Codependency Is Sneaky and Powerful

Focusing thinking and behavior around someone else is a sign of codependency. We react to something external, rather than our own internal cues. Addicts are codependent, too. Their lives revolve around their addiction – be it food, work, drugs, or sex.

Codependency derived from the term “co-alcoholic,” originating in studies of family members of substance abusers who interfered with recovery by enabling.

Family therapists found that their codependent behavior developed in their childhood growing up in a dysfunctional family. In the 40s, German psychoanalyst and humanist Karen Horney wrote about neurotic behavior caused by self-alienation. She described personality types that fit codependency and believed that they resulted from faulty parenting and the “tyranny of the shoulds.”

The 12-step program Codependents Anonymous (CoDA) was founded in 1986 by Ken and Mary, two therapists who had grown up in abusive families.

Definitions

Codependency is considered a disorder in the American Psychiatric Association, due to lack of consensus on a definition and empirical research. However, the Diagnostic Statistical Manual of Mental Disorders does list a dependent personality disorder, described as someone more passive, submissive, and dependent than most codependents. In 1989, experts at a National Conference arrived at a suggested definition: “A pattern of painful dependency on compulsive behaviors and on approval from others in an attempt to find safety, self-worth and identity.” Other definitions by experts in the field include:

* Melody Beattie: Allowing another person’s behavior to affect him or her and obsessing

about controlling that person’s behavior.

* Earnie Larsen: A diminished capacity to initiate, or participate in, loving relationships.

* Robert Subby: Resulting from prolonged exposure to oppressive rules.

* John Bradshaw & Pia Melody: A symptom of abandonment – a loss of ones inner reality and an addiction to outer reality.

* Sharon Wegscheider-Cruse: A brain disorder that leads codependents to seek the relief of soothing brain chemicals, which are released through compulsive behaviors, including addiction to work, substances, gambling, food, sex, and/or relationships.

* Charles Whitfield: A disease of a lost selfhood.

Beattie’s and Larsen’s definition centers on relationship behavior. I agree with Bradshaw, Melody, and Whitfield that codependency resides in us whether or not we’re in a relationship. I also agree with Wegscheider-Cruse that addicts are codependent and that relief is sought through substances, processes, and people. However, unlike Cruse, I believe codependency is learned behavior that’s trans-generational. Other influences are cultural and religious biases. Although research shows that some teens had brain abnormalities even before they became drug addicts, their twins did not become addicted, so the full impact of genetic and organic causes is still unclear, particularly in view of the brain’s plasticity in adolescence.

Core Feelings and Behavior

Codependent feelings and behavior vary in degree on a continuum. Like a disease and addiction, if untreated symptoms become compulsive and worsen in stages over time.

Core feelings include:

  • Denial
  • Low Self-esteem
  • Painful emotions: Shame, Guilt, Anger and Resentment, Anxiety, Depression
  • Core Behaviors include:

  • Dependency
  • Intimacy problems
  • Dysfunctional communication
  • Dysfunctional boundaries
  • Control of oneself and/or others (includes Caretaking)
  • Core feelings and behaviors create other problems, such as, people-pleasing, self-doubt, mistrust, perfectionism, high-reactivity, enabling, and obsessions. Codependents are usually more attuned to other people’s needs and feelings than their own. To quell anxiety about rejection, they try to accommodate others, while ignoring their own needs, wants, and feelings. As a result, they tend to lose their autonomy, particularly in intimate relationships. Over time, their self-worth declines due to self-alienation and/or allowing others to devalue them.

    Codependents have varied personalities, and symptoms differ in type and severity among them. They also have diverse attachment styles. Not all are caretakers or are even in a relationship. Some seek closeness, while others avoid it. Some are addicts, bullies, selfish, and needy, or may appear independent and confident, but they attempt to control, or are controlled by, a personal relationship or their addiction. Sometimes that relationship is with an addict or narcissist. A relationship that is one-sided or marked by addiction or abuse is a sign of codependency. But not all codependent relationships are one-sided or abusive.

    Recovery

    Untreated codependency can lead to severe anxiety, depression, and health problems. There is help for recovery and change. Recovery goes through stages that normalize codependent symptoms. The goal of recovery is to be a fully functioning adult who is:

  • Authentic
  • Autonomous
  • Capable of intimacy
  • Assertive and congruent in expression of values, feelings, and needs
  • Flexible without rigid thinking or behavior
  • Become informed. Get guidance and support. Codependent patterns are deeply ingrained habits and difficult to identify and change on your own. It often takes an experienced third party to identify them and to suggest alternative beliefs and responses. Therapy and 12-Step meetings provide this. In recovery, you will:

  • Come out of denial
  • Let go of others
  • Build an autonomous Self
  • Raise your self-esteem
  • Find pleasure – develop friends, hobbies
  • Heal past wounds
  • Learn to be assertive and set boundaries
  • Pursue larger goals and passions
  • Self-Help and Therapy

    Codependency is highly recoverable, but requires effort, courage, and the right treatment. A therapist should be knowledgeable in treating codependency, shame, and self-esteem, as well as be able to teach healthier behavioral and communication skills. Cognitive-behavior therapy is effective in raising self-esteem and changing codependent thinking, feelings, and behavior. In some cases, trauma therapy is also indicated.

