Rx15 presummit mon_200_neri
-
Upload
opunite -
Category
Healthcare
-
view
215 -
download
0
Transcript of Rx15 presummit mon_200_neri
Breaking the Intergenerational Cycle of Substance Abuse
National Rx Drug Abuse Summit, Atlanta, GA, April 6th 2015Robert L. Neri, LMHC, CAP - Senior Vice President, Chief Program / Service
Officer WestCare Foundation, Inc.
The Study of “Epigenetics”The Study of “Epigenetics”
How the environment actually turns certain genes…
On or Off
Healthy Family ExpansionHealthy Family Expansion
CommunicationCommunication RolesRoles Emotional InvolvementEmotional Involvement Behavior ManagementBehavior Management
World of Abnormal RearingWorld of Abnormal Rearing
DeprivationDeprivation SurvivalSurvival Dependency NeedsDependency Needs
““De·pend·ent”De·pend·ent” Dependent (adj):Dependent (adj): relying on someone or relying on someone or
something else for aid, support, etc.something else for aid, support, etc.
Dependent (n):Dependent (n): a person who depends on or a person who depends on or
needs someone or something for aid, needs someone or something for aid,
support, favor, etc. support, favor, etc.
Controlled by a variableControlled by a variable
Based on the Random House Unabridged Dictionary, © Random House, Inc. 2006.
Causes of DependencyCauses of Dependency
An inability to fulfill An inability to fulfill
one’s needs independentlyone’s needs independently
Core Core Healthy FamilyHealthy Family Themes Themes
Nurturance & Trust
Expectations & Control
Relationships & Self Esteem
Core Core Healthy FamilyHealthy Family Themes Themes
Nurturance & Trust Support
Expectations & Control
Relationships & Self Esteem
UnderstandingUnderstanding
The W.A.R. CycleThe W.A.R. Cycle““World of Abnormal Rearing”World of Abnormal Rearing”
Stages of the WAR CycleStages of the WAR Cycle
ConceptionConception
Wanted/ Wanted/ UnwantedUnwanted
PregnancyPregnancy
Stages of the WAR CycleStages of the WAR Cycle
ConceptionConception
Wanted/Wanted/ UnwantedUnwanted
PregnancyPregnancy
Unrealistic Unrealistic ExpectationsExpectations
ATTACHMENTATTACHMENT is the drive is the drive to be Close to be Close
and and Cared AboutCared About
Attachment RelationshipsAttachment Relationships give us our concept of the world:give us our concept of the world:
Hostile Hostile FriendlyFriendly
NurturingNurturing
ATTUNEMENT ATTUNEMENT
is about being in tune emotionally is about being in tune emotionally with the child with the child
PARENTING PARENTING
is more about theis more about the
Relationship Relationship than than TechniquesTechniques
Stages of the WAR CycleStages of the WAR Cycle
ConceptionConception
Wanted/ Wanted/ UnwantedUnwanted
PregnancyPregnancy
Unrealistic Unrealistic ExpectationsExpectations
Role ReversalRole Reversal
CChildren learn to behildren learn to be
stress absorbers –stress absorbers –
““Soaking up the worries Soaking up the worries
of their parentsof their parents.”.”
Living in a constantLiving in a constantenvironment of stress environment of stress
means thatmeans that high-stress becomes high-stress becomes
my “Baseline”my “Baseline”
II will seek outwill seek out
Stress and CrisisStress and Crisis
as my “Comfort Zone”as my “Comfort Zone”
Stages of the WAR CycleStages of the WAR Cycle
ConceptionConception
Wanted/ Wanted/ Unwanted Unwanted
PregnancyPregnancy
Unrealistic Unrealistic ExpectationsExpectations
Role ReversalRole Reversal
ComplianceCompliance
COMPETENCY BASED COMPETENCY BASED
APPROACH TO LEARNINGAPPROACH TO LEARNING
Competency Mastery Requires:Competency Mastery Requires:
o Information knowledgeInformation knowledge
o Implementation knowledgeImplementation knowledge
Both are Both are Internalization ProcessesInternalization Processes needed to achieve Recoveryneeded to achieve Recovery
Internalization is checking for Internalization is checking for UnderstandingUnderstanding
Taking ownership of new Taking ownership of new KnowledgeKnowledge
InternalizationInternalization is about making is about making learning Relevantlearning Relevant
Making associations between Making associations between characters and situations that characters and situations that
can shape their decisionscan shape their decisions
Stages of the WAR CycleStages of the WAR Cycle
ConceptionConception
Wanted/ Wanted/ UnwantedUnwanted
PregnancyPregnancy
Unrealistic Unrealistic ExpectationsExpectations
Role ReversalRole Reversal
ComplianceCompliance
IsolationIsolation
Adults who had Adults who had predictable, predictable, nurturingnurturing parents are comfortable parents are comfortable::
o Being close and aloneBeing close and aloneo Have a secure attachment styleHave a secure attachment style
Adults who had Adults who had inconsistentinconsistent, , emotionally unavailableemotionally unavailable parents: parents:
o Often have an anxious attachment style
o Crave closeness and fear abandonment
o Want and need less space and are
more smothering
Adults who had parents who were Adults who had parents who were
rejectingrejecting often have an: often have an:
o Avoidance attachment styleo Resisting closeness o Seeking spaceo Fear of being hurt
““Adults are Adults are unpredictableunpredictable People” People”
“ “ People turn on you ”People turn on you ”
“ “ Trust only myself ”Trust only myself ”
Stages of the WAR CycleStages of the WAR Cycle
ConceptionConception
Wanted/ Wanted/ UnwantedUnwanted
PregnancyPregnancy
Unrealistic Unrealistic ExpectationsExpectations
Role ReversalRole Reversal
ComplianceCompliance
IsolationIsolation
Trust Not Trust Not LearnedLearned
