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Transcript of BASES Brain Training for Addiction Recovery- Chapters 1-3
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8/6/2019 BASES Brain Training for Addiction Recovery- Chapters 1-3
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D. SCOTT KELLY
B.A.S.E.S.B.A.S.E.S.Brain Training for
Addiction Recovery
$10.00
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BASES Brain Training
for Addiction Recovery
D. Scott Kelly
BASESTeenCenter.org
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Copyright 2011
First Printing
ISBN 1-58241-394-0
2011 D. Scott Kelly. All rights reserved. No part of this book may be reproduced in any form without
written permission from the author.
BASES Brain Training for Addiction Recovery, written and edited by D. Scott Kelly. Produced by Harbor
House Publishers, Inc. Manufactured in the United States of America. While every effort has been made
to ensure the accuracy of the information presented, the author and the publisher do not guarantee
accuracy and are not liable for any omissions or errors. Please report any new information to the author.
Harbor House Publishers, Inc.
221 Water Street, Boyne City, Michigan 49712 USA
800-491-1760 [email protected] www.harborhouse.com
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iIntroduction /
Why this book, this subject, right now? In the old days, sev-eral generations ago, we understood that a bit of the creative
forces of the universe lived within us. Our job in the past was
to listen to this internal voice and act accordingly. As our world
has become more capitalistic, market focused and individual
consumer oriented around our new god, the almighty dollar,
our brains have been hijacked. Those who want to influenceour spending choices battle every day for our beliefs, our
values and our perceptions because they know this becomes
income for them.
Introduction
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ii / BASES Brain Training for Addiction Recovery
Twelve step programs have been around for over 75 years.The solution found in these programs attempts to bring peo-
ple back into connection with an internal sense of an
individualized higher power. Twelve step programs knew
years ago that the addicts brain has already been hijacked so
the issue became how to discern the different voices inside
our head. The Oxford Group outlined the Higher Powers will
as being unselfish, loving, pure and honest. The AA method as
outlined by Bill W. focused on identifying self-will selfish-
ness, resentment, fear and dishonesty. As we choose a higher
path, our lives experience an upward spiral to greater levels of
health, prosperity and meaning.
This book outlines solutions and guide posts along this
journey. It is important that we learn how to live in accordance
with our universal life energy and learn how to recognize this
in others. As we realize we are all made of the same stuff, we
take on more compassion and empathy for one another. Learn-
ing how to share and get along with one another are still the
keys to our survival whether it be the pre-school playground
or international affairs same solution, same process.
The message from the great ones has always been the same.
The difference has been for those who put it into practice.
Ghandi said, The greatest form of violence is poverty. Jesus
said, Love one another, and on and on. But, we dont have
the luxuries of having them with us here and now so we need
to awaken to our internal voice and listen to the voice of love.
May this become our legacy to our children the great trans-
formation of our times was to return to an open mind and
heart that was receptive to the love that has been with us all
along.
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iiiForeword /
Scott Kellys book about recovery approaches the criticalissue of how to achieve sobriety from all directions. From myexperience in over 20 years of working with substance depend-
ent people in the court system, thats what it takes to make
lasting progress, an all fronts plan.
In the court system we often experience short term fixes,
or behavior interruptions, only to have relapse occur once
the pressure is off. Anyone who has tried to quit smoking
knows what I mean.
By the same token, everyone who has been in smoking
recovery for some time knows that long term remission canoccur, 29 smoke free years and counting for me. But like recov-
ery from substance abuse you have to incorporate new ways of
living your everyday life.
As this book points out there are many facets of your life
that are all in play together and affect sobriety in inter-related
ways every day. What you put into your body and your mind.
Who you spend your time with and what you do with your
time. And, of course, how you handle or process lifes contin-
uous series of unexpected events. Everything counts.
In the court system we see people who have not only bro-ken the law but have also done serious damage to their family
relationships, employment opportunities, and their long term
health. Young people fall behind in school and drift into situ-
Foreword
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iv / BASES Brain Training for Addiction Recovery
ations and relationships that can impair the rest of their lives.As a judge trying to respond to substance users, I am humbled
by the limits of what the law alone can accomplish.
