Monday, December 28, 2015

Our brain on Gambling

Good morning readers. I have the pleasure of talking to a group via online, sharing some of my experience and clinical practice of working with people who suffer from a gambling disorder. This particular talk will concentrate on what the brain does and how it changes when gambling addiction and addiction occurs. I get many questions from parents or loved one's of gamblers, in how the brain can get addicted so quickly to gambling? The neuroscience in the last decade of understanding the brain and gambling has improved. In the middle of our cranium, a series of circuits known as the reward system links various scattered brain regions involved in memory, movement, pleasure and motivation. As humans we engage in an activity that keeps us alive or helps us pass on our genes, neurons in the reward system push out a chemical messenger called dopamine! This boost of satisfaction and encouragement allows us to make a habit of enjoying meals and sex! When the brain is stimulated by drugs such as amphetamine, cocaine, or other additive drugs, the reward system disperses up to 10 more times of dopamine than usual. Addictive substances keep the brain flooded in dopamine that it adapts by producing less of the molecule and becoming less responsive to its effects. The negative, addicts build up a tolerance to a drug, which means they need more to get high! Research shows that pathological gambling and drug addicts share many of the same genetic predispositions for impulsivity and reward seeking. However, gamblers tend to put themselves in riskier ventures in my experience. The withdrawal periods from gambling with the brain is tricking the brain. The reward circuitry becomes underactive. Researchers have gleaned that drugs and gambling alter many of the same brain circuits in common ways. Many of you are aware or have read studies that discuss the neurodegenerative disorder of Parkinson's disease and compulsive gamblers. Remember Parkinson's is caused by the death of dopamine-producing neurons in the part of the midbrain. Gambling and the brain appear to create fantasy thinking or irrational thoughts. The risk and impulsive decision making goes array. At one time, I have read that 80% of gambling addicts never seek treatment. Addiction is the substitute satisfaction on an unmet need. Nearly two million people in the United States are addicted to gambling, that number may be going up! Stay in your health, stay in the moment.

Sunday, October 25, 2015

Mowing in 38 degrees early morning......

Many of you will hear me preach exercise, and get outside to enjoy nature. I know I tell, text, our clients to be active on beautiful fall days. Today was the perfect example. Instead of taking my normal reflection walk this morning, I decided to mow as frost was trying to cover my leaf, filled, yard. I got on my favorite stocking hat, old hole sweats, and layered up for the crisp feeling of fall, soon to be winter. The lawn mower did not want to start, it was that cold this morning. As I started the lawn, something strange happened. I was looking at all of our Halloween decorations dancing in the wind on our trees when I looked up and saw a deer, looking at me from the side of the house. The noise of the lawn mower did not spook her. She looked right at me, probably 30 yards in the brush by the trees. I stopped mowing, but the mower was still going. I figured if I continued, she would prance off into the woods. All of sudden she, it was a doe, came out of the woods towards me. Like that I let go of the mower. At first I thought, there is no way she is going to come up the side and into the neighborhood. That would be impossible, right? She started slow, then turned like a rabbit and went back into the forest. I saw her jumping, over the brush every three feet. She ran all the way to the field. I started the mower again, and begin to think. If I would of waited to 11am to mow, I would of missed this. I continued mowing, and started in the back yard. The front was done, side completed, and I did not loose my train of thought and accidentally run over any Halloween decorations. I began to think of things that I was thankful for. Two things came to my mind. First,  I was able to mow, walk, exercise, and feel the air on my face. Second, I was grateful for every client that was trying to work our program. I then wanted to thank in my mind each parent and sibling that was part of the helping process. I was still mowing, but my mind felt stimulated with happiness. I could see each face that I try and help each week. My higher power was working. Something greater then me, that I could count on. I continued to think, and then it happened, just like that. I began to pray, row after row, I was mowing, but I also was praying. Stay in your health, stay in the moment.

Tuesday, October 20, 2015

Sometimes listening can be giving.

