Drug Rehab Center

By Daniel Jordan

I came across this video featuring Gary Wood, author of Don’t Wait for Your Ship to Come In: Swim Out to Meet It, and thought that it was worth a look for two reasons: (1) it recommends a practical way to “learn” gratitude and (2) pairs gratitude with anticipation.

A Practical Way to “Learn” Gratitude

One way to “learn” gratitude, also recommended by TV personality Deborah Norville in her book, Thank You Power, is to write down in a notebook or diary (preferably before bedtime) three things you are grateful for that happened that day. Write down anything that uplifted you at the time it happened, that brought a smile to your face or your heart, or something you are glad about. Better still, after each situation, write down why this was good for your life. For example, perhaps you received a Christmas card from an old friend. You are thankful for your friend’s gesture because it reminds you of some good times you had with this person when you were young. Besides, it’s nice that someone from your old neighbourhood thinks enough of you to send you a card.

Sometimes you have to think hard about something to be grateful for, particularly if you are having a bad day. However, this mental exercise is the whole point of the exercise so keep thinking even if something doesn’t immediately come to mind. Gary Wood calls this an example of a “personal experiment” which can help individuals, at an experiential level, that perception colours our experience or, as Dr. Wood puts it, “viewing influences the doing.” By focussing on the “good stuff”, Dr. Wood suggests that you can change the way you see the world.

Your Other Daily Bookend: Anticipation

Recording 3 things for which you have gratitude for at the end of your day is a great way to develop a sense of gratitude in your life. Dr. Wood has a great way of starting your day off in similar fashion. However, the difference in the morning is that you envision, rather than reflect on, events which are worthy of thanks.  In this way, anticipation is a sort of “daily bookend” when combined with gratitude. It’s important to record 3 things you are looking forward to before you get up so that your mind is not clouded by “busyness.”

A Special Note to our Alumni

Remember the black personal planners you were provided during your stay at Sunshine Coast Health Center? Recording your daily lists of gratitude and anticipation is a great way to use your planner and maintain your recovery.

Further Learning on Gratitude

Sunshine Coast Program Director, Geoff Thompson, has recently posted a video on gratitude that spoke of the importance of gratitude for people with addictions.

Geoff Thompson, MA, CCC

Geoff Thompson, Program Director at Sunshine Coast Health Centre, discusses the importance of forgiveness and the impact this can have on every aspect of your life, including physical health.

By Daniel Jordan

For the past few weeks, alumni of Sunshine Coast Health Center have been participating in a new topic on our online support program: making “positive change.” By practicing these new ideas, clients are applying some of the leading edge approaches in psychology since, for the past 10 years or so, researchers in the health sciences are recognizing that being “disease-free” does not necessarily equate to being healthy. This is true regardless of whether we are talking about physical disease such as cancer or mental illness such as depression.

When it comes to addiction, researchers are also reaching the same conclusion: being “disease-free,” or remaining abstinent, is not enough. This is not really news for people who have worked in the addiction field. We all know a client who has stayed clean and sober and then relapsed after coming to the conclusion that “if this is what recovery is like, then I might as well go back to being a drunk!”

Using Your Strengths: Creating Good Feelings in Recovery

Researchers in a particular branch of psychology known as Positive Psychology have recognized that some of us are happier than others and more resilient to problems when misfortune strikes. Over time, researchers such as Martin Seligman and Christopher Peterson identified virtues and character strengths as the key to happiness and resilience. In their book, Character Strengths and Virtues: A Handbook and Classification, Peterson and Seligman have created a systematic classification that lists six virtues and 24 strengths to go with them:
 
I. Wisdom and Knowledge
a. Creativity (originality, ingenuity)
b. Curiousity (interest, novelty-seeking, oppenness to experience)
c. Open-Mindedness (judgment, critical thinking)
d. Love of Learning
e. Perspective (wisdom)
 
