Inspirational Women of 2018

Posted on March 19th, 2018

The ‘Me Too’ and ‘Times Up’ movements were sparked by women speaking out about sexual assault, harassment and misconduct. The greater global message in both movements is safety and equity in the workplace and women’s empowerment.

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Is There a Genetic Predisposition for Alcoholism?

Posted on July 10th, 2017

Many people wonder if there is an alcoholism gene that automatically gets passed from generation to generation and determines whether people will drink in an unhealthy way.

It’s true that certain genes do make some people more vulnerable to excessive alcohol use but it’s also true that not everyone who is at risk for alcoholism will become an alcoholic.

Research clearly shows that there can be a genetic predisposition for alcoholism and that alcohol use disorder (AUD) can run in families, but there are many other factors at play.

Genetics play a role but so does early childhood experience.

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Trauma Reenactment Can Run (and Ruin) Our Lives

Posted on July 6th, 2017

By Natalia Balasundaram, Trauma Therapist, Promises, Young Adult Program

Amy grew up in a household that was dominated by her father’s cocaine addiction. She stayed away from drugs, but she always seemed to find partners with drug problems. A part of her hoped she could save them in a way that she could not save her dad.

Brian had a mom with a severe mental illness who needed constant caretaking. As he grew, he dated women who were emotionally frail and who needed to be taken care of. Being with people he could intensively care for was familiar and comfortable.

Yolanda’s father hit her when she was a child and her mother called her names like “fat” and “pudgy face.” Both parents dished out enough abuse to help shape Yolanda’s life into one filled with fear of ridicule, shame and low self-esteem. For most of her life she drifted toward partners who abused her physically and verbally.

Although Amy, Brian and Yolanda grew up in different circumstances, they shared something that studies show is very common:  Trauma reenactment. It is the often subconscious compulsion to recreate the traumatic circumstances of youth. Because of this undercurrent and need to continue what began in childhood, they select certain opportunities and draw certain kinds of people to them ― as adolescents and into adulthood ― who set the stage to reenact the kinds of behaviors and experiences of childhood.

Three Things You Need to Know

People who experience trauma may have a wide range of symptoms and experiences related to their childhoods. Trauma reenactment can manifest in different ways in different individuals until they become aware of the patterns they are recreating.

It’s a chronic condition.  People with trauma may suffer from PTSD or live in a constant state of anxiety. Having experiences that recreate the original trauma can be terrifying or exhilarating. They may literally “get high” from the drama.

It’s often driven by the subconscious. Some people go from one life experience to another based on the original trauma and never know what causes their behavior. They constantly find themselves in similar situations, with the same kinds of people. This could include always surrounding themselves with people similar to their family of origin ― the names change but the types of people do not ― or constantly getting involved in high-risk activities.

Even if aware, they may try to suppress it. Some people realize they are constantly choosing unhealthy friends and partners, and getting involved in negative experiences. Unable to cope, they try to drown out the feelings in substances and process addictions such as overeating, sex, gambling, shopping and other experiences that activate adrenaline and excitement.

Seeking High-Risk Behaviors

Trauma impacts the parasympathetic nervous system and can keep people in a state of hypervigilance or flight, fight, or freeze. Trauma reenactment can perpetuate the physical experience of trauma, which is an underlying driving force of thrill-seeking and risky behaviors.

For example, if someone has kleptomania, they will go out and steal or seek out high-risk activities because of the high that it releases.  Someone with childhood sexual abuse trauma may find themselves in the grips of a sex and love addiction, domestic abuse or in a consistent pattern of self-harm.

Other trauma reenactment might lead people to seek out heightened feeling states that closely resemble those habits common to people we might think of as “adrenaline junkies.”  This may not be the precise activity that caused their childhood trauma, but it is somewhat familiar and provides an “extreme” experience. It escalates over time, with the need to have even more extreme experiences in order to feel anything.

The nervous system becomes so used to being high on adrenaline that it is hard to bring it down. So they’ll go out and seek even more advanced, high-risk activities. Some will turn to substances for this extreme and, because of the need for the state of physical arousal, addiction can be the end result.

Trauma Reenactment Is Not Always a Bad Thing

In recovery, the first thing to do, always, is to identify the problem. When people begin to see the trauma that has driven the recreation of certain patterns and experiences, they can begin to heal.

Trauma reenactment can also be used consciously as a way to reset the internal experience of trauma that drives the external behaviors.

Some people relive their worst trauma and go back to the scene of the trauma as a way to heal themselves. For example, Kara witnessed the shooting death of a friend when she was young and for years she suppressed her grief and pain with high-risk sexual activities like one-night stands and maxing out her credit cards with comfort purchases and food. She avoided the scene of the crime for many years, sometimes driving by and wanting to stop but going to a bar instead of spending a moment at the scene expressing her grief.

