Midwest Psychiatric Center, Inc. is a private psychiatric practice owned by my colleague, Dr. Rakesh Kaneria. I provide therapy to adults and a small number of children/adolescents at this location. We can accept most commercial insurances, as well as Caresource (of Ohio Medicaid) and Medicare. Adult clients who work with me at MPC also have the option to see Dr. Kaneria for evaluation and medication management if desired or needed. Child psychiatric evaluation and medication management are not available with MPC. We are located in West Chester, OH near the UC West Chester Hospital, just off I-75, between Liberty Way. and Tylersville Rd.
When scary things happen, like the terrible shooting in Dayton last night, it’s good to make an effort to restore feelings of safety as much as possible. That’s one of the reasons the Dayton Convention Center has been converted to a Family Resource Center to help people reunite with loved ones and get and feel safe again.
I was not directly affected by the shooting, but someone very dear to us was there and played an important part in helping the victims of the shooting. The Oregon District has been a place I’ve enjoyed good food and friendship. This horrific shooting rocked my sense of safety in very new and real ways, and I am brokenhearted for the city I call home.
Trying to find some reassurance and calm again, I went to two places today that reliably help me settle down: my church and the farmer’s market. The opportunity to cry, pray, sing, and receive some comforting words from our associate pastor did wonders for me, but I still needed more. So this afternoon I went to a farmer’s market near our home. It smelled of sweet melons that were warm from the sun. I took my time looking and smelling and picking. I chatted with the kind woman working there. Soon I felt a little more relief.
If any of you are feeling unsettled, frightened, or unsafe after the news of the shootings that have occurred in El Paso and Dayton, or certainly if you were directly affected by these incidents, I encourage you to take some steps to help reassure you body and your mind of your current safety. We cannot guarantee safety everywhere 100% of the time, but we can seek out moments of calm and safety when we need them.
One tool that I teach many of my clients to help find some calm when life feels chaotic or scary is a resource called “The Calm Space.” It’s a very simple visualization technique that can help settle the body and the mind, releasing tension, quieting racing thoughts, and slowing down the activated central nervous system. It’s a fairly simple process.
To start with, find a physical space where you can sit or lie still with minimal distractions. You might have to tell people around you to not bother you for a few minutes.
Get in a comfortable posture in which your body is supported, like lying down on your back or sitting in a comfortable chair.
Start to deepen your breathing, making sure you take full breaths that cause your belly to expand, as opposed to a shallow breath that makes your shoulders move a lot.
Begin to picture in your mind a place where you feel calm and safe. It can be made up or real. It could be the beach, a field of sunflowers, a cabin by the lake, or even a space in your own home.
Once you have the place in your mind, bring up the sensations that you enjoy in that place: the things you see (colors, shapes, movement), sounds (distinct sounds or ambient noise), smells, tastes, and things you can feel through the sense of touch (temperature, texture, objects to hold). Take your time to enjoy these pleasant sensations and savor them.
If you like, pick one specific detail to focus on for a new moments – for me right now it’s the smell of the sugar cube melons at the farmer’s market!
When you’re done enjoying your calm space, slowly and gently start to shift your attention back to the present moment, maybe by noticing the breath or the sensations in the space where you are sitting/lying.
Notice how your mind and body feel different now.
The Calm Space resource is a great way to help relax a tense body and quiet an overactive mind. It’s best to use this when you intellectually know you are safe, but you body and emotions cause you to feel unsafe. Do not use this resource if you are currently in a dangerous environment or one that requires alertness like while driving a car.
Resources and coping skills like this can help you manage between counseling sessions are while you are working on setting up counseling services, but they do not replace psychotherapy. If you are in need of crisis services or ongoing counseling help is available. If you have medical insurance, your insurance card will have a phone number on the back that you can call to find a counselor. You could also try doing a provider search on your insurance company’s website. Another resource for those with and without insurance in your county’s mental health board. A simple google search will likely help you find a phone number for them. You may also call my office at 513-217-5221. If I cannot help you myself, I will help you find someone who can!
Originally published in 1995, Gary Chapman’s book, “The Five Love Languages: The Secrets to Love That Lasts” has become a very popular reading choice for couples looking to deepen, strengthen, and maintain the love that forms the foundation of their relationship. The subsequent editions of the book have been updated and the author has also written additional books applying the Five Love Languages to the unique needs and experiences of children, teens, and men.
Chapman identifies the Five Love Languages as:
Words of Affirmation
Acts of Service
His premise is that we all give and receive love in different ways, but we can run into trouble in relationships if we are not “speaking the same language” as our partner. We can miss expressions of love from our partner if we’re not away of the way they say “I love you”, and we can be misunderstood just the same.
As a Baptist Pastor, Chapman’s presentation of the Five Languages takes a very Biblical and Christian slant, though his degrees in Anthropology clearly inform his work as well. Though the book has a “churchy” feel in a lot of ways, I believe non-Christian readers can certainly benefit from the book.
