Shea Barakatt LCSW, LCDC, EMDR Trained

Clinical Director, Burning Tree Recovery Ranch

I have been blessed for many years learning from clients, families, staff and my own personal experiences about the processes that allow an individual the best chances of living a substance-free life. I have always lived my life as an individual who will call it like it is, who is up front, who tells anyone who is inquiring about the no-holds-barred truth of a situation. The truth about this inquiry is that I will not be spouting out long clinical terms that make me look smart because no one will get that. But what I can share is my experience. I can share my experience on the miracles that have happened over long periods of time. I can share my experience working with clients for over a year, helping facilitate families heal, and developing new tools for communication and functionality. Yes, I may have lots of education, but I value my experiences and I love to share with others what I see as valuable.

There are so many treatment centers in the United States that discuss how their centers and modalities are the “best.” There are many great treatment centers out there that facilitate success for many addicts and alcoholics. What I will be discussing is the type of client that cannot stay substance-free but will continue to ride on the circuit of multiple treatment centers, only to seem to fall deeper in their disease, while in the meantime exhausting all financial means for themselves and their family. Their family begs for a solution to the chaos, destruction and the wreckage that occurs in the path of the client. I am referring to the client that belongs in Long Term-Treatment. The National Institute on Drug Abuse defines Long Term-Treatment as 6 months or more in residential care. Residential care is where long term treatment is given in a setting where the individual is living at the facility, receiving clinical services and supervised by staff twenty-four hours a day. I will discuss why this is so important for the chronic substance user.

Time- The concept of time is so important. This is the first factor that most clients and their family discount. Most individuals discuss how they must return to work, their family, and their life. The truth is, most of that is wrecked anyway, not to mention possible legal consequences? Most clients that enter Long Term-Treatment have destroyed most of what they deem to be important. This delusion about “saving time” must be smashed. Without recovery, most of what they say they value, and love will be gone anyway if the time is not put into all the processes and experiences necessary for the individual to recover. In Long-Term Treatment, the staff must have time to work with the whole family, not just the individual. A family will send their loved one to treatment to fix the “identified problem,” the substance abuse. Well, guess what, that is not the case. Addiction is a family disease and we must have the time to separate each individual and help them work on themselves first. We then bring everyone back together to work on the family unit. Each individual had been playing a role that was not working. With this disease, the staff needs time to identify, solidify and unify solutions for each individual to help promote change in the family. This is a process and the process can be messy, but if everyone is willing and gets into action, change is just around the corner.

Time is very important to identify and treat the individual. Any co-occurring disorder may continue to precipitate active use. Most individuals that enter treatment have some form of secondary diagnosis, such as depression, anxiety, bi-polar, PTSD, etc. This also is why time is so valuable. Most chronic substance users have had multiple diagnoses over the years, and most of those diagnoses have been made while the client was either still using substances or in a matter of days or weeks after abstinence. What we know is that it takes time for the brain to reach some form of homeostasis. There are multiple studies that show it can take anywhere from 9 months to a year for the brain of a recovering addict to reach a baseline. These numbers all depend on the age of the individual, time in active substance use and the substances used. We must first treat acute symptoms for stabilization and then continue to evaluate the client over time to see if symptoms go away after the mind, body and spirit begin to heal. This is vital for an accurate diagnosis and the identification of the correct treatment. The process of medication management, clinical interventions and repetition will rule out what was actually behaviors and symptoms of either withdrawal from substances or active substance use.

Time is important to identify trauma in clients that have had these identified experiences. Many therapists have started using the modality of EMDR (Eye Movement Desensitizing and Reprocessing). This modality is very effective when practiced over periods of months in a safe environment such as Long-Term Residential Treatment. EMDR can be harmful to an individual when dealing with complex trauma outside of a safe environment and/or when practiced in a short-term setting. I believe it is unethical to start this treatment with an individual who will be leaving treatment in two or three weeks. There are a lot of memories and there is central nervous system disruption that can occur with this process. Therefore, the client and the therapist will need a long period of time to safely open and close each target to reach healing and a cognition shift. This is done effectively with an informed and experienced staff that can monitor, evaluate and process over time. EMDR is used in outpatient settings with clients that are more emotionally stable and have tools to deal with life on life’s terms in between sessions.

The final elements that demonstrate the importance of time are discipline and repetition. Behaviors and thought processes do not change in 90 days. Clients must have a consistent environment that pushes them to practice the tools learned. A client can be informed and given information. But if the client is not forced to put the information into practice over a long period of time, there may be no change in behavior or shift in thinking. This is vital in recovery. The addicted individual must have new muscle memory to carry out a new way of being in their new life. Change is not comfortable and most change is resisted. I always say the first step to new behavior is being “comfortable” with being “uncomfortable.” When this is acknowledged, new behaviors, solutions, and thinking can be initiated. And all of this takes time.

By: Megan Souther, Alumna

The Problem:

When working in treatment, I’ve seen and heard it all. “Drugs made me feel better at first, and then I felt empty.” “I got sober for a little while, and then the depression came back.” If drugs and alcohol were my only problem, then I would be fixed once I went detox and got it all out of my system. The problem lies in the spirit, mind and body. A spiritual malady is a “disease or ailment.” Regarding alcoholism, it means that feelings have become unmanageable. The unmanageability has nothing to do with the consequences that have occurred due to addiction. As an addict or an alcoholic, I use drugs or drink to change the way I feel. Examples of the spiritual malady are loneliness, depression, irritability, restlessness, discontentment, anxiety, etc.

Addiction is a spiritual problem that no drug or drink can fix. The Big Book of Alcoholics Anonymous states on pg. 64 that “Our liquor was but a symptom. So we had to get down to causes and conditions.” The causes and conditions are those unbearable feelings and those lies we tell ourselves that we think make it okay to get high or drunk. Addicts and alcoholics are unable to see the truth from the false. As an addict, I may think, “it will be different this time,” or “this time I won’t go to jail.” But, addicts and alcoholics use drugs and alcohol to fill a void that only a Higher Power can fix. This spiritual malady demands to be treated. I might treat it with substances, food, sex, gambling, etc., or I treat it with a Higher Power.

There are only two alternatives. One is to go on to the bitter end, blotting out the consciousness of our intolerable situation as best as we can. The other alternative is to accept spiritual help (pg.25 of The Big Book of Alcoholics Anonymous). Most addicts and alcoholics search for that third option, but they will not find it. Once the problem is clear, then the solution is attainable. But it requires action.

 

The Solution:

An internal problem can be treated with the 12-steps and by building a relationship with and connecting to a Higher Power. The 12-steps are one way that I can work towards my own recovery. Burning Tree is a 12-step program where the clients work the steps and focus on learning to cope with their feelings by building a relationship with a Higher Power. Throughout the Big Book there are promises of how to overcome the spiritual malady. By working the steps, these promises come true. An example is the 9th step promises: “We are going to know a new freedom and a new happiness. That feeling of uselessness and self-pity will disappear” (pg.85 and 86 of The Big Book of Alcoholics Anonymous). The promises of the 9th step occur when I as an addict make amends for my behavior. But the promises are all throughout the book and occur long before this step. Getting connected to a Higher Power is possible and can create a life of joy and peace. At Burning Tree Ranch, our goal is helping our clients achieve lifelong sobriety and to live happy, useful lives.