    Recovery can generate more anxiety, so it’s important to maintain a self-help support system such as, Al-Anon or CoDA 12-Step programs to build self-esteem and become more assertive.

    ┬ęDarleneLancer 2019

    ADHD – An Overview

    ADHD is neither a “new” mental health problem nor is it a disorder created for the purpose of personal gain or financial profit by pharmaceutical companies, the mental health field, or by the media. It is a very real behavioral and medical disorder that affects millions of people nationwide. According to the National Institute of Mental Health (NIMH), ADHD is one of the most common mental disorders in children and adolescents. According to NIMH, the estimated number of children with ADHD is between 3% – 5% of the population. NIMH also estimates that 4.1 percent of adults have ADHD.

    Although it has taken quite some time for our society to accept ADHD as a bonafide mental health and/or medical disorder, in actuality it is a problem that has been noted in modern literature for at least 200 years. As early as 1798, ADHD was first described in the medical literature by Dr. Alexander Crichton, who referred to it as “Mental Restlessness.” A fairy tale of an apparent ADHD youth, “The Story of Fidgety Philip,” was written in 1845 by Dr. Heinrich Hoffman. In 1922, ADHD was recognized as Post Encephalitic Behavior Disorder. In 1937 it was discovered that stimulants helped control hyperactivity in children. In 1957 methylphenidate (Ritalin), became commercially available to treat hyperactive children.

    The formal and accepted mental health/behavioral diagnosis of ADHD is relatively recent. In the early 1960s, ADHD was referred to as “Minimal Brain Dysfunction.” In 1968, the disorder became known as “Hyperkinetic Reaction of Childhood.” At this point, emphasis was placed more on the hyperactivity than inattention symptoms. In 1980, the diagnosis was changed to “ADD–Attention Deficit Disorder, with or without Hyperactivity,” which placed equal emphasis on hyperactivity and inattention. By 1987, the disorder was renamed Attention Deficit Hyperactivity Disorder (ADHD) and was subdivided into four categories (see below). Since then, ADHD has been considered a medical disorder that results in behavioral problems.

    Currently, ADHD is defined by the DSM IV-TR (the accepted diagnostic manual) as one disorder which is subdivided into four categories:

    1. Attention-Deficit/Hyperactivity Disorder, Predominantly Inattentive Type (previously known as ADD) is marked by impaired attention and concentration.

    2. Attention-Deficit/Hyperactivity Disorder, Predominantly Hyperactive, Impulsive Type (formerly known as ADHD) is marked by hyperactivity without inattentiveness.

    3. Attention-Deficit/Hyperactivity Disorder, Combined Type (the most common type) involves all the symptoms: inattention, hyperactivity, and impulsivity.

    4. Attention-Deficit/Hyperactivity Disorder Not Otherwise Specified. This category is for the ADHD disorders that include prominent symptoms of inattention or hyperactivity-impulsivity, but do not meet the DSM IV-TR criteria for a diagnosis.

    To further understand ADHD and its four subcategories, it helps to illustrate hyperactivity, impulsivity, and/or inattention through examples.

    Typical hyperactive symptoms in youth include:

    • Often “on the go” or acting as if “driven by a motor”
    • Feeling restless
    • Moving hands and feet nervously or squirming
    • Getting up frequently to walk or run around
    • Running or climbing excessively when it’s inappropriate
    • Having difficulty playing quietly or engaging in quiet leisure activities
    • Talking excessively or too fast
    • Often leaving seat when staying seated is expected
    • Often can’t be involved in social activities quietly

    Typical symptoms of impulsivity in youth include:

    • Acting rashly or suddenly without thinking first
    • Blurting out answers before questions are fully asked
    • Having a difficult time awaiting a turn
    • Often interrupting others’ conversations or activities
    • Poor judgment or decisions in social situations, which result in the child not being accepted by his/her own peer group.

