Treatment for Borderline Personality Disorder

Kimberly Peters

Kimberly Peters, MSSW, LCSW

By Kimberly Peters, MSSW, LCSW
Primary Therapist, Sierra Tucson

I still remember my first encounter with someone living with borderline personality disorder; I was in graduate school working as part of an assessment team for a closed psychiatric unit. As we were about to walk in to meet with the patient, my mentor looked at the chart and said, “Oh, she’s borderline.” The interesting thing about this experience is that years later, I don’t remember the assessment or the patient, but what I do remember is my mentor’s dismissive tone of voice and the negative stigma associated with the diagnosis.

For years, borderline personality disorder (BPD) and manipulation were synonymous in the mental health community. With growing research and training, we now understand that people with BPD are simply doing what they know works to get their needs met. When we look at someone with symptoms of BPD, what we often find is someone who was born acutely sensitive to his or her surroundings; perhaps this was a baby that took longer to soothe after becoming activated. If this child is raised in an environment that is validating and helps him or her learn to soothe appropriately, then the child learns how to advocate for him or herself using healthy copying mechanisms. However, if this child is raised in an invalidating environment, often including a trauma, then he or she learns maladaptive coping mechanisms in order to get his or her needs met. As long as these maladaptive coping mechanisms are working, the child will continue this behavior.

Dialectical behavioral therapy (DBT) targets maladaptive behaviors on four fronts: mindfulness, emotion regulation, interpersonal effectiveness, and distress tolerance. DBT skills address identity confusion, feelings of emptiness, cognitive deregulation, interpersonal chaos, fears of abandonment, labile affect, excessive anger, impulsive behaviors, suicidal threats, and parasuicide.

While not every resident that comes to Sierra Tucson is in recovery for borderline personality disorder, many are struggling with how to appropriately manage emotions, foster relationships with others, and cope with life’s stressors in healthy ways. Since Marsha M. Linehan, PhD, ABPP, developed DBT in the late 1980s, not only has it been proven effective for people with BPD, but it has also been effective for individuals that are struggling with depression, bipolar disorder, anxiety, post-traumatic stress disorder (PTSD), addiction, and eating disorders. I personally believe that DBT can be beneficial for anyone regardless of whether or not they have a diagnosis. After all, the goal of DBT is to have a life worth living. Who doesn’t want that?

At Sierra Tucson, DBT skills groups are a part of each individual treatment plan. Our DBT groups are led by trained DBT therapists. Individual DBT appointments may also be added to a resident’s treatment plan per the treatment team or resident’s request. We believe that a life worth living is possible, and we teach our residents how to achieve that on their own merit.

For more information about Sierra Tucson’s comprehensive residential programs, please call our Admissions Coordinators at (800) 842-4487.

Body Positivity: Celebrating every body and the person within

Scott Frazier, MSC Manager of Sierra Tucson's Eating Recovery Services

Scott Frazier, MSC
Manager of Sierra Tucson’s Eating Recovery Services

Body Positivity. Two buzzwords and a very hot topic in today’s society. But what does it really mean, and how do premier treatment centers like Sierra Tucson incorporate this concept into their therapeutic milieu? Scott Frazier, MSC, manager of Sierra Tucson’s Eating Recovery Services, explains.

Q: What is Sierra Tucson’s stance on body positivity?
SF: At Sierra Tucson, we teach residents to be loving and kind to their bodies. Many residents need to make amends to their bodies, treating them with love and respect. We challenge body-hatred talk by helping individuals explore a healthy approach toward a body-positive attitude.

Residents start to develop a new pathway of love and acceptance. This pathway increases the more they focus on what they like about their bodies. We encourage residents to think about self-love and offer ways in which to show compassion toward self. Residents get in touch with new body sensations and learn how to love and be connected with their bodies. Self-love and how one views self is a highly important piece that builds the foundation of being in touch with one’s body. It also reinforces the idea that when an individual treats his or her body well, positive feelings ensue. Truly, body positivity is vital to a person’s emotional wellbeing.

Q: How do Sierra Tucson’s Eating Recovery Services contribute to the message of body positivity?
SF: Sierra Tucson believes that disordered eating exists in tandem with one or multiple other disorders, including depression, anxiety, substance use disorder, trauma, or chronic pain. Our Eating Recovery Services place emphasis on the idea that the body is sacred and must to be treated with care. In other words, it mustn’t be starved or stuffed full of food. As part of their treatment, we help residents find a meal plan that works for them and nourishes their bodies in a healthy manner.