Salutations from the ocean. (I wrote this last week on vacation/work) It was 85 degrees, the wind was blowing as I was watching the yachts come into the bay. The largest boat show in the world was gearing up right in front of our hotel. These vessels were voluminous at best. I was sitting on the dock reflecting on the day. I looked over and under the bridge was a homeless man. He appeared to be getting his fishing pole ready to fish. He saw my glance, and waved his hand, I waved back. I then walked over and looked at him. Right away, I wanted to help. I offered him some money, he looked at me and said he was fine. He then started asking me questions. I answered all of the questions. I found myself sitting next to him on the pier, and we talked shop about fishing, and the different types of fish that could be caught in the ocean. I had taken my helper hat off (as my wife begs me to do when on vacation and just relax) and listened. He apparently had another peer, down the pier, who was his friend and they would go from bridge to bridge for sleeping. I apologized for offering money, and he said it was ok. I then asked if I could buy him some fishing gear, because I wanted to buy some too. He thought that was a good idea after more talking. I gleaned that this person was a school teacher years ago, lost his wife to cancer, and his son was killed in prison. He went through a rough patch with alcohol, and was trying to take day by day. I kept to my word, and did not ask anything about his alcohol behavior. He then shared that he was going into a homeless rehab next Monday, when a bed was available. I kept to my word, and did not ask anything about his alcohol behavior. He then went on to talk about some positive things he was looking forward to doing once in rehab. He then caught a fish, reeled it in, I was able to take off the hook for him. My son was calling for me down the dock, and I thanked the man for his company. Sometimes listening can be giving. Stay in your health, stay in the moment.

Friday, September 25, 2015

What do you do when the program is not working?

A great question from a parent via Skype. In this particular case, (ok to share) their son was a successful lawyer, going through a gambling addiction, and possible incarceration. The mother was checking in with me today, her son going on 10 months clean time, a former client. What do you do when the program is not working? Sometimes any program may not be the right fit for the person, it happens. I remember two years ago, I was working with this particular client and family. The family was upset with the lack of progress with the client. I spent many hours with this family, each member had its own issue. Six months had passed, and I decided to call another intervention with the client and family. The parents were outraged, and the client was more then non-compliant. As I ended the intervention, I suggested three possible avenues of support for the client and family. The family, (as it turns out- I just found out last month) went to each referral that I sent. Unfortunately, the addiction cycle was still present in the client and the family appeared to be struggling more. The client reached out a month ago. I fielded the call, and we talked. The family called the next day, to assure they had no interest in our services again. The client reached out that weekend. The family called me that Sunday night and told me each referral I sent them, the helper had referred them back to me! I asked why did they think this happened? The father explained that when they were interviewing with each therapist, all they did was talk about how Tod was the only one to develop a love/hate relationship with their daughter. The daughter spent two of the sessions telling the other helper how much she despised this writer, but missed the exercises, working out, laughing and yelling at this writer. The father continues with each helper asked what they could do for the client and family? The father then asked me if I would see the daughter again. I respectfully, said no. The father then firmly asked if I would see his wife and daughter. I respectfully, said no. This time, the father, looked right at my face, and asked very quietly, if I would see the whole entire family, with the daughter and start over. I respectfully said yes, on one condition. The father said, I know, we all need to complete our daily homework, and make all of our sessions. The point of this story, each person we try and help, along with their family will not always work. Sometimes this writer may be the wrong fit for the client and family, it happens. But, I still try and stay positive, using what did work and offer other people or services that may be better suited for the person and family. As I told the mother who I was skyping with, you have to be patient, but willing to see the positive. Stay in your health, stay in the moment.

