Recovery Through Music Therapy: An Interview with Tim Ringgold

Among the glowing testimonials from knowledgeable people on music therapist’s Tim Ringgold’s website, one woman mentions his “sheer kinetic energy,” and Joe Polish, founder of The Genius Network, says, “I work with some of the very best speakers in the world. There are very few people that can hold people’s attention better and inspire others more than Tim Ringgold.”Recently, I experienced that when I witnessed Tim give a Zoom public talk about his craft as a music therapist. Even so, as a former editor of The Fix, I found the content of his talk – using music therapy to treat emotional pain and addiction - even more compelling than his smile-inducing kinetic energy. I thought Fix readers would benefit from knowing about him and music therapy.A singer and classical musician before he was a music therapist, at 16 he sang solo to Pope John II in St. Peter’s Square before 13,000 Catholic pilgrims. In his twenties, he morphed into a rocker who played some of LA’s major clubs. In his thirties, reverting to classical music, he sang at the Hollywood Bowl and in some of the oldest and largest European cathedrals.Ringgold’s path to musical therapist was guided by pain, including struggles as a recording artist and with addiction, with added trauma from the early death of his father, the murder of his five best friends, and the life and death pain of his special-needs daughter. Recovery took him into the Landmark Forum where his exceptional natural gifts for teaching and empathy moved him up the ladder to Introduction Leader. Then, merging his music and counseling aptitudes, he studied music therapy. In 2008, with Landmark behind him, he was certified to practice by the certification board for music therapists (there are 8,000 nationwide, with a very small percentage working in addiction treatment).Tim began his practice working in oncology before he segued into the addiction recovery field, with a second career as an in-demand public motivational speaker. Now, apart from the sessions he leads for a multistate addiction recovery center, he manages a team of eight other music therapists across the country. Each music therapy session is one hour, once a week, and includes four to six clients, though some clients opt for one-on-one sessions.Since 2008, Tim has annually worked with 500 to more than a thousand recovery clients, primarily in groups. He also leads online workshops, a grief retreat, as well as hosts the Stress Elimination Summit and the podcast Reduce Your Stress with Tim Ringgold. Tim is also the author of Sonic Recovery: Harness the Power of Music to Stay Sober, and gave the first TEDx talk on music therapy in 2012.The Fix: What’s the relationship of music to addiction?Tim Ringgold: First, let me say that people who are in treatment for substance abuse and addiction are there because of underlying issues of trauma, depression, anxiety, high ADD, ADHD, PTSD, and/or traumatic brain injury. Addiction never occurs in isolation. The addiction is a solution to those problems. Problem is, it’s a crummy solution because it causes more problems than it solves. Most people think it is the problem itself, but it is really just a symptom - like a cough - of an underlying issue. So, the real game is to be addressing the underlying issues, which is what we want to get to with music therapy.What’s a story example or two?One day, I am leading a group, and we are doing active music making using rhythm instruments -  drums, percussions, shakers - and we’re improvising and just creating spontaneous music. The purpose is to explore the sounds of the instruments and connect with the beat.One of the clients is a teenage boy who doesn’t say much the whole session. We’ll call him Dave. Dave is playing a buffalo drum which is a Native American rhythmic instrument where you hold the drum with one hand and you have a mallet in the other hand and you play the drumhead with it.Throughout the improvisation, it is clear Dave is exploring this drum. There is a discovery happening, but he doesn’t verbalize anything. At the end of the session, there is a group note that all the clients have to fill out that asks things like:  “What was your greatest takeaway? What did you learn? Identify an emotion you feel.” Dave wrote: “I finally found the way to get the violence out of me.”One of things that was notable and remarkable about Dave were all the scars on both forearms, from his wrists on the outside of his forearms up and down his forearms. Dave had a history of cutting. Clearly, he had been trying to get the violence out of him. On this day he was introduced to a drum - and in his own words the drum was more effective than anything he’d tried up to that point.So, music therapy is about empowering and equipping clients and patients to use music as a tool for their own regulation, their own expression, in ways that talk therapy simply cannot access.Second story?Larry. It’s his first day at an adult residential drug abuse treatment program. In group, Larry says: “No offence, but I don’t trust anybody in this room and I certainly don’t trust any of the staff here,” myself [Tim] included. I said, “That’s okay, Larry. What’s one of your favorite bands?“ And he answers “The Eagles,” and I said “Cool, what song from the Eagles do you really connect with?” And he answers “Desperado.” Now this is one of those clinical moments you cannot make up. Because the lyrics from “Desperado” are so auto-biographical for so many men who find themselves in treatment. The song paints the picture of somebody who is tired and alone.And so it was no surprise that this guy - who said he doesn’t trust anybody - identifies with this song. It’s his story. So in one word he’s told me clinically more about himself by saying “Desperado” than if he had spent five minutes telling the narrative of what brought him to treatment.So, I say to Larry “Okay for the next week I don’t want you to trust anybody here but I do want you to trust the Eagles and I want you to trust “Desperado” and I want you to listen to the Eagles during the week.” Well, you should have seen the look on his face that I gave him permission to trust something that he felt safe with as opposed to something I felt safe with.People tend to trust the music they love because their music doesn’t scold them