For those who find the book helpful, online resources on the Five Love Languages (including a really fun test you can take to identify your love language!) are available at www.5lovelanguages.com.
I give this book a B+.
Chapman gives practical advice that can be applied in everyday life, which is one of the primary things I look for in any self-help book. I love the specific instructions and guidance he offers of things to try, even in the most challenging of relationship dynamics (see Chapter 12: Loving the Unlovely). One recommendation Chapman encourages that I find essential for a healthy relationship (and I’m speaking as both a therapist and as a married woman) is prioritizing a regular date night. He even offers solutions for prioritizing time together when schedules and budgets are tight.
I do have some complaints about this book, however. While I feel very confident that Chapman has noble intentions, “The Five Love Languages” does lack attention to diversity. Chapman’s examples and recommendations reflect a strong bias toward the white Christian (and Protestant) heterosexual relationship. I suspect many non-Christians might be turned off or even discount what could otherwise be very helpful. Additionally, Chapman’s writing is only minimally trauma informed. His recommendations related to physical intimacy lack an awareness toward survivors of sexual trauma, and there is minimal consideration of dysfunctional power dynamics linked to domestic violence.
As with all self-help books, this cannot take the place of therapy (especially couple’s therapy), but it can supplement or even help identify areas to address with a therapist.
Chapman, G.D. (2015). The 5 love languages. Chicago: Northfield Pub.
On April 7th I had the honor of participating in a very special community concert in Dayton. The choir I sing with at Incarnation Catholic Church in Centerville joined together with many other community choirs and music groups to put on a concert called “Unity through Harmony” with the Dayton Philharmonic Orchestra, directed by Neal Gittleman. The concert featured sacred music from around the world representing multiple religions, ethnicities, and languages. Some of the participating choral groups included the Dayton Jewish Chorale, Omega Baptist Church Choir, Ministerio de Música Hispano Nuevo Amanecer, the University of Dayton Ebony Heritage Singers, and the University of Dayton World Music Chorale. We performed at the Dayton Masonic Center to a large and enthusiastic audience.
At this special event we were able to celebrate diversity and a shared love of music. We learned to move to the music in new ways, sing in new languages, and form relationships with our neighbors of different religious backgrounds. At one of the rehearsals, I had a lovely conversation with some singers representing the Jewish community. We were able to draw interesting parallels between our two religions and learn about one another. It was a reminder to me that Truth can be found in connecting with strangers…who can become friends!
The concert itself was a moving experience, particularly in the pieces we performed after intermission when all the choral groups joined together in one massive choir. The fullness of sound when all those voices of different ages, backgrounds, ethnicities, and faiths sang as one ensemble made my heart swell with joy! I was encouraged to see such unity at a time when division in our country seems to be increasing. While there were times when the combined choirs sang in harmony, one of the pieces (One Voice by Ruth Moody, arranged by Neal Gittleman), closed in unison with the following moving lyrics:
This is the sound of one voice.
One people, one voice,
A song for every one of us.
This is the sound of one voice.
After the concert ended, and we all said our goodbyes, I found myself reflecting on the powerful experience I had rehearsing for and performing in this concert. The therapist that I am, I couldn’t help but think about the mental health benefits of what we had just experienced as a group of musicians, and more importantly, as human beings. It’s also no wonder then, that 32.5 million Americans regularly sing in a choral group (Chorus America, 2009).
In one of my favorite books on trauma treatment and recovery, “The Body Keeps the Score,” Bessel Van Der Kolk (2014) writes about the benefits of communal rhythm, theatre, and group song. He reminds us that humanity has used creative expression, especially music, “to cope with [our] most powerful and terrifying feelings” (p. 332) and that, “Collective movement and music create a larger context for our lives, a meaning beyond our individual fate” (p. 333). Throughout history, communities have used music to express, cope, heal, teach, and grow. We see this in examples such as Ancient Greek Theatre, the religious rituals practiced around the world, military drills, and cheers and songs at sporting events. During the Civil Rights Movement in the United States, group song encouraged growth and healing for the nation, particularly the well-known anthem, “We Shall Overcome.” Similarly, communal song and dance were integral parts of the Truth and Reconciliation Commission’s work in South Africa in 1996 as the country healed from the wounds of Apartheid. As Van Der Kolk states, “Our sense of agency, how much we feel in control, is defined by our relationship with our bodies and its rhythms. Our waking and sleeping and how we eat, sit, and walk definitely the contours of our day” (p. 331). So it’s no wonder we find relief and healing in movement and song.
In 2011, the Victorian Health Promotion Foundation in Australia published a survey and literature review highlighting the benefits of group singing for individuals and communities. The publication emphasized that findings in numerous studies show group song leads to increased self-confidence, empowerment, sense of wellbeing, and interpersonal skills. It decreases feelings of isolation, increases social capital, and fosters denser social and friendship networks. I’ve condensed some of the specifics of these findings below.
