PTSD and substance use often are closely connected, but many people may not be aware of this. Here is some information from our IOP workbook, inspired by the amazing work Seeking Safety by  Lisa M. Najavits.

  • You are not alone! For people with substance abuse, PTSD is one of the most common dual diagnoses. Among women in treatment for substance abuse, 30-59% have current PTSD. Among men in treatment for substance abuse, 11-38% have current PTSD.
  • There are many reasons why people with PTSD abuse substances. Some may do so to access feelings or memories, or to do the opposite–to escape from feelings and memories. Others may abuse substances to get through the day; to compensate for the pain of PTSD; to commit “slow suicide;” because they grew up with substance abuse in the family; or because they aren’t able to take care of their bodies.
  • People with PTSD and substance abuse tend to abuse the most dangerous substances: cocaine and opiates.
  • Two main themes of both PTSD and substance abuse disorder are secrecy and control. Secrecy means you may feel ashamed and wish to keep your problems a secret (e.g., the traumas you experienced, the amount of your substance use). Control refers to the idea that with trauma and substance abuse, you feel out of control. In PTSD, a terrible even occurred that you neither chose nor wanted. In substance abuse, you have lost control over your ability to stop using. Learning the skills of honest and regaining control and thus important for healing.
  • Each of the disorders makes the other more likely. If you have PTSD, you are at increased risk for substance abuse. If you have substance abuse, you are at increased risk for trauma. It is thus important to try to keep yourself safe to prevent further trauma and substance abuse.
  • The relationship between PTSD and substance abuse is complex. Using substances can either increase or decrease the PTSD symptoms. Yet abstinence from substances can also increase or decrease PTSD symptoms. Try to notice the patterns that occur for you. Getting to know the relationship between the two disorders in your life can help you cope better with the recovery process.

Why do PTSD and substance abuse occur together? Four patterns are common:

  1. PTSD can lead to substance abuse. To overcome the terrible symptoms of PTSD, you may use substances to “self-medicate” to try to feel better. For example, you may have begun using alcohol to get to sleep at night.
  2. Substance abuse can lead to PTSD. If you abuse substances, you may be vulnerable to dangerous traumatic situations because your guard is down or your self esteem is low. For example, getting drunk at a bar and going home with a stranger who assaults you.
  3. PTSD and substance abuse may have both occurred together. Some people grew up in a home where family members abused substances and also hurt each other.
  4. PTSD and substance abuse can be connected in a “downward spiral.” PTSD can lead you to use substances; by abusing substances you are at increased risk for more trauma; if more trauma happens, you may use more substances to cope; and so on.

The big picture priorities for treatment are to eliminate substance use, learn to manage PTSD, and become safe.

You can heal from both PTSD and substance abuse! 

See our post on EMDR and how it helps heal PTSD.

Call us at 425-462-8558 to make an appointment for an assessment and start your healing journey today.

Sometimes we experience traumas or events in our lives that leave us with unseen scars or wounds. These psychological wounds, if untreated, can fester and affect not only our lives but also those around us, in particular immediate family members. Here at Eastside Center for Family we are committed to treating and helping those affected with these traumas to heal, which is why we have trained therapists in a type of trauma therapy called EMDR.

What is EMDR?

EMDR stands for Eye Movement Desensitization and Reprocessing. It is a form of therapy that helps people heal from trauma or other distressing life experiences. EMDR has been extensively researched and has demonstrated effectiveness for trauma.

How do I know if I need trauma therapy or EMDR?

A good way to assess if you have need for EMDR therapy is to ask yourself if you have experienced the following symptoms:

  • Flashbacks or nightmares of traumatic events
  • Emotional numbness
  • Avoidance of places, people, and activities
  • Difficulty sleeping or concentrating
  • Feeling jumpy, or being easily irritated and angered.

If you answered yes to any of the above, you might be experiencing symptoms of PTSD. EMDR has been proven to help!

How does EMDR work to heal past traumas?

Our brains have a natural way to recover from traumatic memories and events. This process involves communication between the amygdala (the alarm signal for stressful events), the hippocampus (which assists with learning, including memories about safety and danger), and the prefrontal cortex (which analyzes and controls behavior and emotion). While many times traumatic experiences can be managed and resolved spontaneously, they may not be processed without help. Stress responses are part of our natural fight, flight, or freeze instincts. When distress from a disturbing event remains, the upsetting images, thoughts, and emotions may create feelings of overwhelm, of being back in that moment, or of being “frozen in time.” EMDR therapy helps the brain process these memories and allows normal healing to resume. The experience is still remembered, but the fight, flight, or freeze response from the original event is resolved.

