Leslie Glass's Blog, page 421

Stop Rolling Those Eyes And Listen

Can you listen when you think you already know it all? Not really. When you’re listening to something and you think, “I already know this,” there is no learning. Subsets of this lack of paying attention to another person are: “I’ve heard this before,” and “Here we go again with this story.” No Progress can be made.

When these phrases pop into our thoughts, there is no communication. Nothing the other person says afterward can penetrate these walls. In an effort to be in the conversation, people often repeat themselves. No wonder we believe we’ve heard it before – we probably have!

These are visible walls in a conversation – they look like an eye roll, a sigh, a shift in gaze, leaning back, crossing the arms, pointing the body or the feet away from our partner and fidgeting with our cellphones. These are the nonverbal communication blocks that we add to the foundation of our conversations. And they are effective. Confronted with negatively perceived nonverbal cues, a common response is to stop talking – to stop wasting our breath. Talking when no one is listening is painful for the one doing the talking; not feeling heard or listened to often results in feelings of being devalued or disrespected. Additionally, it can keep us out of the next conversation if we attach it to our self-worth or importance. “Why bother” can become a catch-phrase when communication looms. Before we know it, keeping ourselves out of the conversation turns into a habit of being isolated.

Two People have to Talk and Both Have To Listen

Communication is a two-way street, not a dead end. Being fully in the conversation takes being present and it takes practice. Practice by putting away your cellphone and making the other person the focus of your attention. Approach the conversation as if you are meeting this person for the first time; ask questions and listen to their replies. Be curious if the conversation moves into a story you think you’ve heard before; what does your partner want you to know about him/her from the story? How come you haven’t heard it?

Showing up in the conversation opens communication. Open communication promotes free self-expression and trust. It’s a win-win.

 

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The Co-dependent’s Lazy Turkey

I needed compliments, and I needed them bad. So I invited 40+ people to my home for a Turkey Day extravaganza. For weeks, I cleaned, decorated, and baked. I made Martha Stewart worthy place settings, centerpieces, sides. Of course, I refused any help; those compliments were MINE.

Then like a ravenous animal, I feasted:

“Your house is so lovely.”
“This meal is delicious.”
“How did you manage to pull all this off?”
“It must have taken hours.”

Following a cycle similar to one of addiction, I tried harder, year after year, to chase the high of affirmations, but it was never enough. I was exhausted, resentful, and unsatisfied. Finally, after months of recovery, I see the motive behind my madness; I was starving for love.

Last week, I bought another 13+ pound Butterball, but I didn’t use it as bait for compliments. I skipped the brining and massaging, and I made the laziest turkey known to man for my family of THREE. They loved it, and I wasn’t disappointed with fleeting compliments that only left me hungry for more.

The Co-dependent’s Lazy Turkey
Ingredients:

1 Turkey
1 Roasting pan
Salt and pepper
Aluminum foil

If the turkey is frozen, let it thaw in the refrigerator for 3-4 days, depending on size. I let mine thaw in the roasting pan. On baking day, I cut the plastic open and slid out it into the pan. I didn’t rinse the turkey, nor did I grease the pan. I removed the giblets and threw them away. The neck was MIA, and I didn’t waste any time looking for it. I salted and peppered the bird, covered it with foil and put it in the oven. I set my oven to 215 degrees F, and I went to work. The goal is to cook the bird low and slow.

The Results

When I got home eight hours later, the turkey was done and bathing in a delicious protein-rich broth. The skin was a pasty beige, and the meat was a little dry, so I drizzled mine with the broth. Eight hours was too long, but that worked for me, and my family thought it was the best turkey we’ve ever had.

3 Easy Tips For A Better Bird

Bake at 425 degrees for approximately 30 minutes until the skin is brown and crispy. Then reduce the oven temperature to 215 or lower. Next time, I’m going to try 185.
Bake the turkey when you’re home so you can check for doneness. It probably only needed to bake for four to six hours. The turkey is done when a meat thermometer reads 180 degrees F in the thigh, 170 in the breast and 165 in the stuffing.
Rub the turkey with an equally lazy herbed butter – put 1 stick of butter, salt, pepper, fresh rosemary, sage, and 2 cloves of garlic into a food processor. Pulse until smooth. For extra flavor, shove some of the butter under the skin.