about how they feel, what they think, or what they do. So, they feel emotionally and psychologically safe around their music. That’s why someone can actually be feeling more safe and connected alone in their room with their headphones on than in a room full of people.PS: the next week in group Larry was fully invested - not just in group but in treatment overall. So that’s Larry’s story.What’s the age range of most clients?We mainly treat adolescents and young adults, which is very inspiring to me, because potentially they have so much future ahead and comparatively very little past. Because we imprint music on our psyche so deeply between the ages of 14 and 24, music is like our co-pilot in our journey of becoming our identity as an adult. To leverage music in such a personal and powerful way at such a time of crisis is so deeply rewarding.Even if they get sober, they are going to have a deeper relationship with music for the rest of their life - and it’s not going to be just entertainment. It’s going to be a vital tool in their ongoing recovery. Because music can trigger a craving, or it can relieve one. Showing clients the right way to reach for their music so their own music doesn’t undo all the work they are doing in treatment, is not only important but deeply satisfying.For me, to be a part of their treatment at this stage of their chronological journey holds great promise compared to when I worked in oncology with people at the end of their life and I was soothing their transition, which was deeply gratifying in a different way.How do you as a music therapist make it relevant to everyone in the room? What is the process? There are five clinical outcomes that we are addressing in any given group, and when combined they spell the acronym SOBER. It stands for Stay present, Open up, Be creative, Escape stressors, and Reconnect. The different types of groups that we lead are all focused on addressing one or more of those clinical outcomes - and those clinical outcomes are relative to everyone in the room. The session is tailored to address one or more of those outcomes. The interactions include active music making, song analysis, relaxation, creative arts, songwriting and song selection. The difference between song analysis and selection is that in song analysis the therapist chooses the music to address an underlying theme of treatment. In song selection, the clients choose the music that describes some part of where they have been, where they are, or where they want to go.Okay, so there are six clients in a room with you, and what is the flow? What do you start with, what happens after that, and how does it get individuated to six people?  Let's take an active music-making session, for example.Why do you even choose an active music-making session?Active music making is the most effective session because it addresses all five clinical outcomes simultaneously. It is efficient and effective - and empowering - because a lot of people have a story or belief that they are not musical, or not musicians, or couldn’t possibly play music, that they don’t have talent... some version of that belief. However, through our training, music therapists know how to get any human being making music in a matter of seconds.So, we are able to smash that belief - not by convincing but through a person’s successful engagement with the music. And the tools we use are rhythm-based instruments and voice because the human body runs on rhythm. Every cell, every organ, every system, literally every body – the fundamental organizing system of everything happening in the body is rhythm. For example, you walk in rhythm, talk in rhythm, chew in rhythm, sleep in rhythm, your heart beats in rhythm, you breathe in rhythm, you even scratch in perfect rhythm. As music therapists we just put instruments in the way of rhythms that the body already has experience with. That’s relevant because the person in treatment has that belief that music is hard, time consuming and relegated to those who have talent. But when we smash that belief in a matter of seconds by improvising with rhythm instruments, it opens the door to a conversation about what other limiting beliefs they have that aren’t serving them and are simply an illusion.Again, what is the step by step by step process?First thing we start with is teaching the acronym SOBER so they know why we are doing music and it is not for entertainment and is not for education, but as a tool for recovery. And then we introduce the instruments in the room and demonstrate them, showing how easy they are to play successfully. Then I will invite the participants to select an instrument that looks interesting. I play a bass drum and lay down a heartbeat on the bass drum and I simply say, “Explore the sounds on your instrument and then connect the sounds to the beat.” They only have two tasks: one Explore, two Connect.After we groove for a period of time I have them switch instruments and a new groove begins. After a period of time we switch instruments a third time. At this point, depending on how long we have been improvising together, I can take the group in one or two directions. The first is a discussion around what instruments they connected with and why?Now we begin the verbal process and look at how the tasks of “explore and connect” apply to all the other kinds of therapy groups they attend at the treatment center. We know they are not going to connect with every group, just like every one of us doesn’t connect with every type of exercise, but we all know exercise is vital in minting mental health. So, it is up to us in recovery to explore different types of exercises so we connect with one we enjoy.So, we use the music therapy experience as a metaphor and expand the conversation further out into their treatment. We might ask them to talk about what groups they have connected with in treatment, what staff have they connected with, which fellow client have they connected with, what family member do they feel connected with? The client begins to see the thread, the connection, as part of the road to recovery - and it all started with “just a shaker” or just a drum.At this stage of the group we will circle back to the SOBER acronym and ask them which one of the SOBER letters did we address in the group? And now they have to integrate their experience with the