The Lady In The Waiting Room

two-women-talkingI was sitting in the waiting room of a doctor’s office one day and overheard a woman talking about addiction…how it “impacts everyone” and how the addict “just keeps on using”.  How she wanted to go to “those meetings” and tell “those addicts” just how badly they hurt others; how they need to listen to their family and friends and just stop it.  As a therapist in the field of mental health and addiction, I could not help but to say something.  I shared with her that AA and NA meetings are for those who are working to be sober, that these individuals know how they are hurting their family and friends. I shared with her that there are resources out there for the families of addicts as well and that she may find Al-Anon more helpful to her situation and give her a place to express her fear and frustration and, ultimately, find support.

After hearing more of her story,  I found myself talking to this woman openly, not sharing what I do as a professional, but rather speaking as a fellow human waiting for their own loved one to finish a procedure in a doctor’s office.  We talked about mental health and it’s impact on addiction, how the effects of adoption may have a role in how a person behaves, and how feelings of abandonment develop and impact our lives.

Moments like this help me connect authentically in my chosen profession. As a Licensed Clinician, my focus is on helping others daily…helping them grow, improve, survive.  To move toward not only existing but living, engaging and thriving.  To help them find peace knowing they have areas of need and care and that they can find places, people and things to help them be well.

I think about that woman in the doctor’s office often and I pray that she found an Al-anon meeting to express her feelings and thoughts.  I could feel the pain behind her words which to an unknown person, may have sounded mean and ignorant, but I had the blessing to be the one listening that morning and I am honored to have the opportunity to guide her to her own healing and also hopefully, help her to understand that the pain she had in her life, with her loved one who is suffering from trauma, addiction and mental health is just trying to live the best way they know how. With the guidance of those who will listen and care, helping guide them in meetings, therapy, and yes, sometimes a doctor’s office waiting room, they will come out the other side ALIVE and thriving.

What Is Al-Anon and Alateen?

al-anonAl‑Anon is a mutual support program for people whose lives have been affected by someone else’s drinking. By sharing common experiences and applying the Al-Anon principles, families and friends of alcoholics can bring positive changes to their individual situations, whether or not the alcoholic admits the existence of a drinking problem or seeks help.

Alateen, a part of the Al-Anon Family Groups, is a fellowship of young people (mostly teenagers) whose lives have been affected by someone else’s drinking whether they are in your life drinking or not. By attending Alateen, teenagers meet other teenagers with similar situations. Alateen is not a religious program and there are no fees or dues to belong to it.

About the Author

Kristen SmithKristen M. Smith, LMHC, CTT, EMDR trained
Kristen has been working in the mental health and substance abuse field since 1997. She has always focused her career, education and training on trauma survivors, the healing process of her clients and their ability to move forward into safer, healthier futures. Kristen is a Licensed Mental Health Counselor for the state of Florida and a supervisor for licensed interns. Kristen’s trauma work experience has ranged from in-home, outpatient, inpatient and out of home placements as well as private practice. Through trauma specific treatment modalities such as EMDR, Kristen has provided safe, nurturing and heartfelt healing to children, adolescents and adult trauma survivors. She is always humbled by the strength and integrity of her clients as she plays a part in their steps to recovery from traumas and addictions. Kristen believes everyone can heal their hearts through the care, love and the commitment of another human being who takes the time to listen, help and even sometimes cry with.

The Selfish Me

“As a night nurse, I want to be able to tell clients that we are here not just for meds but also to listen to them” Rosemarie Stanton, RN, The Refuge – A Healing Place

patient“Look at me. You called me strong. I always take care of you, my love, my family, my friends and yet I always feel alone. I cry too you know. I need a shoulder to cry on too. I need someone to hear me too. I am always here to listen to you and yet I cannot say a word when I don’t want to hear you or look at your tears anymore. My heart breaks too. And yet..I am falling deeper in my loneliness. I need to be selfish and look after myself. I need to heal inside and only I can tell myself to get it together. Leave a piece of me to hang on to. This is my life, my own world I must draw. I need a hand to guide me through. Help me. ”

How many times have we heard these words and yet not really heard it? Of course, we understand what it means, our books tell us the meaning of loneliness, desperation but a cry for help? Without invading their inner soul? Is it possible? Our optimistic side would tell us of course, it is. Do we try to decipher their problems, what caused this? What can I do to unravel this mystery called life?

nurse-or-mdAs a nurse, I think about interventions. What can I do to help the client feel comfortable, but then I always look at my human side and think…nothing…just listen. Maybe that 15 seconds of silence is the answer to it all. The human touch without touching but reaching out is a way of saying…I am here..I will help you.


