Blog : Recovery and Addictions

Lia Williams

Anndrea Terry: Inspiring Balance

The Mental Wellness Counseling “Meet the Counselors” series offers a deeper look into each counselor’s background, experiences, motivations, values, and philosophies. In this series, I put counselors on the couch to learn why and how they do what they do.

Survival of the Sickest

As a 21-year-old undergrad, Anndrea Terry’s life was changed forever at a pool hall. When a broken bar stool collapsed under her, Terry crashed face-first into the metal pocket of a pool table. “My top row of teeth were shattered and twisted up into my gums,” she said. “My face was so swollen that you couldn’t see my nose to my cheeks—it was like a wall.” After eight hours of oral surgery, doctors were able to save Terry’s teeth. With the looming threat of infection, however, she received twice-a-week dental examinations, five root canals, and a “laundry list” of antibiotics for one year. During this time, Terry was in “straight-up survival mode.” “All I could think was to eat, take my pills, and clean my stitches,” she said.

Nutrition…

Ice creamBasic needs like sleeping and eating became taxing challenges. Since she couldn’t chew solids, Terry swallowed milkshakes, applesauce, jello, or noodles at meal times. “I still felt hungry all the time,” Terry said. “The ability to chew has a psychological aspect. I could dump liquid down my throat all day and still feel starved.” Unfortunately, her heavy diet of milkshakes, ice cream, and junk foods induced digestive issues and a dairy allergy. “My body was in shock all the time. My stomach was constantly upset and I got really sick,” she said. Terry’s dietary battle drew her attention toward proper nutrition.

Yoga…

YogaAdditionally, Terry started practicing yoga, which allowed her to process her emotional and bodily trauma. “When I was in a particular stretch, I would feel a weird sensation in my body, and then all of a sudden I was crying,” she said. “It was all the tension I had bottled up in my body. Yoga was a way to start peeling back those layers of emotion.” Terry’s yoga teacher encouraged students to express their feeling freely, something she desperately needed to do. “That was a really big moment for me,” Terry said. “People would always say ‘don’t worry, you’ll get better,’ but at that point, no one had said “just let it out, whatever needs to come out.’”

and Therapy, oh my!

While continuing yoga and meditation, Terry discovered another emotional outlet in counseling. After undergoing therapy herself, she decided to make a career of it. “My recovery inspired me to pursue counseling because I realized how powerful being able to talk to people was,” Terry said. “In the Western medical world, we generally look at particular areas of the person, but we don’t look at the whole picture. For instance, for weight loss, we prescribe a plan to cut calories and work out, but we don’t necessarily look at our relationship with food.”

Healthful Living 

Anndrea T QuoteJust as her full recovery involved a combination of health factors—nutrition, sleep, exercise, and therapy—Terry wanted to counsel the same way. “I realized I could have approached my healing differently with everything that was encompassed with my accident,” she said. “Being mindful of the things we do in our daily lives all affect how we feel emotionally and mentally.” Terry’s “360-degree” model of wellness is based on the interconnectedness among physical, mental, and emotional health. In sessions, she not only relies on therapeutic techniques like motivational interviewing, but also yoga, meditation, and mindfulness—all while taking into consideration her clients’ diet, sleep, exercise/movement, self care, and lifestyle habits. For clients struggling with anxiety or depression, a few deep breathing exercises can reduce symptoms and “give them back a sense of control over their body.” “Mindfulness is cool that way,” Terry says. “It opens a lot more doors as opposed to necessarily always going into the deep end of the pool. In the long run, I think it gives counseling a better name because people don’t think you’re just laying on a couch for six hours a week.”

“I Live What I Love”

Terry is enthusiastic about expanding her counseling approach through more holistic practices and experiential therapy. She teaches stand up paddle board yoga/meditation in Traverse City and hopes to organize more group counseling sessions in the future, such as women’s self care retreats. With the lessons learned from her accident, Terry aims to equip people with the knowledge and skills of wellness so they can live all-around healthy lives. “The most rewarding thing is seeing people change—being free of something that used to confine them and just watching them blossom into their full potential,” Terry said. “Counseling gave that to me when I was going through my accident, so if I can offer that back in any way, that’s the greatest thing ever.”

Anndrea Traverse City counselor headshot
Anndrea Terry, MA, LPC, NCC, RYT

Click here to learn more about Anndrea or to schedule an appointment.

Want to schedule an intake? Click here.

Lia Williams

Lucy Seefried: Intimate Human Connections

The Mental Wellness Counseling “Meet the Counselors” series offers a deeper look into each counselor’s background, experiences, motivations, values, and philosophies. In this series, I put counselors on the couch to learn why and how they do what they do.

Q: What influenced you to become a counselor?

A: As an undergraduate, I studied abroad in a few different places. I worked with non-profits in the educational and environmental sectors, and eventually found my way to human rights advocacy. I loved doing advocacy work, but it takes a long time for things to change. Part of me realized I needed to find a different way to channel my energy so that I could still help people, but help people in a way that I could actually see change occurring, rather than wait years for something to change. I wanted to have more of a direct impact. I decided to go into counseling because I love working with people one-on-one. I’m fascinated by people’s stories. I’m always inspired and incredibly humbled by people and their experiences, particularly how they get through difficult times.

Q: What techniques have you employed in your practice?

A: When I work with individuals, I like pointing out things they are already doing well and strengths they already have. Often times people come in thinking they’re not doing anything right. Since I’m not the one in the situation, I can listen objectively and see things they’re doing that’s working. I identify strengths that can help them move toward feeling better about themselves.

Q: What is the most rewarding thing about what you do?

Lucy loveA: Being a part of people’s lives and seeing them change and grow. The therapeutic relationship is so intimate. When I was new to counseling, I remember thinking to myself, “Wow, people are just opening up to me. It’s crazy.” Now it’s something that I value so much. To be a part of someone’s life in such an intimate way is so gratifying. It’s a privilege to work with people who have faced adversity, to see them realize their potential, begin to make changes, and feel strengthened. I feel very humbled every time I work with someone.

Q: What is the most valuable thing you’ve learned from your work?

A: Being able to relate emotionally is something I learned while abroad. I was working with people with totally different cultural backgrounds. Even though they faced struggles that I couldn’t even comprehend or imagine, they still experienced similar situations and had similar emotional responses to those situations as me, my family, or my friends have.

The most valuable thing I’ve learned is that everybody has internal challenges that impact them on an individual level. While we don’t all go through similar things, we all have a very similar emotional makeup. The way we experience joy, fear, shame, guilt, and happiness is all the same. We may respond to it differently, carry it differently, or deal with it differently, but we all experience it and can connect through it. This is our shared human experience. There is not a person who I’ve worked with, no matter what their walk of life, who I could not relate to because at the end of the day, we’re all human beings. We are way more alike than we are different.

Lucy Traverse City counseling counselor therapist
Lucy Seefried, MA, LLPC

Click here to learn more about Lucy or to schedule an appointment.

Want to schedule an intake? Click here.

Lia Williams

Steve Greenman: Fostering Individual Strength

The Mental Wellness Counseling “Meet the Counselors” series offers a deeper look into each counselor’s background, experiences, motivations, values, and philosophies. In this series, I put counselors on the couch to learn why and how they do what they do.

A New Start

The 2008 economic recession catalyzed a life-changing series of events for Steve Greenman. Within eight months, he was forced to close the doors on a business he owned for thirty years; he also lost his home, his marriage, and his father. Along with his two sons, he moved from a roomy house in Traverse City to an apartment with only a handful of rooms. “I remember my oldest son looking around the apartment saying, ‘you know, dad, we had a lot of wasted space at the old place,’” Greenman said. With the support of his sons and a newfound respect for self care, Greenman was able to adapt and grow from all of the sudden changes. “How I’ve been able to get through those circumstances was invaluable. As a counselor, those life experiences have been just as important as my education.”

Years later, memories of his former self became relatable anecdotes to utilize in his counseling practice. “By the time you get to my age, you’ve experienced a lot of different things,” Greenman said. “I probably share with clients more than other therapists. I can give them scenarios that I lived through so they don’t feel isolated, that they’re the only one feeling this way.”

Individual Therapy

With the diversity of clientele that enter his office, the focus of Greenman’s practice is tailoring to each individual. “We’re all wired differently, so my client is the theory,” he said. “Therapists have to be like chameleons. We adapt to each and every person.” To foster a comfortable environment with younger clients, Greenman may donn a T-shirt and shorts. For other clients—like PTSD victims or substance users—adapting may mean trying different therapies such as psychotherapy, cognitive conditioning, or motivational interviewing.

Persistence is Key

However, Greenman says “there are no easy answers” to any type of therapy. His most difficult cases tend to involve working with clients suffering from PTSD. With PTSD and couples counseling, “it can be really difficult because you don’t know if you’re getting anywhere or making it worse.” Making progress requires both Greenman and his clients to persist through the thick of any situation. In other words, “you have to root out the weeds and let the dust settle to be able to patch the new lawn,” Greenman said. In particular, helping clients understand the “underlying currents” to their own behaviors is what encourages change. “Change doesn’t happen from me, it all happens from the client,” he says. Seeing substance users gain sobriety or PTSD victims adopt coping strategies are some of Greenman’s most memorable experiences as a counselor.

“Steve, You’re Fired”

Through attending to each person’s needs, respecting individuality, and helping clients discover strategies for self sustainability, Greenman looks forward to the day that his clients walk out his door and never need to come back. “I tell clients when I first meet them that their goal is to fire me,” he said. “Some clients like a periodic check-in, others fire me after a month. That’s what I want, no matter how long it takes.”

