Voices of Freedom

Who's Calling the Shots? The Alarming Rise of Binge Drinking in Girls

Thu, 16 Feb 2012 14:45:17 -0500

Why Are Our Girls Outdrinking Boys?

In 2011 Dr. Catherine Steiner-Adair, renowned psychologist, author, expert on adolescent development and friend of Freedom Institute, came across research suggesting that binge drinking had risen (for the first time) more in girls than it had in boys. What’s behind this alarming trend? What can we do to protect our daughters? Please join us for a panel discussion on Wednesday, March 7th, to address these and other questions. Dr. Steiner-Adair will be joined by Yalda T. Uhls, LA Regional Director and researcher at Children's Digital Media Center from Common Sense Media, FI adolescent counselors, and female college students currently on the front lines.

When: Wednesday, March 7 - 6:00PM-7:30PM
Where: Ballroom at Sacred Heart - 1 East 91st Street, New York, NY 10128
Cost: Free
Who: For upper-school students and parents

For questions, please contact Kathryn Crosby at kathryn.crosby@freedominstitute.org or 212-838-0044 x 37.

News and Updates

Tue, 14 Feb 2012 15:41:04 -0500

Extra! Extra!

There are so many new and exciting things happening at freedominstitute.org. Our web presence is growing and we are welcoming more and more visitors every day. Here is a sampling of what you'll find inside:

New blogs have been posted by Kathryn Crosby, Kathryn Hecht and Donna Wick (Donna's original article was picked up by Caroline Miller at ChildMind.org and touted as a great response-piece along with Judith Warner and Dr. Ned Hallowell). Community Member and old-timer, Sober75, has started a discussion welcoming any and all input and questions in the Freedom Community Forum. And check out the latest testimonials about Freedom.

Last but not least, be sure to check FI Goings On for upcoming events.

Thanks for stopping by!

Relationship First - Education a Close Second

Tue, 14 Feb 2012 10:17:58 -0500

We received an overwhelming response to our Something to Consider blog, much of it questions from parents who are worried about the link between substance abuse and ADD/HD. So as a follow up, we’d like to offer parents some suggestions and strategies from the Family Program counselors here at Freedom, as well as our school-based counseling team.

If your child has ADD or ADHD, educate both yourself and your child, about the elevated risk of substance abuse that is associated with ADD/HD. Discuss the issue with your child’s clinician, and if he or she advises stimulant medication, consider the option carefully, in the context of all the available research about ADD/HD. Make sure that your child is evaluated and treated by a psychologist and psychiatrist (respectively) who specialize in this field. Under no circumstances should any other medical professional (for example, your internist or pediatrician) prescribe Adderall or Ritalin for your child.

Resist the temptation (this happens more frequently than you might imagine) to take your child’s medication, even once. While I sympathize with the impulse to “test” the medication on yourself before giving it to your child, you wouldn’t test-drive your child’s Cipro. More importantly, you don’t want to inadvertently model to your child the idea that it is acceptable to take medication that is not prescribed for you.

Pay close attention to your child’s behavior. This is good advice for all parents, but particularly those with children who have ADD/HD. If you have any indication that your child is experimenting with drugs or alcohol, it should be taken seriously. If your child is on medication, he or she should be educated about the fact that there are some illegal drugs (cocaine, for example), that will interact disastrously with Adderall or Ritalin. In our experience, adolescents who end up abusing Adderrall are usually abusing other substances as well. If your child is on medication and you suspect that he or she is using other drugs, inform your child’s clinician immediately. It may be necessary to monitor his or her Adderall consumption.

Don’t rely on medication to “solve” your child’s ADD/HD. Children and adolescents who have ADD/HD usually benefit from behaviorally-based therapy and/or focused skills training. With therapy and training many children develop aptitudes in these areas that do not come naturally to them. The brain is ever evolving, changing and growing. We now know that our brains continue to develop well into adulthood. If it is appropriate for your child to take stimulant drugs for ADD/HD, it’s best to combine them with teaching or behavioral therapy that develops specific cognitive skills.

Finally, let’s briefly revisit the article that inspired Something to Consider. Alan Sroufe was roundly criticized for the tone of parental blaming in Ritalin Gone Wrong. However, at least in my view, he does have a point. Attachment and infant research has conclusively demonstrated that the single most critical factor in healthy child outcomes is the quality of the parent-child relationship. In other words, nothing else you do for your child matters as much as the fact that you understand her or him. Not medication, tutoring, therapy, travel soccer teams, piano lessons or Harvard. The very best protection you can offer your ADD/HD child (or any child) is a close, loving, parenting relationship.

Why Whitney's Death Matters

Mon, 13 Feb 2012 13:04:42 -0500

I was at the Film Forum on Saturday night taking in the re-release of Wings, the first movie to win the Oscar for best picture. When the movie reached its intermission, the hosts announced a five minute break. Out snapped the cell phones and fingers flew over various apps to help connect each user with what the rest of the world was thinking and feeling. Within seconds the moviegoer in front of me whispered to his date, “Whitney Houston is dead.” A short silence passed and then plans ensued for what new venue the couple should try for their 10PM dinner hour. But the statement sent a chill up my spine and then my own phone confirmed the news: Whitney Houston, pop-icon, was dead at 48.