    Typical symptoms of inattention in youth include:

    • Not paying attention to details or makes careless mistakes
    • Having trouble staying focused and being easily distracted
    • Appearing not to listen when spoken to
    • Often forgetful in daily activities
    • Having trouble staying organized, planning ahead, and finishing projects
    • Losing or misplacing homework, books, toys, or other items
    • Not seeming to listen when directly spoken to
    • Not following instructions and failing to finish activities, schoolwork, chores or duties in the workplace
    • Avoiding or disliking tasks that require ongoing mental effort or concentration

    Of the four ADHD subcategories, Hyperactive-Impulsive Type is the most distinguishable, recognizable, and the easiest to diagnose. The hyperactive and impulsive symptoms are behaviorally manifested in the various environments in which a child interacts: i.e., at home, with friends, at school, and/or during extracurricular or athletic activities. Because of the hyperactive and impulsive traits of this subcategory, these children naturally arouse the attention (often negative) of those around them. Compared to children without ADHD, they are more difficult to instruct, teach, coach, and with whom to communicate. Additionally, they are prone to be disruptive, seemingly oppositional, reckless, accident prone, and are socially underdeveloped.

    Parents of ADHD youth often report frustration, anger, and emotional depletion because of their child’s inattention, impulsivity, and hyperactivity. By the time they receive professional services many parents of ADHD children describe complex feelings of anger, fear, desperation, and guilt. Their multiple “failures” at getting their children to focus, pay attention, and to follow through with directions, responsibilities, and assignments have resulted in feelings of hopelessness and desperation. These parents often report feeling guilty over their resentment, loss of patience, and reactive discipline style. Both psychotherapists and psychiatrists have worked with parents of ADHD youth who “joke” by saying “if someone doesn’t help my child, give me some medication!”

    The following statistics (Dr. Russel Barkley and Dr. Tim Willens) illustrate the far reaching implications of ADHD in youth.

    • ADHD has a childhood rate of occurrence of 6-8%, with the illness continuing into adolescence for 75% of the patients, and with 50% of cases persisting into adulthood.
    • Boys are diagnosed with ADHD 3 times more often than girls.
    • Emotional development in children with ADHD is 30% slower than in their non-ADHD peers.
    • 65% of children with ADHD exhibit problems in defiance or problems with authority figures. This can include verbal hostility and temper tantrums.
    • Teenagers with ADHD have almost four times as many traffic citations as non-ADD/ADHD drivers. They have four times as many car accidents and are seven times more likely to have a second accident.
    • 21% of teens with ADHD skip school on a regular basis, and 35% drop out of school before finishing high school.
    • 45% of children with ADHD have been suspended from school at least once.
    • 30% of children with ADHD have repeated a year of school.
    • Youth treated with medication have a six fold less chance of developing a substance abuse disorder through adolescence.
    • The juvenile justice system is composed of 75% of kids with undiagnosed learning disabilities, including ADHD.

    ADHD is a genetically transmitted disorder. Research funded by the National Institute of Medical Health (NIMH) and the U.S. Public Health Service (PHS) have shown clear evidence that ADHD runs in families. According to recent research, over 25% of first-degree relatives of the families of ADHD children also have ADHD. Other research indicates that 80% of adults with ADHD have at least one child with ADHD and 52% have two or more children with ADHD. The hereditary link of ADHD has important treatment implications because other children in a family may also have ADHD. Moreover, there is a distinct possibility that the parents also may have ADHD. Of course, matters get complicated when parents with undiagnosed ADHD have problems with their ADHD child. Therefore, it is crucial to evaluate a family occurrence of ADHD, when assessing an ADHD in youth.

    Diagnosing Attention Deficit Disorder Inattentive Type in youth is no easy task. More harm than good is done when a person is incorrectly diagnosed. A wrong diagnosis may lead to unnecessary treatment, i.e., a prescription for ADHD medication and/or unnecessary psychological, behavioral and/or educational services. Unnecessary treatment like ADHD medication may be emotionally and physically harmful. Conversely, when an individual is correctly diagnosed and subsequently treated for ADHD, the potential for dramatic life changes are limitless.

    A medical doctor (preferably a psychiatrist) or another licensed, trained, and qualified mental health professional can diagnose ADHD. Only certain medical professionals can prescribe medication. These are physicians (M.D. or D.O.), nurse practitioners, and physician assistants (P.A.) under the supervision of a physician. However, psychiatrists, because of their training and expertise in mental health disorders, are the best qualified to prescribe ADHD medication.

    While the ADHD Hyperactive Type youth are easily noticed, those with ADHD Inattentive Type are prone to be misdiagnosed or, worse, do not even get noticed. Moreover, ADHD Inattentive Type youth are often mislabeled, misunderstood, and even blamed for a disorder over which they have no control. Because ADHD Inattentive Type manifests more internally and less behaviorally, these youth are not as frequently flagged by potential treatment providers. Therefore, these youth often do not receive potentially life-enhancing treatment, i.e., psychotherapy, school counseling/coaching, educational services, and/or medical/psychiatric services. Unfortunately, many “fall between the cracks” of the social service, mental health, juvenile justice, and educational systems.

