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!

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…

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!

Charter gains a touch of Alchemy…

UK’s top Addiction Specialists launch Charter Adolescents

Have communications with your adolescent broken down? Do they seem unhappy or anxious?  Are you concerned they may be drinking or using alcohol or other addictive substances? 

Then Charter Adolescents can help.

Research shows that Adolescents are more vulnerable than any other age group to developing, alcohol and other drug addictions in fact drug use is higher among young people than the adult population as a whole[1], yet there are a lack of specialist facilities to help them.

[1] http://www.homeoffice.gov.uk/publications/science-research-statistics/research-statistics/crime-research/drugs-misuse-dec-1112-tabs/extent-young-tabs

Which is why Mandy Saligari, Founder and Director of leading London addiction facility Charter Day Care, Residential and Counselling Centres has joined forces with Stephen Noel-Hill of Alchemy to form Charter Adolescents.

Stephen has extensive experience working with adolescents and young people spanning twelve years working at the Priory Hospital Roehampton and Adolescent Units in Holland.

Mandy has a well-established presence in independent schools lecturing on addiction, parenting for prevention and self-esteem. She has long since wanted to set up a service especially for adolescents addressing the issues that are brought to the surface in these school talks.

“Adolescents are particularly vulnerable to self-defeating coping mechanisms, our main aim with this service is to encourage a valuable sense of self, working with the young person and their parents – many of whom just don’t know how to cope with the issues their children are raising or the behavior they are presenting.”

Both Mandy and Stephen understand that that early intervention and prevention are fundamental to successful outcomes. It is this common vision that led them to merge Alchemy into Charter.

Charter Adolescents is an exciting new service that will do what Charter does best: intensive non-residential treatment and multi-disciplined counselling and therapy. The focus is on early intervention, education, emotional development and appropriate referral to give the adolescent and the family a new lease of life.

With a counselling team who are specialists in this area and experienced in work with young people, alongside Stephen’s expertise and Mandy’s guidance, this service will be dedicated to young people.

Working in groups, individual and family sessions and workshops, after school hours and at weekends, Charter Adolescents is an intensive and brief intervention and counselling service targeted to work with addictive disorders and emotional disturbance.

Charter is well established as a leading London addiction facility offering focused, flexible and effective day care for all addictive disorders at competitive rates.

For more information visit www.charterdaycare.com or call 020 73234970 or email  info@charterdaycare.com

Charter Day Care, 15 Harley Street, London W1G 9QQ

 

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Addiction Experts, Spokespeople, Advice Columns, Latest Research, Case Studies and Images available.

Enquiries: Jenny Rose, jenny@happypr.co.uk M: 07957 551 697.

 

 

 



 

 

Parenting for Prevention Workshops

I have been presenting Parenting for Prevention workshops in schools across the UK for around 10 years and am now planning to bring this material into the treatment environment as a workshop targeted towards helping parents whose children suffer from addiction.

Every parent with a child of any age who is acting out in an addictive way needs to be aware of their boundaries, be able to present a consistent response to any demand or behaviour, and to feel that their decision is seated in respect and self esteem.

I often get asked where the line is drawn between good parenting, ie the duty to love, guide, punish and teach, and unhealthy enmeshed parenting where there is often an over involvement and overt sense of responsibility and resentment. Although the age of the child is relevant in this discussion, the core principles are the same and a big question is who is in charge?

In a family where addiction is present it can often appear as if the addict is running the show, able to hijack any interaction or event and frequently create worry and drama. But of course it is not the addict per se, it is addiction itself that is operating within the family system. Once parents and family members start to behave in a coordinated and healthy way, changes always happen.

This workshop is specifically designed to illustrate adolescent reactions that can feed conflict and splitting which are instantly recognizable. There is usually a lot of laughter in this workshop before parents get down to working on understanding and then practicing the simple responses that can make all the difference.

These patterns always exist in addictive relationships and it is vital that those close to the addict know how to navigate them, to feel confident that they are supporting the solution not feeding the problem.

Please contact the office if you are interested in attending any of our workshops in the future: 020 7323 4970

Family Groups

Family Group is a very important part of Charter’s addiction treatment programme.  Currently costing just £150pa per family member for unlimited access, the groups provide an introduction to addiction and vital peer and counselling support for family members of an addict.

The familiar position of lose:lose is the domain of the families of addicts, where it is so hard to know what to do as your loved one perpetually holds the proverbial gun to their own head and, finger on trigger, reacts what you say and do.

At Charter we advocate re-establishing a sense of nourishment and self respect in the family member so that they too can make a decision instead of just reacting to a situation:- fire fighting. This takes time and commitment and I am proud to say that we have a core group of hard working family members cementing the changes with their increasing understanding and personal growth. When one person changes, the dance changes. So whether your addict is on board (yet) or not, working in the family group can make all the difference to the possibility and nature of recovery in your life.

We also hold family workshop weekends that provide a more intensive introduction to letting go with love, enablement vs tough love and how to take care of you – many family members recoil from such apparently new age statements (as did my own parents many years ago) – but these workshops have proven to be of fundamental use to those struggling to gain purchase on this slippery and destructive condition in the life of someone they love.

Addiction is all consuming, self centred, provocative and relentless. It takes experience to know how to behave around it, and courage and compassion not to feed it.  The group will support you while you learn…

Co-dependent love Kills

The recent tragic death of Eva Rausing, daughter of a Pepsi executive and married to the heir of the Tetra Pak billions is yet another sad addition to the long list of deaths claimed by addiction. In a relationship fuelled by co-dependence, it is clear that neither partner would ever get recovery long enough to have a proper chance at life.

This situation is so familiar to those of us working in the field. Over and over again I warn my clients about getting into a relationship in treatment or early recovery and those who don’t listen – self will run riot – (and who stay in touch) have almost always found themselves in difficulty later down the line. And although it is the truth, to say ‘almost always’ to an addict they will illicit an attentional bias towards ‘almost’, encouraging the inherent arrogant belief that every addict has that they will be the exception.

It is so obvious to me that in rehab where you are putting down your drug of choice, you are wide open to an alternative, something to fill the gap, the void that any addict in early recovery feels – indeed must feel and learn to tolerate. For this lack of tolerance IS the addictive process in action. An inability to not know, to feel exposed, alone, afraid… – to feel vulnerable generates the compulsion to use. So a relationship in early recovery is a collusion between addicts to mutually fix and avoid this seemingly intolerable void, dressing it up as something worthwhile.

Sadly most of the time the addicts themselves are completely unaware of what is going on, usually insisting that they do know and they are actually in love, and treating those who seek to challenge the addiction (family, sponsors and therapists) as lacking in understanding, punishing and unreasonable. In turn this can drive the couple into secrecy, into the false yet seductive intimacy of ‘them and us’… as the  examples given by the journalist of this article displays, feted couples Burton and Taylor, Cobain and Love, Britney and Kevin, Whitney and Bobby – all very Bonnie and Clyde: over romanticised sickness ending in disaster.

At Charter we work on co-dependence and relationships (with self and others) as a mainstay of our programme. Addiction is at its roots relational and addicts need to be able to have healthy interactive relationships that nourish them, or they will relapse. I have had the privilege to support many people to avoid an ending such as Eva’s despite all the priming that might make that their destiny, and I am grateful for these clients’ willingness and trust to follow my direction. It is not easy, never easy, but it is most definitely worth it.

Read more:  http://m.guardian.co.uk/uk/us-news-blog/2012/jul/13/drug-using-couples-eva-rausing?cat=uk&type=article