When Love & Addiction Collide

When Love & Addiction Collide

Love is a funny thing; sometimes it makes a lot of sense and other times it’s quite bewildering. Similarly, addiction appears in the same fashion. What we’ll be exploring today is what happens when your love interest develops a substance abuse problem or an outright addiction and how you can help them (and yourself).

What you’ll find below is the result of a large collaboration between three Austin mental health professionals, William Schroeder and Julie Osofsky of Just Mind, and Dr. Daniel Hochman of SelfRecovery.org. Together, we understand the intricacies of addiction and the human mind, as we discuss it regularly amongst ourselves and within our patient sessions. We hear the same questions arise, so we’ve attempted to answer some of the most common concerns and questions below.

What are some character or behavior traits an addict might display?

Addiction affects individuals differently, but there are some commonly seen behavior changes that could be cause for alarm. Most of these are identified by a quick or dramatic change in areas of their life where they used to be very consistent and reliable. Examples of this can include, them not showing up to work or commitments on time, pulling back from mutually-enjoyable and healthy relationships and diving into toxic ones, becoming unreliable, being irritable or on the defensive, disappearing for hours on end, and getting short on once available money coffers. Many of these actions occur because the user is most likely feeling a wave of guilt and shame for their addiction and are trying their very best to keep it a secret. In general, rapid changes in money and/or appearance can be some of the first major indicators of when their controlled-habit is unraveling into full-blown addiction and they’ve saddled up for the ride.

If I become suspicious that a loved one is battling an addiction, what should I do?

There are several things you can do if you suspect your loved one is grappling with addiction, which are meant to help them and protect your own health and happiness. To begin, we suggest talking to them about it, but not in a combative or accusatory way. So many people (with great intentions) jump into this moment in the perfectly wrong way and say something like: “I think you’re an alcoholic and you need to stop.” That’s actually one of the quickest ways to make them defensive and shut down about it. One of the trickier things about addiction is the isolation a person experiences. Many people find themselves using a substance as a way to cope with some turmoil or uneasiness, so shaming them about it is counterproductive.

Many times, addiction is an indicator of something else that the patient is struggling with, so our suggestion is just to try to connect with them in a safe and loving way, while showing your concern. Address some specific changes you’ve noticed in their behavior or actions. Something similar to, “I’ve noticed you’ve been more upset with people recently and you’ve been drinking a lot more… I’m worried about you. What’s bothering you?” This is much easier and inviting for them to respond to or at least begin the conversation.

Lastly, you also need to seek help for yourself. Get your own support through some sort of group or therapist. Ultimately, you cannot control or change what your loved one does. Being able to accept that can be a difficult process, but it’s a needed one for both of you.

How can I best show support? What are some things I should avoid saying?

Like we’ve agreed upon before, we’d avoid judgment or shaming. This helps no one. You’ll likely need to set boundaries, but if done in a transparent and loving way, this is more effective than making them feel badly about their addiction. We’ve considered this next point a lot and we agree, once someone gets to this point, it is not enjoyable for them. Sure, the first drink or hit might provide them with a rush of euphoria, but we assure you that’s followed with anguish and torture.

Research indicates how important it is to have a supportive community for those who are struggling with addiction. This is partially behind the practice of sober houses and the decriminalization of drug crimes in most European cities. Community support and alternative thinking is how Iceland got kids to say no to drugs and essentially wiped out a massive “epidemic” they were experiencing. It’s also quite helpful to distinguish the difference between the person and their addiction; treat the addiction as its own being. You might say, “I love you, but I’m becoming anxious the addiction might come back.” Instead of, “What is wrong with you? Why don’t you just stop?” This depersonalizes the addiction, which can help the person to be less defensive, as it’s a separate entity.

Remember, your goal is to convey that you care and emphasize your willingness to be leaned on as support, while they navigate their options for help. When different approaches are compared, the best ones outcomes come from those that that treat a person suffering in addiction no differently than another illness, such as cancer. Nobody wants a life of addiction (or cancer). Both are absolutely horrible, and we have to understand that.

If my loved one already has a therapist or psychiatrist, should I call them? Can the therapist or doctor speak with me or is that a confidentiality issue?

