From our blog, articles tagged: Dream Journal

Dream Journal

Andrea Barthwell MDNote From Dr B.

I created the “3-7-3” philosophy as part of my commitment to holistic, evidence-based treatment that is both all-inclusive and highly effective. Patients are required to examine their progress introspectively throughout their stay at Two Dreams and spend every day working to complete the three phases of treatment via our seven dimensions of treatment. When both the patient and the staff feel that the individual has achieved the three main outcomes of recovery, mental peace, physical wellbeing, and personal productivity, they are ready to transition out of our facility.

The first few editions of the Dream Journal this year are going to focus on the first “3” of the “3-7-3” philosophy, a number that represents the three phases of treatment at Two Dreams. The three phases are a naturally occurring progression; they are not time limited, and clients can transition in and out of them depending on several clinical factors. The first phase, and the subject of this edition of the Dream Journal, is the "Coming In Phase."

The Coming In Phase is about easing into recovery and making a conscious commitment to health and wellness. It is about establishing a feeling of safety and comfort around the staff and peers in the program in order to create a platform on which to build the recovery experience. It is about engaging in the development of healthy rituals, and building the self-confidence necessary for achievement in therapy and the following treatment phases. It is also about exploring new behaviors, as well as becoming aware of existing thought processes and coping mechanisms. Patients must embrace their stories fully and honestly, and learn to share their experiences, as difficult as that might be.

Although the Coming In Phase is introductory, it is vital to the continuation of recovery. Without embracing the self, patients cannot possibly continue the therapeutic work necessary for developing new life skills and holistic wellness. This phase is challenging of course, but our caring, professional staff is consistently able to guide patients through their obstacles and towards the end-goal of self-actualization.

Please call us today at 504-510-2331 for more information about the Coming In Phase or our treatment program in general. We look forward to speaking with you.

Sincerely,

Dr. B

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Dream Journal

Andrea Barthwell MDNote From Dr B.

In 2011, researchers from Case Western Reserve University published an article in Alcoholism Treatment Quarterly indicating that volunteer work and service to others are integral to the recovery process. This finding is consistent with the stated purpose of Alcoholics Anonymous, to stay sober and help others achieve sobriety as well.

At Two Dreams, clients embrace the power of service to themselves and others through regular group therapy sessions. Clients help each other process their emotions and provide feedback on their progress in their recovery. We encourage clients to keep in touch after leaving the facility and we stress the importance of open communication in the milieu. We find that clients are able to build deep relationships with each other based upon their common experiences, and they are therefore able to help each other through difficult challenges and emotions that come along with addiction. Helping others at different stages of treatment also reminds clients of where they have been or where they aim to go in terms of recovery. This enforces a commitment to combatting the addiction and increases the determination needed to succeed.

During this holiday season, it is especially important for us to remember that giving should not be followed by the expectation of receiving. Give of yourself freely because you can make the world a better place.

Happy Holidays and Happy New Year,

Dr. B

Sources cited:

https://www.sciencedaily.com/releases/2011/01/110128104242.htm
http://alcoholrehab.com/addiction-recovery/service-in-recovery/

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Dream Journal

Andrea Barthwell MDNote From Dr B.

Addiction is a disease of learning, memory, motivation, and choice that results in biological, social, psychological, intellectual, and spiritual alterations. In this edition of the Dream Journal, I want to focus on the spiritual aspect.

One of my favorite definitions of spirituality comes from a 2000 edition of "The Physician Executive," in an article entitled "Spirituality and the Physician Executive: Reconciling the Inner Self and the Business of Health Care." The author, Kaiser, claims that spirituality "…refers to a broad set of principles that transcend all religions. Spirituality is about the relationship between ourselves and something larger. That something can be the good of the community or the people who are served by your agency or school or with energies greater than ourselves. Spirituality means being in the right relationship with all that is. It is a stance of harmlessness toward all living beings and an understanding of their mutual interdependence." (Kaiser 2000)

According to this definition, spiritual alterations occur when one’s individualized ability to seek purpose and meaning is changed. In this sense, spirituality is not necessarily synonymous with religion; it is more strongly associated with a connection to the universe in some capacity.

The Big Book stresses surrender to a "Higher Power," which many people take to mean "God," but it actually means so much more than that; it transcends mere religion. It is nature. It is music. It is art. It is the relationship between family and friends. It is existence. It is resonance. It is love.