Steve Greenman Traverse City Counselor
Steve Greenman, MA, LPC, NCC

Click here to learn more about Steve or to schedule an appointment.

Want to schedule an intake? Click here.

Teen Addictions: From Warning Signs to Treatment
Joseph R. Sanok, MA, LLP, LPC, NCC

Teen Addictions: From Warning Signs to Treatment

 

By: Steve Greenman, MA, LPC, NCC

Sam came into my office with fear in his eyes. His father had called me and stated he needed to find some help for his boy – all had not been right for a while. Sam was a freshman in college and had been doing outstanding in his studies. During the Christmas break, Sam had gone to a party and though he has smoked pot occasionally, he was about to experience drugs in a whole new light.

The mixture was LSD and Ecstasy – candy flipping. Being inexperienced with the drugs, he took five times the normal dosage and three months later, he was still dealing with side effects.

After the pleasurable effects of candy flipping, Sam dealt with unwanted after-effects, which typically occur two to three days after the drug use and are known as blues or suicide Tuesday:

  • Depression, anxiety, panic attacks, paranoia
  • Problems with sleeping
  • Poor concentration
  • Fatigue
  • Loss of appetite
  • Craving for the drug

But what made it even worse for Sam was not just the normal side effects but he had incurred possible brain damage with side effects still affecting him months afterwards: difficulty sleeping, erratic behavior, temper issues, balance and difficulty with light tracing.

Sam had to drop out of the following term and was struggling with holding a job and at times, dealing with simple reality. What began as an experimental night out with friends became a struggle to understand for the family: Would this be his new reality for the rest of his life?

Teen Dilemma

  • In 1998, nearly 10 percent of adolescents (age 12 to 17) reported using an illicit drug at least once during the past month. About one in 12 youth (8.3 percent) in this age group are current (past month) users of marijuana, the most frequently used illicit drug, and 19.1 percent are current users of alcohol.
  • More than half (55 percent) of our nation’s 12th graders have tried an illicit drug and more than one-quarter (29 percent) have tried a drug other than marijuana, such as cocaine, inhalants and heroin.
  • Youth age 16 to 17 have the second highest rate (16.4 percent) of current illicit drug use in the country. The highest rate (19.9 percent) is found among young people age 18 to 20.
  • It’s estimated that 400,000 adolescents are in need of substance abuse treatment
  • Reports from eighth graders first use of substances by the fourth grade: alcohol 6.8%, cigarettes 7.3%, inhalants 3.6%, and marijuana 1.1%
  •  Although consumption of alcoholic beverages is illegal for people under 21 years of age, 10.4 million current drinkers are age 12 to 20. Of this group, nearly half (5.1 million) engage in binge drinking, including 2.3 million who would also be classified as heavy drinkers.

Being Attentive

People who interact with adolescents in the home or community need to be alert to changes in an adolescent’s behavior and appearance that may signal substance abuse.

By recognizing the potential warning signs and symptoms of substance use, you may be able to get help for a teenager in need of treatment. The following behavior changes, when extreme or lasting for more than a few days, may indicate alcohol-related or drug-related problems and the need for further screening by a professional.

Sudden changes in personality without another known cause:

  • Loss of interest in once favorite hobbies, sports, or other activities
  • Sudden decline in performance or attendance at school or work
  • Changes in friends and reluctance to talk about new friends
  • Deterioration of personal grooming habits
  • Difficulty in paying attention, forgetfulness
  • Sudden aggressive behavior, irritability, nervousness, or giddiness
  • Increased secretiveness, heightened sensitivity to inquiry

Consequences

Adolescents face unique risks associated with substance abuse. The use of substances may compromise an adolescent’s mental and emotional development by interfering with how young people approach and experience interactions. In addition, adolescents are at serious risk for a number of direct and indirect consequences, including the following:

  • Delinquent Behavior—Adolescents who use marijuana weekly are six times more likely than non-users to report they run away from home, five times more likely to say they steal from places other than home and four times more likely to report they physically attack people.
  •  School-Related Problems—Adolescent substance abuse is associated with declining grades, absenteeism from school and dropping out of school. Cognitive and behavioral problems experienced by teens abusing substances may interfere with their academic performance.
  • Traffic Accidents—Nearly half (45 percent) of all deaths from traffic accidents are related to the consumption of alcohol and an estimated 18 percent of drivers age 16 to 20 (or 2.5 million adolescents) drive under the influence of alcohol.
  • Risky Sexual Practices—Adolescents who use drugs and alcohol are more likely than non-using teens to have sex, initiate sex at a younger age and have multiple sex partners, placing them at greater risk for unplanned pregnancies and HIV/AIDS, hepatitis C and other sexually transmitted diseases.
  • Juvenile Crime—Adolescents age 12 to 16 who have ever used marijuana are more likely at some point to have sold marijuana (24 percent vs. less than one percent), carried a handgun (21 percent vs. seven percent) or been in a gang (14 percent vs. two percent) than youth who have never used marijuana.
  • Developmental Problems—Substance abuse can compromise an adolescent’s psychological and social development in areas such as the formation of a strong self-identity, emotional and intellectual growth, establishment of a career and the development of rewarding personal relationships.
  • Physical and Mental Consequences—Smoking marijuana can have negative effects on the user’s mind and body. It can impair short-term memory and comprehension, alter one’s sense of time and reduce the ability to perform tasks that require concentration and coordination, such as driving a car. Evidence also suggests that the long-term effects of using marijuana may include increased risk of lung cancer and other chronic lung disorders, head and neck cancer, sterility in men and infertility in women.
  • Future Use Disorders—The earlier the age at which a person first drinks alcohol, the more likely that person is to develop an alcohol use disorder. A person who starts drinking alcohol at age 13 is four times more likely to develop alcohol dependence at some time in his or her life than someone who starts drinking at age 20.

Treatment

Treating adolescents for substance abuse requires special consideration of the adolescent’s individual experience and how it affects the nature and severity of his or her alcohol or drug use. Understanding the adolescent’s situation will help explain why alcohol or drugs are used and how they became an integral part of his or her identity. Factors that need to be considered when tailoring treatment for adolescents include the following:

  • Developmental Stages—Treatment for adolescents must address their unique developmental needs, which vary with the age of the client. Developmental features of younger adolescents are different from those of older adolescents. For example, older adolescents are more capable of abstract thinking and are more likely to openly rebel than younger adolescents.
  • Ethnicity and Culture—Norms, values and health beliefs differ across cultures and can affect substance abuse treatment. For example, some cultural groups may consider treatment invasive; others may wish to involve the extended family. Treatment services need to be culturally competent and use the preferred language of adolescent clients and their families.
  • Gender and Sexual Orientation—Factors that influence adolescent substance abuse and involvement in treatment differ by gender. For example, whereas adolescent girls more often have internalizing co-existing disorders such as depression, boys are more likely to have externalizing disorders such as conduct disorders. Effective treatment for gay, bisexual and transgendered youth includes helping them to acknowledge and accept their sexual identity.
  • Co-existing Mental Disorders—Adolescents with substance abuse disorders are more likely than their abstinent peers to have co-existing mental health problems such as anxiety disorders, attention deficit-hyperactivity disorder and depression. In these teens, substance abuse may disguise, exacerbate or be used to “self-medicate” psychiatric symptoms. Without tailored treatment, co-existing mental disorders could interfere with the adolescent’s ability and motivation to participate in addiction treatment and could increase the potential for relapse.
  • Family Factors— An adolescent’s family has a potential role both in the origin of his or her substance abuse problem and as an agent of change in the adolescent’s environment. Treatment should take into account family factors that increase risk for substance abuse problems in youth, such as any history of parental or sibling substance abuse problems or addiction; domestic violence; physical, sexual, or emotional abuse, and neglect. Whenever possible, parents should be involved in all phases of their adolescent’s treatment.

Parental Influence

Alcoholism and other drug addiction tend to run in families. Children of addicted parents are more at risk for alcoholism and other drug abuse than are other children:

  • Family interaction is defined by substance abuse or addiction in a family.
  • Families affected by alcoholism report higher levels of conflict than do families with no alcoholism.
  • *A relationship between parental addiction and child abuse has been documented in a large proportion of child abuse and neglect cases.
  • Children of addicted parents have a high rate of behavior problems.
  • Children of addicted parents experience greater physical and mental health problems and higher health and welfare costs than do children from non-addicted families.

Encouragement

Adolescents who are in treatment or recovery need all the support they can get from their families and communities. Consider taking one or more of the following actions to support youth undergoing treatment for and recovery from substance abuse. Encourage schools to offer student assistance programs, counseling on substance abus, and confidential referral to treatment and recovery resources in the community.

  • Encourage purchasers of health insurance to obtain comprehensive coverage for substance abuse and mental health services.
  • Encourage treatment centers, schools, and community-based youth organizations to conduct support groups for children of parents who are addicted to alcohol and drugs.
  • Encourage adolescents who have recovered successfully from addictive disorders to participate in community events that target their peers.
  • Because alcohol and drug use among youth often occurs in groups, be aware that encouraging one young person to seek help may lead others in his or her social group to seek treatment.
  • Encourage environmental changes in your community that promote recovery such as reducing the number of billboards advertising alcoholic beverages and holding alcohol-free recreational events.
  • Encourage the participation of family members in all aspects of the treatment and recovery process for adolescents and foster the availability of family-centered support groups and other services that address the needs of the entire family.
  • Be a positive role model for young people in treatment and recovery by not engaging in any illegal or unhealthy substance use.
  • Get involved in organizations that to support substance abuse treatment and recovery programs for adolescents.
  • Stay informed about available local resources for treatment and recovery and use this knowledge to help others.

