Trauma & Addiction etiology & resolution

1. Trauma & Addictionetiology & resolution Sam Darcy, MA, CAP The Refuge – A Healing Place Ocklawaha, FL sdarcy@therefuge-ahealingplace.com

2. Big ‘T’ & little ‘t’ trauma Whoever survives a test, whatever it may be, must tell the story. That is one’s duty Ellie Wiesel The Twin Towers Public or Private Trauma: • The IMPACT is neuro-chemical , physiological, and characterological & a tough population • Hebb’s Law • HIGH MORTALITY RATE

3. Trauma: A Working Definition • Horror • Beyond the threshold of pain • Acquired emotional refinement to detach, dissociate, defend, protect or numb • Childhood and/or Adult “events” • Surviving Implies coping, resiliency • Co-occurring mental health symptoms: Depression (major), schizoaffective, Personality Disorders, Sexual Disorders, DID(?), Eating Disorders, Self Harm . . . Refined Reactive Coping Skills

4. Complex Grief, Shame & Guilt • “The Creative Arts have a unique ability to help trauma survivors and addicts navigate through life experiences and defenses to the center of the soul.” Dr Ericha Hitchcock-Scott, Ph.D.

5. Images of Trauma’s Impact

6. The Brain’s Reaction Constriction, abnormal amydala, abnormal hippocampus FIGHT, FLIGHT, FREEZE = HYPERVIGILENT

7. Escaping & Coping with Pain • Addiction(s)- Substance, Sex, Cutting, Gambling, Dissociation, Work, Internet, Exercise • Don’t talk, don’t trust, don’t feel until ***Crisis & Collapse*** Destabilizing event(s) that propel change: Arrest, Homelessness, Hospitalization, Divorce & Televised Intervention . . .

8. Clients Present with: • Loss of self w/EGO • Chameleon • Somatization • Isolation • Happy & miserable • Argumentative/Blocking • Hyper-verbal/Reticent • PTSD=Identity theft • Move Toward: • MOTIVATION • RESTORATION Personality Disorder NOS, Cluster B Type • Is • Trauma Clustered Behaviors Re-create a sense of healthy integrated strength

9. You Went Through All That! • Strive to Find the Client’s Emotional Strength(s) • External Boost to Healthy Ego • Habilitation and Rehabilitation • Explain the Brain’s Reluctance to Heal • Build on Already Established Coping Skills • Applaud Even the Smallest Success(es) • Always Cycle Back to Feeling(s) • Keep Telling One’s Story

10. Tell Your Story &Search for Resiliency GOAL SETTING, EYE ON THE PRIZE – achievable & attainable

11. How to Intervene . . .In Patient v Out PatientInductive Reasoning • 12 STEP RECOVERY • TIME LINES • COLLAGE • MASKS • FAIRY TALE • BODY MAP • LOVE LETTERS • DRUM CIRCLE • MUSIC • EQUINE THERAPY • TALK THERAPY • CBT/DBT • HOLOTROPIC BREATHWORK • ART THERAPY • STRUCTURE • ACCOUNTABILITY • EMDR • DRAW, WRITE • ROPES COURSE • PSYCHODRAMA WHAT ABOUT MEDICATIONS?

12. MEDICATIONS . . . • Can’t (successfully)Medicate Axis II with Medications! • Axis II = Trauma Clustered Behaviors (reactions) • Depression, Anxiety, Self- Harm or Manic-type behaviors = Consulting Psychiatrist/Physician • Avoid prescribing for the label & avoid prescribing for short-term reactive behaviors • Can’t prescribe for Willingness & Compliance

13. Medications/Alternative Therapy • Understanding “Trauma Clustered Behavior” • Can’t Medicate Axis II back to healthy • Caution regarding treatment du jour • Affordable: Financial, emotional, situational & circumstantial. Primum non nocere

14. HOLDING ON TO SUCCESS • Relapse Prevention • Support Network • Plan B • Victim to Survivor to Thriver • Plan C • Expect Relapse & Regression Yet Anticipate Healthy Response

15. High Mortality RateEntrenched Symptoms“Triggers” & ReactivityWorsening of Symptoms No Definitive “Cure”Compound Complexity of DisordersExperiential v Cognitive/Behavioral

16. References/Summation Google: • Dr B van der Kolk • Joseph E. LeDoux • Dr Patrick Carnes • Dr Don Meichenbaum • Lisa Najavits • Dr Mel Pohl, MD • Dr Ericha Scott • Sonja Lyubormirsky Self care for the clinician