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Notes on trauma, inclusion, & Children’s Protection Services
I am attending the Crime Victims Rights Conference in Wichita. It has gone paperless and I left my notebook in the car so I am preparing a blog post as a vehicle for notes. Lots of stuff on trauma, I hope they get beyond the basics. They didn’t but a few gems amongst a lot of very basic programming. Glad it’s over. Don’t recommend.
The four R’s of Trauma: Realize, Recognize, Respond & Resisting Revictimization. Trauma Informed shifts from what’s wrong with you to what has happened to you.
Defensiveness and resistance can be signs that we are ready for growth.
Gossiping is a form of numbing, points to need to have better outlets for trauma. Proactively address healthy conflict resolution and look at workplace gossip through a trauma lense.
The success of an intervention depends on the interior condition of the intervenor. Autonomy and freedom are more important than safety. Accountability is support. It needs to be encouraged and rewarded.
Cultural competence is better termed cultural relevance or cultural humility. Diversity, Equity, inclusion & Belonging. They are progressive steps. Individuals are not diverse. As a group we are diverse.
We have to look at who we serve and who we are not serving. Who is in our community? Who is already serving that community? Who are served, inadequately served, not served? How are people’s identities influencing their experiences and outcomes?
Belonging is when folks with a marginalized identity can bring organizational authority and be themselves. For a team member we can push back on systems and ensure a safer place to land.
I will add to job ad: Members of marginalized communities are strongly encouraged to apply. A false sense of urgency is a white dominant value move to flexibility and realistic work plans.
Are you a mandated reporter should be an interview question. 51.5% of reports are screened. 76% neglect, 16% child abuse, 10% sexual abuse. 82.9% of prenatal substance exposure were screened in. 18% of reports are substantiated, 13% receive an alternative response. Law enforcement, educational personnel and medical personnel are top reporters.
Black folks are screened in at twice the average of whites. Children with disabilities screen in four times higher. There is an overutilization of child welfare system. Most situations can be resolved without child protection intervention. Mandated reporting does not lessen child maltreatment rates nor does it reduce future rates.
Poverty is not neglect. The indicators look the same. Thinking of neglect “when reasonably able to do so”. “Reason to believe” is in most statutes and creates a subjective standard allowing reporters to think critically.
Protecting children is everyone’s responsibility. Child Protection is a government agency that does not address the situation very well. Making a call and then not thinking about what happens is not good ethical practice.
We were unable to find any high-quality research studies suggesting that mandatory reporting and associated interventions do more good than harm. Supporting caregiver/child relationship is the biggest factor in ameliorating Adverse Childhood Events.
Studies of risk assessment of children being left alone showed it was based on moral approval or disapproval of where the mother was. 50% of black mothers will have a CPS report before their child is 18.
Trauma Bond: captivity brings long contact with coercive control. Goal is the fear of death and gratitude to be allowed to live. Attachment is the rule not the exception.
7 stages of trauma bonding in relationships: Lovebombing, Gaining Trust, Shift to criticism and devaluation, Gaslighting, Resignation and submission, Loss of sense of self & emotional addiction. , If
NA step 2 part 2
Hmmm, just tried to link to the cyber recovery page after writing a little intro but it just cancelled out my post. Dang. Well this is part of a project to translate the 12 steps of Narcotics Anonymous into simple concrete English with all hearing references removed. I hope to finish by Sunday in spite of being horridly busy.
http://www.cyberrecovery.net/NA/StepTwo.html OK, there’s the link, it came up when I was trying to paste in the actual language of the step. Let me try that again.
“We came to believe that a power greater than ourselves could restore us to sanity.”
Some people say church is for people are afraid of Hell. Knowing God is for people whose life has been Hell. Faith is the gift we get for accepting the truth. If the second step is hard we should look at what we think is important or valuable. If we feel we are not getting important stuff or it doesn’t work well we should change. We want to change. Step 2 is about finding and using extra power to change. Believing is knowing what we think is important and what we hate. Believing helps us get what we want in the future. Being weak and feeling trapped makes us value not feeling pain. When we start to love and do God’s will we can still have bad things happen because what we think is valuable hasn’t changed yet. Changing what we think is right as God changes our life helps us “come to believe”.
One way to figure out what we really want is to put in words what we want in the future. It helps to believe in what will help us get what we really want. When we know the future can be good without limit it changes how we see. Many people try to clearly remember what they wanted out of life in early recovery. Then when it happens we will be happy. As we grow in recovery new dreams come. When we tell these dreams to others in recovery we grow and become stronger. Sometimes our dreams help other people instead of us.
We see more when we learn from what others have done. We become more free and helpful to others when we train, study, and work on what we are learning. A part of changing is enjoying how we have changed and seeing it help others. It helps when we can Give it up to God when we believe God can’t help us enough. The belief that God can’t help us is old or not thought out or only a piece of the truth. Most of us are surprised we can change what we believe about God. D0ing drugs hurt us more then health and legal problems but have hurt the way we think. If you put in wrong thoughts you get out wrong thoughts and actions. Because we were afraid we did not slow down and think clearly. We get used to thining wrongly and believing bad things will happen.
When we did drugs we thought the world was bad and we continue to think that. Healthy relationships are an important part of life. Being healthy means we have healthy places to go, healthy things in our life, and healthy people to be around. As we change we can feel weird as we change how we deal with people. Just because something feels uncomfortable doesn’t mean its wrong. We have to ask other people in recovery about stuff that feels uncomfortable. We feel uncomfortable as we change how we look at the world but haven’t gotten used to it yet. If we are sensitive and respectful to God we can learn to see things in a new way. We stop having beliefs that are to small to work.
