From our blog, articles tagged: Outer Banks

When it is time to start searching for an addiction treatment center, you may have many questions.

In fact, the whole process may seem overwhelming to you right now. Whether the treatment center is for you or a loved one, when you don't know very much about the treatment process or even finding a good treatment center, it can feel daunting.

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Addiction treatment options include in-patient and out-patient programs; in both patients are encouraged to get physically fit and engage in more outdoorsy activities. Many people find working out in outdoor naturalistic environments peaceful and calming and a way to find release from the stress of life and the challenges to come.

For over a century, people have noticed that being outdoors confers an advantage improving the course of health during recovery (from addiction as well as other ailments). Not a lot of research has been done to determine all of the reasons why, so in the future we may hear about more reasons why being in nature is good for our health. Below are some of the known reasons (backed by science) you should include outdoor activities during alcohol and drug addiction recovery.

 

1. Synthesis of Vitamin D

It was recognized a long time ago that the health of patients with tuberculosis improved when they spent time outside in the sun. It was later discovered by scientists that the sun helps us synthesize an important nutrient in our diet, vitamin D.

Getting all of your vitamins is necessary for maintaining your body’s health. Vitamin D has been investigated for its contributions in treating a number of health conditions (infectious diseases, cancer, psychological conditions, etc.), and has been found to play a vital role in recovery. Everyone who spends time outdoors who wants to take advantage of this benefit should include at least 20 minutes without sunscreen to ensure synthesis of vitamin D.

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Dream Journal

Andrea Barthwell MDNote From Dr B.

The suggestion associated with the 12-step principle of "discipline and action" is as follows: "We are continuing to remove the barriers than can block forward sober growth. We are getting ready to sweep our side of the street clean. Make a list of all those people you have harmed both through actions and not being present or living up to obligations." In the context of recovery, the term "discipline" is synonymous with self-control. It does not refer to punishment, nor does it refer to a harsh, unforgiving way of life. The term "action" suggests both making amends and being present during recovery. Taking action is meant to ease the transition into sobriety and strengthen connections that were weakened during the period of active addiction.

At Two Dreams, clients engage in both process groups and individual therapy sessions to explore wrongdoings and brainstorm possible solutions. We encourage reconciliatory conversations with friends and family, and offer guidance on strengthening social connections. Additionally, we encourage self-discipline in the form of mindfulness. Clients engage in HALT (hungry, angry, lonely, tired) checks throughout the day to monitor their vital signs and moods. Instead of acting irrationally in response to triggers, these regular checks are designed to keep clients disciplined and planning ahead of low moods. Discipline and action are cornerstones of the Two Dreams curriculum; call 504-510-2331 today if you are interested in learning more about our program.

Sincerely,

Dr. B

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Dream Journal

Andrea Barthwell MDNote From Dr B.

Humility is a critical component of the recovery process. It not only necessitates modesty, but also perspective. Oftentimes, addiction causes the individual to become self-centered, leading to low or elevated mood, so clients at Two Dreams use process groups to develop an appropriate understanding of themselves and the world around them. Processing emotions and situations in a group therapy setting allows for a more balanced mood and a more realistic outlook on life.

Humility is not self-deprecation, nor is it a weakness. One can still be strong and proud while possessing the personal quality of humbleness. Without humility, the full benefit of a recovery program is lost to pride and conflict. There is a middle group between “being a doormat” and being arrogant, and we strive to help our clients find it.

Sincerely,

Dr. B

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We previously posted a list of 60 substance abuse group therapy activities to give readers an idea of what kinds of topics they might encounter during a theme/support group.

We received positive feedback on the list, so we found 60 more to keep you inspired!

Please note that Two Dreams utilizes process groups as opposed to theme/support groups. Process groups are focused on self-exploration and giving/receiving feedback. They provide a safe environment in which members can practice newfound interpersonal skills and behaviors. Process groups are mostly unstructured with no singular topic of discussion. Theme groups are focused on support and finding commonalities between members. They tend to have more structure than process groups and focus on a single topic.

Two Dreams prefers to hold process groups in order to enhance the holistic treatment experience and to help clients equip themselves with the tools needed for their own recovery.

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Dream Journal

Andrea Barthwell MDNote From Dr B.

