Self Harm

Self harm is a pattern of behaviour that, like so many addictive patterns and dysfunctional coping mechanisms, can be hidden in plain view, even in those as young as under 10 yrs old. Here are some important early warning signs, behaviours and influences that may help you catch it sooner and in a way that is helpful to you and your child. 

There is always a danger of a child being out of their depth when they are driven by emotion, as the self-regulation function is out of register. So for example when someone is angry they will have elevated levels of adrenaline and noradrenalin in their system, which inhibits the experience of pain. So when they are e.g. cutting themselves they may well cut too deep as they simply do not feel it. Its incredibly important to accept a child’s emotional expression, even if it feels too much or out of order.  A child will earn quickly if you help them manage their experience and expression of these emotions respectfully and with boundaries.

If your child is cutting or burning, seek medical help for the wounds; if you feel out of your depth and that you cannot deal with the way your child is behaving then seek support from a child and adolescent psychotherapist (one with integrative arts training is particularly effective for less invasive intervention and assessment) or an EMDR therapist who specialises in working with children. You can also seek support for yourself from an addiction specialist. Trying to deal with it yourself and failing can generate negative emotions, making the child feel even more hopeless and the parent feel useless. Both will foster resentment, which in turn drives the urge to self-harm – a vicious circle.

Please note a child can also self harm by inviting and provoking physical assault from siblings or parents. It is a way to indirectly ventilate emotion, such as anger or hurt, by making another person responsible. If your child (or indeed any member of your family) is perpetually making you want to rage at them or hit them, then they may be using you as a conduit to express their own pain. The acting out is simply a purging of the overwhelm and will not deal with the problem. So the parent who feels ‘better’ after screaming is describing the feeling of empty before inevitably ‘filling up ‘ again. The answer is to treat the pattern as a clue to a hidden issue that if dealt with appropriately can be treated. Again EMDR is particularly effective as a brief and non-invasive trauma intervention. It works with an ‘unconscious’ part of the brain, and can bring about significant changes for a person in terms of how they manage mood and memories, in a relatively short period of time.  Highly effective for children as they don’t need to be able to talk well to get well.

I think we need to keep in mind how much pressure children are under to perform in today’s globally competitive world. They are competing physically, mentally, socially, practically…. And children are very quick to criticise and shame one another, and have access to multiple ways to put themselves up by putting another person down. (i.e. bullying, cyber bullying). The impact of negative attention can spread widely and quickly, alienating and scapegoating a child almost overnight. Children know this and are keen to remain ‘in’ with one another, placing them on high alert about what they wear, look like – weight, size, fashion sense, ability, image, spots, hair growth, etc.

Constant exams and testing places them under strain to pass but doesn’t introduce a concept of in-depth learning and consideration, so they are culturally encouraged to skim the surface – by implication, this does not teach them how to cope with deeper emotions. I often meet children who think they are ridiculous and over sensitive for having certain emotional needs or experiences, yet on further exploration I will often find they are displaying and experiencing a ‘normal’ level of affect.

I believe that many children are left to their own devices too much and do not have what I would consider to be a consistent model of a ‘good enough parent’ – providing the temporary regulation, a respectful guide, in a consistent way of a parent who is in good shape themselves. Many parents are over stretched and as a result either the child ends up taking care of the parent (not needing or wanting anything from them) or they sadly neglect the child’s core needs believing that to simply feed them, have a laugh and get them to school is enough. Children’s brains are not fully developed until the end of the teen years so until then they require guidance (decreasing as they get older) from someone they can trust and respect – pie in the sky?

I have met countless children in the middle class demographic, who when they experience profound emotion will seek ways to cope with it that are self-sufficient and appear to be short term. (ie hitting self when angry, punching self, banging head against a wall, scratching, cutting, burning, starving) and their families know they do it have not taken it seriously, often coping with it by making a joke of how sensitive the child is, perhaps in the hope that it will simply ‘go away’. But in my experience these things often graduate into eating disorders, codependence (needy giving), and alcohol and drug abuse and misuse. It is a visible part of the addictive cycle that is awash in today’s culture and it should be dealt with seriously at an early age when there is an opportunity for effective and brief intervention.