 

Steve Greenman, MA, LPC, NCC is a counselor at Mental Wellness Counseling in Traverse City, MI. He specializes in helping families dealing with complex family situations, addictions, and transitions. Steve is also helping clients through the Intensive Recover Program, which helps with recovery treatment, alcohol treatment, and other addictions treatment. Contact Steve at 231-714-0282 Ext. 701

Steve Greenman Traverse City Counselor
Steve Greenman, MA, LPC, NCC | Thoughtful Experience
Help Your Clients Stop Self-Defeating Behaviors
Joseph R. Sanok, MA, LLP, LPC, NCC

Help Your Clients Stop Self-Defeating Behaviors

By: Steve Greenman, MA, LPC, NCC

“All forms of self-defeating behavior are unseen and unconscious, which is why their existence is denied.” Vernon Howard

What are Self-Defeating Behaviors?

 In their book, Going Home: A Positive Emotional Guide for Promoting Life-Generating Behaviors (Honu Publications 2005), Drs. Gregory and Lori Boothroyd state that “self–defeating behaviors are any behavior or attitude that a person uses to such an extent that it diminishes the best life possible for that person” (p 5).

Self-defeating behaviors (SDBs) are behaviors used to protect oneself against perceived dangerous stimulus from the outside world. These behaviors are often not regarded as self-defeating initially, but rather survival mechanisms. An example could include a young child who is outgoing, but is continually regarded as irrelevant. This contrast could bring SDBs such as negativism or alienation to protect him/her against classmates’ attack.

SDBs tend to live far beyond the initial encounters and become staples of current and future personality traits. The Boothroyds further state that defeating behaviors interfere with the true internal self. Through continual use they can damage physical health, social and interpersonal connections, mental, emotional, and spiritual growth, vocational and educational connections, and financial stability (p 5).

The Boothroyds list of common self-defeating behaviors include:

  • substance abuse – used as a form of escapism
  • inferiority – constantly comparing oneself with others
  • excessive worry – can cause possible health issue due to created stress
  • alienation of others – can lead to loss of possible life-giving and changing contact
  • defensiveness – not willing to listen to others makes one shallow in understanding different points of view
  • negativism – it is hard for others to enjoy a relationship if it is never positive in nature
  • procrastination, disorganization, and indecision – these could all be unhealthy traits for the implementation of a career choice

The Continuing Pattern of Self-Defeating Behavior

 In Going Home, the Boothroyds describe continuing SDB as a circular pattern of behavior. Each step the individual partakes in further strengthens the SDB response imbedded in the unconscious.

The steps are as follows:

  1. Situation (Flashpoint): Something strikes a chord and the SDB is initiated; cues bring out the SDB response.
  2. Conclusion (what the behavior is supposed to prevent): Experience now shows that the SDB is the safest and the smartest thing to do for that particular situation and it is repeated.
  3. Fears (If I don’t use the behavior then….): Individuals wants to avoid being in a frightening situation without the SDBs that have protected them for so long.
  4. Choice (to throw the self-defeat switch again): This stage happens so fast one does not realize they have made a decision to use old SDB; it is an unconscious reaction.
  5. Techniques (tools to implement the choice): Techniques are any kind of thought and action that help promote and deliver the SDB.
  6. Results (consequences of the choice): Using SBDs over time greatly affects one’s emotional and physical well-being. The result stage can be an important avenue of change when one realizes what was lost and is finally willing to do something.
  7. Minimizing (denial of results): A person using SBDs denies that the behavior is bad.
  8. Disowning (dump the responsibility): This stage allows the individual to release the responsibility to anyone or anything other than themselves for their behavior. The individual paints him- or herself as the victim of circumstances.

 How to Eliminate Self-Defeating Behavior

 The Broothroyds share that “it’s time to rediscover and thereby recover home that place within us that’s not in form, not in time and not in space. It’s just here – waiting and beckoning” (p 41).

How to go about rediscovering oneself is laid out in the following 12-step program:

  •  Step 1 – Identify your self-defeating behavior: One should pick a strong, often-used SDB and focus attention on one at a time. The SDB chosen may affect other SDBs and you may kill two birds with one stone.
  • Step 2 – Isolate the flashpoint situation: What creates the stimulus to use the SDB? What particular events or situation arouse your need to use the SDB? It is important to connect arousal points so as to be know when to be aware of your responses to situations.
  • Step 3- Identify your favorite techniques: Techniques are used to carry out the SDB. This is the stage that gives you the ability to catch yourself before implementing an old SDB. The Boothroyds use examples of internal techniques, such an individual dwelling on past hurts or anticipating negative results, and external techniques, such as failing to meet obligations and manipulating others.
  • Step 4 – Do a thorough damage assessment: This is a critical stage in which an individual assesses and connects the dots, so to speak, with SDBs and the effects they have on many aspects of one’s life.
  • Step 5 – Identify your minimizing strategies: In this step, it is time to confront your past minimizing behavior after using SDBs. It takes courage for the individual to realize what is truthful about their behavior and its effect on the quality of one’s life.
  • Step 6 – Identify your disowning targets: Now it is time for the individual to face their personal responsibility for past behaviors.
  • Step 7 – Identify a replacement behavior: People need this step to fill the void in a positive manner that will replace the old SDB.
  • Step 8 – Identify replacement techniques: This step encourages the individual to realize that to be able to sustain behavioral changes will not be easy, and that it will be a continual work in progress.
  • Step 9 – Seize the moment of choice: In this step, it is critical that the individual empower the moment of choices. Take advantage of the changes of behavior one has been working on and don’t be afraid to implement them into a process of action.
  • Step 10 – Identify life-generating results: This step revisits step 4 but instead of listing a self-defeating behavior and its effects, the prescription of this step is to list all positive consequences of the life-generating behavior. Listing positive outcomes will hopefully be a positive reinforcement toward the implemented behavioral changes that are underway.
  • Step 11 – Maximize and enjoy the results: One should be able to take credit for his or her behavior. This does not mean becoming cocky about what one has accomplished, but rather giving oneself credit for the new pathway one is traveling in generating a new lifestyle.
  • Step 12 – Own your new behavior: Finally, one should be able to enjoy the fruits of his or her labor. Realizing the importance of this accomplishment will hopefully give one confidence to tackle other aspects of life that may also be leading to SDBs.

 SDBs are powerful avenues that people take to live their lives. Many times, one does not realize how strong the emotions are in wanting to not be hurt. The goal is to become what Abraham Maslow describes as a “fully functioning individual” versus an individual striving to survive and cope in the scary world that we envision is around us.

“Self-acceptance comes from meeting life’s challenges vigorously. Don’t numb yourself to your trials and difficulties, nor build mental walls to exclude pain from your life. You will find peace not by trying to escape your problems, but by confronting them courageously. You will find peace not in denial, but in victory.” Donald Walters

 

Steve Greenman, MA, LPC, NCC is a counselor at Mental Wellness Counseling in Traverse City, MI. He specializes in helping families dealing with complex family situations, addictions, and transitions. Steve is also helping clients through the Intensive Recover Program, which helps with recovery treatment, alcohol treatment, and other addictions treatment. Contact Steve at 231-714-0282 Ext. 701

Steve Greenman Traverse City Counselor
Steve Greenman, MA, LPC, NCC | Thoughtful Experience
Why Do People Become Addicted?
Joseph R. Sanok, MA, LLP, LPC, NCC

Why Do People Become Addicted?

By: Steve Greenman, MA, LPC, NCC

 

“Every habit he’s ever had is still there in his body, lying dormant like flowers in the desert. Given the right conditions, all his old addictions would burst into full and luxuriant bloom.” Margaret Atwood

When discussing an addiction or dependency, most standard beliefs center around the continued repeatability of use of a substance and/or behavior, in which the user loses site of the ramifications of his/her actions. The user can become so attached to substances or an action (pornography, gambling) that the instant gratification of the moment far overrides the consequences.

It is like having a little voice on your shoulder telling you everything will be fine–go ahead–just one more. Someone who is fighting an addiction or dependency is fighting both urges from the outside world and a battle with voices inside of themselves.

Negative Reinforcement: I am Worthless Because You Say I Am

Many of my clients have suggested their addictive behaviors began with the need to escape or numb from the world around them. They understood the consequences of their addictive behaviors, but the pain—through either anxiety or depression—was so intense they could not seek any other alternative.

To someone overwhelmed in the moment, long-term recovery seems as difficult and tedious as climbing a mountain. On the other hand, their addictive behaviors can be instantly satisfying.

All of the judgment and opinions from friends and loved ones in fact become reinforcement to continue. To a certain extent, it is socially acceptable to use alcohol, gamble, or shop when emotionally stressed, as long as you don’t cross certain social norms. When a user does violate those norms, the reaction of others reinforces the feelings of weakness, worthlessness, and being out of control. So, he thinks, I might as well keep using.

As Robin Williams once stated in Weapons of Self-Destruction: “As an alcoholic, you will violate your standards quicker than you can lower them.”

When talking about any kind of addiction, it is important to recognize that its cause is not simply a search for pleasure, and that addiction has nothing to do with one’s morality or strength of character. Experts debate whether addiction is a “disease” or a true mental illness, whether drug dependence and addiction mean the same thing, and many other aspects of addiction.

