Fine Tuning Recovery

Moving Toward a Wellness Model in the Treatment of Addictions

Addiction Studies Institute 2014

Ohio River watercolor by Harlan Hubbard

A wellness-based model for recovery provides opportunities for counselors and coaches to learn new strategies and techniques to help both themselves and their clients.

Presented by Steven J. Rendina, MTS, LICDC, LMT www.finetunehealthcare.com srendina@gmail.com

This is a brief synopsis of a presentation and technique demonstration (original presentation included 108 slides and demonstration of principles of qigong breathing, standing, and meditation as well as examples of each of five animal frolics and their application in group therapy)

Premise: Addiction is similar to other chronic disease If addictions are disease processes at work – can they not also be treated as other chronic diseases – with basic changes to improve health including proper nutrition, adequate exercise, rest, sunlight, fresh air, plenty of water, and stress reduction techniques? The Healing Power of Nature Naturopathic medicine recognizes an inherent self-healing process in people that is ordered and intelligent. Naturopathic practitioners act to identify and remove obstacles to healing and recovery, and to facilitate and augment this inherent self-healing process. http://naturopathic.org/content.asp?pl=16&sl=59&contentid=59 Holistic Medicine Holistic medicine is a form of healing that considers the whole person -- body, mind, spirit, and emotions -- in the quest for optimal health and wellness. According to the holistic medicine philosophy, one can achieve optimal health -- the primary goal of holistic medicine practice -- by gaining proper balance in life. http://www.webmd.com/balance/guide/what-is-holistic-medicine Nature’s Seven Doctors Sunlight, Fresh Air, Exercise, Rest, Clean Water, Wholesome Nutrition, Quiet/Relaxed Mind Addiction from the perspective of Chinese medicine

§ Chinese medical theory is based on the concept of yin and yang, which are dynamic and complementary opposites observed in all the processes of nature.

§ In a healthy individual, yin and yang are in relative balance. Addicts often suffer from a

deficiency of yin. § Chinese medical theory, which comprehends the body metaphorically, relates yin to substance

(being centered), quiescence (inner peace), and the element of water (able to flow). § Yang relates to function (sense of purpose), activity (doing as opposed to being), and the element

of fire (passionate intensity). Yin nourishes, and yang consumes.

§ When yin, or the water element, is deficient, fire is not held in check and rages out of control. § Since it is the product of a deficit, it is called empty fire because it has no substance to fuel it.

On a psychological level, such an imbalance creates feelings of emptiness and desperation. § The goal or intention of an approach to addiction treatment using Chinese Medicine is to put out

the fire § Increasing the level of inner calm, yin energy is crucial to the effectiveness of any recovery

process

- Steve Phillips, Lac http://acupuncturehealingarts.com/addiction-article.html

American Society of Addictive Medicine - ASAM New Public Policy Statement: Definition of Addiction http://www.asam.org/DefinitionofAddiction-LongVersion.html

§ Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors

. § Addiction is characterized by inability to consistently abstain, impairment in behavioral

control, craving, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response.

§ Like other chronic diseases, addiction often involves cycles of relapse and remission.

Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death.

Medical Model

The medical model is moving in the direction of Harm Reduction and Replacement Therapies – not unlike medical approaches to other types of chronic illness

§ Suboxone, methadone, chantrix, etc § Needle exchanges, Moderation management § Patches, e-cigarettes

Wellness Defined

§ Wellness is much more than simply an absence of illness and/or disease. Wellness is a proactive and preventative approach that’s designed to provide optimum levels of health, emotional and social functioning.

§ Wellness involves our recognition that we have psychological, physical, spiritual and social

needs that are necessary for us to have higher levels of functioning.