When I was barely a teenager, the emergence of Whitney’s voice in the 80’s was the promise of adulthood and all the fun and freedom those years promised to bring. I learned every word to every song and mimicked her cadence and tone while imagining myself every bit the superstar she was becoming. As time went on, Whitney got into drugs and alcohol and took that all-too-familiar celebrity spiral down to public depravity. Her bottoming out was sad and distressing but she was far from me and I had other worries and pressures besides Whitney Houston. The last prominent Whitney blip on my radar dates back to 2000 when Faith Hill replaced her at the last minute at the 72nd Annual Academy Awards. “Hmmmm,” I thought, “that can’t be good.”

Fast forward to today and both Michael Jackson and Whitney Houston are gone. For so many of us, these stars were emblematic of our childhoods. But their deaths were not shocking for me, nor did they drum up any profuse mourning. Had I lost interest because I was no longer a child or because their public behaviors were disappointing and even gross? I believe it is both.

At FI we know that people get lost. When someone crosses the line from a cucumber into a pickle it’s anybody’s guess what comes next. Sometimes we see clients when everyone else in their lives has given up on them. And sometimes people make it to us with their families and jobs still intact. It is different for everyone. But the “crossover” happens regardless of wealth, fame, fortune, race, creed or color because of one common thread: addiction is a disease like cancer is a disease. Though it is easy to brush off Michael, Whitney, and any of the other stars who so magnificently devolve into punch lines and train wrecks, at the end of the day, these people were all sick. Addiction treatment is tough and some people never find their way. But addicts should not be summarily dismissed and forgotten when the disease gets ugly. There is always hope for both the addict and the people who love him or her.

Working in the recovery/treatment field gives me the opportunity to practice compassion and tolerance. It also affords me the chance to look at these seemingly innocuous “far away” occurrences as a possible reality (God forbid) for someone much closer to me than a pop icon. The point is this: the only difference between Whitney Houston and our friends in recovery or struggling with substance abuse is that she was Whitney Houston and they are not.

There, but for the grace of God, go we.

A Little Good News

Thu, 09 Feb 2012 11:36:47 -0500

At our Parent Talks, counselors often field questions about how substance use has changed since they were teenagers. It is comforting to hear the statistics from Monitoring the Future summarized in Tara Parker-Pope's blog in the NY Times. Despite the fact that marijuana is more potent and beer advertisements more ubiquitous, a lot of adolescents are making healthier choices. The article highlights several factors contributing to this decline in use. With the hundreds of workshops our counselors provide each year, we also think non-judgmental education and open communication around this topic are keys to prevention and minimizing risk.

If you are a concerned parent or school professional please contact me at kathryn.crosby@freedominstitute.org for information on how we can help.

Something to Consider: The Link Between ADD/HD and Substance Abuse

Wed, 08 Feb 2012 11:31:50 -0500

L. Alan Sroufe’s recent article in the New York Times, Ritalin Gone Wrong, has ignited a maelstrom about the use of “stimulant” drugs in treating ADD and ADHD. Specifically, Sroufe, a noted attachment researcher at the University of Minnesota, stated that his research demonstrates that medication for ADD/HD is not effective after two years. Even more provocatively, Sroufe questioned if ADD/HD was actually a core neurological deficit at all. In his view, ADD/HD is more likely the result of “experiences in early childhood” and “over-intrusive parenting.” Not surprisingly, these statements precipitated a flood of outraged responses to Sroufe, much of it centered on the tone of “parental blaming” in the article. (For two excellent point-by-point rebuttals to Sroufe’s argument, see Righting the Record on Ritalin from the Child Mind Institute, and Dr. Hallowell’s Response from Ned Hallowell’s blog.)

I am not an expert on the subject, but Sroufe’s claim that stimulant drugs are not effective for the treatment of ADD/HD is counter to everything I’ve learned about ADD/HD. As the Executive Director of Freedom Institute, I am primarily concerned with the ways in which ADD/HD interacts with addiction. There is considerable research indicating that 1) children and adolescents with ADD/HD have an increased risk for substance abuse, and 2) that treatment with “stimulant drugs” is a protective factor for these children (Biederman (2003), Wilkes (2003)). In other words, children and adolescents with ADD/HD are less likely to engage in substance abuse and other high risk behavior when they are taking the appropriate medication.

This may seem paradoxical, but should be considered in light of research indicating that children with ADD/HD are more likely to engage in all forms of risk taking behavior. ADD/HD is a thought process characterized by impulsivity and a lessened ability to perceive consequences. In addition, some children and adults with ADD/HD find that high-risk endeavors help organize their thoughts; they can focus more easily when engaged in behavior that requires additional adrenaline. As a result, all children and adolescents with ADD/HD are at increased risk for engaging in dangerous experimentation with drugs and alcohol because they are likely to perceive and respond to risk differently than children without ADD/HD.

When risky experimentation develops into substance abuse, it’s likely that unmedicated adolescents are self-medicating, for either the primary effects of ADD/HD, or the secondary effects that are often a result; low self-esteem, poor peer relationships, and academic or parental pressure to achieve more. This is not to suggest that medication is a magic bullet that will always protect children with ADD/HD from self-medicating with other substances. Some adolescents will end up abusing the stimulant drugs prescribed for their ADD/HD, mostly commonly Adderrall. (See Jimmy's testimonial Righting My Wrong Perception). Unfortunately, parents and psychiatrists have no way knowing when medication treatment begins if their child or patient will be one of the unlucky ones ensnared by substance abuse. It’s a leap of faith, but in my view, it is far less risky to be taking legal, prescribed drugs under the close supervision of a qualified psychiatrist than to self-medicate as the result of a condition for which there is appropriate medication.