Tuesday, September 1, 2015

Out of State Helping

I am blessed to be sharing some of our positive stories with all of you. I would like to thank this family for allowing me to blog. As summer comes to a end, and the leaves begin to change color, I find myself seeing new families outside of our state. This particular family, I want to personally thank for being flexible, and waiting until I could start services. The mother just got out of treatment, and the son was going into treatment. We did our intervention, a positive but emotional experience for all. Mom was struggling with enormous cravings post-treatment. Dad was doing all he could do to keep the family under a safe umbrella. The son, began to talk, and it was evident that he was in denial, (he later came clean with this on our private 1:1) but wanted to speak his mind. There was tension. They lived by the river, and we could all feel the breeze coming through the windows as the room got louder, and louder. I decided it was time to modify the intervention. I stood up in the kitchen and very softly asked everyone to follow me, no talking, no questions, just please follow me. I heard some f-bombs behind me, but soon, it was quiet. Now, mind you, I am not privy to the layout of this beautiful home, but I navigated on my own higher power to the deck, down to where we could see the water. I then turned around and looked at the family. They were sweating, but seemed more relaxed. We all sat down, and started again. This time, I could feel there was a breeze of respect lingering in the air. Everyone remained calm, and got a chance to talk. We then walked up the hill to the deck and back to kitchen. The son, got everyone something to drink, and we started to form a plan. Mom was going to see this writer, son was going to see this writer, and we began to plan out our schedule as I do with every client and family. I started to walk out, and say goodbye to each as the Dad walked me to my car. He gave me a firm hand shake, and thanked me for my time. I was no more then 2 miles down the road, and Mom called. Then the son texted me, and I knew the healing would begin for this family. Stay in your health, stay in the moment.

Wednesday, July 29, 2015

Success

I was skyping with a client yesterday from across the seas. This particular client was struggling with how success was not finding her. I think many people share the same thought. I know I did when I was in my gambling state of mind. Success is keeping it simple. One thought at a time, one goal at a time, and we all know the famous saying, one day at a time from our friends at A.A. My skyping client asked me to share this thought in my next blog and was curious to see how many other people struggle with the thought of success. Right there, I had to stop her, she hit it right on the head. The thought of success. In our program, leaning how to control one's thoughts is pivotal in success. We want our clients to feel empowered with their self, that can control the thought of self-medicating. Each client learns how work through the struggle, you know you can use, drink, gamble, game, purge, and have unhealthy sexual behavior, but you can choose not to! You have the ability not to make the urge or craving bigger in your own mind, and work through it, that is success. Success is keeping it simple. To often people and this writer to will put to much energy and emphasis into large, lofty, and sometimes fantasy thinking images of what success is. I began to frame success is like a road leading to other positive things and aspirations in your life. We all want to obtain these things that are suppose to make us happy, right? These things cost money. We then try and validate our self with the notion, if we make more money, we have more things and we are then successful. Unfortunately, that does not work. Been there, did it, failed miserably. The key is when you start on your road, each step is all part of the process. You may trip, don't laugh, I have done that. You may fall on your but, been there, done that. However, you continue on your road, learning from each fall. That is success. You can still have aspirations, on what you see down the road, but you need to keep it simple. This writer has learned that when I am balanced, life is simple, that is success. Staying balanced is learning how to make the best of each step in your journey. I encourage all of our clients to believe in something greater then self. I call that a higher power. A higher power can give self that feeling of success know matter where you are in life. Success is staying on your path, but, taking the time to enjoy each moment. Slow down your brain, one thought at a time. Positive energy starts with positive behavior. When you are faced with a challenge in your life on your own road, take the time to work through it. That is success. Stay in your health, stay in the moment.

Sunday, June 28, 2015

The walls are caving in

How many times have you felt the walls are caving in? For many of us, this can be a common thought that can lead back into the negative thinking that can cause urges and cravings or spiral one back into high anxiety with feelings of depression. This last week I was skyping with a new face that needed some addiction education. The person, was suffering from that same feeling, the walls are caving in she acknowledged many times in the beginning of our Skype. She was very honest about her situation, and wanted to share her experiences with others if it could benefit them in any capacity. It was clear that this professional woman was sincere about getting help for herself and determined to not let her negative energy influence her life anymore. I listened to her speak, and was amazed how organized her thoughts were. I thought this was a good time in our discourse to ask what her addiction problems were? The walls were caving in she replied again, but this time she seemed confused why this writer was not picking up on her, "venting". I let her continue on with her story. It was a sad story. Her son, had recently exited or abandoned his residential treatment program and went missing. He was struggling with addiction behavior, and she was exasperated with him. The son was living in Colorado, where he went into his fourth treatment in three years. The family has the resources to help him, she noted several times during the conversation. She explained the last treatment the son decided to do something he had never done. The son came out of the closet. He expressed his own sexuality to the group. The mom reports he was ridiculed, and assaulted by two other clients. The night of the assault, her son fled the treatment facility. She began to cry and talk loudly how the walls are caving in. Slowly, I began to draw on my magic marker board, attempting to make walls that were surrounding her. She looked up, and started to give me direction on how big the wall was. I was not making the wall big enough, she shouted out. I then made the wall bigger, and bigger, I soon made the wall as big as the board when I stopped. She then told me that I was making this way to big on the board! I stopped, put the maker down, looked back at the screen, and said, "The walls are not caving in", "take a deep breath, squeeze your hands, tight, tighter, and release". She did. We then started to erase part of these walls. She directed me on where I could and could not erase. The positive I began to tell her, her son broke down these walls, and came out, for who he wanted to be for himself. She nodded her head in tears, but realized this was a positive. You are the only one that can let these walls get bigger, I told her. Control the thought, let out the negative energy and focus on how you balance your thoughts right this second. She nodded again, this time with a small smile. We talked more. She began to see that her walls were not caving in. She loved her son, and knew all along. Things started to make sense in her mind she replied. Tod, I am a therapist she explained. I thought so, I replied. Addiction can manifest in any family, any person, and the feeling of walls caving in happens. But, you have the mindset and power to erase these walls, see the positives, set appropriate boundaries for yourself, and try again with your son. Tod, you will be the first call when I talk to him again. Stay in your health, stay in moment.