This is something that has come up in the past, so we thought we should answer this definitively. We have received voicemails or emails from a friend or family member who is expressing concern regarding the patient. This is usually triggered by a recent event, such as suspecting a relapse or displaying troubling behavior like we highlighted above. Other times, it’s overt displays of struggle, like being hospitalized with a high blood alcohol level or overdosing. No matter how much we would love to comfort you in this time of uncertainty, unless we have a signed agreement allowing us to talk with others about the patient (signed by the patient), we can’t reply due to confidentiality. That being said, if you think you have valuable information that could assist in their recovery, a good provider will appreciate your disclosure and will make use of it, albeit discreetly and without acknowledgment, we received your correspondence.

Another approach you could present to the patient is to join them in one of their sessions. This not only strengthens your commitment and resolve, but it also will give you the opportunity to potentially have a voice with them and their counselor. So long as the patient is fine with your joining, most providers won’t have an issue with your addition.  

I’ve had it! Can I have someone committed into rehab involuntarily?

Not really, and for good reason, as it is difficult to legally force a free person into any kind of treatment (yes, even while intoxicated). It is feasible to involuntarily commit someone for a detox program and most states have a system in place for that. This involves proving (with documentation) that the likelihood of imminent physical harm (beyond intoxication) or a fundamental lack of capacity to provide for their own basic needs. However, this is exceedingly rare in practice, considering the amount of people harming themselves with their addiction every day. It can also be impractical to force detoxification without the patient being completely on-board, as they might not be ready for it. So the answer to the question relies on which situation and state you’re in.

Anything else I should know?

With certain substances, it is best not to stop cold-turkey without the guidance of a medical doctor, as some addictions can prove fatal if stopped suddenly. This should not deter any addict from seeking recovery, it just means that should be honest with their desires to stop. Alcohol, benzodiazepines (also called benzos), and opioids are of the gravest concern. To provide the patient with their best foot forward, medically-supervised detoxification should be considered as an option or at the very least, get your doctor’s approval to wean off at home.   

Secondly, addiction recovery can take many forms. The evidence shows that most people can improve greatly at a traditional outpatient clinic that’s well-versed in how to address underlying mood issues that drive addiction. When it comes to recovery, many people often incorrectly believe the best (or only) solution is to arrange for a 30-day on-site rehab. The evidence is quite clear that it’s typically not needed, on top of being only 5-10% effective. Why is the effective rate so low in rehab facilities if I see my favorite celebrities going to them all the time? Well, there are many reasons for this, including very few regulations on the standards of care and the lack of utilizing evidence-based treatments. Additionally, there’s a type of fallacy when you’re part of an in-patient rehab program, as it’s “easier” to get well in this removed and idyllic setting. However, many patients that show promise while in rehab have been known to struggle when they return to their “real life” and all the toxic opportunities, situations, and/or people present themselves. This was the idea behind SelfRecovery.org: to make evidence-based strategies available to everyday people in their everyday environments. One thing we can all do to help is to destigmatize addiction so more people reach out for the help they need and get there earlier.

Finally, a common misunderstanding is around the topic of relapses, which are unfortunately an expected part of the journey. We typically educate clients to not think of a relapse as the worst thing that can occur, but a possible hurdle they might experience. We want to be clear here, we don’t recommend relapses, so don’t strive for them or allow yourself a weekly “cheat day”, as that won’t get you into the clear, but it could happen. The truth of the matter is that if a relapse occurs, the goal is to make them less frequent, less intense, and to decrease the duration. It’s not so much what happens when you get bucked off the horse; it’s what happens when you’re on the ground.

Photo by Ben White on Unsplash

Things To Do With Kids In Austin

What To Do With Kids In Austin

By: Loren Lomme, LPC, RPT

Have you ever thought, “Man, things would be so much easier if parenting came with a handbook!”? (I have!) While it’s true that there’s no one handbook for all things parenting, there are lots of resources out there for parents. The problem is it takes a lot of time and energy to not only find them but to figure out which ones might be helpful. Our goal is to make your life a little easier by offering a “field guide” of what to do with kids in Austin, parenting resources, a one-stop-shop for finding what you need to help w/ parenting skills, stress relief, connecting and engaging with other parents, fun places and activities, and maybe a little humor because, hey, parenting is hard yall!