Sometimes we make stuff by really believing things we knew were true but we couldn’t really believe. Addicts are sensitive to the truth even when they deny it or hide from it. Growing God shows us that we make ourselves and how we make ourselves affects other people. Staying close to God keeps us in our new beliefs. Our beliefs get stronger and more a part of us.
Things that don’t work for us take time to get rid of but beliefs won’t change by themselves. Its easier to go looking for a belief we may have been interested in for a while. We can try to find something that we feel good about and try to learn more about it. Many people find that what they believed as children will work now. Being confused by using drugs might have kept our beliefs from working good. Our new beliefs are not only easier but work better and we get more of what we want. The need for beliefs that work is stronger then being afraid. Once we belief this step it will stick with us and we won’t have to go back and do it again. Thinking about stuff all the time was a way we used to get stuff we thought we wanted. We had problems because we needed so much. Thinking about drugs all the time was about feelings and not meeting our needs. People could see we were crazy. Every time we give up an old fear our freedom and responsibility increase. As we give up our old fears our faith grows. Faith gives us more energy and allows us to do more with what we have. We are clear headed and relaxed.
Fear is false beliefs that we think are real and it is important to addicts. Fear keeps us from doing stuff that hurts us or makes our lives worse. When we are sane fear keeps us in a place where we are comfortable and our feelings won’t get hurt. When we were addicts much of what we believed was crazy. In other areas some things we think we know are not true but it doesn’t matter. Many things are in the middle and sometimes it matters if we are right. Figuring out what is true or not is a lot of work that we have to do every day. Freedom in recovery is comparing what we get to what we lost from being an addict. The longer we are clean the more important the truth is and that is why we keep going to meetings and working the steps. When we were using drugs we were afraid of getting caught and we may have continued to be afraid in early recovery. Maybe our real secret was we built our own cage out of fear? We replace fear with faith. We start to work the steps and we learn to feel pain without using drugs. When we remember the old craziness we learn to face the truth and get better.
Well that’s about all I have this afternoon. Looks like I won’t finish step 2 this week. I will try to get it done on my vacation. I am looking forward to not being maddeningly busy all the time. The only reason I could do this is I am supposed to be doing something else and I’m not. I’ve lost a little focus with a little “short term ego depletion” from all the challenging stuff I’ve been doing.
step one part 1
Introduction:
I’ve had the great pleasure to get to teach the 12 steps of recovery, specifically Narcotics Anonymous over the past year or so. I am a treatment person not a recovery person so I do not usually presume. The Steps are supposed to be worked by a Sponsor. Someone experienced in The Program who has worked the steps themselves. For people with multiple challenges Recovery can be an arduous path and unique accommodations must sometime be made.
If an individual speaks only a foreign language or is deaf and only speaks sign both NA and AA graciously make interpreters available but only for meetings not to meet with sponsors. Using deaf as an example you also have the unique challenge of concrete thinking, translation, and lack of all reference even through metaphor for hearing. I just looked the steps on line(cyber recovery) and translated. And its been cool. One of the most interesting therapeutic approaches I’ve ever tried. Has made me really have to understand the text.
Someone requested I write it down for them. I told them it would be a lot of work but it may be of general interest so I would share it.
Step 1
“We admitted that we were powerless over our addiction, that our lives had become unmanageable”
Not understanding the first step makes people use drugs. Addicts have other problems besides using drugs. People in NA can only help others by caring about them and living life as it is not how we want it to be or fear it to be. NA just focuses on not using drugs.
Using drugs makes you selfish and step one helps that. If we are powerless we don’t have to stick up for ourselves or try to do stuff we can’t do. When we used drugs we tried to hurt ourselves, not because we wanted to but because we were sick. Our sickness is because we can’t remember what has happened or learn from other people. We lie to ourselves and can’t see how things are. Sometimes people wait to make decisions until they’ve been clean awhile and they’re better. Recovery is confusing in the beginning and waiting to make decisions helps. We can’t do that forever as we get better in recovery if we want to grow.
We can’t give it up to God without understanding other addicts. We do what other addicts who have been clean longer suggest. We read, study, and ask questions when we can. We share with others so we don’t plan to use drugs. We try to understand we are sick and can’t get better alone. The most important word in the first step is We. “We admitted we were powerless over our addiction and our lives have become unmanageable”. We are not alone we are in a group in NA. We don’t have to do this step alone.
When we were using drugs we felt the strongest when we were making our biggest problems. Sometimes it almost killed us and ruined our life. We thought we were strong but we could just make people do stuff we wanted. Other times we felt weak and nervous. When bad things happened we would admit we have a problem and things would get better. “We admitted we were powerless over our addiction and our lives have become unmanageable”. Then we can keep getting better forever, unless we decide we’re powerful.
Most ask “Tell me how it’s done? Show me what to do. I am afraid to try.” In NA we see people like us who have gotten better. We wonder if they are like us how can they do good? They do things we don’t think people can do. As we get better we learn that how it was when were using isn’t that way anymore. We are no longer dazed by drugs. We have meetings to go to. We learn new positive thoughts.
We learn to catch ourselves and slow down before getting caught up in things. Almost anything, even important things can wait five minutes. Taking time to think doesn’t mean we can’t do some things. It helps us not to feel hurt. Sometimes we don’t have to do anything and we can give it to God. Then we think of good things to do, people to call, and good things happen when we pray.
Some things remind us of drugs. Sometimes it does and we don’t see it and we don’t know why we want to use drugs. Some people make us think about when we were kids or when bad things happened or like they are the cops and we want to get away. This keeps us from getting better. Learning more about what reminds us of stuff lets us change it. Intense anger, fear, or shame for no reason shows you have a problem. We have to give everything in our life to God. When we remember we are not in control problems go away. Without giving it to God we can’t get better and we will do what we used to do. Part of giving it up to God is remembering we made our lives small. We did bad things and bad things happened. We get confused because we did drugs and need other people to help us. All addicts feel nervous sometimes but they help each other.