Residents can start practicing self-care by replacing disordered eating behaviors with healthy new behaviors. Somatic Experiencing® helps a person understand how the body responds to trauma or anxiety and how he or she has turned to unhealthy coping skills. Yoga helps one to understand the sensations of the body and how his or her body is something to be enjoyed. Support groups with an emphasis on body expression help residents understand that expression versus restriction leads to body positivity. Sierra Tucson’s Therapeutic & Recreational Activities Program help individuals understand that creating and overcoming vulnerability within the body leads to a stronger, more empowered view of the body. Residents experience what it’s like to stop engaging in disordered eating patterns during their time at Sierra Tucson. Consequently, they feel a sense of pride in what they’ve accomplished and have faith that they can continue with long-term recovery outside of treatment.

We have seen dramatic improvements and witnessed residents reach goals and make momentous strides after completing treatment at Sierra Tucson. Our integrative approach “care-fronts” the way one looks and feels about his or her body and integrates evidence-based practices to fully address the trauma, addiction, and/or mood issues that are the root cause of disordered eating behaviors.

Q: What are some tools that professionals can offer their clients to promote body positivity in their own practice?
SF:
1.    Learn to challenge negative body talk in an encouraging way
2.    Align yourself with the healthy aspects of your client
3.    Encourage your client to use his/her body by participating in pleasurable, non-addictive activities
4.    Recommend reputable books about how to heal from disordered eating behaviors
5.    Help your client start to feel and embrace new sensations in his/her body
6.    Help your client treat his/her body as a vessel to his/her soul

For more information about Sierra Tucson’s comprehensive residential programs, please call our Admissions Coordinators at (800) 842-4487.

Empty Nest Syndrome: Healthy tips for re-fluffing your feathers

Chief Operations Officer Jaime Vinck, MC, LPC, NCC, CEIP If your last child is getting ready to leave the nest, or he or she has already moved out, you might find yourself at a crossroads of emotions. Empty nest syndrome doesn’t affect every parent; one parent might endure a sense of loss while the other might find an empty house liberating.

It’s common for parents to feel emotionally unprepared when their child leaves the home, having regrets about missed opportunities in his or her life, feeling vulnerable without other things to focus on, or experiencing grief and mourning. Although not a clinical diagnosis, this condition affects the quality of life of the person who is battling it, as well as those closest to him or her.

Do you find yourself thinking or worrying about empty nest syndrome? Sierra Tucson’s Chief Operations Officer Jaime Vinck, MC, LPC, NCC, CEIP, sheds light on why men and women experience empty nest syndrome and what can done about it.

Q: What is empty nest syndrome?

JV: Empty nest syndrome is a normal developmental experience where children leave their family home for college, marriage, career, etc. This often becomes a challenge for couples, as they must redefine their relationship in ways other than as parents or reproducers. For many people, this also occurs when their parents are ill or dying, thus creating another void in the nest.

The nest often empties at the same time that careers have maxed out and retirement becomes a reality. This creates a need for another redefinition of self, and could mean a change in lifestyle, the selling of a family home, and a tightening of the belt financially.

Q: How does one overcome empty nest syndrome?

JV: I prefer to think of re-feathering a nest rather than it being empty. This season of life is about celebrating accomplishments of one’s past and accepting his or her adult children as they become their own independent beings. Nests can be re-feathered with a spousal relationship that does not revolve around the rearing of children. It’s also a time for enriched relationships with siblings, friends, and colleagues (running out the door every night at 5 p.m. for a soccer game is a thing of the past). It can also be a time for new passions, dusting off an old hobby, and self-care.

Taking care of yourself is essential when re-feathering your nest. This includes keeping up with your physical and mental health. This can be as simple as making all of your dental and vision appointments to taking up yoga, meditating, and journaling. Time is another important element of the re-feathered nest. While you find more time on your hands, use it wisely and celebrate the present rather than longing for what once was.

Q: Why is it important to redefine ourselves?

JV: I like to think of it as becoming reconnected with oneself beyond the role of spouse and parent. Depression often kicks in because the empty nest triggers a loss of identity and the feeling of being needed. Take this as an opportunity to do something you’ve always wanted to do, whether it’s going back to college, getting back into the workforce, or taking those archery classes you never had time for. Volunteering is also a great outlet that allows you to continue caring for others in a way that is interesting, fulfilling, and familiar.

This season of life should be a time to embrace who you are and to celebrate the wisdom that has been gained. Learn to enjoy your new surroundings and newfound self, knowing that you have earned this stage in life through decades of selfless efforts.

