Recovery Michigan

Child abuse. Rape. Sexual assault. Brutal physical attack. Being in a war and witnessing violence, bloodshed, and death from close quarters. Near death experiences. These are extremely traumatic events, and some victims bear the scars for life.

The physical scars heal, but some emotional wounds stop the lives of these people dead in their tracks. They are afraid to get close to people or form new relationships. Change terrifies them, and they remain forever hesitant to express their needs or give vent to their creative potential. It may not be always apparent, but post-traumatic stress disorder (PTSD) stifles the life force out of its victims. It is no use telling them to “get over” it because PTSD fundamentally changes the brain’s structure and alters its functionalities.

The most significant neurological impact of trauma is seen in the hippocampus. PTSD patients show a considerable reduction in the volume of the hippocampus. This region of the brain is responsible for memory functions. It helps an individual to record new memories and retrieve them later in response to specific and relevant environmental stimuli. The hippocampus also helps us distinguish between past and present memories.

PTSD patients with reduced hippocampal volumes lose the ability to discriminate between past and present experiences or interpret environmental contexts correctly. Their particular neural mechanisms trigger extreme stress responses when confronted with environmental situations that only remotely resemble something from their traumatic past. This is why a sexual assault victim is terrified of parking lots because she was once raped in a similar place. A war veteran still cannot watch violent movies because they remind him of his trench days; his hippocampus cannot minimize the interference of past memories.......

A new psychological disorder has been identified in a series of recently published studies - Maladaptive Maydreaming (MD). Researchers from the University of Haifa, in Israel, Fordham University in New York City and University of Lausanne, Switzerland, have found that people with the disorder spend an average of 60% of their waking time in an imaginary world which they themselves have created, realizing that it is a fantasy, and without losing contact with the real world. "Daydreaming usually starts as a small fantasy that makes people feel good, but over time the process becomes addictive until it takes over their lives. At this stage the disorder is accompanied by feelings of shame and a sense of lack of fulfillment, but because till now the disorder has been unknown, when they come to receive treatment, therapists usually dismissed their complaints," explains Professor Eli Somer of the University of Haifa, one of the researchers and the first to identify the disorder.

Wandering of thoughts, fantasies and daydreams are part of the inner world of almost everyone, and they are depicted in popular culture - in literature and film, for example. However, until now science has not addressed the pathological aspects of this, otherwise normal mental activity. A series of new studies published recently in several leading journals in psychology and psychiatry shed light on a psychological disorder that was not known until now. The story begins in 2002, when Prof. Somer was treating adults who had been sexually abused as children. Somer identified six survivors who used to escape regularly into a world of the imagination, where they fantasized compensatory empowering stories in which they enjoyed traits and life experiences that were missing in their real lives. Professor Somer named the phenomenon "maladaptive daydreaming" (MD) but at the time did not continue his investigation of the phenomenon. This article was followed in 2011 by a study by Jayne Bigelsen and Cynthia Schupak of 90 people who complained of excessive daydreaming. Their study that showed that MD is also spread among many individuals who have not had adverse childhoods. In the wake of these two studies, Somer and Bigelsen began to receive communications from countless individuals from around the world who related to them how they had suffered from exactly the same phenomenon asking for their advise and help.

Untold thousands of patients misdiagnosed as vegetative are actually aware. Theirs is the civil rights fight of our times.

I had just finished giving a talk about severe brain injury, and told the story of Terry Wallis, a man in Arkansas who’d had a car accident in 1984. He survived but was left in a vegetative state, and his doctors and family thought he would be unconscious forever. Then in 2003 he began to speak. Tentatively at first, he said ‘Mom’ and then ‘Pepsi’. It was a stunning development almost two decades after he was injured. Terry’s words became the stuff of international headlines, baffling commentators who thought that recovery from the vegetative state was impossible.

The trouble is that, most of the time, MCS patients are unable to demonstrate their awareness. One problem is that their level of arousal fluctuates. They cannot sustain attention and can drift in and out, making it difficult to engage with the outside world. And when they do interact, they are burdened by impairments in cognition.

This makes MCS more than a problem of communication, like the locked-in syndrome so poignantly captured by Jean-Dominique Bauby in The Diving Bell and the Butterfly (1997). Bauby, unlike the MCS patient, was cognitively intact. He had a communication disorder but was still able to write his memoir, blinking to create the words in a kind of personal Morse code.

Bullying is a serious public health problem, with significant short- and long-term psychological consequences for both the targets and perpetrators of such behavior, and requires a commitment to developing preventive and interventional policies and practices that could make a tangible difference in the lives of many children, says a new report from the National Academies of Sciences, Engineering, and Medicine.

The programs that appear most effective are those that promote a positive school environment and combine social and emotional skill-building for all students, with targeted interventions for those at greatest risk for being involved in bullying. There is emerging research that widely used zero-tolerance policies -- those that impose automatic suspension or expulsion of students from school after one bullying incident -- are not effective at curbing bullying or making schools safer and should be discontinued. Instead, resources should be directed to evidence-based policies and programs for bullying prevention in the United States.

The Bipartisan Task Force to Combat the Heroin Epidemic has developed this toolkit in conjunction with the Addiction Policy Forum to connect families impacted by addiction with evidence­based resources around prevention, treatment, and recovery. Information for Caseworkers. 

This Toolkit includes resources around prevention, drug treatment, recovery support and general information for families, community organizations, schools, and parents concerned about addiction and looking for support. This toolkit was assembled to provide each Member of Congress and their staff resources to connect our constituents directly with resources. 

