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New Freedom, New Happiness, New Year

January is synonymous with heartfelt resolutions. We tell ourselves about how this year “everything is going to be different.”  

Unfortunately, for many of us, by the time February rolls around that new gym membership is getting used less and less. We avoid even opening the closet that we swore we were finally going to organize. The diet has completely been thrown out, and we finally just delete the language-learning app from our phones.

Perhaps even more painful than any of these other failed resolutions, year after year, some of us may have told ourselves, or listened to our family members say out loud, “This is the year that I’m going to quit drinking and using.” Or at least: “This year I’m going to get things under control.”

Yet despite the best intentions, this important resolution continues to fall by the wayside. 

For 45 years we have worked with people who repeatedly have tried and failed to keep this resolution, in January and throughout the rest of the calendar year as well. Whatever they may think about themselves, it is not because they are “bad people” or that they are not “trying hard enough.” These are often the mistaken ideas people with addictions have about themselves, but they are not true.  

Rather, with addiction, we are up against a disease that is bigger than the individual. It’s something that their own willpower alone is no match for. 

We have found that with the proper clinical support, 12 Step immersion, and the residential treatment that we provide that long-term recovery is possible. This is even the case for people who have gone through multiple treatment centers and continue to relapse.

For our clients, their past failures are their greatest assets. It is the failures that help remind them that they alone are powerless over their disease. But with the right support, these past failures can be the foundation for a life full of purpose, meaning, and connection.

The 9th Step Promises are typically read aloud at the beginning of every A.A. meeting, and they boldly state, “We are going to know a new freedom and a new happiness. We will not regret the past, nor wish to shut the door on it.”

At MARR, we firmly believe that this type of complete recovery is possible for people suffering from addiction and for their family members who are suffering as well. But we also believe that it cannot be done alone. 

Our Clinical Assessment Team is available for a confidential and free conversation about the next steps you can take to get help for yourself and your loved ones. Call us at (678) 805-5100, or you can reach out via the chat box in the lower right-hand corner of our website.

Recovery During the Holidays

For many of us, the holiday season brings with it a sense of hope.

This time of year often gives us much-needed time away from our hectic work lives. It provides opportunities to reconnect with family and friends, and oftentimes, the holidays include religious observances that give people the time and space to reflect on their deepest values.

For many of our clients and their family members, recovery means slowing down, and the holidays can provide that. This change of pace can serve as an invitation to let our Higher Power come into our lives in more significant ways. A little bit of stillness can help us cut through the urgency of daily life with all its “musts” and “shoulds” and allow us to make way for the rhythms of our own souls and connection to something deeper.

But this isn’t always the case, particularly for people who are still struggling with addiction in their own lives or within their family. Rather than providing hope, the holidays can introduce increased uncertainty and pain.

Addiction is a disease of isolation, and the holidays can serve as a painful reminder of this. When addiction is part of the family dynamic, holiday gatherings intended to be restorative and hopeful may lead to revisiting painful relationships. Overpowering feelings can unexpectedly flare up in such situations. A family Christmas party can easily lead to heated disagreements, waves of sadness, a sense of loss, or other lingering difficult emotions.

Any family member of a person with an addiction has likely experienced a holiday gathering where a loved one drank too much and became a source of unwanted attention. And any person who has struggled with addiction has likely experienced the hopelessness and sense of remorse the next morning after having ruined another family gathering.

And in cases where the disease of addiction is in its later stages, friends and family members of the person in active addiction may not even have contact with them, which is painful for everyone involved.

If you find yourself in any of these difficult situations, we want to acknowledge that no matter how alone you may feel this holiday season, we can assure you that you are not. In the course of 45 years, we have worked with countless others who have been where you are and have returned to a life full of purpose, meaning, and deep connections.

Our Clinical Assessment Team is available for a confidential and free conversation about the next steps you can take to get help for yourself and your loved ones. Call us at (678) 805-5100 or reach out via the chat box in the lower right-hand corner of our website.

The first step away from isolation and desperation towards connection and hope usually involves reaching out to talk.

Solving the Puzzle of Addiction

Kimberly Alexander, MBA, LPC, CPCS
Chief Clinical Officer

The original 3x3x3 Rubik’s cube has 43 quintillion (43,252,003,274,489,856,000)  possible combinations. This number is so big that it’s difficult for most of us to even comprehend it in a concrete way. But despite the massive number of possible starting points, the approach to solving a Rubik’s cube is the same every single time.