Pleasure Principle: This is Your Brain on Drugs

The brain registers all pleasures in the same way, whether they originate with a psychoactive drug, a monetary reward, a sexual encounter, or a satisfying meal. In the brain, pleasure has a distinct signature: the release of the neurotransmitter dopamine in the nucleus accumbens, a cluster of nerve cells lying underneath the cerebral cortex. Dopamine release in the nucleus accumbens is so consistently tied with pleasure that neuroscientists refer to the region as the brain’s pleasure center.

All drugs of abuse, from nicotine to heroin, cause a particularly powerful surge of dopamine in the nucleus accumbens. The likelihood that the use of a drug or participation in a rewarding activity will lead to addiction is directly linked to the speed with which it promotes dopamine release, the intensity of that release, and the reliability of that release.

Even taking the same drug through different methods of administration can influence how likely it is to lead to addiction. Smoking a drug or injecting it intravenously, as opposed to swallowing it as a pill, for example, generally produces a faster, stronger dopamine signal and is more likely to lead to drug misuse.

Is it a wonder that a depressed individual would seek out this pleasure—any form of relief from the darkness that surrounds their soul?

Diagnostic Criteria for Addiction

Based on the criteria by the American Psychiatric Association (DSM-IV) and World Health Organization (ICD-10) an addiction must meet at least three of the following criteria:

  • Do you use more alcohol or drugs over time?
  • Have you experienced physical or emotional withdrawal when you have stopped using?Have you experienced anxiety, irritability, shakes, sweats, nausea, or vomiting? Emotional withdrawal is just as significant as physical withdrawal.
  • Limited control. Do you sometimes drink or use drugs more than you would like? Do you sometimes drink to get drunk? Does one drink lead to more drinks sometimes? Do you ever regret how much you used the day before?
  • Negative consequences. Have you continued to use even though there have been negative consequences to your mood, self-esteem, health, job, or family?
  • Neglected or postponed activities. Have you ever put off or reduced social, recreational, work, or household activities because of your use?
  • Significant time or energy spent. Have you spent a significant amount of time obtaining, using, concealing, planning, or recovering from your use? Have you spent a lot of time thinking about using? Have you ever concealed or minimized your use? Have you ever thought of schemes to avoid getting caught?
  • Desire to cut down. Have you sometimes thought about cutting down or controlling your use? Have you ever made unsuccessful attempts to cut down or control your use?

Many people with addiction issues who I have spoken to shared how they had a high tolerance, and could drink more than peers when in their early stages of drinking. At the time, one who could chug the beer and down the shots and still be able to stand was regarded in high esteem. Many clients have told me, though, as life went on, having a high tolerance for booze became a curse as it became a thirst that could not be quenched.

Relapse and Recovery

Symptoms of addiction include tolerance (development of resistance to the effects of alcohol or other drugs over time) and withdrawal, a painful or unpleasant physical response when the substance is withheld.

Many people who are addicted deny it. They often emphasize that they enjoy drinking or taking other drugs.

People recovering from addiction can experience a lack of control and return to their substance use at some point in their recovery process. This faltering, common among people with most chronic disorders, is called relapse. To ordinary people, relapse is one of the most perplexing aspects of addiction. Millions of Americans who want to stop using addictive substances suffer tremendously, and relapses can be quite discouraging.

To appreciate the grips of addiction, imagine a person that “wants to stop doing something and they cannot, despite catastrophic consequences,” says Dr. Nora Volkow, director of the National Institute on Drug Abuse. “We’re not speaking of little consequences. These are catastrophic. And yet they cannot control their behavior.”

Many in the addiction recovery field suggest that it takes more than just “not using” to fully recover. Recovery needs to come from the heart and the way one perceives him- or herself.

The following are important points your clients in recovery should know:

  • Check into your values; what’s important to you. What are the things that mean more to you than remaining addicted.
  • Develop and practice the skills you need to manage your life without relying on your addiction
  • Learn how to control addictive urges through mind management techniques
  • Find and appreciate the rewards that come from a “sober” (non-addicted) lifestyle
  • Build and appreciate personal relationships and turn to positive communities for support and companionship
  • Find your purpose and plan a future that leads to accomplishing your life goals
  • Mature into a new, non-addicted you — a person who simply and naturally rejects addiction in all forms

“I am spinning the silk threads of my story, weaving the fabric of my world…I spun out of control. Eating was hard. Breathing was hard. Living was hardest. I wanted to swallow the bitter seeds of forgetfulness…Somehow, I dragged myself out of the dark and asked for help. I spin and weave and knit my words and visions until a life starts to take shape. There is no magic cure, no making it all go away forever. There are only small steps upward; an easier day, an unexpected laugh, a mirror that doesn’t matter anymore. I am thawing.” Laurie Halse Anderson, Wintergirls 

 

Steve Greenman, MA, LPC, NCC is a counselor at Mental Wellness Counseling in Traverse City, MI. He specializes in helping families dealing with complex family situations, addictions, and transitions. Steve is also helping clients through the Intensive Recover Program, which helps with recovery treatment, alcohol treatment, and other addictions treatment. Contact Steve at 231-714-0282 Ext. 701

Steve Greenman Traverse City Counselor
Steve Greenman, MA, LPC, NCC | Thoughtful Experience
Self-Esteem: Set-Up for Success or Failure
Joseph R. Sanok, MA, LLP, LPC, NCC

Self-Esteem: Set-Up for Success or Failure

By: Steve Greenman, MA, LPC, NCC

 

Many people go through life expecting the worst. Alfred Alder, the 19th century Austrian psychotherapist, stated: “Meanings are not determined by situations, but we determine ourselves by the meanings we give to situations.” But you can help your clients change their perceptions of themselves and the world and, as a result, work toward positive and high self-esteem.

In the words of self-help pioneer, Maxwell Maltz: “Low self-esteem is like driving through life with your hand-break on.”

When people have deep spiritual, physical, and emotional wounds, they can carry these burdens with them through life. In so doing, they cloud their perception of their own value or importance. And our perception of ourselves is what dictates our self-esteem.

In carrying the burdens of low self-esteem, people often substitute these feelings with dependency self-gratification methods, such as alcohol, drugs, gambling, and pornography. In some ways, these people want control of changing their low self-image, and for too many the answer is to indulge or self-medicate. Dependencies allow them to deal with the status quo and numb away the negative feelings.

What is Low Self-Esteem?

Self-esteem refers to the overall opinion we have of ourselves and the value we place on ourselves as people. Low self-esteem means that the tone of this opinion is negative: for example, “I’m unlovable” or “I’m useless.”

Of course most people have mixed opinions of themselves, but if the overall opinion is that you are an inadequate or inferior person, or if you feel that you have no true worth and are not entitled to the good things in life, this is low self-esteem. And low self-esteem can have a painful and damaging effect on one’s life.

The Ways People Support Their Low Self-Esteem

 Matthew McKay and Patrick Fanning in their book Self-Esteem (New Harbinger Publications, 2000) list ways in which one maintains a low view of oneself. Talk to your clients to see if they practice any of these bad habits:

  • Overgeneralization: From an isolated event, you make a general, universal rule. If you failed once, you’ll always fail.
  • Global Labeling: You automatically use negative preconceived labels to describe yourself, rather than accurately describing your qualities.
  •  Filtering: You selectively pay attention to the negative and disregard the positive.
  •  Polarized Thinking: You lump things into absolutes, black and white categories, with no middle ground. You have to be perfect or you’re worthless.
  •  Self-Blame: You consistently blame yourself for things that may not really be your fault.
  •  Personalization: You assume that everything has something to do with you, and you negatively compare yourself to everyone else.
  •  Mind Reading: You assume that others don’t like you, are angry with you, don’t care about you and so on, without any real evidence that your assumptions are correct.
  •  Control Fallacies: You either feel that you have total responsibility for everybody and everything or feel that you have no control; that you are a helpless victim.
  •  Emotional Reasoning: You assume that things are the way you feel about them.

Ways of Increasing Self-Esteem

 We are what we think. What people take in influences their perceptions of themselves, and the filters they use to gather information about themselves is key in how they feel.

The problem with changing anything in life is that people fight it: no matter how bad they feel, humans are creatures of habit.

The following is a list of potential ways of increasing self-esteem that you can recommend to clients in your practice:

  •  Use positive self-talk: Tell yourself you can handle it and support yourself in going after your goals.
  • Engage in regular physical activity: Regular exercise fends off depression, low energy, and disease, while increasing stress management abilities and enhancing your mood.
  • Take care of your needs: Be good to yourself by getting adequate sleep, taking care of your personal hygiene, creating time to be alone, saying no when you need to, eating in nutritious ways, stimulating your mind, and connecting with others.
  • Let the little things go: It is damaging to your health to beat yourself up over every little thing.
  • Own who you are: Give yourself permission to like what you like and not like what you don’t like.
  • Practice self-acceptance: Get to know yourself. Let go of any need to be perfect.
  • Be creative: Creativity helps you achieve a greater sense of well-being and gain better control of your thoughts. Step out of the box.
  • Have a grateful and optimistic attitude about life: Practice daily gratitudes.
  • Have personal integrity and live by your values: Listen to your inner voice.
  • Participate in meaningful activities: Follow your passions.

The bottom line when it comes to self-esteem is we play the most important role in our own self-esteem. One’s personal happiness can greatly increase by taking positive action in changing one’s attitude.

Advise your clients to take time in their days to meditate and take stock in how they are processing the world around them. Teach them to be attuned to setting healthy boundaries with themselves and others, and not be afraid of asking a trusted love one to give a valid and honest assessment of how they are doing. Lastly, tell them to take the brake off, and allow themselves the freedom to enjoy the ride of their lives.