A turkey this size feeds approximately 10 people. If your family isn’t into leftovers, consider freezing half of the meat and broth for an even lazier turkey dinner in the near future.

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Thanksgiving Traditions That Work For Me

The holidays are full of traditions and rituals. Often these give our lives a sense of peace and security, but sometimes they add to our stress and anxiety. For me that is true of having everyone eat at my home. If I host Thanksgiving, my anxiety and stress build up just worrying about what might happen. What if one of my sons shows up under the influence or become intoxicated while at my house?

Ghosts From My Thanksgivings Past

Seeing my children drunk triggers many unhappy memories of past Thanksgivings. Too many times, my husband became intoxicated and yelled at me for no reason. Before I learned about having choices, I simply grinned and beared whatever occurred. I grumbled as I prepared the traditional Thanksgiving dinner everyone expected. Everyone’s favorite dish was on the menu. My codependency came out full force during the holiday season. Often alcohol was followed by arguing, tears, and one or more guests leaving heartbroken and early. I finished the day by washing the dishes alone and resentful. I was exhausted from serving so many people, only to feel trapped in my own house.

With many 24 hours of recovery behind me, I’ve learned to enjoy Thanksgiving. The best thing to do is to have a neutral place for our family get together so I can leave if needed. This way, I’m not judging my adult children; I’m just keeping myself safe because that’s my responsibility.  My tradition is different from other families’ traditions, but it works for me.  We’re still working out the details for this year’s celebration. While I wait, I create my own recipe for a successful Thanksgiving using the slogans of recovery:

Let Go And Let God

My Higher Power knows the perfect place for my family to get together and give thanks this year. I simply let go and see what happens. This year my youngest daughter decided she wanted to host the family. Last year her sister hosted. I’ll support them, but it is their show.  I tell them often how much I appreciate them opening their home to the family. To keep my co-dependency in check, I remember I’m a guest, not a host. This lets me let go of my need of control. Instead, I focus instead of how proud I am to see them putting together their own Thanksgiving. Everything’s going according to plan, it just isn’t my plan.

Don’t Force A Solution

In the past, I forced what I thought was best on everyone. This added fuel to the already tense atmosphere. To avoid past problems, it’s tempting for me to make a reservation at a restaurant. However, that only lets me escape bad behavior and keep myself safe. By not forcing a solution, I’m able to see what others can come up with. Going with the flow keeps me out of the drama. My day stays serene and I am able to offer bits of ideas that the hostess may or may not use. I’m good either way.

Keep It Simple

I only bring dishes I’m comfortable making. I try not to change the recipe either because my children like their food exactly as they remember it. I don’t make healthier versions of their favorite dishes. Nor do I stress over whether anyone will like what I made. Keeping it simple gives me room to breathe and enjoy what others bring.

Do The Next Right Thing

On Thanksgiving Day, there can be a little confusion about what is happening especially if we are in a new environment with new people. I keep my serenity by doing the next right things whether that is washing a dish or walking a dog. Perhaps I need to go for a walk to get away from the noise, or share a happy memory about their father who passed away from the disease of alcohol use disorder (formerly alcoholism). I am sure to stay present so I do what is the best thing for me.

Maybe this Thanksgiving will be a disaster with a burnt turkey and tears over hurt feelings again. Using my recovery tools I know it will be within my control to make it the best Thanksgiving ever for me.

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Marrying For The Right Reasons

When I got engaged to my ex my mom said, “Life doesn’t have to be hard. There is an EASY button.” And then she leaned back and let me discover what that meant for me. Marrying my ex didn’t turn into the life time I had hoped. When I discovered my husband’s infidelity and stepped out of the relationship, my father said, “We used to call him ‘the weasel’ … never did like him.” I was shocked. They always acted in a generous and welcoming way to him and his daughters. They even set up a college fund so the girls would have a safety net while  navigating adulthood and pursuing their dreams. At first, I was angry… “Why didn’t you say something?” I demanded. “Why didn’t you tell me what you really thought of him?” You could have saved me so much grief, I bemoaned.