A Smoother Road to Eating Recovery

Alisa Fliss

Alisa Fliss, EdS, MBA

Sierra Tucson’s Evolved Approach to Disordered Eating
by Alisa Fliss, EdS, MBA
Director of Business Development, Acadia Healthcare – Recovery Division

Recently, I received an invitation to a conference call to learn about the latest updates on Sierra Tucson’s Eating Recovery Program. I have to admit, this was a conference call to which I looked forward. There’s a real need in our communities for programs like that of Sierra Tucson’s, a treatment center that truly treats the entire individual using an integrated approach and addresses the underlying issues alongside the behaviors. During the call, it was announced that, from now on, Sierra Tucson will treat disordered eating as a co-occurring condition to primary diagnoses such as depression, anxiety, trauma, chronic pain, or substance use disorder.

At first, I was somewhat perplexed. I took the weekend to reflect on these changes, and it brought me back to my early years in recovery from anorexia and bulimia. I thought about my own treatment experience, and my mindset started to shift. I thought about what my recovery might have looked like had I, after multiple times in treatment, received help to address the underlying issues as the primary focus of my work, while concomitantly receiving the support needed for my eating disorder. I wondered, “Could this be what the eating disorder treatment industry has been missing all along?”

Let’s face it: I was an expert on food before treatment, and I was an expert on food after treatment. I knew what I needed to do, but I did what my disordered self wanted to do. Subsequently, every inpatient or residential stay for my eating disorder was spent with the majority of those weeks learning how to eat all over again, every time. I’m not saying that I didn’t need structure and to regain a normal state of nutritional and behavioral equilibrium, but did I need to return to the basics? I couldn’t help but wonder.

Given I had the unique experience of having one of my final eating disorder treatments chronicled in an HBO documentary, I could very well say that most people with whom I have a relationship know my story. Unfortunately, though, even the documentary focused predominantly on weight and food, food and weight, and the maladaptive behaviors that I used to lose weight. That’s not actually my story though, and today I am proud to say that. My story is so much richer and goes far deeper than the behaviors. To understand the disorder, wouldn’t one need to know the back story?

What most people don’t know, and what I’ve very rarely acknowledged or disclosed even to those who know me, is that my eating disorder was how I managed, or mismanaged, and suppressed my depression, anxiety, and trauma. Most people have heard me say, “I’m in recovery from an eating disorder.” Nevertheless, I don’t know that I’ve ever said out loud that I have battled with depression and anxiety, and that I am a trauma survivor, probably because most of my residential therapeutic work was around the disordered eating behaviors, symptom stabilization, and body image work.

I’ve been in recovery for 13 years now. Early on, I had an encounter with someone who was still struggling with her eating disorder, and she asked me what recovery felt like. I paused for a moment and tried to put feelings into words – feelings that, at the age of 30, I was just realizing were actual sensations in the body and not just thoughts and ideas. I remember responding to her question, “It’s awful, grueling, painful, anxiety-provoking, miserable, and depressing!”

She then asked, “So why in the world do you do it?”

I confidently stated, “Because all of the pain, anxiety, and misery are still so much better than the nothing I felt when I was active in my disorder.” I also remember saying, “I don’t starve myself anymore, nor do I binge and purge, but I still get anxious over having to pay bills, among many other things. I still get nervous in certain situations, and I still go into avoidance mode when I get too overwhelmed, and…” the list goes on.

The road to recovery was very bumpy, but I’m not so sure it needed to be. For someone like me, who knew “how” to eat, was a program with a primary eating disorder focus necessary the second, third, or fourth time around? Had I known there were primary programs for mood, anxiety, trauma, and/or PTSD, where I could focus on the underlying issues while still receiving the necessary support for recovery from my eating disorder, would I have learned to deal with the uncomfortable emotions and core issues? Maybe the road to recovery would not have been so riddled with pitfalls.

Sierra Tucson gets my stamp of approval! As a clinical community, it’s time to evaluate what clients need at any given time in their process. For one individual, stabilization and medical intervention may be required, in which Sierra Tucson might not be appropriate; but for another, time might be needed to figure out how to live a healthy life in a world filled with fears, stressors, triggers, flashbacks, feelings of depression, and, let’s not forget, those who trade their eating disorder for other addictions whenever the going gets tough.

As the director of business development for Acadia Healthcare – Recovery Division, I work with professionals to match treatment and recovery programs that are right for their clients/patients. Our team of treatment placement specialists (TPS) is an important link in the recovery chain. Every TPS must fully understand what makes each facility and its offerings unique. These dynamic professionals come from a diverse collection of healthcare backgrounds and individual experiences in behavioral health treatment that allow them to guide individuals in finding the most comprehensive help available. As such, it takes more than just education for us to be effective. It takes a special kind of expertise and compassion that serve as a true resource for professionals and their clients/patients.