The solution lies in algorithms or sequences of moves. The key to solving a cube quickly is committing the algorithms to memory and learning to recognize patterns that require specific algorithms.

Recovering from drug and alcohol addiction is like solving a Rubik’s cube.

Recovering from drug and alcohol addiction is like solving a Rubik’s cube. That may sound cryptic or over-simplified, but the parallels remain true.

Addiction is a chronic disease characterized by compulsive, substance-seeking behaviors without regard for the devastating consequences that follow.1 The consequences of addiction often include legal repercussions, financial devastation, physical maladies, and the loss of meaningful relationships. Each case of addiction is as unique as the individual who is suffering, but there will always be common symptoms, behaviors, and consequences when we look for them.

In the case of a Rubik’s cube, there are numerous algorithms that can be used to solve it, but the actual process is always completed by focusing on each layer, one at a time. The same steps–done in sequence–will solve it every time. And the algorithm works regardless of whoever may be responsible for scrambling the cube.

The first layer is done intuitively. This means following practical steps and committing to the process, knowing it will require doing some hard work on your own. The second and third layers require repetition until the cube is solved. If you don’t keep going, the cube won’t get solved.

Doesn’t that sound familiar?

The same is true in recovery. Regardless of when or why addiction has developed and progressed, there are core principles of treatment that can successfully address the core issues if the person is open and committed to recovery.

The parallel between the algorithms of solving the Rubik’s cube and the steps towards recovery from addiction is in the process. Think of this process as the 12 Steps of Alcoholics Anonymous (AA).  Each step, when worked carefully and seriously, can lead to lifelong recovery. The 12 Steps are meant to develop behaviors that allow the individual suffering from addiction to gain insight and support to maintain sobriety in any circumstance.

Principles of Effective Treatment

Addiction is absolutely a treatable disease. Much like recognizing which algorithm is needed for a specific scramble of a Rubik’s Cube, addiction treatment must be individualized. So while no one treatment is right for everyone, several studies indicate that long-term treatment are more successful in terms of both lower relapse rates and longer length of sobriety.2 

Because addiction affects both the brain and behavior, effective treatment should address both.  Effective treatment addresses all of your needs, not just your substance use.3  These needs include addressing medical concerns and also co-occurring disorders like depression, anxiety, or past trauma. 

When seeking treatment, you should look for treatment programs with both a history of success and core character-based qualities, such as integrity and spirituality. A program with proven success will include:

  • Individual and group counseling
  • Clinically trained staff members (which should include a board-certified psychiatrist or addictionologist), licensed behavioral health clinicians, and medical and non-medical staff including NPs, RNs, and assistants 
  • Comprehensive clinical programming that contains psychoeducation and treatment strategies for both addiction and non-addiction related client concerns
  • A treatment component for family members
  • Strong partnerships in the community to ensure quality referrals for clients when it is clinically necessary

With clinical treatment and the support of a community, recovery is not only possible, it is probable and sustainable. Recovery can lead to a rewarding and fulfilling life of choices that cultivate joy, peace, and healthy relationships, built on a foundation of perpetual hope. Effective programs support successful recovery and give those who are battling addiction the skills and experience necessary to maintain recovery into a future of uncertainty. 

Developing sustainable recovery skills is like memorizing the algorithms for solving a Rubik’s cube. With practice, you will learn to discern the circumstances that call for each of your tools.