Why Didn’t You Tell Me

My mother calmly replied, “Because we trusted you. Your life is not ours to dictate. Your life is for you. Besides, you wouldn’t have listened to us anyways!” She went on… “Your father courted me with persistence and was certain that he would marry me. I wasn’t as sure and when I asked your grandmother what I should do, she said ‘How does he treat you?’ and left it to me. She trusted me as I trust you.”

My friends echoed my parents’ feelings with a common thread of “finally” and “we knew you’d figure it out!” Everyone took that step back and let me uncover the relationship for what it was all by myself. How humbling that they would love and trust me unconditionally and not judge my choices.

I’m Getting Married

As my wedding date nears, I often wish my parents were here. I wonder what they would think of my fiancé and then I realize that their hands are in all of this and it is because of their support and stretch that I am here at all…

Marrying Ron For the Right Reasons

My future husband doggedly pursued me with the same kind of sureness that my father had about my mother. He is just the right amount of support and stretch that I need to feel respected and loved. Ron stood by while I grieved my parents, never too far out of reach if I needed a friend. He would step up and inquire about moving into a relationship often, always so sure that there were more chapters to our story…. and then step back so I could create the space I needed to figure myself out. He spent the last couple years standing by me and for me as I navigated life without my parents’ immense presence in it. Ron is generous and kind, confident and thoughtful, and oh how he makes me laugh! He is my protector and my friend, and he adores me. I wasn’t expecting him to propose, but he had other plans, even asking my best friend for her blessing.

Ron’s Way Of Proposing

We were getting a car out of storage and putting on the license plate, when he said, “Since I’m already on one knee … will you marry me?” I laughed, and said, “Be serious, Ron.” He motioned me to stay put. He retrieved the ring from the car and got back on one knee.  “I am serious,” he said. He opened the little white box to reveal the ring he had chosen for me; three diamonds, each stunning in its own right, but together making an exquisite display and representing the past, present, and future. He went on. “I’ve loved you from the moment I met you.  I’ve waited 35 years for you. Will you marry me?”

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What Gratitude Means To Me

When I came into recovery, I was MAD at God. I didn’t trust Him or approve of any of His plans for my life. When someone suggested a gratitude list, I wanted to throat punch him. Fortunately, I found a different way of understanding gratitude that works for me.

Forced Gratitude Didn’t Help

My co-dependency was a swirling mess of manipulating and control. I was afraid to trust anyone, and I was terrified of doing something wrong. Somehow, I came to believe it was my job to keep my friends, family, neighbors, and even complete strangers in complete harmony. I felt responsible for everyone else’s behavior.

During this time of fear-driven control, I thought prayer worked like this:

Identify the problem.
Map out the best possible solution – be concise and elaborate. Include names, dates, times, GPS coordinates, and a flow chart if possible.
Agonize about the problem and potential plan for days or even weeks.
Present plan to God.
Wait for God to follow MY plan.

Can you believe this never worked? At some point, someone told me if I wanted God to answer my prayers, I should practice gratitude. So I added a new step. Before I presented the plan to God, I took two or three minutes to tell Him what I was thankful for.

This didn’t work either because my motive wasn’t pure. I wasn’t thankful. I was just trying to appease God, who in my mind was more like the Wizard of Oz.

Recovery Restored My Sanity

There are many paths to recovery, and the 12-steps work for me. In step 1, I learned my life was unmanageable. In Step 2, I reluctantly agreed power greater than myself could restore me to sanity. After all, nothing I did worked, and I tried everything. Yet I wasn’t ready to trust the God I learned about in Sunday school. I tabled this idea and kept working the steps.

In my fourth step inventory, I saw the role I played in all of my messes. I learned about co-dependency, and I began to see how my unanswered prayers were really an attempt to force solutions and control unmanageable problems.

After many months of recovery, the God of my understanding is still my Sunday school God, but we have a much better relationship.

What Gratitude Means To Me

What is gratitude in recovery. In step 11, I “improve my conscious contact with God, praying only for knowledge of His will for us and power to carry that out.” My gratitude is a written account of how since recovery, trusting God has changed my life. It reminds me that God isn’t who I thought He was, and it keeps me from falling back into an unhealthy pattern of fear and control.

