Category Archives: Treatment

Local Support




It can be overwhelming  seeking support outside of your friends and family when you have an addiction.   This is usually a significant step that needs to be made when you have multiple relapses; however, I see many people try to reassure themselves that this time it’s going to be different and not take this step.

They have their plan.  It usually is a decent plan.  We have worked on either a Wellness Action Plan, Crisis Plan, or Relapse Prevention Plan.    In therapy we have also came up with wonderful “tools” to use in their daily maintenance and their “emergency kit”.  We have practiced, role played, and brought in family and friends.  But yet they’ll be another relapse.  Another lie told.  Another promise broken to self or others.  They show back up sometimes beaten down, ashamed, and lower in spirit and energy.  Or they’ll show up determined that this time will “be different” only to end up like the previous scenario eventually.

The piece that is missing is support outside of treatment, friends, and/or family.  It is tapping into something positive that is larger than oneself.  This could be in the form of a religion/faith.  It could be in the form of AA/NA.  I have seen people invest themselves into a close knit wellness communities, like with Rock Climbing or Yoga.    I have seen folks begin to invest in service communities, like with Habit for Humanity, Urban Ministries, etc..  It doesn’t seem to really matter what it is as long as it has a higher principle and has other people to connect with.  This step  of participating with something outside of our individual community touches on the “spiritual” side that so many addictions counselors will talk about.  It touches on this piece of us that is sometimes very difficult to conceptualize.  People think they have to go to church or start praying.  Although this could be a path for some, it doesn’t mean it has to be the path of all searching for that “higher power”.  But one key element in this is the “investment”, the “participation” that makes it work.  Just visiting a community or group is not enough.  One must get involved so that an investment is made.   This investment will bring returns though.

In order to help with this connection, I want to provide some resources below for AA, NA, Al-Aanon.  These are by no means the only I recommend but they are the main ones folks can access easily in our community and have shown to be reliable supports and places people can become involved and invested through working steps, finding a sponsor, sharing story, etc…

Greensboro Al-Aanon

Al-Anon General Site

Greensboro AA meetings

Greensboro NA meetings

Making “Not-So-Good” Habits Work for You

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“A process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.” – This is SAMHSA’s working definition of recovery.  this could be recovery from Mental Health or Physical Health concerns.

Recently I have seen  a good many clients that have come in reporting very similar symptoms.  They feel somewhat down or even distressed.  They are functioning relatively okay with work and home but feel like they have lost their way.  They report feeling empty, tired, anxious.  Most of these individuals have been very involved in family and/or community.  They have been the family coordinators, the church volunteers, the community activists.

When looking at the above working definition of recovery, these folks are definitely self directive, but somehow the other two areas of health and wellness and full potential have been overshadowed by others needs (others in their own family and others in the community).  When using the needs assessment tool I incorporate into my practice (the DLA20), it is clear that many facets of their life have been neglected and continue to be drained.  There’s just not enough nourishment and recovery built into their lives to keep pace with all the other routines in their life.

We live in a society of go, go, go.  Ample supplies of caffeine and energy supplements.  Ample supplies of foods and other items to grab quickly from moving to one activity to another.  We more and more are getting out of habits of nourishment and allowing for our bodies to recover.   Recovery is not just a mental feat but very much a physical feat as well.    We have to develop healthy routines to nourish our bodies and brain.  These routines have to be consistent in order to make an impact.   Just like we consistently go to the coffee pot, check Facebook, or volunteer to help another, we need to consistently eat nourishing foods, take time for some quiet,  and get some stress relieving physical activity.  But how?  It sounds simple but if it were that simple we wouldn’t have this problem of course.

The trick is to begin by connecting one activity to another.  The activity can be good or bad.  If you drink coffee every morning or check Facebook before bed on a consistent basis, then these are great activities to link with more nourishing habits like 10 slow breaths or eating an apple.    Once you have successfully linked these habits consistently you can build in more healthy habits like a walk or some yoga.  It’s better to start small though.  Later you may decide to even phase out the original activity, especially if it was doing more harm than good.  Getting overwhelmed and not doing anything at all is not an option if you want to stop the cycle of constant drain, low energy, and feeling like you’re in a fog.