 

New Year Sober

It can be a real challenge staying in recovery at this time of year. Everywhere you look there seems to be food, alcohol, drugs…it’s hard to see anything other than the things you have decided to stop doing.  I’ve noticed this phenomenon before in my life, for example after I had a miscarriage all I seemed to see were pregnant women everywhere.  Believe it or not, this process has a name: attentional bias.  Your brain can take in massive amounts of diverse information, but we would live in a state of perpetual overwhelm if we didn’t have a filter system. So according to past preferences and current stimuli, your brain begins a selection process to decide what to bring to your conscious attention. Thus if you have prioritised a certain topic for long enough, your brain is primed to clear it through the selection process and hey presto: it arrives as a conscious thought.

Thus in the early stages of recovery your behaviour may have changed but the filter system remains as it was for a while, offering up ‘stinking thinking’ supported by evidence provided by your brain’s attentional bias. You need to be able to challenge this primed experience and seek out new experiences that are clean and sober, as they do exist.

It is that familiar dichotomy: listen to your feelings, don’t listen to your feelings. This means that you need to be able to have your feelings, but don’t let them dictate your behaviour. Do not believe your own press, instead stick to the plan!

So this New Year’s Eve don’t wait to be hijacked by old thoughts, make plans!

  1. Find out if any of your sober friends want to go out and make arrangements to meet and go out together as a crowd
  2. Go somewhere familiar – its often tempting to do something different because its NYE, but it often goes wrong
  3. Don’t call anyone from your past on a whim: stay in the present with people you are with
  4. If you do want to go out in a mixed crowd, make sure someone you trust in onside to help support you to stay sober, and lean on them
  5. Know what you will drink – here’s a few of my and friends favourites… ginger beer, cranberry juice, lime and soda, lemonade, elderflower, appletise, Virgin Mary,
  6. Remember it’s the build up of feelings (usually resentment) that fuels a relapse – be with people you can talk honestly to, and talk to them!
  7. If you decide to stay in on your own make sure you have things to entertain you – DVDs or a good book, with a healthy meal and a couple of friends phone numbers to check in with because that pang of loneliness may come and it’s a powerful adversary to take on alone…channel flicking at midnight is NOT a good idea as you are likely to see the best bits of everyone else’s parties and you will feel its too late to call to chat…
  8. If you run into trouble, call the AA/NA helpline – there is always someone to speak to who understands…you are truly not alone: many have gone before you and many will follow, all you have to do is the rest right thing
  9. Get to a meeting on NYE and remember the gift that is recovery: share positively
  10. Before you take any decision, play the tape forward and call someone

And at the end of the day, remember, its just another night.  So here’s wishing you all a very HAPPY NEW YEAR! I hope that 2013 mark the beginning of a year that you are proud of.

Illness

Couldn’t believe it…as I turned the key behind me on Friday night, I almost immediately felt ill. Over the 2 hours commute home I felt worse and worse and by the time I got back I could barely walk. I took cold and flu capsules and took to my bed, only to wake the next morning with a ferocious cough and cold that left me breathless. But I had been meticulously working towards this week for months and was going to put up a fight!

Being ill is always a challenge for people in recovery.  Do you take the meds or not? Should you take ones that make you drowsy or contain codeine? Not a great idea… So where is your bottom line?

Thankfully I have had the good fortune to know an amazing natural healer who has shared many secrets with me over the years, one of which I shall share with you now…

A drink that tastes FAR better than it sounds (it couldn’t taste worse!), this will boost your immune system, and protect many of your main organs including the heart and the liver (it will also get you socially rejected…don’t take it personally!).

Whizz: 3 peeled garlic cloves, 2 unpeeled carrots I stick of celery with leaves, I medium tomato, 1scrubbed sweet potato, unpeeled, & cut into sticks, ½ deseeded Jalepeno pepper, a thumb length of white radish and add water for texture.

Drink twice a day for 3 days!

Good health and happy Christmas!

One year clean and sober, in a letter to her brother, this Charter alumni feels the pain of the family illness…

“A year and a half ago you came to visit me in one of the detox centres I was in and out of, and told me you were scared I was going to kill myself in my active addiction. You were so frightened I would die and at the time I couldn’t and didn’t want to hear you. I was so in it I couldn’t acknowledge what I was doing to myself or to my family.

Thank you for trying though and for being there.

Today I need to tell you how I feel: Its my turn to feel scared that now you will kill yourself with your alcoholism. You and I share the condition of alcoholism/addiction (it’s one and the same) and what I also want to tell you is this: it is soooo possible to have a good quality life without drugs or alcohol!