There is hope, and Sierra Tucson, with its evolved and comprehensive approach to disordered eating treatment, is here to help. If you, your loved one, or your client/patient continues to struggle and is ready to address the underlying issues that keep him or her stuck in the cycle of disordered eating, call (800) 842-4487 to speak with an Admissions Coordinator, or find your local treatment placement specialist (TPS) by visiting www.treatmentplacementspecialists.com.

The Opioid Epidemic: Prevention, Recognition & Treatment

Teresa Jackson, MD, Director of Sierra Tucson's Addictions / Co-occurring Disorders Program

Teresa L. Jackson, MD

By Teresa L. Jackson, MD
Director of Addictions / Co-occurring Disorders Program

Prince, Michael Jackson, Heath Ledger, Whitney Houston, Amy Winehouse, Philip Seymour Hoffman, John Belushi, River Phoenix, Janis Joplin…the list goes on and on. It’s shocking to hear when a famous rock star or actor has died of a drug overdose.

What’s more disturbing…

  • 91 people die each day in the United States from an opioid overdose.
  • 33,000 people died from an opioid overdose in 2015. Half of these deaths were from prescription opioids.
  • Drug overdoses are the leading cause of accidental death in the United States, ahead of motor vehicle deaths and firearms (deaths).

In the last 15 years, the number of prescriptions for opioid pain medications has quadrupled. Prescription opiates like methadone, oxycodone (Percocet), and hydrocodone (Norco and Vicodin) are the leading cause of prescription opioid deaths. The United States uses 99 percent of the world’s hydrocdone. The majority of people that use heroin started with an opiate pill. Sadly, heroin is readily available and less expensive. We are in the midst of an opioid addiction and overdose epidemic in the United States.

The best way to prevent opioid overdose deaths is to improve opioid prescribing, reduce exposure to opioids, prevent abuse, and stop addiction. Prescribing physicians must carefully regulate opiate prescriptions. Preventing abuse of prescription opiates is a combined effort between physician, pharmacies, patients, and family members. It is very important to keep all controlled substances in a secure location. Never share your prescription and always destroy the medication when it is no longer needed. Pharmacies often accept medications. In addition, they can be discarded in cat litter or coffee grounds.

Early recognition and treatment of addiction to opiates can save lives. Medication-assisted treatment (MAT) combines the use of medication with counseling and behavioral therapies. Unfortunately, behavioral interventions alone have a poor success rate in opioid addiction, with a relapse rate that is greater than 80 percent. The addition of medication to behavioral intervention greatly increases the outcomes. FDA-approved medication such as buprenorphine (Suboxone, Subutex), methadone, and naltrexone improve the success rate and decrease the associated risks of opiate addiction, including HIV, Hepatitis C, and overdose. Extensive literature and systematic reviews show that maintenance treatment with either methadone or buprenorphine is associated with retention in treatment, reduction in illicit opiate use, decreased craving, and improved social function.

Often, patients express concern about seemingly trading one drug for another. Abstinence is always an option; however, MAT allows the brain to heal from opiate dependence. The patient can concentrate on recovery without ongoing withdrawal symptoms and cravings. The brain gradually heals from opiate dependence and the medication can be slowly tapered. One of the most common fears for patients is withdrawal. The Surgeon General and government are responding to this epidemic by increasing funding for the treatment of addiction, including MAT. In addition, life-saving medications that can reverse an opioid overdose are now available to patients who are prescribed opiates and for the loved ones of patients addicted to opiates. Naloxone (Narcan) can reverse an opiate overdose. The nasal spray is easy to use and more readily available now.

Early treatment for opioid addiction saves lives. If you are concerned about a loved one’s use of prescribed opiate pain medication or use of illicit opiates such as heroin, please seek professional help. The combined use of medication, counseling, and behavioral therapies may save his or her life.