When you let me in your heart and allow me to reach out, only then can I help you. Look at me in the eye and tell me…’I need help’…only then can I help. If you tell me to listen and not say a word, I will listen with my heart and not my ears. I may not know all the answers, I will never know your pain, but I can ease the burden in your soul. Keep talking, try to reach hand will always be here for you to hold on to. Day or night, I will be your nightingale.

Rose Stanton RN



Go Ahead and Celebrate: Overpowering Imposter Syndrome

Imposter-Syndrome-MaskIn a recent interview with ABC News Viola Davis made a comment that took the world by surprise and hit all to close to home for so many of us. Davis, who has won an Oscar, an Emmy and a Tony for her work said “I still feel like I’m going to wake up and everybody’s going to see me for the hack I am.” This nagging doubt that we are not enough, that our achievements are not deserved and the fear that we may be exposed as a fraud has been defined by psychologists as “Imposter Syndrome”  We look at others with love, respect and admiration. We celebrate their accomplishments, but when it comes to seeing that in ourselves we cant.

Self-doubt and fear are certainly part of the human experience. People often doubt their abilities to be good parents, employees, and friends, and sometimes people even struggle to envision their potential to succeed in certain endeavors. Fear, which frequently accompanies self-doubt, can thwart even the smartest, most talented, and most driven individuals from simply attempting a task or working towards a goal. People often say they are worried that their peers will find out “they don’t know what they are talking about” or that they will find out they are a “phony”. However, when one pushes beyond these feelings and takes action to bring a goal to fruition, the fruits of the labor involved can certainly be sweet and rewarding.

Relishing in one’s success and celebrating achievement is, for many, a short-term experience. Regardless of the time, effort, sweat, pain, and strife that led to reaching a goal, people often reach that mountaintop and feel like they need to get back down right away. But why? Why do some people put so much work towards achieving a goal, attain it, receive recognition for it, and then feel as though they are somehow undeserving or should hide their success? According to some experts in the field of mental health, imposter syndrome, or the imposter phenomenon, may be to blame.

maya-angelou-quote-600x400While not considered a clinical diagnosis, imposter syndrome occurs when a person feels as though he or she has achieved success fraudulently. Even if an individual reached a goal via the most genuine and authentic means, imposter syndrome can cause an individual to feel like a “fake.” When these feelings emerge, they can tarnish a person’s sense of accomplishment and potentially prevent future goals from being achieved. Additionally, such negative thoughts, when left unabated, can eventually manifest into symptoms of mental health disorders like depression. People will continue to ask questions like:

  • Do I have any business doing this job?
  • Who do I think I am accepting this praise / promotion / award / raise?
  • What if they figure me out?
  • Do I really deserve this?

Despite hard work and substantial effort, self-talk such as this often occurs and can sound like an annoying inner voice that is trying to minimize a person’s achievements and personal sense of pride. Fortunately, there is something that can be done about it.

Take overcoming some sort of trauma, for example. It can be difficult, require a lot of work, and challenge a person to his or her limits. However, persevering beyond the pain of the past is possible and most certainly warrants celebrating this sort of personal success. But what if the imposter phenomenon rears its ugly head and puts a damper on such a personal victory?

While not always easy to do, the key is to refocus one’s attention, remember what it took to get where you are,  smile, and continue the celebration. Turning negative thoughts and opinions that one has about one’s self into positive beliefs can extinguish the imposter phenomenon and allow a person to enjoy positive progress, recovery success, or any other beneficial outcome that resulted from putting the time and energy into achieving healing. Even if it seemed easier than expected to overcome a traumatic past, newfound confidence, beneficial coping skills, optimism for the future, and improved overall wellness can remain in the trophy case of life for as long as one wants.

At The Refuge, A Healing Place, men and women from all walks of life battling a variety of concerns, including trauma, addiction, and mental health issues, entrust the staff at this center to help them reach their treatment goals in a deeply meaningful manner. By participating in the holistic care available, men and women are able to heal in a multitude of ways, and are encouraged to truly celebrate the healing and recovery success that they have worked so hard to achieve. Even if imposter syndrome becomes an issue for an individual, and even if there is still more for the individual to do to truly become well again, achievements in healing (both big and small) are what The Refuge is all about – helping men and women develop the skills and confidence needed to live the healthy lives they deserve.

If you are questioning your success or doubt your place in the world, know that you can ‘name the beast’. Call out your fear, talk about it with someone you love and trust and be open to hearing and embracing their support and praise. You are worthy of success. You are worthy of others respect. You are worthy!