Though I am the first to understand and the last to judge how you live your life, I am extremely worried for and about you. Frequent drunk driving and destroying our body and health are just two of the many examples of crazy things we both do in active alcoholism/addiction. I can’t continue to stand by and pretend it’s okay, that’s it’s normal and that’s just the way it is- it’s not okay- it’s not normal- and you deserve so much better. You are a beautiful and very special person who deserves a good and happy life.

Before, I couldn’t imagine a life without drink or drugs- what would be left of me?? I was also really scared to stop because then I would have to face my past and my demons and deal with my issues- I thought it would be harder than continuing to use. But nothing is worst than the acute pain of the shame, loneliness and guilt that accompanies active alcoholism/addiction.

Life is not easy but from where I was, I am now generally content and even often happy! And I feel free of that constant shame, guilt, obsession and control- no more lies, I can look people in the eyes (including my family who I adore) and I feel free and hopeful!

THIS IS POSSIBLE FOR YOU TOO!! I believe this 100% and I am so here for you if and when you decide to ask for help. And we can kick this disease in the ass!

I love you and hope to see you soon.”

Minimum Price for Alcohol

http://www.guardian.co.uk/society/2012/nov/28/45p-minimum-alcohol-price-crime

I completely support a minimum price for alcohol of 50p per unit, and welcome the introduction of 45p. I hope it doesn’t stop there. Research shows that money plays a big part in young drinkers and heavy drinkers where quality is not the point, getting drunk is the sole goal, but we need to not only make it difficult for these drinkers to achieve this but also support them to work through whatever their time bomb is that drives them to binge drink in the first place.

 

National Treatment Agency warns club drug users

I read this article with great interest. I have worked with many club drug users and it does demand a different approach insomauch as it is crucial to attend to the person in relation to their peer group as a fundamental part of treatment. Like with any other drug dependence, we have to help the person get abstinent, but for this to be sustainable, they must learn how to allow themselves to have fun, socialise, dance and meet people clean.  So many people relapse (or live miserably) because they just cannot function socially without the drug – it becomes a choice between sober isolation of drug affected interaction. It’s not easy to overcome social anxiety at the best of times, but when your ability has been propped up by years of drug use, it can feel impossible.  Working to develop a strong sense of who you are, your own sense of humour, a comfort in your skin so you can stand without feeling self conscious, dance without reservation, chat with less fear is fundamental to a successful and wholehearted recovery.

Read the full article:  http://www.nta.nhs.uk/Club%20drugs%20report%202012.aspx

Outside Edge

I have just had the great pleasure of spending the afternoon on a houseboat in Chelsea at an intimate showing by Outside Edge of excerpts from Jerusalem, performed by Mark Rylance, and three others from this pioneering theatre company.

Outside Edge is the brainchild of Phil Fox who, with the vital support of David Charkham and trustees Simon Woodruffe of Yo! and Led Zepplin’s Jimmy Page, takes productions that are written to mirror the audience’s story, into treatment and prison settings. The way it works is in a way like an extended role-play, so that the audience is encouraged to interact with the actors and affect the process and ending by responding to the script and action as the performance goes along.

Role-play is a fundamental part of the programme at Charter and for my work in schools, so that a person inhabits the other persons skin, walks for a moment in another persons shoes…you could call it momentary other centredness and it works like magic (most of the time!) Outside Edge does this in a structured way on a bigger scale, though it remains simple and personal, and very accessible.

Simon Woodruffe and Mark Rylance spoke with commitment and passion for a society where this kind of resource is available to everyone, and I echo this; access to the resources and benefits of recovery should not be marginalized to the world of severe addiction.

Prevention is better than cure, early intervention is key, and inspiration and education can play a huge part in changing the direction of a young persons life. Outside Edge, like many of us in the recovery community, has a powerful resource at its fingertips with a much wider application than addiction. I am in no doubt that the 12 steps helped me to recover from completely losing hope when I fell foul of severe Rheumatoid Arthritis. There is so much more we can do with what we have if we all join hands and work together…I’m in…

‘Functional Alcoholics’…an oxymoron fuelling denial

If you are alcoholic you cannot function as a whole person. That is one definition of the condition. There is a behaviour in place (alcohol) that compensates for an emotional need (eg stress, self esteem, intimacy) that has become a need in its own right (continued drinking) so that this emotional need does not leak into the real world. Thus the person is not really known by those ‘close’ to them, as they perpetuate an image, a version of themselves, that is not quite the truth, all the while bolstered by alcohol. So do they function? Or do they only function?