MAT: A Case Study

Jane is a 34-year-old woman addicted to heroin. She started using oxycodone in college on the weekends. She began working after college and married a man that also used oxycodone. After a miscarriage and the death of her father, Jane’s use escalated to daily use of up to 600 milligrams of oxycodone. She was spending $600 daily on oxycodone. Her drug dealer introduced her to heroin. Her use of heroin escalated to 2 grams per day. She tried stopping on her own and could not. She tried two detox programs and immediately returned to using. She was overwhelmed with anxiety and cravings without heroin. Upon admission, she was prescribed Suboxone® to help with withdrawal symptoms. Within 24 hours of her admission, her withdrawal symptoms were gone and she was feeling well and participating in groups and activities. Because Jane had been using for many years and relapsed several times after trying to stop on her own and detox, she is candidate for MAT. She was discharged on Suboxone maintenance therapy for at least six months. Suboxone®, in addition to Intensive Outpatient Treatment (IOP) and relapse prevention meetings, is the reason Jane is drug-free today and enjoying life.

The TPS Role: Your Treatment Guide

Andrew Suma, MA, LPCBy Andrew Suma, MA, LPC
Director of Business Development, Acadia Healthcare – Recovery Division

In a recent edition of Sierra Tucson’s Progress newsletter, Marina Rodina, director of business development for the Western region of the Treatment Placement Specialist (TPS) team for Acadia Healthcare – Recovery Division, provided an in-depth exploration of what it is like to work with a TPS and why such a role exists, as well as a glimpse into what can be expected when a referring professional reaches out to his or her local TPS team for assistance. The article centered on the position’s origins, as well as the TPS team’s collective “why” and core motivations. This provided a step-by-step deconstruction of why and how each TPS, through the informed treatment guidance is uniquely positioned to offer clinical communities a distinct kind of resource that solidifies the TPS as a true extension of the treatment and clinical process. Therefore, if you are a professional who has yet to work with your local TPS, and you are curious as to what kind of value your local TPS may be able to offer you or your clients, I would strongly recommend taking a moment to read Marina’s article, “Spotlight on Our Treatment Placement Specialists,” for more information.

In a similar way, the intention of this article is to extend that conversation and offer a parallel exploration of why and how the experience of receiving guidance from the perspective of the patient/client who has yet to begin his or her treatment journey, does – in and of itself – offer a critical sense of value to the overall patient/client experience.

Although the specific nature of every individual’s experience is likely to differ, what is almost universally true is that at some point over the course of a person’s treatment stay, he or she will experience something most commonly understood as a “breakthrough” or “aha moment” that can instantly offer the kind of insight which changes everything. Often this experience of clarity and integration has the power to fundamentally alter the way in which people decide to live their lives moving forward. It is within these kinds of moments that sustainable progress is born. This type of progress is fueled by a deeply personal experience of self-empowerment and is often the catalyst for an individual’s renewed sense of hope and restored ability to see what is truly possible for his or her future.

The experience described above is an attempt to illustrate the inner workings of what is truly responsible for a “successful outcome” or “positive treatment experience.” It is also a description of the kinds of moments that a TPS helps make possible for a prospective patient/client with whom we have the privilege of working. We believe that these experiences truly accelerate growth and the healing process in the lives of those we treat. The TPS’ role will remain committed to helping clients find the right treatment environment within which these experiences of restoration, clarity, and self-empowerment are found.

The TPS service and all of the value it offers to those who utilize it would not be possible without the leadership and commitment to patient-centered progress, which is at the heart of the statement commonly heard throughout all levels of leadership at Acadia Healthcare: Good treatment is good business, not the other way around. This is what guides our decisions and approach to business development, as well as overall patient care. The integrity and unwavering commitment to a patient-first approach, which pervades every corner of this organization, is how the Treatment Placement Specialist role came to be. This initiative to move our compassion for helping those in need into a state of action is vitally important.

It is that same level of passion and commitment to excellence that can be seen each and every day at Sierra Tucson. Sierra Tucson is a leader in the mental and behavioral health field, as well as a provider of world-class treatment, because of the willingness of staff to accept the responsibility that comes along with being a leader. The quality of the treatment experience at Sierra Tucson is a direct reflection of the quality of the individuals who work within its walls. It is because of this fact that the TPS team and Sierra Tucson work so well together. Simply put, we expect the absolute best from one another because we want the absolute best for those whom we treat. It is this shared vision that makes the partnership mutually beneficial and is ultimately at the head of our shared “Progress.”

Exciting Announcements at Sierra Tucson

Valerie_Kading_DSC03937_cl-030316

Valerie Kading, DNP, MSN

By Valerie Kading, DNP, MSN
Chief Medical Operations Officer

It is with enthusiasm and gratitude that we share the exciting news of recent key additions to Sierra Tucson’s Medical Department:

Director of Addictions/Co-occurring Disorders Program

Teresa Jackson, MD, is the director of the Addictions/Co-occurring Disorders Program at Sierra Tucson and started her tenure in late 2016. She received both her undergraduate degree and medical degree from the University of Arizona. Dr. Jackson started her career as a surgeon, and then entered the field of addiction medicine after adopting a sober lifestyle. Dr. Jackson is board certified in addiction medicine. She specializes in medical detox and medication-assisted treatment for drug and alcohol addiction. In her spare time, she enjoys running and cycling.

