prevalence of Trauma in Our Culture

Dr. Drew: What are you seeing with trauma these days?
Dr. Uram: There’s a lot of stress and strain and what I call relational trauma that’s inherent to modern American culture… It often leads to addiction, trauma, and depression.

The ACEs study showed us that when we’re children and we’re exposed to the stresses and strains of family and psychological traumas— “soft” traumas that are really not soft—they go on to create all kinds of psychological problems, medical problems, heart problems, lower socioeconomic levels, and more. So, those traumas we are exposed to as children and may not even recognize as traumas can go on to wreak havoc in the body, the brain, and the mind… I see that a lot.

On Unhealthy Relationship Patterns

Dr. Drew: People with traumas often seem to be magically attracted to the kinds of people who have features or qualities similar to the perpetrators of those traumas. And, of course, if you are drawn to a perpetrator they will oblige you and re-perpetrate. Where is your sense of where that’s coming from?

Dr. Uram: There’s a part of the brain called the brain stem, which is located physically at the lowest level of the brain and is evolutionally hundreds of millions of years of years old. Since it’s so ancient it doesn’t have sophisticated wiring. In addition to homeostasis, procedural memory is one of its functions. Procedural memories are habits or patterns that get locked into our brains. Every single function of the brain stem, including procedural memories, is unconscious. So, when patterns get locked in there, we are no longer aware of them. It’s like learning to tie your shoes. At first, it took a lot of effort, but once you got it, you could do it without thinking. So, how to tie your shoes is a procedural memory.

Procedural memories are also made up of any types of patterns that we picked up from our formative years, mainly birth to age five. They can be simple motor activities, like tying your shoes, or they can be tied in with strong emotions, fears, and expectations. Once something gets registered as a procedural memory, we’re off to the races. We’re going to keep repeating procedures related to those early emotions and all we can do is notice it. We have little to no control.

Another rule of thumb with the ancient brain areas like the brain stem is that they like for us to stay in the zone of comfort. Even if we consciously hate the zone of comfort we end up staying with it. So, for a woman who has been abused as a child and ends up in abusive relationships as an adult over and over and over—She may hate that she does that, but to her ancient survival brain areas, that’s the zone of comfort. That’s what it knows. It knows abuse. It knows neglect. It knows perpetrators…

Dr. Drew: Some people can trust their so-called instincts, but if you’ve had trauma… No. Or if you find that you repeat behavior you don’t like, or repeating circumstances you don’t like or relationships you don’t like—that’s when you can’t trust your instincts.

Dr. Uram: The real wisdom that we all have deep inside of us tends to be a very quiet voice—most of us don’t hear it all. But the voice of addiction, the voice of trauma, and the Fight, Flight, Freeze voice screams at us… By the time most of are three months old, our thinking brain has started to come online and we have our first dawning sense of “Oh, there’s a me.” That triggers our flight, fight, freeze survival responses like crazy. Especially if we are exposed to trauma, the survival voices are screaming loud voices inside our heads. They make us forget entirely how to listen to the quiet voice inside of us that contains our sixth sense and our wisdom.

On The Essential Self

Dr. Uram: We all have a soul—an essential self that we are born with and die with. It gives us our inherent sense of worth, and our wisdom, and our sense of peace and happiness—real, deep happiness… By the time we are young adults, most of us have long forgotten who we really are, because layer upon layer of false beliefs, expectations, symptoms, and negative feelings have built around our essence. We have to learn how to reclaim the essential self—How to get back down to that essential self and connect with it.

Learn more about The Essential Self and Trauma

Listen to the entire, hour-long podcast for more of Dr. Uram’s conversation with Dr. Drew. They go into more depth about the essential self, building interpersonal relationships, and the implications of trauma and the ACEs study.

Dr. Uram’s book, Essential Living: A Guide to Having Happiness and Peace by Reclaiming Your Essential Self is currently available for pre-order on Amazon.com. It will be available April 4 wherever books are sold.

Couples Recovering from Sex Addiction Can Reconnect

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By Dr. Georgia Fourlas, LCSW, LISAC, CSAT, Rio Retreat Center Lead Therapist

There is an indescribable beauty in watching participants move into a deeper level of intimacy after struggling through the destruction of sexual addiction.

We recently held our first session of Discovery to Recovery Part 3: From Grief to Hope, a unique workshop for couples who have already begun a journey of recovery from sex addiction. The workshop focuses on helping the couple make a transition from despair to renewal.

The rebuilding process set in motion during the workshop helps couples move their focus from the individual’s addiction to the couple and their attachment. Many couples come to this session feeling that they are stuck in grief, which can leave them feeling hopeless and helpless. The grieving process that couples embark on together throughout the week allows them to honor the pain caused by other forces in their lives while examining how that pain has kept them emotionally separated.

Through honoring that pain and re-connecting with one another, couples begin to experience the hope that not only can attachment be repaired, but also that they can experience emotional intimacy that can surpass what they ever believed possible in their lives. I like to think of this as intimacy beyond their wildest dreams, which can be experienced regardless of whether or not the couple is staying together.