Summer is upon us, and with it comes the inevitable lethargy brought on by the intense heat. All over town you can hear cries of, “it’s too hot; let’s just do something else!” Similarly, in addiction treatment, we often hear clients complain that it’s too difficult to work through recovery, that they’d rather just stay in their diseased state than go through the steps necessary for living a healthy lifestyle. That’s where the theme of the month, willingness, comes into play.

Individuals in recovery need to be willing to push past the initial roadblocks to find sobriety. They must be willing to be introspective and engage in beneficial behavioral changes. They must be willing to listen to the rhythms of their bodies, and they must be willing to pause before they act. Recovery is a humbling experience, but it is also one of the most rewarding processes you will ever go through.

At Two Dreams, we encourage clients to keep an open mind and remain willing to try new things. We schedule activities that might push some clients outside of their comfort zone, such as improv classes or dancing. We suggest that everyone try new foods while living in our residential facility, even if they initially seem unappealing. We ask that everyone speak up during group therapy, even if they have to break through a shell of shyness to do so. The willingness to do work is one of the most important parts of breaking the addictive cycle, and is therefore a key component of our recovery program here. Are you willing to make changes that will better your life?

Sincerely,

Dr. B

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Dream Journal

Andrea Barthwell MDNote From Dr B.

Spring is in full bloom at Two Dreams, even at our Chicago office, and my favorite flowers have been emerging for weeks. Before Dr. David and I downsized our home, I would watch a parade of flowers emerge from the snow along our front walkway. While I do miss the floral ceremony, I appreciate that the freedom of our smaller home allows me more opportunities to travel between the various Two Dreams locations. The crocus, daffodil, and highly fragrant hyacinth remind me that there is beauty and peace in the earth. They also remind me that, when nurtured with light and warmth, the flora will emerge. Each individual in treatment and recovery needs similar light and warmth to stimulate their own exciting growth path and develop their own integrity, which is incidentally the theme of this month’s Dream Journal.

You may have noticed that our Dream Journal themes this year follow the principles underlying the Twelve Steps of Alcoholics Anonymous. Last month our theme was courage; this month our theme is integrity; and next month we are going to work with the concept of willingness. These three concepts are reflected in the cluster of AA steps that are sometimes referred to as the "cleaning it up" steps (in contrast with the “giving it up” steps [1-3], “making it up” steps [7-9] and “keeping it up” steps [10-12]). The searching, fearless moral inventory of the fourth step requires courage to complete, as it promotes honesty and sharing in relationships. The fifth step, admitting we were wrong, promotes honesty and integrity in intimate relationships. Finally, the sixth step, a readiness to remove our shortcomings, requires self-awareness and willingness, which we will discuss next month.

Integrity is needed to work this fifth step, but what is integrity? Integrity is the quality of being honest and having strong moral principles; it is moral uprightness and the state of being whole and undivided. It is more than just simple honesty, though. As clinical psychologist Henry Cloud proposes, people with integrity: 1) are able to connect with others and build trust, 2) are oriented toward reality, 3) finish well, 4) embrace the negative, 5) are oriented toward increase, and 6) have an understanding of the transcendent.

Individuals who succeed in recovery display resilience buttressed with flexibility. In contrast, one area in which steadfastness is required over flexibility is personal integrity, as it is neither conditional nor mercurial. I am reminded of the old adage, "to thine own self be true," or as Frederick Douglass put it, "I prefer to be true to myself, even at the hazard of incurring the ridicule of others, rather than to be false and to incur my own abhorrence." When you find that inner strength, the growth path to recovery becomes clear; the little voice from an internal GPS guides every decision.

Integrity guides us in our work of making amends to people we have harmed, except when doing so would harm them or others. There are no guarantees when making amends and "coming clean;” in fact, there is often a fear that, in dealing with material related to our transgressions, we will be judged and rejected. If we are trying to create a certain outcome, such as winning someone back, gaining forgiveness, etc., we are certain to be disappointed…we might even lose the love, if not the respect, of someone important to us. But, in the process we gain the respect of the most important person on the planet to each of us: ourselves. The truest concept in the world, which has been shown to be true over and over again, is that the unexposed fact is more powerful than the exposed one. We have a saying here at Two Dreams: “mold does not grow where the sun shines.” Shine a light on that which you fear most and start your growth journey. Part of the treatment process is the identification of your personal holdbacks, asking yourself “what have I not been able to explore, admit, discuss, embrace, stare down in prior treatment episodes?” These holdbacks sap our energy and diminish our self-esteem. When we live with integrity, we live life knowing who we are and what we want, and we are able to ask for these things. The growth journey is one of harmony and we feel discordant when we are in the presence of people who don't have our best interests at heart…and speaking of the heart, it beats free.