For persons with addiction and serious abuse issues more
is needed. In our counties we have emphasized a community
approach that combines the efforts of the court, local school
systems and area substance abuse professionals. In this model
the court and its probation staff operate court schools that
partner with local school districts to provide safe, sober, and
respectful learning environments. This is combined with the
critically important recovery treatment and education provided
by local professionals like Scott and Celia Kelly.
Recovery is like a bicycle wheel with numerous spokes
required to keep the wheel in round. The spokes may need con-
tinuous and appropriate adjustment to keep rolling. BASES
Brain Trainingoffers over fifty spokes that may work for your
own wheel or the wheel of some one important to you.
Fred Mulhauser
Probate and Family Court Judge
EDITORS NOTE: The Honorable Frederick R. Mulhauser is a currently serv-ing Michigan trial court judge for Charlevoix and Emmet counties. JudgeMulhauser was first elected in 1988 and in addition to the normal courtdocket currently presides over the juvenile drug court, a community centeredproblem solving program.
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Chapter 1 How did we get here? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1
Chapter 2 The King is Naked! . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7
Chapter 3 Addiction is a Brain Illness . . . . . . . . . . . . . . . . . . . . . . . . . . .8
Chapter 4 Adverse Reactions to PrescriptionDrugs Leading Cause of Death in U.S. . . . . . . . . . . . . . . . . .10
Chapter 5 TFM-CSS The brains warning lights . . . . . . . . . . . . . . . . .11
Chapter 6 DABDA The stages of grief . . . . . . . . . . . . . . . . . . . . . . . . .13
Chapter 7 NBA What teens need . . . . . . . . . . . . . . . . . . . . . . . . . . . .15
Chapter 8 We need to learn how to TLC Think,Learn, Cope with Change . . . . . . . . . . . . . . . . . . . . . . . . . . .17
Chapter 9 SMART How do we make smart decisions? . . . . . . . . . . . .20
Chapter 10 HOW How do we get better? . . . . . . . . . . . . . . . . . . . . . . .22
Chapter 11 168 How many hours in a week? . . . . . . . . . . . . . . . . . .24
Chapter 12 Committed or involved the pig or the chicken? . . . . . . . .26
Chapter 13 ALL What do we need to do to recover from addictions? . .28
Chapter 14 What is enabling? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .31
Chapter 15 CCC What are the key ingredientsin healthy relationships? . . . . . . . . . . . . . . . . . . . . . . . . . . . .33
Chapter 16 CCC How do we deal with other peoples addictions? . . .34
Chapter 17 4-3-2-1 What are ten stressreducing activities? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .37
Chapter 18 HSLMP Healthy decisions aremade when we Help Someone LearnMy Plan for making healthy decisions . . . . . . . . . . . . . . . .41
Chapter 19 WWHPD What would healthy people do? . . . . . . . . . . . .43
Chapter 20 TFAURs What internal experiences do I need tolearn how to identify and communicate with others? . . . . .46
Chapter 21 ISAC What are the stages of adolescent development? . . .48
Chapter 22 DMR Developmental Model of Recovery . . . . . . . . . . . . .51
Chapter 23 Relapse is a Process . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .57
Chapter 24 PCPAM Stages of Change . . . . . . . . . . . . . . . . . . . . . . . . .63
Chapter 25 SIR The heros journey . . . . . . . . . . . . . . . . . . . . . . . . . . . .66
Chapter 26 PMA Positive Mental Attitude . . . . . . . . . . . . . . . . . . . . . .70
vTable of Contents /
Table of Contents
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Chapter 27 Play Smart or Dont Play Long . . . . . . . . . . . . . . . . . . . . . . .72
Chapter 28 -10 to +10 Scale Healthy is in the Middle . . . . . . . . . . .73
Chapter 29 Addictive Relationships . . . . . . . . . . . . . . . . . . . . . . . . . . . . .75
Chapter 30 ASP Anti Social Personality . . . . . . . . . . . . . . . . . . . . . . . .78
Chapter 31 Levels of Intimacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .82
Chapter 32 0-10 Scale Symptom Severity Charting . . . . . . . . . . . . .86
Chapter 33 History of Alcoholism Treatment . . . . . . . . . . . . . . . . . . . . .88
Chapter 34 GIATKI Give it away to keep it . . . . . . . . . . . . . . . . . . . . . .91
Chapter 35 Surrender, Sharing, Restitution, Guidance . . . . . . . . . . . . . .94
Chapter 36 Rise Above Dont define the
events of life, its just the way it is . . . . . . . . . . . . . . . . . . . .96
Chapter 37 May my gratitude be reflected in my actions today . . . . . . .98
Chapter 38 To pause that is what makes all the difference . . . . . . . . .99
Chapter 39 Its not them the 2% rule . . . . . . . . . . . . . . . . . . . . . . . . .101
Chapter 40 Boiling a live frog outside help is needed! . . . . . . . . . . . .103