While in recovery for sex and spending addictions, she was able to return to the place where her friend was shot with a supportive person by her side and allow herself to mourn as she remembered that awful, traumatic moment that set her on a path of self-destruction.  There was still an old bloodstain on the concrete in front of the store where the shooting occurred. She was able to leave a rose where the body had been.

Instead of heading to a bar for a drink and a pick-up, she went home and allowed herself to cry.  It was a huge step toward healthy recovery.

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3 Brain and Body Based Therapies That Can Help Heal Preverbal Trauma

Posted on July 6th, 2017

By Natalia Balsundaram, Trauma Therapist, Promises, Young Adult Program

Lily was so excited about becoming a mother. She lovingly collected baby items and built a nursery for her first child. She couldn’t wait to meet him.

In her sixth month of pregnancy, she discovered her husband was gambling — heavily.  He told her it was to “make money for the baby.”

When she lashed out at him in dismay over his behavior, he packed a bag and left her for two weeks to go off on a gambling spree, putting their family life in disarray. Abandoned and filled with despair, she cried herself to sleep at night, patting her stomach, and promising her baby she’d find a way to take care of him. But she did not feel very hopeful.

When her husband returned, broke and broken, their marriage was never the same and their finances were drained. Every day was filled with stress, worry and arguments. When she went into labor, she had a friend take her to the hospital instead of the father of her child.

As much as she tried to protect her unborn baby from her stress, there was no way she could totally shield him. The seeds of ​preverbal trauma​ had been planted.

Womb With a View

Just as small children can be impacted by stressors in the home, unborn babies can be affected by what goes on in their mother’s mind and body during pregnancy. The first signs of trauma can occur before they even enter the world.

The unborn baby’s only environment is the uterus and if the mother is having chronic aggravation, or the mother has mental health issues or uses drugs, it all impacts the baby’s environment. For example, if the mother is stressed or has PTSD, she is constantly on high alert. Or if she is in an abusive relationship, and is constantly having exposure to those stress chemicals, that’s going to impact the child.

In Lily’s case, the devastation of her marriage while pregnant took a toll on her. Once she gave birth, she researched how her own traumatic experience may have impacted her son and learned that, ultimately, it may come down to nature vs. nurture. Some people are exposed to trauma while still in the womb and will not develop trauma. Others can go on to develop PTSD, anxiety and other disorders, or addictions. Some of the factors that exacerbate preverbal trauma are these more commonly known traumas.

  • Childhood trauma​. A disturbing life experience, or a series of experiences, that deeply wound people in their early years between ages 0 to 6. This may include: Physical, sexual, or emotional abuse, exposure to domestic abuse, addiction or violence between parents, siblings or within the community, and experiences in natural disasters or in war zones. It also encompasses devastating accidents or injuries, pediatric medical issues and loss.
  • Complex trauma​. Repetitive exposure, usually within the home, sets children up for chronic problems that can include PTSD.  It could be repeated sexual abuse or physical abuse at the hands of a relative, or witnessing a mother or sibling regularly beaten by a family member. It might also occur from seeing a caregiver continually drunk or on drugs or neglect by one or more parents. It happens when an environment is unsafe, there is not enough food or basic needs being met and a child has no one to turn to for help.
  • Attachment disorder​. Infants cannot fend for themselves and when they do not receive the care they need from primary caregivers, it disrupts normal child development. Secure attachment occurs when comforts are offered and basic human needs are fulfilled. But if parents are unable to bond with babies, are non-attuned, or if there is neglect or abuse, the lack of stability produces disruptions in the child’s neurophysiological systems. The more secure and stable the earlier attachment, the more success we have later in life at regulating emotions. Conversely, the more disruptions experienced can lead to issues later in childhood and in adulthood.

Treating Preverbal Trauma

Mothers have lives, human emotions and pain and cannot shield their children from every exposure to negative experience or from every one of life’s slings and arrows.

Fortunately for Lily’s son, she went into therapy and in the process of healing her own wounds learned more about how to bond with her baby to counteract some of his preverbal trauma. This gave him at least one healthy parent who did her best to be attuned to him. Ultimately she may have reduced or preempted the risk factor for preverbal trauma.

Not every mother can be expected to know how their stress has impacted their children, so many people grow up with symptoms of preverbal trauma.  Some of the following therapies have been found to be effective.

  1. EMDR​ (eye movement desensitization and reprocessing). This exposure therapy helps people “reprocess” negative life experiences and psychological trauma in order to desensitize the experience. The person begins by identifying the worst part of the trauma, naming it, and through a series of steps desensitizing its intensity.
  2. Brainspotting​. This is a psychotherapy​ that recognizes there is activation in the body when describing trauma and it correlates with a particular part of the brain. A therapist observes the physical reaction and uses the visual field to assess the part of the brain connected to the trauma.
  3. Somatic Experiencing Therapy​. This therapy allows someone to re-experience the trauma in small doses and to recognize where in the body shame, fear and pervasive thoughts may be stuck. This helps them get “unstuck” physically and move on from the trauma emotionally.