Some couples decide it is best for them to move forward apart while building on the hope that they can continue to honor one another as healthy co-parents or in another capacity that respects both partners while they go their separate ways. Others decide to make staying together in a mutually fulfilling and loving relationship their goal.

Experiencing Recovery Together

Dr. Ken Adams, the architect of the Discovery to Recovery workshops, has a deep passion for healing couples. He recognized that there was a gap in services for those who were looking for ways to re-attach, seek the next level of change, and achieve deeper levels of recovery together.

Dr. Adams describes how couples survive the chaos of addiction, but do not always have the opportunity to experience full emotional recovery together. They often become stuck in the negative patterns of interaction that are driven by ineffective attempts to feel understood and to have their emotional needs met by their partners. They move from the addiction to a place where they either continue to spin in pain, shame, anger, and resentment, or they disconnect emotionally and feel stuck in a relationship that they feel is emotionally unsafe.

Dr. Adams says that he views the Discovery to Recovery workshop series as “an invitation to integrate recovery concepts as a couple.” This requires a paradigm shift—the perception must move away from the problem of the individual toward the solution that can be provided as a couple. The solution involves healing through emotional reconnection and attachment repair.

One participant who recently completed the workshop said, “This workshop facilitated an 180-degree shift in how we have been relating to each other. We were very much stuck in conflict and separate corners, wanting to come together, but lost as to how to do that. This workshop showed us how to soften toward each other to allow the connection we both wanted to find, a starting place.”

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U.S. Surgeon General Issues a Call to Action on Addiction

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U.S. Surgeon General Vivek Murthy’s release of Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health at yesterday’s Facing Addiction Summit was an unprecedented moment in our country’s fight against addiction and substance misuse. It is the first time in history that a U.S. surgeon general has issued a report focused on drug and alcohol addiction.

The report comes at a time when more and more Americans are struggling with the effects of addiction to opioids and heroin. One person dies every 19 minutes from an opioid or heroin overdose. And, the statistics related to other addictions are no less grim. One in seven people in the United States will face a substance misuse disorder, and only 10 percent will get the treatment they need to overcome it.

“We have to recognize (addiction) isn’t evidence of a character flaw or a moral failing,” Murthy told USA Today. “It’s a chronic disease of the brain that deserves the same compassion that any other chronic illness does, like diabetes or heart disease.”

Treating Addiction as a Brain Disease

At The Meadows, addressing the neurological aspects of addiction alongside the social and spiritual aspects has always been a top priority. The Meadows Senior Fellow Dr. Shelley Uram often says that our approach includes both “Bottom Up” and “Top Down” therapies. To put it in the simplest of terms, the way your brain has been primed to respond to emotional triggers through your childhood experiences has an impact on the development of addictions and other behavioral health disorders.

Automatic emotional responses (fear, anger, disgust, etc.,) are deeply embedded in your limbic brain—the “bottom” part of your brain—which operates subconsciously.

Your choices and your rationalizations for those choices are a function of the “top” part of your brain, the pre-frontal cortex, which is the conscious, “thinking” part of your brain.

The Meadows programs include therapies that are designed to help our clients improve their overall brain functioning at both the conscious and subconscious levels.

Talk therapies, or “top down” therapies, engage the conscious, prefrontal cortex. They help you to gain a greater understanding of why you respond to triggers in the way that you do, how you can make different choices, and allow you to learn more about who you really are. Examples of these types of therapies include individual counseling, group sessions, and 12-step work.

Even as you gain a greater understanding of yourself and your disorder through top down therapies, automatic emotional responses to triggers remain lodged in your subconscious mind. “Bottom-up” therapies like Yoga, EMDR, Somatic Experiencing, and Heart Rate Variability training help to dislodge the automatic responses from your limbic system, so that your responses to triggers are less intense. These types of therapies are crucial to helping clients prevent relapse. The therapeutic devices and techniques available in our Brain Center are designed to help our patients work at this deeper level.

What about Trauma?

We could not be more pleased with Surgeon General Murthy’s efforts to combat myths about addiction and help more people get the treatment they need. These are important steps toward healing and turning the tide against our growing substance misuse epidemic in the United States.

We believe additional steps can and should be taken toward addressing emotional and psychological trauma as the underpinnings of addiction and mental health disorders.

“Understanding trauma and how to deal with it is paramount to our accomplishing as a society the goals the Surgeon General has set out,” said The Meadows Senior Fellow Dan Griffin, who attended the Facing Addiction Summit.

“At The Meadows, our program is significantly structured around our understanding of the impact of trauma on the brain, and the ways in which trauma and addiction intersect.”

If you’d like more information on The Meadows integrated treatment model, give us a call at 866-356-9801 or read more at http://www.themeadows.com.

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The Impact of Childhood Sexual Abuse on Adult Sexuality

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By Cassandra Rustvold, LMSW, MEd, Trauma Therapist at Gentle Path at the MeadowsChildhood sexual abuse (CSA) has the potential to transform the trajectory of one’s life in a multitude of ways. While the effects of childhood sexual abuse are largely individualized and can manifest at different points throughout the lifespan, commonly reported symptoms and long-term effects include dissociation, depression, anxiety, eating disorders, self-harm, relationship difficulties, and addictive or compulsive patterns of behavior (Aaron, 2012).

