Wednesday, February 27, 2013

A Boundary is Like Your Skin- Don't Leave Home Without It!

People will often experience stress, depression, anxiety and/or addiction as a result of what’s going on in their relationships. Often this is due to a lack of a healthy boundary between ourselves and our own needs and the needs and expectations of others. Poor boundaries will often lead to unhealthy relationships, stress, depression, anxiety and addiction, not to mention poor self esteem!

So, what is a boundary? The simplest and most common analogy that clarifies what a boundary is and the importance of having boundaries …is one of the most obvious and easy to remember….your skin!

Our skin is a boundary. It keeps our insides protected from the outside environment. Imagine what your life would be like if you didn’t have any skin? Life would be quite difficult if all of our internal parts were exposed to our external environment, the scorching heat, cold frost, prickly plants or our pets jumping on our bodies … ouch! Imagine what life would be like without that boundary.

Having boundaries is key to living a healthy and happy life. Think about it, even though our skin is a boundary for our internal tissue, we protect our skin by shielding it with clothing, protective sunscreen or other protective cover to ensure that our skin is able to do its job which is to protect our insides. If we didn’t have this protection, we would start to feel pretty exposed, burned, cold and perhaps feel violated both literally and figuratively.

Did you know that nobody respects a person who they can use? People will often use people they can use, and respect people they can’t use. What are your needs? Perhaps it starts with the need of setting a limit asserting yourself by saying “No” to what you don’t want anymore.

Best of health and warmest regards, Paul Radkowski

Monday, February 4, 2013

Adverse Childhood Experience Study - Is your past childhood trauma slowly killing you? Part 2

Welcome back, so in the previous post we talked about how trauma can cause severe and chronic stress and that the majority of us have had at least one Adverse Childhood Experience.

What does this all mean? Again, trauma is much like a 3rd degree emotional burn that lingers long after you have gotten out of the fire.  If you have a major burn, it kind of makes sense why someone might want to use to soothe and resort to an addiction as an attempt to have an outlet.

Trauma is a form of severe and chronic stress which can translate into someone having the kind of core beliefs previously mentioned:
  • I‘m not safe
  • I can‘t trust anyone
  • Feelings are bad (or ―I‘m bad, weak, a failure)
  • I can‘t handle it (life, feelings stress etc)
  • I have to be in control
Having even one of these often ongoing core beliefs can activate the stress response where the body produces high amounts of the stress hormone cortisol (among others). This is good in the short term if you have to run for your life, not so good in the long term as it will beat up your immune system, shrink cells in your brain (how is that for making ―good decisions while stressed) and as shown in the graph you were introduced to earlier, can result in disease, disability and early death.

Beliefs become biology and beliefs coupled with unhealthy ways of coping by using to soothe, e.g. smoking, drugs, gambling, over eating (obesity), lead to an even greater effect on biology (i.e. your body). If you have a core belief that you are not safe, and feel as if you are always in emergency-survival mode‖, then this will result in major physical and chemical reactions juicing up your body. And so I ask you one simple question, ―how long can you expect to run a car at 10,000 RPM‘s before something breaks down?

An interesting example of this is a UCLA study that measured the immunity of actors. Take a group of actors and have them spend a day acting out a stressful, depressing scene and their ―immune responsiveness is impaired. Have the same group of actors spend a day on a happy, uplifting scene and their immunity is better than baseline i.e. normal (Futterman, A., Kemeny, M., Shapiro, D., & Fahey, J., Psychosomatic Medicine 56 (1994):499).

Imagine what it‘s like to not just act out an emergency every day but actually live it every day. Imagine being on the edge of ―survival‖ for years and years. The end result, survival is indeed affected pushing your health more and more to the edge of the cliff (disease, disability, early death).

Of course these issues can make a huge impact on relationships later in life. It‘s difficult to know or be in a healthy relationship, if you have never seen one before.

Fortunately, there are things you can do about it. For example, Cognitive Behavioural Therapy, exercise, relaxation techniques can tip the scale more in your favour towards greater health and longer life.

