Legal Highs

So pleased to note that Reading Festival banned Legal Highs from their festival over the weekend.

Legal Highs pose a particular kind of problem that to me signals exactly why drugs should maintain an identity in terms of the law. The lack of any kind of legal identification paradoxically indicates safety – ie these are ok as they are no illegal. Yet these substances, clearly identified as ‘not for human consumption’ are made with poisons and toxic substances that are completely unregulated and unidentified exposing the curious teen to life threatening experimentation in the name of a good time and rock ‘n’ roll; particularly when mixed with alcohol.

People need proper education around drugs so they know what risks they are taking, and the proper support available when they run into difficulty.  They also need to recognise difficulty when it happens; sounds strange but it’s true.  An aspect of Addiction is denial; so knowing you have a problem is genuinely hard. The role of the justice system should be to provide support by maintaining a legal line in the sand for those who abuse the system.

How many more deaths need to occur before we take action and follow Reading’s example?

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.

 

Mandy and Professor David Nutt Discuss UK Drug Policy

Good Morning Wales, with presenters Oliver Hides and Bethan Rhys Roberts have had a specialised set of programmes focusing on Drug Policy in Wales and the UK.

Friday saw the series conclude with an outside broadcast and a discussion about UK wide drug policy with Mandy Saligari and Professor David Nutt taking part.

Listen to the interview click link :  BBC Radio

Post Induction Therapy

pit photo

Pia Mellody and her training team with Mandy, Dita and Victoria from Charter!

Last week I was fortunate enough to attend a week of Post Induction Therapy with Pia Mellody in Arizona.  The model is focused on recovery from the relational trauma that manifests painfully later in life in self-destructive processes such as addiction, codependence and dysfunctional relationships.

As you can see from the photos I am not good at having my picture taken and closed my eyes to the experience!  I also do not have a great reputation for attention in class, with past school days littered with truancy.  (We teach best that which we most need to learn…!) But last week I was captivated.  Not all week I admit as I found the lecturing a bit tiring, but the information itself, the model, is wonderfully human and accessible.  It makes sense, and is interwoven with personal experience, crucially demanding that the therapist also is well!

The genuine integrity of the model was reinforced by the humility of the teachers. Both Pia and Sarah, who was co-facilitating, were keen to teach yet not hungry for applause. In fact Pia regularly yet subtly sidestepped the guru status that was often laid at her feet instead asserting the model as the prize and encouraging personal responsibility.

The PIT model aligns easily with the  therapeutic model at Charter, which is also borne of hard graft and personal experience and it should be relatively easy to integrate the two. This means the clients will experience more bodywork and shame reduction work, paying increased attention to relational childhood trauma and to the 5 core symptoms of codependence Pia describes in her books. We will also provide an intensive 3-day Trauma Reduction Workshop every 6 weeks which is inspired by ‘Survivors’ (The Meadows).

This is not a self-indulgent model it is an operation. It’s all about going home and getting on with your life, which is like a breath of fresh air.

Thank you too to my travel companions and co-trainees, Dita and Vic.  Getting to know you and spend last week with you was really special and enormous fun and I am privileged to have you on the Charter team.

 

 

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!

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…

Ecstasy Trial

I am an advocate for medicine that works, and am personally enormously grateful that my Rheumatoid Arthritis is now in remission due to the well-researched medication I have been prescribed. But I doubt that RA meds trials would attract the kind of sensation seeking headlines that The Ecstasy Trials achieved last week. In a society where we bemoan the attraction of illegal drugs to our eg teen population, Channel 4 uses this very sensationalist profile to up its ratings and contribute to both Channel 4’s identity and brand as being ground breaking, and Ecstasy’s as being worthy of the limelight.

Of course scientists want to achieve notoriety and fame, and TV is the perfect vehicle; Channel 4 wants to be seen as ground breaking and edgy, and scientists are the perfect companion to lend gravitas; and I’m sure all those involved will argue for these trials’ validity – possibly even ridiculing those who argue against. A bit like the ‘do you don’t you [take drugs]’ exchanges that happen everyday in school playgrounds around the country: its humiliating to say ‘no, I don’t’. The power of the drug culture and the desire to be in the ‘in crowd’ was replicated I think by the slight ridiculing that happened on the programme when scientists debated the issue and David Nutt seemed to adopt a supercilious sneer.

The fact remains, television is a construction: to be accurate these trials need to take place in controlled environments to limit the influence of other elements.  Performing (and I choose that word deliberately) these trials on national television is not an appropriately controlled environment that would show with any certainty the effect of the drug only. Those taking part (including the scientists) are aware they are in front of millions of viewers, and researchers cannot be certain this has no effect. For example the argument for using a celebrity who would be comfortable in front of the camera was cancelled out as he sought to control his vulnerability on camera when the drug affected him. It was farcical and sadly, I believe, dangerous, as it brought Ecstasy into the limelight as something to experiment with, a play thing, despite the words of warning (to fulfill the requirement of a corporate disclaimer) by Channel 4 presenters advising ‘Do not try this at home’. Do you as I say, not as I do…

What is clear is that no one seems to know much about MDMA and its impact on the human brain. I’m no better informed after watching this programme either. Perhaps more serious trials could be undertaken, privately, responsibly and without sensation: submit the research through the normal channels and allow the process to take the time it needs for culture to adjust and Government to respond. This ‘quick fix’ approach that is so often represented by TV is not always positive, as ideas need time to germinate, and the ground to be primed so that growth and change is sustainable and well supported.

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…?)