The sexual functioning and sexual identity in adolescence and adulthood is a particularly vulnerable factor in survivors. When a child suffers sexual abuse, sexual arousal becomes activated prematurely and can largely impact the survivor’s sense of autonomy over their body and sexual sense of self (Roller, Martsolf, Draucker & Ross, 2009).It can also draw early connections in the neural networks of the child’s brain that associates sex with power, fear, shame, confusion, secrecy and/or pain. It is not difficult to imagine why those whose sexuality has been impacted are more vulnerable to struggles with intimate relationships and sexuality.

When attempting to reconcile one’s abuse, a particularly confusing component for survivors of CSA is the experience of pleasurable physiological responses to their abuse, in conjunction with their emotional and psychological distress. Children who have experienced these positive and pleasurable feelings often report feelings of shame and responsibility tied to their abuse and sexuality, and may experience an overall distrust of their bodily reactions (such as arousal) or physical dissociation (Hunter, 1990 & Long, Burnett & Thomas, 2006).

This fusion of shame, secrecy and pleasure has the potential to predispose one to sexual aversion, sexual anorexia, dysfunction, or compulsion; thereby deterring them from developing healthy sexual scripts in adulthood.

The Link Between Sexual Abuse and Sex Addiction Three commonly experienced symptoms of childhood sexual abuse are also cornerstones of sexual addiction: compulsivity (the inability to control one’s behavior), shame, and despair.

In sex addiction, shame and despair act as a precursor to the beginning of future cycles, where the need to keep emotional pain at bay leads to mental preoccupation as an escape. The result of this addictive cycle often includes isolation, anxiety, alienation from loved ones, a breaking of one’s own value system, and secrecy; all things that often increase feelings of despair and a yearning to escape and repeat the cycle.

When an individual is struggling with intrusive thoughts of their sexual abuse or insidious negative self-talk as a result of their abuse, the lure of escape through addictive patterns of behavior is not only compelling but sometimes a means of psychological preservation.

In Dr. Patrick Carnes’ book The Betrayal Bond, eight trauma responses common among individuals who meet the criteria for sexual addiction are identified: trauma reactions, trauma pleasure, trauma blocking, trauma splitting, trauma abstinence, trauma shame, trauma repetition, and trauma bonding.

These patterns of behaviors are often unconscious attempts to reconcile, reframe, or repair the abuse that happened in youth. Unfortunately, they do not always accomplish this task and can result in perpetuated psychological and emotional damage.

The Role of Gender Gender differences also appear to play a role in how these difficulties manifest in adulthood and whether or not someone will seek out help.

Even in 2016, boys and men are still provided with narrow cultural and familial messages about what it means to be a masculine. This narrative includes such things as devaluing emotional expression and vulnerability, while prioritizing promiscuity and maintaining control.

Research has found that male survivors are less likely to report or discuss their trauma and more likely to externalize their responses to childhood sexual abuse by engaging in compulsive sexual behaviors (Aaron, 2012). For a male survivor of childhood sexual abuse, these expectations are in large conflict with the need to shatter the secrecy of their trauma and/or obtain and maintain healthy sexual relationships; both of which require an open and honest dialogue.

Healing from Childhood Sexual Abuse and Redefining Your Sexuality

For men struggling with childhood sexual abuse and sexual addiction, learning to abstain from problematic sexual behaviors that reinforce abusive sexual scripts is just as important as learning how to develop healthy intimate bonds and create a sexual identity that is affirming.

For someone attempting to face these complex issues the importance of having acceptance and unconditional, non-judgmental support cannot be understated. It is the abusive and negative interpersonal interactions that created the pain and it is the supportive and affirming ones that have the power to lift it.

At Gentle Path at The Meadows, we specialize in creating this space while offering a host of trauma-based services that are informed by the most current understanding of the nature of trauma and its impact on the person as a whole. Additionally, the therapeutic focus at Gentle Path includes not only learning to identify which components of one’s sexuality are subtracting from the quality of their life but also identifying or creating ones to enrich it.

Give us a call today at 800-244-4949.

References

Aaron, M. (2012). The pathways of problematic sexual behavior: a literature review of factors affecting adult sexual behavior in survivors of childhood sexual abuse. Sexual Addiction & Compulsivity, 19(3), p. 199-218.

Carnes, P. (1997). The Betrayal Bond. Library of Congress Cataloging-in-Publication Data.

Hunter, M. (1990). Abused Boys: The Neglected Victims of Sexual Abuse. Library of Congress Cataloging-in-Publication Data.

Long, L. L., Burnett, J. A., & Thomas, R. V. (2006). Sexuality counseling: An integrative approach. Upper Saddle River, NJ: Pearson/Merrill Prentice Hall.

Roller, Martsolf, Draucker & Ross (2009). The sexuality of childhood sexual abuse survivors. International Journal of Sexual Health, 21, p. 49-60.

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