Procrastination!

TED Talk - The Mind of a Master Procrastinator

What If My Child Is Suicidal?

Posted by Brad Reedy, Owner & Clinical Director at Evoke Therapy Programs on September 05, 2016

Someone told me not to write on this subject unless I was prepared to write another book. They suggested, “Nothing you write, no matter how much, will be enough to answer the questions a grieving parent can ask.” Many reports suggest the greatest tragedy that a person can experience—which becomes compounded if the death is the result of a suicide—is the death of a child. As a father of four, I cannot imagine losing one of my children, and I cannot imagine how I would manage to go on with that kind of grief. I assume this is a wound from which I would never fully recover. When I am asked the question about how far a parent should go to essentially ensure their child’s survival, I cannot answer it. No therapist or expert can ever answer that question. Even if we did, and the parents followed our advice exactly, yet their child still took his or her own life, then the parents would likely blame both us and themselves for not doing more.

READ THE FULL BLOG POST....

How changes in today's marijuana make it more addictive...

Listen to this, from CBC Radio show The Current:

How changes in today's marijuana make it more addictive

http://www.cbc.ca/listen/shows/the-current/segment/10924557

Legalized marijuana is on its way next year. And one of the big questions looming is what it will mean for Canadian teens. A CBC investigation looks into the potency of today's pot.

Thank you Rand Teed for this gem...

“Starting over is not a sign of failure. I look at it this way: A person enrolled at the wrong life college, underwent some hellish classes, passed a lot of difficult tests, majored in perspective, and a minored in minor things. However, they graduated at the top of their class and are now qualified to teach a course titled, How Not To Do That Ever Again.”  Shanon L. Alder

CCSA - Clearing the Smoke on Cannabis, Sept 2016

Highlights – An Update

This document highlights findings from a series of reports that reviews the effects

of cannabis use on various aspects of human functioning and development. Specifically, the reports address: Chronic Use and Cognitive Functioning and

Mental Health; Maternal Cannabis Use during Pregnancy; Cannabis Use and Driving; Respiratory Effects of Cannabis Smoking; and Medical Use of Cannabis

and Cannabinoids. This series is intended for a broad audience, including health professionals, policy makers and researchers.

What is it?

• Cannabis is a greenish or brownish material consisting of the dried flowering, fruiting tops and leaves of the cannabis plant Cannabis Sativa.
  
• Hashish or cannabis resin is the dried brown or black resinous secretion coating the flowering tops of the cannabis plant.
  
• Cannabis is known by many names including marijuana, weed, hash—and others.
  
• Cannabis is most often smoked in a “joint.” It is also smoked in a water pipe or “bong,” where the smoke is drawn through water to cool it and lter out small particles before inhaling. It can also be vaporized in an e-cigarette or consumed in edible products.
  
• Currently in Canada, licensed producers and registered individuals can supply cannabis for medical purposes in fresh, dried and oil forms (Health Canada, 2016).
  Who’s using it?
  After alcohol, cannabis is the most widely used psychoactive substance in Canada.
  

• About 11% of all Canadians aged 15 and older have used cannabis at least once in the past year according to the 2013 Canadian Tobacco, Alcohol and Drugs Survey (CTADS) (Statistics Canada, 2015).
  
• In the CTADS report for 2013, about 28% of those who used cannabis in the past three months reported that they used it every day or almost every day (Statistics Canada, 2015). 
  
  
  READ THE REST OF THIS REPORT

Who Says Self-Care Has to Be Monumental?

Simple Yet Effective Practices You Can Use on the Go

Ashley Davis Bush • 11/10/2016 • 2 Comments

It was a series of upending life events over a period of years—some bad, some good, all unexpected and disorienting—that gradually propelled me into a state of mind-numbing, body-exhausting burnout. First, there was my husband’s cancer, his surgery, and the seven months spent watching him suffer through the spirit-breaking ordeal of chemotherapy. During those months, I’d prayed and cried and white-knuckled my way through an endless, dark valley of alternating fear, anguish, and desperate hope.