Sometimes we need reminders, so setting timers, getting others involved are great ways to ensure more consistency.  Also subscribing to a blog whether it is mine or another wellness author could also be a good way to get a tickler to continue to work on developing healthier practices.  As with much in life persistence against failure eventually develops consistency regardless, so keep trying.

How to Get a Good Night’s Rest

Recommended Sleep ChartThe above chart comes from the National Sleep Foundation.    It suggests that an adult my age needs 7-9 hours of sleep.  Like good diet and exercise, sleep is a critical component to overall health.

The sleep foundation explains:

“One of the vital roles of sleep is to help us solidify and consolidate memories. As we go about our day, our brains take in an incredible amount of information. Rather than being directly logged and recorded, however, these facts and experiences first need to be processed and stored; and many of these steps happen while we sleep. Overnight, bits and pieces of information are transferred from more tentative, short-term memory to stronger, long-term memory—a process called “consolidation.” Researchers have also shown that after people sleep, they tend to retain information and perform better on memory tasks. Our bodies all require long periods of sleep in order to restore and rejuvenate, to grow muscle, repair tissue, and synthesize hormones.”

Many of us have difficulty sleeping.  Here are some general guidelines to follow in order to have a good night’s rest.

Stick to a sleep schedule , even on weekends.
Practice a relaxing bedtime ritual .
Exercise daily.
Evaluate your bedroom to ensure ideal temperature, sound and light.
Sleep on a comfortable mattress and pillows.
Beware of hidden sleep stealers , like alcohol and caffeine.
Turn off electronics before bed.

For those with an overactive mind:

Keep a notepad/journal and a pen near your bed to write down thoughts or things you want to remember.

You can also use this method to write down worries or concerns and if you’re having a hard time letting them go after writing them down, remind yourself you can just deal with it in the morning after you wake up.

At my practice:

Sleep problems are a common co-occurring issue that I see with my clients.  I usually help each person develop their own individual bedtime routine.  Many times we look at the therapeutic effects of yoga postures and breath techniques.  We practice these techniques in the office to figure out the right practice that will help calm the mind and body enough to allow sleep to take over at night.  Many times coming up with an answer to the individual’s problems will occur after tracking one’s schedule and diet over a week.  It is amazing what “hidden” sleep stealers we encounter throughout our day.  Sometimes changing something like when you have your last caffeinated beverage will be the miraculous fix.  Other times, what might solve the issue is long-term work on developing and keeping more healthy habits like exercise, balanced diet, and meditation.

If you would like to talk about finding your solution, please contact  Amanda.




Work-Life Balance

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I was asked to do a talk on “Work-Life Balance” the other week.  “Work-Life Balance” is the new catch phrase that’s being used instead of “Burn-out Prevention”.  So in essence my focus was on preventing burnout.  Burnout occurs when someone had once really loved what they do at their job but started giving more and more to the job until it took over more and more of their lives.  After this process starts, the individual then usually starts to resent their work and job to the point where they start to do less and less quality of work.  This usually results in low work performance and increasing resentment for not getting any past rewards they use to get for doing a good job.  It really is a downward spiral if there is no intervention.

The idea of “Work-Life Balance” is getting more to the root issue  in that one must have balance and perspective with the roles they possess in order to not experience burnout.  A good exercise is sitting down and listing all the roles you possess.  If there are roles you don’t want then you may want to take them off the list.  If you can’t get rid of the role then keep it, such as the role of “house keeper” if you are single parent and cannot afford to hire this role out.  So once you have the list of all the roles you have, then list one task to do for each of those roles.  Next get your calendar out and place that task on a day and a time to accomplish it.

This is just one way to help maintain balance during the week, but you will start to feel overwhelmed if you forget the role of “caretaker of self”.  You can’t forget to schedule in time for yourself to do something nurturing, like an hour to read, get a massage, see a movie.   You need time to reconnect to what relaxes and/or inspires you so that you can recharge and be able to do these other tasks in your calendar.  Don’t forget that you need time to let go of the other roles and remember yourself.