II. Courage
a. Bravery (valor)
b. Persistence (perseverance, industriousness)
c. Integrity (authenticity, honesty)
d. Vitality (zest, enthusiasm, vigor, energy)
 
III. Humanity
a. Love
b. Kindness (generosity, nurturance, care, compassion, altruistic love)
c. Social Intelligence (emotional intelligence, personal intelligence)
 
IV. Justice
a. Citizenship (social responsibility, loyalty, teamwork)
b. Fairness
c. Leadership
 
V. Temperance
a. Forgiveness & Mercy
b. Humility & Modesty
c. Prudence
d. Self-Regulation (self-control)
 
VI. Transcendance
a. Appreciation of Beauty & Excellence (awe, wonder, elevation)
b. Gratitude
c. Hope (optimism, future-mindedness, future orientation)
d. Humour (playfulness)
e. Spirituality (religiousness, faith, purpose)

In the introduction to this book, authors Peterson and Seligman explain that their classification of positive characteristics is distinguished at three conceptual levels:

1. Virtues – these are values by which society judges an individual to be of good character (wisdom, courage, humanity, justice, temperance, and transcendance). Seligman and Peterson found these six virtues were valued as much by ancient tribes as they are by modern culture.

2. Character Strengths – these are the positive traits that individuals display  to others. Practicing these character strengths bring about good feelings and gratification. In other words, character strengths are virtues in practice.

3. Situational Themes – these are the specific habits that allow people to exhibit character strengths in given situations. It is our ability to be aware of our surroundings that determine when we call forth our character strengths. For example, having dinner with friends may be a great opportunity to practice humour, whereas displaying leadership in the same situation may not be necessary (unless you are the one preparing the meal).

Character Strengths Vary from Person to Person

Recognizing that all human beings are unique, character strengths vary just like physical attributes such as height and weight. Likewise, all people are born with certain character strengths (called “signature” strengths) while other character strengths do not come naturally and require regular use in order to develop them. 

In grade school, we all remember classmates to whom all other kids would gravitate to (“leaders”), or those who always had their noses buried in books (“curious”, “love of learning”) while still others were constantly getting in trouble (again “curious” but also “brave” and sometimes “humourous” for the pranksters). But what about those kids that always seemed happy? What character strengths were they fortunate enough to have?

The Top Five Character Strengths That Correlate with Happiness

Research comparing people’s natural top strength to their sense of happiness have identified five strengths which tend to be most highly correlated with high levels of positive of positive emotion and life satisfaction: (1) curiousity, (2) gratitude, (3) enthusiasm, (4) optimism, and the (5) capacity to love and be loved.

Again, the individuals that were part of this study had one or some of these natural or “signature” character strengths. However, like muscles, authors Peterson and Seligman suggest that we don’t have to be born with these strengths, we can also develop these through practice and regular use. Developing these character strengths can help individuals feel inspired and invigorated rather than depleted and drained.

Identifying Your Own Character Strengths

Many of us have adapted to life using our character strengths without even knowing it. On the other hand, some of us are not utilizing our character strengths. Why? It could be based on advice from our parents or other external forces. For example, you may have chosen a job that you thought would win the approval of others or would make a lot of money. Yet, you may feel utterly bored and dissatisfied at work. 

What you say about yourself can also bury your character strengths. For example, you may privately say to yourself, “people don’t like me.” These negative messages we send ourselves have a habit of being self-fulfilling.

Often, we lose sight of our “signature” strengths at our own peril. We may even pick up drugs or alcohol to fill the void left by living a life that is not consistent with who we really are or were meant to be.

Identifying and Nurturing ”Sobriety” Strengths and Signature Strengths in Addiction Treatment

At Sunshine Coast Health Center, we recognize that our clients all have one thing in common: addiction to drugs or alcohol. So we recommend that all of our clients develop “sobriety” strengths or what the Big Book of Alcoholics Anonymous refers to as Spiritual Principles: gratitude, humility, forgiveness, and tolerance.