We have to look at what we do in recovery. We do stuff for a long time and we don’t think about it. We don’t remember why we do stuff we just do it. The longer we are in recovery we can do things better. We ought to think about what we do especially the stuff we were doing when we were using drugs. They make our life like it used to be. We are afraid at red and blue lights because of the cops but we aren’t breaking any laws and don’t have to be afraid.
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had hoped to finish but will call this part 1. The steps can seem daunting but they are front loaded with length and depth. Most of it is really clear. Occasionally I am lost by a thought. In talking with a translator I was told “clarity” was the essential quality. I am curious of what people who know this material better then I think. I enjoy abstraction but its been cool to lay it down for awhile. In the concrete there is room for God but not a Higher Power. If the New York Times said God is dead in the 60s for this exercise Higher Power is dead killed by vagueness and abstraction.
Krampus Day Eve
Happy Krampus Day Eve. Krampus, if your unfamiliar with him is the Swedish anti-Santa. He beats bad girls and boys with birch twigs and has kind of a demonic cast to him. I have been wishing people Happy Krampus Day Eve and telling folks about him all day.
I have done mine up in style making my biggest splash into the spirit of the holidays yet so far. Kevin and I went and got a tree from the Optimists. I got a longleaf pine this year. I like firs and don’t mind paying a little bit more but I got one last year and thought I would mix it up. Its not my first but we never got them when I was a kid because Mom thought the short needle ones were less of a mess. I like it because it has a shaggy look like something out of Dr Seuss.
I didn’t have it bagged because the truck was close and I thought waste the plastic and that was the right move because it was pretty easy. The Optimists cut off the bottom for you too. I have two tree stands, struggling with crappy stands is not worth the trouble. I used the big plastic one because it will hold like a gallon and a half of water so I usually only have to water every other day to stay out of trouble.
I am going to have a New Years Day party so I will want it looking fresh through that long at least. It has scented up the whole house, much more than the fir I got last year. I considered going to a cut your own place but the Optimists are close and it goes to a good cause. I have the angel on top but haven’t put up lights or anything yet. I still may do that tonight. I will also decorate Mom’s ficus and moved it to the other side of the living room instead of the corner next to the tree so it should be more prominent.
I also went to the Odd Fellow’s Christmas banquet. It was fun. I played door man and wished people a good afternoon. It seems early to wish people a Merry Christmas and the fellahs who go to meetings I’ll see twice more before the day. Tomorrow is the meeting and I didn’t walk the dog today, maybe I’ll do that instead of decorating the tree. Getting some dinner and a walk would be a struggle.
After the dinner I went to Amy and Michael’s so Fido could play with Olive. They had a good time and Fido is sacked out. He’ll get up for a walk though. Although since he got a good play in he’s probably fine to wait until Tuesday for his walk. I worked pretty much a full day on Saturday so with the abbreviated weekend it might not be a bad idea to just chill. Curl up with a She Hulk comic and relax. I’ve been reading a stretch of hers lately starting at the beginning. Pretty crappy but they’re getting better in the second year, the character is fleshing out and becoming a little more interesting. Watching this growth process has been interesting, certainly a lot more to it that I didn’t get when I was reading them as they came out.
I’m also continuing to read Foucalt’s archaeology of modern thought. I’ve been reading the book off and on for like seven years now so I am certainly savoring it. Currently reading about the dualism of man with the Cogito no longer proving existence because what we know rests on this foundation of the unknown and we know enough about thought to know a lot of it is unknown to us. I’ve been reading 2-4 pages a couple times a week and taking time to let it settle in.
I’ve also been talking about dreams. I did two groups on them Saturday, what they are and how they work and am working it into conversation so I learn the stuff. PET scans have shown which parts of the brain are active, visual and feeling motion, deep centers of emotion with a deactivated volition, propriety, and logic centers. Explains a lot about dreams. To sum it up dreams are thinking but they feel different because of chemical changes in the sleeping brain. We think in dreams about the same stuff we think when we’re awake. You need dreams to solidify memory and they can be used to problem solve, hence the old saw, ‘let me sleep on it’.
What does all this mean and have to do with Krampus anyways? I don’t know, let me sleep on it.
The Salamander Dance
Fido is restless wanting to go in and out. He’s been by himself most of the day. He is not a fan of being home all day when I work, even though I come home for lunch but he deals. Tonight I went out immediately after work just stopping by to let him out and pick up the car. I had hoped to leave work early because my lunch got mangled but the day was too difficult to disengage from gracefully except a mere 5 minutes early.
I was rushing because I decided to squeeze a little Occupy Como before my beer and a movie I had planned. Elise was in town and saw her there but I didn’t see the “You Are Awesome” sign which is my favorite. I settled with “There’s Nothing Wrong With You” after passing over a lot of other signs. Even the “We Are the 99%” didn’t resonate today. I am part of the 100%.
I didn’t stay long and headed over to RagTag and had a Cuban and a Schlafley APA, which were both familiar favorites that performed as expected. I also picked up a loaf of Ancient Grains bread and caught a flick with Trevor. We saw Urbanized which was pretty good but dragged a bit and felt like school. Would’ve been a nice break from a boring professor in a class on urban development. But it was visually interesting and showed stuff I did not know. Copenhagen and Stuttgart are smaller then I thought. A human’s visual field is 100 meters by 100 meters and classic cities make their central square that big probably the most interesting thing. I’d never thought of that seems obvious in retrospect. I love stuff that’s like that.
So after unsuccessfully trying to extort a piece of desiccated liver Fido is settling into some tug-o-frog interspersed with some fetch so my post drags out in spits and spurts. its good though he needs the attention and the fun. He’s my buddy.