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What Causes Mental Illness? Scientists Hope Lab-Grown Mini Brains Will Help Them Find Out

Psychiatric research is full of complex problems and the appeal of new technologies to untangle them is high. A new study in Translational Psychiatry aimed to do just that: By growing cerebral organoids, or mini brains, derived from the cells of a group of patients with schizophrenia, Michal Stachowiak’s group from the University at Buffalo claimed to be one step closer to understanding the cause of this chronic and severe mental disorder.

Schizophrenia is typically understood as an illness that starts in the brain at a very early stage of development. Stachowiak’s researchers sought to test this older hypothesis using the latest technology—growing miniature organs that mimic the real brain at the earliest stages of fetal development.

The team used skin cells from one group of adult patients diagnosed with schizophrenia as well as a group of adults who were cognitively unimpaired, and, in a process that involves bathing the cells in nutrients and spinning them through a machine that prevents gravity from flattening them, developed organoids from both groups.

After growing the mini brains, Stachowiak ’s group compared the ‘schizophrenic organoids’ to the controls. The schizophrenic group, they discovered, showed architectural differences in the part of the brain known as the cortex: immature cells that would one day turn into the nerve cells known as neurons were spreading out in too many directions, with too much distance between them.

“Essentially there are hundreds if not thousands of defects in the genome [the genetic material of an organism] that lead to common diseases,” Stachowiak told Newsweek.

Stachowiak’s idea was to zero in on the changes or aberrations that this genetic pathway creates. And, he claims, problems in a genomic pathway known as INFS could lead to some of the physiological changes that are responsible for some of the symptoms of schizophrenia.

A figure from Stachowiak’s paper comparing images of the organoids from the control group to the experimental group. Courtesy of University at Buffalo

“I think for the first time we have a proper experimental tool to try to see if we can either correct or prevent some of these events,” Stachowiak said.

But Madeline Lancaster, a neuroscientist at Cambridge University who was one of the first to work on organoids as a research tool nearly eight years ago, took issue with the ones used in Stachowiak’s experiments.

Lancaster told Newsweek that trying to find some of the roots of schizophrenia using cerebral organoids was “an interesting premise,” but that the execution was lacking.

“It’s difficult with a really new field like this,” Lancaster said, admitting that her standards were “probably higher” than those of most researchers.

But, she added, the organoids that Stachowiak ’s group developed as part of this experiment were not well formed enough to make meaningful conclusions.

The organoids Stachowiak grew, Lancaster claims, were allowed to develop randomly in a way that introduces too much heterogeneity. The small size of the study is another issue: The study looks at three control organoids and four developed from the cells of people with schizophrenia.

Schizophrenia is a complicated diagnosis, one that is itself the subject of controversy. Organoids may be a fruitful way down the line of exploring some of these hypotheses, but the technology is still evolving. Studying the developmental factors that can contribute to schizophrenia is a live area of research, one that other neuroscientists are actively pursuing. But, as is the case with any innovation, an understanding of how best to use this new technology needs to be agreed on first.

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Head of FDA has harsh words about kratom use

A strongly worded statement this week from the commissioner of the Food and Drug Administration (FDA) warns of dangers of the plant-based product kratom and suggests that to this point it has no place in any treatment associated with opioid use disorders. Shortly after the statement was released, the consumer-based American Kratom Association (AKA) announced that it would ask the Department of Health and Human Services (HHS) to have this week’s FDA public health advisory related to kratom risks overturned, saying it is based on discredited claims.

The Nov. 14 statement from FDA Commissioner Scott Gottlieb, MD, says that kratom is increasingly being marketed to treat a variety of conditions, including symptoms of opioid withdrawal, despite risks of addiction and even death.

“The agency has a public health obligation to act when we see people being harmed by unapproved products passed off as treatments and cures for serious conditions,” Gottlieb said.

The AKA countered in a news release this week that there have been no documented deaths caused by kratom in the U.S., and suggested that any attempts to place restrictions on the product’s availability could drive consumers toward more harmful use of opioids.

“For years, the FDA has published scientifically inaccurate information on the health effects of consuming kratom, directly influencing regulatory actions by the [Drug Enforcement Administration], states and various local governmental entities,” a statement from the AKA reads.