Inpatient Psychiatrist

James Prickett, DO, serves as our inpatient psychiatrist and completed his residency at the University of Arizona. He received his Doctor of Osteopathic Medicine degree from Des Moines University in Iowa. Dr. Prickett’s primary interest lies within psychopharmacology, traditional medicine, and the relationship between belief, spirituality and mental health. He has been a guest speaker on topics including autism, psychedelic drugs, adolescent substance use, and addiction. He has traveled to Ecuador on several occasions to study traditional medicine in both the Andes and Amazon basin. His research regarding the possible mechanisms by which ayahuasca treats addictions has been published in The Journal of Psychoactive Drugs.

Naturopathic Physician

Erin Hayford, NMD, BCB, is a naturopathic physician who received her diploma from Bastyr University in Seattle, Washington, in 2016. Dr. Hayford is completing her residency training at Sierra Tucson and has a primary interest in mental health. She pursued elective coursework during her doctorate training to support her desire to serve this population, including additional counseling classes, and became board certified in biofeedback in 2016. As a naturopath, Dr. Hayford believes in the body’s innate ability to heal itself and works with residents to support this healing process through various modalities, such as herbal medicine, nutraceutical supplementation, lifestyle change recommendations, and stress reduction techniques. Dr. Hayford sees each resident as an individual, and along with the other care providers at Sierra Tucson, she works to meet each person’s unique needs to create a tailored treatment plan.

More About Sierra Tucson

The Medical Department continues to use principles of integrative medicine and remains the leader in offering innovative, evidence-based treatment for addictions/co-occurring disorders, trauma, chronic pain, and mood and anxiety disorders. Our medical interventions are customized to meet unique needs of each resident. Transcranial magnetic stimulation (TMS) is an FDA-approved, non-invasive treatment for depression, and we are one of the few residential treatment facilities offering TMS Therapy to residents suffering from depression and anxiety disorders. Pharmacogenomics testing is available to all residents upon admission and supports clinical decision making when prescribing psychotropic medications, thus reducing or eliminating multiple medication trials and unwanted medication side effects. Core integrative services – including acupuncture, EMDR, Somatic Experiencing®, massage and shiatsu – remain central and integral to our integrative approach and are instrumental in the overall medical management of each resident.

Sierra Tucson Out and About

Several of our medical thought leaders have been featured at national conferences and workshops to share their expertise. As chief medical operations officer, I held a three-hour workshop, “Across the Life Span of Women’s Mental Health—An Integrative Approach to Postpartum Depression and Perimenopause Mood Dysregulation,” for therapists and medical providers on April 27-28 in Denver, Colorado. On April 23, I also delivered a presentation titled “Best Practices—An Integrative Approach to Optimizing Maternal Well-Being” to an audience of mental health providers in San Francisco. On April 21, Jerome Lerner, MD, director of Sierra Tucson’s Pain Recovery Program, delivered a keynote presentation, “New CDC Opiate Guidelines and the Future of Pain Management,” at the 2017 Austin TAAP Symposium. On April 12, Dr. Jackson was featured on KGUN-9’s Tucson Morning Blend to discuss the statistics and consequences of alcohol use. On April 3, Tena Moyer, MD, associate medical director, and Jaime Vinck, MC, LPC, NCC, CEIP, chief operations officer, presented “The Mature Adult Treatment Experience: Residential and Beyond” at the Foundations Innovations in Recovery Conference in San Diego, California. On March 30, Maureen Schwehr, NMD, director of integrative services, presented “The Gut Brain Connection: How Digestion Affects Mental Health” at the Phoenix Be Informed event. On March 8, Dr. Moyer and Vinck also co-presented “Collaborative Complex Co-occurring Disorder Treatment” at the 2017 Chicago BFI Summit for Clinical Excellence. Dr. Moyer also facilitated an Addiction Professional webinar, “It’s Not About Food, It’s About Feeding,” on February 15.