That’s the decision my husband and I made several years ago for our daughter who has ADD. At the time, we were not focused on the link between ADD/HD and substance abuse. We just wanted to make her academic life easier. And for her, the drugs worked. She didn’t abuse other substances, she avoided drugs that would interact with her Adderrall, and she never abused her ADD medication. As she tells me, I don’t have to worry, because she doesn’t “like it enough” to do so. She feels like it flattens her out.

So my personal story has been a lucky one. Parents have to make their own choices about stimulant medication for their child. But in my professional capacity at Freedom Institute, I would be remiss if I didn’t draw parents’ attention to the correlation between ADD/HD and substance abuse, as well as the studies that indicate that stimulant medication is a protective factor.

Autophagy = Self Destruction (but the good kind)

Fri, 03 Feb 2012 14:35:35 -0500

After years of abuse our bodies deserve a break. From headaches to back problems to the more serious physical ramifications of our disease, our physical selves cry for freedom from the abuses we heap upon them. Further, even in spite all of the damage we cause, our bodies are working in the most infinitesimal of ways towards cleanliness and health. In her blog entry for the New York Times, Gretchen Reynolds explores recent data that suggests exercise contributes to the body’s wellness on a cellular level.

Scientists have long appreciated that cells maintain a self-cleaning (or self-destructive) ability called autophagy that rids themselves of wastes and toxins. What this new research shows is that consistent exercise may actually aid in that process. The key word is consistent. Reynolds sums the research up succinctly:

…the study underscores, again, the importance of staying active… [even a] baseline level of cellular housecleaning wasn’t enough to protect [the test subjects] from developing diabetes in the face of a poor diet. Only when the control animals ran and pumped up their intracellular trash collection did they regain their health.

This sounds eerily familiar. In 12 step programs we do a 4th step which is often referred to as a “rigorous housecleaning.” Just like exercise, we know that this is crucial to long-lasting health. Any old-timer will tell you that if one doesn’t do their 4th they are likely to pick up a fifth. Yet, step work doesn’t end. We never graduate from recovery. Our sponsors tell us the same thing that this recent study shows: “Keep coming back.” Even when we “finish” the steps we are taught to circle back around and start again and take sponsees through the steps as well. It is the “daily reprieve” that keeps us sober. The key word here is daily. So just as consistent exercise helps the body maintain the “good” kind of self destruction enacted by our miraculous cells, maintenance of our recovery programs ensures steady freedom from the character defects that lead us back to self destruction of the negative variety. It IS a lot of work but it is the kind with a rich, almost-guaranteed pay-off.

As the old-timer says, “I really only need one meeting a week but I never know which one it will be.”

Family Night

Tue, 31 Jan 2012 11:45:07 -0500

No matter what, you don't have to do this alone.

Included in our IOP and Phase I package is our Freedom Institute Family Night. This orientation evening is open to any and all family members including children of all ages. This group will be offered the last Wednesday of every month from 6-7:30pm. The first group will be held on February 29^th, 2012.

At Family Night, we will introduce our Family Program, offer support and education about what to expect as your family experiences recovery, and provide you with an opportunity to meet other families facing similar challenges and opportunities.

For any questions or to sign up, please contact Frank Wells, Family Therapist at 212-838-0044 or frank.wells@freedominstitute.org.

Beverages and a light snack will be provided.

Independent School Program - Focus Group Save the Date!

Mon, 30 Jan 2012 16:19:26 -0500

Advice on Advising: Enhancing your skills

Freedom Institute Independent School Program is inviting a select group of counselors to help design "Advice for Advising", a counseling skills workshop for advisors and teachers. "Advice for Advising" will address the needs of school faculty who are not trained as counselors, and need exposure and information about basic counseling skills to provide more support for students. Freedom Institute has developed a curriculum to teach these skills, based on feedback from the school community, twenty years of offering faculty trainings, and research from The Stanley King Institute, The School Counselor Development Program at Teachers College, Columbia University, and Harvard University’s School Counselor Training.

Now we need you. No one knows your school faculty's advising needs better than you. Please join us to share your expertise and experience with other counselors in the independent school community and Freedom Institute ISP counselors.

When: April 20, 2012 8:45AM-3:00PM
Where: FI Offices, 515 Madison Ave, 21st Floor (53rd/Madison)
Cost: Free. But space is limited so please RSVP to kathryn.crosby@freedominstitute.org by April 4th.

Agenda

8:45am-9:00am – Coffee and Introductions

9:00am-10:20am – Session #1 "Listen Up: Really hearing a student"

10:25am-11:45am – Session #2 "Walls & Bridges: Setting boundaries and building connections"

11:45am-12:10pm – Lunch (provided)

12:10pm-1:30pm – Session #3 "Development, Diversity, Differences"

1:35pm-2:55pm – Session #4 "Red Flags and the Flagpole: Warning signs and how to handle them"

2:55pm-3:00pm – Evaluations

We hope you can join us. Due to the limited space, we ask that there be no more than 2 counselors per school and preferably that the counselors serve different populations (i.e., middle and upper school). If you have any questions or to RSVP by April 4th, please contact Kathryn Crosby at kathryn.crosby@freedominstitute.org.

