Trauma

The Recovery of Craig K.

Posted on by Christy Weeks
“First responders are usually the first on the scene to face challenging, dangerous, and draining situations,” explains a Supplemental Research Bulletin by the federal Substance Abuse and Mental Health Services Administration (SAMHSA). “They are also the first to reach out to disaster survivors and provide emotional and physical support to them. These duties, although essential to the entire community, are strenuous to first responders and with time put them at an increased risk of trauma.”
According to the SAMHSA Bulletin, “It is estimated that 30 percent of first responders develop behavioral health conditions including, but not limited to, depression and posttraumatic stress disorder (PTSD), as compared with 20 percent in the general population (Abbot et al., 2015). In a study about suicidality, firefighters were reported to have higher attempt and ideation rates than the general population (Stanley et al., 2016). In law enforcement, the estimates suggest between 125 and 300 police officers commit suicide every year (Badge of Life, 2016).”
Experiencing severe trauma is strongly correlated with substance use disorder (SUD). In a study investigating alcohol use in police officers following Hurricane Katrina, there was a significant association between involvement in the hurricane relief efforts and hazardous alcohol drinking (Heavey et al., 2015). In another study, the average number of alcoholic drinks after Hurricane Katrina increased from 2 to 7 drinks per day (McCanlies et al., 2014).
Many traumatized first responders attempt to alleviate their mental health symptoms with drugs and alcohol. Former police officer Craig K. was one of them. As a young man, the Harmony alumnus entered a work environment where you “push horrible calls to the back of the head,” downplay the horror, and move on. The traditional macho culture prevalent among first responders taught him how to “party like a cop” to release the stress.
When traumatic episodes start to show an impact you still don’t think you have a problem: “They tell you about the stress but they don’t build in a mechanism to deal with it.” One time, Craig was called to the scene of a helicopter crash. The smell of the jet fumes connected with the carnage he was forced to witness is etched into his memory. Craig refers to these traumatic events in his career as demons.
One of his main demons is the Columbine high school shooting. “To this day I can’t hear fire alarms,” he says. “I freak out when I hear fire alarms.” More than twenty years later, Craig is still angry with the teenage perpetrators.
In the aftermath of Columbine, his drinking “took another level” and he could not stop watching the news about the shooting on TV. Like many of his colleagues he was traumatized and felt the police were unjustly blamed for not doing enough to stop the massacre. Craig took it personally.
Family hardships followed: his son was born without an immune system and “everything was thrown out of kilter,” including his marriage. All the while his alcohol use disorder (AUD) became steadily worse. “We started going to therapy” but talking about the health problems of my son was just “an easy way to avoid talking about my problems,” Craig remembers. The inevitable negative consequences started to pile up, he left the police force and got a divorce.
The AUD kept destroying his life, “everything after 2011 is really cloudy.” At the end of last year, Craig finally realized that something was wrong. On New Year’s Eve, he was hospitalized for four days. “I still didn’t realize why I was shaking so much.” After his discharge, he started drinking again and by February he was back in the hospital. On that occasion, “the ER doctor tells me ‘if you keep this up, you’re going to die in three months.’”
By this time, however, Craig was firmly in the grip of active addiction, so he kept on drinking. After getting fired from his job, he saw his pastor who told him about Harmony Foundation. Craig was finally ready to change.
Traumatic life experiences are extremely common among patients with substance use disorder. Because of this strong correlation, trauma-informed care is an important part of addiction treatment at Harmony. All staff have been trained in trauma-informed care. When SUD patients arrive for treatment, they often have few coping skills to deal with their traumatic memories and emotional pain. They have to learn to manage emotions and situations without drugs and alcohol.
Craig finally realized that “ego was not his amigo.” Your ego “makes you cocky and doesn’t allow you to see your real self,” he says. “I rode the ego train 24/7.”
Things are much better now for Craig. “I don’t want to be that person anymore. I’m really excited that I am getting clear and more focused. I’m starting to understand things that I read in the Big Book, that we talk about in meetings, that I’m witnessing.”
At Harmony, he began to learn how to process his trauma, acquiring important coping skills. After his discharge, he connected with a sponsor within a week and—thanks to Zoom—was able to attend several meetings a day. The Daily Reflections and two other AA books go with him everywhere he goes.
“I have to work at this every day. It’s like a diet or going to the gym – you have to put in the work.” If you don’t work on your recovery every single day, you’re cheating yourself.
Recovery is always possible. If you or a loved one is struggling with substance use disorder, or you have questions about our programs, call Harmony today at (970) 432-8075 to get the help needed as soon as possible.