The truly beneficial impact of group singing continues to be reaffirmed, study after study. The positive social, personal, and functional outcomes of making music with others cannot be denied, especially in offering healthy meaningful activity and social connectedness even for those in adversity (Dingle, et. Al., 2013).
I can attest to the many benefits of group singing from both my personal experiences and those shared with me by friends, family, and clients. Even for those who claim they are “not musically inclined” group singing can bring such joy and togetherness.
I close with some poignant yet playful lyrics from an old school Sesame Street song (Rapso, 1971). This song has become a classic, covered by many artists and singing groups. I hope in encourages you to smile and lift your voice in song, friends!
Sing, sing a song Let the world sing along Sing of love there could be Sing for you and for me.
Van Der Kolk, B. (2014). The Body keeps the score brain, mind and body in the healing of trauma. New York, NY: Penguin Books.
Gridley, H., Astbury, J., et. Al. (2011). Benefits of group singing for community mental health and wellbeing: Survey and literature review. Victorian Health promotion Foundation (VicHealth), Carlton, Australia.
Chorus America. (2009). How children, adults, and communities benefit from choruses: The Chorus Impact Study.Washington, DC: Chorus America.
Dingle, G. A., Brander, C., Ballantyne, J., & Baker, F. A. (2013). ‘To be heard’: The social and mental health benefits of choir singing for disadvantaged adults. Psychology of Music, 41(4), 405–421.
Mental health is essential to everyone’s overall health and well-being, and mental illnesses are common and treatable. So much of what we do physically impacts us mentally – it’s important to pay attention to both your physical health and your mental health, which can help you achieve overall wellness and set you on a path to recovery.
Did you know that Mental Health America (MHA) founded May is Mental Health Month back in 1949? That means this year marks MHA’s 70th year celebrating Mental Health Month!
MHA is expanding its focus from 2018 and raising awareness about the connection between physical health and mental health, through the theme #4Mind4Body. We are invited to join in exploring the topics of animal companionship, spirituality and religion, humor, work-life balance, and recreation and social connections as ways to boost mental health and general wellness. A healthy lifestyle can help to prevent the onset or worsening of mental health conditions, as well as chronic conditions like heart disease, diabetes, and obesity. It can also help people recover from these conditions. For those dealing with a chronic health condition and the people who care for them, it can be especially important to focus on mental health. When dealing with dueling diagnoses, focusing on both physical and mental health concerns can be daunting – but critically important in achieving overall wellness.
There are things you can do that may help. Finding a reason to laugh, going for a walk with a friend, meditating, playing with a pet, or working from home once a week can go a long way in making you both physically and mentally healthy. The company of animals – whether as pets or service animals— can have a profound impact on a person’s quality of life and ability to recover from illnesses. A pet can be a source of comfort and can help us to live mentally healthier lives. And whether you go to church, meditate daily, or simply find time to enjoy that cup of tea each morning while checking in with yourself – it can be important to connect with your spiritual side in order to find that mind-body connection.
Mental illnesses are real, and recovery is always the goal. Living a healthy lifestyle may not be easy but can be achieved by gradually making small changes and building on those successes. Finding the balance between work and play, the ups and downs of life, physical health and mental health, can help you on the path towards focusing both mind and body.
The April marks the 18th annual Sexual Assault Awareness Month (SAAM) campaign. This year’s theme, “I Ask” builds on the idea that consent is a healthy, normal, and necessary part of everyday interactions. “I Ask” champions the power of asking — whether it be asking to hold someone’s hand, for permission to share personal information with others, or if a partner is interested in sex. It also highlights the importance of listening to and accepting the answer without pressuring someone to change their mind.
Working with survivors of sexual violence is a big part of my work as a Certified Trauma Practitioner, as sadly the problem is all too prevalent. In the U.S., one in three women and one in six men experienced some form of contact sexual violence in their lifetime. I am proud to offer EMDR Therapy as a highly effective, evidence-based form of psychotherapy that promotes healing and empowerment for survivors. Part of the healing process can including activism and awareness building, so I encourage all my clients, but especially those who are survivors of sexual violence, to join me in spreading the word about this year’s “I Ask” SAAM campaign.
Launched in April 2001 by the National Sexual Violence Resource Center (NSVRC), Sexual Assault Awareness Month is an annual awareness and prevention campaign observed in April and is coordinated each year with assistance from anti-sexual assault organizations throughout the United States. For more information on this year’s national campaign, visit www.nsvrc.org/saam.
Consent can be confused or complicated with one partner of a relationship holds more power than the other. It is important to be aware of how balance or imbalance of power can impact healthy intimacy in relationships. There are ways to make sure your partner feels comfortable communicating their needs. As a part of the “I Ask!” campaigne, here are some suggestions from NSVRC about power and consent that can be helpful in navigating relationships with love and respect.