At the same time, however, we also recognize that clients are unique individuals. Therefore, clinicians also work with clients to help  to develop their own, unique signature strengths that will help them after they complete treatment. Since these signature strengths vary from individual to individual, the program allows for a certain amount of flexibility.

Conclusion

The 12 Steps have long established the importance of sobriety strengths and many books have been written on humility, gratitude, forgiveness, and tolerance. Now, modern psychology shows empirical support for working with the client to develop these four spiritual principles as well as 20 more identified character strengths.

Unfortunately, many programs are still stuck in the old model of getting rid of the disease rather than focussing on positive change. While we recognize that addiction does have certain disease-like characteristics, spending too much time with clients dwelling on the negative aspects of addiction is not helpful. It may even be detrimental if the client ends up leaving treatment fearful of relapse rather than looking forward to applying their new skills in recovery. 

At Sunshine Coast, we are committed to having clients experience a new lease on life that goes far beyond mere abstinence.

Recommended Reading or Websites

Character Strengths and Virtues: A Handbook and Classification (2004) Christopher Peterson, Martin E.P. Seligman

Marcus Buckingham Company – website of Marcus Buckingham -author of “Now, Discover Your Strengths”

Now, Discover Your Strengths (2002) Marcus Buckingham, Donald O. Clifton

VIA Institute on Character - founded as a  non-profit organization in 2000 by Dr. Martin E.P. Seligman and Dr. Neal H. Mayerson.  Take the VIA Survey and discover your strengths.

Part of a larger interview with Alan Steinfeld, John Demartini gives his insights on understanding gratitude.

Daniel Jordan
General Manager

Introduction

In an increasingly integrated world it is interesting to see the growing popularity of all things Eastern in our Canadian society. Yoga is not just yoga anymore. It’s Ashtanga (or it’s Western variant , “power yoga”), Hatha, and Bikram (“hot yoga”). Martial arts is more than just Bruce Lee or David Carradine’s Kung Fu. Today our kids could be taking karate, judo, tae kwon do, and we might just as easily be registered in a tai chi class. 

Examples of Eastern influence can also be seen in mainstream psychology . Mindfulness and its Western advocates such as Jon Kabat-Zinn and Zindel Segal have brought Buddhist and Yoga concepts to a new audience in North America. Research has shown it effective in the treatment of depression and substance abuse.

Eastern wisdom is also having an impact on self-help (or “self-development”) as our society grows increasingly disillusioned with materialism as the path to fulfillment.  One author in particular has embraced Eastern wisdom in a big way: Wayne Dyer. Dr. Dyer is a best-selling author of over 30 books that stretch back to his 1976 book Your Erroneous Zones.  His latest book, Change Your Thoughts – Change Your Life, is a translation of the classic text the Tao Te Ching, or the Great Way, and includes 81 verses of The Tao, compiled from research of ten respected translations. According to Chinese tradition, The Tao Te Ching was written around the 6th century BC by Lao-Tzu, a record-keeper of the Zhou Dynasty court. 

The exploration of these 81 verses has some interesting applications for those struggling with the paradoxical nature of addiction.

Verse 1 – Living the Mystery

As Dr. Dyer states in the first verse of his book, “paradoxical thinking is embedded in Eastern concepts such as yin and yang or the feminine and the masculine, and where things are comfortably described as both this and that.” When we encounter something we do not understand, we in the West are uneasy with merely allowing the mystery to unfold over time. We want the answer and we want it now! 

Part of the first verse of the Tao Te Ching reads:

“Ever desireless, one can see the mystery;
ever desiring, one sees only the manifestations.
And the mystery itself is the doorway
to all understanding.”

Dr. Dyer sums up this verse by suggesting that “letting go of trying to see the mystery will actually allow us to see.” Paradoxical thinking allows us to flow between wanting and allowing that is more in tune with our physical world. For example, a woman may want to have a child but at some point nature takes over and little is asked of the expectant mother except to allow the process to continue to fruition. While pregnancy may bring many changes, the miracle of birth occurs independently of our desire for understanding how or why it happens.