outcomes – it’s almost like a recap that cements the whole experience. It’s almost like “lecture, then lab, then lecture” - lecture and lab all in one. Its analytic and left brain and its experiential and right brain all in the same session.Say more about the instruments available.Usually there are more instruments than people. It’s like a buffet. They play three or four in the course of a session but there are 10 plus instruments at their disposal - mostly rhythmic percussion instruments – so drums, shakers, wood blocks. I used to run a group where they had to raid the kitchen and make instruments out of utensils, pots and pans. But the chefs didn’t like that.Are the one-on-one sessions much different?One-on-one mimes the others but we focus on guitar or ukulele lessons because learning guitar or uke is really useful as a recovery skill. That’s really hard to teach in a group setting but really easy to do one-on-one. But the main difference maker is client song selection where the client is the DJ for the hour and selects music that represents how they are feeling. What they are struggling with or, on the flip side, music that inspires them – there are lots of different prompts.The music creates a bridge between the client and the therapist because oftentimes an artist articulates emotion in the form of music and lyrics better than the clients with just words.So, you ask a client how are they? And they say, “I don’t know.” But if you ask them to play a song that might match how they are feeling, there is a whole world of emotion contained in the music and lyrics and it helps a client express those elusive feelings that they may not be able to put words to.Seems music therapy works best in concert with other therapies.In treatment there is no therapy that is a stand-alone therapy for addiction. Addiction treatment is a cluster or constellation of modalities. It is an inter-disciplinary approach because talk therapy alone doesn’t treat trauma, so you need multiple modalities that address the bio, psycho, social and spiritual aspects.Have you been doing this all on zoom this last year?During the pandemic we’ve been leading Zoom sessions most of the time and some of the time we lead in-person sessions wearing masks and social distancing. Learn more: Tim Ringgold.View Tim on YouTube. 

A Pandemic of Grief

COVID-19 has killed more than half a million Americans. That in and of itself is a jarring statistic, but there’s another grim number to be aware of: each of those deaths has left about nine bereaved people behind. That means that roughly 5 million Americans are grappling with grief and loss, which could put them at higher risk for opioid or other substance abuse. Pain — whether physical, mental or emotional — can cause people to seek out relief. Too often they find it by using or abusing opioids or other drugs.“Grief is a universal feeling that most of us will need to endure at one time or another,” says Clare Waismann, RAS/SUDCC, Waismann Method® and Domus Retreat founder. “Whether you are grieving the loss of a loved one, a job, or even a relationship, grief hurts. When the grief is the result of a death, the level of pain is substantially higher.”The pain of grief can be accentuated by the pandemic, which has disrupted the rituals that are meant to help us process grief. If you are unable to see a loved one before they die, travel to be with your family, or have a funeral, you’re more likely to suffer from complicated grief. Complicated grief is characterized by pain that is so overwhelming it can interfere with your ability to live your day-to-day life. Normally, complicated grief affects about 7% of bereaved people, but during the pandemic the prevalence is likely even higher.Many people with complicated grief turn to maladaptive coping strategies, including substance use and abuse. This is especially true for people who have a history of mental illness or drug dependence.“When the pain becomes overwhelming, the natural emotional response is to search for relief,” Waismann says. “Those with a history of mental health issues or addiction are more likely to fall into a pattern of substance abuse in order to cope.”Preventing substance abuse amid griefThere’s no prescriptive or expected way to move through grief, especially in the shadow of a global pandemic. Even the well-known Stages of Grief are often circular, rather than linear. Generally speaking, however, grief should become more manageable as time passes.“Most people experiencing grief can start the healing process after some time,” Waismann says. “While grief is a familiar and healthy feeling to experience, it is unpleasant and unresolved grief can significantly increase addiction-related issues.”If you feel entirely overwhelmed by grief, it’s important to reach out for professional help from a counselor before you try to self-medicate by using or abusing substances. These steps can also help you process grief:Talk to your loved ones about your feelings.Join a support group for people who are grieving. These are currently available online.Take care of your physical and mental health by exercising and meditating.Do activities that bring you joy, like reading or art.Staying ahead of griefIf you feel that your grief is more overwhelming than it should be, you should seek professional guidance. Remember, there’s no harm in reaching out, but doing so could make a world of difference.“You don’t have to wait until symptoms of grief persist to seek treatment,” Waismann says. “Remember, get ahead of your emotions. Don’t suffer more than you have to.”At Domus Retreat, Waismann provides support for relapse prevention. This can include for people who are experiencing grief, including the death of a loved one during the pandemic. The entire experience at Domus is designed to help people focus on their recovery and wellness.“There are no chores, no pre-set expectations, length of treatment or protocols. We will provide care based on your unique needs,” Waismann says. “We also offer services to support your overall physical and mental wellbeing including yoga, massage, drama therapy, tai chi, and individual psychotherapy.”Stepping back can be exactly what a person needs in order to process their grief and move forward in a healthy way.“We reach you where you are at and help you get where you need to be,” Waismann says.