Sometimes people are hesitant to seek help for past traumas based on the belief that they will not be able to handle the emotions when they are brought up again, and the fear of “reliving” those past traumas. However, EMDR is different from other forms of therapy and traumas will not need to be explained in detail in order to be processed.

Is it necessary to tell my therapist all the details about my problems in order for them to be processed?

No, it is not necessary to talk about all the details of your experiences for them to be processed.

Will I get emotional?

Yes, you may. Emotions and sensations may come up during processing; although, you will be prepared and your therapist will help you safely manage them. Once they are processed, they rarely come back!

Is EMDR like hypnosis?

No. During EMDR processing, you are present and fully in control.

Is EMDR a brief treatment?

EMDR, as with all treatment approaches, will help you accomplish your treatment goals. The length of time that it takes is dependent upon the complexity of your problems. Frequently, EMDR is only one of several treatment approaches that will be used to help you reach your treatment goals.

What can EMDR be used to treat?

  • Anxiety, panic attacks, and phobias
  • Chronic illness and medical issues
  • Depression and bipolar disorders
  • Eating disorders
  • Grief and loss
  • Pain
  • Psychosis
  • PTSD and other stress related issues
  • Sexual assault
  • Sleep disturbance
  • Substance abuse and addiction
  • Violence and abuse

What will therapy look like?

You have come to treatment expressing concerns. Your therapist will help you understand the dynamics of the presenting concerns and how to adaptively manage them. An overall treatment plan will be developed that will accomplish your goals. Within that treatment plan, EMDR, along with other therapy approaches, will be used to accomplish your treatment goals.

The EMDR session:

You will be asked a set of questions to access and activate the negative experience and the desired adaptive resolution. Sets of rapid eye movement (or other forms of bilateral stimulation) will be applied. You will be encouraged to just “free associate” and allow the brain to work through the experience. Sets of eye movements will be alternated with brief reports about what you are experiencing. EMDR processing will continue until the past experience has been updated to an adaptive present perspective. With long standing issues, this process may take multiple sessions. Once the disturbing experiences have been updated, you and your therapist will work together to integrate these new insights and perspectives into your daily life.

Call us at Eastside Center for Family and start working toward a better tomorrow today. 425-462-8558

Studies showing effectiveness of EMDR:

We are pleased to announce that our therapist Rachel Larson now has EMDR specialty! This service is available for people who are dealing with symptoms of trauma, anxiety, and depression. EMDR is highly effective in helping clients process and find greater freedom from emotional pain. Rachel is taking new clients. Please contact us if you would like to make an appointment.

 

An excellent drama is presented within the BBC video production, “Mountain Gorilla, Kingdom in the Clouds” involving a three-year-old baby gorilla abandoned by her mother in the mountains of the African Congo. The baby was part of a Gorilla troop, but ignored and forgotten by the other members. This is a very dangerous situation for an infant gorilla who is normally well tended by her mother until the age of five or later. The other mothers took their babies into the tree tops to nest for the night, leaving this baby alone on the cold ground. The leader of the Gorilla family is a massive male Silverback a powerful and dangerous animal exercising total control of the troop. He’s too heavy for the slender tree tops, so sleeps on the ground. His huge muscular body generates plenty of heat so he stays warm all night. Silverbacks are known to kill infant gorillas they don’t recognize; the Silverback is not one to trifle with. With this scenario the men observing and filming this group leave for the evening, concerned for the baby. The observers are not allowed to stay the night for their own safety. The men return the next morning and find the baby missing. As they search around they discover the baby snuggled up in the arms of the sleeping giant, lazing about in the cool morning. The 400 pound Silverback permitted the baby to approach and even accepted and adopted her thereafter. It’s a small part of the entire story, but a part with a striking and heart-warming message. Sometimes trusting is the only option left to one in need.

We all want to be independent, healthy and strong. But our situation and our fortune can change unexpectedly and often we’re not prepared for the change. The baby gorilla had to take a chance approaching the Silverback or perhaps die in the cold mountain night. Our circumstances may rarely be about life or death, but they could be. It is very common to face a puzzling array of confusing issues that may feel like a trap; there is just no apparent safe way to go. This is when we need to trust the help that is available. An empathetic, quarter-ton gorilla may not be the answer for us but like the wizened, experienced, powerful Silverback, a highly trained, experienced, empathetic person is often the dream come true for a person overwhelmed by circumstances. The therapists and counselors of Eastside Center for Families are able to shoulder the issues you might encounter that exceed your present limits. The professional skills and experience available to you to meet most any needs you may have recognize the trust you bring to the therapeutic session. Like the BBC video, our gorillas are strong, smart and deeply concerned with the care, protection and growth of those who come to us for help.