§ Wellness emphasizes the whole individual. It’s the integration of the spirit, body and the mind; and the understanding that everything we do, feel, think and believe has a direct impact on your state of health.

http://wellnessproposals.com/wellness-articles/definition-of-wellness/

How A Wellness Lifestyle Can Help Prevent Relapse

§ Helps anchor clients in their recovery, reinforcing their commitment to clean and sober living. § Helps safeguard against relapse during early recovery – when mind and body are most

vulnerable. § Fosters resiliency needed to deal with life’s ups and downs, without having to turn to drugs.

file://localhost/Dr. John Newport http/::www.wellnessandrecovery.com: Alcoholism and Nicotine as Co-Addictions

Many of the pioneers of twentieth century recovery self-help groups died of smoking-related disorders including Bill W. (emphysema) and Dr. Bob (cancer), co-founders of AA White, W. (2011). Smoking and addiction recovery. For people in recovery. Posted at http://www.williamwhitepapers.org. Perhaps we should see the continued acceptance of tobacco use in drug and alcohol treatment for what it is – another harm reduction/replacement therapy - but with no medical justification Dean Ornish Program for Heart Health

§ A very low-fat diet including predominantly fruits, vegetables, whole grains, legumes, and soy products in their natural, unrefined forms

§ Moderate exercise such as walking, tai chi, qigong

§ various stress management techniques including yoga-based stretching, breathing, meditation,

and imagery

§ enhanced love and social support, which may include support groups http://www.pmri.org/lifestyle_program.html Let’s apply a version of the Dean Ornish program to recovery!

Basics of Qigong

qi – the image of steam rising over a pot of rice Qigong translates as “energy cultivation” Qigong is a modern term – ancient term was yang shen (nurturing life) or nei gong (internal exercises)

Qigong as harmonizer – spirit-body-mind 3 tunings: breath, body, mind • Breathing Method – slow, deep, smooth, even, fine, round, natural/relaxed • Postural Correction – fine points of standing, sinking weight, lifting bones • Heart-Mind Intent – calm, empty, quiet, alert, aware, open, present, non-judgmental

Fluid Dynamics of Weight Shifting – kelp forest, lava lamp Walking Dynamics – the redwood tree and the water strider

Three “C’s” – Circularity, Continuity, Complementarity Repetitions – nines 70% rule – take it easy, build results slowly over time (pain = no gain) 100 days to change – neuroscience confirms, neural networks grow Contraindications - it is best to avoid doing vigorous qigong exercise if one is feeling weak or ill. Breath work and use of meditation and healing sounds while lying or sitting may be all one can do until strength returns. It is also possible to feel faint or weak after practice while one is building strength and health. Nausea from exertion and holding postures too long for one's current level of vitality may also occur. Muscles may become sore from being used in new ways. Take it easy if need be. Avoid exercising in cold drafts or excess heat. Keep hydrated. It is best to avoid practice right after eating. Practice is often best in the morning as a foundation for the day but may be done at any time. Rarely, a person will develop obsessive or compulsive desires to overdo it. If you have such tendencies, be reasonable. It may be necessary to find a teacher who understands the 70% rule. Be aware of your own limitations. If you experience pain, modify or avoid the specific exercise. Stay in tune with yourself. -various sources

Benefits of Qigong in Recovery The qigong practices described in this text can be quite helpful for those people who are in the process of recovering from an addiction. Here are some of the benefits for those individuals:

• Negative, resentful, and self-critical thinking can get in the way of recovery. Qigong practice can help the individual cultivate a more positive, uplifted frame of mind.

• You may find that the early days of sobriety are like an emotional rollercoaster. Additionally,

one of the main obstacles to achieving long-term recovery is to develop emotional sobriety. Qigong grounding and centering exercises can help to stabilize volatile moods and build self-control.

• Anger and stress resolution as well as problem-solving skill building each are enhanced through

the mind-body-breath harmonies found in regular qigong practice.

• Addicts tend to suffer from low self-esteem and feelings of shame. Regular practice of the qigong principle of mind-intent helps to develop a sense of mastery over one’s own body with the mind, bringing improved confidence and self-esteem.

• One fairly common and unpleasant symptom for addicts who have stopped using is mental fog.

Regular qigong practice helps to improve mental clarity and focus. Practicing qigong exercises, breath-work, self-massage, and self-care routines can also help develop a normal sleeping pattern.

• Triggers and cues to alcohol or drug use can be managed through the self-discipline of regular

qigong practice. Cravings can be reduced or re-directed through the principles of relaxation, sinking, and letting go that are central to many of these qigong exercises.