How to Benefit from a Gratitude Practice

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         I think many of us can identify the calmness and peace that comes with having the thought of thankfulness.  If any of you have read my recent client manual or seen any research on what happens to the body when we experience stress versus when we cultivate peace and calm, you would put 2 and 2 together and know that anything bringing peace is going to have the power to heal.  This is something we intuitively understand but the science is building to show this as well.
         Dr. Masaru Emoto, the Japanese scientist and water researcher, discovered that vibrations affect the molecular structure of water. In his years of water research, through high speed photography of thousands of water crystals, Dr Emoto has shown the most “beautiful” (symmetric and well organized)  crystals are those formed after the water is exposed to the words ‘love and gratitude.’   When water was exposed to words of “anger and hate”, the water crystals became asymmetric and disorganized.  The fact that the human body is made of 70% water, one would consider how  our thoughts can have profound implications on our health.
         The wonderful thing about this feeling of gratitude is that it can be cultivated quite easily.   One can do 15 minutes a day of gratitude practice and experience immediate benefits.  The long-staying results though comes like anything does…. with consistent daily practice.  That’s the kicker, right?  Many of us will start a practice for a week or so and then see it flicker out.  Here’s some steps to help build a daily “consistent” practice of gratitude that has good potential to last.
  • Start small, 5 minutes.  Success will lead to you trying again and not being overwhelmed.  Set a timer and resist doing more.
  • Link your practice to something else you already do daily, like a morning cup of coffee or brushing your teeth.
  • Do it right before or after this already daily routine.
  • During this 5 minutes jot down 3 things that make you feel gratitude.
  • Do this for a month.
  • Bump up to 10 minutes the next month.
  • Bump up to 15 minutes the third month, this time add a nice sitting posture and a minute of quiet after.
  • Continue to build as you feel so, adding other health routines like yoga or breathwork if desired.

How to Start a Breathwork Practice

keep calm and breath pdf

Breath is a powerful connecting force between the mind and the body.  Building and expanding on our breath not only increases vitality and energy, it can also be an amazing healing tool.  Although it is recommended to have an experienced teacher before beginning any significant breathwork practice, anyone can initiate this journey with some simple steps and create a 15 minute practice.  This practice can be added to a regular yoga asana practice or meditation practice.

  1. Identify a dry comfortable area to practice in.
  2. Limit distractions such as turning off or down your cellphone
  3. Wait a little after eating so you don’t have a full stomach. A little water before starting can be helpful.
  4. Avoid coffee before practicing.
  5. Decide on time to practice. Early morning is an ideal time to practice before your money cup of coffee/tea.
  6. Lie on your back or find a comfortable sitting position.
  7. Begin by just observing and tracking the breath as it comes in through your nose and down your windpipe into your diaphragm and track as it exits the body.
  8. Spend 5-10 minutes practicing observing.
  9. Spend the next 5-10 minutes focusing on long slow exhales.
  10. Sit in quiet for 3-5 minutes with normal breath.

At this point the work is on being the observer. Breathwork is not completed by “controlling” or forcing the breath, it is done effectively by observing and “playing” with the breath. If your goal in breathwork is increased vitality and wellness, then the safest way to begin your practice is by observing where you are first.   This takes time and cannot be determined with one breathing practice session but must be observed over time.  Variables like a new stressor or trying something for the first time can alter your baseline habits.  Overtime however one can determine the average count and length of the breath and identify a good goal to work on.  The goal is usually in lengthening both inhales and exhales comfortably without strain.  This will increase vitality.  However sometimes a person may need more help specifically with inhaling or exhaling and a trained instructor can guide the person in their practice.  There are also techniques like holds and various therapeutic practices that can target a particular healing aspect of the breath.  For more information on pranayama, a good book to reference is The Yoga of Breath: a Step-by-Step Guide to Pranayama by Richard Rosen.

Are you struggling with food addictions?

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Many of us at times develop unhealthy relationships with food.  A little while of feeling bad after maybe overeating and seeing its effects we are able to reign our behavior in and there’s not much harm.  However sometimes this unhealthy relationship can be ongoing and can start to cause other parts of our lives, relationships and recreations for example, to not function well.  When this happens, a food addiction might have formed and may call for more specific intervention.