I was walking him the other day at the Bear Creek Park out past the little lakes and met an old vet walking with a cane. Fido was a little skittish but we struck a conversation and he said “dogs are pretty good partners” and they are. After having been married, lived with folks, siblings, political cooperatives, unintentional communities, roommates, and road trip buddies Fido is enthused, low maintenance, and can make me smile just thinking about him. Its supposed to be nice tomorrow and we’ll go on a long walk. Even if I never get my shit shoveled. Actually should finish that Saturday weather permitting or Sunday for sure. Seems to take all my energy to do much more then tread water.
So once again I am mostly posting to get more poetry up. My hits have been up and I’ve been picking up subscribers as I put out more stuff. I guess at some point I’ll have to start writing some new stuff. I keep singing “Black Iron Prison” hoping to get more but I haven’t added anything I want to keep. But I bet I got at least another 100 floating around in my head and 50 more on scraps of paper and old books and notebooks and probably another 50 floating in the world. So maybe I can keep up the production.
I might share a poem in my ed group tomorrow. I was covering Feelings Management and somehow our ultimate nature came up. I had stated I am not my feelings, I am not my thoughts, and when asked what I was I thought my truest self was my will. That was called my actions but that doesn’t sit right but I couldn’t really explain how the will was different any better then Epictetus’s “moving towards a thing” or a sense of purpose. I also suggested a narrative or a story. There’s a couple of really smart dudes in treatment so it makes me want to take it up a notch and I may share my: i-believe-i-am-a-pattern I posted a couple posts back.
Well tonight’s offering goes back to the ill fated Appalachian Trail hike of 2000. I found it pretty challenging physically and it was an emotional low point but it was also filled with a sense of accomplishment intrinsic in climbing mountains every day and there was poignancy that makes that era very memorable. I had a tangible sense of intense nostalgia when I visited in September. I want to go back and hike more this Spring if I can get motivated on a few projects to make it happen. But anyway the biggest thing I remember was being cold and wet all time. It rained a lot, there was frequent heavy dew, and seemed times we lived in clouds, and sometimes above.
One night we (I hiked it with my wife at the time Amee) got a trail side shelter on the side of a mountain. The clouds came up below us and the other mountain peaks poked up and it was like being on an island in the clouds. But it was hard sometimes to keep spirits up in the rain and wet. But I noticed that that was when the salamanders and such would leave the little springs and streams and you could spot a lot of them out on the trail if your eyes open. I sparked this one and sang it as I wrote it hoping to cheer Amee up (and truthfully myself as well) when it started to rain for the umpteenth day in a row. I called all four of the pieces on the trip Appalachian Spring and a number. This one is number 4 so likely the last, but I can’t be sure of that without looking at a map. I went through a fairly intense non-linear period that I am still not completely over. Have to warn you its more then a bit silly, nonetheless “Appalachian Spring #4 (The Salamander Dance)”:
If it starts to rain by chance
The salamanders do their dance
They do their dance
The salamander dance
And if it starts to rain some more
Then the frogs begin to soar
There’s flying frogs all over the place
There’s flying frogs flying into your face
And if it starts to rain in pails
Then out will come the snails
With their slimy trails
Of snail entrails
And when the rain is finally done
Then out will come the sun
and the hikers will smile
For another mile
But if it starts to rain by chance
Then the salamanders do their dance
They do their dance
The salamander dance
11/11/11
Happy Armistice Day. It commemorates the ending of The Great War or the War to End All Wars, and if only it did, it wouldn’t have morphed into Veteran’s Day. I like the old version better, a day to celebrate peace which is a glorious thing and well worth fighting for. Today is an extra special day with the trifold elevensies. I was telling the agency psychiatrist that numerologically 11 meant “magic”. Kabbalistically 1-10 is a progression from the source at 1 (Kether) to the material world at 10 (Malkuth). Eleven is magical because it goes one further, “this one goes to eleven”.
I find myself with time on my hands because I called in sick today. I had tummy troubles and unsettling dreams and woke at one and could not go back to sleep. Don’t have it today and rest is obviously in order. I will attribute both to peperoni and sausage pizza perhaps, could be a virus or something as well as I’ve got a bit of scratchy throat. I hope to nap and feel better, read some more John Byrne era Fantastic Four maybe more of my Stirling novel the Peshawar Lancers which kept me company through my long night of stomach upset.
My dream was vivid, I have been having vivid dreams throughout the night with increasing frequency and intensity since I read a couple articles on dreaming in the latest Scientific American Mind. There are articles on using dreams to problem solve and lucid dreaming, which I was always doubtful of but they can see it in f-MRI so it probably exists. Its a useful technique for PTSD so I have been trying to learn it and have definitely increased my dream awareness, which has been largely cool. My dreams are banal things of petty frustrations, ennui, and little anxieties mostly.
Last night I dreamed I was visiting the homeland and was feeling very out of sorts. There was some holiday or parade or something and I decided I needed to go the hospital. I went to Boone Hospital and after a long journey through white tile corridors I ended up in this cafeteria and a psychiatrist invited me to eat lunch with him and we talked. He had a large platter of bacon, which was good at first but became increasingly cold and greasy (see why I think there was a pizza connection?). Before we were done there was some kind of break for prayer or meditation or something and everyone in the room got into a big circle and put their arms around each other and prayed or meditated or something involving droning and people rubbing other people’s heads. I found it all very weird but was glad to be a part of it and it broke up and the doctor and I walked down a long corridor and he asked more questions. He asked me what I was feeling and I told him that I felt like a large crystal a picture of this became the dream a complex crystal structure but that I felt very fragile. He surprised me when his tone went from a convivial camaraderie to the voice of authority and he told me he wanted me to go to University Hospital for an evaluation. I thought it odd already being in a hospital but I asked him why I needed to be in a hospital. He said because you said you were fragile.