Rutgers Study Links Tobacco Use with Other Substance Use Among Sexual and Gender Minority Populations

Posted on by Christy Weeks

Cigarette smoking is associated with frequent substance use and poor behavioral and physical health in sexual and gender minority populations, according to Rutgers researchers.

The study, published in the journal Annals of Behavioral Medicine, examined tobacco use by sexual minority men and transgender women to better understand the relationships between smoking tobacco, other substance use, and mental, psychosocial, and general health.

The Rutgers researchers surveyed 665 racially, ethnically and socio-economically diverse sexual minority men and transgender women, 70 percent of whom reported smoking cigarettes.

They found that smoking was associated with race/ethnicity, marijuana, and alcohol use, and mental health concerns of the participants. Current smokers were more likely to be white and reported more days of marijuana use in the past month. The study also found that current cigarette smoking was associated with more severe anxiety symptoms and more frequent alcohol use.

“Evidence also tells us that smoking is associated with worse mental health and increased substance use, but we don’t know how these conditions are related to each other, exacerbating and mutually reinforcing their effects,” said Perry Halkitis, dean of the Rutgers School of Public Health and the study’s senior author.

LGBTQ+ people are more likely to smoke than their cisgender and heterosexual peers to cope with an anti-LGBTQ+ society, inadequate health care access, and decades of targeted tobacco marketing. Those social stressors drive the health disparities they face, which are compounded by a lack of LGBTQ-affirming healthcare providers, research shows.

“Our findings underscore the importance of holistic approaches to tobacco treatment that account for psychosocial drivers of substance use and that address the complex relationships between mental health and use of substances like alcohol, tobacco, and marijuana,” said Caleb LoSchiavo, a doctoral student at the Rutgers School of Public Health and the study’s first author.

The study once again illustrates the strong correlation between severe stress—especially trauma—and substance use disorder (SUD). LGBTQ+ and transgender people continue to be exposed to strong social stigma—and even physical violence—simply because of their sexual choices or gender identities, leaving many of them severely traumatized.

As a webpage by the Centers for Disease Control and Prevention (CDC) about LGBTQ+ health warns that, “Stigma comes in many forms, such as discrimination, harassment, family disapproval, social rejection, and violence,” putting LGBTQ+ people at increased risk for particular negative health outcomes.

In many cases, smoking tobacco, and using other psychotropic drugs and alcohol are so strongly correlated because they are symptoms of the same kind of psychological stress. The more intense the stress, the greater the likelihood that a SUD will develop—and LGBTQ+ and transgender people generally experience higher levels of stress than their cisgender counterparts. They are simply trying to alleviate their stress with maladaptive coping skills.

Negative life experiences—especially in childhood—and persistent stress also increase the probability of developing mental health conditions such as anxiety, depression, posttraumatic stress disorder (PTSD), and panic disorders—all currently intensified by the COVID-19 pandemic and all in turn correlated with substance use disorder.

The Rutgers scientists correctly emphasized the “importance of holistic approaches to tobacco treatment that account for psychosocial drivers of substance use.” Evidence-based addiction and mental health therapy must address all underlying conditions to achieve a positive outcome.