Miss Representation Screening Makes Lasting Impression

Wed, 25 Jan 2012 11:47:34 -0500

The film was filled with information that boggled my mind. Did you know that in eight states and the District of Columbia, domestic violence is considered a “pre-existing” condition? Women can be denied health care because they were beaten by their husbands or partners. Did you know that 65% of women and girls have an eating disorder or that women spend $12,000-15,000 a year on beauty and spa products?

Neither did I. At Freedom Institute, part of our job is to make parents, educators and students aware of things that can hurt adolescents. We have operated a prevention education and counseling program in Manhattan Independent Schools for twenty years. We want to help kids before they turn to drugs or alcohol for self-medication.

We want them to never need us.

For information about the Freedom Institute Preventative School Program, contact Kathryn Crosby at kathryn.crosby@freedominstitute.org. For information about Common Sense Media, a not-for profit organization that teaches educators, parents and children about how to be responsible digital citizens and consumers go to www.commonsensemedia.org. For information about Miss Representation, go to missrepresentation.org.

Watch the film or sponsor a screening. Become conscious of the messages we are sending to all our children

College Student/Sober Student

Tue, 24 Jan 2012 10:02:42 -0500

In her recent Times article author Abigail Sullivan Moore combines statistical data along with anecdotal evidence to prove that the growing trend of sober college living is both necessary and fruitful. There's real hope to close the gap between teenage recovery and everything that comes after it. People are paying attention.

2012 Mona Mansell Award Dinner

Thu, 19 Jan 2012 16:25:40 -0500

What a Difference a Year Makes!

We were sad to miss our own Benefit last year, so we are doubly thrilled to gather together again with Freedom Institute's closest friends for the Mona Mansell Award Dinner. Please save the date: Monday, May 14, 2012, at The Pierre Hotel. For further information please contact Rachel Russell at Rachel.Russell@freedominstitute.org or 212-838-0044 ext. 16.

New Year’s Resolutions: Why Keeping it Simple Works

Fri, 06 Jan 2012 16:49:49 -0500

Small changes that you can successfully incorporate into your life may do more for your happiness than “going for the gold”, according to research studies. So rather than overwhelming yourself this year with a list of resolutions that you may have trouble implementing, consider the benefits of making one or two simple resolutions that you can actually maintain. We apparently have a happiness “set point” that is more affected by little things than big things. In a study on “happiness” Stanford psychologists asked participants to rate their overall level of happiness, on a scale from 1 to 10. Most people indicated about 6.7 or so. Interestingly, it was discovered that a divorce, or serious injury, even the loss of a limb, only caused this level to go down a point or two, for a year or two. But then “happiness levels” usually came back to about 6.7.On the other side of the scale, falling in love or winning the lottery caused the level of happiness to go up a point or two for a year or two, but then it went back to the previous level. People in the study reported that it was the little things that actually affected their level of happiness more than the big ones which implies that small, positive changes in habit, that can be sustained, may have as significant an affect on our sense of well being as major changes. Adding a walk, going to a meeting and sharing feelings, or journaling, for example all impact both the body and the mind, elevating our immune system and getting those soothing body chemicals like serotonin (nature’s anti-depressant) to course through our bodies on a daily basis. They may be worth as much or more to your happiness “set point” than winning the lottery, taking that great vacation or getting “too rich or too thin.”

Why Less is More

Another interesting piece of brain science from Stanford University may shed light on how we might set ourselves up for failure if we want too much too fast. When we try to make too many resolutions, we might be putting our brain on overload and actually causing it to function moor poorly than if we made no resolutions at all. Apparently, the prefrontal cortex, which helps us to organize goals, exercise will power and make long range plans, can get overwhelmed when it comes to making decisions in the moment. In this research study the ability to resist temptation appeared to be related to brain overload or stress. Several dozen undergraduates were divided into two groups; one group was given a two-digit number to remember, while the second group was given a seven-digit number. They were then told to walk down the hall, where they were given two different snack options: a slice of chocolate cake or a bowl of fruit salad. Researchers found that the students with seven digits to remember were nearly twice as likely to choose the cake as the students given two digits. The reason, according to Stanford’s Prof. Baba Shiv who conducted the experiment, was that the extra numbers took up valuable space in the brain and became a "cognitive load". When we’re already feeling overwhelmed we seem to continue on that path; the prefrontal cortex gets so overtaxed that all it takes is five extra tiny bits of information before the brain starts to give in to temptation.

“This helps explain why, after a long day at the office, we're more likely to indulge in a pint of ice cream or eat one too many slices of leftover pizza,” says Jonah Lehrer, author of Proust Was a Neuroscientist. (In fact, one study by researchers at the University of Michigan found that just walking down a crowded city street was enough to reduce measures of self-control, as all the stimuli stressed out the cortex.) A tired brain, preoccupied with its problems, is going to struggle to resist what it wants, even when what it wants isn't what we need.

The obvious correlation with those in recovery is this: take baby steps and do what you say you are going to do. One good resolution well followed is worth more to our happiness and resilience that all the best laid plans! Twelve step programs are filled with slogans like easy does it, a day at a time and take the next right action that help us to slow down and function better. So among your New Year’s resolutions you might consider accessing the support that will help you to sustain motivation and Good, Orderly Direction.

Attach: It’s good for you

Mon, 02 Jan 2012 14:48:49 -0500

Welcome to “Voices of Freedom”, the Freedom Institute Blog. This is my first entry in the “Wellness” category, and it comes from Attach, and give your brain a break from stress, a paper written by Dr. Jon Allen at the Menninger Clinic in Houston, Texas. In Attach, Jon describes the results of results of some neurobiological research on attachment, conducted by Dr. Jim Coan at the University of Virginia. Attachment is my field, so pretty much anything about it catches my attention. But I think this research is particularly compelling because of its focus on wellness. I find myself sharing Jon’s impulse to tell “patients about (this) work every chance I get.”