Anxious about going out into the world? You’re not alone, but there’s help

It’s the moment we thought we were all waiting for…or is it? We were cautiously optimistic about the end of the pandemic in view of increasing vaccine availability and decreasing case numbers after the peak in January.Then, whether due to variants, pandemic fatigue or both, cases and case positivity began to increase again – throwing into question whether the end was as near as we thought. This is merely one of the most recent of the many reversals.I am a physician and associate professor of medicine at Michigan State University’s College of Human Medicine. In my role as the director of wellness, resiliency and vulnerable populations, I speak with staff and faculty members who may need a sympathetic ear or may be struggling.Amid the happiness and relief that people are feeling, I also see confusion and some fear. Some people are wary of going out again, and others are eager to throw a party. Some learned that they like being alone and do not want to stop nesting. I think this is all normal from a year of what I call the zigzag pandemic.Change after changeAwareness of the novel coronavirus for most of us rose between January – when the first cases in China were reported – and March 11, 2020, when the World Health Organization officially declared a pandemic. Since the declaration, daily uncertainty and contradictory information has been the norm.First, no masks were needed. Then you had to wear a mask. Hydroxychloroquine looked promising and got emergency use authorization, but that was revoked fairly quickly and officials said not only was there no benefit but there was some potential harm.We were transiently afraid of groceries, packages and surfaces. Then data emerged that surfaces were not as dangerous as previously thought.In the absence of a coordinated national policy, states began to fend for themselves, creating their own policies regarding shutdowns and masks. Even now, there is state-by-state variability in which businesses may be open and at what capacity and whether masks are required, suggested or neither.Both inevitable and avoidable factors played into the back-and-forth. Part of the whiplash is due to the “novel” part of the novel coronavirus, or SARS-CoV-2. This virus is new and many of its characteristics unknown, leading to policy revisions becoming necessary as more becomes known.Part of the zigzag is due to the nature of clinical trials and the nature of the way scientific knowledge emerges. Learning about a new pathogen requires time and the willingness to challenge initial assumptions. Part is due to the lack of a reliable source of information trusted to act in our collective best interests and a lack of preparedness.Given the reversals behind us and uncertainty ahead, we need to examine both individual and societal responses moving forward.Different experiencesThere is no question that all of our lives have changed. However, the ways in which they have changed has varied widely. The variation depends on our jobs – think of the differences for grocery store, tech and health care workers – our living situations, our underlying physical and mental health, our financial status and our personalities, just to begin with.For example, some introverts have been fortunate enough to work remotely in comfortable clothes with broadband internet and no children to educate, while their extroverted colleagues have longed for more social connection. Their colleagues with young children and jobs that could not be done remotely have been scrambling. Many have hit the wall and find themselves adrift and unmotivated, while others have seemingly thrived doing long-postponed projects.Nearly everyone has been affected in some way. A recent systematic review concluded that the pandemic is associated with highly significant levels of psychological distress, particularly in certain higher-risk groups.As individuals, what can help us get through this?What we can do for ourselvesFirst, we can begin by making a fearless assessment of our current reality – the state of now. Sometimes making an actual list of our needs and assets can help us to prioritize next steps. Steps may be visiting a community health center, a virtual therapist, a job fair or even something as simple as carrying a printable wallet card with stress reduction tips.What might work for you might not work for your spouse, partner or best friend. We need to be doing whatever is known to foster resilience in ourselves and our family members.This includes making human connections, moving our bodies and learning to regulate our emotions. Looking back at how we handled past difficulties may help us. Mental health concerns have become more common, and evidence on overall impact of the pandemic on mental health is still being collected.There has been increased public awareness about these issues, and telehealth has eased access for some seeking help. Our society – individuals as well as institutions – needs to continue to work to make it acceptable for people to get mental health care without worrying about stigma.Deciding which of your normal activities you wish to resume and which to let go of helps you to prepare for the future. So does noting which new activities you’d like to hold on to. These lists potentially include attending family or sporting events, traveling, going to the gym or live worship. You may choose to continue to cook at home or work from home if you have the choice. Of course, all of these choices should be made in accordance with CDC guidelines.And then there