At Two Dreams, clients are encouraged to carve their own spiritual paths and choose their own Higher Power. The staff works with each individual to create a personalized recovery plan so that the lessons learned in treatment resonate long after discharge. Everyone expresses spirituality in his or her own way, and Two Dreams embraces that amazing piece of the human condition in order to help each client find mental peace, physical wellbeing, and personal productivity.

Sincerely,

Dr. B

Source:

Kaiser, L. (2000). "Spirituality and the Physician Executive: Reconciling the Inner Self and the Business of Health Care. The Physician Executive. 26(2). March/April.

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Dream Journal

Andrea Barthwell MDNote From Dr B.

Before I was officially sworn in as Deputy Director for Demand Reduction in the Office of National Drug Control Policy under the Executive Office of The President, I went through a period of indecision and stress. In short, the President announced that I would be appointed to the position, but then the statement was withdrawn because of controversy in the White House at the time. Recovery advocates were planning to march in protest on my behalf, but a friend suggested to me that I try to prevent the march on Washington because what you do is always open for review and critique and how I handled the situation would stick around throughout my career.

That thought has helped to define my attitude: you only get one shot at a first shot, and the only thing you have in this life is your reputation. Sometimes things don’t work out and you can be disappointed, and other times opportunities come out of nowhere and you get lucky. No matter what, though, you must always conduct yourself with dignity. Even when situations don't go according to plan, I try to maintain a positive attitude and remember the ever-changing nature of life and luck.

Acceptance is key; we can only control our reactions.

Sincerely,

Dr. B

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Dream Journal

Andrea Barthwell MDNote From Dr B.

When we harbor resentment towards others, we cause nervous system dysregulation, or a buildup of negative energy in the body. This leads to the increased production of cortisol and adrenaline, as well as an over-stimulated amygdala, a part of the brain that plays a large role in emotional control. This state of chronic anxiety may lead to health issues and truly hurts us more than it hurts the person we harbor resentment against.

So let go of your resentments. Let go of your negative feelings. Forgive your oppressors for your own benefit; if they refuse to hear you or forgive you, they’re only hurting themselves. We cannot control the actions of others, but we can control the actions in which we choose to engage. Do it for you.

Sincerely,

Dr. B

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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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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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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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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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Dream Journal

VOLUME XXIV / DEC 2014


December Cover

Two Dreams is a wellness program led by Andrea G. Barthwell, MD, FASAM that provides individualized care for those who dream of recovering a healthy lifestyle.

MONTHLY PROMISE

#12: "We will suddenly realize that God is doing for us what we could not do for ourselves."

By: Brett Dunning, TDOB Clinical Director

If a spiritual experience has taken place in your life, I do not need to explain December’s promise to you. Often, those of us in a 12 Step fellowship needn’t explain the spiritual experience, nor do we want to, due to the fact we may skew our perception of it with intellect and emotion. We simply acknowledge the fact that a power greater than ourselves exists and that any attempt to try to dissect our higher power (or explain our personal spiritual experience) would not do justification to it. To those who believe they may not have had a spiritual experience, I will do my best to explain.

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Dream Journal

VOLUME XII / DEC 2013


Two Dreams is a wellness program led by Andrea G. Barthwell, MD, FASAM that provides individualized care for those who dream of recovering a healthy lifestyle.

NOTE FROM DR. B.

Dr Andrea Barthwell MD

This is a WONDERFUL time of the year. It is a time to celebrate all the great things we are blessed to be a part of and reflect back on valuable and important lessons we learned the hard way. It is a time to give thanks for the ability to live in gratitude "one day at a time" while setting goals for our future. In this month’s Dream Journal we are reflecting on Step Twelve and specifically the topic of being of service. It is a special edition for the holidays and I am thrilled to once again feature original art by our Assistant Art Director, Kara Hamilton. She is really talented and I just love her adaptation of the Twelve Days of Christmas. You will also find an inspiring article by our guest writer and friend of Two Dreams Mr. Terry Shapiro.

I would like to thank all of our Two Dreams Supporters, Dream Journal Readers, the staff at each Two Dreams location, and especially our guest and families for a very special year. I am truly thankful for you all and I wish you all Happy Holidays and a great New Year!

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