In Defense of Lying

Guest Blogger: Monica O’Connell, MA LMFT

liarAs a trauma therapist, I spend a lot of time educating people about how we got ourselves into the pickle of using a specific behavior to solve life problems.  All the while now knowing that those behaviors aren’t working for us any more and counting to do them. It might have worked brilliantly to get drunk in college; c’mon, all our friends did it. It’s not working now though. It’s getting in the way of going to work. Eating a cupcake used to boost our mood, now we’re 4 cupcakes in, our tummy hurts and we’re still in a lot of pain. Lying is another one of them. Now most people will say that drinking too much, eating too much and lying are behaviors that never really ‘worked’ for us. And while that may be true, the way they worked at first, was adaptive. It made a lot of sense. On some level, they kept us safe, kept us out of scary feelings and for some people, kept us alive.

For some, lying has become primary coping skill and the lying is particularly prevalent for the person in their significant relationships. This tends to seem counter-intuitive for those who have never used lying as a coping skill.  I hear often from partners, loved ones and parents, “Why would you lie to someone you love?”

The answer is never as simple as a basic response but usually it goes like this:

I anticipated that there was a “right” answer to your question

I felt shame when you asked that personal question about me.

I’m not sure it’s safe enough for you to see who I really am.

If I give the wrong answer, you might leave.

I’m bad and I need to cover that up.


liar 2These fears tend to drive the behavior and the more the behavior keeps us safe, the more we tend to repeat it. It’s reinforced over and over again by our brain feeling relief by the behavior being soothing and getting us out of a danger response. In my clinical experience, most people that I’ve worked with are aware of a few things. The first awareness they have is that they are lying. The second is that lying doesn’t actually work in the long run. The third is that lying hurts people. The person can hold those in present awareness and still, when push comes to shove and they are under attack, still lie.

Lying can come in many shapes and sizes including lying about simple goofy things and ranging to big sweeping accusations about others in an effort to protect ourselves. From the truth about our favorite color, flavor of popsicle to huge parts of our lives and extending outward to the truth about the character of others. Most of the people with whom I work, after doing some significant trauma work, will say that the lying they did was dumb, that they wish they wouldn’t have done it and that they realize just how harmful it was to those around them.

If you find yourself lying about teeny tiny things up to really huge fundamental truths, you’re not alone and it doesn’t need to be the way you’re living your life. You can find a way to experience enough safety to tell the truth. You can learn how lying was a trauma response. You can learn about trauma and the impact it has on your life.  Through healing the trauma, you can have more options about your behavior, including decrease to extinguishing the lying behavior. In doing this work, you also get to learn ways to connect with yourself and with others in ways that are fulfilling so you don’t have to feel so alone. Lying might be your primary defense mechanism now and I get why you might want to use it as such. Let’s get you some more options.


monicaBlog By: Monica O’Connell, MA LMFT
Private Practice Clinician
National EMDR, LBGTQ and EMDR Trainer

Monica is a therapist in private practice specializing with clients who are at the intersections of addiction & maladaptive coping strategies, mental health and trauma.  She is an EMDR practitioner and is an EMDRIA consultant in training.  Monica’s specialties extend to working within the LGBTQ communities.  She is a recovery advocate and often times works with people on their own definition of recovery and its impact on their relationships to self and others. She provides consultation and supervision to people who are seeking LPCC & LMFT post graduate licenses, particularly those specializing in dual license/dual diagnosis areas and to those pursuing further education/training in EMDR.  Additionally she provides local and national trainings on addiction, the LGBTQ community and trauma informed care.

Redefining Fun


When I work with younger people in their journey of recovery, one of the first roadblocks I encounter is combating their very destructive ideas about what fun and excitement looks like. I once had a mentor of mine describe insanity as changing our goals to meet our behaviors! To most individuals, running from police, getting beat up or exploited sexually, using chemicals and being on the verge of overdose and narrowly escaping death on a weekly or daily basis sounds awful. However, for many young addicts, especially those with histories of unresolved trauma, it sounds like a typical Tuesday. It is their reality, and to survive such a chaotic and self-destructive way of life, rationalization kicks in and the abnormal becomes normal.