Monday, June 15, 2015

Anger

The other day I was talking to a brother of a client. I did not anticipate the conversation would go a full hour. He was expressing his dissatisfaction with his younger brother. My client is the younger brother. I think it is positive when family members can vent when addiction is present in their family. However, I think it is positive when anger can be released, regardless if addiction is not the primary challenge with the person venting. In this case, this was evident. The older brother was not angry with the younger brother, he was angry with his parents in how they enable his younger brother. I feel fortunate to share this story with our readers. Anger can build up through the years. In this writers experience, I believe anger can be over shadowed with positive energy if you are willing to believe in yourself! In this particular case, I suggested that the older brother let  out all of the negative energy by communicating with this writer. That is step one, vent. Then I directed the older brother to list positive things in his life at this particular second. Step two, is where you identify with what is positive in your life at this moment in time. He started to rattle off positive areas in his life. Essentially, giving self credit for the hard work.  Now it was time to examine the final step in releasing the anger. Step three is being patient or not allowing your negative emotions to get the best of you! This is where I constantly tell our clients that you have been given a timeout, you are not allowed to react just yet. Step three is really a time out! All you can do is take a deep breath, and only allow your thoughts to pause, yes that is correct, pause. You have the brakes on from what you may be wanting to do, act, or say. Remember, I already let you vent in step one. All the negative should of came out then! Step two is where you train your mind to think positive and what list you have created in your thoughts. Step three is patience. Come on, I said, to the older brother, relax the thoughts. He was fighting step three as many do when I first introduce this anger exercise to someone new. I was watching his body language, his tone became softer. I could not see this vein in his forehead, where I did in step one, as he was loud, and extremely angry with his words. I think he wanted to yell more, but he did not. Being patient with our anger allows us to not overreact and say things that will not help the situation. I was sensing he wanted to talk more, I was wrong. He smiled at me, and walked away. Stay in your health, stay in the moment.

Sunday, March 22, 2015

Emoji communication

I can tell this writer is getting old, and I mean out of date old with the rest of the technology world with clients. I enjoy spring for a number of reasons. The positive energy seems to melt the snow (which I pine for snow) and clients appear to have a new, healthy, boost in their step when the cold, ice, and below zero temperatures dissipate. I personally look forward to working with new referrals and their families as well seeing clients discharge and start their path of balance, higher power and creating healthy fun while they stay in the moment. There is something new this spring at Addiction Services, I have been forced to glean the Emoji communication symbols from my teenage clients near and far. A couple of weeks ago this communication became real for this writer. I got several texts from a new client. She was journaling via text for me, in Emoji symbols. At first thought, this was really creative and seemed like a breaking point for her and I to establish a working relationship. However, this writer needs to understand the meaning of the symbol in order to develop this interpersonal relationship, right? The slang of a teenager. Luckily, I have other teenage clients who use this scripted, code if you will, to help this old writer ascertain the true meaning. I know what all of you are thinking now? So much for the healthy journaling in Emoji communication. I decide to call my client and get to the bottom of this symbol jargon, or was it? She answered, I begin to ask questions, and hoping for her to self-disclose, (she goes only if you put this in your blog) sure I thought, this could be a positive for her, and others. She begins to dissect each symbol she chose to text me, and provide insight. This went on for a straight hour folks, and I think we were half way done? I was amazed at the creativity and her feelings. This was positive, I mean really therapeutic. She was journaling her thoughts, emotions, and letting the negative out in her Emoji, regardless of the content. I listened intently, as I was scrambling to write notes. Stay in your health, stay in the moment.