Last weeks press commented on a middle class population drinking themselves into ill health and I believe these are the very same ‘functional alcoholics’. The commuters, workers, mums in the school yard – these are today’s problem drinkers it seems ‘responsible for 10 times the costs of young drinkers’ according to Alcohol Concern, ‘unwitting[ly] …taking serious risks with their health’ and drinking their stresses and exhaustion away. Only it doesn’t go away, it sits there ignited into its own need for more alcohol. To drink alcohol to compensate for emotional need is to make a monster.

And this functional behaviour, is this to appear civilized, all the while arguing and stressing behind the scenes?

I meet children of functional alcoholics who are often scapegoated into addictive behaviour themselves. Mutinous they sit in my rooms, often with a parent wringing their hands, bemoaning their loss of potential. And when these children start talking they are angry. They have often been given money to fix emotional need, as it is the currency that enables the parent to feel functional. They have been placed second to the drinking. The lies and secrets that they have been silently asked to keep so that the alcoholic status quo can rule has left them no alternative but to act out, or act in. Welcome to ACOA – the adult child of an alcoholic: self sufficient yet insecure, these children also often feel guilty about their feelings of anger and sense of neglect as they can see their parent is working ‘so hard’ or is ‘so damaged’ or that the child is ‘given everything’ so wherefore this sense of loss, of anger?

But sadly it does not surprise me. The denial in our society is supreme. Drinking is endorsed, celebrated as a badge of strength – caner’s pride – or brushed under the carpet (again) with bullish denial that shames the concerned into silence: ‘it wasn’t that bad’, ‘everybody does it’, ‘lighten up’, or  ‘do you want me to stop drinking and stay at home every night?’ Or some such variation on a theme that employs tactics that minimize, exaggerate, universalise, generalise – whatever they do they ameliorate the fact and park the issue one more time.

It is so very very hard for a family member to bring a concern about a loved one’s drinking – so hard that most people miss the opportunity for early intervention, coming to someone like me when they are on their knees – can you save my marriage / my job / have I ruined my children? But I need to say that the shame, fear and regret does not have to be such a burden if you get help sooner!

Recovery Awareness Reception

Our forthcoming Recovery Awareness Reception on October 2nd will be held in alliance with eating disorder experts, Montrose Manor who are based in Cape Town. With a long-standing relationship in collaboration of care we share similar views about addiction – what it is and how it should be treated – and similar frustrations around how the illness is perceived and therefore treated in the UK.

Charter is predominantly designed as a day programme where people can get well in the context of their lives. This is a deliberate design as those addicts I want to work with are not at the critical end of the continuum (though they may feel it) but somewhere in between, where denial still reigns and trouble usually follows. These people, these addicts, are living amongst us, on the tube, at work; they are serving you, picking up the kids, functioning at some level. These are my clients. I work where intervention happens in time for a full and happy life to be possible.

I believe that abstinence is not the goal, but the means, and thus at Charter we work with each client on the core characteristics of addiction rather than necessarily the drug of choice, reducing the risk of devastating relapse and cross addiction.

Addiction is a human condition, it’s relational and it operates on a continuum. Where you are on that continuum plays a huge part in what sort of treatment you will respond best to. The work we do here is extraordinary, consistently turning out sustainable recovery, as evidenced by our thriving aftercare community. It is possible not only to get clean, but also to live a happy and fulfilling life. Aim for the stars…(and don’t stop flapping your wings ‘til you get there!)

One of the reasons I was interested in hosting this event with Montrose was because we need challenging dialogue amongst the thinkers and decision makers who are interested in this incredibly difficult human condition so that addiction is not marginalised to the confines of the extreme cases, but seen in a broader light, often where an opportunity of early intervention lies. (Is this where I mention being able to spot an addict at age 7…?)

Stress and Addiction

The fact that stress is causing an increase in alcohol consumption and prescription/over the counter drug use does not surprise me. Sadly though this is a pattern that becomes increasingly habitual and with trouble usually hot on its heels.  We cannot control what happens in life, but I maintain we are responsible for how we behave in response to life’s curve balls. Drinking or numbing yourself from reality – indeed anything that fosters an attitude of fear, procrastination, deceit and denial – will only delay the inevitable, amplified by that delay.  Drinking should be a pleasure not an escape; prescription drugs should medicate diagnosed mental illness, preferably by a psychiatrist or psychologist; over the counter medications should provide temporary relief for physical symptoms- and counselling provides a forum where you can ventilate your emotions and learn how to live apace with the highs and lows in your life without compromising your integrity – now theres a thought!