I’d like to say that when younger recovering individuals come to treatment they realize the gravity of their current situation and immaturity goes by the wayside and they get to work. Sadly, this is rarely the case for young adults OR older adults for that matter, and they need a lot of help staying on the path. It can be quite a shock and even feel quite boring to suddenly step away from a lifestyle where these young adults were on high alert at all times; vacillating between hustling to get high and being high, “running and gunning”, and desperately trying to avoid withdrawal and emotional turmoil on a moment-to-moment basis. Three meals a day, quiet nights and people providing affirmation and support 24-hours a day is a totally foreign and often unsettling contrast from their normal day-to-day in addiction. So many times these young women and men will create the chaos and drama they crave in treatment! They will gossip and create dissension amongst peers, “hook-up” with the physical manifestation of their unresolved traumas, engage in process addictions, create drama with roommates, pull inappropriate pranks on fellow clients and staff, and sometimes they find obscure and bizarre ways to relapse on chemicals in treatment.

What’s so destructive about this struggle to re-define fun and excitement is that more often than not, a client will be labeled as defiant or resistant to authority for these behaviors, deemed too much of a threat to the clinical milieu and discharged. I have worked with countless young clients who were discharged for these types of behaviors, who wanted to get better, craved a chance to heal and grow, however they were never given the skills and tools necessary not to shoot themselves in the foot in the interim. It’s important that we understand why many of our clients engage in this self-destructive behavior in an effort to have fun and stimulate themselves. Essentially it’s a desperate attempt to not be in their own skin, or the moment, and at all costs. The truth is its hardwired and connected to the central foundation from which our minds develop: Attachment.

Ambivalent AttachAttachment shapes who we are, how we gauge and respond to danger and how we organize and process the information with which we encounter in our worlds (Ainsworth & Bowlby, 1991 ). The first three years of a child’s life is critical for healthy attachment to be developed via consistent and secure connections with parental figures. Many of our clients did not have parents that were around, sometimes for reasons that were truly negligent and tragic and sometimes because they simply had to work and work a lot. That was their reality. Other clients had parents that were physically there but due to their own addictions, were a million miles away emotionally and psychologically. Countless clients remember dad being there but always being drunk, or mom being there but always being half asleep with her bottle of pills never too far away. Kids are very perceptive and because of their size in relation to the rest of the world, they have to be to survive. Inebriated parents do not allow for that central foundation to become established.

I have had the pleasure of attending some weekend trainings with Dr. Dan Siegel, a man whose books you’ll find on many clinicians shelves at The Refuge. He discusses how the attention a child receives from their parents reflect back to that child their place in this world, and their worth. It is the cement of that foundation we’ve been talking about: It is the formation of a child’s internal process, or as Dr. Siegel calls it, “the subjective See-Inside (Siegel, 2011)”. When this “see-inside” is not fostered, when no attention is given to that child, the story they often make up is that it’s because there is no one to know. Thus, no internal process is established and no see-inside is developed; certainly not a healthy one. So these children, our clients, are constantly seeking fulfillment outside of themselves to spark an internal sensation and response. To feel excited they smoke crack. To feel relaxed they shoot heroin. To feel sexual they engage in exploitive and toxic relationships, in and out of treatment. To not feel empty/to feel full, they eat until they throw up… Get the idea? That internal process and any skills or ability to regulate their internal dysphoria, is simply not there. No wonder, on occasion, we find a baby alligator in a client’s bathtub: It’s about so much more than a prank. It’s about an individual that doesn’t have any connection to their internal process, no ideas how to understand or regulate their emotional states, and is desperate for either stimulation or relief. (I want to say here that I am not trying to diagnose or define addiction as a linear, cause and effect behavior, or that addicts engage addictively to simply “spark” something within. What I am asserting is that the addictive behaviors our clients engage in began for a reason, they are but a symptom of a larger issue, and it should be of no surprise that that same addictive logic spills over into other areas of our clients reasoning lives…)

OLYMPUS DIGITAL CAMERAIt is so important that on top of all the recovery tools and healing, that our clients be shown how to re-define and re-experience fun! I loved when a client would complain to me on a Saturday, saying they were bored and that they had nothing to do. I would remind them of the fact that The Refuge was literally an old YMCA camp; a place parents would send their children so they would have lots of things to do and that they were in treatment in a part of the country that most families can only dream of vacationing to. So I would play kick ball, softball and touch football with them, ride the canoes down the river, very hesitantly climb our ropes course, ride our horses around our beautiful 90+ acre property in the Ocala national Forrest, and hit golf balls while talking about their fears and goals. Every once in awhile I would catch them smiling or laughing and point it out to them: “SEE! Sober fun is possible.” This usually elicited an annoyed response but I knew, that they knew, they had been caught enjoying themselves, and that I was right. That maybe there was something to this sobriety business.