Usually for dream interpretation the question to be asked is what was the overall feeling of the dream. Bewilderment. I chalk it up to being sick as any larger meaning, but its made me think. Which is one of the points of dreams to look at things differently.
In the spirit of 11/11/11 I wanted to share an older poem I wrote about Solomon, our preeminent magic man. It probably goes in a series with my Biblical Biopics with a Twist with the one about Jesus and John and Salome.
Wise Old Solomon
Wise Old Solomon was an old soul
Walked closely with the Lord
But he could still rock -n- roll
From time to time
He had a thousand wives and concubines
Was courted by the Queen of Sheba
He drank her wine
He was a wise man
He won the prize to understand
That if one is ever truly wise
One sees through child’s eyes
He knew the names of a thousand angels
Never known before
He knew the names of a thousand demons
And what’s more
He put them down
Into the ground
So they never got up again
He bound them for their mischief
He bound them for our sin
He was a wise man
He won the prize to understand
When one is truly wise
He can fell opponents of any size
Solomon built a house
Where the Lord did dwell
And the dead went to Sheol
They’d never heard of Hell
And the Lord won’t dwell in a house
Built by human hands
And what Solomon built with
Few can understand
He is a wise man
He won the prize to understand
That if one is truly wise
One never dies
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i believe i am a pattern
I have been working on a poetry archive on my blog with links to each of the poems I have posted. You should definitely check it out if you’re into that sort of thing. One of the bonuses is it gives me a definitive list of what I’ve got up on the blog. This one I could have sworn I put up as I recall posting different versions as it came together but the the most recent version I came across in the poetry category was incomplete. This one I’m quite proud of as it says what I believe in a pretty tight and succinct way. Hope you like it.
I believe I am a pattern
A pattern of information
Built from millions and millions of simplicities,
Organized through emergence
I arise up from the bottom,
I am many but still I am me.
And I believe I am a pattern
A consciousness construction
Will, sense, imagination, memory
And though I surely rise up from my body
I am much more a story
Told in the hearts of everyone who knows me.
And I believe I am a pattern
A pattern set in motion
In oscillation with the tides
Not just the ocean
But the Universe besides.
In every mind’s eye there is a cup
Its not the one from which I drink
But its close enough
Occam’s Razor cuts simplest is the best
Is my idea of cup unique from the rest?
Or do we all drink
From the same cup
After all?
For I believe I am a pattern
A process not an object
Like pendulums swing together
When they’re on the same wall
My heart beats to the rhythem
Of the One and the All
And I am subsumed in
The One.
And I believe there is a pattern.
self esteem
I’ve been talking about self esteem in my Friday education group. It used to be a four week presentation but this iteration is looking like six. Its a really important topic in recovery because there is an inordinate amount of self sabotage amongst folks in substance abuse treatment. Intellectually the topic appeals to me because its so difficult to do anything productive on the topic. In general attitudes and beliefs are hard to shift and our sense of self is the oldest and most solid piece of who we are. It takes years of concerted effort to make serious headway and pointing people in that direction, laying it out and providing the tools feels like activism. “You Are Awesome” my favorite Occupation sign says. Its animated my thoughts.
I also like teaching on self esteem because it excuses me a chance to explore just exactly what we are and where we have emerged from. I discuss the mirror test, an ability to recognize yourself in a mirror requires self awareness. “Hey that’s me in there.” 6 month olds, dogs, cats, and monkeys they can’t do it. 18 month olds, chimps and other great apes, elephants, grey parrots, and dolphins can. What were we doing around that age, toddling around getting into shit. At some point we all went to touch the stove, that’s how babies explore the world and someone who loved us smacked our hand and said, “bad baby, don’t touch the stove”. What’d we learn besides don’t touch the stove. “I’m the bad baby who tries to touch the stove”. We are learning who we are.
How we view ourselves is so vital because of confirmation bias, the tendency to see evidence to support what we already believe. We like to believe we look out on the world in an objective way but really we only perceive what is in line with our existing beliefs. Now what is the risk if you believe you are a piece of shit? That is why it is so vital. The thesis I try to make is to pick a concrete strategy and stick with it for years even. When you achieve mastery pick another. I learned about self esteem and started to work on it around 16 probably in my high school psychology class. I’ve been at it ever sense. I’ve made some significant progress but my journey is not yet done.
I have been working on eliminating the word “should” out of my self talk for five years. I still catch myself thinking it. (the re-frame for “should” is “could”). I pretty much ferreted out “can’t” (the re-frame for “can’t” is “I’ve struggled with this in the past but I’m getting better on it because I’m working on it” [not as pithy as “could” but memorable in its absurdity]). “Always” and “never” have had their place.
I teach a 2 step of do the right thing and give yourself credit. Challenging the inner critic instead of hiding from it or tuning it out. Ask it questions; “is this true?”, “does this preserve my life?”, “get me what I want?”, “keep what I don’t want from happening?”, “improve my relationships?”.
I told the story of getting shit canned at Food Town after 29 days when I was 17. Not because I wasn’t a hard worker but because I was to insecure to ask questions and didn’t know how to stay busy. Felt intimidated by the customers, not knowing where stuff was, and the bosses, easier to putter around the bottle room. I had always wanted to be a bag boy too. Mom wanted a kid to go to the store, you got to pick out the cereal and get a comic book at Crairie’s Drugs. When I was a little kid I looked up to the bag boys who brought our groceries out to the car back then. (You know when there were jobs for people to do.)