On the Continuum of Wanting and Allowing: The Serenity Prayer

By reading the Serenity Prayer, one cannot help but see the parallels between the 1st verse of the Tao:

God grant me the serenity
to accept the things I cannot change;
courage to change the things I can;
and wisdom to know the difference.

Living one day at a time;
Enjoying one moment at a time;
Accepting hardships as the pathway to peace;
Taking, as He did, this sinful world
as it is, not as I would have it;
Trusting that He will make all things right
if I surrender to His Will;
That I may be reasonably happy in this life
and supremely happy with Him
Forever in the next.
Amen.

– Reinhold Niebuhr

According to the AA Grapevine, Bill Wilson, founder of Alcoholics Anonymous, was heard to remark, upon first seeing the prayer, ”Never had we seen so much A.A. in so few words.” Essentially, Niebuhr is suggesting, as does verse 1 of the Tao, that we distinguish between wanting and allowing and not only understand it, but live by it.

By Daniel Jordan

I recently had the pleasure of attending a Jack Hirose workshop on the 6th & 7th of November that featured Matthew D. Selekman, MSW, LCSW. Matthew is a family therapist and addictions counselor in private practice and the co-director of Partners for Collaborative Solutions, an international family therapy training and consulting firm in Evanston, Illinois.

Matthew is probably best known for his collaborative strengths-based brief therapy approach to his work with adolescents, particularly with self-harming adolescents. At first, I didn’t expect much of Matthew’s presentation to be relevant to my primary interest – men with addictions. Surprisingly, however, self-harming and substance misuse have a lot in common.

Similarity #1 – Rationale for Self-Harming

Matthew listed the most common reasons why teens say they self-harm:

1. “it’s like a friend” – “when I’m having problems you are always here for me”
2. tension release
3. to quickly alleviate emotional pain and distress
4. to feel alive inside
5. to feel numb
6. to have control
7. to get a rush
8. feel empty
9. vent anger
10. to feel connected to friends
11. to stop bad thoughts
12. purge out bad feelings

Even the comment, “the warm blood dripping down my arms calms me” is similar to some of the physical sensations that people who drink or use drugs may experience. Matthew explained that when an individual cuts there is a rush of endorphins which not only masks some of the pain but helps explain its habit-forming characteristics.

Similarity #2 – Feelings After Self-Harming

Matthew also showed research that surveyed how adolescents felt after self-harming:

Immediately = 70 % feel better, 21% feel worse, 9% no change

The immediate effects of self-harm can be said to resemble substance misuse. In his conversations with youth, Matthew will often ask “why would you stop something that works so well for you?” as he recognizes that so many find immediate relief from their problems by self-harming.

Few Hours Later = 30% feel better, 47% feel worse, and 23% feel no change.

This can be explained that after a few hours of self-harming, the endorphins wear off and feelings of guilt and shame return. The cycle then repeats itself as self-harming becomes a way to get rid of these negative feelings.

Few Days Later – 18% feel better, 50% feel worse, 32% no change

Similarity #3 – Frequency and Duration

Just as there are social drinkers, binge drinkers and regular heavy drinkers, so too with those who self-harm:

• experimenter/follower
• episodic
• regular/moderate
• heavy
• severe

Similarity #4 – Co-existence of Substance Misuse and Suicidal Behavior *

Adolescent substance abusers are 3 times more likely to make a suicide attempt than non-users.

(*) Note: Suicidal behaviour and self-harming behaviour are not the same thing.

Similarity #5 – Relapse

The presentation on relapse prevention for self-harming behaviour I found particularly interesting. According to Matthew:

“Clients’ slips are inevitable and go with the territory of change. It is important to predict the likelihood of slips and normalize them when they occur.  When someone has a slip, you can respond in the following way:

• “We could not have made headway if we did not have a slip.”
• “Slips are like teachers. They offer us valuable wisdom. What did you learn from your slip on Tuesday that will put to use the next time you are faced with a similar stressful situation?”