Tuesday, February 3, 2015

Controlling the addiction

Working with gambling clients can be a difficult task at times. In this writer's opinion, gamblers are a rare addict, they have the ability to camouflage or mask their honesty, and appear to present themselves as in control of their addiction. When I see this behavior with clients or potential referrals (after the initial intervention) I use caution. We want our clients and referred patients to control their thoughts, and then their behavior. Trying to control the addiction as a compulsive or pathological gambler will not work. Gamblers present themselves as being in control, especially with their finances. Gamblers are notorious with fantasy thinking behavior, they seem to believe that their budgeting or financial situation is always under control just as their gambling is always under control. This dissociation with reality is part of the gambler's way of how they believe they are controlling their own addiction. Regardless of the type of gambler, (there are many types of gamblers) they continue to live out what this writer calls, the gamblers fallacy. Some days they control their spending, and may not even gamble, but it is only a matter of time, (the next hour, or next day) that they reward themselves for not gambling (validate this to themselves) by gambling again, the addiction cycle continues. The gambler is trying to control the addiction, instead of trying to control their thoughts. The impulsive thinking of the gambler is fueled by what they can win, or how they think the "big win" will bail them out and life will be good. The chase is on for the gambler. Unfortunately,  that fantasy thinking turns quickly into the gamblers fallacy, where reality is distorted and manipulated with insidious behavior for the gambler. Gamblers are only controlling their continued destruction of self. The interpersonal relationships between the gambler and others begin to crumble. The gambler is now avoiding his or her loved ones, and seeks to control the addiction. Spiraling out of control, the gambling usually hits rock bottom, (sometimes this happens more then once to each gambler) and the gambler is forced to step out of their fantasy thinking world. It becomes clear to the gambler that their own illusion of trying to control the gambling will not benefit them anymore. The path to financial, emotional and psychological despair magnifies the gamblers current situation. This is when the gambler begins to heal, acceptance is developing for the gambler, and being honest for the first time in the gambler's life starts to get better. Making amends with all the gamblers destruction behavior to people becomes a goal. They know longer are willing to try and control the addiction, but are ready to control their thoughts and begin to work on self.  One thought at a time. Learning how to identify their unmet needs and replace them with met needs. Addiction is the substitute satisfaction of an unmet need. The gambler begins to recognize the urges and triggers by understanding (as they play it forward in their head- and remember the past gambling behavior with consequences) they know they can gamble, but they are choosing not to. We want the gambler to find balance again with their own mental health, and start new activities, building new, safe, healthy interpersonal relationships. Exercise and mediation will play a pivotal role in self getting balanced. A higher power will help the gambler with their own faith, and understanding there is something bigger then self that can help navigate through life's struggles in a healthy met need. As the gambler works on self, learning how to balance their thoughts, and every day routine, their higher power gets stronger each day bringing fun back into their life. The gambler begins to have fun without gambling and will learn how validate their clean time with more clean time having fun in their life as they stay in the moment. The control of self is the transformation for the gambler to be mindful of where they are at right now in life! Stay in your health, stay in the moment.

Monday, February 2, 2015

Mindful of how much energy you waste a day?