The research is complex, but the results are simple. Coan studied “highly satisfied” married couples during an experiment in which the wives were warned that they would be periodically shocked by electrodes taped around their ankles. MRI studies found that the most powerful way for these women to calm the fear induced by such a threat was remarkably easy: holding their partner’s hand.

So what does this study (elegantly and appropriately titled “ Lending a Hand”), tell us? We clinicians spend a lot of time help our patients learn how to “self regulate”; the emotional resilience required to manage their emotions when stressed. This is particularly true in the case of chemically dependent patients, who are often accustomed to handling stress by self-medicating. But as Jon Allen points out, it’s hard to do this. In his words, it’s “a costly strategy: it is effortful.” And as adults, we certainly need to learn how to self-regulate; we won’t always have the option of holding our partner’s hand whenever we feel threatened.

Yet, as Allen asks, if the most efficient way to calm fear and anxiety is to literally “reach and touch” someone we love, shouldn’t we teach our patients that?

- Donna Wick, Executive Director

Two Wrongs Don’t Make a Right

Mon, 19 Dec 2011 07:30:00 -0500

As I entered a class of 11th grade girls, one of the girls looked at me, huge smile on her face, and said, “Freedom Institute! Are we going to talk about drugs and sex?”

“Is there something more interesting you’d like to talk about?” I responded. The group unanimously decided that those were the most exciting topics we could discuss.

Although the primary focus of the Independent School Program is Substance Abuse Prevention, substance use and sex are inextricably linked for teens. I asked a class of 17 girls to raise their hands if they knew someone who had done something under the influence of alcohol or another substance that she later regretted. All but two raised their hands. I asked them to keep their hands raised if the regrettable action was something sexual: no one put her hand down. The consumption of alcohol seems to function in three ways for teens when it comes to sexual behavior:

A student gets drunk (probably more than they intended to) and ends up making risky decisions and doing things they never intended or desired to do.
The “courage in a can” idea: teens use alcohol to relieve the social anxiety they feel in a new situation. They also use it to alleviate any stress felt about certain sexual actions they may otherwise feel uncomfortable with.
Students use alcohol as an EXCUSE for doing things they want or fully intend to do, but would be embarrassed to do if they were sober. Essentially, “being ‘drunk and easy’ is better than ‘just being easy’,” in the world of adolescent reputations.

All three are certainly issues we should be discussing with our teens. The third, however, presents a particularly worrisome attitude that is quite prevalent among teenagers, especially the girls. Although casual weekend “hook-ups” would typically earn someone a bad reputation by Monday morning, these unhealthy decisions tend to be forgiven and forgotten if the person was drunk or high[see num=1]. Teens are acutely aware that they lose control of their judgment and decisions while intoxicated. The dangerous belief betrayed in this attitude is that drunkenness is completely socially acceptable - so much so that it neutralizes less socially acceptable behavior. In reality, this is an extremely dangerous state to be in, as it makes students more vulnerable to the risks that accompany being drunk or high. This is especially true when it comes to sexual decisions. Students have shared with counselors from Freedom Institute that even when they thought to use a condom while having sex after drinking or getting high, they were unable to use it correctly. This obviously exposes teens to an array of risks, such as pregnancy and STI’s.

In settings where drinking and “hooking-up” is prevalent, many girls have found themselves in, if not dangerous, then at least regrettable, situations. One high school student shared with me, “If a girl is drinking, and isn’t alert - if she can’t talk about what she wants or doesn’t want, then the guy will make the decision for her.” Nathalie Bartle, in her book “Venus in Blue Jeans” highlights a survey stating that 90% of girls between 12 and 19 point to alcohol as a major factor leading to sex (Bartle, 1990).

In their efforts to feel more comfortable in certain situations, or to justify their actions, teens are unlikely to consider carefully the great risks they incur by placing themselves under the control of chemicals and other people. It is important for educators and parents to combat the idea that getting drunk, or experimenting with getting high, is a harmless “rite of passage” for adolescents. The following communication tips come from our Parent Guide:

Use the media. Reference one of the many movies or TV shows that display (and probably glorify) teenage drinking, partying and sexual behavior. Ask your teen if she knows people who have found themselves in similar situations. This springboard can act as a way for you to gauge your teen’s attitudes about the issue, and as an open door for you, the adult, to share the information you have, in addition to the values and expectations you hope to impart to your child.
Acknowledge that it is an awkward topic, but important nonetheless. Emphasize that there is nothing your teen can share or ask about that will change how you feel about him, and that when it comes to issues of safety and health, you would always prefer he come to you. Express that you do not anticipate him putting himself in compromising situations, but if he or a friend does happen to be in trouble, you expect them to contact you.
Engage your parenting partner. It is important, if you have a parenting partner, to include him or her. This doesn’t necessarily mean that both parents need to always be present for a formal conversation, as that could intimidate your teenager. It does mean that you should be intentional about being on the same page; you don’t want one parent expressing the dangers of adolescent substance use while the other parent shares stories from college about the funny things friends did while drunk or high.

