My Day Working At A Women’s Residential (Addictions) Facility: Observations And Thoughts

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Yesterday I was blessed to be able to go and work with a group of women in a women’s residential facility. All of these women varied in age from barely twenty to the elderly, yet they all battle some form of substance abuse.

None of them looked like “typical addicts” and they were all extraordinary women.

Many of them were mothers or wives and of course daughters who had lost nearly everything due to their alcohol, cocaine, crack-cocaine, prescription pills, meth or heroin addiction.

One older lady had battled addiction for most of her life and at one point became homeless before finally making up her mind to try to get sober and clean. She has seven months sobriety.

Another woman who looked like she couldn’t have been a day over twenty, but had a five year old child, had been clean for four years before an old dealer of hers found her on Facebook and seduced her into using again.

And another older female had been pretty much a functioning alcoholic for the past five years and then one night out of the blue had an alcohol related gran mal seizure that landed her in the hospital for five days and she was court-ordered to rehab from there.

A lot of the women had tragic stories, including a very young girl who I don’t think was even twenty and was in rehab for the first time after being court ordered into treatment.

She was adopted, her birth mother was a drug addicted, her birth father was in prison and when her adopted father died two years ago she started using any drug she could get her hands on to numb the pain she felt.

Working with these women yesterday in group and individual settings I took a lot away from not only what it meant to become and remain substance free, but also what it meant to accomplish any major goal.

Having a good support system of course is important.

The women who had a supportive family, a supportive group of people such as Alcoholics or Narcotics Anonymous, supportive healthy friendships, supportive professionals or a supportive sponsor all seemed to be doing better than those who did not.

Having a belief in and a relationship with a Higher Power also seemed to help.

Not that there weren’t many women there who weren’t religious, but it was obvious that those who had some type of relationship with God, the universe, or whatever, seemed to be doing better in recovery compared to does who didn’t.

Also, those who were honest with themselves and in touch with reality seemed to be doing better than those who seemed to be a bit oblivious to reality.

The one thing that bothered me most about a lot of the women in the facility were that a lot of them were lying to themselves as we all do from time to time, especially when trying to stop a bad habit.

Many of the women still had “addict behaviors” not only in the fact that they were lying to themselves, but they were also lying and being sneaky to others.

For instance, this was a smoke-free facility where these women are prohibited from smoking, yet a number of the women sneak out and smoke.

That may seem relatively harmless in comparison to their bigger addictions, but that type of sneaky, dishonest behavior sets the stage for future relapse.

Relapse is not something that usually just happens, but develops overtime in the way a person thinks, feels, and acts.

A sober, clean person may start feeling agitated, lying, sneaking off to do things they know they shouldn’t, etc., days, weeks or months before actually relapsing.

They start lying to themselves, saying things like, “I can just have one drink” or “I can just take one hit and walk away, I know how to control it now”.

Before you know it, they are back in the thick of their addiction, driving under the influence to get more alcohol or selling whatever they can get their hands on to get more drugs.

Most of these women displayed some of those signs of a future relapse, from sneaking off to smoke, to being angry and irritable, to the woman who had the seizure asking me:

“How much do you think I’ll have to drink for that to happen to me again, because it scared the hell out of me. I don’t want to drink any more, but I just want to know if I have one drink, or two drinks, how many would it take before that happened again?”

Although she’s telling me she doesn’t want to drink again, she is lying to herself. It is obvious that in her conscious or unconscious mind, she is trying to figure out if she can get away with drinking “just a little”, but she is an alcoholic, and knows that there is no drinking “just a little” for her.

The women sneaking off to smoke, will be the same women sneaking off to drink or get high once they are out of rehab. That is “addict behavior” at it’s best.

Just like in trying to quite anything from smoking to losing weight, people generally relapse and it takes a few tries before they get it right. Relapse at some point is usually expected which is why there is often a focus on relapse prevention.

One of the biggest things to know about relapse is that if you mess up, if you have a drink, or a hit, or a donut, it doesn’t mean you just give up and give in. You can still back away at that point and start over before the addiction truly regains a hold of you.

All the women in this facility are at different points in their recovery and no doubt, for many of them, this will not be their last time in treatment, but hopefully one day they will get it right.