Algorithms: Your Tools for Maintaining Recovery

  •  Stay connected to a recovery network
    • Although many AA and NA meetings have stopped meeting in person in the midst of COVID-19, most have begun using online platforms. Now is the ideal time to connect to a larger network of supporters than normally possible.
    • Initiate conversations with a sponsor for support and accountability.
    • Take time to read books or articles, or listen to videos or podcasts that are recovery-focused. Our Stories of Recovery Podcast could be a good place to start (https://www.marrinc.org/resources/marr-podcast/).
  • Avoid isolation and idle time
    • In a time where many things are far from “normal,” it is especially important to find ways to avoid isolation.
    • Call, video chat, or plan a safe way to commune with friends and loved ones.
    • Create an agenda for your day that includes activities that will help you be and feel productive. Finish home projects you haven’t completed. Instead of binge-watching television or mindlessly surfing the internet, try productive activities like reading self-help books.   
  • Make self-care a priority. Find healthy ways to manage stress.
    • Get moving! Exercise. Go for a walk/run. Garden or fish. Make healthy eating choices and get the rest you need. 
    • Meditation and spirituality practices can reduce the anxiety about the uncertainty of everything around you.
  •   Don’t beat yourself up if you relapse. Seek help.
    • Relapse does not have to be the end of the story. Don’t beat yourself up.  You can still make healthy choices, but it may be too challenging to do alone. A global pandemic is a rare opportunity to take the time you need to tend to the problem before it wreaks more havoc in your life.
    • If you are currently struggling with excessive drug or alcohol use, call our Clinical Assessment Team at 678-805-5100. We can help you get back on the road to lifelong recovery.

The goal of treatment is recovery. Recovery begins with sobriety and evolves into a high-quality of life that restores identity, dignity, and peace. It is an ongoing process of growth, accountability, learning, and adjusting. With effective treatment and a recovery network, you can continue to learn the algorithms that work for you. Once you commit to the process, you will begin to see that the solutions really can work and that a life of recovery is possible.

 

References

  1. NIDA. 2020, July 10. Treatment and Recovery. Retrieved from https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery on 2020, August 16
  2. Greenfield L, Burgdorf K, Chen X, Porowski A, Roberts T, Herrell J. Effectiveness of long-term residential substance abuse treatment for women: findings from three national studies. Am J Drug Alcohol Abuse. 2004;30(3):537-550. doi:10.1081/ADA-200032290
  3. National Institute on Alcohol Abuse and Alcoholism. (2020). [Website]. Retrieved at https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/understanding-dangers-of-alcohol-overdose

 

Mindfulness & Addiction

By Matt Wagner, NCC, LPC
www.mattwagnerlpc.com

Matt Wagner is a Licensed Professional Counselor who has a private practice in Decatur, Georgia. He specializes in guiding his clients through mindfulness, meditation, and tapping. As one of our trusted partners in the community, we asked him to contribute this article. 

Addiction is a disease that affects brain chemistry and the ability to recognize where one’s choices to use substances are no longer their own. In fact, when a person experiences the cycle and symptoms of addiction, their brain misinterprets thoughts, emotions, and physical sensations that are usually associated with ”using” (a phrase that in this article will be used to refer to either drinking alcohol or taking in illicit substances) as survival instincts. Such a dynamic will reinforce the user’s behaviors and further strengthen the importance and desire to continue use. By raising awareness to these thoughts, emotions and physical sensations, one can learn to apply Mindfulness, a practice that helps to increase observation and recognition of addictive behavior.

External interventions for treating a person with addiction are currently well known and often a first step towards initiating change for the user. The phrase “external interventions” refers to what other people will do to try to make the person stop using. Some examples of what others might do include confronting the addicted person, removing substances from the house, cutting off access to the person’s substance of choice, and many more. For a period of time, these approaches may work, but often, in the case of addiction, the addicted person will find a way to get around these obstacles set out by others.

Internal interventions, however, have the potential to help the addicted person navigate through Stages of Change (in order: pre-contemplation/denial, contemplation, preparation, action, and maintenance; relapse can occur at any point and lead a person to a previous stage), and arrive at a place of action from a deeper level. “Internal interventions” refer to the experiences one has when they are able to notice for themselves that their drug or alcohol use is no longer serving them and is in fact endangering their lives and potentially the lives of others. These moments can occur at any time during addiction or in recovery and can often be a sign that a person is entering a new Stage of Change.  

Default Mind Behaviors

When a person experiences addiction, their mind engages in common, automatic thinking processes. Some of the most common thought processes include:

  • Denying that a problem exists
  • Justifying their behavior
  • Blaming their problem on situations or people in their lives
  • Minimizing the extent of their use or comparing themselves to others who are worse off
  • Ruminating on how to get the substance again
  • Romanticizing who they are when they are under the influence, which can lead to a false identity
  • Experiencing high levels of dissatisfaction with situations not including their substance of choice.

These symptoms are most often not intentional by the addicted person themselves; rather, they are experiencing Default Mind behaviors that are symptomatic of the disease of addiction.

