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Substance Use Whether you are combating substance abuse, are in search support, or have questions about drugs or alcohol, ask in this forum.

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  (#1 (permalink)) Old
Briana Offline
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Treatment? - May 7th 2017, 05:59 AM

Was just curious if anyone has ever received treatment for any kind of addiction? I'm going, my first time, this week and I'm super nervous and overwhelmed about it. Going for alcohol, mainly.

Just curious what to expect? Should I bring anything? Notebook?

I believe it will be a group therapy, individual, and a psychiatrist will be meeting with me as well.

I bought myself a fidget spinner...which is helping. I plan on taking it with me, but, any advice would be great.


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Re: Treatment? - May 8th 2017, 06:41 AM

Hey there,

First things first, congratulations on making the decision to seek treatment! That's a huge step in the right direction and I'm sure it wasn't an easy choice to make. It's definitely something you should be proud of yourself for.

While I've never received treatment for substance abuse, I do work for a substance abuse facility. Every facility does have different procedures, so your experience might differ slightly, but there are some basics that you can expect.

Will you be receiving inpatient or outpatient treatment? The level of care that you are going in for will have an impact on the way things will be run. For example, if you are entering a residential facility, it's likely that the initial focus will be on detox and helping you handle withdrawal symptoms in a safe manner. However, if you are attending an outpatient program, the treatment will likely be more therapy-centered.

It's great that you're going to be seeking support in multiple ways while undergoing treatment. While it might all sound a bit similar at the beginning, each method serves a slightly different purpose.
  • The individual therapy is intended to see how YOU are doing on a one-on-one basis. It's an opportunity to speak with your therapist about your successes, your fears, your struggles, and any other thoughts you might have about the process. Your therapist will also work to help you come up with substitutions for drinking and help you on a path to recovery, which may include following a 12-step program.
  • Your time with your psychiatrist will likely go hand in hand with that, as they will be assessing your well-being in other areas (ex: levels of depression/anxiety during sobriety) during the treatment process to ensure that it doesn't cause problems that may lead you to turn back to drinking.
  • The purpose of group therapy is to provide you with a support system made up of others who are going through the same treatment as you. It's a time for you to share stories about the impact alcoholism has had on your life, celebrate successes, and provide accountability and encouragement for one another in times of struggle. After all, no one will understand your struggle as well as others who are in similar situations will.
As far as bringing things goes, that's really up to you. You can always ask your therapist or psychiatrist if there is something they would like you to bring to each session. If you'd like, bringing a notebook to your individual sessions could be a great idea, as it will give you a place to write down steps and goals that you and your therapist come up with. The fidget spinner also sounds like an incredibly useful tool, as going to treatment for the first time can definitely cause some nerves.


Overall, the most important thing is to be honest with yourself and those who are coming alongside you in the treatment process. Don't be afraid to open up about anything that you're feeling or thinking, regardless of how negative it is. Everyone working with you, as well as those in your life, are there to lift you up and encourage you throughout this journey.


If you'd like to talk about this further, feel free to reply to this thread or shoot me a PM. Best of luck with your treatment!


Take care,
Sammi


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Re: Treatment? - May 11th 2017, 10:36 AM

Well anxiety and stress are pretty much what causes addiction. People turn to drugs and alcohol to escape, to escape anxiety and stress, and it works, initially, and the midbrain learns it works, so the next time it feels stressed, it immediately thinks, "I know how to fix this, drugs and alcohol will fix this. Get me some drugs and alcohol."

Now the rational thinking prefrontal cortex part of the brain decides that drugs are bad, drinking alcohol is bad, and it doesn't want to do that anymore.

Unfortunately, the rational thinking prefrontal cortex isn't the part of the brain that becomes addicted. It's the primitive emotional midbrain that becomes addicted. The primitive emotional midbrain says, "I'm stressed. Get me alcohol."

This is all better explained in a video by Dr. Kevin McCauley:
https://www.youtube.com/watch?v=b2emgrRoT2c

And you can look for other videos by him where he also explains it.

I've been studying addiction for a few years now, and I've found some interesting things about how the brain works and how it relates to addiction. Understanding this helps lead to understanding how to pursue recovery.

Pretend your arm is your spine. Make a fist, that's your midbrain. Place your other hand over your fist, that's your prefrontal cortex (the wrinkly stuff when you look at the outside of a brain.)

(The brain has more parts, but for this discussion we're interested in the "midbrain" and the "prefrontal cortex" (or prefrontal cortex).

The midbrain is the most primitive part. This is where emotions come from. The midbrain's purpose is to keep you alive and pass your genes on to the next generation. If you see a scary tiger running towards you, your midbrain goes, "Yikes! Run!" and you run. If you see delicious food, your midbrain urges you to approach the food, reach out, and eat it. If you see a handsome man, your midbrain urges you to approach and engage. The midbrain tells us what to do, without bothering to explain why we should do these things. It doesn't explain why we should run from scary tigers, why we should eat food, or why men are attractive to us. It just tells us what to do, and a very long time ago that was good enough.

Then we developed a prefrontal cortex. This is where rational thought resides. This is where we imagine possible outcomes, consider consequences, and make rational decisions. The prefrontal cortex can override the desires of the emotional midbrain that just wants what feels good.

The prefrontal cortex is however rather slow at figuring things out. If the prefrontal cortex sees a scary tiger running towards you, it might think, "Hmm, that looks like a large tiger running towards me. Let me project into the future possible outcomes. The tiger might jump on me, knock me down, rip me apart with its claws, bite me with its teeth. OK I don't think that would be a good thing to have happen to me. Let's see, what options do I have to deal with this. What can I do to avoid this unfortunate projected outcome? I could run away. Yes, let's try that. Let's run away."