    Youth with unrecognized and untreated ADHD may develop into adults with poor self concepts low self esteem, associated emotional, educational, and employment problems. According to reliable statistics, adults with unrecognized and/or untreated ADHD are more prone to develop alcohol and drug problems. It is common for adolescents and adults with ADHD to attempt to soothe or “self medicate” themselves by using addictive substances such as alcohol, marijuana, narcotics, tranquilizers, nicotine, cocaine and illegally prescribed or street amphetamines (stimulants).

    Approximately 60% of people who had ADHD symptoms as a child continue to have symptoms as adults. And only 1 in 4 of adults with ADHD was diagnosed in childhood-and even fewer are treated. Thanks to increased public awareness and the pharmaceutical corporations’ marketing of their medications, more adults are now seeking help for ADHD. However, many of these adults who were not treated as children carry emotional, educational, personal, and occupational “scars.” As children, these individuals, did not feel “as smart, successful and/or likable” as their non ADHD counterparts. With no one to explain why they struggled at home, with friends, and in school, they naturally turned inward to explain their deficiencies. Eventually they internalize the negative messages about themselves, thereby creating fewer opportunities for success as adults.

    Similarly to youths, adults with ADHD have serious problems with concentration or paying attention, or are overactive (hyperactive) in one or more areas of living. Some of the most common problems include:

    • Problems with jobs or careers; losing or quitting jobs frequently
    • Problems doing as well as you should at work or in school
    • Problems with day-to-day tasks such as doing household chores, paying bills, and organizing things
    • Problems with relationships because you forget important things, can’t finish tasks, or get upset over little things
    • Ongoing stress and worry because you don’t meet goals and responsibilities
    • Ongoing, strong feelings of frustration, guilt, or blame

    According to Adult ADHD research:

    • ADHD may affect 30% of people who had ADHD in childhood.
    • ADHD does not develop in adulthood. Only those who have had the disorder since early childhood really suffer from ADHD.
    • A key criterion of ADHD in adults is “disinhibition”–the inability to stop acting on impulse. Hyperactivity is much less likely to be a symptom of the disorder in adulthood.
    • Adults with ADHD tend to forget appointments and are frequently socially inappropriate–making rude or insulting remarks–and are disorganized. They find prioritizing difficult.
    • Adults with ADHD find it difficult to form lasting relationships.
    • Adults with ADHD have problems with short-term memory. Almost all people with ADHD suffer other psychological problems–particularly depression and substance abuse.

    While there is not a consensus as to the cause of ADHD, there is a general agreement within the medical and mental health communities that it is biological in nature. Some common explanations for ADHD include: chemical imbalance in the brain, nutritional deficiencies, early head trauma/brain injury, or impediments to normal brain development (i.e. the use of cigarettes and alcohol during pregnancy). ADHD may also be caused by brain dysfunction or neurological impairment. Dysfunction in the areas in the frontal lobes, basal ganglia, and cerebellum may negatively impact regulation of behavior, inhibition, short-term memory, planning, self-monitoring, verbal regulation, motor control, and emotional regulation.

    Because successful treatment of this disorder can have profound positive emotional, social, and family outcomes, an accurate diagnosis is tremendously important. Requirements to diagnose ADHD include: professional education (graduate and post graduate), ongoing training, supervision, experience, and licensure. Even with the essential professional qualifications, collaboration and input from current or former psychotherapists, parents, teachers, school staff, medical practitioners and/or psychiatrists creates more reliable and accurate diagnoses. The value of collaboration cannot be understated.

    Sound ethical practice compels clinicians to provide the least restrictive and least risky form of therapy/treatment to youth with ADHD. Medication or intensive psycho-therapeutic services should only be provided when the client would not favorably respond to less invasive treatment approaches. Therefore, it is crucial to determine whether “functional impairment” is or is not present. Clients who are functionally impaired will fail to be successful in their environment without specialized assistance, services, and/or psycho-therapeutic or medical treatment. Once functional impairment is established, then it is the job of the treatment team to collaborate on the most effective method of treatment.

    All too often, a person is mistakenly diagnosed with ADHD, not due to attention deficit issues, but rather because of their unique personality, learning style, emotional make-up, energy and activity levels, and other psycho-social factors that better explain their problematic behaviors. A misdiagnosis could also be related to other mental or emotional conditions (discussed next), a life circumstance including a parent’s unemployment, divorce, family dysfunction, or medical conditions. In a small but significant number of cases, this diagnosis of ADHD better represents an adult’s need to manage a challenging, willful and oppositional child, who even with these problems may not have ADHD.

