Two Pillars of Recovery Reflect How Nature Works Geoff Kane, MD, MPH Brattleboro, VT February 6,...
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Two Pillars of Recovery Reflect How Nature Works Geoff Kane, MD, MPH Brattleboro, VT February 6, 2013 Kane, MD 2013
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Transcript of Two Pillars of Recovery Reflect How Nature Works Geoff Kane, MD, MPH Brattleboro, VT February 6,...
Two Pillars of Recovery
Reflect How Nature Works
Geoff Kane, MD, MPHBrattleboro, VT
February 6, 2013
Kane, MD 2013
Kane, MD 2013
Overview
• Nature (never takes time off)
• Neurobiology Behavior Addiction Powerlessness Recovery
• The Two Pillars of Recovery
Kane, MD 2013
“Addiction is like gravity— governed by laws of nature and never takes time off.”
-Kane
Kane, MD 2013
“…the essence of addiction: uncontrollable, compulsive drug seeking and use, even
in the face of negative health and social consequences.”
- Alan Leshner, PhD
Kane, MD 2013
Addiction
• Subjective: Powerlessness
• Objective: Persistent use despite adverse consequences
Kane, MD 2013
There is more to who we are and more to why we do the
things we do than what meets our own minds.
Kane, MD 2013
Lower centers of the Central Nervous System can act independently of higher
centers.
Kane, MD 2013
Kane, MD 2013
“New research shows that emotions have a separate system of nerve pathways,
through the limbic system to the cortex, allowing emotional
signals to avoid conscious control.”
-Robert Ornstein, 1991
Kane, MD 2013
-Robert Ornstein
“…unconscious decisions for action go on constantly inside the head.”
Kane, MD 2013
-Robert Ornstein
“We’re worse off than Freud thought, because many actions proceed
without our knowing anything about them.”
Kane, MD 2013
“Our limbic system sets the mind’semotional tone and stores our
highly charged emotional memories.”
- Tian Dayton, PhD
Kane, MD 2013
Addictive chemical substances change the brain and change
behavior.
Kane, MD 2013
“I have a passion for alcohol.”
- 25 year old female
Kane, MD 2013
“Any addict knows, you’ll do anything to get it.”
- 23 year old male
Kane, MD 2013
• Violate their own rules for behavior/values when under the influence?
• Break promises to themselves about use?
• Pay an emotional price for using (shame, guilt, fear, remorse, anger at self)?
• See a different version of their own drinking/drugging than other witnesses?
• Would become defensive or lie if asked these questions?
- John and Pat O’Neillin Help to Get Help
Are they really hooked?
RELAPSE RATE OVER TIMEA
bsta
iner
s (%
)
Time (Months)
0 1 2 3 4 5 6 7 8 9 10 11 12
2 Weeks
100
90
80
70
60
50
40
30
20
10
0
Heroin
Smoking
Alcohol
Kane, MD 2013
Kane, MD 2013
Kane, MD 2013
Two Pillars of Addiction Recovery
• Keep your distance!• Ask for help!
Kane, MD 2013
“The treatment of addiction is [still] people.”
Kane, MD 2013
“Suggestions” Made in Addiction Treatment
• 90 meetings in 90 days• Obtain and use sponsor• Do some Step work• Participate in an aftercare group• Participate in counseling/ psychotherapy
Kane, MD 2013
Counseling Tips
• Be Empathic, Nonconfrontational• Offer Choices• Emphasize Patient’s Responsibility• Convey Confidence In Patient’s
Ability To Change
Kane, MD 2013
Determinants of Client “Change”
• Client factors 40%• Relationship factors 30%• Expectancy & Hope 15%• Model/technique 15%
- Michael Clark, MSW
Kane, MD 2013
Positive interpersonal relationships change the brain
and change behavior.
Kane, MD 2013
“Neural repatterning comes as we enter into and sustain new types of relationships that allow us to reregulate
our sense impressionsslowly and over time.”
- Tian Dayton, PhD
Kane, MD 2013
“Interpersonal experience shapes the mind as it continues to develop
throughout the lifespan…
Interactions with the environment, especially relationships with other
people, directly shape the development of the brain’s structure and function.”
- Daniel J. Siegel, MD
Kane, MD 2013
“ …the amygdala, along with related areas…, plays a crucial role in
coordinating perceptions with memory and behavior. These regions are
especially sensitive to social interactions.”
- Daniel J. Siegel, MD
Kane, MD 2013
Some Recovery Skills/Tips• Be honest• Embrace your pain• Mistrust yourself• Keep your distance• Seek people, not chemicals• Pay attention!
Kane, MD 2013
Treatment/Recovery EssentialsPatient• Understand & accept “laws”• Avoid or manage “triggers”• Use supports, human
& spiritual• Avoid abusive
relationships• Take meds when
appropriate
Community• Understand “laws”• Reduce drug
availability• Make professional and
other positive relationships available continuously
• Protect people from abusive relationships
• Make appropriate meds available
Kane, MD 2013
Abstinence results from Skill Power
not Will Power
CRAVING
WITHDRAWAL
HABIT COPINGDocherty’s Craving Triangle
Kane, MD 2013
Kane, MD 2013
Kane, MD 2013
SpiritualityInvolves Relationships With:
• Self• Other Human Beings• Nature• Creator, God, Higher Power
Kane, MD 2013
A Model for Recovery
• Emotional Arousal
• Sense of Hope
• Sense of Mastery
• Love and Humor
- Modified from Jerome Frank, MD