Parenting Resources:

Most of us are plugged in to the online world in one or several ways, so while you’re there, here are some ways to connect and get advice from fellow parents as well as experts:

thebump.com

  • Full of pregnancy, baby, and parenting tips and information
  • Join their message boards to connect with other parents that have similarities to you
  • (trying to conceive, moms of newborns, parents of multiples, etc.)

ahaparenting.com

  • This is probably one of my favorite, online parenting resources. 
  • The website contains information and advice in the form of articles from a clinical psychologist and fellow mom, Dr. Laura Markham, for every stage from pregnancy through the teenage years.
  • Follow the Aha!Parenting Blog for extra articles and advice.

Facebook Groups

  • Search for FB groups that meet your needs: moms, dads, grandparents, foster parents, moms of girls, parents of kids with food allergies, etc…..if you can think it up, there’s probably a FB group for it where you can connect with others for advice, community, and support.
  • Join Austin Moms’ Network – this group is FULL of local momos, activities, opportunities, and information
  • Follow Austin Moms Blog for articles, funny videos and memes, information, and events geared toward moms and families in the Austin area
  • Join Hike it Baby Austin – this group does both parent and child led hikes and playdates around various parts of Austin

do512family.com

  • This website lists upcoming activities for kids and families around the Austin area.

Are you a reader….or a listener like me (Audible for the win!)? Here’s a short list of must-read books for parents:

  • ANYTHING by Dr. Dan Siegel; seriously, he’s the best! If you need a good starting place, read The Whole Brain Child. The information about child development is paired with strategies for nurturing your child’s mind and their bond with you as well as tackling difficult behaviors. Have a teen? Check out Brainstorm. It’s a bit more of a challenging read, but the information and insights about how the teenage brain works are well worth your time and efforts.
  • The Connected Child by Karyn Purvis, David Cross, and Wendy Lyons Sunshine – If you have (or are planning to) foster and/or adopt a child, this book is for you! This is also a great read for any parent of a child with special behavioral or emotional needs.
  • Hold Onto Your Kids: Why Parents Need to Matter More Than Peers by Gordon Neufeld & Gabor Mate – The focus of this book is attachment and why it’s crucial for your relationship with your child. The updated edition even includes a section on screens and social media.
  • The Highly Sensitive Child: Helping Our Children Thrive When the World Overwhelms Them by Elaine Aron – Dr. Aron discusses the trait of “high sensitivity,” the benefits and challenges that go along with being highly sensitive, and the keys to successfully parenting an HSC and helping them thrive in the world.
  • The Out of Sync Child: Recognizing and Coping with Sensory Processing Disorder by Carol Kranowitz – If your child is affected by any type or level of sensory processing issue, this book will be immensely helpful for you in making sense of your child’s behaviors as well as in providing you with approaches in managing them.

How about those times when your kid’s behavior is so out of control or overwhelming for you that you’re just not sure what to do next? We thought it would be nice to give you a short list of ideas for those hard to handle moments when you feel stuck.

  • First, make sure YOU’RE breathing. I’m talking about the slow, deep breaths that calm our bodies down and engage the parts of our brain that we need for problem solving. The other benefit of keeping calm is that when we regulate our nervous systems, we can influence our child’s nervous system to follow along.
  • Go back to the basics and HALT. Check in with your child or think about your schedule for the day. Is it possible that your child is:

*H – Hungry or thirsty? Sometimes a quick snack or drink of water can make a world of difference.

*A – Angry or experiencing an intense emotion? Try reflecting what you think your child is feeling or experiencing, This often provides good insight about what to do next.

*L – Lonely? Maybe your kiddo needs some nurturing. Offer an opportunity for connection with you – a hug or snuggle, reading together, sing a song together, play a quick game of 20 questions, tag, or something that your child chooses.

*T – Tired or overstimulated? They might just need a nap or a break. Try removing them from the activity or environment for a few minutes to give them a chance to wind down.