Default Mind behaviors occur within every person, regardless of whether or not the person is addicted to a substance. The term “Default Mind,” also referred to as “Default Mode Network,” is used to describe unintentional thinking processes, which often arise when a person’s mind is drifting, wandering, or is uninterested. Consider different times when you might experience Default Mind behaviors by reviewing the following questions:

What do you think about when…

  • You try to go to sleep?
  • You’re bored and unstimulated, or zoned out?
  • You are doing a very simple task, such as washing dishes or folding laundry?
  • You have so much going on in your life that you are unable to focus on what is in front of and around you?
  • You’re on a familiar commute where you don’t have to pay too much attention to turns, directions, etc.?

During these moments, is your mind paying full attention to what is happening in front of and around you? If not, you are likely experiencing Default Mind behaviors when your mind is thinking of anything other than the present moment. Default Mind behaviors have been found by neurologists to identify specific areas of thinking, which include: dissatisfaction with the present moment (what this author is calling “Resistance”); worry about the future and wanting to change experiences from the past (“Time Travel”); viewing situations and experiences from a first-person perspective (“Self-Referential Processing”); and comparing oneself to other people, for better or worse (“Social Comparison”).    

The behavior referred to here as Resistance is describing our disapproval for what the current situation or moment includes. This is not necessarily an intentional thinking process (none of the areas of the Default Mind network are), but an internal cognitive response that automatically comes up when something we view as unpleasant happens.

Time Travel consists of our mind thinking about desired experiences for the future, which can include planning, coordinating, intending, creating a mental to-do list, etc. This also includes reflecting on experiences in our past and wishing they were more enriching or pleasant. 

Self-Referential Processing is experienced when our mind relates any situation back to “me” and how “I” am affected, as opposed to considering how events affect other people.

Social Comparison happens when we notice something about ourselves personally, and think whether or not this is normal, if we’re as good as others who do this thing or if we’re better than everybody else, etc. The phrase “keeping up with the Joneses” can fall into this category. 

Consider the Default Mind behaviors mentioned earlier for a person addicted to drugs/alcohol (denial, justification, blaming, minimizing, ruminating, romanticizing/glorifying, resistance). Each of the examples mentioned, as well as additional addictive behaviors, fall into these four categories of Default Mind network.

The emphasis of Default Mind behaviors is not done to shame or point out that these processes are wrong or that they should be avoided. Instead, it is to normalize and accept that these are naturally occurring experiences of the human mind, and to recognize that it is our relationships to these events that determine our resistance or willingness to engage in them. 

Mindfulness as a Tool

This is where Mindfulness can impact our experience with Default Mind behaviors as well as addictive processes. Jon Kabat-Zinn, a well-known advocate of Mindfulness and author of several books on the subject, describes Mindfulness as a practice of increasing our awareness to the present moment, and to do so intentionally and without judgment. By practicing Mindfulness, we can become more aware of the thoughts that emerge in our minds and notice our initial reaction to those thoughts. Rather than reinforcing the resistance and struggle that can come up in reaction to certain thoughts, we can instead learn to accept that our minds, to a certain extent, behave on their own. Bearing witness to this process – of noticing what happens in our minds without any judgment or admonishment – leads to higher levels of self-acceptance and can greatly diminish the dependence our minds and bodies have on external sources of validation and satisfaction, especially when those sources consist of illicit substances. Note: Mindfulness is not enough to overcome situations in which a person needs a medical detox to come off a substance (alcohol and benzodiazepines).

The process of acceptance that is such a vital and important part of Mindfulness does not always coincide with approval or agreement. When moments like this come up, Mindfulness encourages you to notice and observe both what is going on outside of you, as well as within. Observing a resistant voice that shows up in your Mind can help to create space between thinking the initial thought and acting on it. In the case of a craving, a person can identify that their Mind is thinking about drinking, and with curiosity, notice what physical sensations are felt throughout the body. By observing these physical sensations, or perhaps noticing other thought processes that occur after the initial thought of drinking (i.e., glorifying, ruminating, excited anticipation), a person can make space for them to exist, instead of resisting them and being so uncomfortable with them that they have to act on the thoughts.

Putting it to Practice

The how of Mindfulness consists of where to begin. You might be thinking “how do I observe these thoughts?” or “how do I notice physical sensations and sit with them?” The most accessible point to beginning a practice is to purposely focus and concentrate on present-moment sensations and experiences. Your breath and body are two grounding points, or anchors, you can always pay attention to at any given moment. The points of focus are often used in meditation, in which non-judgment and willingness to observe the present moment is practiced intentionally.