The reason these “Brain Body Based” therapies and others help with preverbal trauma is that they work on the nervous system, on both the body and the brain.

People use their frontal lobes to think. That’s where the executive functioning part of the brain resides. But in targeting PTSD and preverbal trauma, the attempt is to reach the older part of the brain, the reptilian brain. That is where the fight-or-flight response, the survival mechanism, is out of whack.

When the deepest traumas cannot be accessed through talk therapy, these three trauma therapies are a helpful addition to the healing toolbox.

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6 Reasons Men Keep Their Depression a Secret

Posted on June 30th, 2017

By Kenneth England, MFT, Primary Therapist, Promises Malibu

My son was 2 years old when he started preschool. I was astounded when I discovered they were teaching kids that young how to say, “I don’t like that.” Both boys and girls were encouraged to speak up for themselves. My son was shown how to express emotions without having to act them out, which was a big change from my childhood.  When I was a kid, boys were taught to get aggressive with someone or yell rather than say, “Hey, I don’t like that.” And we were taught to hide other emotions, like sadness, at all costs.

Happily, my son, now 14, is part of a younger generation that is more oriented around feelings. But this is not the case with all guys, and certainly not the generations before him.

Men, in our culture and around the world, are taught to hide real feelings and suppress emotions deep down inside, which is one of the major reasons depression in men is underdiagnosed and undertreated. Research shows  men are less likely than women to ask for help when it comes to depression. Many don’t even realize there’s a problem. Studies show there is a discrepancy between a man’s perception that he may need help and actually seeking it.

One of my main jobs as a therapist, especially with men, is to introduce them to the idea that they need a more emotional life. As they develop more emotional familiarity, they can learn to experience feelings, address them and cope more effectively.

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Men and Depression: Five Ways to Recognize and Heal Sadness

Posted on June 29th, 2017

By Kenneth England, MFT, Primary Therapist, Promises Malibu

We’ve all heard the expression, “Man up.”

Men have grown up with tough guy heroes as role models and have spent their lives hearing messages that they should be strong and unemotional. They learn that they cannot let things “bother them.” And if they are upset and depressed, there are only certain expressions of emotions allowed.

Sadness is not one of them. However, research shows almost 10% of men in the United States have anxiety or depression.

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7 Factors That Contribute to Addiction in College Students

Posted on June 28th, 2017

Every day newspapers carry heartbreaking stories about young adults lost to drug addiction and drug overdose. Families are making their private tragedies public as a way of educating others about the prevalence of substance use disorders in college-age young adults. Colleges are also taking action, such as instituting on-campus recovery programs and counseling.

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What Happens to Your Body When You Overdose on Cocaine?

Posted on June 23rd, 2017

Cocaine is a powerfully addictive stimulant drug that can be snorted, smoked or injected. It causes an intense high that doesn’t last very long, triggering an intense compulsion to obtain another dose. If you use cocaine habitually, you will find that as time passes it takes a higher dose to attain the same effect. This can cause you to keep increasing the amount you are using, and you may end up using dangerous amounts of this powerful substance, leading to a cocaine overdose.

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Sober Summer: 10 Sober LA Activities This Summer

Posted on June 22nd, 2017

Pool parties, patio barbecues, picnics in the park and, if you are in sunny Los Angeles, afternoons on the beach!

As the days get warmer, we begin thinking of all the fun activities that make the summer season special. Unfortunately, for people who are trying to embrace a sober lifestyle, those summer activities represent environments that usually include a cooler full of beer, chilled wine or a pitcher of margaritas — huge triggers for relapse and not conducive to a sober summer.

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5 Common Objections to Rehab: Excuses for Not Going

Posted on June 21st, 2017

Denial and resistance to change is one of the insidious hallmarks of addiction.

It’s not uncommon for addicted individuals to resist getting help and to reject the notion that they need help. You may have heard the phrase, “I’m not going to rehab,” countless times because your loved one truly believes they do not have a problem.

And as the sober family member suffering through the devastating behavior brought on by a loved one’s addiction, you might even be in denial yourself, at first.

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Kids in the Suburbs May Have Higher Risk for Future Addiction

Posted on June 19th, 2017

Adolescents from the suburbs and other upper middle-class communities are two to three  times more likely to misuse, or abuse, alcohol, marijuana, stimulants such as Adderall, and club drugs like ecstasy and cocaine, according to a study that followed two groups of students through high school and four years of college. The study results emphasize a link between growing up in affluent communities and developing an addiction to drugs and alcohol in adulthood.

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