Family Connection, Mental Health & Recovery

Life changes

All individuals and families go through transitions or life changes. Some are normal growing up changes, some are more jarring. Transitions include changing schools, divorce, the death of a loved one, moving, a new job. During this current pandemic, families have been going through many changes at one time (losing jobs, getting sick, relationships being tested).

When three or more of these changes occur within a short period of time, family members may become symptomatic. Every life change requires multiple tasks and when there’s an imbalance between the number of tasks and available resources, this adds stress to the individual and family. (Landau, 1982) If this pattern continues, family relationships are disrupted until the problems are resolved. When the stressor is a traumatic event, the result is more likely to be systemic and appear across generations. 

Power of Connection

Enter connection.

Connectedness is interpreted as a reward by the brain and is associated with the release of dopamine. Conversely, brain imaging studies suggest that the same parts of the brain are activated during social rejection and physical pain. (Ethan Kross, University of Michigan) That’s why it’s important to enhance positive connectedness.  At ARISE we draw on the family’s inherent resilience rather than labeling behavior and communication patterns as dysfunctional, which leads to continued vulnerability and risk-taking, rather than increased self-esteem, competence, and self-efficacy.

We teach families to say goodbye to the shame, blame, and guilt that’s been plaguing them for generations. At ARISE we don’t just specialize in intervention, we specialize in family connection. We don’t work with just one person. We work with the whole family. We believe in whole family healing. Everyone needs to be heard and honored and given the tools to heal and strengthen their family unit (whether it’s biological or chosen).

Healing is a whole family affair

Everyone is capable of healing. What happens so much of the time is people think that once they get help for the person that’s struggling that their job is done. That’s not the case. Real healing is when the whole family network acknowledges that they all have work to do. 

Comprehensive Care

Bring in ARISE Comprehensive Care. If you peruse our website or read any of our publications, you’ll find it come up a lot. It’s one of our favorite things to talk about!  But what the heck is it?

Comprehensive Care is where long-term healing and resilience come together. This is where families learn the tools to uncover their strengths and change their whole family system for generations to come. Sounds pretty great, huh? That’s why we love it so much. 

As you may or may not know, Comprehensive Care works with substance abuse disorder, mental health issues, dual diagnosis, behavioral compulsions. This list goes on. ARISE is successful in all of these areas because ARISE is about connection. 

With ARISE Comprehensive Care we work with families for a minimum of six months. This allows time for families to learn and practice the tools necessary to access their resilience and handle future struggles that come their way.

Learn more

If you are interested in learning more about Comprehensive Care feel free to call or email us or check out our website, including our publication section. It is our goal to help as many families as we possibly can to reclaim their strength and set up success for their future generations.

References

Landau, J. (1982). Therapy with Families in Cultural Transition. In Ethnicity and Family Therapy (1st ed., pp. 552-572). New York: Guilford Press.

Landau, J. (2012). Family and community resilience relative to the experience of mass trauma: Connectedness to family and culture of origin as the core components of healing. In D. Becvar (Ed.), Family Resilience (pp. 459 – 480). New York, NY; Springer Publishing Company.

Meet your Ancestors. Find your Resilience.

“When we illuminate the road back to our ancestors, they have a way of reaching out, of manifesting themselves…”

~Raquel Cepeda

Ingrained in each of us are intergenerational patterns that are taught and passed down for generations. Those cute family trees we made in elementary school with our handprint as the branches and our grandparents, aunts, uncles, and cousins listed on them is just the beginning. Our stories go back much further and deeper.

As an interventionist or counselor, understanding your own family-of-origin story is a valuable tool when working with families. When we become aware of the patterns that appear throughout our family’s history, we can learn to capitalize on our family’s strengths and vulnerabilities. Without awareness of these patterns, they will continue to play out over and over again for generations.