If you’ve tried meditation before and struggle with it, consider anticipating the struggle, to expect that your mind will definitely wander and drift. This is essential for meditation, much in the same way that resistance is needed in physical exercise. Each time you realize that your mind has wandered off, returning your focus to the present moment will strengthen your awareness. By doing this, you will also increase the likelihood of enriching active moments throughout your day, thereby making life more fulfilling and meaningful.

An example of a Mindfulness thinking process might go something like this: notice how your body expands when you breathe in, and then how it changes when you breathe out. What changes in that process? How is your next in-breath different than the one before? The realizations of this practice may not be mind-blowing or seem particularly interesting at first, but the practice of strengthening your awareness and sitting with resistance, unpleasantness, uncertainty, and dissatisfactory experiences will eventually lead to a greater tolerance for such moments.

The practice of Mindfulness also applies to your immediate environment, which can often be ignored or unnoticed if the scenery is not spectacular. Grounding Techniques are routines to intentionally notice your surroundings and increase your appreciation for them. One such example is called “5-4-3-2-1,” and it involves observing items by activating your five senses. To do this, name five things you can see, four things you can feel, three things you can hear, two things you can smell, and one thing you can taste. If you can’t name enough items for a particular sense, notice that your thinking Mind (prefrontal cortex, where rational thinking occurs) is looking for information, a process which decreases the activity in the emotional Mind (midbrain, where addictive thinking occurs). 

Mindfulness practices can also be useful for family members who are affected by a loved one’s addiction. Just as an addicted person experiences dependence to their substance, a family member will experience similar default behaviors towards their loved one. (For example, a family member might deny their loved one’s alcohol problem, much in the same way that the alcoholic will deny a problem with alcohol.) By practicing Mindfulness techniques, a family member can experience appropriate detachment, and thereby help themselves before helping others. 

In closing, the steps of Mindfulness are simple, but not easy, so let it be a gradual process in getting started. Receiving help in Mindfulness training can be available through therapists, treatment centers, or local Mindfulness groups, some of which meet virtually. Building a practice can be done in just a few minutes a day, adding on time as you see fit. Meditation and Grounding Techniques can help with this as you get started. Regardless of where you are in your recovery, if you are a day in or have years at this point, Mindfulness is an invaluable tool to help bring awareness to automatic thinking, and thus create an opportunity to do something different. 

 

The Paradox of Grief & Gratitude

“Grief and gratitude are kindred souls…each pointing to the beauty of what is transient and given to us by grace.” – Patricia Campbell Carlson

Some of the most powerful and potent truths of life are held within paradoxes. Like this one: grief & gratitude. If you are in the process of grieving, gratitude may be the last thing you want to think about. It may even spark feelings of anger or frustration. You may think: How can I be grateful when I have lost someone or something that was so important to me? 

The “Right” Way to Grieve

When we experience loss, whether it be that of a loved one, a relationship, a life we once lived, or even a part of ourselves, grief is a common emotion. We feel a deep sorrow or emptiness, because something that was once an important part of our life is now gone. It is important to accept all of the complex emotions that come with loss. Grief is a universal experience, but that does not make it any easier to understand or navigate. 

After years of extensive work with terminally ill patients who were near the end of their lives, Dr. Elisabeth Kübler-Ross famously outlined the five stages of grief as it relates to death: denial, anger, bargaining, depression, and acceptance. But these are not meant to be an exact roadmap, nor do they always occur in this order. Everyone experiences grief differently, and we may go back and forth between these stages, or skip some altogether. There is no “right” way to grieve. We are allowed to feel intense emotions. We are allowed to acknowledge the pain and the feeling of hopelessness.

Grief often comes as a result of things that we cannot control: sickness, accidents, or other people’s decisions, to name a few examples. We cannot control whether or not we grieve. However, there are parts of the grieving process that we can control. 

As the Serenity Prayer states, “Grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.” When we can begin to make a distinction between the things we cannot change and those we can change, there is simultaneously a declaration of powerlessness and power. There are some things we can change–even in the midst of grief.