I do have a problem with the use of the term “slip” as Terence T. Gorski points out that short-term relapses are never accidental. However, I have never heard the term “normalize” used in connection with relapse and I think it is an excellent word to describe an effective response. After all, shame and guilt often follow relapse (see Similarity #2).

Similarity #6 – The Need to Deal With Distress When it Occurs

One great idea that Matthew shared with the workshop participants was the idea of a “chilling out” room as a distress management tool. A chilling out room is a room in the house which is designated by the family as “a safe and sacred space to secure adaptive and positive multi-sensory pleasure when experiencing emotional distress. Second, it serves as an effective pattern intervention for disrupting the problem-maintaining patterns of thinking and behaving that inevitably leads to a self-harming episode.”

Matthew recommends that the chilling out room should:

•  be quiet
• have at least one window,
• be regularly stocked with colorful and fragrant flowers
• be regularly stocked with art and photography books and photo albums
• have a music library wih some soothing and contemplative selections (Carlos Nakai, Lonnie Liston Smith, Pharoah Sander were recommended)
• be stocked with fresh clay (most people like to run their fingers through fresh clay and make things out of it)

The chilling out room is also good for other family members as a place where they can decompress.

Conclusion

I haven’t even touched upon the therapeutic approaches that Matthew recommends for dealing with self-harming adolescents, which he calls a collaborative strengths-based brief family therapy approach as well as positive psychology interventions. Matthew offers an integration of solution focused brief therapy, narrative therapy, positive psychology, mindfulness, and multi-systemic family work. His recommendations on using clients’ signature strengths and nurturing resiliency and protective factors are areas that we at Sunshine Coast Health Center have also been exploring with our clients.

Recommended Reading – Matthew Selekman

Selekman, M.D. (2009) The Adolescent and Young Adult Self-Harming Treatment Manual: A Collaborative Strengths-Based Brief Therapy Approach.

Selekman, M.D. (2006) Working with Self-Harming Adolescents: A Collaborative Strengths-Based Therapy Approach.

Selekman, M.D. (2005) Pathways to Change: Brief Therapy with Difficult Adolescents (2nd Ed.)

Selekman, M.D. (1997) Solution-Focused Therapy with Children: Harnessing Family Strengths for Systemic Change.

About the Author

Daniel Jordan is the General Manager of Sunshine Coast Health Center and hopes that these postings will help  take away some of the mystery often associated with addiction and its treatment.

By Daniel Jordan

One of the benefits of being the marketing person at Sunshine Coast Health Center is that I get to sit in on presentations led by some of the top experts in psychotherapy. Basically, I set up my exhibit, hand out some brochures during the break, and spend the rest of my time sitting in the back of the room taking notes. At Sunshine Coast, we are always trying to figure out ways to make our alcohol & drug treatment center better so I have a particular listening when I hear these presenters. Typically, the questions I am asking myself are typically “how does this apply to addiction?”, “have we already incorporated some of the presenters ideas in our program?”, “is this better than the programming we are already providing?”, etc. So, in other words, I have a particular agenda but almost without exception there is something to be learned from every presenter regardless of whether the topic is addiction- or adult-focused.

For the past two days, I have been in a hotel in Northeast Calgary with Dr. Donald Michenbaum, Ph.D., presented by Jack Hirose & Associates. Dr. Michenbaum is one of the leading experts on Post-Traumatic Stress Disorder (PTSD) and is well-known for his work in both Canada and the United States. Dr. Meichenbaum was one of the founders of Cognitive Behaviour Therapy and in the American Psychologist magazine, North American clinicians voted Dr. Meichenbaum to be “one of the ten most influential psychotherapists of the century.” Dr. Meichenbaum is also the Research Director of the Melissa Institute for Violence Prevention and Treatment of Victims in Miami, Florida.