We can help remove the emotional burdens of our clients and give them skills to maintain their recovery, but if we do not teach them tangible ways to entertain themselves and consume their days, they are far more likely to relapse (we cannot expect to remove a behavior that consumed 100% of our clients lives and not expect them to be left with a significant hole and no clue how to fill it!) At The Refuge we have lots of fun and exciting things to do, an amazing and full-time recreational and adventure therapist, and a beautiful property. We do this not because we are trying to sell who we are with cosmetics, but because our clients need help, support, and lots of different and unique opportunities to re-define who they are and how to be with themselves! We have an opportunity to help our clients and the wounded little girls and boys within to re-discover what makes them laugh, smile and get excited. We have the opportunity to help them re-define what fun means, and in the process, who they are and how amazing a sober life can be! 



Ainsworth, M. D. S., & Bowlby, J. (1991), An ethological approach to personality development. American Psychologist, 46, 331-341.

Siegel, D. [PsychAlive]. (2011, March 3). On Avoidant Attatchment [Video file]. Retrieved from

Nourishing the Body, Nourishes the Soul

Patrick SushiThe Refuge – A Healing Place is a residential treatment program, in Ocklawaha, FL, that specializes in substance abuse, Trauma, PTSD and co-occurring disorders. The program is 12-step based with a strong  emphasis on holistic and experiential modalities that include Equine, Somatic Experiencing®, Art Therapy, Massage, Meditation, Acupuncture and an array of other body based and experiential treatment approaches. 


The Refuge philosophy to treating both addiction and trauma includes a three pronged approach to addressing the needs of the body, mind and spirit. As part of this approach, nutrition and education play an intricate role in helping nurture our clients back to health and teaching them to take better care of their bodies. Research shows that those in active addiction do not eat a balanced diet, often times suffering from malnutrition, dehydration and compromised immune systems that can cause them to be more susceptible to depression, infection and overall poor health. The focus of the culinary program at The Refuge is to not only provide balanced meals for our clients, but to educate them on how healthy eating can aid them in their recovery while also providing them with hands on instruction on how to cook for themselves and learn kitchen safety.

Led by Executive Chef, Patrick Cahill, The Refuge culinary team takes a hands on approach to making sure that all of our client’s dietary needs are met. Patrick has been the Executive Chef at The Refuge since 2004, but neither his story with The Refuge  nor his love for food started there. Patrick began his career working in restaurants and serving as a private chef , but his path, much like many others took an unexpected turn and he wound up having to seek treatment for addiciton. Patrick was client number 22 to admit to The Refuge when it was opened in 2003 and it was his time in treatment, that led him back to The Refuge to apply for a job and become the first alumni ever hired. He has since taken this job and turned it in to a lengthy career that has impacted the lives of thousands of clients who have been through the program.

In 2015 Patrick and his team launched weekly cooking classes for the clients as a part of the new, more in-depth life skills program. “ I wanted to develop these classes for the clients to have fun, escape treatment for a little while, learn a new skill and have something to show and enjoy at the end of the day” says Cahill. Since this program began clients have made sushi, empanadas, crab cakes and a number of other creative dishes. “I strive for greatness. I am constantly thinking what I can do to make our clients experience the best it can be. The food was horrible when I was in treatment, I want everyone who leaves this place to rate the food and their experience with the kitchen as five-star” Patrick is passionate about the culinary program at The Refuge and says he “wants the clients to look forward to a good meal every day”. Patrick’s passion and dedication have led his team to become some of the most loved and respected in the industry. He is an intigral part of The Refuge staff and the clients experience would not be the same without him.

Healing Through Experiential Therapy

LeftRail-6When an individual experiences a traumatic event it can impact the emotional, physical and spiritual state of that person. As a survival mechanism, the body and mind tend to disconnect to allow the person to cope with the unwanted experience. While traditional talk therapies, such as cognitive behavioral therapy, can be helpful, experiential therapies allow the individual to access various parts of the brain not traditionally accessed by talk therapy.

Experiential therapy is just like it sounds, an experience.  This category of therapy involves actions, movements, activities, and role plays which allow the clients and clinicians to identify and address hidden or subconscious thoughts or memories . Examples of various experiential therapies include equine therapy, art therapy, music therapy, adventure therapy, psychodrama, and recreational activity.

The idea behind the practice is to take clients that have previously engaged in traditional psychotherapy and remove them from the clinical or office setting. This allows the client to take their mind off of the therapy itself and encourage them to function in the moment, thus allowing the client to let their guard down and promote open dialogue.