We get to choose how we cope with our grief. If we do not allow ourselves to grieve externally, grief that is trapped inside will likely become even more consuming and destructive. As we begin to walk the path of grief, there is the possibility of using  negative coping mechanisms like isolation, using drugs or alcohol, and other self-destructive behaviors. Then there are positive coping mechanisms like counseling, connecting with loved ones, meditation, or a practice of gratitude.

Grieving with Gratitude

In times of intense grief, gratitude probably does not exist naturally. It is something that we must choose to practice. Cultivating a practice of gratitude in a time of grief can be a powerful step towards taking control of your own thoughts and actions. As outlined in our previous article, Gratitude | The Opposite of Addiction, practicing gratitude can have positive effects on mental health, connection in relationships, and the brain itself. But especially during periods of grief, gratitude holds a distinct power.

It may seem counterintuitive at first, being grateful during a time of pain. And if you have never had a gratitude practice before, it may feel like exercising a new muscle–very unnatural at first and most definitely sore at some points. Although the grief will not disappear, gratitude can radically change the grieving process by reframing the way you think about your own experience. Now let’s consider a few ways that gratitude may shift our thoughts and experience.

First, it may be helpful to note that the sheer fact that you are grieving may be a reason for gratitude, because if you are grieving, you had something to lose. Whether it is a person, a relationship, or a part of your life, you experienced something that was so important to you, that its absence is painful. Could we consider being grateful for that experience, even if it is in the past now?

Second, gratitude can be a way of fully experiencing the present moment. When we notice things that are here right now, we become more grounded in our own reality. Becoming present is not meant to lessen or erase the past, it is meant to help us move through our hours, days, and months mindfully and stay aware of what we are experiencing. Grief can often become a blur of time and reality as it pulls the rug out from under us and we try to remember how to navigate through our lives. Gratitude exposes things that are happening right in front of us that we may not otherwise notice. 

“I am grateful for the sunrise today.”

“I am grateful for the people who are here to support me.”

“I am grateful for the body that carries me.”

Third, gratitude can transform your connections with others during the journey of grief. Grief is often accompanied by isolation, mentally, spiritually, and physically. It is natural to feel like no one can understand the feelings of loss and emptiness that we are experiencing. But as we stated earlier, grief is a universal experience. Anyone who exists long enough will experience loss and grief at some point. And although everyone has unique and individual experiences of grief, there is common ground to be found. If we allow gratitude to keep us grounded in the present, we may look around and see people who are ready and trying to support us. 

If we choose to really engage in the journey of grief, we will probably even find people who have experienced pain that is very similar to what we are feeling. And all of a sudden, grief doesn’t have to be quite so lonely. We can see someone who is a little ahead of us on the journey, and it might bring a semblance of hope. And as we go, we can look back and guide those who are behind us, letting them know that the future is brighter than they can imagine right now.

A common experience of grief is an inability to imagine what your life might look like in the future. It can be so difficult to picture yourself being content without having whatever it is that you lost. Gratitude can help transform that; not all at once, but just the slightest bit each time we practice, by allowing ourselves to see that there is still good happening around us. And then eventually we might see that there is still good happening within us, walking hand in hand with our pain.

Gratitude is not a medication for the pain of loss. It is not meant to end your grieving or make you forget. It is a shift in perspective, and nod of your head and your heart towards what was good and what is good.

Women & Treatment: What gets in the way?

Lauren Davis, MS, LPC, Director of Admissions
Kristen Render, LMSW, Assistant Director of Admissions 

When it comes to getting treatment for substance use disorder, women are generally more likely to be faced with obstacles and are overall less likely to seek treatment than their male counterparts. This is true nationwide, regardless of sexual preference or marital status, although heteronormative family structures do perpetuate it. At MARR, our Clinical Assessment Team observes this trend every single day. We see, on average, more than twice as many admissions to our Men’s Recovery Center compared to Traditions Recovery Center for Women, even though the structure of these two programs is very similar. 

We hear from family members and loved ones every day who are all facing the same challenges in getting treatment for the women in their lives. This may not be your experience, but it is important to acknowledge this overarching trend and some of these specific obstacles, especially if you have a female loved one who may need treatment for substance use. Knowing some of these barriers up front can foster more productive conversations in the process of considering treatment.