The bag boys seemed like gods. Kids who did what adults did, that’s what I wanted to be and I told my mom I wanted to be a bag boy and she said “You can’t because we’re not Lutheran and Francis Foods only hires Lutherans”. I told the story pretty matter of factly and a brother in the second row just looked dumb f0unded and said “You’re shitting me”. He couldn’t wrap his mind around a world where you couldn’t get a job because you were the wrong denomination. With all the growing problems of modernity, maybe things are getting better.
two up, two down
Watching baseball, Yankees/Tigers play off baseball. The kid is pitching and he bunched out Granderson and Verlander was just grinning. Didn’t need any patience to enjoy that half inning. I feel like tonight is our best chance, I’m worried about our five spot, not confident with Fister coming up again or the new guy. Maybe an ensemble. The bullpen is tough and deep. But i would be content if tonight was the night and the next game is a rested Verlander against the next team.
Well, back for a day of work after a long weekend road trip. Busy day and still a lot i didn’t get to. Cooked dinner, spanish rice and peas and carrots which i did with fresh grated ginger and black walnuts, salt and pepper of course. I was a little headachey i think from the 11 hour drive home from the homeland and then dozing in front of last nights game, but rocked through my day nonetheless. So it feels good even as Granderson makes a beautiful catch and we don’t get a couple of runs.
Went for a somewhat whirlwind trip to the homeland. Took a half day on Friday for working the Saturday after my vacation. John is teasing my live blogging baseball. “the reader will have known who won but i don’t”, beautiful. John was a fun traveling companion especially doing all the driving. Smokey sat up front, she likes to scan for cows so she can bark like crazy at them. She has a pretty good eye for them, and can smell them from a distance depending on the wind. She was good company up in the big front seat of dad’s truck. Hard to think about having to get rid of it.
We stayed with Brenda and its nice to see her doing well. She hopes to make it down for her CNA test in Missouri around Thanksgiving. I am going to get an heirloom turkey. I’ve only had bobtail white, you too i bet. Not that they’re not a nice turkey, I’d just like to try something else. Didn’t order one quick enough last year. More salt in the brine Brenda requests, last year must have been a little tough. “Probably just from it being able to walk around” was John’s take.
We got in late late Friday so I was a little out of sorts but John brought dark roast Panamanian. Yemeni today at a light middle it loses something when it gets darker but it needs something. John has been a great roaster and taught me some tricks and is leaving his roaster so i don’t have to figure one out.
Brenda and I went to the market and I was really impressed. It had grown a lot and the pavilion was full. There was a nice selection with some good buys and some stuff I can’t get at home (black walnuts for example). The pineapple bread was crumbly and expensive but the cider was cheap and excellent. Got some beautiful red peppers 2 for a dollar and some this and that’s. Brenda picked up some ground chuck from Dannies and I made burgers for supper with fresh tomato. Forgot to bring pickles but Brenda had some store bought ones.
Called Chad Osborne and he happened to have plans with Chad Olson and was meeting another friend at the Red Coat in Royal Oak. It was fun and enjoyed a white ale and some good company. I had a cuban which was good but not exceptional. We went out for another round after and it was nice to reconnect and Chad and I had a good catch up conversation as Chad napped on the drive home.
Sunday Brenda made us breakfast scrambled eggs (local free range) with cheddar and feta, fried potatoes with the red pepper, and biscuits and hamburger gravy. Good stuff.
Earlier Saturday we went to a nuclear power protest at the statue of Custer that stands downtown in Monroe. There were better then 30 people and a lot of people driving by honked. One person rolled down a window and yelled “go fuck yourselves” which hasn’t happened to me in a long time. No death threats though. Some people like having a job so i’m not bitter.
There was a singer songwriter and some people made speeches and a lot of plants were representing. Detroit and Toledo folks too, Mike Keegan I think was the only one from Monroe. It was part of an international day of action being Oct 1 and all. Mike Leonardi mentioned in his speech that the Trapp Brothers drove up from Missouri for the event and we had organized protests and been pushed over on tripods (not true john was doing support for the tripod guy that got pushed over and was maced and randomly snatched up before he could handcuff himself to the police car had been his plan), jumped off the Martin Luther King bridge, and chained myself to that very statue of Custer (actually it was just handcuffs). Saw Jesse Deerinwater which was a bonus as last we’d heard she was in KY.
The protest then caravaned down to Promenade Park on the Toledo waterfront. There were bands (someone out of flint the insurgents or something, very political but fun and sincere and not too cheesy) and speakers (we left during Kucinich, hohum a politician). It was mostly nice seeing people although i liked the occupy toledo kids. especially the one who can’t keep her hands off dogs.
After that we went to Costco so John could get the dog food he likes. They don’t have one in Columbia. I picked up a few things and it wasn’t as overwhelming as that type of thing can be. I owe it more to sleep deprivation and protesting all day outside more then the horror of the big box. Toledo waterfront is beautiful, there are some cool statues and the new bridge is a sight.
Couldn’t believe I jumped into the Maumee off the old Cherry Street Bridge. The water was cold, I didn’t even check the temperature just asked someone who’d done it how late in the year he went. We got picked up by a sail boat to avoid unpleasant conversations with the police and fire department and such about the wisdom of such things. The boat could only get so close being a sail boat coming up on a bridge (hadn’t thought that through) and we had to swim quite a ways out to get picked up. Joe got cold and was having trouble swimming. I held him up and swam him the rest of the way in. John Schwartz was crewing and I can’t remember who else pulled Joe in and when it came time for me to climb out I realized I couldn’t move my legs. Only been cold like that a couple of other times but don’t want to get started on knocking your core temp out of whack. I’ve got way to many stories and though dreary it wasn’t too cold.
We had a big family dinner on Sunday at Bob and Pam’s. Pam made pot roast which was excellent and Betty made this killer squash/yam casserole with ginger, nutmeg, cinnamon, and a little clove I think. Brenda made deviled eggs (with the free range, she gets little ones for a dollar a dozen) which sparked a conversation what mom put in them (mayonnaise, yellow mustard, salt and pepper was the majority opinion with a little paprika on top). I make mine more daring but they were good. Bobby and Julie brought an apple pie from a local orchard that was killer (it was the walnuts). Sparked a conversation about Smuckers and I’ll try to get Brenda to bring down a blueberry one for Thanksgiving. You should come, looks like there is going to be a feast (i got extra guests last year by posting the menu).