Things To Do: Austin has sooooo many indoor and outdoor activities available, and we know it’s hard to keep track of them all. Here are some ideas:

  • Toybrary Austin – check out toys, attend an event, go play.
  • Local libraries – check out a book, play in the children’s area, attend storytime or craft time, check their calendars for events.
  • Austin Nature and Science Center
  • Parks, Pools, and splashpads – use the City of Austin website to find them all.
  • YMCA – there are many locations and each one has activities for adults and kids.
  • Catch Air – Shoot soft colorful balls throughout the air while competing with others or just because it is that much fun. Included in the arena is a ball fountain that is fun for the family.
  • Mt. Playmore – Your kids won’t ever want to leave once they see the largest indoor playground in Central Texas. Food, Games, Parties and prizes round out the fun!
  • The Thinkery – An evolution of the Austin Children’s Museum, Thinkery is Austin’s home for “why” and “how.” It’s a place where science and families play side by side.
  • Austin Aquarium – Come experience the most astonishing underwater view with hundreds of species!
  • Epic Fun – Bumper cars, Laser Tag, ropes course, rock climbing, and so much more.
  • Little Land Play Gym – Little Land Play Gym & Pediatric Therapy. One of a kind indoor playground developed by a pediatric therapist to help kids grow and develop while having fun!
  • Austin Park and Pizza – Attractions include go-karts, bumper boats, mini golf, batting cages & a rock-climbing wall.
  • Chuck E. Cheese
  • Austin Ninjas – Kids go through an obstacle course with training and classes.
  • Little Gym – they offer parent/child classes – The Little Gym is a children’s gym offering activities for kids including parent/child classes, kids dance, gymnastics, sports skills and karate.
  • Coffee shops and restaurants with kids play areas: Maudie’s (in the Triangle), The Hive, The COOP, Hat Creek Burgers, Phil’s Ice House, Cosmic Coffee + Bar, Home Slice (new location on North Loop), Salt Lick (in Round Rock), Almost Grown Play Cafe, Cuba 512, Central Market (North Lamar), Brentwood Social House, Cherrywood Coffee House (they have kids’ bands play outside on Sunday mornings), Whole Foods (downtown location has a playground on the roof with a picnic area & the north location has a small play area with picnic tables and a stage).
  • Winnie app – use it to find nearby places to take your kids and family (parks, restaurants, activities, child care, etc).
  • Free Forest School – find a local chapter and attend their events to engage your child in free nature play groups.
  • Tinkergarten – find a group/class local to you and join in for outdoor classes geared toward building cognitive, social, and physical skills through play-based learning.

What about when you need a break from parenting? It’s so important to take time for yourself and your relationships, both the romantic ones and friendships. Self-care and “me time” can range from anything to taking time to read a book, going to the gym, getting a massage, engaging in a hobby, joining a yoga class, going on dates, going on outings with friends, or really anything that reminds you that you’re not only a parent. (It’s easy to forget this about ourselves). You could even check out UT Informal Classes to learn about a topic or skill that interests you (for fun or to enhance your career goals). The classes vary from semester to semester and are reasonably priced. Here are some ideas for child care so that you can get some much-needed adult time:

  • Check to see if your church offers parents’ night out or other childcare options
  • Many preschools also do parents’ night out
  • Ask around to find a high school or college age kid in your neighborhood that you could get to know as a reliable resource for watching your kiddo
  • Toybrary Austin – drop off childcare 
  • Nanny-share! Child care is expensive, but finding another family to share a sitter or nanny with helps lower the costs and gets your kids playdates with their friends.
  • Care.com – This service connects you with child care providers in your area.
  • Are you in a neighborhood that uses the Nextdoor.com app or website? That can sometimes be a good place to connect with someone close by that is looking to babysit.
  • Find a drop-in child care facility. Here are a few: Ashley’s Playhouse, Kid Spa Austin, Clubhouse for Kids, Tree Tops Learning Center
  • Talk with your friends about taking turns watching each other’s kids for a date night or agree to a group playdate with several friends and split the cost for a sitter

Hopefully some of the ideas and suggestions in this post will save you some time and energy (since parents often have little to spare)! Our hope is that you will be able to spend less time looking for resources you need and more time engaging in meaningful activities and interactions. Good luck and enjoy! If you like this article, you might also like “How to Boost Self Esteem in Kids“, “In Defense of Relentless Problem-Solving“, and “Stop Back-to-School Stress Before It Starts with 4 Simple Tips.”