But then it was over. My husband got better. The casseroles stopped appearing on our doorsteps, and the encouraging cards and calls stopped coming. We both plunged heart and soul back into our lives. Daniel, as if to make up for the time he’d lost, started full-time graduate school in mental health counseling. I began expanding my practice to cover the costs of his schooling and the pile of medical bills we’d accumulated. I also signed a contract on a book deal, with a deadline looming. Meanwhile, we had five children of our blended family still at home, four of whom were teenagers. Life felt something like walking uphill, against the wind, in a blizzard.

The Breakdown

And I got tired—tired all the time, and irritable much of the time with Daniel and the kids. Worse, I began feeling apathetic at work, even as my clients’ painful stories began following me home, haunting my dreams at night. Then my back blew out, as if telling me I couldn’t bear the weight of my life. As I recalled the story of a burnt-out colleague who’d quit the field altogether to open a Greek restaurant, I began to wonder if this was my fate.

At work, the final straw came one evening when my seventh client of the day—a 34-year-old woman devastated by the unexpected loss of her mother—sat across from me, and I found myself, a grief counselor for more than 20 years, wanting to slap her across the face and say, “Get over it!” That I could even think such a thing was a body blow to my sense of professional ethics and self-respect. What kind of therapist feels like that about a grieving client?

Suddenly, I felt not only overworked and undernourished, but potentially unhelpful, or even damaging, to the people I wanted to help. So I started reading any book I could find on burnout, anything about being personally or professionally fried, toasted, mashed, boiled, and charred.

The dominant advice was simple: do more self-care. Unfortunately, the suggestions, which I’ve since come to call macro self-care, usually seemed to require substantial commitments of time, effort, and often money: take more vacations, meditate 40 minutes daily, join a health club or at least do yoga and get aerobic exercise four or five times a week, begin painting or cooking or gardening, go to a spa, spend time in nature, make lists every day of what you’re grateful for, get more sleep, and so on. It wasn’t that there was anything necessarily wrong with these suggestions, but always implicit was the idea that self-care needed to be a big, life-changing project, and that unless you approached it with that kind of investment, you were wasting your time.

The Breakthrough

Fortunately, a few days later, something happened that started me on a different kind of route to burnout prevention—an approach that even I could follow. It all began when I started to come unglued during an intake interview with a grieving mother, who was telling me in excruciating detail about discovering her 18-year-old son’s dead body in his bedroom after he’d hung himself with a belt.

Although I’d heard numerous graphic and heartbreaking stories throughout my career, this time, I actually started to feel lightheaded. I considered excusing myself to go to the bathroom but was afraid I’d faint if I stood up. I thought about redirecting the conversation, but in that moment, I couldn’t actually speak. I just kept nodding.

And then I remembered an exercise called “strong back, soft front” I’d heard about in a webinar by Buddhist abbot Joan Halifax, author of Being with Dying. She’d devised the practice for people working with the dying and their families to help them strengthen their back for support and soften their front for compassion. So right there in the session, I pulled my belly button toward my spine and straightened my back, imagining a string pulling me up from the top of my head. Then I took a deep belly breath, relaxing my stomach outward and mentally softening toward my client. This process took all of 15 seconds, while my client kept tearfully telling her story, unaware of my experience.

It worked. I felt better. The deep breathing had stimulated my parasympathetic nervous system, making me immediately more relaxed. I regained my dual awareness and recognized that my client’s feelings weren’t my own. I felt more present in the room as my mind cleared.

After my client left, I asked myself, What just happened? I’d had a freakout followed by a turnaround. I’d engaged in a spontaneous, brief practice that had helped me feel calmer right in the midst of a disturbing experience. I’d interrupted a stress response without interrupting the session—and it hadn’t cost any money or taken much time. In essence, I’d protected and replenished myself through the use of a directed and intentional practice of micro self-care.

The Shift

I felt I was onto something, and the germ of an idea—micro self-care—began to grow. Self-care wasn’t just a remote possibility outside the office: it was available inside the office, even during a session. So why not try more quickie, self-replenishing practices throughout the day, every day? While macro self-care was great when I could fit it in, micro self-care was available at all times, on demand. I could assemble an array of brief tools that would be simple, free, and doable.

Micro self-care, I decided, is about the benefits of making small changes with reliable frequency. This mirrors what we’re learning from the newest developments in self-directed neuroplasticity—that the brain’s ability to reorganize itself with new neural networks happens with the targeted use of brief, repetitive experiences. The emphasis is on repetition. Small and frequent works better to create desirable neural pathways than big and seldom.