“Only as high as I reach can I grow, only as far as I seek can I go, only as deep as I look can I see, only as much as I dream can I be.” Karen Ravn

 

Steve Greenman, MA, LPC, NCC is a counselor at Mental Wellness Counseling in Traverse City, MI. He specializes in helping families dealing with complex family situations, addictions, and transitions. Steve is also helping clients through the Intensive Recover Program, which helps with recovery treatment, alcohol treatment, and other addictions treatment. Contact Steve at 231-714-0282 Ext. 701

Steve Greenman Traverse City Counselor
Steve Greenman, MA, LPC, NCC | Thoughtful Experience

 

What Happens in Rehab and Recovery
Joseph R. Sanok, MA, LLP, LPC, NCC

What Happens in Rehab and Recovery

By: Steve Greenman, MA, LPC, NCC

“You can get the monkey off your back, but the circus never leaves town.” Anne Lamott.

In the modern recovery world “rehab” can mean many things. To treat addictions a person can choose long-term (usually 90 days) and shorter-term (30 days to 2 weeks) in-house programs. Each type of program has its own specific strengths and weaknesses.

Inpatient Rehab

The benefit of an inpatient program is that an individual is isolated away from their substance of choice and is thus given an opportunity to begin to think clearly. Isolation away from behavioral triggers allows them to focus solely on their recovery without distractions from the outside world.

Over time, family members and close friends may be invited to participate in visiting days or family therapy sessions. This helps to build the support system that is so crucial to those in recovery once they leave the rehab facility.

Outpatient Rehab

In outpatient, the individual has freedom of movement and is able to handle day-to-day activities of life outside of a facility. Depending on possible involvement of court system, there could be required drug testing in place.

An outpatient program gives an individual the opportunity to gather facts and converse with fellow members of the group to learn coping skills to avoid the decisions of the past. Outpatient care is best for those with short-lived dependence and is not recommended for those with serious or long-term addictions or those with dual diagnosis conditions.

What Happens in Rehab

Once an individual passes through the initial detox from drugs or alcohol, they will move on to the rehabilitation portion of the recovery process. The rehab portion of recovery is where the patients get to evaluate the underlying reasons behind their addictions, addressing those issues so they can effectively move on with their lives without going back to drugs, alcohol, or other addictive behavior.

In individual behavioral therapy, the patient will identify when they began using the substance and why they started abusing it. The patient will receive strategies on how they can direct their time to focus on getting involved in new hobbies or interests. Time management skills will allow them to better use their time so they have less opportunity to think about relapse.

Patients learn to identify triggers, and how to deal with these triggering situations when they come up. If patients have a plan for various tempting situations, they are more likely to put their plan into action and avoid relapse. This type of cognitive behavioral therapy also addresses thoughts that patients have in relation to substance abuse, or life in general. It helps to reform their thinking patterns and make behavioral changes toward a healthy, sober life.

The addiction rehabilitation process usually includes group therapy. These group sessions allow the recovering addict to interact with others who are in the same situation. It is often helpful for recovering addicts to know that they are not alone in their struggles. Likewise, it can be beneficial for addicts to share their own stories of addiction and recovery, as others find solace in them. This sense of community support is integral to the recovery process.

Most addiction rehabilitation facilities offer family therapy as part of their program. Addiction is far-reaching, affecting many more people than just the individual with the addiction. Family members are often those who are most deeply affected by their loved one’s addiction, and they are an important component of the recovery process for that person.

Initially, patients may be restricted from contacting loved ones, but later in the recovery process, family members are often welcomed to participate in family therapy sessions. During these sessions, family members can discuss pain caused by their loved one’s addiction and their desire to see that person live a healthy life. Family therapy can help to resolve issues so the family can serve as a pillar of support once their loved one leaves the rehabilitation facility.

Choosing a Drug Treatment Program

According to the National Institute on Drug Abuse, there are several things to consider when choosing a drug treatment program. These include:

  • There is no one-size-fits-all solution to treatment.
  • Different treatments work for different people.
  • Patients must commit enough time to treatment in order to effectively overcome their addictions.
  • Everyone should have easy access to treatment when they need it.
  • Addiction affects the way the brain works.
  • Effective treatment should address all areas of the addict’s life, not just the abuse or addiction.
  • Medicinal treatment is often necessary and should be used in conjunction with therapy.
  • Treatment plans should continually be tailored to meet the individual’s needs and circumstances.
  • Mental disorders are often linked to drug addiction and should be addressed in treatment.

A setting that provides recovery in a holistic manner and provides services that treat the underlying reasoning behind the need to escape or numb is critical to helping those we serve to find long-term recovery.

The best services include the following components:

  • Individual and Family Therapy
  • Dependence Education
  • Self-Realization
  • Individual Treatment Plan Creation

The service must be helpful in creating long- and short-term goals in the recovery process:

  • Establishing an individual relapse prevention plan
  • Daily reflections and meditations
  • Learning how to encourage longer-term dependent free living
  • Creation of a spiritual-based premise of a higher power

To meet the goals prescribed above a service covers areas such as:

  • Past and current medical history
  • Employment and educational background
  • Basic needs being met currently
  • Substance abuse history
  • Legal issues (current and past)
  • Family/social genogram of dependent history
  • Psychiatric diagnoses (current and past)
  • Personal insights and supports each client has

What Exactly is “Recovery”?

After a patient has completed a rehabilitation program, they are not finished with recovery. In fact, recovery is a process that an addict must work at for the rest of their life.

Sometimes, the path to lifelong recovery will be easy. Other times, it will be difficult for individuals to withstand the temptation to relapse. Like anything in life, it’s a journey that may feature varying terrain, so constant support is essential.

Prior to leaving an addiction treatment program, a patient will meet with counselors to discuss a plan for aftercare. Many addiction rehab facilities offer follow-up programs to assist the patient as they return to normal life.

These may include weekend stays back at the rehab center when the individual feels a touch-up stay is needed. Or a patient may live in a sober living facility for a while with other recovering addicts before returning home. This offers a supportive transitional time for recovering addicts before being thrown back into “normal” life.

Many patients maintain regular therapy sessions post-rehab, and some submit to scheduled drug testing as a way to keep them accountable to their sobriety. Group therapy is a method for building a support system in your local area. Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) are well-known 12-step groups that many recovering addicts attend on a very regular basis. Both AA and NA have meetings all across the country at easily accessible times.

There are various offsprings of the AA model for a wide range of other addictions, such as Overeaters Anonymous (OA), Emotions Anonymous (EA), Gamblers Anonymous (GA) and Sex Addicts Anonymous (SAA). There are also subsets of NA for specific drugs, like Cocaine Anonymous (CA) and Crystal Meth Anonymous (CMA). Some addicts find the type of support they can get in very specific 12-step groups is more beneficial, whereas other addicts gain the help they need from more general groups.

In the end the most important aspect of any rehab and recovery is that it is not just the mind thinking about recovery but also the heart. One must be willing to sacrifice immediate gratification with at times a long arduous plan that leads to fulfillment in never-ending recovery process.

 

Steve Greenman, MA, LPC, NCC is a counselor at Mental Wellness Counseling in Traverse City, MI. He specializes in helping families dealing with complex family situations, addictions, and transitions. Steve is also helping clients through the Intensive Recover Program, which helps with recovery treatment, alcohol treatment, and other addictions treatment. Contact Steve at 231-714-0282 Ext. 701

Steve Greenman Traverse City Counselor
Steve Greenman, MA, LPC, NCC | Thoughtful Experience

 

On Setting Boundaries
Joseph R. Sanok, MA, LLP, LPC, NCC

On Setting Boundaries

By: Steve Greenman, MA, LPC, NCC

“No” is a complete sentence.”
Anne Lamott

When I was working at an in-patient recovery center as a therapist, we would discuss boundaries in group. Many of the men in my group were between the ages of 18-30 and had issues relative to their addictive behaviors such as dual diagnoses like depression and/or anxiety.

Many in the groups I chaired shared how they felt like failures and that they were behind in what society deemed appropriate behaviors such as: doing a good job; supporting a family; and having a house with a white picket fence.

They deemed themselves failures which precipitated relapses once they went back to old environment.

The men shared they had kept going to AA meetings and kept vigilant about triggers, cues for potential relapse but put themselves again and again in compromising positions not understanding the concept of proper boundaries for their sobriety.

Why are Boundaries Important?

Each of us experiences reality in terms of:

  • The body – what we look like
  • Thinking – how we give meaning to incoming data
  • Feelings – our emotional response
  • Behavior – what we do or don’t do

Setting boundaries enhances a person’s ability to have a sense of self and to control the impact of reality on the self and others.

Our boundaries allow us to take in what is deemed necessary emotionally, but if the created boundaries  are negative, our perception of ourselves will be enhanced in a negative light.

Individuals experience self-esteem by directing to the self their perception of appearance, their thoughts and responses and what they should or should not do with their lives. Boundaries act as filters to the soul, what we perceive that we are, we become.

How do Boundaries Work?

We learn to set boundaries on two levels:

  • The external system that protects the body and controls distance and touch.
  •  The internal system that acts as a filter or block to protect one’s thinking, feeling and behavior.

External boundaries are violated by actions such as:

  • Touching or standing too close without permission
  • Intruding on a person’s privacy; for instance, walking into a bathroom or bedroom without knocking or getting into another person’s possessions without permission.

Examples of internal boundaries being violated include yelling, screaming, name calling, ridiculing, lying, patronizing, sarcasm, negative control, unrealistic expectations and demanding one’s own way or point of view as the only choice.