Chapter 41 Chinese Bamboo sometimes
the changes show up all at once . . . . . . . . . . . . . . . . . . . . .105
Chapter 42 Be Nice, Pay Attention, and Be Honest . . . . . . . . . . . . . . .107
Chapter 43 Bird in the Barnyard morals of the story . . . . . . . . . . . . . .111
Chapter 44 I have survived countless disasters
1% of which actually happened! . . . . . . . . . . . . . . . . . . . .112
Chapter 45 Parenting Suggestions . . . . . . . . . . . . . . . . . . . . . . . . . . . . .114
Chapter 46 Refusal Skills . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .116
Chapter 47 Dealing with unhealthy people . . . . . . . . . . . . . . . . . . . . . .118
Chapter 48 GIGO Garbage In, Garbage Out . . . . . . . . . . . . . . . . . . .120
Chapter 49 Healthy Activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .122
Chapter 50 Peer Selection Skills . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .124
Chapter 51 7 of Diamonds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .126
Chapter 52 Book flop with Eddie What is faith? . . . . . . . . . . . . . . . .128
Final Comments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .132
About the Author . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .133
Brain Training Worksheet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .134
Select Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .136
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1How did we get here? /
Bay Area Substance Education Services (BASES) is a non-profit corporation that was founded in 1993 by my wife Celiaand I to address the needs of local youth and their families
experiencing substance abuse problems. My job at Boyne City,
Michigan schools as a student assistance social worker ended in
1994 due to a failed millage election. Nearly 100 of the students
that I had been working with protested the loss of my position
by walking out of school and picketing along the highway. I
avoided the local media blitz and returned home to join Celia
at BASES to come up with a plan which is the basis of this book.
In 1995, BASES became involved with a group of countyrepresentatives to brainstorm about how to address the issues
of adolescent substance abuse. We had directors from the
intermediate school district, a local school, probate court, hos-
pital, law enforcement and local agencies meeting on a regular
basis brainstorming ideas about how to provide more intensive
services for our local youth. At that time, teens that needed
inpatient or residential treatment were sent to programs three
or four hours away and the parents could rarely participate due
to the distance. These services typically cost $8-$12,000 per
month and teens that completed these programs oftenresumed using within two weeks of returning home.
In 1996, we learned of a planning grant whereby represen-
tatives from the county could participate in a county-wide
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needs assessment investigating the issues of juvenile delin-quency and substance abuse. This was based on a program
called Communities That Care (CTC) which was developed by
Hawkins and Catalano in the Seattle area following their ten
years of research.
The new local needs assessment showed that teen alcohol
and drug use was above the regional, state and national levels.
The results of this needs assessment made us eligible for a four
year federal grant. The elevated risk factors from the CTC
model that we chose to address included: a) community laws
and norms favorable toward drug use, and b) friends whoengage in problematic behavior.
One goal to address the laws and norms involved the devel-
opment of four community teams in the county where local
groups could learn about the findings of the county-wide study
and begin to look at their specific community needs. These four
community groups were located in Charlevoix, Boyne City, East
Jordan and Beaver Island, Michigan. We also wanted to start
weekly groups for parents of high risk teens to address these
community laws and norms issues.
Another goal of the project was to provide substance abuseeducation and support services for high risk teens in the county
to create more non-using peers by starting two teen groups per
week. We utilized local recovering teens between the ages of
18-20 as Peer Helpers and had them model healthy behav-
iors and attitudes about staying clean and sober. This was done
by having them work with small groups to develop positive
relationships with these teens. Each session first had a large
group presentation of key information, concepts and an
overview of activities to develop healthy life skills. This was fol-
lowed by small groups of three to five teens to practice thesenew skills, develop new friendships, and discuss the things
being presented with their peer helper.