Working with Genograms

One of the tools we use at ARISE when working with families is the genogram. In basic terms, the genogram is a family’s graphic depiction of the family tree that also shows more specific details about the individuals (ex. careers, mental & physical health issues, traumas) and their relationships with each other in the family. (ex. The grandson is very close to his grandmother and has stopped speaking to his father.) 

One of the reasons we love working with genograms with our families is that by understanding their intergenerational patterns they learn to reduce their shame, blame, and guilt by seeing and understanding how far back the problems started. We teach them how to look at their family story to not only find the struggles but how their family members overcame them. 

Genograms use symbols and different colors to represent transitions, relationships, and illnesses. It’s powerful to look at a completed 5 generation genogram and see lots of different colors showing what your family has been through. You can see how the patterns replay over and over again through the years as people in the family are faced with different struggles; the loss of a child, divorce, moving to a new country, etc. The power comes in understanding that the patterns exist and what triggered them and also seeing (visually) that their family has survived – for generations.  

As an interventionist or counselor, you can show them that theirs is a family who survived. This is a family who was able to use their strengths to overcome really hard times. And now that they can see the patterns, we can encourage them to remove their shame, blame, and guilt and embrace their family story and recognize the strength and resilience they have in them, running deep for generations.

“I am the product of all the ancestors getting together and deciding these stories need to be told.”

~Rupi Kaur

LEARN MORE:

• If you are interested in learning more about Genograms, we have an online course available. You will learn more about their use and practice creating genograms from case studies.
• If you are interested in learning more about ARISE Comprehensive Care with Invitational Intervention training, click here.
• If you are a family member interested in learning more about ARISE Comprehensive Care with Invitational Intervention, call us at 877- 308-0335.

Taking care of clients during “Stay at Home” order

Over the past couple of weeks, I have been receiving a number of inquiries from interventionists, clinicians and recovery specialists about whether or not to see clients and/or travel when asked to do an intervention or a companionship. I have put together a brief response and hope that it will be helpful.

We have to consider:

• Two levels of providers:
  • Level I: If you are a licensed physician, nurse or emergency or frontline service provider, or
  • Level II: Non-frontline nonessential level services (interventionists, addiction counselors, counselors, recovery specialists, etc.) and these are the majority of the queries I’m receiving, so this is the group I’m going to focus on:

• Level I: For the first group there’s very little choice because, typically, the answers are very clear according to workplace and responsibility level. This group is generally working for healthcare services and would need to negotiate with their employers if they themselves are at high risk and should not be on the frontline.
• Level II: For those at level II, the first question to ask is whether the service can be provided virtually. If it can, then follow the quarantine ruling of your state. Do not cross state lines unless it’s absolutely essential. This is a time for humility and creative service. Forget about competition and how good you are, and that no one else can do as well as you or your favorite program across the country. Start compiling a list of local clinicians, interventionists and programs. I have done many virtual interventions, not meeting my client and family until they are settled into treatment and sometimes only after discharge. We all have the training and skills to provide our best services online.  We can  coach the family through some of the activities that we would typically do live, as we continue to support them and our Person of Concern (POC) through this challenging time. Over the years, I have found both my immediate and long-term results to be the same, whether the service was provided in person or online.

Decision Steps:

• 1^st rule of thumb: Safety for all. If at all possible, stay home, safe and quarantined, so you can serve many other people in the future while keeping yourself, your family, your clients and their families safe. You will also be contributing to the decrease in spread of this potentially lethal virus.
• Before agreeing to travel: 
  • Assess acuity: If extremely acute, refer to their local emergency room and have the client and POC sign a release of information (ROI) for the emergency room personnel to be in direct contact with you.
  • Check locality: If not acute, is it possible to provide the service on HIPAA- compliant video conference? If yes, go ahead and provide the service online with all your usual skills and paperwork. If admission is needed, refer to a local facility and collaborate with them as usual. Honor the first rule of thumb: Safety for you, your family, your client and their family.
  • If the client refuses virtual assistance or signing an ROI and is not acute, I personally would not agree to work with them, and would refer elsewhere. If the POC is reluctant to work (or join the group) virtually, use your engagement skills and coach the client and other members of the support system to invite the POC as you would if this were live. Remember that you have the skills, and this is just applying them through a different delivery system.
• Providing service on-site:
  • If you are already providing on-site service as a live-in companion, the best way to protect everyone is to stay right there. If you need a break, try first to arrange it on-site. Find a quiet space. If your client can safely be alone for several hours at a time, this is a lot easier. If you are in a family situation, is there a family member, or other member of the support system, who could be trusted with your client and would be prepared to provide you with a regular 2-4 hour break? If you are alternating with another companion (something I would not recommend at this stage of the pandemic), careful consideration will have to be given as to how both of you will maintain quarantine and safety during switchovers. The risk in a situation like this is potentially to three families (yours, the other companion’s, and your client’s family) who in turn are at their own risk. A changeover would exponentially escalate everyone’s risks.
  • If you are providing in-home therapy, counseling or coaching, switch to a virtual mode.
• If you are asked to provide a new on-site service, your decision-making has to be very deliberate. You are being asked to put yourself at risk at a time when people are being asked, very firmly and with convincing rationale, to stay at home. Do you have a family? How many people will you be putting at risk? Given the current lack of testing, do you know whether you have the virus and might be putting the clients at risk? Again, if you choose to put yourself in this situation, please be aware of the risks. If you have any underlying condition that puts you or your immune system at risk, I would not recommend your taking this risk. If the situation in which you are being asked to serve is truly “life and death,” there are facilities that are staying open for service with residential or in-patient programs. They are effective and safe and will not put you and your loved ones at risk.
• Providing virtual services safely and effectively: There are several HIPAA-compliant services that are designed to meet all our confidentiality needs so we can practice virtually.

Please stay safe and healthy and maintain all your connections to loved ones, friends and colleagues. We have put several resources for you on our Facebook page. I hope these are helpful. I am also including a useful link for decision-making. This was developed by Al Jonsen, PHD Former Chair of Medical History and Ethics at University of Washington, a four-box model for decision-making that I have found very useful over the years.  The link to a PDF is below as a citation here.

Sala Gahle (stay well),
Judith

Reclaim Family Trauma

Reclaim Family Trauma. Empower Your Future.

Families have existed since the beginning of time. All families suffer loss, obstacles, and hardships. Many times when people are faced with multiple hardships or transitions in a short period of time they develop destructive patterns in an attempt to find a way to soothe their grief, loss, or trauma. These patterns can be transmitted across generations. This can leave individuals feeling hopeless, helpless and full of fear. They sit in waiting for a tragedy, like addiction, to strike another family member as it has for generations.

Family Patterns

In times of stress and transition, the common human reaction is to disconnect and the family network becomes weak. Left untreated, these transitions can lead individuals to addiction, depression and suicide, violence and other risk-taking behaviors.

Addiction in refugee populations is approximately 30% higher than the general population (Landau & Saul, 2004; Landau, 2005). It’s not surprising when you consider the incredible disruption of the traditional family functioning, forced migration and cultural conflicts in their new living situation. Before World War II, the rate of alcoholism in Jewish families was very low. After the war studies show the drastic increase in subsequent generations of Jewish families. (McGoldrick, Pearce and Giordano,1982; Perel & Saul,1989). By not facing their trauma head-on, these families get stuck in the same family life cycle, repeating similar patterns from generation to generation.

All in the Family

Dr. Judith Landau and James Garrett coined the term “Family Motivation to Change”.  It is described as “the combined forces operating within a family guiding it towards maintaining survival in the face of serious threat, and towards healing when threat is removed”. They discovered that the force that drives the family toward health is the same that leads them to risk-taking behavior in an attempt to protect the family and keep it together during hard times.