Harmony has provided cutting-edge treatment at its Estes Park center in Colorado for half a century. Our modern, holistic approach to addiction treatment acknowledges the important role mental health conditions and psychosocial factors play as drivers of substance use disorders.

If co-occurring conditions are not comprehensively addressed, clients are more likely to relapse because they may continue to use psychoactive substances to self-medicate those issues. All staff at Harmony have been trained in trauma-informed care. Modern addiction treatment requires a holistic approach that addresses all mental health issues relevant to the SUD and provides a solid foundation for sustained recovery from addiction.

If you or a loved one is struggling with substance use disorder, or you have questions about our programs, call Harmony today at (888) 986-7848 to get the help needed as soon as possible.

Harmony Foundation Upgrades Mental Health Services

Posted on by Christy Weeks
Mental Health Team

by Michael Rass

Harmony has provided addiction treatment at its Estes Park center in Colorado for half a century. In the beginning, Harmony was a place where alcoholic men could “dry out,” attend AA meetings, and then return home. Over the years, this first treatment approach was expanded to include group therapy sessions, the expertise of a physician, and a treatment protocol based on the Minnesota Model.

Beginning in 2008, Harmony expanded its detoxification facilities and revised its protocol to include Subutex detox methods for opioid addicts. More recently, Harmony added the HOPE Program which offers medication-assisted therapy using buprenorphine to clients with opioid use disorder.

Led by chief clinical officer Annie Peters, Harmony has now upgraded its dual diagnosis capabilities. Dr. Peters developed a roadmap for Harmony to become a dual-diagnosis capable facility serving clients with SUD and co-occurring mental health disorders. Dual diagnosis (also referred to as co-occurring disorders) is a term used for patients who experience a mental illness and a substance use disorder simultaneously. Harmony is now fully dual diagnosis capable.

This modern, evidence-based approach to addiction treatment acknowledges the important role mental health conditions play as drivers of substance use disorders. People may misuse drugs and alcohol because of mental health issues like trauma, depression, and anxiety. “If co-occurring conditions aren’t addressed, clients are more likely to relapse because they may be drawn to substance use to self-medicate those issues,” says Dr. Peters.

People with addiction may also have traumatic experiences as a result of their substance use. “When people are using substances, they may find themselves in dangerous, potentially traumatizing situations that cause further emotional pain, which then leads to more substance use,” says Peters. “This is a difficult cycle for people to pull themselves out of without help.”

Traumatic life experiences are extremely common among patients with substance use disorder. Many suffered adverse childhood experiences. “Studies of drug addicts repeatedly find extraordinarily high percentages of childhood trauma of various sorts, including physical, sexual, and emotional abuse,” writes Canadian physician Gabor Maté in his seminal addiction study In the Realm of Hungry Ghosts.

Because of this strong correlation, trauma-informed care is an important part of addiction treatment. All staff at Harmony have been trained in trauma-informed care. “When people come to treatment, they often have few coping skills to deal with traumatic memories and emotional pain,” says Peters. “Our primary goals are to help them feel safe in the world, manage emotions and situations without substances, and improve their self-esteem and quality of life.”

Trauma-informed dual-diagnosis care begins with a careful assessment. “Every client gets screened for mental health disorders,” says Harmony therapist Gretchen Leezer. “We identify the needs of the patient and establish which ones we can start working on immediately while they are at Harmony and what follow-up treatment they should get once they have been discharged.”

It’s important to address mental health issues as soon as possible, even if the main focus of treatment is the addiction. “When someone comes into addiction treatment with a long history of depression, anxiety, suicidal thoughts, or trauma, we want them to leave here with a roadmap for recovery from all of these difficulties,” says Peters.

Harmony mental health professional Uric Geer likens Harmony’s dual diagnosis approach to a Möbius strip which can be created by taking a paper strip, giving it a half-twist, and then joining the ends of the strip to form a loop. If one side reveals the SUD and the other the mental health disorder, then the twist makes both sides visible whereas a normal paper ring would keep the condition on the inside hidden from view. “If you only treat what’s visible on the outside—the substance use disorder—then an important part of the problem remains hidden and untreated,” says Geer.