I hope you enjoy the following thoughts about a character from Juan Mascaro. Please be careful about what you allow your mind to dwell on; negative thoughts are called "stinking thinking" for a reason. Even though our thoughts seem unavailable to others, remember that they are not just in your head; they are in your character.

“The thought manifests the word;
The word manifests the deed;
The deed develops into habit;
And habit hardens into character;
So watch the thought and its ways with care,
And let them spring forth from love
Born out of compassion for all beings.
As the shadow follows the body, as we think, so we become.”

Sincerely,

Dr. B

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Dream Journal

Andrea Barthwell MDNote From Dr B.

The Ancient Greeks identified four Cardinal (pivotal) Virtues sustained in the face of difficulty: prudence (or wisdom over time), justice, courage, and temperance. Courage is sometimes equated with endurance, the ability to stand firm and immovable in the midst of danger, toils, and certain death. It is the midpoint between cowardice and recklessness, which are the objects of fear and daring, respectively. Fear is a powerful feeling that arises when we sense danger, and when level of danger increases we feel more fear. Cowardice is the shortage of courage keeping us from acting in the face of, or in spite of, fear. Daring is a way of being that ignores danger; it allows us to take action in the face of danger. When the level of danger increases, our daring is reduced/checked. If we ignore the increasing level of danger, we show recklessness and act with an excess of courage.

While at Two Dreams, clients “face weakness with strength and fear with courage .” The process of identifying and expressing feelings is an important part of recovery work. What do we fear as we begin the journey of recovery? Do we fear the loss of devotion to a substance, even though giving it up will save our lives? Do we fear living life with an aching desire that will forever go unfulfilled? Do we fear losing time that can never be recaptured? Do we fear failure? Do we fear success? In my pain blog (https://drbarthwell.wordpress.com/) I talk about the fear of getting my hopes up, only to have them dashed again. I found it more tolerable to be in pain than to contemplate investing in yet another program or activity that might not work.

Nietzsche writes ”the great epochs of our life are the occasions when we gain the courage to re-baptize our evil qualities as our best quality.” At Two Dreams, clients learn that “who you are is not defined by your mistakes, but by your potential” and to “accept the past so you can create your future.” It takes a shortage of courage, or cowardice, to bully friends and family members. If you are looking around and the only people in your life are those who support or tolerate your addiction you need to find your courage to call. It takes an excess of chemical-fueled courage to recklessly stare down death every day, every injection, every huff, every swallow. Channel that daring “to take stock and take care in a place where your best interests are not only looked after but discovered.”

The Serenity Prayer, attributed to Protestant Theologian Reinhold Niebuhr, has been used by AA since the 1940s. This prayer speaks to the serenity of acceptance, the courage of change, and the wisdom of prudence. The courage of change starts with 1) imagining a different life, 2) the self-investigation to generate insight, the recognition that a problem exists paired with a desire to change it, and 3) taking an action, and having the preparation and fortitude to hold a course against inertia, the resistance to change.

Can you imagine a life different than the one you have now?

Sincerely,

Dr. B

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Dream Journal

Andrea Barthwell MDNote From Dr B.

Faith has been a significant part of my recovery journey with chronic pain. It keeps me optimistic in the face of surgeries and steroidal injections. It allows me to push through agonizing physical therapy sessions, knowing that I will come out on the other side stronger and more relaxed. It prevents me from submitting to the pain, even when I feel that shifting focus is impossible. It inspires me to keep stretching, even when I want to give up.

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Dream Journal

Andrea Barthwell MDNote From Dr B.

Hope is the driving force behind recovery. You can see it in the glowing smile of the elderly man who finally made it through a full year without a drink. You can feel it in the bouncing step of the middle-aged woman whose regular physical therapy sessions have caused her pain levels to decrease. You can hear it in the proud applause of parents watching their now drug-free son walk across the stage to receive his college diploma. You can taste it in the glass of water that the teenage girl chooses to drink instead of alcohol at a friend’s party.