Finally, just a bit of a word regarding stigma. The issue of stigma i.e. not seeking help for fear of judgment by others (including mental health professionals) is a huge concern for many people struggling with addiction, mental health and trauma issues and is one of the big determinants of people not seeking help (National Co-morbidity Survery 2005).

Trauma creates a "third degree emotional burn" for its survivors and addiction becomes more obvious as an attempt to soothe from painful emotions. Clinicians and treatment centres not taking a trauma history from their clients or not operating from a trauma framework, are at risk of doing greater harm to its clients and possibly re-traumatizing them.

I believe it‘s in the highest interest of the individual not to go around with a guilt or self blame statement of ―What‘s wrong with me? i.e. what‘s causing me to use and feel so weak as a person. Instead this trauma model enables a more compassionate question: What happened to me? i.e. that has lead me to feel so beat up and want to use to soothe? The past does impact the present. This beat up, anxious, overwhelming, depressed feeling I‘m feeling might be a normal response to incredible and ongoing stress.

Please don‘t let the years go by with your problems getting worse and worse before you do something about it. You deserve better for yourself.

Best of health and warmest regards, Paul Radkowski
Psychotherapist, CEO/Clinical Director, Life Recovery Program

Saturday, February 2, 2013

Adverse Childhood Experience Study-Is your past trauma slowing killing you? Part 1

Trauma often creates a state of severe and chronic stress. It is akin to a 3rd degree emotional burn that lingers long after someone has gotten out of the fire.

One landmark study, the ACE (Adverse Childhood Experiences) Study is the largest study of its kind ever conducted (more than 17,000 study participants) to determine the range of how adverse childhood experiences and health related outcomes and addictions intersected. The effect studied was unprecedented.

The Centre for Disease Control teamed up with Kaiser Permanente to develop:
"… a large-scale epidemiologic study of the influence of stressful and traumatic childhood experiences on the origins of behaviors that underlie the leading causes of disability, social problems, health related behaviors, and causes of death in the United States. Unlike most prior studies in this area which had tended to focus on single types of childhood abuse (especially sexual abuse) and specific health problems (usually mental health issues), the ACE Study was designed to simultaneously assess childhood exposure to multiple types of abuse, neglect, domestic violence, and types of serious household dysfunction such as substance abuse.‖ ( pg. 3)

The ACE study revealed that the majority of participants had experienced adverse childhood experiences (i.e. trauma‘s) 50 years earlier and that most of us are not just subject to one adverse condition (i.e. having an alcoholic parent and everything else is perfect) but in fact groupings of toxic experiences.

Among the Initial ACE Study Findings: ACEs Are Common
  • Two-thirds of participants reported at least one ACE

ACEs Tend to Occur in Groups
  • Of persons who reported at least one ACE, 87% reported at least one other ACE.
  • 70% reported 2 or more others, and more than half had 3 or more others!
  • Only 1/3 of those studied had not had adverse experiences and for those that did, their past was still affecting them (their health) 50 years later. The adage of ―Time will heal all wounds‖ just doesn‘t add up.
How does this relate to addiction?
Of those with higher ACE scores here are the results:
When compared to persons with an ACE score of 0: Those with an ACE score of 4 or more were
  •  twice as likely to be smokers
  •  12 times more likely to have attempted suicide
  •  7 times more likely to be alcoholic and
  • 10 times more likely to have injected street drugs.

The behaviors such as alcohol or drug abuse, smoking, or sexual promiscuity are likely the result of the effects of ACEs on childhood development, which we now know to be neurodevelopment. In many, if not most cases the behaviors may act to alleviate the emotional or social distress that results from ACEs. Thus, these behaviors, typically considered to be problems, continue because they function as short-term solutions, even though they have detrimental, long-term effects. The findings from the ACE Study suggest that problems such as addiction frequently have their origins in the traumatic experiences of childhood (pg.3)"

More of these findings will be discussed in the next blog.
Best of health and warmest regards, Paul Radkowski
Psychotherapist, CEO/Clinical Director, Life Recovery Program