The treatment team at Harmony works hard every day to address all relevant needs a client might have. “The culture at Harmony is simply amazing,” says Harmony psychologist Rob Leach. “The leadership has a great vision and the team as a whole is extremely dedicated. They put in great effort to meet clients where they are and develop individual treatment plans. There is great coordination of care. Really listening and meeting clients where they are, creates an atmosphere of trust and that’s crucial for their recovery.”

A Family Affair: Navigating Holiday Triggers by Khara Croswaite Brindle

Posted on by Christy Weeks
Family: Holiday Triggers

It’s that time of year again, the time where people like to highlight the good, the cheer, and the happiness of the holiday season. But what if holidays bring on a sense of dread? What if you have to navigate the heavy drinking of your family members? Or be in the same room with a person who hurt you in the past? What if holidays create loneliness, risk of relapse, or critical self-reflection as the year comes to a close? For many people, these worries are just the beginning of what they may navigate from November to the New Year. So how can we each feel supported through the stressors of the season?

Bolstering Boundaries

One important element of being successful in our functioning around family is boundaries. Boundaries can be defined as physical or emotional in the way they are implemented to allow feelings of safety. Here are some examples of boundaries to consider with family to support feelings of safety and security during the holiday season:

  • Allowing someone’s refusal of a hug from a family member they barely know
  • Supporting comfortable distance between individuals throughout holiday activity
  • Encouraging space when close proximity is triggering such as a walk or errand
  • Listening for verbal cues about safe and unsafe topics during meals
  • Honoring a person’s decision to decline an activity due to risk of relapse

In other words, identifying ideas of how to support each family member’s needs can encourage enjoyment in all holiday festivities without judgement or conflict. This mindfulness of self and others can entice individuals to fully participate and engage in positive experiences as a family.

Tracking Triggers

Mindfulness can support positive experience through coping with triggers in the holiday environment. Supporting each family member’s self-awareness of triggers can be a first step in determining adjustments to allow full participation in festivities.  In the hope of healthy family connection, below are some examples of triggers that may arise:

  • Interacting with a family member that was formerly abusive
  • Talking of trauma topics that create conflict such as the time they had a drinking problem, eating disorder, or abusive partner
  • Engaging in traditions that encourage relapse including spectator sports
  • Recognizing people or places that are connected to trauma memories such as the holiday party where they experienced sexual assault
  • Feeling peer pressure to engage in activities that feel unsafe including binge drinking
  • Having the perception of criticism or judgement by their family, coworkers, or friends
  • Remembering trauma anniversaries that overlap with the holidays including death and breakups
  • Experiencing sights, smells, and other sensory information that connect to trauma such as cologne/perfume, alcohol, or ice and snow

Cultivating Connection

With all of the potential triggers at play during the holidays, it becomes crucial that we feel a connection to one another in our efforts to contain the stress. Reaching out to trusted family and friends or seeking the help of a professional can support a person in navigating the holiday demands. Balancing out stress with positive connection can make a significant difference in our ability to participate in holiday traditions and create new, positive memories where trauma memories formerly dictated our experience. By connecting with people who can relate, we may also learn new skills of how to remain fully present in the holiday experience and find joy in the family and traditions we’ve come to value.

 “Write it on your heart that every day is the best day in the year.”

Ralph Waldo Emerson

Khara Croswaite Brindle, MA, LPC, ACS, is a Licensed Professional Counselor in the Lowry Neighborhood of Denver, Colorado. She received her Masters Degree in Counseling Psychology from the University of Denver with a focus on community based mental health. Khara has experience working with at-risk youth and families, including collaboration with detention, probation, and the Department of Human Services. Khara enjoys working with young adults experiencing anxiety, depression, trauma, relational conflict, self-esteem challenges, and life transitions.