A New Path to Healing: Refuge Recovery

SandraGuilfoyle_050117_DSC04438By Sandra Guilfoyle, MS, LPC, NCC
Primary Therapist

Over the last nine years working with clients with substance use issues, I kept hearing over and over, “I don’t like the 12 Steps. I don’t have a Higher Power, it doesn’t make sense.” Once a client made up his or her mind that he or she would not be involved with the 12 Steps, the options grew very limited for other types of recovery tools. I could relate to an extent and recalled from my own early recovery how meditation saved my life. I began teaching mindfulness and meditation to help clients connect with themselves and learn tools like compassion, forgiveness, generosity, and service to others.

A few years ago, I heard about a Buddhist teacher named Noah Levine, a former addict and punk rocker adorned with tattoos who teaches meditation to addicts based on the Buddhist teachings of the Four Noble Truths and the Eightfold Path. I was curious and wanted to find out more; I bought his book, “Refuge Recovery.”

Refuge Recovery is a practice, a process, a set of tools, and a path to healing addiction and the suffering caused by addiction. The main inspiration and guiding philosophy for the Refuge Recovery program are the teachings of Siddhartha (Sid) Gautama, a man who lived in India twenty-five hundred years ago. Sid was a radical psychologist and a spiritual revolutionary. Through his own efforts and practices, he sought to understand why human beings experience suffering. He referred to the root cause of suffering as “uncontrollable thirst or repetitive craving.” Sid came to understand and experience a way of living that ended all forms of suffering through a practice and process that includes meditation, wise actions, and compassion. After freeing himself from the suffering caused by craving, Sid spent the rest of his life teaching others how to live a life of well-being and freedom, a life free from suffering.

Refuge Recovery focuses on continuing Sid’s work, allowing the opportunity to connect with oneself and practice healthy behaviors of service, mindfulness, and compassion to others while using meditation, generosity, forgiveness, and peace to stay sober.

Sierra Tucson offers weekly Refuge Recovery meetings for all residents, as suffering can be related to addiction, mood, trauma, disordered eating, and chronic pain. A typical meeting opens with introductions, the Refuge Recovery preamble, a short meditation, and readings from the Four Noble Truths and Eightfold Path, followed by a discussion of how and what action can help us accept and move toward having more awareness, building a community, and finding support for healing.

About Sandra Guilfoyle, MS, LPC, NBCC
Sandra Guilfoyle’s experience in substance abuse began at age 15 when she started attending Alateen—and later Al-Anon—to learn coping skills around family members using substances. After a successful career in the symphony orchestra field for 15 years, she received her Master of Science in Clinical Counseling from the University of Phoenix, Tucson Campus. Sandra went on to community mental health, where she treated a broad range of mental health disorders, deepening her understanding of multifaceted needs of clients. She went on to work at the Tucson Center for Psychotherapy and then moved to Ohio for family reasons. She holds a Licensed Professional Counselor license in Ohio, where she had a private practice specializing in substance abuse, LGBTQ, adolescents, and women’s issues. She also worked at Legacy Freedom Treatment Center, a holistic 90-day intensive outpatient program. She uses an integrated and holistic approach in her work, drawing from mindfulness, dialectical behavioral therapy (DBT), person-centered therapy (PCT), transpersonal psychology, cognitive behavioral therapy (CBT), and family systems theory, as well as her personal study of meditation. Sandra believes in a person’s innate ability to grow, transform, and heal when he/she has the tools and feels safe to explore the deepest parts of himself/herself.

Is Logic Compatible with Recovery?

Victor P. Gilbert, MSW, LISACBy Victor P. Gilbert, MSW, LISAC
Primary Therapist, Sierra Tucson

The views expressed herein are derived from observations of persons in my groups during the course of my career as a therapist. When possible, I have attempted to reconcile these observations with known long-term outcomes.

Early on in my profession, there was an individual in my group who presented as being less than highly motivated. That person completed (superficially in my opinion at that time) the treatment plan and discharged. For the subsequent five or six years, a Christmas card arrived containing a detailed report of her successful recovery. Those Christmas messages presented both a joy and a challenge. The challenge being, how could my assessment of her motivation have been so inaccurate?

Several more years of observations of persons in my groups followed. Then the answer to the challenge became clear. The assessment I had made had been based upon my need to see a motivation connected to logic. The important piece that had been overlooked was the value she had placed upon herself. Thus my question (and the title of this article): Is logic compatible with recovery?

A clarification of terms as used in this article would be appropriate at this point.

Logic: Typically defined as correct reasoning that is valid deduction or induction.

Recovery: Identifying and changing something in one’s life that is not working and/or is causing distress. Recovery will be considered as being of two phases: 1) early recovery and 2) continuing recovery.

Early recovery involves making a decision to change an identified, unwanted aspect of one’s life. It is in this phase that logic often gets in the way.