Smith, S. G., Chen, J., Basile, K. C., Gilbert, L. K., Merrick, M. T., Patel, N., … Jain, A. (2017). The National Intimate Partner and Sexual Violence Survey (NISVS): 2010-2012 state report. Retrieved from the Centers for Disease Control and Prevention, National Center for Injury Prevention and Control: https://www.cdc.gov/violenceprevention/pdf/NISVS-StateReportBook.pdf
April is National Child Abuse Prevention Month. The theme this year is “Strong and Thriving Families.” This month and throughout the year, we have the opportunity as individuals and organizations to play a role in making our community a better place for children and families. By ensuring that parents have the knowledge, skills, and resources they need to care for their children, we can help prevent child abuse and neglect by creating strong and thriving children, youth, and families in our communities.
Research shows that protective factors are present in healthy families. Promoting these factors is among the most effective ways to reduce the risk of child abuse and neglect. The factors are:
Nurturing and attachment
Knowledge of parenting and of child and youth development
Concrete supports for parents
Social and emotional competence of children
April is a time to celebrate the important role that communities play in protecting children and strengthening families. Everyone’s participation is critical. Focusing on ways to connect with families is the best thing our community can do to strengthen families and prevent child abuse and neglect.
In support of these efforts, the U.S. Department of Health and Human Services’ Children’s Bureau, Office on Child Abuse and Neglect, its Child Welfare Information Gateway, the FRIENDS National Center for Community-Based Child Abuse Prevention and over 30 national prevention partners have created 2019 Prevention Resource Guide: Strong and Thriving Families. The resource guide, designed for service providers who work throughout the community to support families, is available online at https://childwelfare.com/topics/preventing/preventionmonth/resources/resource-guide/.
One of the first things people notice when they come in my office for the first time is the series of three paintings of giraffes on my wall. Many have asked, “Leah, what’s with the giraffes?” I LOVE to share the answer to that question.
There’s no doubt that giraffes are a source of inspiration for many people. They show up in art, literature, children’s toys and books, music, and mascots. Their graceful and majestic appearance captivates the eye and the mind, and their endearing expressions draw us in. For many, giraffes symbolize welfare and happiness. Often referred to as “Africa’s gentle giant”, giraffes represent cooperation, resourcefulness, intuition, and patience. Due to their height and long, elegant necks, they are frequently used as symbols of vision, perception, and the elevated mind.
Giraffes, particularly in their various stages of development, can illustrate the stages of recovery, and that is precisely the meaning I wanted to convey when I selected this art for my office. Each of the three giraffe paintings in my office is intended to depict a phase of healing or recovery. For the sake of this explanation, I will discuss the paintings in the context of recovery from addiction, however the concepts certainly can translate to healing from other forms of trauma or adversity.
The first painting depicts a baby giraffe with its mother, and it represents the beginning of the recovery process. Baby giraffes are born after 14 months gestation, and delivery typically occurs while the mother giraffe is standing. This means Baby drops about six feet, crashing down head-first into a new, scary, and dangerous world. The fall does not hurt Baby, but forces causes him to the first deep breath of life. Not too long after delivery, the baby giraffe begins to test out his body, walking on long, gangly legs with knobby knees and a wobbly gait. Baby is very vulnerable at this stage. In the wild, predators like lions, leopards, and hyenas are a threat to giraffes, especially calves that don’t yet have the strength or awareness to protect themselves. So this means Mama Giraffe (and often times other females of the herd) look after the little ones, providing protection and guidance.
Acrylic on canvas, Amy Jacomet, 2018
To me the calf parallels the experience of individuals who are newly sober. Even though they may believe that sobriety is good and desirable, sober living is a scary thing because it’s new or even unknown. In the early stages of recovery, we need the support of safe and trusted people to help us, guide us, and even offer a little protection. Supportive family members, AA sponsors, counselors, and trusted friends can offer the much needed encouragement to help us through the scary and vulnerable beginnings of recovery. We also sometimes need a protected environment like a sober living house, treatment program, or new housing arrangements as a part of relapse prevention. Just like the baby giraffe is not helpless (remember Baby gets up and walks very soon after delivery), in early recovery we must begin by taking action toward change. This can look like joining a 12-step fellowship, participating in an Intensive Outpatient Program (IOP), and changing up our habits to limit our exposure to the people/places/things that can lead us to use.
The second painting in the series depicts the juvenile giraffe, or as I like to call him, Junior. By now he has grown larger and stronger. He moves with more confidence and can run, reach, and explore. He has learned some things about the world around him like who is friend and who is foe, where there is safety and where there is danger. With this growing strength and confidence comes a little curiosity and even some boldness. Junior begins to stretch, reach, and try new things – he’s learning to “stick is neck out”, as they say. Sometimes Junior might get a little too bold and find himself in some sticky situations that could require the help of the older, wiser, or more experienced members of the herd. (Actually, Google tells me a group of giraffes is actually called a “Tower.” Very apropos.)