Photo by Anna Samoylova on Unsplash

How To Find The Right Therapist

How To Find The Right Therapist

By William Schroeder, MA, LPC, NCC

The question of how to find the right therapist comes up frequently from friends. In our group practice, we have clinicians who are part of our scheduling team, and they individually screen clients to ensure that we do everything possible to make sure clients get paired correctly. In general, I tell friends and clients alike that finding a good therapist can take a bit of shopping around. What goes into shopping for a therapist? I usually suggest people ask friends, their doctor, check Psychology Today, Yelp, Google reviews, and even ask therapists they know. This can help to get referrals with some trust authority behind them. Check out their website and see how they position themselves. Check out their practice social media and blog posts. Look at their photos and see if they seem relatable. All of this helps to give an understanding of what their true specialization is. 

I should also mention a bit of a disclaimer here… many experienced therapists are not super techy or social media savvy. It’s likely you will encounter some who do not have websites and others who have a website that looks like it was created in 1990 and when AOL was vogue. This says nothing about their level of quality but it may mean they don’t take insurance, credit cards, and it’s unlikely they will send appointment reminders. They also may be slower to respond to an online inquiry and are likely easiest to reach by phone.

Psychology Today can be very helpful in weeding out providers by area of town, specialization, insurance they take, etc. I would also suggest paying special attention to what they describe as their core specialization in their longer descriptions and see if it lines up with their website as well. All of that said, it doesn’t mean any of this guarantees you will like them. Most research seems to point out that people know within 30 seconds if they feel like it’s a fit. This is why I encourage people looking for counseling to try a couple of places and see what the person feels like. You have to know if you are comfortable or not with someone before you begin opening up to them, so this is an important evaluation process. It can be helpful to assess how at ease or safe you feel with this person — and sometimes this can take time.

More Psychology Today Tips:

  • Pay attention to how therapists describe their specialization.
  • How long ago were they licensed? This helps to understand how experienced they are.
  • Does their profile have a million specialties listed or is it more narrowly focused? Often those early in their career or more broadly focused.
  • Do they take your insurance? This isn’t a deal breaker but it’s helpful to note.
  • What area of town is their practice?
  • Do they list special training in the area you are looking for support?

Pay attention to what feels right. I know one time I went to a therapist, and I liked them at first. Unfortunately, their style of therapy tended to be less relational and more structured. By this, I mean that as I began laying out what I was looking for support on, they flipped into teacher mode and broke out their whiteboard and starting writing out some psychological theories on the issue at hand and they talked a lot. At the time I was looking for support with grief counseling and this wasn’t a fit. I remember feeling the distance grow with every squeak of their marker.

Finding that right fit sometimes can take a couple of sessions. The initial session is often where the therapist tries to assess the situation, which can mean they are asking a lot of questions. Not every therapist is this way nor is every session this way but this can be helpful to know going into it. Also, I would suggest you think about what you would like to get out of therapy and state that going into it. This way the two of you can craft a plan to work towards those goals. When you are ready, you might find our post on how to prepare for your first counseling session helpful. 

Photo by Brooke Lark on Unsplash

 