Common Obstacles

Oftentimes in women, it is not as obvious that a substance abuse issue exists. Women are generally more open and honest about things like depression, anxiety, disordered eating, and medical problems than men are, so substance abuse is often masked by these other issues. These struggles are also generally more accepted and deemed as more “normal” in females. It is normalized for women to suffer from anxiety or disordered eating without getting treatment, but when men are suffering from the same issues it is deemed a more pressing issue. 

Due to the barriers to accessing treatment, it typically takes women longer in their disease before becoming willing to enter treatment. In that time, women tend to develop stronger skills of being secretive and manipulating those around them. Many of our female clients enter treatment with personality disorder symptoms that result in excessive manipulation and difficulty regulating their emotions. Women are used to just saying, “It’s okay.” They quell the worry of those around them and they even convince themselves that they do not need help. Even if a female client begins to acknowledge her suffering, it is often so radically minimized and delusional that it is difficult to determine whether she even sees it as an issue.

Women also often hold and internalize a lot of shame. Oftentimes in addiction, this shame grows and manifests as denial, both for themselves and for their families. The family members of women that we talk to have often spent months or even years feeling like they are walking on eggshells. Families are scared of how the women they love are going to react, afraid that they will be met with anger or intense emotion that they won’t know how to navigate.

Women are also more likely to have suffered from some sort of biological trauma in their history. They may have had a physically, sexually, or emotionally abusive relationship that led them to using substances. They also may have suffered from reproductive issues like infertility or miscarriage . While these traumas may have initially led them to start using, they often become a justification to loved ones: Just leave me alone because I am dealing with ___________. And families silently allow the substance abuse  to continue because they feel pity or guilt.

 One of the biggest obstacles for women getting into treatment is the dynamic and well-being of their household. The thought of leaving their children for any period of time can be a huge strain on women. If they are the ones taking care of the household–cooking, cleaning, watching the kids–they question how these things would be maintained in their absence. Also, families are often less likely to spend money on treatment for a woman if she is not working, because they do not have the incentive of trying to preserve a job and an income through treatment. However, if a woman works and runs the household, this turns into a different challenge, because the family would be losing income as well if she left for treatment. These obstacles are all a reflection of this reality: women tend to not put themselves first. They prioritize others, even when it ultimately means not getting what they need to be healthy.

Family dynamics often pose a huge challenge to women getting treatment as well. In general, families are more dependent on women to maintain a sense of normalcy, and therefore less likely to push them to get treatment. In heterosexual relationships, husbands tend to have some level of codependency with their wives and are not often willing to hold boundaries and push them into treatment. Families are more willing to accept a substance abuse issue in a son or husband than in a daughter or wife. Substance abuse issues in women are often written off as stress, anxiety, or depression.

COVID & Treatment

In the past six months, COVID-19 has changed a lot of things in our society, including the dynamics of entering treatment for substance abuse. 

For many women, this transition has caused a lot of stress and has created an environment in which they can no longer keep up with everything that is being asked of them: being a full-time mom, a teacher, and possibly still keeping up with their own career. The normal busyness and “go-go-go” schedules have ceased. More time at home has created more stillness and caused women to sit with feelings of discomfort that they have ignored in the past. In many cases, this leads to an increase in drinking or using as a way to cope with all the feelings that are emerging. In other cases, their “hiding place” has been taken away–with spouses and other family members at home, their substance use becomes more noticeable or obvious.

On the flip side, we are seeing that COVID has actually created some unique circumstances that are allowing some women to enter treatment who otherwise would not have done so. Having a spouse or other family member at home consistently lessens women’s fear of leaving the household, because someone else will be there to take care of it. A halt in social obligations and activities has actually created space and possibility for many women to consider taking a break to go to treatment. Before, the thought of being away from home for three months may have caused a lot of shame, guilt, and embarrassment, but this shift in social obligations makes it a lot more feasible. 

What’s Your Story?

These dynamics and examples are not relevant for every family, but it is important for us to recognize some of the overarching trends that we see happening every day in the families that we work with. If you or your loved one is experiencing something different, we will walk with you through your unique circumstances, regardless of your history or family structure.

The most important thing to know is, regardless of your journey, you  are not alone. Our Clinical Assessment Team is here to support you and walk with you through the process of getting the best treatment possible, even if that’s not at MARR.

Getting yourself or a loved one into treatment can often be a messy and complex process, but it can also be the best decision you’ve ever made.