 Fans struggle with Seahawks' Super Bowl loss ...

How people make the decision to pick one counselor or program over another when seeking help seems to come down to one thing, does the therapist call you back.  If you are able to get a call back what to ask is the next step towards getting in to see if you like the person and their philosophy.

I am particularly sensitive to times when a person talks about their experience in seeing a therapist for the first time and leaving feeling like they drove into a cul-de-sac and came back to the point they started.  No doubt it is frustrating to look for someone, fill out the paperwork, make time in your day to go to an appointment, get there and discover it feels all wrong and you cannot believe all you went through for very little.

I am a pragmatist, for the most part, and it seems to me that word of mouth is a helpful way to choose someone who has helped a friend. But is that the best approach to choosing a counselor? What worked for a friend may have very little applicability as it relates to personality, the issue at hand as well as availability.

One thing to help with this is to ask a counselor if they would talk with you by phone for a few minutes giving you an opportunity to screen him or her.  Preparing a list of questions before the call is essential when speaking to the average busy therapist.  In my case I schedule phone appointments for this purpose for 15 minutes to help us both figure out if the issue that a person is seeking resolve for is something I can help.  Questions about training that you may find helpful include:

•How many years has the person practiced their approach?

•Do they receive supervision for their services from a more experienced and skilled therapist on a regular basis (monthly is very common)?

•How did they come to find this approach (their life experience led them, a friend who had the issue, etc)?

•Why do they find the approach helpful?

•How do they address the problem of a client not improving, do they have a time frame they work in, do they give you a referral, will they inquire about what is being done outside of sessions to improve the outcome)?

One approach to choosing a counselor is to screen for someone with the same beliefs as you.  Getting validation from a like minded professional can sometimes be the most valuable help of all in a time when you are feeling wobbly about what you are doing.  You may be approaching something effectively but if self doubt is eroding your confidence getting time to discuss your situation discreetly can be a valuable form of support.

Another approach is to find someone with a different way of seeing things or with training in a specific area in which you can learn something different from what you’ve tried.  Like the years spent in school, we learn new things that give us information to examine our own beliefs and challenge the notion of “that’s the way it’s always worked.”

Would you be willing to take a moment to pause?    Take a deep breath….then think for a moment about how you make choices. Take another pause and breathe again.  Ask yourself these questions:

1. What component of your dilemma is causing you to look for help?
2. How will you know you are accomplishing your goals?
3. What outcome you are seeking?

Laura J. Halford

compassion fatigue

In doing a little research recently, I came upon a site that talked about Mother Teresa’s philosophy on the work of helping others.  Her plan indicated that she understood compassion fatigue based on her recommendation that her nuns take a year off from their work every five years to allow them time to heal from their work of care giving.

The effects of living with someone who suffers from a mental health disorder, substance use disorder or is otherwise ailing can become debilitating for the care giver.  The effects of providing compassionate care to another person year after year can eventually begin to negatively affect the caregiver.  Like the build up of a relapse, compassion fatigue is a process that over time accumulates to the point of exhaustion emotionally and physically.  This buildup can eventually result in a state of numbness that short circuits an otherwise caring and loving person’s ability to fully experience emotion and feel connected to others

How does a person know if they are at risk?  To the degree that an individual is exposed to situations that over power one’s ability to cope or that cause strong reactions on a repeated basis are indicators of the need to maintain a plan for self care.  Signs of compassion fatigue include the following:

  • Feeling exhausted
  • Having little tolerance for others and becoming irritated easily
  • Becoming overly involved with others
  • Feeling as though little is accomplished but working harder than ever
  • Feeling ill and/or having physical pain
  • Wanting to avoid work
  • Feeling disconnected from others
  • Upon waking the feeling as if you did not sleep
  • Stress response to situations that feels traumatic
  • Difficulty with boundaries with others and with one’s self
  • Becoming indifferent or lacking compassion for others

Tips to help:

 

  • Find a confidante or therapist and talk to them regularly
  • Write a daily gratitude list
  • Look for fun activities and hobbies and do them
  • Take vacations and mini getaways
  • Eat healthfully
  • Exercise daily
  • Meditate
  • Avoid drinking alcohol or using drugs to take off the edge
  • Identify personal strengths
  • Take daily breaks to step out of the situation, breath, wash your hands, walk the block, stretch
  • Acknowledge your on feelings

 

 

 

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