When you spend a little time with Dr. Meichenbaum, it doesn’t take long to realize that trauma has long tentacles that extends into our schools, homes, and workplaces – particularly with special populations such as First Nations and military veterans. At our treatment center, trauma often seems to go hand-in-hand with addiction so it’s an important consideration in our work with clients.

Probably the biggest statistic that Dr. Meichenbaum mentioned was one that showed that while more than half of Americans report having at least one traumatic event in their life, only a fraction (10 – 20%) who experience a traumatic event will actually develop persistent PTSD.

I. THE CAUSES OF PTSD

So how are 90% resilient to these traumatic events while 10% develop PTSD? Dr. Meichenbaum has identified four factors that influence the development of PTSD:

1. The Traumatic Event (objective and subjective features)

There are two sides to a traumatic event: (1) What actually happened to the survivor and (2) what the survivor thought happened.

Details of Actual Event

- extent, severity, duration of stressors (were survivors exposed to grotesque sights, smells, sounds or did they witness others being traumatized?)
- type of stressor – (50% of POWs develop PTSD while only 4% of natural disaster survivors develop PTSD)
- proximity to traumatic event, suddenness, unexpectedness, lack of preparedness

According to Dr. Meichenbaum, rape, sexual molestation, and childhood physical abuse most commonly produce PTSD.

What Survivor Thought Happened

-perception of threat (whether the perceived threat was perceived as deserved or simply an accident)
-sense of responsibility (survival guilt, blame, shame, what survivor feels could have been done to avoid the event)
-attibution of deliberateness, intentionality and self-blame (intentional harm is more distressing than impersonal harm)
-belief about future dangers, about helplessness, about emotions, persistent attention to attribution of cause

Marilyn Laura Bowman states that “pre-event individual differences in emotionality, beliefs, actions, disorders and intelligence account for more of post-event distress syndromes than do the event characteristics.” Source: Bowman M.L., Individual Differences in Posttraumatic Distress: Problems with the DSM-IV Model (February 1999) Canadian Journal of Psychiatry, Volume 44.

2. How the Survivor Reacted to the Traumatic Event

- How did the survivor react at the time of the event? Did he/she space out (dissociate)?
- How is the survivor dealing with the traumatic event today? Is he/she drinking/drugging to self-medicate? Isolating? Prone to angry outbursts?
- Is he/she functioning in other areas? Still working? Maintaining close ties with family and friends? Eating right and exercising?

The degree to which a survivor’s social network (friends, family, work colleagues such as military) were also traumatized can also play a part in a survivor’s reaction to a traumatic event.

3. Pre-Existing Characteristics of Survivor

Individuals can be more vulnerable to trauma based on factors such as:

-Prior victimization – repeated trauma (cumulative) increases the incidence of PTSD
-Premorbid stability – those with pre-existing anxiety and depression are 3x more likely to develop PTSD)
-Trait emotionality – how emotional one is in response to trauma
-Vulnerability due to family factors – family history of mood disorders, substance abuse, antisocial behavour
-Intergenerational victimization – if parents have PTSD their children can develop PTSD with less traumatic events (divorce, death of loved one)
-Socialization factors – childhood separation, harsh discipline, neglect, family instability
-Age and gender factors – more vulnerable at a younger age

4. Recovery Environment

A survivor’s recovery environment following the event and current environment can also be a factor in the development of PTSD:

- Current Stressors – marital status, trouble with the law, financial struggles, etc.
- Nature of recovery environment – availability and convenience of services, absence of stigmatization, absence of revictimization

II. WHAT YOU NEED TO DO TO DEVELOP PTSD

Dr. Meichenbaum also presented a tongue-in-cheek list of what individuals need to do (and not do) to develop persistent Posttraumatic Stress Disorder:

1. Engage in self-focused thoughts that have a “victim” theme
-see self as being continually vulnerable
-see self as being mentally defeated
-dwell on negative implications
-be preoccupied with others’ views
-imagine and ruminate about what might have happened