During an experiential activity, clients are given the opportunity to experience success, identify obstacles, increase self-esteem, and claim responsibility for their actions. If clients are participating in a group experiential exercise, they are given a chance to build trust, learn to work as a member of a team, gain a sense of belonging, and ideally experience the need to ask for help. Both during the activity and immediately following, the client or group of clients take a moment to process the feelings and emotions that come up during that exercise, this allows the clinician a chance to offer feedback and guide the client/s to understand their decisions, actions, and reactions.

As a secondary benefit of experiential activities, clients have the opportunity to learn new and healthy ways to fill their time that was once occupied by unhealthy coping skills. Often time’s people forget how to ‘have fun.’ They can become engrossed in their negative thoughts and believe that they can no longer find happiness in simple leisure activity. Recreational activity can help these clients reprogram how their brain reacts to positive stimuli and allow for enjoyment to overcome the need to hide or use other unhealthy coping skills.

At The Refuge, we use a variety of experiential exercises to help the clients find the root of their trauma that is not allowing them to function to their full potential. Some of our programs include equine therapy, ropes course, breath work, meditation, yoga, and recreational activity.

Equine Therapy

Equine Therapy

The ropes course offered by The Refuge allows clients to build trust, teamwork, and self-determination by asking them to participate in a series of both low and high rope activities. Many clients experience fear and/or anxiety before performing one of the challenges, and we ask that they fight through that barrier to accomplish the task at hand, thus gaining a sense of success and perseverance.

The Refuge also offers many recreational activities for the clients, such as canoeing, pontoon boat trips, bowling outings, campus field days, karaoke, game night, and various sporting events. The idea behind the recreational activities is to help the clients understand how to have ‘sober fun.’ Once they leave the serene and safe property of treatment, they must have the tools available to continue their journey of recovery and sobriety. Allowing them to experience guided recreational activities in treatment will help them find such events in their new day-to-day life and hoping they will use these coping skills instead of slipping back into negative behaviors.

All in all, experiential therapy is a process to help individuals connect their mind, body, and soul. It allows the person to step outside the realm of traditional talk-therapy and physically experience their growth and change. All of which fits in perfectly to the holistic approach used here at The Refuge-A  Healing Place.



The Healing Ability of Gratitude

By: Brennon Moore, MS, CTT, CADC-II

gratitude  An addict can come to The Refuge and spend months, maybe  even years,  and do every assignment, attend every group and  process their past trauma  until their lips fall off, but they will  still need to work hard at their recovery  every day, starting the  moment they leave our property. In my experience, it  seems  that once a person changes the wiring of their brain and  makes that  connection between an addictive behavior as a survival skill, there is often no  going back. What The Refuge does is help to remove the heavy emotional and  mental chains that our clients have been carrying their entire lives but it is up to them to keep them off!

I’ve heard many addicts, who having been through treatment (sometimes several times), tell me that they tried employing therapeutic strategies to self-care after a relapse, or while using. Often this was because they came to a hopeful conclusion, usually on their own, that their unresolved issues were the problem, not the addiction. Perhaps now that they have excavated their insides, done some healing work and been given some tools, they could drink and use drugs like ladies and gentlemen. Not surprisingly, however, yoga doesn’t quite seem to have the same positive results when you’re high on cocaine, and providing that inner-child the love and support they need while constantly visiting massage parlors and porn sites is not easy. It’s really hard to stay awake while practicing mindfulness on OxyContin and, well, being authentic and maintaining genuine relationships while drinking whiskey all day is quite difficult. We have to do something to protect our recovery on a daily basis so that we may continue to heal and grow.

Honestly, I don’t really care what my clients do to maintain their recovery if it works and they are happy and usefully whole as a result! However, they must do SOMETHING! You cannot take a behavior that you have been using, usually daily, as your greatest coping skill, your go-to pain reliever and numbing agent, your greatest lover/friend/protector, and not replace it with something. And that something better have some teeth!
Often times people are told to attend 12-step recovery and many are very resistant. I am often told by clients and sometimes family, “where’s the evidence? It sounds like a cult to me!” There will never be a comprehensive research study done within 12-step groups about efficacy because it goes against the traditions and structure of the group. However, this does not mean there isn’t a ton of pretty amazing evidence behind why it works!