• Uncomfortable, unpleasant physical symptoms of withdrawal and issues of un-medicated

physical and emotional pain can be managed through specific qigong practices.

• When people are active in addiction they typically have caused significant damage to their health. Qigong helps restore physical vitality and promotes healing of the body. Specific qigong exercises are directed toward promoting healthy functioning of all internal organs including lungs, heart, liver, kidneys, and digestion.

• Boredom can be a problem for people in early recovery, and it is a common reason for why

certain people relapse. Developing balance, patience, and self-discipline add to a meaningful life in sobriety helping the individual to keep things in perspective and avoid relapse.

• Those who are newly sober will likely need to distance themselves from drinking or drugging

friends. Qigong practice groups offer a good opportunity to socialize and meet new people. Support networks themselves are beneficial for strengthening and healing.

• Following a spiritual path can provide one with a purpose in recovery. Qigong meditations and

breathing exercises can be good tools to strengthen the spiritual warrior. Some of the initial statements were revised from, others are my own: http://alcoholrehab.com/alcohol-rehab/qigong-for-addiction-recovery/

Preliminary Research Methods Over the course of about 6 months I had participants in my therapy groups fill out a before and after session simple questionnaire which indicated their perceived level of physical pain and their perceived level of anxiety and stress. A sample of the questionnaire is available separately. The session activities usually lasted between 30-45 minutes and involved a variety of qigong exercises including, breathing and meditation, self-massage, 8 brocades, animal frolics, coiling silk, 5 phases, basic standing and walking postures. An example of an activity is included (urge surfing using standing meditation). These questionnaires were an initial process to determine whether more specific tools or methods would be worth doing. The results indicate a great deal of promise. Preliminary Research Outcomes – Pain

§ Pre Session Pain compared to Post Session Pain § 597 total Pre 383 total Post § 36% decrease in Perceived Pain § Total Clients Surveyed 294 in 28 sessions

Preliminary Research Outcomes - Anxiety

§ Pre Session Anxiety compared to Post Session Anxiety § 722 total Pre 336 total Post § 54% decrease in Perceived Anxiety/Stress § Total Clients Surveyed 294 in 28 sessions

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Sample Exercise - Urge Surfing With Qigong

Points to remember when practicing Standing Meditation: Be Centered - The breath is fundamental to our life process. When we are born, we must take our first breath to stay alive. Our final act before death is to take our last breath. So breath is what connects us to life, and it is our most readily available tool to use to effectively change our mental, emotional, and even physical state. Use deep, slow, even breaths into your abdominal core – a process that helps us to keep centered. Be Grounded - Aligning our posture so that our spine is lengthened and the head lifted, while simultaneously sinking the weight of the body into the feet and ground is a conscious practice that helps us feel more rooted, more solid, less easily swayed by distractions and the opinions of others. We become more grounded. Be Uplifted- keeping our mind free of distractions, complications, and worry allows for the development of a more positive outlook on life, we develop the feeling of being uplifted. This is reflected in the way we carry ourselves: confident, comfortable, and fully conscious of our capacity to be well. Feel uplifted. Practice Practice Practice Be Prepared - by tuning the mind, breath, and body - one becomes able to handle stressors more effectively. But this only works with practice. Emergency responders, the firemen who rush into a burning building practice their drills until the actions become a natural part of them, in a crisis they can act without having to think cautiously of each next move. It is the same for you. Become a trained fireman who can put out the fire of addiction. Once you have practiced these fundamentals for several months, it becomes second nature to you. When a crisis or challenge hits, you don't have to calm yourself, you remain calm, because that is where you live.

Working through triggers and urges to use alcohol, drugs, or tobacco can be like riding a wave. Instead of fighting the urge – learn to ride it out. Waves come and go – they rise to a crest then break – when they reach the shore, they lose their energy and disappear. If you can learn to ride out your cravings, they too will soon pass. Qigong standing practice gives you a simple method to manage your energy, develop self-control, patience, and the confidence to defeat addictive craving and compulsion.