The thing about treatment for substance use disorder that is most key in my opinion is this idea of changing your people places and things. For those who aren’t aware, this is a common statement made in SUD treatment. What it means is that for you to be successful in your ability to not fall back into patterns that led to substance use, you must change the environment around you up to and including who you engage in spending time. Scientifically the idea of changing your people places and things really has to do with creating opportunities for the development of new neural pathways. The more opportunity to practice the habits developed before encountering past triggering effects increases potential success to continue participating in these new behaviors. In addition to the element of peer and community models I have written about previously, this is one of the essential contributing factors SUD treatments and its current potential model to be able to display rapid observable positive outcomes.
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A former manager I worked for was known for his affinity to the substance use population. In a raw moment between us, he admitted the reason to be the ability to see real change that is not usually expected with any level of traditional mental health treatment. This was really a fairly sad admission by a professional to me as someone who has struggled severely with mental illness and come out the other side. I won’t say I haven’t had my fair share of substance misuse to accompany my symptoms of mental health struggle. I have never struggled with any one specific substance that I could not recognize its ultimate damage and been able to quit on my own. I have repeatedly sought out something to make sense of the severe generational and developmental trauma I experienced. I went through more than seven years of incredibly poor mental health treatment, primarily by means of overmedication. Never did I do and intensive outpatient, never a residential, not more than weekly meeting with mediocre therapists at best, for years. Given the consideration to what treatment there was for me, how could one expect drastic change of any kind to be able to occur?
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With consideration to couples who have most likely engaged in some form of trauma bonding, I have the utmost empathy. It is pitiful to work on the admissions end of substance use treatment. I cannot tell you the dire needs for family and couple models of treatment to be introduced to mental healthcare. It would be so common for a couple to want to admit to a form of rehab together. The staff would snicker behind closed doors in the most merciless display of misunderstanding possible. For me, as a sufferer of severe relational trauma and neglect, I understand with every part of me the chemical impact of a dysregulated attachment style. It is incredible to observe this opioid epidemic as it is such a clear display, in my opinion, of the depth of the mother wound. When we consider the Oxytocin literally inspires life through the initiation of labor, it is easy to recognize what we all want and have always wanted is to be loved by our mothers. This is the primary neurotransmitter involved in trauma-bonding. These couples who have infused to one another through fulfilling what the other lacked deserve more opportunity for their love to be invested. Currently, the professional field of healthcare is largely filled with neurotypicals and empath enablers. This means almost the entirety of the field in treatment to those in need lack understanding of those they are serving’s needs. And I want to be very clear when I say –what your provider looks like has little to nothing to do with it. For me, a white, middle-class American, every mental health provider I went to that got it wrong with me was also a white, middle-class American. It was not until I had a provider with an overlapping diagnosis to my own complex diagnosis that I was able to make real progress.
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It was at a recent doctor appointment visit for my older child that I observed the front desk, scheduling staff. Upon hanging up the phone, the front desk women cackled about this couple needing to be scheduled with their appointments at the same time. “I’d never be that codependent!” declared one – as if the reason for this couldn’t be the need to save money on gas. Also, if I was someone knowingly struggling with codependence that healthcare facility is now the last place I will seek assistance for this, if I ever do at all. These are the things that people just don’t consider. As if that same codependence wasn’t hijacking the same neural system that an opioid withdrawal does—there is a serious lacking of compassion. If you consider it from this framework. This means that each time a person with relational trauma experiences a trigger, they go into immediate withdrawal in a similar way that a person who just received Narcan would be removed from their state. This provides insight to the severe irritability experienced when a codependent person has an adverse behavior. In an alternative approach to families with codependency there need to be push and pull working towards challenging the production of new behavior by all involved. Perhaps, this looks like creating more opportunities for new neural pathways to be created. This may look like big move as a family. This may look like forced engagement in new activities. What I know when it comes to family mental healthcare is something has got to give from a macro level perspective. All this individuality has caused us to abandon systems in need of much repair. As it is, there is little opportunity for this to occur. As for my own life, I am amidst the largest changes of my life. I am choosing to take a chance on myself, my family, and my faith that something will come out of all we have gone through in our commitment together.
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