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If you've found yourself struggling with alcohol or drug addiction, you may have considered entering an inpatient rehab program. But you have your doubts about the effectiveness of various programs.

Perhaps you have had an addiction problem in the past, entered a residential alcohol or drug rehab program, and now find yourself back at square one, addicted to drugs or alcohol again and feeling like a complete failure.

Or perhaps this is your first time considering a drug or alcohol rehab program and you're saying to yourself, “Why can't I just handle my addiction problem on my own without entering a rehab program? Is there any program out there that can help me? And why do I need to go to a rehab program in the first place?”

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Substance-use exerts a large amount of physical stress on the human body. Drugs take precedence over basic necessities during active addiction, so health often falls by the wayside.

Malnourishment, for example, causes the body to function improperly due to a lack of essential nutrients. Some drugs create the illusion of “fullness” so the body doesn’t convey to the brain that it needs sustenance. Some drugs nurture such a strong dependence that users forget to eat or simply aren’t motivated enough to find nutritious food options. Poor diet can cause damage to the digestive system, resulting in indigestion, diarrhea, constipation, etc. It can also compromise the immune system, which greatly increases the risk of developing a number of diseases, from the common cold to cancer. Malnourishment can cause liver damage, skin damage, tooth damage, weight fluctuation and more, so it is important to make healthy food choices as often as possible.

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Dream Journal

Andrea Barthwell MDNote From Dr B.

The idea of making a “New Year’s Resolution” is appealing to individuals across the globe, but it also adds a great deal of pressure to the actions of the upcoming year. People oftentimes make unrealistic promises (ex. I will exercise every single day from now on) and end up disappointed when they are unable to live up to the standard of perfection they set for themselves. So, as a means of relieving ourselves of this unnecessary stress, I propose that we all strive for progress in this upcoming year instead of perfection. Start out small; for example, you could resolve to exercise twice a week instead of “an hour each day for the rest of my life.” You could promise to start journaling at night, instead of vowing to keep your emotions under control at all times. When we are honest with ourselves about our abilities and limitations, we are better able to achieve our goals. Living a healthy lifestyle is not about making the right choices all the time; it’s about balance and staying in tune with your body’s signals. You don’t have to be flawless; you just have to move forward.

Sincerely,

Dr. B

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It used to be, if you visited a physician for a medical exam, he or she would most likely ask you few if any questions at all about your lifestyle: what kind of food you ate each day, how well you slept each night, and whether or not you incorporated exercise into your life on a regular basis.

Today, it’s standard practice for many healthcare professionals to use a holistic approach in treating their patients. And most likely, when you step into your doctor’s office for a visit, your physician will not only pull out his or her stethoscope, he’ll also inquire about how much exercise you get each week, how much stress you experience in your life on a regular basis, and whether or not you toss and turn each night or get a good night’s sleep most nights of the week.

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Dream Journal

Dr Andrea Barthwell MD FASAMNote from Dr. B.

The holidays can be a difficult time for individuals in recovery: frustrating family members, crazy Christmas parties, stressful shopping trips, etc. You don’t have to let the season get you down though! There are plenty of ways to stay centered and sober during the winter season. Make sure to listen to your body and avoid letting yourself get hungry. Maintain a regular meal plan full of nutritious fruits and vegetables. Eating a plateful of cookies may seem like a good idea when you’re at an event, but the inevitable sugar crash is likely to make you feel irritable and fatigued shortly afterwards. Negative emotions can be a precursor to relapse, so try to avoid the unhealthy snack table as much as you can. I recommend bringing a bag of healthy trail mix to events so that you’ll be prepared if you get hungry.

Sleepiness can also cause irritability and negativity. You are more likely to make irrational decisions when you’re running on a couple of hours of sleep, so try to get at least 7-8 hours of shut-eye every night. Waking up and going to bed at the same time every night will help to keep your body functioning regularly, so try to avoid attending too many late night events. It is also important to sleep in a dark environment, so keep the Christmas lights and glowing decorations out of the bedroom.

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Dream Journal

Note from Dr. B.

The ongoing opioid overdose crisis has prompted the CDC to take action in the form of developing new guidelines for qualified prescribers. First and foremost, the CDC stresses that opioid therapy should be utilized only if all other treatment options have been exhausted. Opioids can vastly improve functionality and quality of life, but the benefits must be weighed against the risks of tolerance, addiction, overdose, etc. If opioids are absolutely necessary, the prescribing physician and patient should work together to formulate a safe plan of approach and establish realistic treatment goals before starting therapy.