Acrylic on canvas, Amy Jacomet, 2018
To me Junior reflects a lot of the experiences that go along with middle stages of recovery. By this point we may have a few months or even a year (plus) of sobriety behind us. We’ve identified triggers, overcome some cravings, and begun to establish habits that support continued sobriety. We might be more than familiar with the 12 steps and have a growing number of effective coping skills and resources to help us manage when life gives us challenges. There is still danger at this stage though. Sometimes, like Junior, we get a little too bold and take chances that can compromise our recovery. It’s important to stay self-aware and have accountability to others (like an AA sponsor) to help us stay on track or get back on our feet if we slip up.
The third painting is of the fully grown, adult giraffe. I like to call him Dude. The mature giraffe is fully developed, strong, and aware. He had gained a lot of experiences that inform his decisions, keep him safe, and help him thrive. Dude has strong muscles, and he moves with grace and efficiency. He knows how to navigate his world and is able to find food and water to help keep him well. When Dude encounters a problem, more often, than not, his instincts serve him well. Giraffes, even fully grown, are still prey, so Dude has to remain aware and pay attention to his surroundings. While he is self-assured and resourceful, he knows he is still vulnerable. Hungry predators are still after him, so he can’t let himself become overly confident.
Acrylic on canvas, Amy Jacomet, 2018
The adult giraffe shares a lot of similarities with an individual who has been sober for an extended period of time. In order to achieve years of sobriety, we have learned a lot about ourselves. We are more self-aware and resilient than before. Like Dude, we are skilled and equipped to handle many of the challenges that everyday life throws our way. We have instincts, knowledge, and reliable resources. But just like a mature giraffe, we must remain alert and aware of potential dangers. We must be on the watch for threats to our sobriety and make daily efforts toward relapse prevention. Too much confidence can land us in precarious situations.
Recovery from addiction is not the only way to relate to the giraffes. Certainly we can all relate to the process of growth and healing. The dynamics of healing from just about any adverse life experience can be reflected in this metaphor. Getting through a painful breakup, recovering from a severe illness or injury, moving to a new school/job/town, grieving, and so many of life’s challenges take on a similar progression.
My invitation to you is to reflect on these three paintings and their messages. Which painting do you connect with the most at this point in your life? How can you use that awareness to help you be health, safe, and fulfilled?
A Message from the Artist
The three giraffe paintings are the work of artist and writer Amy Jacomet from the Miami Valley. You can find some of her commissions on display at Dayton Children’s Hospital. A courageous woman with a strong sense of spirituality, Jacomet shares her faith through her art. Here is a bit of her story:
Amy Jacomet, Artist and Writer.
“A type 1 diabetic at age 10, I found myself blind, with kidney failure and desperately needing an organ transplant at age 26. By 28, I received two healthy new organs and had regained some of my sight; however, I was left with the inability to see colors correctly.
I went back to my roots of art many years after that and took to painting. At that time, I wanted to find a way to glorify God through my work. He had shown me so much love through my valley and I wanted to return that love to Him.
After a quick prayer and creating my first painting, I heard Him say that He wanted His messages on the back of my work. I didn’t know what that meant until He gave me my first message and then placed it in the perfect person’s hands.
Since then, I have been creating pieces for Him to show this world His great love.
He has used my “inability” to see colors and detail to show His ability. I have felt so honored and blessed to be on this amazing journey with Him.”
Below are the messages Jacomet inscribed on the back of each of the giraffe paintings.
A journey awaits you. Do not be afraid to step into the unknown or unseen. Instead, know that I have already gone before you, and I am patiently extending My hand to pull you up out of your debris. The past is the past and you are no longer bound to it. Be of good courage and take the first step. I promise I will be by your side. I am leading you to a land of prosperity, so take My hand, child, and allow Me to be your guide. I know you are fearful, and I know you feel unsure. But know that I would not call you out of your dry and desert land if I didn’t have a plan and a purpose. You were created for great things. Believe these things I say to you. You haven’t yet seen your best days. They lie ahead. Now venture out and take this journey with Me. I promise you will not be disappointed. I have so much ahead of you as you draw near to Me. Take one step at a time. I promise you will get there. Take that first step. I am waiting to embrace you in My loving arms and show you the person you were created to be. Trust Me. I have you.
You’re experiencing so many new things and being tested in new situations and circumstances. Keep your eyes focused on Me like never before. Allow me to lead you on the path to the mountaintop. You’ve exited the valley and are growing by leaps and bounds, but do not forget about Me and all that I have done for you. I am still working My will and purpose for your life, shaping you along the way. Allow Me to mold you. Allow Me to show you the way to your victory. You will conquer all. Just be patient and do not rush ahead. There is a time and place carved out especially for you. It has been set aside and you have been set apart. Be patient in your process and see what I can and will do in and through you. You will be in awe when you see My plan unveiled before your eyes. Trust Me.