Some signs to keep in mind:

  1. Eating more than planned when you eat certain foods.
  2. Keep eating certain foods even if you are not hungry.
  3. Eat until you feel sick.
  4. If unable to get a specific food, go out of your way to obtain that food.
  5. Eat certain foods in such large amounts that you start eating food instead of working, spending time with family or doing recreational activities.
  6. Avoid professional or social situations where certain foods are available.
  7. Have problems function effectively at your school or work because of food and eating.

If you checked a good many and have been experiencing these for over a month, it may be that it is time to seek further support.

Feel free to contact me for a free consultation if you feel this may apply to you.  I have been working for over 10 years  with people that suffer from all types of addictions and can help.

7 Ways to Begin Managing Stress

Stress is something that happens to us daily.  There’s good stress.  You know the type that makes you show up for a meeting on time and also enabled you to prepare the night before.  There’s also not so good stress.  The kind that wears at you and makes you want to run and hide (or eat chocolate, drink a beer, smoke a cigarette, etc… )  It’s the kind that may start out as good stress but then added to all the other little worries morphs into something that is not helpful.

There are a few things you can do when you start to feel this negative stress come on that may help you gain control and not run and hide.  Some such as the first item may seem deceptively simple. We tend to take these for granted but often they are neglected resulting in a low threshold for negative stress and its effects.

1.Take a drink of water.  Many of us stay dehydrated and when we are dehydrated it is more difficult to reduce stress hormones and that feeling of tension.

2. Take a breathing break.   Concentrate on long slow exhales. When we are stressed we hyperventilate (longer inhales than exhales) which signals the body to go into “fight or flight”.

3.Eat well.  Eat meals with a variety of protein, whole grains, fruits and vegetables.  Attempt to eat something with protein and fiber at least every 4 hours while awake.  This will keep blood sugar from dropping low enough to signal a stress  response.

4. Walk or do some sort of exercise.  Just 15-20 minutes a day will reduce stress hormones in the blood; 30-60 minutes will optimize this.

5. Shrink your to-do list and focus on only the top 3 tasks.  If that’s too much, shrink it to the most important task you can do right now.   Looking at 20 items can be overwhelming but when you are focusing on just the next step, you feel more in control.

6. Nurture close relationships.  Contact someone positive whom you want to keep in your life.  Soak in some of their positive energy to help give you more resilience.

7. Get enough sleep.  Work on things that will help you get better sleep like cutting out caffeine after 5pm.  Getting 4-8 hours of sleep a night enables your body to clean up toxins and excess chemicals like the stress hormone cortisol.  Sleep helps to give you a “clean slate” for the next day.

*If still no relief, reach out to a support group or professional assistance through a counselor or other healthcare provider.


Weekly Wellness Post – Burn Out

Burn out, I think on some level we all have experienced.  I am studying for my CCS (Certified Clinical Supervisor) and one of the areas I’m reviewing includes the identified stages of burn out by Edelwich and Brodsky.  What I have found interesting about these stages every time I have read about them in the past is that the first stage involves “Enthusiasm“.  This is described as a tendency to be overly available and to give a lot of oneself due to the motivation and excitement.  I think many people forget when they are burned out that at one time they probably had an excitement for what is burning them out currently.  A lot of time we start our work with a certain idealism or a vision of “how things could be”.

The next stages include “Stagnation“.  This is described  by stating “expectations shrink to normal proportions and person discontentment begins to surface”.  Basically this happens when we have a desire to make something happen or to do our work a certain way and we get thwarted.  Frustrations start to mount up as we realize we can’t do what we had set out to as easily as expected and we see no movement toward our goal or vision.  This can happen when a company also doesn’t encourage collaboration and has a very dictatorship culture.  Or this can happen when a person does not have a full understanding of the field they are going into and only see a small window of the bigger picture until they are actually doing the work.  Other ways this could happen is that environmental factors such as  unexpected reduction of supplies  or resources occur that could be related to a natural disaster or unusual fluctuation in the economy.