The DEA last year slowed plans to place kratom under the same Schedule I classification as heroin (signifying no accepted medical use and a high potential for abuse), amid significant public protest. In addition, some researchers want to see more inquiry into the properties of the plant, which grows naturally in parts of Asia, because they believe this research could lead to more effective and less addictive pain treatments.

Gottlieb’s statement says that while the FDA remains open to kratom’s possible medicinal uses, more research is needed and a proper evaluative process involving both the FDA and the DEA would have to take place.

“It’s very troubling to the FDA that patients believe they can use kratom to treat opioid withdrawal symptoms,” Gottlieb said, adding, “There is no reliable evidence to support the use of kratom as a treatment for opioid use disorder.”

Kratom users have reported euphoric effects, but without the same type of intensity common to opioids. Withdrawal effects that have been cited as being associated with kratom’s use include muscle aches, mood swings and hallucinations.

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Patients should have access to all opioid dependence medications

To the medical director at Caron Treatment Centers, giving physicians and patients multiple options in treatment stands as a primary goal. That is why Joseph Garbely, DO, FASAM, is reassured by results of two recent studies, including one published this week, that showed comparable efficacy and safety between sublingual buprenorphine and injectable naltrexone for opioid dependence.

“We as physicians need choices,” Garbely tells Addiction Professional. And one factor remains unmistakable to him when it comes to treating patients with opioid addiction: “They have to be on medication-assisted treatment. We have to get them on medication-assisted treatment.”

Garbely says Caron definitely leans toward the monthly injectable Vivitrol as its preferred medication treatment for opioid dependence. As an extended treatment program, Caron is able to negotiate the factor that the most recently published of the two studies identifies as the main impediment to success with injectable naltrexone: the challenge of successful induction to the antagonist drug due to the patient needing to be opioid-free before receiving the initial dose.

This open-label U.S. study, published online this week in The Lancet, involved 570 adult patients with an opioid use disorder who were randomized to monthly injections of Vivitrol or daily self-administered doses of sublingual Suboxone film for 24 weeks. When looking only at patients who were successfully initiated on a medication, the researchers found similar rates of opioid-negative urine screens and patient relapse, as well as comparable adverse effect results. But the researchers reported that while the initiation rate was 94% in the buprenorphine group, it was only 72% in the injectable naltrexone group.

Lead author Joshua D. Lee, MD, of the New York University School of Medicine’s Department of Population Health, tells Addiction Professional that while the study results confirmed practical issues that already were well-known, such as the initiation challenge with injectable naltrexone, the main emphasis was to examine the trajectory of treatment with each of the medications over six months. “The heartening finding was that outcomes were comparably quite good for those initiating either treatment,” Lee says.

The other recently released study, a Norwegian study involving 159 patients that was published last month, found comparable efficacy and safety profiles between buprenorphine and injectable naltrexone over a three-month period. Garbely says that study bypassed the issue of induction.

“We needed to look at these two modalities head to head to see if both work, and are they safe,” says Garbely. Once patients were successfully initiated, patients on the medications had largely equivalent results, in both studies, he says.

Lee explains that in the study published this week, the comparative risk of relapse between the two medications appeared to favor buprenorphine at the early stages of the study, then evened out between the two drugs, and then appeared to skew more in favor of use of injectable naltrexone.

He hopes the findings will add to evidence that could convince more substance use treatment programs to offer their patients access to all of the available medications for opioid dependence, including methadone as well. Lee also says these findings should counteract the effect of some recent unflattering media portrayals of Vivitrol and the marketing efforts behind it—coverage that he believes has inaccurately portrayed the drug to some as “snake oil.”

Caron’s procedures

Garbely explains that after Caron patients in detox complete a Suboxone taper, they wait about seven days on average before they are initiated on Vivitrol. With opioid cravings predictably strong during that period, “This is a window where you have to engage the patient,” he says.

A number of factors play into the question of which medication treatment is selected for a particular patient, given that Caron uses both buprenorphine and injectable naltrexone post-detox. These considerations include any relevant medication history, insurance coverage, aftercare prospects, and compliance issues, with Vivitrol often seen as advantageous in terms of compliance because of its monthly dosing.

“There may be stakeholders in the patient’s family who’ll get them there for their monthly injection, rather than having to depend on the patient to take buprenorphine daily,” Garbely says.