    It is critical that before an ADHD diagnosis is reached (especially before medication is prescribed), that a clinician consider if other coexisting mental or medical disorders may be responsible for the hyperactive, impulsive, and/or inattentive symptoms. Because other disorders share similar symptoms with ADHD, it is necessary to consider the probability of one mental/psychological disorder over that of another that could possibly account for a client’s symptoms. For example, Generalized Anxiety Disorder and Major Depression share the symptoms of disorganization, lack of concentration, and work completion issues. A trained and qualified ADHD specialist will consider differential diagnoses in order to arrive at the most logical and clinically sound diagnosis. Typical disorders to be ruled out include: Generalized Anxiety, Major Depression, Post Traumatic Stress Disorder, and Substance Abuse Disorders. Additionally, medical explanations should be similarly sought: sleep disorders, nutritional deficiencies, hearing impairment, and others.

    When a non-medical practitioner formally diagnoses a client with ADHD, i.e. a licensed psychotherapist, it is recommended that a second opinion (or confirmation of the diagnosis) be sought from a psychiatrist. Psychiatrists are medical practitioners who specialize in the medical side of mental disorders. Psychiatrists are able to prescribe medicine that may be necessary to treat ADHD. In collaboration, the parents, school personnel, the referring psychotherapist, and the psychiatrist, will monitor the effectiveness of the medical component of the ADHD treatment.

    In summary, ADHD is a mental health and medical disorder that has become increasingly more accepted and consequently treated more effectively. To achieve high professional assessment, diagnostic, educational, and treatment standards, it is important that trained and qualified practitioners understands the multidimensional aspects of ADHD: history, diagnosis, statistics, etiology, and treatment. Training, experience, a keen interest for details, a solid foundation of information, and a system of collaboration creates the potential for positive outcomes in the treatment of ADHD.

    References and citations are available upon email request: [email protected]

    Life Skills and Trauma Stressors

    Health professionals may be baffled when survivors of trauma come to them after recovery, on reassessment, find out symptoms have recurred.

    Trauma is a serious assault on a human’s life functioning.

    What happens to get in the way of a regular day-to-day activity like paying the bills or problem-solving to suddenly make it all seem like a monumental feat?

    Could it be a day or two before, or after a holiday gathering that negative emotions or physical symptoms got triggered, and a survivor remembers a traumatic moment that surfaces without a warning?

    Trauma happens to people who experienced a psychologically distressing and life-risking event. A person having survived an accident, injuries, illness, physical, verbal, emotional or sexual abuse, or other crime; a person who is a war veteran, army officer, or settlement refugee who comes from war-torn or a violent country; it can happen to a search and rescue worker; natural disaster survivor, or a bystander of a traumatic episode.

    A survivor can relive moments of terror, feelings of culpability, remorse, rage, or disillusionment about life.

    Reliving a traumatic event can arouse emotions that cause fatigue, low energy, weepiness or lack of concentration or impatience with others. Outbursts of anger happen for no reason. The memory of trauma comes by flashbacks and nightmares, and it can become so severe it’s difficult to lead a normal life.

    Unbeknownst to a survivor of trauma, belief that healing has taken place and recovery is over and done with plays havoc on the mind. Thoughts, feelings and emotions are stirred-up. Without warning, symptoms return to cause grief. The ability to manage simple home or work tasks becomes daunting.

    Joint pain or inability to sleep throughout the night can occur during a traumatic flashback. Agitation and self-inquiry like “who am I” and “will I ever feel normal? Or “am I going crazy?”

    Disharmony grows in relationships and clouds of doom become a veil over the survivor.

    The Canadian Mental Health Association reports this kind of impact can develop into acute anxiety or more commonly “post-traumatic stress disorder (PTSD).”

    PTSD is one of several conditions known as an anxiety disorder. It affects about 1 in 10 people, characterized by reliving a psychologically traumatic situation, long after any physical danger involved has passed.

    Taking care to know and understand disruptive emotions that could arise after flashbacks are vital life skills tools.

    Self-awareness and self-care is arsenal for a trauma-episodic memory.

    Life can suddenly become crushing because an onset of images, conversations, smells, or sounds, serve to remind something happening now related to a traumatic event back then.

    Psychology Today reports PTSD affects about 7.7 million American adults. It is often accompanied by depression, substance abuse, gambling, eating and anxiety disorders.

    When other conditions are appropriately diagnosed and treated, the likelihood of successful treatment increases.