The most important thing is to continue to communicate with your teen on a regular, informal basis about these issues. Teens are bombarded daily with messages about what is expected of them when it comes to alcohol, drugs and sex. It is very easy to buy into those ideas if there is no opposing view reinforced, and no reminder about the risks of such activities. For the sake of physical and emotional health, it is important to emphasize, especially to the girls, that drinking does not neutralize the negative effects of casual, or “accidental” sexual encounters, though it may seem like it minimizes the social effects. Underage drinking is not an adequate cover for irresponsible sexual behavior, and in most cases amplifies the negative effects.

Family Support in Adolescent Treatment

Mon, 05 Dec 2011 23:50:08 -0500

All parents want the best for their kids, and never is this more true than when kids need help. So what is best when it comes to dealing with adolescent substance abuse/dependency? There is limited research on the relative effectiveness of various substance abuse treatment approaches. However, research does indicate that family-based approaches are effective in treating substance abuse in adolescents (Williams & Chang, 2006).

At Freedom Institute, we have found success in treating adolescents with our integrative approach, which combines individual adolescent substance abuse counseling with family therapy. The individual counseling allows for the adolescents and young adults to feel like they are in the driver’s seat of their treatment, and provides them with the opportunity to assert their independence and process experiences and feelings in a way that they might not feel comfortable doing with their parents. It is important that adolescents have a safe place in which to explore their issues and further develop their insight and awareness of how their behaviors are affecting their lives.

However, the problem often lies deeper than just the individual, and is embedded in the family system as well as the larger social environment. Family therapy allows for the family to explore substance abuse not just as an individual’s issue, but as a family problem. This involves exploring together: family history; what was occurring in the family and larger community at the time substance use or abuse began; how substance abuse has impacted the family dynamics in both negative and positive ways; and how family members can support each other in a way that promotes healthier and collaborative coping mechanisms.

At Freedom Institute, our adolescent program and family program closely collaborate to enable maximum support, to provide a comprehensive education program, and to most effectively facilitate open communication between adolescents and their parents. For example, if a family calls because their adolescent is caught smoking marijuana at school and the family chooses to be involved, then it provides us with the opportunity to hear all perspectives on the situation, learn more about the individual’s environment and how this bigger picture has both contributed to the problem and can help with healing. In addition, we make sure that treatment caters to each individual and family’s needs and that there is no one-size-fits-all treatment approach.

In our experience, when we have worked together with families and adolescents, we have had great results helping the individual and family reach sobriety and improve communication to prevent the continuation of risky or problematic behaviors.

Helping Teens Say S.O.S.

Mon, 07 Nov 2011 15:01:30 -0500

Every fall, after students return to high school and college, there are tragic news stories about those who die of alcohol poisoning. These tragedies could often be averted if teens were better prepared to call for help. When we speak with teens in our classroom prevention workshops, they often express concern about what to do at parties when peers are highly intoxicated. Yet while they express concerns about their friends, they also express fears that if they call adults for help they will get in trouble, or if they call 911 for an ambulance they will get arrested. Another common worry is that the intoxicated friend will be mad at them the next day for “getting them in trouble.” These fears can be overwhelming and make it difficult for teens to reach out for help in a time of crisis. It is vital that caring adults convey to young people a clear message: alcohol poisoning is a serious medical emergency that requires immediate medical attention; and while underage drinking is not condoned, if they or someone they are with is in need of medical attention because of underage drinking, they should call 911 and involve adults without the fear of punishment.

Alcohol poisoning is when the quantity of alcohol in the blood is so high that it threatens respiration. Teens are at a much higher risk of alcohol poisoning than adults because they metabolize alcohol less efficiently. Teens get drunker faster and stay drunker longer on less alcohol. Binge drinking (defined as 4-5 drinks in a single sitting) and playing drinking games, both common among teens, cause Blood Alcohol Content to rise to dangerous levels in a short amount of time. The liver has no time to catch up, which creates a backlog of alcohol in the blood stream. It is also important to note that drinking after the use of any kind of drug, prescribed or illicit, can increase the risks of alcohol poisoning.

Everyone should be aware of warning signs that indicate someone is suffering from alcohol poisoning.[see num=1] The first symptom of alcohol poisoning is usually vomiting. This is the body’s attempt to protect itself by preventing any alcohol that remains in the stomach from being absorbed into the bloodstream. Additional signs are as follows:

Unable to stand up or remain standing without assistance.
Not responsive to talking or shouting.
Clammy or cool skin, or bluish to purplish skin that appears very flushed.
Not responsive to any physical contact, i.e., shaking, poking, pinching.
Passed out, especially if unresponsive to any attempt to wake.
Vomiting while passed out and not waking up is an additional red flag.
Slow irregular breathing, irregular pulse or a pulse rate slower than 40 beats per minute.
We stress to teens that these symptoms should not be taken lightly. The only solution to alcohol poisoning is to call 911 and remain with the person in need until EMS has arrived. Furthermore, teens should not wait until someone is passed out and is unresponsive – it could be too late.

Teens often ask whether there will be any legal repercussions if they call 911. In our experience, there has never been a case of an underage drinking arrest under these circumstances. We also point out that in a medical emergency, saving someone’s life trumps any legal action that may be taken, and that any potential legal consequences could be much worse if the alcohol poisoning ultimately resulted in death.