Stages of the WAR CycleStages of the WAR Cycle
ConceptionConception
Wanted/ Wanted/ UnwantedUnwanted
PregnancyPregnancy
Unrealistic Unrealistic ExpectationsExpectations
Role Reversal
ComplianceCompliance
IsolationIsolation
Trust Not Trust Not LearnedLearned
I’m No GoodI’m No Good
Stages of the WAR CycleStages of the WAR Cycle
ConceptionConception
Wanted/ Wanted/ UnwantedUnwanted
PregnancyPregnancy
UnrealisticUnrealistic ExpectationsExpectations
Role ReversalRole Reversal
ComplianceCompliance
IsolationIsolation
Trust Not Trust Not LearnedLearned
I’m No GoodI’m No Good
Selection of Selection of Friends Friends
Social Support DeficitSocial Support Deficit
Choosing relationships with people who have “like” Choosing relationships with people who have “like” problemsproblems
Stages of the WAR CycleStages of the WAR Cycle
ConceptionConception
Wanted/ Wanted/ UnwantedUnwanted
PregnancyPregnancy
Unrealistic Unrealistic ExpectationsExpectations
Role ReversalRole Reversal
ComplianceCompliance
IsolationIsolation
Trust Not Trust Not LearnedLearned
I’m No GoodI’m No Good
Selection of Selection of Friends Friends
Select PartnerSelect Partner
Relationships DamagedRelationships Damaged
Relationships are about Relationships are about Dependency & Dependency &
using each otherusing each other
Stages of the WAR CycleStages of the WAR Cycle
ConceptionConception
Wanted/ Wanted/ UnwantedUnwanted
PregnancyPregnancy
Unrealistic Unrealistic ExpectationsExpectations
Role ReversalRole Reversal
ComplianceCompliance
IsolationIsolation
Trust Not Trust Not LearnedLearned
I’m No GoodI’m No Good
Selection of Selection of Friends Friends
Select PartnerSelect Partner
Relationship Relationship Fails Fails
Themes & Stages of the WAR CycleThemes & Stages of the WAR Cycle
ConceptionConception
PregnancyPregnancy
Unrealistic Unrealistic ExpectationsExpectations
Role ReversalRole Reversal
ComplianceCompliance
IsolationIsolation
Trust Not Trust Not LearnedLearned
I’m No GoodI’m No Good
Selection of Selection of Friends Friends
Select PartnerSelect Partner
Relationship Fails
Nurturance & Trust Support
Expectations & Control
Relationships & Self Esteem
WAR Cycle – Adults look back WAR Cycle – Adults look back
at what helped them:at what helped them:o One-on-one time with a loving adultOne-on-one time with a loving adult
o Informal support from a neighbor, Informal support from a neighbor, teacher, coach, ministerteacher, coach, minister
o Early insight – “It’s not about me” – Early insight – “It’s not about me” – “These people are sad and angry.”“These people are sad and angry.”
A passion for reading, musicA passion for reading, music A sense of humorA sense of humor Love for the ArtsLove for the Arts Physical activity – release from painPhysical activity – release from pain
Assess/Deprivation NeedsAssess/Deprivation Needs
Abuse HistoryAbuse History Resiliency FactorsResiliency Factors
Understand Role ReversalUnderstand Role Reversal
Facilitate PredictabilityFacilitate Predictability Address childhood play Address childhood play
through safe, social through safe, social activitiesactivities
Facilitate movement from Facilitate movement from compliance to internalizationcompliance to internalizationthrough gradual reduction of through gradual reduction of
structure and insight workstructure and insight work
Create a treatment culture Create a treatment culture that promotes that promotes
“Mistakes are wonderful “Mistakes are wonderful opportunities to learn.” opportunities to learn.”
Establish a therapeutic allianceEstablish a therapeutic allianceand facilitate and facilitate
transfer of trusttransfer of trust
Victims of Emotional Manipulation
Disclose “way too fast”
No small talk which is “testing talk”
Each conversation goes a little deeper (gradual)
Clients Are SkillfulClients Are Skillful
at at
ADAPTINGADAPTING
o Face Readers
o Can be Manipulative
WWe teach them by e teach them by observing us being observing us being genuinegenuine
& & authenticauthentic
= Role Modeling= Role Modeling
Relational FrictionRelational Friction – – Beats them upBeats them up
Relational Work in TherapyRelational Work in Therapy – –
Restores themRestores them
Hearing their narrative (story) as Hearing their narrative (story) as
a survivor – a survivor –
““Empowerment is Therapeutic”Empowerment is Therapeutic”
Teach social network mappingTeach social network mappingand assist clients with buildingand assist clients with building
a social support networka social support network
Teach everything you can aboutTeach everything you can aboutrelationships including patterns,relationships including patterns,
boundaries, roles, etc.boundaries, roles, etc.
Establish ConversationsEstablish Conversations
ParentingParenting Contact Comfort Contact Comfort Family ExpansionFamily Expansion
Competency Based ContinuumCompetency Based Continuum
Numbness Apathy Numbness Apathy Self Help Self Help
Learned Helplessness Learned Helplessness Mutual Help Mutual Help
IndifferenceIndifference Industrious Industrious
Arrested Development Arrested Development Social Learning Social Learning
“ “No Learning” Learning from No Learning” Learning from ExperienceExperience
Unpredictable Adults Unpredictable Adults Role ModelsRole Models
IsolationIsolation Connected to Self/Connected to Self/ Higher Power/ Higher Power/
OthersOthers
Emotional DeprivationEmotional Deprivation Contact Comfort Contact Comfort Emotional Literacy Emotional Literacy
Self Soothe Self Soothe
Displacement Displacement BelongingBelonging