How to get into the habit of exercising every day

How To Get Into The Habit Of Exercising Every Day

Frequently I will have clients seek guidance on how to get into the habit of exercising every day. Exercise is an important component of mental health as it decreases cortisol levels (a stress hormone), stimulates the process of neurogenesis, it helps to increase dopamine and serotonin levels. If you exercise, it helps to cut anxiety and stress as well as it can increase your quality of sleep. Exercise is an activity that promotes self-esteem, can even help you build sexual desire, and can even help with adult ADHD and anxiety. Let me also say that anyone considering exercise should first check with the physician to make sure they are cleared for physical activity. One more cautionary note, exercise, like most things, should also be kept in moderation and the body needs time to repair. Too much of anything can be bad for us. Make sure to consult with someone (counselor, dietician, doctor) if you have questions about what is the right balance for you.
  • One simple tip can be to write out a 30-day plan but make it simple. This could be things like walking for 30 minutes. Take a picture of this schedule and make it your phone home screen.
  • A doctor once recommended a plan that was for someone trying to get back to running. It involved starting with walking for 10 minutes, every other day for a week. Then the next week you would walk for 50 seconds and jog for 10 seconds. Then each week you up it by 10 seconds till you are finally running for 10 minutes. After this you up it by 1 minute of running time each time you run.
  • Smartphones can help or hurt as they can distract too. My favorite apps are Beachbody On DemandNike Training ClubNike Running ClubCouch to 5k, and Sworkit. Beachbody has a huge selection of programs you can do and for the home workout person, this one is great. It has a variety of levels of programs for men and women that help you to stretch, do cardio, bodyweight, or limited weights home workouts in 30 minutes or less. They also have some yoga and pilates programs too. You can put the app on a mobile device but I would suggest you stream it to a TV. They are very cost effective if you are looking to avoid going to the gym. Nike Training Club is a fantastic app that for working out at home or at the gym. You can select the intensity, equipment available, and time available to help tune the workout. You can also do some workouts designed by professional athletes. Whatever your skill level, it has options and the videos and audio cues give you tips on form and instructions. Nike Running Club is very similar and each will build personalized plans for you with notifications to remind you to stay on track. Couch to 5K is similar to the program the doctor above had mentioned. It’s a real gradual program that helps you get going with running. Sworkit is my workout in a pinch option. Truth be told, I used to do this in my office while on a break. Even if you have 5 minutes, it’s fantastic and it’s something.
  • Tell friends and family about your goal. Nothing helps like externalizing your goal.
  • I suggest looking at your schedule and looking at where might make the most sense to insert exercise during the day.
  • Get a workout partner. Nothing helps like a good accountability partner. I tend to suggest selecting someone who is good with staying with goals and possibly is ahead of where you are.
  • If things get off track, take stock and see why. Did you go to bed to late? Did you pre-pack a gym bag? If not, might that help? Would getting a locker at the gym help? Does time of day or hunger limit you? Does proximity to the gym factor in?
  • Put a picture or a phrase that will encourage you somewhere to help remind you of your goal.
  • Get a trainer – This is a more expensive option but they can help keep you on track.
  • Do a group exercise class. These are lower cost and can have a lot of social support.
  • If you have home exercise equipment or go to the gym, make the time more enjoyable by streaming your favorite show on your iPad or smartphone. I tend to watch shows that are compelling and adrenaline-inducing so I can have more pep in my step. If you are into gaming, watch things on Twitch.
  • Some might find that they like to play games while they workout. This can be done if you are recumbent biking and playing a mobile device based game. There are also apps that really make working out into a game like Zombies, Run!
  • Would walking with a neighbor or getting a dog help you?
  • What about joining a running club? These groups of runners meet at a specific time and have different skill levels.
  • Would it help you to make phone calls and catch up with friends or family as you walk?
  • Would an Apple Watch or Fitbit help keep you on track? I use the Apple Watch and it pushes notifications as me and my friends hit our daily workout goals.
  • Do you prefer hiking or outdoor things like frisbee golf?
  • Would joining an adult sports league help you? Things like this can be fun and you can try different sports.
  • Orange Theory, Soulcycle, Barre classes, yoga, pilates – all of them can be fun. Try different ones and see what fits. Do you have any friends that also go?
  • ClassPass can give you a TON of options if you are the type that can easily plan ahead and doesn’t mind the variety. I find it’s best for those who preplan their week of workouts.
  • Beth Myler, LCSW, JD suggests to “Work with a coach or counselor trained in the science of health promotion. There is robust research evidence supporting specific interventions designed to cultivate motivation for behavior change and sustain positive changes. It is increasingly clear that working with a coach/counselor improves outcomes.”

Whatever you end up doing, pay attention to what works and what doesn’t and learn from it. Personally, being a little ADHD, I end up liking having a variety of things to do. I go to the gym, do home workouts, run alone and with friends, workout with friends, use apps to help workout, etc. I have also learned a lot from what doesn’t work… I don’t like going to the same type of class over and over. If I don’t pack a gym bag the night before I am not going. If I am going to do elliptical, it helps to have a show I like already identified before I go. If I don’t have charged Bluetooth headphones, I am less likely to go (hint, keep a charger and cable in your gym bag or use Apple Airpods). If I am hungry, recently ate, or tired, I have a hard time going (hint, find snacks like nuts that can help give you some quick energy but don’t weigh you down or change the time you go). What have you learned from your experiences and how do you find exercises helps you? Want to let us know how to get in the habit of exercising every day? Tweet us @justmind and let us know. Also, if you need support for things like anxiety counseling or depression counseling, contact us.

William Schroeder is passionate about exercise and owns a counseling practice in Austin, TX. He also loves good food.

Photo by Kristian Egelund on Unsplash