I like logic, but not when misapplied. It is not unusual to find persons coming into treatment wanting a logical answer to any number of “why” questions. Those persons are seeking a linear cause-and-effect relationship external to themselves. If one is able to establish this relationship, there is no need to change one’s thinking. Years ago it was not unusual to have a staff member say to a client, “It was your best thinking that got you here.” Or as Albert Einstein is reported to have said, “We can’t solve problems by using the same kind of thinking we used when we created them.”

If not logic, then what? Early recovery, to be successful, requires one to make a commitment to self. I often refer to this as developing a recovery attitude. An “I-will-do-whatever-it-takes-because-I-am-worth-it” type of mentality. This commitment is particularly important given that recovery is often tiring and inconvenient.

Sustaining this commitment requires that one dispute the “logical” proofs that one is defective, not good enough, stupid, or bad. The list of self-deprecating beliefs people bring into treatment can be long and strongly held.

These self-critical beliefs have become embedded, so completely, into one’s internal dialogue as to be highly resistant to discovery and change. This resistance is supported by guilt, shame, fear, and emotional pain. Applying Einstein’s statement, the thinking to be changed is that which determines how one views self. A change which requires working through the emotional charge attached to facing character “defects.” The potential danger of attempting to use logic at this early stage of recovery is that often, logic has been invoked to support the “truth” of one’s so-called defects.

As stated earlier, I like logic. Where then, does logic fit into the recovery journey? Logic is critical to sustaining continuing recovery. The relationship is simply this: If I do not continue that which I have found to work for me, I will quickly return to my pre-treatment pain.

For more information about Sierra Tucson’s comprehensive residential programs, please call our Admissions Coordinators at (800) 842-4487.

Eating Disorders vs. Disordered Eating: When Is It Time to Seek Treatment?

treatment for eating disordersAs a society, we put a lot of pressure on ourselves to look, act, and feel a certain way. With the infiltration of, and our obsession with, social media, we are subconsciously (and even sometimes knowingly) comparing ourselves to a perceived image of perfection.

According to the National Eating Disorders Association (NEDA), many individuals struggle with body dissatisfaction and disordered eating attitudes and behaviors. And, the best-known contributor to the development of anorexia and bulimia is body dissatisfaction.

Psychology Today reports that up to 50 percent of the U.S. population has experienced some sort of disordered relationship with food, body and exercise. Given that nearly half of Americans are struggling with food issues, makes it even more important to talk about the differences between eating disorders and disordered eating.

Do You Know the Difference?

Eating Disorders include psychological disorders characterized by abnormal or disturbed eating habits:

  • Extreme emotions
  • Attitudes
  • Behaviors surrounding weight and food issues

Eating disorders are serious emotional and physical problems that can have life-threatening consequences for females and males, such as anorexia, bulimia, and binge eating.

Disordered Eating includes behavior commonly associated with eating disorders, such as:

  • Food restriction
  • Binge eating
  • Feelings of guilt when unable to maintain healthy eating/exercise habits
  • Chronic yo-yo dieting

It’s important to note that while individuals with eating disorders may show signs of disordered eating, not all disordered eaters are diagnosed with or have an eating disorder.

Call a Doctor If…

While nearly 30 million people in the U.S. battle an eating disorder and 50 percent suffer from disordered eating, the numbers are suspected to be far greater because so few seek treatment. Following are some warning signs that it’s time to seek help:

  • Showing signs of anorexia, including rapid weight loss, eating very little, and being overly concerned about weight and appearance
  • Fearful of gaining even a small amount of weight
  • Being secretive or lying about eating habits
  • Feeling the need to exercise excessively, especially after meals
  • Abusing laxatives/diuretics, or vomiting voluntarily
  • Excessive and uncontrollable eating

Family Matters

Positive communication is critical for making a change. One thing we know about families dealing with mental health disorders is that somewhere along the way, communication collapses. When one person in a family behaves in a way that harms others despite their hopes, expectations and previously understood norms, it can cause an entire family to crumble.

At Sierra Tucson, we believe that family involvement is a fundamental part of the recovery process. Because we know that friends and family members are considerably affected by a loved one who is struggling with an eating disorder or any other mental health challenge, their participation is an essential component of our comprehensive treatment programs. Our Sierra Tucson Family Program is available for all family members age 18 and older. The goal of this program is to create a shift in attitudes and behaviors among family members, and provide them with the tools needed to become healthy, supportive figures.

If you would like more information on the Eating Recovery Program at Sierra Tucson, please call our Admissions Coordinators today at (800) 842-4487.