In the end, the ability to set boundaries may take several forms: The person who, because of low self-esteem, childhood training or painful experiences of the past, is unable to unwilling set limits and thus has no protection.

Example of Creating Boundaries – Enabling

It may be easier to find a list of don’ts in dealing with chemical dependency boundaries creation, for it is easier to understand why you fail than to know how to succeed. The following list is not inclusive but it makes a good beginning:

  • Don’t allow the dependent person to lie to you and accept it for truth, for in so doing, you encourage this process (enabling). The truth is often painful, but get it.
  • Don’t let the chemically person exploit you or take advantage of you, for in so doing, you become an accomplice (enabler) in the evasion of responsibility.
  • Don’t let the chemically dependent person outsmart you, for this teaches him/her to avoid responsibility and lose respect for you at the same time–enabling.
  • Don’t lose your temper and thereby destroy yourself and any possibility of help.
  • Don’t lecture, moralize, scold, praise, blame, threaten or argue. You may feel better, but the situation will be worse.
  • Don’t accept promises, for this is just a method of postponing pain. In the same way, don’t keep switching agreements. If an agreement is made, stick to it.
  • Don’t allow your anxiety to compel you to do what the chemically dependent person must do for him/herself.
  • Don’t cover up or abort the consequences of the chemical use. This reduces the crisis but perpetuates the illness.
  • If at all possible, seek professional help.
  • Don’t put off facing the reality that chemical dependency is a progressive illness that gets increasingly worse as use of mood altering chemicals continue.

Why Are Good Boundaries Important?

When you have weak boundaries, you compromise who you are. You lose yourself, your freedom, your control and your “territory.”

Because you are the only thing in which you have complete control, healthy boundaries are an essential part of proper self-maintenance.

You may ask, especially if the addict or alcoholic in your life is your child, how can I be a good partner, friend or relative to this person if I have such limits? IYou may feel like it’s putting a wall up and feel guilty or as if you are betraying this person in his/her hour of need.

Yes, it is excruciating to see someone you love struggle with addiction, but, like they say on the airplane, you need to put your oxygen mask on first before helping others. Good boundaries are critical. You’ll find that you are actually of little or no help to others without them.

Conclusions

As we learned in group, a basic coping skill in interpersonal relationships is the ability to set and maintain boundaries for our interaction with others and with the world as we experience it.

Many allow themselves to be imposed upon and even mistreated because of poor self-image, fear of conflict and uncertainty about their right to exercise control over their lives. Boundaries can be walls of protection or they can become barriers to fulfillment.

“There was a wall. It did not look important. It was built of uncut rocks roughly mortared. An adult could look right over it and even a child could climb it. Where it crossed the roadway, instead of having a gate, it degenerated into mere geometry, a line, an idea of boundary. But the idea was real. It was important. For seven generations there had been nothing in the world more important than that wall. Like all walls it was ambiguous, two-faced. What was inside it and what was outside it depended upon which side of it you were on.”

Ursula K. Le Guin, The Dispossessed

Hearts and fence photo available from Shutterstock

 

Steve Greenman, MA, LPC, NCC is a counselor at Mental Wellness Counseling in Traverse City, MI. He specializes in helping families dealing with complex family situations, addictions, and transitions. Steve is also helping clients through the Intensive Recover Program, which helps with recovery treatment, alcohol treatment, and other addictions treatment. Contact Steve at 231-714-0282 Ext. 701

Steve Greenman Traverse City Counselor
Steve Greenman, MA, LPC, NCC | Thoughtful Experience

 

Coping with–and Reducing Stress, Anxiety and Worry
Joseph R. Sanok, MA, LLP, LPC, NCC

Coping with–and Reducing Stress, Anxiety and Worry

By: Steve Greenman, MA, LPC, NCC

More often than not, when clients enter my office that are struggling with anxiety, they have immediate need for relief and long term plans to gain coping strategies.

Numerous life situations have, in many cases, added up and created the environment for potential relapse back into old patterns for the use of substances and other addictive behaviors to numb and avoid.

At times, it is too easy to fall back into short term behaviors that work in short run but can lead into long term disasters.

When I was working in an inpatient recovery house, the difference between the safe environment of the house versus the outside world was enormous.

Clients would be afraid to walk outside the walls of the house for fear that the worries, stressors and fears would be waiting for them the moment they stepped outside.

They did not want to relapse, but the pull at times of the outside world was too much and a safety plan versus the immediate gratification of the old addiction was too much to handle. Anxiety and worry sit in and take over their lives once again.

“It was one of those days when I was thinking too much, too fast. Only it was more like the thoughts had a mind of their own and going all by themselves at a hundred miles a second, and I was just sitting back, feeling the growing paranoia inside of me.”
Sasha Mizaree

Coping Mechanisms Short-Term

When an individual begins to feel the anxiety of stressful situations, there are ways of temporarily relieving the physical reactions–Band-Aids if you will:

  • Deep breathing – take three deep, full, conscious breaths whenever you need to.
  • Breaks – a quick nap, snack, reading, walk or drive; a bath/shower/sauna; an exercise break (yoga/stretching); movie/DVD/TV; connect with a friend (email/call/text).
  • Healthy Venting – no obsessing, righteous justification or a pity-party!
  • Visualizations – e.g. visualize a peaceful scene (combine this with deep breathing).
  • Gratefulness – recite to yourself a few things you are grateful for despite what might be lacking in your life at this time.
  • Get honest – be honest – with yourself first and foremost. Admitting a difficult truth should bring immediate relief (especially if you’ve been avoiding/resisting it).
  • Separate what you can change from what you can’t – (and focus on the former, not the latter!)
  • “Keep your eye on the prize” – pick your battles (wisely)…pace yourself.

Reducing Stress – Prevention

 The following items take longer to learn, but are fruitful to create longer-term programs combating stressful, worry filled situations. It is best to understand ways of preventing the feeling of anxiety to formulate in   the first place:
  • Make a list of the “warning” signs – of your stress before it gets out of hand.
  • Prepare for a particularly stressful situation – ahead of time if possible.
  • Take responsibility -”own up to” your own limitations, unhealthy biases.
  • Treat: substance abuse (including caffeine), poor eating/sleeping habits, thyroid
  • Expand your roles – i.e. don’t get stuck in one role e.g. achiever/perfectionist/caretaker/rescuer/, comedian, rebel, wallflower; controller.
  • Learn to set boundaries – learn to say “no;” learn to be assertive
  • Resolve old issues – (old baggage) i.e. resentments, trust issues; intimacy issues; chronic low self-esteem; fears of abandonment; strong inner critic.
  • Learn to recognize your limits
  • Learn to live your own life; let others live their own lives
  •  Learn to risk saying what it is you want/need from life – others and yourself (keep it “reasonable”, focus on 60% on your needs and 40% of your wants.
  •  Consistently “let go” of things you cannot control.
  • Don’t get stuck in either/or thinking – for example – not either I do a good job or forget it…either you’re for me or against me but I both do my best and it’s not perfection…you are both supportive of me (in certain areas) and critical of me (in other areas).
  • Challenge unreasonable expectations – desires, demands, standards, etc.
  • Challenge limiting beliefs – challenge dysfunctional loyalties
  • Clarify your goals – one-year plan, three-year plan,five-year plan; take “baby steps”
  • Learn meditation/mindfulness practices
  • Learn good time management skills and good financial management skills.

Conclusions

The more in tune with ourselves, the better off we are to combat the fears and anxieties of life that can, if allowed, paralyze the soul or worse yet, involve ourselves in unhealthy ways of coping (substance abuse etc.)

We so many times in life take for granted how we feel rather than taking the time to examine the underlining causes of our feelings.

Many who I have worked with in substance abuse recovery struggle with the easier coping mechanisms such as submitting to a relapse rather than the daunting task of struggling with what they suggest are demons within their soul.

Anxiety, worry and stress can be regarded as the norm rather than something to be met head on and over the course of time, to understand and mediate to manageable levels.

“I keep the telephone of my mind open to peace, harmony, health, love and abundance. Then, whenever doubt, anxiety or fear try to call me, they keep getting a busy signal — and soon they’ll forget my number.”
Edith Armstrong

 

Steve Greenman Traverse City Counselor
Steve Greenman, MA, LPC, NCC | Thoughtful Experience

Steve Greenman, MA, LPC, NCC is a counselor at Mental Wellness Counseling in Traverse City, MI. He specializes in helping families dealing with complex family situations, addictions, and transitions. Steve is also helping clients through the Intensive Recover Program, which helps with recovery treatment, alcohol treatment, and other addictions treatment. Contact Steve at 231-714-0282 Ext. 701

 

Conquering Codependency
Joseph R. Sanok, MA, LLP, LPC, NCC

Conquering Codependency

By: Steve Greenman, MA, LPC, NCC

I remember the ice hitting the glass.

After working all day and sitting down in the living room, I would hear the noise of the ice from ice maker entering the glass. The hair on the back of my neck stood straight up. My mind raced to what may or may not happen. Would I have to cancel the evening plans? How were the boys? I wonder if anyone noticed we have been missing at meetings? When was the last time my then-wife did not get into an argument, prompting the boys to ask if everything was all right?

I had known for some time that I needed help dealing with my wife’s drinking. I had been trying to control it and always labeled it under the heading “what was best for the kids.” What I was forgetting in all this was the toll the drinking was having on me personally. I was depressed, feeling alone, and just plain tired of it all.