You are bold and courageous, strong and enduring. You have shown great perseverance on your journey. Taking on battle after battle and conquering all that has tried to rise up against you. You have overcome and come to a place of victory. Be very proud of what you have accomplished. You have refused to give up and met every obstacle placed before you with great courage. You didn’t give up when times got tough. Even when you’ve been knocked down, you’ve gotten back up and continued on the path that has led you to success. Congratulations. Be very proud of who you’ve become. Be very proud that you have withstood the test of time. What was once a valley for you has now become a testimony. Never forget where you came from, as it will keep you humble, but always look toward your future. It is so bright, and you are going to embark on many amazing things and opportunities. Always see yourself as I see you. When you look in the mirror, be grateful for you position in life. When I place others on your path, use your discernment and seek My face in knowing who and how to help. I have brought you through this journey for a reason and a purpose. You have not been forgotten. You will be honored. Keep walking forward with your eyes on Me, and know that I hold your destiny in the palm of My hand. I will never let you down.
Alcoholics Anonymous or “AA” is a common part of addiction recovery for many individuals who have struggled with Substance Use Disorders. It is “an international fellowship of women and men who have a drinking problem.” It was founded in 1935 by Bill Wilson and Bob Smith in Akron, Ohio and has spread globally since. AA maintains a group identity that is “nonprofessional, self-supporting, multiracial, [and] apolitical”, and the only requirement for membership is a desire to stop drinking.
The book “Alcoholics Anonymous” (commonly referred to as the “Big Book”) was published in 1939, and the original text has been preserved in subsequent editions. It outlines 12 steps for achieving and maintaining sobriety. The 12 steps are
We admitted we were powerless over alcohol – that our lives had become unmanageable.
Came to believe that a Power created than ourselves could restore us to sanity.
Made a decision to turn our will and our lives over to the care of God as we understood Him.
Made a searching and fearless moral inventory of ourselves.
Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
Were entirely ready to have God remove all these defects of character.
Humbly asked Him to remove our shortcomings.
Made a list of all persons we had harmed, and became willing to make amends to them all.
Made direct amends to such people wherever possible, except when to do so would injure them or others.
Continued to take personal inventory and when we were wrong promptly admitted it.
Sought through prayer and meditation to improve our conscious contact with God as we understood him, praying only for knowledge of His will for us and the power to carry that out.
Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs.
In meetings, participants study the Big Book and the 12 Steps, share their stories (often called “giving a lead”), offer support and encouragement to one another, and build a community of individuals committed to sobriety. Most active participants work with a sponsor to serves as a point person when support is needed, as well as a mentor in the recovery process.
There are many similar programs modeled after AA including Al-Anon (for family members of alcoholics), Overeaters Anonymous, Debtors Anonymous, Narcotics Anonymous, and others. Additionally, there are other 12-step fellowships that are partially modeled off of AA including Celebrate Recovery.
Due to emphasis on confidentiality and anonymity as well as inaccurate depictions of 12-step groups in film and television, there are many misconceptions about AA. At best these misconceptions simply misrepresent the fellowship. At worst, they hinder those in recovery from accessing potentially beneficial support and healing.
Myth #1: I can’t go to AA because I don’t go to church.
Many people in recovery believe AA is not for them because they do not participate in organized religion, have left or been separated from their faith community, or feel uncomfortable in church. The reality is that ANYONE who is interested in recovering from a substance use disorder can participate in AA, regardless of their spirituality. It is actually Step 2 which emphasizes the belief in a Higher Power and Step 3 which encourages surrender to it. While the Big Book uses the word “God”, this is not necessarily restricted to the Judeo-Christian God. The text actually emphasizes the ides of God “as we understood Him”, which allows room for an individual and evolving relationship with a Higher Power. Many AA meetings take place in church buildings, but membership to a particular religion is not required.
Myth #2: After I complete the 12 Steps, I’m done.
An expression commonly used by AA participants is, “I’m working the steps.” Most people work on the 12 Steps with the help of a sponsor. A common misconception is that once a person gets to Step 12, they graduate or finish AA. In reality AA is intended to be an ongoing process. Steps 10, 11, and 12 are actually more like maintenance steps. Step 10 is intended as a method of ongoing self-checking, emphasizing self-accountablity and honesty. Step 11 is the practice of continued seeking, growth, and relationship with the Higher Power. Step 12 calls for service, sharing, and ongoing sober living. Much like a car requires routine maintenance and care, a person in recovery (and I would argue, everyone) needs habits that encourage healthy self-awareness, an ongoing journey or personal growth, and a commitment to relationships and community.
Myth #3: All AA meetings are the same.
There are a variety of types of meetings, each with a different goal, feel, and dynamic. Closed Meetings generally consist of a specific and limited group of people. Open Meetings are just that – they are open for anyone to participate, including observers who are no struggling with a substance use disorder. Speaker Meetings (sometimes called Gratitude Meetings) tend to feature a visiting member who shares the story of their experience with addiction and recovery. Big Book Meetings center around a certain section of passage of the Big Book and group discussion. 12-Step Meetings typically focus on a specific step, and in larger meetings participants may even divide into smaller groups based on the specific step they are working. There are even online meetings. While AA meetings are generally inclusive, there are some meetings aimed at a certain demographic or population (gender, sexual orientation, profession, language).