These goals should be re-assessed throughout the course of treatment to ensure that the patient is still experiencing significant improvement. The CDC recommends that patients start off their therapy by taking low doses of short-acting opioids. The use of high dosage and/or extended-release (long acting) opioids is risky and warned against unless the alternatives are ineffective. Additional precautions should be taken when increasing dosage to 50mg or more per day in morphine equivalents, and increasing dosage by 90 mg or more per day is strongly discouraged. Patients with acute pain should be given a minimal amount of pills initially, as studies have shown that a three-day supply is usually sufficient for non-traumatic instances. This policy would lower the likelihood of abuse and protect short-term users from addiction.

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The Dream Journal

Note from Dr. B.

Dr Andrea Barthwell MD

The Walk on Washington was a great success! The Two Dreams staff gathered in Washington DC on October 4th in a collective effort to support policies that will improve addiction recovery and end the stigma against those with the disease. Major media networks covered the event, so our voices were heard all across the nation. Fall is a time of transformation, and we look forward to affecting more change as we move towards the end of the year.

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Dream Journal

Note from Dr. B.

Dr Andrea Barthwell MD

September is National Recovery Month, a time to celebrate healing and to speak out against the stigma surrounding addiction. The Two Dreams staff members stayed busy this month, especially on the 26th. Clients and staff alike attended the 6th Annual Walk Against Addiction in North Carolina, which was designed to raise awareness of the epidemic that addiction is becoming in America. Our Clinical Director for Two Dreams Outer Banks, Brett Dunning, was a featured speaker at the event. He spoke out against the stigma that patients experience, and emphasized that everyone is susceptible to addiction. Dunning is also currently serving on the Board of Directors for Project Purple, which educates middle school and high school students about addiction and holds events throughout the year. Additionally, the Two Dreams staff is preparing to gather in Washington DC on October 4th for the Walk on Washington. This walk is a collective effort to support policies that will improve addiction recovery and end the stigma against those with the disease.

This month has also been a celebration for the recovering families, the mending friendships, and the reestablished peer-groups of addicts. When an addict makes the choice to pursue treatment, they start a ripple effect of positivity and healing for a multitude of individuals. The sheer magnitude of the impact a person can have by embarking on the recovery process is astounding, yet often overlooked. In short, let’s take time this month to appreciate just how much of a difference once person can really make. Let’s celebrate the shared experience of recovery.

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Dream Journal

Dr Andrea Barthwell MD

Note from Dr B.

It gives me great pleasure to announce that I have been featured in the current issue of Addiction Professional Addiction Professional. I emphasize in the article the call to come together as treatment providers and programs and set aside our differences. This message parallels our theme for this month, which is about losing interest in selfish things and gaining interest in our fellows. The disease we face is complex and relentless, and to keep evolving as a community we must face it together.

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What is group therapy used for?

Group therapy is used to guide clients through the process of gaining insight about themselves, others, and the world around them.

Through the group dynamic, clients foster hope and examine core issues that exacerbate their addictive disorders. They also work to develop their communication skills and learn to engage in fun, healthy social experiences. The group dynamic encourages honest feedback and facilitates bonding between individuals with shared experiences. Clients weigh in on the issues of others in order to offer suggestions or provide outside perspectives, broadening the individual’s understanding of the conflict.

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Light regulates circadian rhythms

Why and How We Live Rhythmically at Two Dreams

The chains of habit are generally too small to be felt until they are too strong to be broken

- Samuel Johnson

Every living organism has a natural rhythm. These rhythms are disrupted by illness, particularly drug and alcohol use. A drug can create false sleep. A drug can stimulate alertness. A drug can suppress appetite. Another can stimulate appetite.

The science behind living rhythmically, strategies that promote and restore natural rhythms, and the role of sleep, nutrition, meditation, and exercise in the 21st century approach to healing oneself in recovery are all important aspects of your journey at Two Dreams.

At Two Dreams the concept of living in the NOW (No Other Way) is central to living a life in recovery. Similarly, mindfulness is a state of active, open, non-judgmental attention on the present. Many treatment programs and practitioners are employing mindfulness in the care and management of patients with mood, anxiety, and substance use disorders- diseases and symptoms which tend to cluster together.

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