are things we may not want to do. That can include behaviors we learned about during the pandemic that don’t make us feel good or serve us well. That may include watching too much news, drinking too much alcohol and not getting enough sleep. And yes, maybe there are some relationships that need changing or reworking.Then, we need to to think about what we can do on a level larger than the individual.Societal and governmental changesFor many people, it feels futile to address individual resilience without addressing what feels like a rigged system.The pandemic hit at a particularly politically polarized time and a particularly unprepared time. This was unfortunate, because fighting a common adversary – such as polio or a world war – can unite a population.In contrast, the coronavirus was subject to multiple conflicting interpretations and even doubt about its severity. Rather than rallying together against the virus, our adherence to mandates became a surrogate for our political beliefs.[Get the best of The Conversation, every weekend. Sign up for our weekly newsletter.]Now that longstanding inequities have been highlighted by differential infection, hospitalization and mortality rates by race, political and public health officials can begin a careful analysis of the gaps in health care coverage by race.While examining how to effectively address longstanding disparities is crucial, so is being prepared for the next pandemic. A coordinated nonpartisan, science-based health infrastructure prepared to rapidly roll out emergency responses as well as consistent clear messaging would be vital. However, without a population willing to consider collective good ahead of individual freedom, we run the risk of repeating history.Claudia Finkelstein, Associate Professor of Medicine, Michigan State UniversityThis article is republished from The Conversation under a Creative Commons license. Read the original article.

Should Happiness Be the Goal? Not Necessarily

In our culture, there’s a big focus on happiness. We’re told to do the things that bring us joy, and we dance to songs called “Happy.” But on a psychological level, happiness isn’t the most important metric to measure well-being.“Although Positive Psychology has focused on happiness, many psychologists say living a personally meaningful life is more important,” says Geoff Thompson, program director at Sunshine Coast Health Centre in British Columbia.At Sunshine Coast Health Centre, Thompson and his team follow the principles of psychiatrist and neurologist Viktor Frankl. Frankl believed that creating a meaningful life was one of the most important pursuits that a person could undertake. Happiness, on the other hand, wasn’t something that a person could prioritize, Frankl believed.“Frankl would say most people mistakenly believe they can pursue happiness as a goal; however, happiness, according to Frankl cannot be pursued; it must ‘ensue,’” from creating a meaningful life, Thompson says. Meaning versus happinessWe might assume that a meaningful life is a happy one, and vice versa, but that isn’t always the case.“Research on happiness suggests that it has more to do with getting personal needs met and being comfortable,” Thompson explains. “Meaning, on the other hand, has more to do with developing courage and resilience, making sense of suffering, and helping others.”Some people who have deeply meaningful lives don’t feel happy in their daily lives — which complicates the question of how to create a life filled with happiness.“Frankl said that happiness ensues from living a meaningful life. You don’t need to work at it. But it’s tricky,” Thompson says. “For example, Mother Teresa was not a particularly happy woman, even though she helped many starving children. We know this because of her letters to her spiritual advisors, which questioned why she suffered so much.”The happiness choiceModern Positive Psychology professes that people can choose to be happy. However, Thompson believes that the choice to be happy comes from choosing to pursue a personally meaningful life.Taking these steps can help you create personal meaning:Know yourself well. Form positive relationships and avoid toxic ones. Choose goals that match your authentic values and beliefs.By focusing on these areas, you can create meaning in your life. Once you have meaningful experience, happiness will ensue.Happiness and recoveryGetting into recovery and sobriety requires a lot of hard work. That might not leave you feeling happy day-to-day, but it likely will help you create meaning in your life.Oftentimes, through therapy, Thompson and his team realize that clients who say that are happy can’t actually pinpoint what that means.“It’s interesting than some clients tell us they are ‘happy,’” Thompson says. “However, when we process this, we typically discover that the client means ‘relieved.’ It’s telling that a client cannot distinguish between the two, almost as if the client has no real idea what happiness is.”If we expect happiness all the time, particularly in recovery, we’re likely to be disappointed.“Alexander Batthyany (a key figure in promoting Frankl’s work) says that a person whose goal is happiness is doomed to fail because suffering is natural to being human,” Thompson explains. “There will always be times when a person is not happy.”Because of that, Thompson recommends skipping the pursuit of happiness.“Much better to focus on living a personally meaningful life,” he says.Sunshine Coast Health Centre is a non 12-step drug and alcohol rehabilitation center in British Columbia. Learn more here.