As with any community of human beings, there is variance in dynamics and group culture among AA meetings. Sometimes it takes a few tries before an individual finds a meeting where they feel “at home.” Unfortunately, not all AA meetings are created equal. There are some that remain very faithful to the original intents of the AA founders and others that stray from the tenants of the model. Similarly, some groups naturally foster an atmosphere of mutual support, respect, and healing, while others can become distorted by unhealthy interpersonal dynamics or even toxically distorted interpretation of AA tenants.
Myth #4: AA is only for alcoholics.
Again AA is generally very inclusive. Many indivuals in recovery have struggled with multiple substance, no just alcohol. It is not uncommon for a participant in a meeting to identify as “an alcoholic and an addict.” AA and its related groups can be very helpful to individuals who struggle with a variety of addictive behaviors (e.g. overeating, gambling, sex, illicit drugs). Open meetings, again, welcome nonalcoholic observers, and meetings like Al Anon, Alateen, and Adult Children of Alcoholics cater to friends and family members of people with substance use disorders.
Myth #5: AA is treatment.
AA and treatment are two different things. AA is more accurately understood as a “spiritual program of action.” It is the adoption of and practice of keep beliefs, behaviors, values, and traditions in the context of a community. AA is peer-led and self-supporting. Treatment on the other hand is facilitated by trained professionals in clinical settings with a prescribed set of interventions (e.g. medical detoxification, partial hospitalization and intensive outpatient programs, and psychotherapy). Treatment can be finite, whereas AA in its truest form is an ongoing process. AA and formal treatment can work beautifully together, along with other community and interpersonal supports, to help a personal on the path of healthy and whole hearted living.
If you’re interested in learning more about AA, consider starting with the main website at www.aa.org. There you can locate meetings near you, access the Big Book and other AA related literature, read daily reflections, make contributions, find other ways to get involved.
Alcoholics Anonymous: The story of how more than one hundred men have recovered from alcoholism (4th ed.). (2001). New York City, NY: Alcoholics Anonymous World Services.
Marich, J. (2012). Trauma and the twelve steps: A complete guide to enhancing recovery. Warren, OH: Cornersburg Media.
Substance Use Disorders and overdose deaths have reached frighteningly high rates in recent years and are sky rocketing in the Dayton and Cincinnati regions. Opioids are one of the more frequently used and abused drugs in the country, to such a degree that in October 2017 the President declared the opioid overdose problem a Public Health Emergency.
What is an opioid?
There are three types of opioids: natural opioids (also called opiates), semi-synthetic opioids, and synthetic opioids. Natural opioids are derived from the opium poppy plant and are commonly prescribed by physicians for pain relief. These include medications like morphine and codeine. Semi-synthetic opioids are natural opioids that have chemically been altered or modified, and they are sometimes combined with other medications. For example, the pain killer Percocet is a combination of the semi-synthetic opioid Oxycodone combined with Acetaminophen (the same thing as Tylenol). Other examples of semi-synthetic opioids include Roxicet, hydrocodone, oxycodone, and hydromorphone. Heroin is also a semi-synthetic opioid. Synthetic opioids are known to have opiate-like effects (meaning they mimic the effects of drugs like morphine or codeine). They provide pain relief and sedation but with significant risks as they are more potent. Examples of synthetic opioids include fentanyl, carfentanil, and acetyl-fentanyl.
As all types of opioids can be abused, but the drug traffickers are increasingly cutting heroin with cheaper and stronger synthetics like fentanyl – a highly dangerous combination contributing to recent spikes in overdoses.
An important thing to consider: Not all overdoses result from intentional drug abuse. Many people are prescribed pain killers after an injury or surgery, and many work with a physician who specializes in management of chronic pain. It is not impossible for an individual to accidentally overdose by confusing when or which medications they have or have not taken. This risk is especially a concern for older adults who tend to take more medications. Monitor your loved ones closely, especially those who can sometimes struggle with confusion or forgetfulness. The danger is present, regardless of the reason the individual ingested the drug.
What is Narcan?
Narcan is a brand name for the drug naloxone hydrochloride. Another common brand of the same medication is Evizio. This drug is used to temporarily the dangerous effects of overdose. It helps the individual begin breathing again and restore consciousness. Many refer to Narcan as “the antidote for overdose.”
Narcan is typically administered by injection or by nasal spray.
The side effects of Narcan are very rare, and the potential benefit of the drug typically trumps the risk of side effects, as individuals who have overdosed on opioids typically die without intervention. Some of the potential (though again rare) side effects include unconsciousness and withdrawal symptoms (e.g. body aches, irritability, diarrhea/vomiting). Life with a small likelihood of temporary discomfort far outweighs a high likelihood of death.
Narcan can be purchased in most pharmacies, and in most states you can purchase Narcan without a prescription. A 2015 Ohio law allows pharmacies to fill Narcan on a standing order from a physician, allowing the individuals to obtain it without a written prescription from their doctor.