The third stage is Frustration.  This is described as “difficulties seem to multiply and the helper becomes bored, less tolerant, less sympathetic, and she or he copes by avoiding and withdrawing.”  So what happens in stage 2 worsens.  No relief or help is available or received and the goal/vision gets further and further away.  At this point feelings of hopeless sink in and people start to give up or not care as much.  This leads to the fourth stage.

Apathy.  Apathy is characterized as “depression and listlessness”.  At this point a person may have forgotten why they entered their line of work in the first place.  They may seek help or quit job.  Some may move on to a more severe form of depression/anger and become harmful to themselves or others.


I think the main point to take away from these identified stages is that the main culprit is a feeling of lack of control. There is much different companies can do to help a person prevent burn out.  Some things include more collaborative style of decision making and planning in which you not only elicit feedback from your staff but they see you use it.    Other things include having resources like EAP for staff to use to help them personally figure out how to take back control of their lives.  Helping folks have more work/life/family balance like incorporating family events or exercise initiatives into the regular work day.  Some people feel burnout b/c they feel they lost control in another area of their life so if they feel like work is taken over and the vision they had for the family or health is not coming to fruition they can feel burn out and project it onto the work place.  Helping employees work on balancing work and home can be extremely helpful.

Individuals can also retake their lives back by indentifying their roles and what parts of their roles are not meeting their own vision and expectations.  Next step would be examining this vision and expectations to see if they are realistic.  If they are not then taking some time to develop more realistic expectations might be in order.  If they are realistic then breaking the steps toward reaching these goals into manageable and measurable pieces would be helpful.  Once we know what the next step is, how we are going to do it,  and when we are going to do it then we are back in control.  The feelings related to burnout will start to diminish as we make progress.


Dyslexia and Visual Talents

I have looked into this topic a great deal due to the fact that my oldest son has had much difficulty knowing left from right and letter reversal issues, for example his 4’s and 9’s look like Ps… A book that made a lot of sense to me although I had questioned how the scientific community held it as factual is the book called ‘The gift of Dyslexia” by   Ronald D. Davis  .  This book describes individuals with Dyslexia to have many talents that those of us who do not have dyslexia are not capable of having.  These talents involve the ability of seeing an object like a cube and being able to turn it around in their mind as if they are seeing it from many different view points instead of the view point of just staring down at it on the table.  The can actually pick it up in thought and turn it around to see accurately the different sides and angles of the cube.  The problem comes in when they are asked to read something on paper that to understand it you have to be looking at it from the same viewpoint as any other person reading it.  Training the brain to look at it from the same view point is the trick.

Well I just stumbled on to an article in Scientific American:Mind, Jan/Feb 2015, on “The Advantages of Dyslexia” which found scientific studies that back this theory up.  So that this ability to see everything 3 dimensional and to be able to  manipulate an object in one’s head without picking it up is quite an asset it areas where one might need to see things in this manner.  In the engineering and sciences this is an extremely helpful talent.

There are many kids that get labeled with a learning disability because of dyslexia.  I believe occupational therapy really helped my son understand how to interpret the perspectives and dimensions of what he is seeing in comparison to what he is expected to see by us 2 dimensional folk.  Also with him he also had difficulty crossing the mid line of his body and I wonder how that all fits in with the dyslexia and his visual/mental ability.  Occupational therapy also fixed that.  He spent a large amount of his occupational therapy time on a “scoot” with his hands moving him in a crawling fashion all around their offices.  He had a blast and it made him do a lot of mid line work.

I’m fascinated by how our brain, visual ability, and physical movement are so interconnected.   We all know this and are taught this but the part our past teachers emphasized was our brain controlling the movement  and not the other way around, our movement controlling/affecting the brain.  Funny how most therapies address the movement aspect last and not first, being that you only get it addressed if sent to a specialist.  It seems like it should just be common knowledge to have our kids do mid line activities and tests that measure “ability” in this spacial/visual talent and less on just sitting in a desk with a sheet of paper and measuring the disability.  It really is a paradigm shift though and that takes time.  The science is there however.