Please disseminate to your district office, make available on your website, and provide these useful resources to your constituents. Our hope is that during Opioid Awareness week we can not only work on meaningful legislation, but also help provide better support to the families in our communities struggling with this epidemic. 

Resources on Prevention, Treatment, and Recovery 

PREVENTION 

1. The Parent Toolkit ­ Whether your child is toddling through preschool, meandering through middle school or cruising through his ’20s ­­ here are tips to help guide him toward a healthy life at every age! 

2. Join a Community Anti­Drug Coalition ­ Community Anti­Drug Coalitions of America (CADCA) is the leading substance abuse prevention organization, representing over 5,000 community­based coalitions across the United States and in 22 countries who

I saw a notice for a table at a local library branch. For two hours, a local “behavioral health” (that phrase is so creepy) organization would have a table available for people, “to learn more or to get information about ALL services [agency] offers.”

That sounded promising, so I went.

The entrance to the library was a sensory nightmare. I had to get past a food box hand-out at the door. I am glad someone was feeding people, but it made for a confusing sensory nightmare plus a big audience of strangers watching me trying to get information about a sensitive topic.

Inside, I struggled to make visual sense of the room. There was a table with a person at it, but no sign identifying who they were or why they were there. It used up just about my last drop of processing to get to the table.

So there I was, fidgeting, rocking, avoiding eye contact, having a really hard time of it and pretty sure it showed. “Is this the [agency] table?”

“Yes.” And they waited for me to say more.

“It said you would have information about your services?”

“What service do you need?”

Now … some of you are Autistic and some of you are parents to Autistics (and some of you are both.) So you know what I’m about to say.

I couldn’t make the words. And even if I could, I was not comfortable telling my troubles to a stranger in a very public setting.

I see now, at least somewhat, what they meant and what I was supposed to say, but in the moment, it was too much.

“What do you have?”

They rattled off a string of words faster than I could process them all– who knows? There might have been a better fit in there for me, but I managed to latch on to “mental health services.”

“Those. Mental health.”

They picked up a pamphlet, “you can call this number, and…”

“I don’t do phone,” I blurted. This should really be an expected response from someone with anxiety issues, right?

“Is there just a pamphlet I could read or something?” By now, I was hitting the end of my “spoons.”

They tried to hand me the same pamphlet. I looked at it. It was for alcoholics and addicts.

“I’m not an alcoholic,” I said, feeling lost and helpless and pretty certain the wizard had nothing in his black bag for me.

“Yes, but this phone number …”

I was sunk. It was back to the phone call. If I could have made a phone call, I would have done it already, not come to a table hoping to get information and answers about how [agency] might help me.

“Thank you,” and I took off out the door, double time, to go sit in my van where I shook and cried, getting myself together enough to drive away.

Context plays a big role in our memories, both good and bad. Bruce Springsteen's "Born to Run" on the car radio, for example, may remind you of your first love -- or your first speeding ticket. But a Dartmouth- and Princeton-led brain scanning study shows that people can intentionally forget past experiences by changing how they think about the context of those memories.

"Our hope was the scene images would bias the background, or contextual, thoughts that people had as they studied the words to include scene-related thoughts," says lead author Jeremy Manning, an assistant professor of psychological and brain sciences at Dartmouth. "We used fMRI to track how much people were thinking of scene-related things at each moment during our experiment. That allowed us to track, on a moment-by-moment basis, how those scene or context representations faded in and out of people's thoughts over time."

The study's participants were told to either forget or remember the random words presented to them interspersed between scene images. Right after they were told to forget, the fMRI showed that they "flushed out" the scene-related activity from their brains.

"It's like intentionally pushing thoughts of your grandmother's cooking out of your mind if you don't want to think about your grandmother at that moment," Manning says. "We were able to physically measure and quantify that process using brain data."

But when the researchers told participants to remember the studied list rather than forget it, this flushing out of scene-related thoughts didn't occur. Further, the amount that people flushed out scene-related thoughts predicted how many of the studied words they would later remember, which shows the process is effective at facilitating forgetting.

The study has two important implications. "First, memory studies are often concerned with how we remember rather than how we forget, and forgetting is typically viewed as a 'failure' in some sense, but sometimes forgetting can be beneficial, too," Manning says. "For example, we might want to forget a traumatic event, such as soldiers with PTSD. Or we might want to get old information 'out of our head,' so we can focus on learning new material. Our study identified one mechanism that supports these processes."

Trauma creates a backwards world. Especially repeated trauma. In trauma the ordinary and the extraordinary change places. What seems mundane becomes the warning sign of impending danger. What is dangerous becomes normal. What seems small becomes big, what is big, seems small. If you spend years with this backwards view of the world it can become habit.

This backwards view of the world—mundane is dangerous, dangerous is safe. Small is big, big is small. This backwards view is one of the invisible wounds of trauma. It isn’t listed anywhere on a symptom checklist. There are no medications to change your thinking. But this backwards view impacts your life, your decisions, your work, your relationships.

Being in a plane like my great uncle and getting immediate feedback that everything you know is backwards is a massive wake up call—you know immediately that you are looking at the situation from a vantage point that will impact your life. But when you have lived with the view that the mundane will kill you, but danger is safe long enough you don’t even notice that you are living on the other side of the looking glass. Your backwards world is the way the world is—at least for you.

The only way to see it is to break one of the backwards rules—do the opposite, check to see if your assumption is true.