I was presenting at a conference not long ago and I was listening to a presenter named Ralph Carson, a doctor specializing in the connection between the brain, behavior and health. He talked about how we essentially have what he called “happiness-cells” in the pre-frontal cortex of our brains. The more of these cells you have, the happier you are! In the 1970’s and 1980’s, we did not have the understanding of the brain that we have now, so we did not believe creating new happiness cells was possible. Thus, our best advice to someone with depression was to hold on and fight because it was simply going to be a grueling battle. Not very encouraging, but I have some really good news: What science tells us today is that we CAN create new happiness-cells and one of the prime ways to do so rests in our attitudes.

stay positive  Ever wonder why there’s so many of those, “damn gratitude meetings”, the ones that often    make you cringe because it’s harder to maintain your pessimistic approach on life. Research      shows that gratitude, which can directly improve our attitude, is one of the most powerful ways  we can create new happiness-cells in the brain (I realize AA was founded long before this  research, but perhaps the topic of gratitude became so popular because people simply feel  better afterwards… Remember, just smiling can trigger the brain to release a shot of dopamine!)

In early sobriety we often feel depressed, dysphoric and the truth is, our brains are usually lacking neurotransmitters needed to regulate mood because of all the foreign chemicals we flooded ourselves with. This is why it is so critical that we have our reality checked daily, hourly or minute-by-minute. It takes time for our brain to heal, and unfortunately, time is often the one thing early recovering people do not give themselves! Instead, they determine that after 20, 30 or 40-days  that they don’t feel better (even though they have been using for 5, 10 or 20-years), that this recovery business just doesn’t work for them (insert the, “I knew it”, or “I told you so” comments), and they may as well go back to drinking/using/acting out addictively. So if you’re wondering why meetings are often so annoyingly positive and upbeat, it’s because there’s often not much time, and hearing positive messages while making positive change, even slowly, can literally re-wire the brain and help an individual to heal.

The truth is, just the act of walking into a meeting begins the process of healing as engaging in positive relationships promote the production of happiness cells. Additionally, the 12th step, what many believe to be the heart and soul of “the program” via giving away what was so freely given to you, is a major part of this healing process as well: Altruistic behavior is also directly linked to the reproduction of these critical cells. I used to hear a saying early on in my own journey: “To build your esteem, you need to do esteem-able acts.” This is actually very true, and it’s not just about sponsorship or being the person at the front of the room leading the meeting, as making coffee, greeting a newcomer, buying someone a big book, cleaning up or just sharing your truth are all examples of the types of altruistic opportunities available to every member of a 12-step recovery program on a daily basis. Simple actions that can lead to major results!

This article is not meant to convince anyone that 12-step recovery is the right choice, a guaranteed fix or better than other approaches. There are indeed other options and I think people should have the freedom to explore and choose which path to take. The market is not cornered and never should be as far as saving our own lives is concerned. If it works for you, DO IT! But again, do something, and don’t let the lack of research articles or fancy hospital endorsements scare you away. That may be part of the magic.



Carson, R. (Director) (2015, May 2). The Healing Brain: Integrating 12-Steps, Positive Psychology, and Neurochemistry into a Model for Recovery. 2nd National Conference on Trauma, Addictions & Intimacy Disorders. US Journal Conference. Lecture conducted from , Nashville.


A trip home: A Lesson in Transgenerational Trauma

columbia river water fallI recently had the opportunity to train an amazing group of professionals at a hospital in eastern Oregon, and it had me driving right through the town where I grew up! I decided to take a little detour through the main drag (about a 5-minute endeavor) to enjoy a little nostalgia. When you drive through my hometown in the Columbia River Gorge of Oregon, you will see murals of the local tribe which used to dwell and thrive in the area. However, the plethora of murals around this small town can be confusing: There is always a majestic waterfall with which these traditionally dressed Native Americans are pulling in Salmon by the net full. Always stoic, always proud and always set against a beautiful waterfall with which this tribe is literally named after. Their provider. Their great spirit. 

Fast forward about 65-years and that waterfall is nowhere to be seen. It’s now buried under a mountain of water after a giant dam was constructed to provide electricity as far south as Los Angeles. The local tribes numbers are dwindling dramatically and their reservation, a small plot of land off of a major highway and railroad, looks upon the gravesite of their former namesake and provider. Those murals… Well, they have become a morbid reminder of what once was and never will be again. Like many Native American tribes, they struggle with problems that were once never an issue prior to white European settlers: Physical and sexual abuse, high incidence of domestic violence, addiction rates far above national averages, and a devastating cultural genocide leaving many lost and struggling to find their way. Even though it’s been many years since the dam was put in place, a horrific domino effect seems to be occurring and new generations who have never even seen the falls, let alone cast a net into it, seem to pick up the same grief, fear, pain and loss of their ancestors. Those insidious and destructive behaviors seem to pass seamlessly to new generations.

trauma brain New research from Emory University School of Medicine, in Atlanta, is showed that certain information can be inherited via chemical changes in DNA during stressful or traumatic events. For example, laboratory mice would inherit their parents conditioned aversions and fears to completely neutral and benign stimulus, such as the scent of cherry blossoms. Dr. Brian Dias reports that the results of this new research, “allow us to appreciate how the experiences of a parent, before even conceiving offspring, markedly influence both structure and function in the nervous system of subsequent generations. Such a phenomenon may contribute to the etiology and potential intergenerational transmission of risk for neuropsychiatric disorders such as phobias, anxiety and post-traumatic stress disorder.”