The star of the show was Mr. Nolan Lagrange all of six weeks old. He holds his head up which is about all you can reasonably expect. Struck me as a serious sort, thoughtful, to the extent all of those little neuronal firings are organized into such a thing. Had good conversation with Bobby about consciousness development and I am glad he and Julie are watching.
Its nice to see everyone doing well. Shane came by and had pictures from his hunt in South Africa. i want to see his stuff when its stuffed. All the meat goes to market. They give discounts on shooting stuff they need for the market. Charge by the critter. He forgoed a giraffe for example for some big thing with horns.
The drive home was a little trying. Hadn’t recovered from the drive up. Enjoyed some WJR. They got some welfare reform so they had the Great Lakes State social services director talking about throwing 11,000 families off welfare for their own good because people get dependent on a check don’t bother learning how to read. lazy shit heels. The next guest was a Yupper congressman talking about oil companies already paying their fair share. All this without irony.
Also caught an hour of Terri Gross interviewing a big wig in the New Apostolic Reformation. A lot of stuff on spiritual warfare and getting control of the guvmint. Scary stuff, very middle ages.
But finally made it home. Bases loaded in the 8th Yankees at bat ahead four to one. Al Albuquerque to the rescue. Leland plays the match up. Nite faithful reader, go Tiges!
medication assisted treatment for addiction
There is a big move in addictions treatment to utilize medications in an attempt to improve success rates in keeping people sober. The following are selections pulled from wikipedia on the most common medications for MAT (medication assisted treatment). Clinical literature and my own experience show that MATs can be a nice adjunct to counseling and social and spiritual supports but are not a replacement for a genuine recovery experience. There are approved MATs for alcohol and opiates with both agonists (activate receptor sites in a similar but safer way then the drug) and antagonists (block receptor sites). For alcohol there is also antabuse which prevents the usual breakdown of alcohol and massively increases the chemicals related to hangover resulting in an immediate negative experience upon consumption. There are significant side effects and contraindications with all of these approaches and everyone in the treatment field or who struggles with addiction would be well advised to do some homework on possible medication options.
Medication Assisted Treatment Medicines (from Wikipedia)
Acamprosate (brand name: Campral):Acamprosate is thought to stabilize the chemical balance in the brain that would otherwise be disrupted by alcoholism, possibly by blocking glutamatergic N-methyl-D-aspartate receptors, while gamma-aminobutyric acid (GABA) type A receptors are activated. Alcohol inhibits activity of biochemical receptors called N-methyl-D-aspartate receptors, or NMDARs, so that chronic alcohol consumption leads to the overproduction (upregulation) of these receptors . Thus, sudden alcohol abstinence causes these excessive numbers of NMDARs to be more active than normal and to produce the symptoms of delirium tremens and excitotoxic neuronal death.[9] Withdrawal from alcohol induces a surge in release of excitatory neurotransmitters like glutamate, which activates NMDARs.[10] Acamprosate reduces this glutamate surge.[11] The drug also protects cultured cells in excitotoxicity induced by ethanol withdrawal.[12] and by glutamate exposure combined with ethanol withdrawal.[13]In addition to its apparent ability to help patients refrain from drinking, some evidence suggests that acamprosate is neuroprotective (that is, it protects neurons from damage and death caused by effects of alcohol withdrawal and possibly other insults). Reports indicate that acamprosate only works with a combination of attending support groups and abstinence from alcohol.[3] Certain serious side effects include allergic reactions, irregular heartbeats, and low or high blood pressure, while less serious side effects include headaches, insomnia, and impotence.[4] Acamprosate should not be taken by people with kidney problems or allergies to the drug. FDA concluded: “Campral proved superior to placebo in maintaining abstinence (keeping patients off alcohol consumption), as indicated by a greater percentage of acamprosate-treated subjects being assessed as continuously abstinent throughout treatment. Campral is not addicting and was generally well-tolerated in clinical trials. The most common adverse events reported for patients taking Campral included headache, diarrhea, flatulence, and nausea.”
Buprenorphine (Subutex, Temgesic, or Suboxone [buprenorphine:naloxone 4:1 preparation] – sublingual tablets – Buprenex – for injection – and Norspan – transdermal patch) is a semi-synthetic opioid that is used to treat opioid addiction in higher dosages (>2 mg) and to control moderate pain in non-opioid tolerant individuals in lower dosages (~200 µg).
Disulfiram is a drug used to support the treatment of chronic alcoholism by producing an acute sensitivity to alcohol. Trade names for disulfiram in different countries are Antabuse and Antabus manufactured by Odyssey Pharmaceuticals. Disulfiram is also being studied as a treatment for cocaine dependence, as it prevents the breakdown of dopamine (a neurotransmitter whose release is stimulated by cocaine); the excess dopamine results in increased anxiety, higher blood pressure, restlessness and other unpleasant symptoms. Under normal metabolism, alcohol is broken down in the liver by the enzyme alcohol dehydrogenase to acetaldehyde, which is then converted by the enzyme acetaldehyde dehydrogenase to the harmless acetic acid. Disulfiram blocks this reaction at the intermediate stage by blocking the enzyme acetaldehyde dehydrogenase. After alcohol intake under the influence of disulfiram, the concentration of acetaldehyde in the blood may be 5 to 10 times higher than that found during metabolism of the same amount of alcohol alone. As acetaldehyde is one of the major causes of the symptoms of a “hangover” this produces immediate and severe negative reaction to alcohol intake. Some 5–10 minutes after alcohol intake, the patient may experience the effects of a severe hangover for a period of 30 minutes up to several hours. Symptoms include flushing of the skin, accelerated heart rate, shortness of breath, nausea, vomiting, throbbing headache, visual disturbance, mental confusion, postural fainting, and circulatory collapse. Disulfiram should not be taken if alcohol has been consumed in the last 12 hours. There is no tolerance to disulfiram: the longer it is taken, the stronger its effects. As disulfiram is absorbed slowly through the digestive tract and eliminated slowly by the body the effects may last for up to two weeks after the initial intake; consequently, medical ethics dictate that patients must be fully informed about the disulfiram-alcohol reaction.[4] A recent nine-year study found that incorporation of supervised disulfiram and a related compound calcium carbimide into a comprehensive treatment program resulted in an abstinence rate of over 50%.