Within the residential setting, Caron has had to build a system to make Vivitrol accessible and affordable to patients, since patients’ prescription benefits generally don’t kick in while they are in treatment. This has included the facility purchasing drug supplies from a wholesale pharmacy, says Garbely.

In a demonstration of Caron’s intensified commitment to medication as part of opioid dependence treatment, data from the last fiscal year indicate that 63% of Caron’s eastern Pennsylvania patients left treatment on some form of medication-assisted treatment, with provisions for ongoing medication treatment in the community. When Garbely arrived at Caron in 2015, that figure was only 19%.

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FDA clears nerve stimulator for opioid withdrawal symptoms

The U.S. Food and Drug Administration on Wednesday cleared for use an electrical nerve stimulator designed to reduce the symptoms of opioid withdrawal.

The device, made by privately held Innovative Health Solutions Inc., is placed behind the patient’s ear for up to five days during the acute withdrawal phase.

The FDA authorized the device, known as NSS-2 Bridge, after 73 patients experiencing opioid withdrawal saw a reduction of at least 31 percent in their symptoms.

Symptoms of withdrawal include sweating, tremors, sweating, stomach upset, joint pain and anxiety.

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Girls Who Are Raped Struggle With Horrible Health Problems All Their Lives

From Harvey Weinstein and Kevin Spacey to the more recent Roy Moore, there has been a steady bombardment of reports concerning men taking advantage of their power to commit acts of sexual abuse. Yes, sexual abuse is always traumatic, but psychologists agree that when the incidents happen during childhood and adolescence, while the brain and personality are still taking form, the mental and physical health consequences can be even more impactful.

The numbers do not lie—victims of childhood abuse seek medical treatment and report medical ailments more often than those without these adverse experiences. A 1996 study from Psychological Medicine showed that victims of childhood sexual abuse have higher rates of medical use and medical problems as adults as shown in both self-reported measures of health and self-reported doctor visits than individuals without a history of sexual abuse. These individuals visit the emergency room more often and have more internal medicine visits than their non-abused counterparts.

“In any kind of victimization during childhood and adolescence there are developmental vulnerabilities,” said Sherry Hamby, a research professor of psychology at the University of the South and founding editor of the research journal Psychology of Violence. “These are people still establishing their sense of identity. They are exploring their own sexuality for the first time as they enter adolescence, and it’s just a particularly vulnerable time to experience those kinds of harms and betrayals.”

Sexual abuse can lead to a number of health problems such as depression and obesity. MOHAMMED ABED/AFP/Getty Images

Sex abuse victims are not making up their symptoms, either, as there is concrete evidence that abuse leads to diagnosable health consequences. Depression and PTSD are often the most cited health problems stemming from childhood sexual abuse, with one 1999 study finding that childhood sexual abuse victims were three times as likely to become depressed as women without this history. Psychological effects from these mental health conditions can also impact physical health, such as obesity, which a 2004 report found was greater in these individuals with a history of childhood sexual abuse.

One of the main reasons for abuse’s effect on health may be linked to stress and stress-related hormones. According to Hamby, sexual abuse in minors can interfere with their cortisol regulation, which may also cause lifelong health problems. “Look at people who have a history of sexual victimization and they also have chronic diseases and sexual pain during intercourse, and some of this is due to the lasting effects of childhood brains and these stress hormones.” In addition, disruption of hormone regulation caused by the severe stress of childhood sexual abuse causes a number of health problems, ranging from digestive and gynecological to cardiopulmonary and pain, a 2010 report from the Journal of Pediatric Psychology revealed.

Equally detrimental, victims of childhood and adolescent sexual abuse are also more vulnerable to dangerous risk behaviors such as substance use, smoking, risky sex behaviors and lack of regular exercise.

Overall, life as a victim of childhood and adolescence sexual abuse is difficult, and the experience can set you back, making it harder to catch up with those who were lucky enough to escape such harms. There is good news, though. Hamby has been working with victims of sexual abuse for more than 20 years and has never seen such a positive response to sexual victims coming forward as she has this year.

“I hope that this turns out to be a turning point in our ability to reduce the amount of sexual violence in our country,” she said.

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