The Plan

I knew that for these behavioral changes to have any effect on my life, they needed to become routine—a series of habits as ingrained as brushing my teeth or drinking my afternoon cup of tea. And I knew that habits are best formed when they include a trigger, or prompt. So I strategically incorporated a grounding tool at the beginning of my workday to start the day feeling anchored and steady, an energizing tool right after lunch to counteract the afternoon energy slump, and a relaxing tool at the end of my workday to help me leave work at the office before transitioning to home.

My initial grounding practice was a one-minute meditation, timed on my phone, inspired by Martin Boroson’s book One-Moment Meditation, which argues that it only takes a minute to reduce your stress and refresh your mind. I focused on one minute of breathing but added a few words. On the in-breath, I thought, I am calm and on the out-breath, I thought, I am grounded. Occasionally, I added a background sound of ocean waves from a free app of nature sounds. What I noticed is that this short practice allowed me to start my day from a place of peaceful centeredness, rather than from the usual careening rush of a breathless “go, go, go.”

For my postlunch practice, I marched in place, knees high, arms swinging, crossing my right elbow to my left knee and my left elbow to my right knee. I learned this exercise, called the Cross Crawl, from Donna Eden, author of Energy Medicine, as a way to balance and energize the nervous system. I added the words I am awake and ready to the practice. After doing this, I could feel the blood flowing through my body, readying me to face the next appointment with enthusiasm, rather than the sluggishness that often comes with the postlunch blues.

My end-of-day practice was an ancient yogic breathing technique I learned from Andrew Weil. You inhale for the count of four, hold your breath for the count of seven, and exhale your breath as if blowing out through a straw to the count of eight. This is repeated three times. Called the 4-7-8 breath or diaphragmatic breathing, this is a standard relaxation resource in the EMDR therapy protocol. For me, it created a state shift in which I could truly leave my work behind and transition more freely to a pleasant evening at home.

For a week, I diligently worked with these three practices. As I used them, I told myself, I’m doing this to take care of myself today. I’m doing this because I need restoration and I deserve self-care. In fact, highlighting the compassionate nature of these activities increased my felt sense of being renewed and fortified my intention to continue.

Today, years later, I’m more on equanimity cruise control than in crisis mode. That said, life is still life. Last year, I grieved the loss of my beloved 15-year-old golden retriever. This year, I launch another child to college, which includes a mixture of pride and joy, as well as emotional and financial strain. And clients continue to come with heartbreaking stories.

So what have I learned? It’s true that self-care is fundamental to my ability to be my best self, personally and professionally. And I haven’t thrown out macro self-care with the bathwater, engaging in those activities as time allows. But it’s the paradigm shift to targeted micro self-care, the cultivation of small replenishing moments throughout the day, that continues to make a crucial difference in my ongoing stress level. I guess my grandmother was right when she told me that “less is more.”

This blog is excerpted from "Little and Often" by Ashley Davis Bush. The full version is available in the May/June 2015 issue, Burnout: New Approaches to Rekindling the Flame.

New York Times Review of "Wilderness", the play....

Therapy Becomes Theatre in "Wilderness"

DIXIE NATIONAL FOREST, UTAH — Standing off to the side of a dusty, unpaved road through the high desert, taking a break from a late-summer hike, the  producer Anne Hamburger listened as a small gaggle of teenagers walked her through a favorite joke. With camp gear dangling from their enormous packs, the teenagers weren’t out there for recreation. They were clients in a wilderness therapy program like the one Ms. Hamburger sent her adolescent son to in 2014 — an episode that inspired her new documentary theater piece, “Wilderness,” in previews starting Friday, Oct. 21, at Abrons Arts Center. She was spending a couple of days with them for research, and the teenagers — four boys and a transgender girl, part of Evoke Therapy Programs’ Group 6 — were lobbying her to put their grim, poignant little riddle in the show. They like to pose it to new arrivals when an airplane passes overhead.