It took two years to develop all of the various components
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of an adolescent residential substance abuse intervention pro-gram. In those two years we added three additional evening
groups, four after school groups, transportation services, spe-
cially trained foster homes, individual counseling services,
extensive drug testing and expanded involvement in the court
school program. The sum of these components has become
Recovery High a developmentally appropriate substance
abuse intervention program that incorporated weekend home
visits into the final eight weekends of the twelve week program.
This feature was added as we found that practicing these new
skills at home and in their own community was critical andwas missing from other programs.
Nearly thirteen years later, BASES and the Recovery High
program are still here! Weve seen over 490 teens participate
in the residential program with 44 different counties in Michi-
gan sending teens to the program. Over 25% of those teens in
the residential component have come from our local area,
Charlevoix and Emmet counties. The Recovery High program
includes a number of attractive components:
Cost-effective intervention services compared to juvenile
detention where no services, if any, are offered Educational services, where teens have an opportunity to
earn credits based on their efforts
Living accommodations in a family setting with trained
foster parents
Socialization in a supportive, therapeutic environment
that addresses teen developmental needs
BASES facility is a teen center where participants have ample
opportunity to work on their socialization skills with three pool
tables, two ping pong tables, foosball, video games, cards, music,
movies, board games and with dozens of comfortable couchesand sofas to sit and relax. BASES is a licensed substance abuse
program with the State of Michigan. Some detention facilities
say they offer substance abuse services, but do not have a sub-
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stance abuse license. This is a major legal liability. The three full-time staff members at BASES are all certified addictions
counselors with over 60 years professional experience. These
professionals are also in recovery themselves, with over 65 years
of recovery getting sober at ages 17, 18 and 26 respectively. We
lead by example and we talk from experience.
Teens in the residential program receive individual coun-
seling each week that addresses their personal issues. These
issues commonly include traumatic events that are frequently
being talked about for the first time. More than 50% of our
clients have co-occurring disorders where they have a mentalhealth diagnosis in addition to chemical dependency. Keeping
them clean is the first step in helping them get back on track.
After four weeks, we normally see significant improvement in
their brain functioning. If they came in with medications, we
may need to have them re-evaluated by their doctor or psychi-
atrist to see if the medications can be reduced or discontinued
altogether. Other teens may not show improved functioning
over time, so we focus on developing their skills in specific
areas to help them cope in non-chemical ways. While we are
not opposed to medications, we are concerned about the ten-dency toward over-medicating; a disturbing trend, here in the
United States. Our web-site has a number of links with much
more information about this subject area. We strongly encour-
age parents to educate themselves about the issue of
medications with teens and young adults. Gwen Olsens 2005
book, Confessions of an Rx Drug Pusher, provides great details
about this subject. James Pattersons 2008 #1 New York Times
bestselling book,Against Medical Advice, outlines the harrow-
ing story of a youngsters experiences with medications.
Over the years, we have had nearly a dozen groups of peo-ple sit down with our collaborative team in hopes of replicating
our program in their area. One of the biggest obstacles that
prevents others from being successful involves the cooperative
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nature of the three very different systems of the probate court,school and social agency. We have learned that trust, fiscal
accountability and ongoing communication between the three
systems are crucial to success. Each organization is meeting
their financial needs to stay afloat while no one is getting
greedy. Each organization is striving to become more efficient
and effective while taking care of their respective staff mem-
bers to prevent burnout.
Another unique component of our program involves the
opportunity for local teens that do not require residential serv-
ices to participate in our groups and classes in a preventiveintervention approach. Those teens that are evaluated and
found to have elevated risk factors for further substance abuse
problems may be recommended to participate in our Life Skills
classes or in our Discovery / Recovery Groups where they can
gain drug education and abstinence skills. If the teen does well,
remains alcohol and drug-free shown by clean drug tests and
positive reports from the family, their intervention may be
completed after attendance at ten or twenty classes.
If there are additional concerns, they may be recommended
to attend two or three group sessions per week for a period ofat least three months. About 5% of our teens fall into this esca-
lating intervention track. Of the 95% of teens that complete
their classes and groups successfully, about 10% of this group
gets referred back to our program sometime before their 18th
birthday due to family, school or court recommendation. With
this second contact, they are bumped into the 2-3 group ses-
sions per week category and are requested to stay problem-free
for a period of three to six months. Some of this group work
their way into group participation five times per week while
still living at home and attending their own school. It is hopedthat the family is involved throughout this process and attend-
ing the weekly parent groups to learn about normal adolescent
development, common substances being abused these days and
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ways to avoid enabling behaviors.For the teens that do not require residential services, they
have access to the teen and parent groups at no cost to the
family. Local fund raising efforts help support this component
of the program. It is rare to have a family with the financial
means to pay for these services. For those with financial
means, they frequently make voluntary contributions to the
organization.