Abuse Reports And Pregnancy Scares: My Week In Review

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This week went by really fast, although it was tiresome and very busy, picking up where last week left off.

Last Friday I had to have a suicidal student Baker Acted (Florida’s statute for involuntary examination/hospitalization), with five minutes of school left, which meant I had to deal with law enforcement and the Department of Children and Families (DCF) for two hours afterwards.

Not the best way to start my weekend.

This week wasn’t as dramatic, but I still had to call DCF on three cases for suspected physical abuse, suspected medical neglect and suspected sexual abuse.

I don’t know why, but I am still at times amazed at the amount of damage done to our kids at the hands of those who are supposed to love, support and watch over them.

Making DCF reports or Baker Acting a client is never the easiest thing to do. Often times clients are initially angry, or scared, but many times they are relieved to finally be getting help, and more often than not, after it’s all over with, they are grateful someone cared enough to get them help.

I even had a mother come in to try to assure me that her daughter is not being abused by her husband, but I tend to believe what her daughter is telling me and will support the daughter psychologically while DCF does their own investigation.

I also had three of my female clients this week tell me that they thought they were pregnant.

I always hate hearing this because I know the affect having a child can have on these inner-city young girls who have enough to overcome already.

Most of the times these young girls think that they can get pregnant and nothing in their lives will change. I remind them that every girl that was in my program last year that got pregnant have dropped out of school.

I was saddened also that these three young girls, all good and intelligent students, weren’t using protection and are potentially pregnant by guys that aren’t even their boyfriends.

It’s one thing to be pregnant by a boy who is supposed to be committed to them, but it’s another thing for a young girl to be pregnant by a boy who has no commitment to them at all.

“Hooking up” seems to be the thing with this generation, in which teens are more likely to have no-strings-attached, physical relationships that could include anything from kissing to intercourse.

Friends with benefits definitely seems to be more popular than actual dating, at least on the campus I work at.

These girls I am referring to, of course really like these boys and want to be with them in a monogamous relationship, but are willing to accept the friends with benefit role, which gives these boys no real reason to commit and give the girl what she truly wants, a relationship with a guy that cares for only her.

These young girls, as much as they would hate to admit it, aren’t emotionally prepared for no-strings attached sex as well as they think, which is one reason many of them are so angry, depressed, emotional and unhappy.

They are clueless about the connection between the body, the heart and the mind.

Luckily, so far one out of the three girls I mentioned has found out she is not pregnant, while the other two are too afraid to take pregnancy tests or go to their family doctor, so they are practicing the wait, see, and pray method.

Two of the girls asked me if I was mad at them (I’ve counseled them numerous times about self-esteem, self-respect, abstinence and using protection if they are going to be sexually active).

I told  them that I wasn’t mad and that I never get mad at them, because it’s true. I did admit to them that I was a bit disappointed in them, because that too is true.

I still care for them and support them unconditionally, even when I don’t like the decisions they’ve made..

Hopefully in the next few days, the other two girls will find out if they are pregnant or not so I can either help them learn to prevent this from happening again anytime soon, or help them prepare to be the best teenage mothers they can be.

Teens, Marijuana and Nutella

The other day during a group therapy session, one of my teenage clients told me she had been tempted to use marijuana for the very first time.

I questioned her about why she was tempted to smoke marijuana and she informed me that she wasn’t going to smoke it, she was going to eat it. She had been offered some marijuana sprinkled on a cracker covered with Nutella.

This was the first time I had ever heard of teens eating marijuana on a cracker with Nutella, but that’s not the point of this post. Most teens believe marijuana is harmless, and I spend a lot of my time trying to convince them that it’s not.

From my experience, working in the field of substance abuse, I tell them that in a lot of cases, marijuana zaps motivation. Teens I work with who use marijuana usually start failing classes, missing school and eventually dropping out or getting kicked out of school.

Also, there is growing evidence supporting a correlation between marijuana use and schizophrenia.

Marijuana doesn’t cause schizophrenia, but it does seem to activate schizophrenia and other mental illnesses in individuals with a predisposition to mental illnesses, especially schizophrenia.