Advances in science such as these really illustrate the importance of understanding our clients unique story… All of it: Past and present! Much like the new generations of Native American’s inheriting the darkness of their ancestors, at The Refuge we have understood for years that the grandchildren of holocaust survivors will often display neurosis consistent with their grandparents or that the children of rape survivors may carry the fears and phobias of their parents, despite never experiencing such an attack! To not understand these generational pieces of the puzzle means we do not fully understand our client and their unique story. In his newest book, “The Body Keeps The Score”, Bessel Van Der Kolk writes that “trauma recalibrates the brains alarm systems.” How true this is, and our clients alarm system may have been calibrated in the womb. No wonder they are so hardwired!

A few years ago, officials in the state of Oregon determined that if they opened certain dam spillways at a lower portion of the Columbia river and closed dam spillways at a higher portion of the river, they could expose the before mentioned waterfall again for 24-48 hours without causing any flooding. The tribe said no; they pleaded that brining it back only to take it away again would be too painful. However, it seems that new generations may still very much experience its loss regardless, and while we cannot change the injustices done throughout history, we can strive to really understand the trauma story and no longer ignore it. Only then can we really understand behavior and the deep layering of pain that may be driving it. Only then can we promote real, lasting healing!

Gray, Richard (2013). Phobias may be memories passed down in genes from ancestors. The Telegraph. Retrieved from

Van Der Kolk, Bessel (2014). The Body Keeps The Score: Brain, Mind and Body in the Healing of Trauma. Penguin Publishing.


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Miracles Happen Here

By: Denise Cannon
Director of Nursing, The Refuge – A Healing Place

It-takes-a-village-to-raise-a-_-2I had made up my mind. I was set out to write a blog on Transformation in Recovery. As I started to review this process I realized as I look all around me how hard everyone works and contributes to make this happen. I am sure you have heard the saying it takes a” village” to raise a child. It’s the same process for clients here. It takes the village to make this process happen for our clients. The out pouring of love and support each and every person has for all of the client’s here is absolutely phenomenal. 

From the moment a potential client calls our admission’s team to the process of being admitted. Which then leads to the Client care techs, Medical team, Case management and our Clinical team. Let’s not forget all the other departments that work behind the scenes to make the Refuge such a beautiful place. I think about all of the moving parts that work together to make The Refuge work and I have to step back and watch with amazement.

Being a nurse here at the Refuge, you get the opportunity to see and experience every client that comes here for treatment. Whether it’s in the med room, out and about in the community or down at the Lodge during meals our nursing staff develop a relationship with all the clients in some way, shape or form.

In my time here at The Refuge I have seen that the path to recovery is such a different experience for each client. It raises the question, What is Recovery? I guess that depends on who is asking. It can mean many different things and I believe it is very individualized. Part of Recovery process is recognizing there is an existing problem. There are reasons why people do the things they do. It’s getting down to the core and working with each client as they go through their process. Establishing real bonds and relationships. The ability to truly express their truths. They are rebuilding their lives from the ground up, entrusting us to help them.

It’s about STRENGTH, EMPOWERMENT, SELF RESPONSIBILITY, GROWTH, CHANGE, and RESPECT as well as a Community of their peers holding each other accountable for their actions.

IMG_0913Clients are vulnerable when they are in the process of upheaval. But you can see the change as they start to feel it with in themselves.  It causes an individual to see things in a different light which in turn makes them do things differently. This is the start of the process of what Transformation is all about. We watch this change happen.  We know how hard client’s work to get to this point. Getting through the Anxiety, anger, tears, sleepless nights and pain with love and support. We watch as they put themselves back together again.  The process is different for everyone. This is part of what makes our job here so unique and very special. We are very proud of our clients when they are ready to leave and go out and face the world again. Knowing how hard they have worked to get to where they are going next. There is a sign on campus that says “Miracle’s happen here” and  I can say that statement is very true.  Miracles walk in our doors every day. These beautifully broken survivors who have endured such difficult lives who come here to learn and heal and regain the light that had been lost in their eyes. They become these beautifully healed, thriving, survivors who then go on to live the life they had always dreamed of! Miracles truly do happen here and I get to see them every day!