    Mayo Clinic oncologist Edward T. Cregan M.D. explains coping with traumatic stress is an ongoing process. He explains we’ll be of more help to our loved one (to ourselves) if we learn about the effects of trauma.

    Life skills can help people draw from a broad range of problem-solving behaviours to meet the challenges at work, home or socially. The extent to which an individual with trauma integrates survival behaviours in their lives after their trauma is in itself a measure of success and deserves much support.

    In trauma recovery people learn during their healing it is important to accept feelings of denial, to keep active, seek support, face reality of the triggers, and to ground themselves after a flashback.

    Trauma survivors need to take time to process feelings associated with the experience and know how to find quiet time to be alone or find someone in the family or among friends to share the experience. They need to know sharing the experience is accepted without judgment.

    The key is to recognize trauma might surface at different times of the year.

    Dr. Cregan describes the best way to approach trauma is by finding some ways of normalising it – thinking about not being overwhelmed or frightened by symptoms and difficulties (as opposed to catastophising thoughts like, ‘It’s happening again, I am back to square one’ and emphasising coping strategies like staying active, taking care of yourself, seeking social support).

    Family members and friends care deeply, yet hold beliefs healing should be done with quickly. This can hinder a trauma survivor’s healing. Advocating “life is too short” and “stop focusing on the past – get over it” prolongs the curing period.

    Healing takes time and it is different for everyone.

    Family physicians notably agree it is part of essential life skills for a survivor to understand and express feelings, deal with anger associated with trauma, and safeguard thought processes so as not to undermine the ability to cope day-to-day.

    Awareness is essential.

    Emotional wounds take time to heal, or some cases may never heal.

    Emotions from a traumatic event can take years to show up and when they do, it’s a rude awakening. A realization surfaces to reexamine the memory and the pain associated with it. What can happen is a recall of more memory, adding to the original trauma. Once this happens, it deserves the processing time for the survivor to work through it, and get ready to come out at the other end stronger for it.

    Trauma can cause ongoing problems with self-esteem. It affects management of simple life skills. Overcoming trauma is easier for some than others. Some go on to inspire others who is just entering the dark stage of a life-changing journey.

    The impact of trauma on the entire person and the range of therapeutic issues are what need to be addressed. Recovery happens when the person is ready to move past the pain of it.

    Symptoms come back in bits and pieces, like a flashback in a movie trailer – it can subside.

    Dr. Creagan believes we can help a loved one with post-traumatic stress by being willing to listen, but don’t push. Choose a time when you’re both ready to talk.

    During the process of recovery from trauma, it can take months, years, even decades. For some, PTSD never leaves.

    Trauma assaults a person’s ability to manage simple life skills. Generally this is needed to help understand the world around or know the tools to allow a fulfilling life. Daily tasks, going to school or work, building relationships, or one’s personal feelings of belongingness or connectedness become visibly exhausting.

    Trauma symptoms get in the way of meeting ambitions to live to one’s full potential.

    Many treatments are available for PTSD to meet the unique needs of the survivor.

    Everyone is different, so a treatment by someone experienced with PTSD may work for one person and may not work for another.

    Life coaching is available to give supportive listening – without attempts to repair but help resolve some of the strong feelings such as shame, anger, or guilt. A life coach can offer strategies to help map out a plan to get beyond PTSD and work at meeting life goals based on a new method of human functioning.

    A life skills approach to trauma is about finding a new personal life balance. Breaking through another wall of understanding and self discovery during recovery of trauma, is about learning to live with a new agenda of coping skills. Taking time to find what works best during healing from the effects of trauma is worthy of investment.

    Giving up is not an option, but seeking self-love and understanding, or getting the help needed all bring added successes to an especially brave life of a survivor living with the stresses of a past trauma.

    Short-Term Application Of Intravenous Amino Acids For The Control Of Cravings And Withdrawal

    Addiction and substance abuse is undermining the very moral fabric and future of America today. In 1995 it was estimated that the cost of alcohol and other drugs reached a staggering figure of 276 billion, not including the pain and suffering of loved ones and friends. Alcoholics have an estimated decrease in life expectancy of 10-15 years, with alcohol the most frequently used and abused intoxicant and involved in 40% of all fatal motor vehicle accidents (1 and 2).

    Although not illegal, nicotine accounts for approximately 25 million people addicted and is the cause of 430,000 tobacco related deaths per year.

    The most commonly abused opiates are, heroin and methadone. It has been estimated by the National Institute of Drug Abuse that approximately 2.5 million Americans have a history of heroin abuse (3).

    Stimulants such as cocaine are widespread as well in America and it is estimated 72 million Americans have tried or are using or cocaine (3).