In the book The Center Cannot Hold: My Journey Through Madness by Elyn Saks she shares intimately about her battle with schizophrenia that all started after her first experience with marijuana.

She thought the hallucinations and thoughts that came and stayed for days were all normal and so she didn’t tell her parents out of fear of being punished for having smoked marijuana.

I’ve worked with a handful of schizophrenic patients who had their first schizophrenic experience after smoking marijuana and initially thought that their experience was typical until much later when the hallucinations and delusions didn’t go away for days, weeks or never.

These people all had a predisposition to schizophrenia which seemed to be activated after they started smoking marijuana. If they hadn’t started smoking marijuana, that doesn’t mean some other life event wouldn’t have activated the gene, but who knows.

Teens argue with me that marijuana is not addicting, but it is. Marijuana is psychologically addicting, why else do people who are regular marijuana users do the some of the same things people addicted to harder drugs do when they are addicted?

Some of the signs of being addicted to anything is when that thing starts to interfere with and effect your life negatively.

Teens I’ve worked with who claim not to be addicted to marijuana have:

  • Missed numerous days of school to stay home and smoke mariuana
  • Come to school high and thus got expelled
  • Got caught smoking marijuana at school and thus got expelled
  • Got pulled over while driving and smoking marijuana
  • Have violated their probation for smoking marijuana after being on probation for marijuana in the first place
  • Have lost jobs for smoking marijuana on their lunch break
  • Have stolen from family and friends to support their marijuana use
  • Have damaged relationships with family and friends over their marijuana use
  • Can’t get jobs because they can’t refrain from marijuana long enough to pass a drug test

These are all signs of addiction. These are all the same things people with cocaine, crack, heroin, alcohol and crystal meth addictions do. Yet these teens still think they aren’t and can’t be addicted to marijuana.

Then they argue that marijuana should just be legal. I’m not going to argue that point here, but even if marijuana was legal it still wouldn’t be available to people under 18 and most likely, not to people under 21.

Even then, employers would probably put in place rules where you couldn’t either test positive for marijuana or at the least, not come to work high. Same goes for places of higher education, the department of motor vehicles and such.

So while teens think legalizing marijuana will mean a free pass to smoke at will, it actuality won’t.

Marijuana use also leads to a higher risk of experimenting with other drugs and I’ve seen enough teens using hard drugs that started with marijuana to know that this is indeed true.

No teen I know who smokes weed can imagine smoking crack, but most people I know who smoke crack started off by smoking weed and didn’t see the day coming when they would be smoking crack or shooting heroin.

I’m not saying marijuana is all bad or trying to bash people who use it, but I do know one think for certain, and that’s that no teenager should be smoking or experimenting with marijuana, especially as their brains are still developing and they have enough trouble making good decision when they aren’t influenced by substances as it is.

The Cycle of Violence, Power and Control

ImageWorking as a counselor in a high school, I am surprised at the amount of abuse many young girls I work with have gone through. Not to mention the sexual, physical and psychological abuse many of them went through growing up, but how much of that has affected them now as teenagers.

A surprising amount of young ladies in high school, and perhaps even in middle school are involved in physically abusive relationships. Having dealt with many of these young ladies, I’ve recognized that many of them believe that if a guy doesn’t hit or get physically rough with them, then “he doesn’t really love me”. This may not make any sense to most people, but a lot of these young ladies have grown up in homes where the people who “love” them, especially the men in their lives, are often the same people who abuse them, so many of these young ladies have subconsciously equated love with violence, manipulation and fear. Also, since many of the people who these women look to for protection, they also equate physical violence with a guys ability to protect them, even if it’s the guy himself they need protecting from.

I’ve had young ladies tell me that they would break up with a guy if he didn’t hit or push her when she got “out of line” because they believed they needed a man who was strong enough to keep them “in line”. They would say, “Sometimes I get get out of control, get a smart mouth and act a fool. I need someone who can put me in my place.” In most cases, these young women grew up in families where men (their fathers’, mother’s boyfriends, uncles, older brothers, etc.) physically, sexually and/or psychologically abused them.