Often the next concern is, “But what about my parents? I’ll get in so much trouble!” This is where parent involvement in prevention is so important. We, as Freedom Institute counselors, encourage parents to communicate with their children, especially as they enter middle and upper school about their expectations regarding alcohol and drug use, and also about their expectations regarding calling for help. For example: “I expect you not to drink. But, I always want you to call me if you are in a risky situation. If you are in circumstances involving alcohol and someone needs help, you should call 911, me or any other trusted adult. I would much rather you call for help than worry about being punished by me. There may indeed be a consequence if you personally have made some unhealthy choices, but my first concern is your safety. In the end, my response to the situation will be much tougher if you don’t call for help when it is needed.” We also recommend that parents review warning signs of alcohol poisoning with their teens.

Time and time again, teens have shared with Independent School Program counselors their struggles to act responsibly in a time of crisis. As caring adults, it is imperative to send to our teens a clear message that promotes healthy behavior, prepares them to respond appropriately in a dangerous situation, and simultaneously conveys support.

Into the Light

Mon, 10 Oct 2011 19:05:24 -0400

In the last several years there has been widespread attention on the sexual behavior of well-known and powerful individuals who previously kept their exploits under the radar. While acting-out behavior, particularly amongst celebrities, is not new, it is not so easily hidden as it once was, due largely to the proliferation of social media and broad internet access. At the same time, we continue to hear about a range of inappropriate sexual behavior by many of less means. In both cases, those involved appear to feel as if they are exempt from following the rules – that is until they get caught. These behaviors, however, are often compulsive and involve a great deal of risk taking, in spite of negative consequences. This is the core of sex addiction.

In spite of the media hype, there continues to be some stigma attached to sex addiction. Historically, it has been hidden out of the light, a topic of conversation that many people avoided. However, the tide seems to be shifting as each new incident occurs, and people’s awareness is growing.

So, what exactly is sexual addiction, what are the root causes, who is at risk, and what is the treatment? The National Council on Sexual Addiction and Compulsivity has defined sexual addiction as “engaging in persistent and escalating patterns of behavior acted out despite increasing negative consequences to self and others.” That is, a sex addict continues the behavior despite knowledge of possible health risks, financial problems, broken relationships or even arrests.

Understanding the origins of sex addiction helps to make some sense of the risk taking behavior. Statistics are that 80% of sex addicts experienced some form of child abuse. The abuse covers a wide spectrum and ranges from violence to lack of validation. The key is the shame that results, the chronic feeling of being defective to the core. The shame-based person will go to any lengths to suppress these negative emotions by seeking a dissociated state, a trance. Sexual acting out brings the illusion of relief but this of course is temporary and the behavior progresses.

In fact, research indicates that the addicted brain fools the body by producing intense biochemical rewards causing intelligent, goal-directed individuals to easily be taken in by the lure of drugs and sex; the emotions overpower the intellect. The addict gains little satisfaction and forms little or no emotional bond with his or her sex partners. Besides the shame and isolation the addict also feels powerless, and a lack of control. The allure of cybersex and online pornography, which appear to be anonymous, affordable and available at the flick of the mouse, creates an illusion of no consequences. However, the impact can be devastating for the addict as the illness progresses and the shame intensifies. As with other addictions most sex addicts live in denial; it takes a significant event: a job loss, the break up of a marriage, an arrest, or a health crisis for the addict to admit the problem and accept help.

Treatment focuses on learning new behaviors and resources to enable moving away from addictive thinking and helping the person to ultimately develop a healthy sexuality and lifestyle. This includes education, individual and group therapy as well as marriage or family therapy in an inpatient or outpatient program. There are also support groups and 12-step recovery groups readily available. In some cases, medication may be suggested to treat the obsessive compulsive nature of the addiction. Fortunately, there has been a increasing attention and focus by treatment professionals. There are books, trainings and an increasing number of well established and respected treatment facilities currently operating. No longer do people have to suffer in isolation.

Can Psychodrama Help Train Our Brains for Recovery?

Fri, 30 Sep 2011 11:30:00 -0400

“You want me to participate in a ‘psychodrama’ group? Don’t I have enough ‘psycho’ ‘drama’ in my life already?” Clients new to Freedom Institute sometimes wonder how a psychotherapeutic method that involves inviting other group members to play our “Inner Addict” can possibly help us stay sober. I can relate. I had a similar reaction myself when I first participated in psychodrama as a client, early in my recovery. All I knew with certainty was that – on my own – I could not get off the endless roller coaster ride my life had become, vacillating between feeling flooded by unwanted emotions and enjoying the adrenaline high that accompanies the illusion of control. Little did I know that 16 years later, brain research would shed light on why and how psychodrama and other action methods can move clients efficiently along their path to freedom from the endless cycle of addiction.

Chemical dependence disrupts our ability to make choices about how we regulate our emotions, because it interrupts and distorts the healthy neural connections between the “emotional” (limbic) and the “executive” (pre-frontal cortex) parts of our brain. Alcohol and other mood-altering drugs train the brain to crave the chemically-induced high, low or numb feeling, circumventing the brain’s natural ability to recruit alternative coping mechanisms. Conversely, healthy connections between our “emotional” and “executive” brain allow us to experience and articulate a wide range of emotions without becoming either flooded or numb.