The remainder of this writing will focus on some of the les-
sons that are emphasized in our program.
At BASES, we teach that addiction is a brain illness and
recovery is about brain training. This brain training comes
from learning and applying the following lessons that are a
sampling of some of the key things that we teach, life skills that
we believe are important and key information to help you be a
more intelligent consumer and citizen.
Give a man a fish and you feed him for a day. Teach a man to
fish and you feed him for a lifetime. Chinese Proverb
It is our hope that your reading of this material will help
you learn for a lifetime.
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If you havent noticed yet, there is something terribly wrongand backwards about our approach to health in the UnitedStates. I say, The king is naked! in the spirit of the little child
who spoiled the scam of the emperors new clothes as he
paraded through town in his new invisible robes in the Hans
Christian Anderson fairytale. In the spirit of common sense,
lets return to using our brain and thinking for ourselves. Its
time to make common sense become common practice in as
many areas as we possibly can. According to numerous studies
and articles that are linked on our web-site, prescription drugs
and iatrogenic illnesses are some of the leading causes ofdeath in the United States. Iatrogenic means illness resulting
from medical treatment. It is time that we become educated and
learn non-chemical coping skills. In order to make this possi-
ble, we will need to address our quick fix urges and learn how
to look at our internal dis-ease as a symptom rather than the
root problem. This includes addiction. All addictions fit into an
obsessive-compulsive system where these various addictive
behaviors serve as a distraction to the internal disease. Denial
and shifting responsibility for these issues to someone else can
no longer be our approach. Its time to call it like we see it ifthe king has no clothes, then obviously, The King is Naked!
7The King is Naked! /
2
The King is Naked!
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Addiction is a brain illness recovery is about brain train-ing. We have learned more about the brain and how it works inthe past ten years than we've known in all of recorded history.
The National Institute of Health is now explaining addiction
as a brain illness or disease that is shown by uncontrollable,
compulsive drug seeking and use, even in the face of negative
health and social consequences. [National Institute of Health,
The Brain: Understanding Neurobiology Through the Study of
Addiction, 2000] Drugs significantly alter brain functioning
and some drugs are showing long-term changes weeks and
months after discontinuing their use.Many of the young people we see begin using in an attempt
to alleviate pain or make themselves feel better through the
euphoric effects of the chemicals. These drug experiences are
unlike anything they have been exposed to and many think, "If
it makes me feel this good, I want more of it." As their use pro-
gresses, tolerance develops as the brain begins to change due to
the presence of the chemicals. The young person responds with
more use, or changing chemicals in search of the euphoric feel-
ing. As they use more and more, they begin to experience loss
of control and find themselves in trouble in a variety of ways.They dont realize that when triggered, a part of their brain is
activated and they experience an urge to use. Without training
and proper skills, this trigger to use becomes an uncontrollable
8 / BASES Brain Training for Addiction Recovery
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desire to mood alter. We sometimes refer to this as the awak-ened grizzly bear that wants to be fed. With no defense against
these cravings, the urge demands to be fed in spite of negative
consequences. This is addiction.
The primary goal of treatment is to regain control over drug
craving, seeking and use. By better understanding the dynam-
ics of the brain, young people begin to feel empowered as they
learn new skills and make healthier choices. We have seen
many teens develop these new skills, effectively deal with their
triggers, make healthier choices and allow their brains the
opportunity to learn and grow.
By training the brain how to deal with triggers, we can
learn how to abstain from chemicals. By challenging some of
our fears about changing, we can develop new social skills and
healthy peer selection skills. By changing our mistaken beliefs
(such as drugs are good for me), we can learn how to take
control of our lives and set out on the course of our own
choice.
Addiction is a brain illness recovery is about brain training.
I learned _______________________________________________
_______________________________________________________
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I need to _______________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
I commit to ____________________________________________
______________________________________________________________________________________________________________
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9Addiction is a Brain Illness /