Life changed dramatically when my wife took a second-shift job. Night brought a quietness and peace I had not felt for some time. I had previously tried to control the use of alcohol by screaming, pleading and trying to ignore the triggers. None of it worked. Once my wife went to evening shift, the drinking took place in the early morning hours, when the rest of us were sleeping. I realized the difference was not allowing the drinking to dominate my waking hours. I needed to take this one step further. After many years of threatening, I finally attended an Al-anon meeting.

Powerless against it

Strength, not weakness. Allowing the controlling aspect of alcohol to dissipate was beginning to slowly enter my mind as I listened at my first Al-anon meeting. Powerless? You mean I did not have the duty to control, enable and cover up any more? I did not have to carry the burden of the disease? I could think about myself?

I could begin to see what alcohol was doing to me. I was dealing with the same urges as the drinker, but didn’t have the release of alcohol to numb my pain. I was in many ways the dry drunk in the family. My reaction to the situation was affecting my 8- and 14-year-old sons more than the actual drinking. I thought I was protecting my boys, but actually I was adding fuel to the fire by creating the environment to drink.

Those at the meeting shared their stories of their first time in attendance. They spoke of being scared; of being too good for this silly program; and that they were not the one with the problem. Each person expressed that control was not an option. The act of controlling was destroying more than the drinking. I was not leading a healthy lifestyle. For once it was all right to think about myself and review my own feelings.

Codependent Relationship

In a codependent relationship, feelings are often painful. You may have cut off the following feelings:

  • Anger. Are you having one crisis after another? Do you feel you’re doing all the work in the relationship? Are you angry you’re covering up for your partner?
  • Isolation. Do you stay home because you’re not sure whom you can trust? Do you feel you have to hide your feelings because things will never change?
  • Guilt. Do you feel no matter how hard you try it’s never good enough? Do you think that if you were a better partner things would be better?
  • Fear. Do you fear confronting your partner because they may abandon you? Do you fear physical or sexual abuse? Do you fear the loss of your home and security?
  • Embarrassment. Do you avoid bringing people into your home because your partner’s drinking is unpredictable? Do you avoid social gatherings where drinking may occur?
  • Despair. Do you feel helpless and trapped at times? Do you feel it will never change so why bother to confront? Do you spend most of your energy worrying about his or her drinking?

The more that was shared, the more it felt I was beginning to break up that wall in my heart. It was all right to take care of myself; it was all right to focus on me for a change.

How to take care of yourself

It is natural to want to protect the people you care about. But in a codependent relationship, how do you begin to take care of yourself?

  • Recognize you have a problem.
  • Start to focus on your needs.
  • Begin to educate yourself on codependency.
  • Start setting limits.
  • Start trusting and get supports.
  • Understand recovery and the process for everyone.

I felt a bit lighter when I left the meeting. I had shared my thoughts with others and I was able to speak freely about control. I was beginning to make a crack in the wall. I was actually telling someone else that we had a pink elephant in the room that in itself was a huge step forward. I was beginning to understand to cover up pain and shame in the family dysfunction. I needed to learn to respond to an outer reality instead of my own inner reality.

Steve Greenman Traverse City Counselor

Steve Greenman, MA, LPC, NCC is a counselor at Mental Wellness Counseling in Traverse City, MI. He specializes in helping families dealing with complex family situations, addictions, and transitions. Steve is also helping clients through the Intensive Recover Program, which helps with recovery treatment, alcohol treatment, and other addictions treatment. Contact Steve at 231-714-0282 Ext. 701

 

The Family’s Role in Addiction and Recovery
Joseph R. Sanok, MA, LLP, LPC, NCC

The Family’s Role in Addiction and Recovery

By: Steve Greenman, MA, LPC, NCC

“It is one of the most beautiful compensations in life that no man can sincerely try to help another, without helping himself.” Ralph Waldo Emerson

Stephanie Brown, in her book The Alcoholic Family in Recovery, discusses four distinct stages that the alcoholic and the family surrounding him or her must go through to achieve recovery:

The 1st stage is the Drinking Stage and is highlighted by the family denying that any family member has a drinking problem, while at the same time giving reasons to anyone who will listen why the drinker has the right to drink.

The 2nd stage is labeled Transition, and the focus is the beginning of abstinence for the drinker. This is a time for the family of the alcoholic to finally come to the realization that the alcoholic cannot control his/her drinking and the co-alcoholic cannot control the drinker. (A co-alcoholic is defined as the person(s) who enables an alcoholic by assuming responsibilities on the alcoholic’s behalf, minimizing or denying the problem drinking, or making amends for the alcoholic’s behavior [Drugs.com, accessed 4/28/2015].)

The 3rd stage, called Early Recovery, is when this couple works on individual healing, versus the healing of the whole of the family unit.

The 4th stage is Ongoing Recovery, where “individual recoveries are solid and attention can be turned back to the couple and family” (Brown, 1999, p114).

 Stage 1: The Drinking Stage

Therapists working with the family in the drinking stage must focus not only on the drinking behavior of the alcoholic, but also the distorted belief system of the rest of the family that emotionally and physically supports the drinking. The family must quit denial and support of the drinking, and begin to find avenues to reach out for help.

For the therapist dealing with a drinker in the drinking stage, the imperative is for the drinker to begin abstinence. Attempts are made to help the drinker gain insight into why life has become for so many in the family unit unstable. However, in the final analysis, it is up to the drinker to begin the process of recovery. The therapist helps to break down the walls of defiance in the drinker’s belief system that they are in total control.

Stephanie Brown describes the insanity of the drinking stage in being like a dance: “The drinker leads and the co-alcoholic follows in a way that keeps them dancing. The leader may stumble, drift away, step all over the follower, or even break up the dance by changing partners. The co-alcoholic’s only response is to try and keep the dance going” (Brown, 1999, p 171).

The therapist must encourage the family to help the alcoholic end the dance by realizing they cannot control and enable the drinking and that only when they reach out for help outside the family system may they be led into the stage of transition.

Stage 2: Transition Stage

The transition stage is a complex ebb and flow during which the alcoholic works through no longer drinking, and the family struggles with the transition of living through the end of the drinking to the beginning of abstinence.

The environment within the family at the end of drinking is made up three distinct variables:

  • Increasingly out-of-control environment
  • Tightening defenses to prevent or forestall systems collapse
  • A last ditch attempt to maintain denial and all core beliefs

The therapist has a multitude of functions in the beginning stage of transition. The therapist must help guide the alcoholic to realize the loss of self-control with their drinking and, with this understanding, help the alcoholic realize that they must reach out to outside help (ie, AA) to have any realistic chance to stay sober.

In the meantime, the therapist has to help the family—who has been dealing with supporting the drinker’s world that is now beginning to crack and crumble—realize their need for help (ie, Al-Anon) in handling how the denial, core beliefs, and out of control behavior made them, as much as the alcoholic, a prisoner of the drinking.

The therapist is a guide to help find sobriety, and a place to go for information when life is a bundle of confusion. “Are you going to meetings?” “How are you feeling?” “Take it one day at a time, first things first, and set priorities” are statements repeated by the therapist until the client can recite them for themselves.

As the family begins to move from drinking to abstinence and to the later half of the transition stage, Brown describes four focal points the family must be aware of:

  • To focus intensely on staying dry
  • To stabilize the out-of-control environment
  • To allow the family support system to collapse and remain collapsed
  • To focus on the individual within the family

The therapist, after seeing that the family is stable enough and has lifeboats in place (AA & Al-Anon), can begin to investigate underlying feelings that may be triggers or causes of past and current drinking relapses. The therapist must also be attentive to how children in the family are being cared for and if they are handling the changes to the family structure.

Forward movement is the key and the best way to help clients reach for and know when is the right time for the family to move to the next stage: Early Recovery. In reality, this may take years based to severity of the past drinking.

Stage 3: Early Recovery

The main difference between the transition stage and the early recovery stage is a general lessening of the physical cravings and psychological impulses for alcohol. The therapist must always look for potential relapse signs, but this factor lessens as time moves forward.

An item the therapist must address in the early recovery stage is continual support within the alcoholic’s family to stay focused on their own recovery. By this stage co-alcoholics, if they are not getting support of their own, may become weary of the lack of attention from the alcoholic who is busy trying to gain support (AA) to stay sober. The co-alcoholic may have been the controller of the drinker and now has to live with decisions of the family being completed by committee. It is imperative that the therapist is able to construct support for both the alcoholic and the co-alcoholic; each has issues that must be addressed so that recovery can continue.

As recovery moves forward, hidden and latent issues that fostered drinking or was created by the trauma of the drinking environment may need individual attention. Not only does the therapist become the guide for the family, but also the provider of information in this stage.

The therapist must:

  • Continue to teach abstinent behaviors and thinking;
  • Keep families in close contact with 12-step programs and help them work on the steps;
  • Keep focus on individual recovery, seeking outside supports for the family;
  • Maintain attention for the children in the recovering family; and
  • Keep a continual eye on potential issues, such as the onset of depression, emotional problems, sleep problems, fear, and/or helplessness.

Stage 4: Ongoing Recovery

This final stage is relatively stable in comparison to the earlier three stages. This is because recovery is now solid, and attention can be turned back to the couple and the family.

The family focus lies in the area of staying on task (sobriety) and committed to recovery, and building up the structure of the family after it had been torn down in the earlier stages. The family had reached for outside help (AA, Al-Non, therapy) and now, after finding themselves and actually liking what they see in the mirror, it is time to do the following:

  • Heal the emotional separation issues
  • Look in-depth at what damage had been done to the family due to drinking
  • Study the underlying causes of the drinking behavior

The ongoing recovery stage is a time for the creation of healthy relational dependence within the family and the understanding that recovery is a process, not an outcome (Brown, 1999).