    Methamphetamine is growing at an unstoppable rate due to the ease of making the drug, and is now competing with cocaine as a drug of choice.

    Although there are numerous examples of addictive drugs in America they all show similar symptoms and qualities of craving and withdrawal conditions. The individuals at greatest risk are genetically predisposed through a neurochemical pathway that alters the minds perception of pleasure and reward. Kenneth Blum, coined the term, “Reward Deficiency Syndrome,” to relate to the neurotransmitter deficit that occurs due to use of drugs and alcohol. Although the pathways may vary, depending on the abused substance, they all show a common final neurochemical pathway in their expression of euphoria when abundant, and craving when deficient.

    The important Amino-peptide neurotransmitters to date are serotonin, dopamine, GABA and the enkephalins. Dopamine specifically is the neurotransmitter of pleasure. When dopamine is in abundance, it provides a state of well-being. Although this research will focus on alcohol, there are many other substances that can alter the increase in dopamine resulting in pleasure. Other altering scenarios can be glucose, impulsive/compulsive disorders, gambling and risk-taking activities, opiates, cocaine and cigarettes.

    When the brain is supplied with a substance a momentary spike in neurotransmitter activity of dopamine occurs. The body then reacts to down regulate this excessive increase by down regulating the neurotransmitter sites of production or receptor sites, or by increasing the breakdown of neurotransmitters. Because of this, the brain develops tolerance and the need for more of the drug to prevent a state of withdrawal.

    The point at which addiction can occur is variable and based on the individual’s genes. Recently, the dopamine D2 receptor called the A1allele, has been known to be a greater prevalence for alcoholics, opiate or cocaine addicts.

    This pleasure and reward system was discovered, by accident, in 1954 by James Otis. By mistake, Otis placed electrodes in the Para limbic system of rats. In doing so, Otis observed he could elicit a pleasure response. This response caused the rats to continuously press a lever, causing an electrical stimulation to this area even to the point of starvation. It was later noted that an increase in dopamine was being released in regions of the limbic system, specifically the nucleus accumbens and the hippocampus.

    Recently, a pharmacological approach to alter these neurotransmitters and help people with reward deficiency syndrome has been found. Studies by Brown and Blum indicate that certain amino acid precursors can relieve cravings and reduce incidents of a relapse. Oral formulas have been formulated and produced with these amino acids, vitamins and minerals cofactors. Recently an intravenous pharmacological approach utilizing amino acid neurotransmitter precursors have shown to have an immediate and profound effect on craving reduction and withdrawals in 86% of the patients with no side effects noted by this researcher or by Excel treatment facility during the last two years. The intravenous amino acids, vitamins, and mineral therapy appears to augment the dopamine and serotonin levels while the body begins to return to better handling oral nutrients and neurotransmitter homeostasis.

    This study has been implemented to determine the efficacy of intravenous amino acids to reduce withdrawal and craving from substance abuse.

    Methodology

    Nine subjects were picked from phone in volunteers from a local Denver newspaper add (Exhibit 1).

    Inclusion into the study are individuals who are between the ages of 18 and 50 years old, in good health, not court ordered and who desire to stop their substance abuse, but to date, are unable to do so. Methadone or a history of psychiatric hospitalize subjects are excluded from this study. All subjects will undergo a history and physical exam and a doctor will be present at all times. Initials will be used for publishing purposes only and strict confidentiality will be observed of all subjects.

    The treatment subjects will undergo 10 sessions (Monday through Friday) of a multi amino acid, vitamin and mineral solution in a 250cc ½ NS bag group or a placebo group of Vitamins (B2, B12 and Folate) in a 250cc ½ NS bag with matching color and volume. All subjects will undergo drug testing for their addiction including random breath and/or urine drug tests.

    If you smoke, you will be asked to keep track of the number of cigarettes smoked daily.

    To be entered into the research group each individual must meet the requirement of the Diagnostic and Statistical Manual of Mental Disorders TR (DSM-IV TR) for an Axis-I drug dependence.

    Axis-I 303.90 Alcohol Dependence

    Axis-I 304.40 Amphetamine Dependence Including Methamphetamine

    Axis-I 304.30 Cannabis Dependence

    Axis-I 304.20 Cocaine Dependence

    Axis-I 305.10 Nicotine Dependence

    Axis-I 304.00 Opioid Dependence

    Axis-I 304.90 Polysubstance-related Disorder

    Other axis-I substance dependence disorders will be assessed on a case-by-case basis.

    The research subjects will be placed randomly into two equal groups A and B.

    The control-or placebo-group will receive an intravenous solution of 250 cc of a ½ normal saline bag with B2, B12 and folate to give the distinctive color to the bags.