Addiction and Estrangement

Addiction can roil relationships with abuse, betrayal, and domestic violence, placing great stress on a family. Typically, parents and siblings who try to help or manage a family member’s addiction find themselves sapped of emotional energy and drained of financial resources. My survey shows as many as 10 percent of respondents suspect that a sibling is hiding an addiction.I wonder: Does the addiction produce family problems, or do a dysfunctional family’s issues result in addiction? It sounds like a chicken‑and‑egg question. I suppose at this moment the sequence of events doesn’t really matter to me. What I need is guidance on helping my brother conquer his alcoholism.Typically, when it comes to addiction, many experts advise using “tough love” to change behavior—promoting someone’s welfare by enforcing certain constraints on them or requiring them to take responsibility for their actions. The family uses relationships as leverage, threatening to expel the member who is addicted. The message of this model is explicit: “If you don’t shape up, we will cut you off.”Tough love relies on solid, established relationships; otherwise, the family member at risk may feel he or she has nothing to lose. My relationship with Scott is tenuous, anything but solid. He has lived without me for decades, and if I try tough love, he could easily revert to our former state of estrangement.I wonder if there might be another way.Possible Causes of AddictionAddiction is a complex phenomenon involving physiological, sociological, and psychological variables, and each user reflects some combination of these factors. In Scott’s case, because alcoholism doesn’t run in our family, I don’t think he has a biological predisposition to drink. I suspect my brother’s drinking results from other origins.Current research identifies unexpected influences that also may be at the root of addictive behavior, including emotional trauma, a hostile environment, and a lack of sufficient emotional connections. Addictive behavior may be closely tied to isolation and estrangement. Human beings have a natural and innate need to bond with others and belong to a social circle. When trauma disturbs the ability to attach and connect, a victim often seeks relief from pain through drugs, gambling, pornography, or some other vice.Canadian psychologist Dr. Bruce Alexander conducted a controversial study in the 1970s and 1980s that challenged earlier conclusions on the fundamental nature of addiction. Users, his research suggests, may be trying to address the absence of connection in their lives by drinking and/or using drugs. Working with rats, he found that isolated animals had nothing better to do than use drugs; rats placed in a more engaging environment avoided drug use.Similar results emerged when veterans of the war in Vietnam returned home. Some 20 percent of American troops were using heroin while in Vietnam, and psychologists feared that hundreds of thousands of soldiers would resume their lives in the United States as junkies. However, a study in the Archives of General Psychiatry reported that 95 percent simply stopped using, without rehab or agonizing withdrawal, when they returned home.These studies indicate that addiction is not just about brain chemistry. The environment in which the user lives is a factor. Addiction may, in part, be an adaptation to a lonely, disconnected, or dangerous life. Re‑ markably, a tense relationship with a sister or brother in adolescence may contribute to substance abuse. A 2012 study reported in the Journal of Marriage and Family entitled “Sibling Relationships and Influences in Childhood and Adolescence” found that tense sibling relationships make people more likely to use substances and to be depressed and anxious as teenagers.Those who grow up in homes where loving care is inconsistent, unstable, or absent do not develop the crucial neural wiring for emotional resilience, according to Dr. Gabor Maté, author of In the Realm of Hungry Ghosts, who is an expert in childhood development and trauma and has conducted extensive research in a medical practice for the underserved in downtown Vancouver. Children who are not consistently loved in their young lives often develop a sense that the world is an unsafe place and that people cannot be trusted. Maté suggests that emotional trauma and loss may lie at the core of addiction. A loving family fosters resilience in children, immunizing them from whatever challenges the world may bring. Dr. Maté has found high rates of childhood trauma among the addicts with whom he works, leading him to conclude that emotional damage in childhood may drive some people to use drugs to correct their dysregulated brain waves. “When you don’t have love and connection in your life when you are very, very young,” he explains, “then those important brain circuits just don’t develop properly. And under conditions of abuse, things just don’t develop properly and their brains then are susceptible then when they do the drugs.” He explains that drugs make these people with dysregulated brain waves feel normal, and even loved. “As one patient said to me,” he says, “when she did heroin for the first time, ‘it felt like a warm soft hug, just like a mother hugging a baby.’”Dr. Maté defines addiction broadly, having seen a wide variety of addicted behaviors among his patients. Substance abuse and pornography, for example, are widely accepted as addictions. For people damaged in childhood, he suggests that shopping, chronic overeating or dieting, incessantly checking the cell phone, amassing wealth or power or ultramarathon medals are ways of coping with pain.In a TED Talk, Dr. Maté, who was born to Jewish parents in Budapest just before the Germans occupied Hungary, identifies his own childhood traumas as a source