We talk about how important positive energy is in the program we implement with all of our clients, addict or not. Energy can be the missing link to some people who waste to much negative energy on their daily routine in life. I was in a video Skype meeting a couple weeks ago sharing my thoughts on energy with a day program for adolescents and adults who struggle with self esteem issues and depression/anxiety with some addiction if I remember correctly. Each day self has the opportunity to control how much energy they want to put forth on things that they can not control. We used a example with one of their clients who shared she was going through a relationship and was looking to make this particular relationship work this time she noted with a strong voice! Apparently, she was recently divorced, and her ex husband was very abusive, and a addict. She began to tell the group how deflated, tired, and appeared to be frustrated that she was not getting anything out of her day program. I interjected with how her day started before the online group with me and her staff. She looked up at the monitor, and asked what did I mean. I then asked again, what she did this particular morning before coming to group. She quickly rattled off her medications, shower, did not eat, did not do her assignment for group, and got on the phone with her current boyfriend and talked for 15 minuets, and was late for group. This writer slowly, began to identify with her how much wasted energy she used to start her day. We as a group examined how not eating breakfast, not doing her homework, and worrying about her boy friend took a tremendous amount of energy out of her, that it proved to be a waste of energy. Then I suggested how we could role play her morning, and try to get positive energy going, therefore; when her thoughts would go to a negative, she could focus more on her self and the positives she had completed this morning. She could talk to her boyfriend after group, sharing her positives and how she is learning to be mindful of her energy!  The exercise in this particular case was educational and positive I was told from her and the group! The point is that self, you right now when you are reading this blog, can control and be mindful of where you are allowing your energy to go! Try to think of where you put energy on a daily basis? Are you wasting energy on things you can not control and then create more negative energy that can cause you to get out of your health? You have the power to put your energy into what ever you want. Stay in your health, stay in the moment.

Wednesday, January 21, 2015

Permision to Speak

The other day I was working with a client in Northern MN, and his family for the very first time was going to join us. He was nervous, (ok to share-leaving the names out for confidential- Addiction Services is very fortunate that some of our clients and families allow us to share their stories- many do not!) The family was anxious too. The parents were very skeptical of how their grown adult son was going to make some positive choices in his life. The family subsystem was doing everything they could to help their son. The family session was reaching a full two hours when, people started to unload. I decided to let some of the negative energy flow, and cautioned everyone in the room to be respectful but share their feelings. The father was angry, and upset. Mother more passive, but wanted to support her husband and it appeared try and be careful to what she was presenting to her son. Dad came back strong again with more past challenging behavior and words. The family has been through family therapy years ago and apparently went to some group support with their son. The son, was a bright, educated, older man who was very successful at his career. However, like most gamblers, (self included) there were many unmet needs that steered the gambling addiction cycle. The family had known for years that their son was a gambler. They did not know how many years of financial, and insidious destruction it can cause. The father continued that life was hopeless and he was backing out from emotional, and spiritual support. I started with this new client five months ago. The family stopped bailing him out when I started, part of our recovery plan. Then the conversation, (as expected got directly pointed at writer) this is where as a helper you really need to listen to the upset parent. Names and clearly anger words were unloaded at myself. Mom was trying to apologize to me as dad continued to get out all of his negative energy. All of a sudden, something happened that this writer was not expecting. The client stood up, and began to talk, but he could not find the words. Dad stopped yelling at writer, mom was in tears, and our client looked at everyone in the room, and slowly began to talk. If I remember correctly, he talked for about 20 minutes and was dating his behavior from 20 years ago. It was amazing to see his Mother recall each negative experience and his father listen, just listen, not one peep of feedback. I slowly sat down in my chair, and watched my client and his family communicate and listen at the same time. My client sat down, and his father came up to me. Now at this time, I really was not sure what was going to happen. My personal space was invaded. In the corner of my eye, I could see his wife wondering if she was going to make a mad dash to my chair. He got closer, I decided to stay in my chair, and just as reached his hand to me, I stood up. I went to shake his hand and he pulled me in closer. Dad was a minister, (human just like the rest of us) and he kind of just held me, did not say a word. My line of work can be filled with family destruction, and verbal attacks from all kinds of people. I am a firm believer that when people unload, it is meant for change, and my higher powers way of a person trying to let of go of their negative energy. Sometimes it can be healthy unloading other times it appears the unloading can be destructive. The point is that when a family and client can be honest with their feelings, healing begins to create a balance. Permission to speak one's mind can be a healthy outcome if the client can be honest with their self, where they are at this second. This particular client has not worked our program with all of his capability. The parents knew it, (they were paying the bill) the client deep down I think understood it. As I share this blog, I reflect and ponder why the client decided to let out all the negative at that time too, but he did, and granted his family permission to speak. Stay in your health, stay in the moment.