    The experimental group will be given an intravenous solution consisting of a patented formula titled TGGRS Treatment (Third Generation Genetic Repair System). The Tigers Treatment consists of multi amino acids, vitamins and mineral solution drip over a 1 & 2-hour period for 10 sessions. All subjects will be randomly be monitored by blowing a B.A.C. or urine drug tests. A questionnaire will also be required to rate their craving and anxiety symptoms each session. Specific cravings will be rated from a zero (0)-indicating no craving or withdrawal, to a ten (10)-indicating maximum craving or withdrawal symptoms.

    The intravenous bags will be marked “Group A” and “Group B” and will be made by a local compounding pharmacist. He will have no contact with the subjects. Heart rate, blood pressure and level of subject mental status will be conducted before each session. During the study, all subjects will be asked to eliminate or cut back on their alcohol or drug consumption but at any time may voluntary return to their pre-study consumption level, or be asked to by the doctor, if sever withdrawal symptoms occur. Failure to participate in 90% of the study will be grounds for dismissal. The people involved in administering the I.V. and monitoring the people will not know which bags contain the amino acids and which contain the placebo. At the end of 10-days the pharmacists will expose which group was the experimental group and which group was the placebo group-A or B, respectively. At that time the experimental and the placebo groups will undergo a daily debriefing and questionnaire rating their withdrawal symptom success and anti-craving level.

    At the end of 10 sessions, the treatment group will be given 5 additional treatments of the same solution with D-phenylalanine added. Afterwards, the placebo group will get the treatment solution for 5 sessions followed by 5 session with D-phenylalanine added. All subjects at the end of their intravenous sessions will be debriefed and given the opportunity to take a one months worth of a similar oral based formula for maintenance efficacy.

    Results

    To stay sober, the war on addiction has many battlefronts to concour from dealing with initial withdrawals and craving to handling family and friend enablers, denial, stress, temptation and faith that we can overcome the disease that seals the heart, soul and life of mankind.

    From Jan 21 until Feb 17th nine volunteers under took a major step to sobriety by introducing nutrition building blocks of neurotransmitters by intravenous means to battle withdrawal and cravings aspects. Only one individual had no response to our amino acids vitamin and mineral cocktail and continue daily drinking with no perceived change in anxiety and craving. All others expressed a significant response from moderate to profound anti-craving benefits by the end of the study.

    The A group (RH, RY, KM, RA) received vitamins for the first 10 sessions, and although noticed a slight reduction in craving and anxiety, RY, KM, KA continued to drink. RH had marijuana addiction problems and throughout the study he did not use. The B group (RM, DR, RD, DB, JD) received the therapeutic formula less the D isomer of phenylalanine. They all continued drinking and showed no significant change in craving and anxiety. The A group noticed no significant change as well to 5 days of the therapeutic formula minus the D isomer. It wasn’t until the last 5 days in both groups that a significant response in drinking reduction in sobriety along with cravings and anxiety reduction occurring.

    The D isomer of phenylalanine appears to be a crucial component in withdrawal and craving issues. Addition to alcohol and drugs is caused by an imbalance or defiency of neurotransmitter activity in a cascade mode. Per Dr Blum serotonin releases enkephalin in the hypothalamus and enkephalin inhibits the release of GABA in the substantia nigra. The inhibition of GABA permits the release of dopamine in both the nucleus accumbens and the hippocampus.

    Apparently up regulation of serotonin by tryptofan is not enough to release sufficient enkephalins to have an impact on up regulating dopamine despite direct stimulation of L-phenylalanine and L-tyrosine on increased dopamine production. The D form of phenylalanine, which inhibits enkephalin, appears paramount in the cascade theory and therefore causing substantial anxiety and craving reduction. Enkephlins are nature’s natural painkillers and a reduction in pain appears critical to suppressing withdrawal and craving symptoms as well as balancing neurotransmitters. This study supports the 86% recovery rate in retrospective review of the current intravenous amino acid (TGGRS solution) being conducted at Excel treatment and recovery program. However, future clinical trials with genetic testing and greater numbers coupled with a variety of addictions would better support statistical efficacy of intravenous amino acid supplementation. In addition, why 10 to 15 percent of the population fail this program possibly could be cause from a yet unknown genetic pathway of metabolism with nationality possibly playing a role in this failure rate.

    Conclusion

    The TGGRS intravenous amino acid program in its current formula had statistical efficacy in nine patient’s ability to handle their craving and anxiety perception and their ability to withdraw from alcohol. The D-phenylalanine isomer appears to be an essential ingredient to this formula. Together with education and counselling and nutrition, intravenous amino acid supplementation will prove to be a powerful tool in initially combating the evil grasp of addiction in today’s society.