Naltrexone is an opioid receptor antagonist used primarily in the management of alcohol dependence and opioid dependence. It is marketed in generic form as its hydrochloride salt, naltrexone hydrochloride, and marketed under the trade names Revia and Depade. In some countries including the United States, an extended-release formulation is marketed under the trade name Vivitrol. Also in the US, Methylnaltrexone Bromide, a closely related drug, is marketed as Relistor, for the treatment of opioid induced constipation. Naltrxone should not be confused with naloxone (which is used in emergency cases of overdose rather than for longer-term dependence control) nor nalorphine. Both nalorphine and naloxone are full antagonists and will treat an opioid overdose, but naltrexone is longer-acting than naloxone (although neither is an irreversible antagonist like naloxazone), making naloxone a better emergency antidote. Its use in alcohol (ethanol) dependence has been studied and has been shown to be effective [1]. Its mechanism of action in this indication is not fully understood, but as an opioid-receptor antagonist it’s likely to be due[citation needed] to the modulation of the dopaminergic mesolimbic pathway which is hypothesised to be a major center of the reward associated with addiction (being one of the primary centers for risk-reward analysis in the brain, and a tertiary “pleasure center”) that all major drugs of abuse are believed to activate. The standard regimen is one 50 mg tablet per day. Initial problems of nausea usually disappear after a few days, and other side effects (e.g., heightened liver enzymes) are rare. Drug interactions are not significant, besides the obvious antagonism of opioid analgesics. Naltrexone has two effects on alcohol consumption.[8] The first is to reduce craving while naltrexone is being taken. The second, referred to as the Sinclair Method, occurs when naltrexone is taken in conjunction with normal drinking, and this reduces craving over time. The first effect persists only while the naltrexone is being taken, but the second persists as long as the alcoholic does not drink without first taking naltrexone. In alcohol dependence, naltrexone is considered a safe medication. Control of liver values prior to initiation of treatment is recommended. There has been some controversy regarding the use of opioid-receptor antagonists, such as naltrexone, in the long-term management of opioid dependence due to the effect of these agents in sensitising the opioid receptors. That is, after therapy, the opioid receptors continue to have increased sensitivity for a period during which the patient is at increased risk of opioid overdose. This effect reinforces the necessity of monitoring of therapy and provision of patient support measures by medical practitioners. Naltrexone can induce early morning erections in patients who suffer from psychogenic erectile dysfunction. The exact pathway of this effect is unknown. Priapism has been reported in two individuals receiving Vivitrol. Naltrexone has been shown to be effective in the reversal of sexual satiety and exhaustion in male rats.[22]The Chicago Stop Smoking Research Project at the University of Chicago studied whether naltrexone could be used as an aid to quit smoking. The researchers discovered that Naltrexone improved smoking cessation rates in women by fifty percent, but showed no improvement for men.[23] Some studies suggest that self-injurious behaviors present in developmentally disabled and autistic people can sometimes be remedied with naltrexone.[25] In these cases, it is believed that the self-injury is being done to release beta-endorphin, which binds to the same receptors as heroin and morphine.[26] By removing the “rush” generated by self-injury, the behavior may stop. Naltrexone helps patients overcome urges to abuse opiates by blocking the drugs’ euphoric effects. While some patients do well with the oral formulation, there is a drawback in that it must be taken daily, and a patient whose craving becomes overwhelming can obtain opiate euphoria simply by skipping a dose before resuming abuse. There are indications that naltrexone might be beneficial in the treatment of impulse control disorders such as kleptomania (compulsive stealing), trichotillomania, or pathological gambling.[28] Clinical trials are ongoing regarding the use of naltrexone in combination with another drug, bupropion, as a weight loss therapy.[29]
Alcohol Dependence and Anti-Depressants
In 2002, Dr. Fulton T. Crews, Bowles Center director, and Bowles Center research associate Dr. Kim Nixon were the first to report that alcohol, during intoxication, has a detrimental effect on the formation of new neurons in the adult rat hippocampus. This brain region is important for learning and memory – in animals and humans – and is linked to psychiatric disorders, particularly depression.
“When used in excess, alcohol damages brain structure and function. Alcoholics have impairments in the ability to reason, plan or remember,” said Crews, also professor of pharmacology and psychiatry in UNC’s School of Medicine. “A variety of psychological tests show alcoholics have a difficulty in ability to understand negative consequences.”
In the new study, senior co-author Crews and co-author Nixon found inhibition of neurogenesis, or brain cell development, during alcohol dependency, followed by a pronounced increase in new neuron formation in the hippocampus within four-to-five weeks of abstinence. This included a twofold burst in brain cell proliferation at day seven of abstinence.
“And when they stop drinking, you can show in a period of weeks, months, years, the brain grows back, there’s a return of metabolic activity, and cognitive tests show a return of function,” Crews said.
“Pharmacological agents such as antidepressants and behaviors such as running, increased physical activity and learning experiences apparently help regulate the process of neurogenesis,” he added. “Our research suggests they could be considered in the treatment of chronic alcohol dependency.”
Multiconstruct 
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