Notice how the prefrontal cortex took a long time to figure out what to do about the tiger running towards you. All the while the midbrain already has an action plan. The midbrain, upon first noticing the tiger, emotionally thought, "Yikes! Run!" However, the prefrontal cortex is overriding the midbrain. The midbrain sees the prefrontal cortex as a liability in this scenario, so the midbrain literally shuts down the prefrontal cortex, allowing the midbrain to gain control so it can quickly make you run away.

That's the tricky part about addiction and the brain. The prefrontal cortex usually overrides the midbrain; however, under duress the midbrain can shut down the prefrontal cortex, so you literally can not think rationally anymore, and you just react emotionally.

The prefrontal cortex is the part of the brain that decides, "I want to stop using drugs / stop drinking alcohol" As long as the person remains in a calm serene happy state, the prefrontal cortex remains in control. However, if the person becomes stressed (and let's face it, our modern day society creates stress everywhere), the midbrain can gain control by seeing the prefrontal cortex as a liabiliy and shutting it down so the midbrain can get what it wants.

This is the dilemma of someone who has developed an addiction problem. They rationally decide they no longer want to do drugs / drink alcohol; then they get stressed, and they find themselves doing what they decided they didn't want to do anymore. They literally can not control themselves anymore, because the midbrain is shutting down their prefrontal cortex where rational thought occurrs.

The solution then, is to learn how to mitigate stress, learn how to relax, learn how to stay calm, learn how to find happiness without using drugs/alcohol. When in a calm serene happy state, the prefrontal cortex remains online and active, you remain in control, and you can contemplate and decide if you really want to use drugs or drink alcohol.

Western philosophy doesn't have much to help with how to remain calm, serene, and happy. Eastern philosophy however specializes in this. Eastern philosophy developed Mindfulness Meditation, yoga, qi-gong, tai-chi, and other similar mind exercises. By practising Mindfulness Meditation for 15 minutes a day, you can strengthen a part of the brain known as the anterior cingulate. This part of the brain helps decide if you will react rationally or emotionally. Brain scans show this part of the brain becomes more active, so you have more control over whether you will react rationally or emotionally to a given situation. You'll find you have more tollerance to stressful situations, you're better able to remain in control (prefrontal cortex remains online, doesn't get shut down).

Thus one tool of recovery is learning Mindfulness Meditation. Yoga, qi-gong, and tai-chi are meditative motion exercises. You're learning to focus your mind on slowly and deliberately moving your own body, while maintaining your focus on your body.

There are Meditation apps you can download to help guide you through a meditation sitting. (Headspace is one which I've been told is quite good.) You may also find a meditation class or group to go to. Alternatively, you can find a yoga class you like, or qi-gong or tai-chi. (Yes, yoga helps cure addiction and is very much a mind exercise.)

Other tools which can help: finding a supportive group of people to meet with regularly. (Hence AA, NA, Al-Anon, Nar-Anon, and similar groups. A residential treatment program is a place where you quickly make friends with other people just like you so you can feel surrounded by supportive people who understand you and accept you as you are. This helps calm the emotional midbrain so it's not so stressed and anxious, making recovery easier.)

Look for ways to alleviate stress (other than engaging in addictive behaviors). Too many classes? Drop a class. No purpose and meaning in life or reason to get up in the morning? Add a class. Develop a spiritual life. (The 12 steps are one path that helps point the way. It's not the only path to recovery.)

If you're interested in further study, you can research the Sympathetic Nervous System (SNS)(fight or flight state) and the Parasympathetic Nervous System (PNS)(rest, digest, restore). Stress leads to triggering the SNS state, while relaxation triggers the PNS state. Relapse can happen when one is in the SNS state (fear, anxiety, stress). Recovery can happen when one is in the PNS state (peace and happiness). Also see "polyvagal theory".

Other things you can do, as mentioned by others: stay away from people/places/things associcated with former drug/alcohol use. Out of sight, out of mind. If the emotional midbrain doesn't see it, then it's not thinking about it.

Sorry this was a long explanation. I hope it's useful. Now you can better understand addiction and how to control it. (I suggest try downloading the Headspace app and give it a try. It'll take a few weeks of practice, but you should then start to notice a change. You'll be more relaxed and happy and able to control yourself.)

A recovery treatment center should be a place that provides fun activities, supportive people to be around, a balance between social groups for fun and processing groups for therapy (where we sit and talk about whatever it was that drove us to drinking, because we need to get that out in the open, so it's not buried inside us anymore. Recalling a traumatic memory rewrites the memory as slightly less traumatic.)

A recovery treatment center should definitely NOT be a place that "teaches" you that drinking is bad. Everyone already knows that! The idea of "Just stop drinking" is esentially the equivalent of saying, "Just stop being an alcoholic", which is like saying, "Just stop having cancer." It's naive. It's not that simple. If it was then there wouldn't be any people who have problems with alcohol and drug addiction.

Also, don't call yourself an alcoholic. Call yourself "a person who has a problem with alcohol." Here's why. If you are an alcoholic, then you are the problem, and there is no solution. If you have a problem with alcohol, then that separates you from the problem, and the problem can be addressed. It's a subtle difference in wording, but a major shift in cognitive framing. It's the difference between having a problem, and being the problem. People can have problems and still be people.

Best wishes.

Last edited by del677; May 11th 2017 at 10:56 AM.
   
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Re: Treatment? - May 22nd 2017, 06:49 AM

rehab is really helpful. i went because of my acid use( which i still occasionally use). everyone was really nice and supportive. plus, there is usually free food..
   
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