“How far away do you think that plane is?” they’ll ask, gazing skyward. The newbies inevitably interpret the question in terms of distance, but the whole point of the joke is time — how long it will be until they get out of this program and fly away home, back to the parents who sent them here for intensive help with intractable problems like drug use or depression, defiance or self-harm. The wry punch line is a ballpark figure: “12 to 15 weeks.”  READ THE REVIEW HERE 

Book Recommendation.....

This is an incredibly useful tool for learningIt's scope reaches far and wide as it's not just about parenting. It's instructive around communication, codependency, healthy boundaries and detachment, it is a model for healthy living. It's also available in ebook and audio book formats. Brad is a colleague I came to know through my work with Evoke Wilderness treatment centres, formerly Second Nature in the US. It is a must read! I got the audio version Amazon's Audible app. Then I bought a hard copy to review and highlight. 

Sustainable Recovery donating to Alberta Fires Appeal....

Sustainable Recovery Counselling has given a portion of revenue this month to support the Alberta Fires in order to help those displaced by the Fort McMurray inferno. 
On Thursday Justin Trudeau's government promised to match Red Cross donations, so we have donated to that umbrella organization to maximize our contribution. 

Susan Raphael 

CCSA Report - Substance Use and Suicide - Summary

Substance Use and Suicide among Youth:

Prevention and Intervention Strategies

Key Messages



Substance use and suicidality frequently co-occur among youth    and share many of the same risk and protective factors. 


Substance use is a significant risk factor for suicidal ideation, attempted suicide and completed suicide. Suicide prevention resources have been developed for healthcare practitioners and others who come into contact with individuals who have substance use issues. 


Further evaluations are needed to determine the impact of these prevention resources and whether they are effective in youth with substance use problems. 


Although the available evidence is limited, there are some promising emerging treatment strategies for youth with co-occurring substance use and suicidality.

What is Comorbidity?

Comorbidity: Addiction & Other Mental Disorders

The term “comorbidity” describes two or more disorders or illnesses occurring in the same person. They can occur at the same time or one after the other. Comorbidity also implies interactions between the illnesses that can worsen the course of both.

Is Drug Addiction a Mental Illness?

Yes. Addiction changes the brain in fundamental ways, disturbing a person’s normal hierarchy of needs and desires and substituting new priorities connected with procuring and using the drug. The resulting compulsive behaviors that weaken the ability to control impulses, despite the negative consequences, are similar to hallmarks of other mental illnesses.

How Common Are Comorbid Drug Addiction and Other Mental Illnesses?

Many people who are addicted to drugs are also diagnosed with other mental disorders and vice versa. For example, compared with the general population, people addicted to drugs are roughly twice as likely to suffer from mood and anxiety disorders, with the reverse also true.

Why Do These Disorders Often Co-occur?

Although drug use disorders commonly occur with other mental illnesses, this does not mean that one caused the other, even if one appeared first. In fact, establishing which came first or why can be difficult. However, research suggests the following possibilities for this common co-occurrence:

• Drug abuse may bring about symptoms of another mental illness. Increased risk of psychosis in vulnerable marijuana users suggests this possibility.
• Mental disorders can lead to drug abuse, possibly as a means of “self-medication.” Patients suffering from anxiety or depression may rely on alcohol, tobacco, and other drugs to temporarily alleviate their symptoms.

These disorders could also be caused by shared risk factors, such as—

• Overlapping genetic vulnerabilities. Predisposing genetic factors may make a person susceptible to both addiction and other mental disorders or to having a greater risk of a second disorder once the first appears.
• Overlapping environmental triggers. Stress, trauma (such as physical or sexual abuse), and early exposure to drugs are common environmental factors that can lead to addiction and other mental illnesses.
• Involvement of similar brain regions. Brain systems that respond to reward and stress, for example, are affected by drugs of abuse and may show abnormalities in patients with certain mental disorders.
• Drug use disorders and other mental illnesses are developmental disorders. That means they often begin in the teen years or even younger—periods when the brain experiences dramatic developmental changes. Early exposure to drugs of abuse may change the brain in ways that increase the risk for mental disorders. Also, early symptoms of a mental disorder may indicate an increased risk for later drug use.  

READ MORE What is Comorbidity?

“…because if to be free is the most important goal of all, then to help someone else to be or to become free must be the most sublime and rewarding of human endeavours.” 

Elie Wiesel