2. Hold the belief that:
-changes are permanent
-the world is unsafe, unpredictable, untrustworthy
-the future is going to be worse than the present
-life has lost its meaning

3. Blame
-others with accompanying anger
-self with accompanying guilt, shame, humiliation

4. Engage in comparisons
-self versus others
-before versus now
-now versus what might have been

5. Thing to do
-be continually hypervigilant
-avoidant thoughts – suppress unwanted thoughts, dissociate
-avoidant behaviours – use substances, withdraw, abandon normal routines
-ruminate and engage in distorted (contra-factual) thinking
-engage in delaying change behviours
-keep secrets by failing to share trauma story
-put self at risk for revictimization

6. What not to do
-don’t believe that anything positive could result from trauma experience
-fail to accept or retrieve date of positive self-identity
-fail to seek social support
-experience negative, unsupportive environments (indifferent, critical people or people that aren’t interested in you “moving on”)
-fail to use faith and religion as a means of coping

III. THE TREATMENT OF PTSD

Dr. Meichenbaum is best known for his work with Cognitive Behavioral Therapy (CBT) so it is not surprising that he recommends CBT-based intervientions such as Prolonged Exposure Therapy, Cognitive Processing Therapy, and Coping Skills Training (anxiety management, anger management, stress inoculation).

Dr. Meichenbaum is skeptical of many approaches to the treatment of PTSD. This is especially true of Eye Movement Desensitization and Reprocessing (EMDR), Thought Field Therapy developed by Roger Callahan, and Critical Incident Stress Debriefing (CISD). In fact, according to Meichenbaum, CISD may actually exacerbate PTSD. Furthermore, pharmacotherapy for PTSD has, at best, modest effectiveness.

In the treatment of PTSD, Dr. Meichenbaum recommends that treatment focus on “here and now” issues, as well as “then and there issues.” Present-oriented interventions that teach coping skills, bolster self-efficacy and nurture a new more adaptive narrative (“story telling”) are as important as the cognitive and emotional reprocessing of the client’s “trauma story.”

Finally, Dr. Meichenbaum cautions that any therapist working with PTSD-affected clients be both culturally-sensitive and developmentally-sensitive. Consultants should be engaged that are familiar with specific cultures (such as Elders with First Nation groups). Each age group responds differently to traumatic events so treatments must factor in the developmental stage of the client.

IV. SUMMARY

Dr. Meichenbaum presented a brief overview of PTSD and and, since this was a workshop for therapists,  spent the better part of two days discussing the treatment of PTSD. Suffice to say that Dr. Michenbaum’s opinions on the effectiveness of some PTSD treatment approaches are often controversial and not welcome by many therapists with alternative approaches.

To conclude this summary here are some interesting points and statistics:

1. It’s not only the traumatic event that is important but how the event was interpreted by the person impacted by the event (“the story they tell”) and pre-existing characteristics of the survivor
2. short-term interventions immediately after the traumatic event can reduce the incidence of PTSD
3. Religion and prayer is one of the leading ways PTSD-affected individuals cope
4. Spiritual injury (“God shouldn’t have let this happen”), not just psychological injuries contribute to PTSD

Statistics

1. in the US, more than half of the population (61% of men, 51% of women) report exposure to at least 1 traumatic event
2. of these, only a fraction (10 – 20%) who experienced trauma will develop persistent PTSD
3. in the US, 1-3% of the general population in the US suffer PTSD
4. 30%-50% of men and 25%-30% of women with lifetime PTSD also have substance use disorders (SUDs)

V. FOR ADDITIONAL INFORMATION

For those interested in learning more about Dr. Meichenbaum or additional trauma-related resources visit the website for the Melissa Institute, a non-profit research and training group founded by the parents of Melissa Aptman, a student attending Washington University who was murdered in 1995.

ABOUT THE AUTHOR

Daniel Jordan is the General Manager of Sunshine Coast Health Center and hopes that these postings will help  take away some of the mystery often associated with addiction and its treatment.