Many non-profit and public agencies also make Narcan readily available. For example, I obtained a Narcan kit for free from the Hamilton Co. Board of Health. It is common for people to prefer the nasal pray delivery to the injected form of naloxone, as the nasal spray is easy to administer and doesn’t pose the challenge of working with a syringe.
Most trainings recommend having at least two doses available, as some individuals require more than one dose to halt deadly overdose reactions. Generally speaking, Narcan can be stored at room temperature, however following the manufacturer’s instructions on your specific kit is advised. Narcan does expire, in that it loses its potency, so keep track of the expiration date and replace as needed.
If administering Narcan, always always ALWAYS call 911 first!
The CDC offers a plethora of helpful resources and information of the addiction crisis in America. They have an especially good fact sheet available on prevention of death by overdose.
The Ohio Department of Health has a wonderful program called Project DAWN(Deaths Avoided With Naloxone), which is a community-based effort focusing on overdose education, distribution of and training on naloxone.
Here is a helpful training video that gives a brief overview on administering the Narcan nasal spray:
Your county’s mental health and addiction services board(s) will have local resources, materials, and training opportunities as well.
So many times when we encounter a friend, loved one, or even an acquaintance we automatically ask “How are you?” as a habit of politeness. When the question is asked of us, the response is usually just and automatic – “Fine.” – But how do you REALLY feel today? Can you answer that question?
The cliche “getting in touch with your emotions” task is intimidating to some people, especially those who have struggled with past hurts or traumas. It can be a little scary to really connect with our feelings when we struggle to manage our actions when feeling intensely. It can also be scary to connect with emotions if we have a “Pandora’s Box” of feelings that might come rushing out. It’s okay to be uneasy though.
Sometimes it’s helpful to just think of emotions like the weather. It can be sunny, windy, cloudy, stormy, foggy, etc. Sometimes we can predict the weather, and sometimes a change in the weather can surprise us or even come out of nowhere. We have limited control over the weather, but we can cope with it or adapt. We dress according to the weather. We wear sunblock when it’s sunny and carry an umbrella when it rains. Sometimes we’re unprepared for the elements, but the more aware we become of the climate, the more equipped we will be. Emotions are the same. The more you observe the trends and patterns of your feelings, the more prepared you will be to respond in healthy ways.
Some characteristics of emotionally aware people include:
The ability to feel emotions deeply
Sensitivity and recognition of feelings in themselves and others
Willingness to experience emotions – even the uncomfortable ones!
Appropriate expression of a wide range of feelings
The ability to manage behavior in the context for strong feelings
As human beings, we have the capacity for experiencing a wide range of emotions from irritation to rage, delight to exhilaration. However, many people do not allow themselves to feel even at all. They avoid, restrict, limit, or bury their feelings. Sometimes we limit our emotional experiences because:
We want to limit unpleasant feelings and only experience pleasant feelings. (Or vice versa!)
We confuse feeling an emotion with acting on it.
We lack the vocabulary to describe various feelings.
One downside to a lack of awareness of emotion is a lack of information. Emotions can teach us so much! For example, if I ignore the fact that I feel perturbed every time I come home from hanging out with a certain person, I might be missing a problem occurring in the friendship – perhaps a problem that can be resolved! Or if I feel fearful when the wind is howling outside my window, the emotion might be telling me to be alert in case of danger. Or if I feel joyful and giddy after a date, my emotions could be telling me to explore developing a closer relationship with that individual.
Another benefit to emotional awareness is appreciating the ups and downs, highs and lows, light and dark or life. We are not superficial beings. We are deep and complex. Experiencing the fullness of our lives requires a variety of emotions, giving our existence color and flavor and helping us continue our evolution as individuals. Recognizing hurt can lead to healing. Acknowledging excitement can lead to growth.
So if you’re ready to dig in deeper…
Commit to feeling your feelings! If you’re interested in building more awareness of emotions in your daily life, here are a few ideas of things to try. If you are currently in therapy, be sure to bring this topic up to your therapist. If healthy emotional awareness and expression is not already a part of your treatment plan, perhaps it could be!
Put pen to paper! Divide a sheet of paper in to four sections. Label the sections “happy”, “angry”, “sad”, and “scared.” In each section, challenge yourself to come up with as many versions of basic emotion. For example, under the “happy” category you might list words like joyful, energized, silly, enthused, or content. Next time you’re communicating an emotion to someone, try use a word that best describes how you feel, rather than settling on a general term.
Do a self-check. Three times a day (I like to use meal time), pause for a brief moment and take a deep breath. Think about where you are and what you are doing. Then simply ask yourself what emotion you are experiencing in that present moment. Label the emotion. You don’t necessarily have to respond to it or change it. Simply allow yourself to notice and feel it.
Link feelings and sensations. Next time you observe yourself feeling a strong emotion, take a moment to scan your body from head to toe, slowly observing the physical sensations that correspond to the emotion you’re feeling. For example, when I feel embarrassed, my face always feels warmer, and I feel my heart beating harder than usual.