So if neuro-chemical disruption is the problem, why isn’t it enough to give up our drugs of choice? Why can’t we feel our feelings without being ruled by them, make mature choices about our behaviors, and act with integrity? One reason is that often our addictions are themselves coping mechanisms for the emotional strain of an internal psychic schism, a splitting-off of parts of self that didn’t serve us when we were younger. Perhaps it wasn’t safe to experience certain emotions in our family system, so we learned to despise ourselves for having them, or to deny their existence altogether. In either case, our connection to self was sufficiently disrupted to prevent us from developing healthy coping mechanisms for life’s stressors (like sleep, fun hobbies and supportive relationships), and we turned instead to chemicals (or food, sex, gambling, work) to avoid feeling overwhelmed. When we give up our drug of choice, we are left to complete the psychological developmental tasks our addiction interfered with – such as tolerating frustration, nurturing ourselves and taking responsibility. This is where psychodrama is particularly useful to the recovering addict.

Fundamentally, psychodrama is about achieving emotional intimacy…with oneself, with other people, and with one’s Higher Power. It achieves this by increasing the group members’ capacity for empathy and the ability to experience and tolerate another person’s reality, without becoming emotionally flooded or shut down. The group chooses a protagonist to act out extemporaneously a scene from his or her life, and the protagonist chooses group members to play the parts. Carefully designed warm-up exercises and the group members’ unconscious connection to each other result in choices which are therapeutically useful to everyone in the room – the protagonist, the group members chosen for certain roles, and the remaining group members who are active observers. As the dialogue unfolds, the facilitator helps the protagonist explore whatever internal block he or she is experiencing in his or her relationship with self or other.

Ironically, often the protagonist demonstrates the least empathy for him- or herself. Through psychodrama, we can clearly hear the internal voices of criticism or self-indulgence that perpetuate the client’s alienation from self and, in turn, his or her vulnerability to relapse. By making conscious and explicit the full range of one’s attitudes, beliefs, behaviors and emotions, the protagonist eventually gains the ability to self-soothe without using drugs or alcohol and to make healthy choices about his or her behaviors.

More research is needed, but emerging brain studies indicate that our ability to self-regulate emotion is born of neural connections first formed in response to the earliest relational interactions with our caregivers, and further influenced by later, formative relationships. In the same way, acting out a scene psychodramatically and later talking about it with fellow group members may restructure and build new neural pathways – chemical connections in the brain – that allow long-lasting shifts to occur in how we respond to emotional triggers or stimuli. Thus begins the journey towards healing and wholeness that defines later-stage sobriety.

Now that’s a theater for which I want front-row season tickets and a VIP pass!

Rupture, Trauma and Healing

Mon, 04 Jul 2011 23:56:56 -0400

We are biologically wired to seek intimate, ongoing attachments, to feel sustained by closeness and disturbed by disconnection. Without this powerful form of bonding, our species would become extinct, baby animals and human children would wander away from parents and parents would forget about their young. Our brains and bodies are wired to connect. Understanding relationship trauma requires understanding the depth and strength of these very intense, life-sustaining bonds. Because these are survival bonds, when they are ruptured, through neglect, mental illness, addiction or divorce, we may experience that rupture as traumatic.

Addiction - let’s face it - threatens these attachments. Those who live with an active addict often feel scared, abandoned and confused. These feelings of extreme fear can put us into states of high stress.

We have all the same instincts as an animal when we’re super stressed. When we feel danger looming on the horizon, our limbic brain/body system kicks our fight/flight response into gear, by flooding our muscles with blood and our bodies with adrenaline, so that we can stand and defend ourselves or make a fast exit. If we can do neither, which is so often the case when dealing with the scary, crazy-making behavior surrounding addiction, we may freeze, like a deer in the headlights.

To complicate matters even more, our prefrontal cortex, our “thinking brain,” temporarily shuts down when we’re terrified. Nature did not want us thinking about whether or not we should run from a saber-toothed tiger, she wanted us just to run, so she put first things first, action before thought. We go on automatic. In the blinking of an eye, we feel fear, read our environment and react by defending ourselves, fleeing for safety or remaining statue-still until danger passes.

All of this happens much in the way that it might happen for any animal; there is an absence of conscious thought and a heightening of sensory awareness. Because the thinking brain is not doing its job of processing “limbic experience” (read: emotions and sensory impressions), those experiences do not get elevated to a conscious level through thought and reason. We carry with us a sort of fragmented jumble of sights, sounds, smells and feelings that lack a coherent core around which to wrap themselves.

So later, in therapy for instance, when asked the simple question, “tell me about what’s bothering you”, we may have the disturbing experience of knowing that we feel bad, afraid or anxious, but not being able to piece together an articulate story as to why. Is it the behavior of the addict? Their swings in mood that are making us nervous? The daily challenges to our sense of “normal”? Our emotional responses to a home under stress? All of the above? This inability to tell a clear “trauma story” can leave us in the vulnerable position of looking to others to tell us who we are and how we feel. Sound a little like codependency? In the absence of our own, clear read, we may want to be told by someone else what we’re feeling and why we’re feeling it.

In early recovery, it can be very helpful to read articles, books and attend lectures that describe families dealing with addiction, so that we can break the fourth wall of the disease, so to speak. We can attend twelve-step meetings and, as we listen and learn, we see our own lives flash across our minds. The fog begins to clear as our emotions and experiences emerge and take shape. We find words to describe what we feel. We slowly gain a clearer picture of what happened and the meaning we made out of it.

In recovery, we learn a new language of emotional literacy. Much like learning any foreign language, at first we may feel like outsiders looking in. With time, however, we learn phrases that become sentences, and these give way to conversation. We become comfortable traveling through a new world, and we learn to communicate with others who are also fluent in this new language, the language of feelings.