The therapist’s main functions in this stage are:

  • Make sure family is continuing abstinent behavior
  • Expand the family’s alcoholic and co-alcoholic identities
  • Ensure that everyone maintains programs of recovery (work the 12-steps and internalize 12-step principles)
  • Focus on the couple and family issues
  • Explore spirituality issues and past childhood and adult traumas

 Final Thoughts

As I constructed this article, I was struck in many ways how involved and complex the role of the therapists is during an alcohol recovery process. It is more than being a listening ear in the background; it is a juggling act of many aspects of recovery.

The therapist is one step ahead of the family—guiding the family and the drinker to realize the importance of changing behavior; all the while wondering if what they are trying to accomplish will actually work.

The family and the drinker must come to a point in their lives that only when heartfelt change is ingrained will real change occur in the family. In truth, the magic of recovery is with the drinker and the family, not the therapist.

Steve Greenman Traverse City Counselor
Steve Greenman, MA, LPC, NCC | Thoughtful Experience

Steve Greenman, MA, LPC, NCC is a counselor at Mental Wellness Counseling in Traverse City, MI. He specializes in helping families dealing with complex family situations, addictions, and transitions. Steve is also helping clients through the Intensive Recover Program, which helps with recovery treatment, alcohol treatment, and other addictions treatment. Contact Steve at 231-714-0282 Ext. 701

What is rehab?
Joseph R. Sanok, MA, LLP, LPC, NCC

What is rehab?

What is rehab?

By Steve Greenman, MA, LPC, NCC

First, let’s start with a great quote about recovery and addictions:

“You can get the monkey off your back, but the circus never leaves town.” -Anne Lamott

Like any journey, the road to sobriety and addictions recovery begins with simple steps forward. The specific steps of one’s addiction rehabilitation process will vary according to the addiction, the treatment plan used, and the individual; however, all recovery processes share certain similarities.

What is in-patient rehab?

In the modern recovery world rehab can mean many things. To treat addictions a person can choose long term (usually 90 days) and shorter term (30 days to 2 weeks) in house programs. The benefit of inpatient programs is that an individual is isolated away from their substance of choice and gives the person an opportunity to begin to think clearly. Isolation away from behavioral triggers allows them to focus solely on their recovery without distractions from the outside world. Over time, family members and close friends may be invited to participate in visiting days or family therapy sessions. This helps to build the support system that is so crucial to recovering addicts once they leave the rehab facility.

What is out-patient rehab?

In outpatient the individual has freedom of movement and able to handle day to day activities of their life outside of a facility but depending on possible involvement of court system there could be testing put in place. An outpatient program gives the individual the opportunity to gather facts and converse with fellow members of the group to learn ways to gain coping skills to avoid the decisions of the past. Outpatient care is best for those with short-lived addictions. It is not recommended for those with serious or long-term addictions or those with dual diagnosis conditions.

Rehab.com states: “When it comes to addiction rehabilitation programs, there is no shortage of options out there but it’s important to find a program that is a good match for you. If you feel comfortable with the facility you’ve chosen, you’re more likely to stick with the program and see it through to its end, increasing your chances of long-term health and sobriety”.

How to choose a drug treatment program

According to the National Institute on Drug Abuse, there are several things to consider when choosing a drug treatment program. These include:

  • There is no one-size-fits-all solution to treatment.
  • Different treatments work for different people.
  • Patients must commit enough time to treatment in order to effectively overcome their addictions.
  • Everyone should have easy access to treatment when they need it.
  • Addiction affects the way the brain works.
  • Effective treatment should address all areas of the addict’s life, not just the abuse or addiction.
  • Medicinal treatment is often necessary and should be used in conjunction with therapy.
  • Treatment plans should continually be tailored to meet the individual’s needs and circumstances.
  • Mental disorders are often linked to drug addiction and should be addressed in treatment.

Does rehab work?

Once an individual gets through the initial detox from drugs or alcohol, they will move on to the rehabilitation portion of the recovery process. This is where the patients get to the core reasons behind their addictions, addressing those issues so they can effectively move on with their lives without going back to drugs, alcohol or their addictive behavior.

In individual behavioral therapy, the patient will do this work by identifying when they began using the substance and why they started abusing it. The patient will receive strategies on how they can direct their time to focus on getting involved in new hobbies or interests. Time management skills will allow them to better use their time so they have less opportunity to think about relapse. Patients learn to identify triggers, and how to deal with these triggering situations when they come up. If patients have a plan for various tempting situations, they are more likely to put their plan into action and avoid relapse. This type of cognitive behavioral therapy also addresses thoughts that patients have in relation to substance abuse or life in general. It helps to reform their thinking patterns and make behavioral changes toward a healthy, sober life.

The addiction rehabilitation process usually includes group therapy. These group sessions allow the recovering addict to interact with others who are in the same situation. It is often helpful for recovering addicts to know that they are not alone in their struggles. Likewise, it can be beneficial for addicts to share their own stories of addiction and recovery, as others find solace in them. This sense of community support is integral to the recovery process.

Most addiction rehabilitation facilities offer family therapy as part of their program. Addiction is far-reaching, affecting many people rather than just the individual with the addiction. Family members are often those who are most deeply affected by their loved one’s addiction, and they are an important component of the recovery process for that person. Initially, patients may be restricted from contacting loved ones but later in the recovery process, family members are often welcomed to participate in family therapy sessions. During these sessions, family members can discuss pain caused by their loved one’s addiction and their desire to see that person live a healthy life. Family therapy can help to resolve issues so the family can serve as a pillar of support once their loved one leaves the rehabilitation facility. 

How does recovery work?

After a patient has completed their rehabilitation program, they are not finished with recovery. In fact, recovery is a lifelong process that an addict must work at for the rest of their life. Sometimes, the path to lifelong recovery will be easy; other times, it will be difficult for individuals to withstand the temptation to relapse. Like anything in life, it’s a journey that may feature varying terrain so lifelong support is essential.

Prior to leaving an addiction treatment program, the patient will meet with counselors to discuss a plan for aftercare. Many addiction rehab facilities offer follow-up programs to assist the patient as they return to normal life. These may include weekend stays back at the rehab center when the individual feels a touch-up stay is needed. Or a patient may live in a sober living facility for a while with other recovering addicts before returning home. This offers a supportive transitional time for recovering addicts before being thrown back into “normal” life.

Many patients maintain regular therapy sessions post rehab, and some submit to schedule drug testing as a way to keep them accountable to their sobriety. Group therapy is a method for building a support system in your local area. Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) are well-known 12-step groups that many recovering addicts attend on a very regular basis. Both AA and NA have meetings all across the country at easily accessible times.

There are various offspring’s of the AA model for a wide range of other addictions, such as Overeaters Anonymous (OA), Emotions Anonymous (EA), Gamblers Anonymous (GA) and Sex Addicts Anonymous (SAA). There are also subsets of NA for specific drugs, like Cocaine Anonymous (CA) and Crystal Meth Anonymous (CMA). Some addicts find the type of support they can get in very specific 12-step groups is more beneficial whereas other addicts gain the help they need from more general groups.

What is rehab? Conclusions

Whatever level of need for services you are there are important factors to consider in supporting the most important item: you’re sobriety. A setting that provides recovery in a holistic manner and provides services that treat the underlying reasoning behind the need to escape or numb through the use of a dependence and help those we serve to find long-term recovery by creating a sound environment in which they can and will recover are critical.

To help the one suffering with a substance dependency it is helpful to find serves that provide the following:

The service must be helpful in creating goals in the recovery:

  • Establishing an Individual Relapse Prevention Plan
  • Daily Reflections and Meditations
  • Learning How to Encourage Longer-Term Dependent Free Living.
  • Creation of a Spiritual Based Premise of a Higher Power

To meet the goals prescribed above a service covers areas such as:

  • Past and current medical history
  • Employment and educational background
  • Basic needs being met currently
  • Substance abuse history
  • Legal issues current and past
  • Family/social genogram of dependent history
  • Psychiatric diagnoses current and past
  • Personal insights and supports each client has.

In the end the most important aspect of any rehab and recovery is that it is not just the mind towards one recovery but also the heart. One must be willing to sacrifice immediate gratification with at times a long arduous plan that leads to fulfillment in never-ending recovery. Let’s end with another quote that can be applied to recovery and rehab:

“Cut.

Take gazillion and one.

This time with a little less weepy-weepy, please. A little less improvisation. A little less lip. A little more faith. A little higher power. A little more prayer, a little less wine. Cut the crap. Cut the line. Tuck the chin. Look left, right, faster, slower. Pick seven dandelions on the first day of spring. Hate less or more. Work harder. Chew slower. Be better. Look to god, God, GOD. Watch your language. Watch your back. Collect rocks. Lick ’em clean. Count the pigeons in the backyard and multiply times forever. Give it up, let it go, take it back, take control. Say yes, say no. Say no, no, no. Stick to the script. Steps One through Twelve. One through Twelve. Keep coming back. It works if you work it.”

― Jessica Hendry Nelson

And so it goes.

 

HEAD SHOT WITH DESCRIPTION GREENMANSteve Greenman, MA, LPC, NCC is a counselor at Mental Wellness Counseling in Traverse City, MI. He specializes in helping families dealing with complex family situations, addictions, and transitions. Steve is also helping clients through the Intensive Recover Program, which helps with recovery treatment, alcohol treatment, and other addictions treatment.

Image by Rennett Stowe