Earlier this year I was walking through the halls of the high school I work at and heard yelling and shouting. I turned the corner and saw a boy attacking a girl. I quickly got between them and he was enraged, evening threatening me, but I didn’t care, I was more concerned about the young lady he was attacking. He quickly told me that it was none of my business and that was his girlfriend. I stayed between them waiting for assistance and then he walked away. I asked the young lady if she was okay, and shew as crying, but said she was okay and she was tired of him hitting on her. I tried to talk to her, but then he yelled for her to come with him and to my surprise she left and went with him. I tried to stop her, and by the time other teachers and security came they had walked off campus. I was so upset with the whole situation that it took me a few days to get it out of my mind. I never got the young lady’s name or I would have called her in and offered her counseling in hopes that with knowledge and empowerment she would leave that unhealthy relationship for a better one.

Also in college I dated a girl who had been physically abused by her father to the point that she was removed from her home. Ever since then and up until we met, every guy she dated physically abused her and I mean beat her like she meant nothing to them, leaving her with bruises and bloodied lips. She never learned how to separate love from abuse once it had forged together in her head.

I find this to be very sad and dangerous and is one of the issues I work extremely hard to correct because these young ladies are putting themselves in extremely dangerous situations that if not corrected will effect them for the rest of their lives along with any children they have. Girls who grow up witnessing violence, even if it is just heard or sensed (through tension, visual cues) are more likely to date guys who will put their hands on them and boys who grow up in that same situation are more likely to think it’s okay to put their hands on women they claim to love.

It’s extremely important that if you are the victim of abuse that you get help. Check out http://www.thehotline.org or any other resources in your area. Look at the Cycle of Violence and the Power of Control wheels below. It doesn’t get better, only repeats and gets worse.

“April”: A Quick Case Study (or more like a synopsis)

Every three months as part of my grant we have to do a report and in that report, besides asking for numbers to validate and show evidence of my value, we have to write about one client that has improved over those three months. I decided to share that client with you.

 “April”

April  (17 year old female) lives in a group home where she has been for about five years after being removed from her family because of neglect and ongoing sexual abuse.

When I met April she was having a hard time focusing in school, often walked off campus and ran away from her group home. Her grades were very poor and she was prone to emotional and angry outbursts. She was brought to me initially by another counselor after she had threatened to punch her school bus driver, walked off the school bus and went missing for twenty four hours and was later found by local authorities.

I begin working with April (using mostly cognitive behavioral therapy) on controlling her emotions as well as working with her group home and guidance counselor to make sure all of her needs were being reasonably met. I put her in a life skills group which initially she was reluctant to join because “I don’t get along with other people” and met with her once weekly in private sessions, often helping her process her anger and fear about her family and about her future. I encouraged her to keep a journal and to write down everything she wanted to say to her family (no communication with her family in almost five years was her biggest issue). I also worked with her teachers to make sure that when April was having a “bad day”, they knew how to appropriately handle the situation and not escalate it or send her out of class which usually led to her walking off campus.

As a result, within a few weeks April stopped walking off campus and running away from her group home as she learned how to self-regulate her emotions. Her attitude improved and the number of referrals for classroom disruptions fell to nearly zero. Her grades improved and her number of “emotional breakdowns” during class fell to zero, as she was able to express her emotions in private sessions with me. She became a very active member of her group and her number of group home infractions also fell. She begin getting positive attention and positive rewards from both her group home and school staff and is a much calmer person today than she was when I first met her.

Because she is much better at regulating her emotions, we are able to spend more of our private sessions processing her feelings of abandonment by her family and working on (in conjunction with her independent living counselor) becoming more self-sufficient in preparation for the day she will turn eighteen and transition out of the group home. In an individual education plan meeting I attended with April a couple of weeks ago, she was highly praised on her many improvements in both academics and behavior.

-April really is one of my favorite clients. She is labeled “emotionally disturbed”, and while she is 17 and functions more often like a 12 year old, she’s grown a lot since the first day she set across from me as a very angry young lady with no respect for authority. She could have been diagnosed at that time as oppositional defiant,  but she had enough labels and I didn’t see the need to label her any more and as she has improved, i’m glad I wrote her initial diagnosis as “deferred” despite the constant push by insurance companies that “everyone gets a diagnosis”. Oh gosh, that is another whole post for another time.