of his addiction: spending thousands of dollars on a collection of classical CDs. He admits to having ignored his family—even neglecting patients in labor—when preoccupied with buying music. His obsessions with work and music, which he characterizes as addictions, have affected his children. “My kids get the same message that they’re not wanted,” he explains. “We pass on the trauma and we pass on the suffering, unconsciously, from one generation to the next. There are many, many ways to fill this emptiness . . . but the emptiness always goes back to what we didn’t get when we were very small.”That statement hits home. Though my brother and I didn’t live as Jews in a Nazi‑occupied country, we derivatively experienced the pain our mother suffered after her expulsion from Germany and the murder of her parents. Our mother’s childhood traumas resulted in her depression and absorption in the past and inhibited her ability to nurture her children.Still, in the end, it’s impossible to determine precisely the source of an addiction problem. Maybe it doesn’t matter anyway. The real question is, What can I do about it? Excerpted from BROTHERS, SISTERS, STRANGERS: Sibling Estrangement and the Road to Reconciliation by Fern Schumer Chapman, published by Viking Books, an imprint of Penguin Publishing Group, a division of Penguin Random House, LLC. Copyright © 2021 by Fern Schumer Chapman. Available now.

The Science of Addiction and the Brain

If you’re of a certain age, you probably are familiar with the famous “This is your brain on drugs” PSA. In the 30-second spot that aired in the 90s, a man holds up an egg (“This is your brain”) before smashing it into a frying pan (“This is your brain on drugs”).The idea of drugs damaging the brain has long been used to try to prevent people from using drugs, or to get them into treatment. While there is truth to the scare tactics, the full picture is much more interesting -- and concerning.Drugs impact your brain while you’re using them, making it more difficult to quit. Brain scans show physical differences in the brains of people with addiction compared to those who do not struggle with substance use disorder. However, there are also signs of hope: research shows that with time, your brain can recover from the damage of addiction.Here are the facts you should know about addiction and the brain.Drugs have a big impact on three areas of the brain. You already know that drugs are bad for your brain, but just stick around for a minute. Understanding exactly how drug use impacts different areas of the brain can help you grasp the nuances of addiction and dependence. With new scientific advances, scientists understand more about the specific impact that drugs have on the brain.While drug use impacts the whole brain, three areas are particularly susceptible to damage from drug use. They are:The basal ganglia: The basal ganglia is part of the brain’s reward circuit. This is where your brain forms habits and patterns, driven by rewards and pleasure. If your basal ganglia finds something pleasurable (like eating, sex or drugs), it will create habits to try to get more of that thing. Drugs overwhelm this system. They’re so overly pleasurable to the brain that they override the ability to experience everyday pleasure, in much the same way that eating a very sweet dish reduces your ability to enjoy the lesser sweetness of fruit. Over time, this means that you can only feel euphoria by taking your drug of choice.The extended amygdala: The extended amygdala controls anxiety, irritation and restlessness. As you use drugs, this area becomes used to having the drug around. When you haven’t used, the extended amygdala kicks into overdrive, creating all the negative feelings of withdrawal. Those symptoms then motivate you to seek more drugs to calm the extended amygdala.The prefrontal cortex: The prefrontal cortex is where your rational, logical decisions are made. As addiction progresses, however, the power of the basal ganglia and the extended amygdala make it more and more difficult for the prefrontal cortex to execute sound decision making.The interaction between liking and needing your substanceMost addiction starts off when someone tries a substance, like opioids or alcohol, and decides that they like how it makes them feel. Maybe it takes the edge off of trauma or quiets a mind that is normally buzzing. Because you enjoyed the sensation that the drug brought on, you seek more of it.Over time, as you continue to use, the processes outlined above unfold. Rather than seeking a drug because you like it, you seek it because you want it, and eventually need it just to feel normal.Soon, you don’t have a feeling of liking the drug any more — you’re not driven by that positive experience. Instead, you’re driven by a powerful need for your substance. You're dependent on your substance, and likely addicted as well.Your brain can recover with time.Learning about the ways that addiction changes the brain can be terrifying. However, scientists are now starting to study what happens to the brain when you get sober. The results are very promising. One study found that within about 14 months, the brains of former methamphetamine users developed normal dopamine patterns, rather than the disrupted dopamine patterns of active drug users.The concept of neuroplasticity tells us that the communication networks in the brain can change and rejuvenate with time. Just like addiction rewired your brain once, recovery and sobriety can rewire it again, this time for the better. Having access to high-quality treatment that includes neural feedback, counseling and medical care can help you heal your brain.Learn more about Oceanside Malibu at http://oceansidemalibu.com/. Reach Oceanside Malibu by phone at (866) 738-6550. Find Oceanside Malibu on Facebook.

Tenets of Treatment for a New Generation

Addiction is an age-old condition, but the idea of getting into recovery is a relatively new phenomenon. Sure, our parents and grandparents had the friends of Bill W. to help them get sober, but they didn’t have research-backed science. In recent years recovery professionals and people whose lives have been touched by addiction have realized that we need a more comprehensive approach: one where science meets compassion to help people have the best chance of getting and staying sober.“It’s 2021, and we have to approach the person struggling with this disease in a different way,” says Matthew Ganem, CEO of Aftermath Addiction Treatment LLC in Wakefield, Massachusetts. When Ganem founded Aftermath with a group of people who were also in recovery from addiction, he vowed to create an addiction treatment facility for a new generation. He and his staff draw on their experience to help their peers succeed. Here’s what that looks like:Ditching The One-Size-Fits-All ApproachToo often, when someone goes to treatment they’re told exactly what their recovery and their sobriety needs to look like. At Aftermath, the staff recognize that there’s no one-size-fits-all approach to recovery. They’ve seen through their own experiences that there are different ways to reclaim your life from drugs or alcohol.“There’s not one right or wrong way to get better,” Ganem says.Aftermath offers an open-ended approach. Clients can choose abstinence, medication-assisted treatment, yoga, physical fitness or any other approach that helps them stay sober, Ganem says.“We have many other support groups or avenues of wellness, mixed with clinical and evidence-based practices to attack the disease from numerous angles.”In his own recovery, Ganem struggled with being told how to get sober, so he doesn’t offer prescriptive advice, but instead lets clients make changes that work for them.“When you have a group of people trying to get better you have to approach them each as an individual,” he says.Focusing on Connection and CompassionAt Aftermath, people in recovery are invited to learn from each other.“It’s people who have been through the fire before and are able to show you the way out that are key,” Ganem says.Aftermath relies on close connections between patients and staff to build trust. When people who are in treatment are handled in a dignified way, with compassion and honesty, they’re more likely to learn from those around them.“We treat people like human beings,” Ganem says. “We support them with compassion and honesty, and try to build them up.”Giving Autonomy to the PatientOne old saying in recovery is still relevant to the new generation seeking treatment: you are the only one who can do the hard work of your recovery.“Essentially, it’s not us as a staff who gets anybody clean and sober,” Ganem says. “It’s the individual and how much effort they put into their recovery that will determine their results.”That doesn’t mean you’re on your own, of course. The staff at Aftermath aim to empower clients, while helping them realize that their health and wellness are in their own hands.“As a staff, we do our best to put them in a position to succeed. Then it’s up to them to put the action in,” he said. “We are in the trenches with them, shoulder-to-shoulder, offering support.”Ganem, who is in recovery himself, hopes that this approach will help people who haven’t found a treatment option that resonates with them.“If you’re struggling right now and it’s hard to find hope, give yourself the opportunity to do better,” he said. “Reach out for help, get into detox, do whatever it takes to give yourself that chance of recovery.”He knows from personal experience just how life-changing taking that step can be.“I promise you won’t regret it,” Ganem says. “Life is a hell of a lot better when you’re not struggling every day to get drunk or high. The fact is that you deserve to have a better life.”Aftermath Addiction Treatment Center is a treatment center located in Wakefield, Massachusetts. Find out more here.