Embrace Your Family Story

Landau believes that families are intrinsically healthy and resilient and that by learning and sharing family stories, people can uncover when and why these destructive behaviors started.  Once they understand why these behaviors started they can release the guilt and shame they feel about where their family is right now and focus on healing. By looking at all of the big transitions their family has gone through for generations, they can learn how to retell their family story and embrace their family strengths.

Author Stephen Covey’s quote about perspective says, “To change ourselves effectively, we first had to change our perspective.” That’s what families need to do. Yes, they may have addiction and depression in their family history, but look deeper, what was the cause? What are the family’s strengths? What have they overcome? Did they escape persecution? Break free from a violent past? Were they able to keep food on the table despite losing their job?  Instead of a story of loss; flip it, learn to tell the story of resilience.

Change is Possible

Landau and Garrett studied the process with different communities at risk and found that people who knew about their family stories and shared the strength in their family history instead of their weaknesses, had less risk-taking behaviors. This offers hope to families facing hardships, like addiction and other risk-taking behaviors. It is never too late to learn and embrace their family stories (Landau et. al.2000).

Getting individuals dealing with alcoholism or drug addiction into treatment is a major challenge. Less than 10% of addicted individuals ever get into treatment (Kessler et al., 1994). With the help of the “Family Motivation to Change”, the ARISE® Network gets over 60% of people into treatment in one week; 83% in three weeks and 96% within six months. The goal is always to empower families to identify resources they can use to cope with life’s challenges and face them head-on so they can change their family cycle back to one of strength and hope.

Originally written for ICAAD blog.

From Trauma To Empowerment

Change is hard

Steve Jobs spoke about the difficulty of change, “People get stuck in those patterns, just like grooves in a record…”. He wasn’t kidding – we run those grooves deep, making it harder to jump to the next song in our soundtrack.

Intergenerational patterns (consciously and subconsciously) play a huge role in writing our grooves. They become ingrained in us as families pass their stories down from generation to generation.

Some of those stories are comforting and empowering: “My great grandfather was a successful entrepreneur. He opened the first general store in town and it’s still there today.” Others can make you feel defeated and hopeless: “My grandmother was an alcoholic, and my mom’s in recovery. What chance do I or my children have?”.

Same trauma, different story

It’s time to challenge you and your family to take another look at your past. ARISE® believes that every family is intrinsically healthy and that we all have strengths and vulnerabilities. By learning to identify patterns we can capitalize on our family strengths, rather than focus on our vulnerabilities.

How can we retell the woman’s story from the second example above, who’s feeling hopeless because alcoholism runs in her family? Let’s call her Jane and learn more about her family.

Jane’s grandfather had a heart attack and died when he was 41. Jane’s grandmother was a housewife when her husband died, leaving her to raise four kids on her own. She got a job working nights and managed to support all four of them through college. There’s a story of resilience in there.

Yes, Jane’s grandmother was an alcoholic, and she started drinking to cope with the stress and sadness of losing her husband. But, she also loved her children so much that she worked seven days a week to make sure they were taken care of. Her grandmother was a woman with extreme strength and determination.

Now, you may be thinking, “Yeah, but what about Jane’s mom? She became an alcoholic just like her mother.” Jane’s grandmother may have never gotten sober, but Jane’s mom did. She’s in recovery and has been sober for five years. That’s Resilience. That’s Strength. Same trauma – a different view of the same story.

Access Resilience

We all have stories like this in our families. Once we identify our patterns and stories of trauma, we can bring change and break free from old patterns. We can embrace the strength of our ancestors and capitalize on their determination to empower our future and the future of generations to come.

Learn More

If you are interested in practicing genograms as well as constructing your own family’s genogram, take the ARISE® online class Introduction to Genograms, available at our online store.

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5 TED Talks for Anyone Struggling with Trauma or Addiction

When people go through hard times many choose to retreat and go it alone. It can seem easier to keep your issues to yourself. Sometimes we think, well I don’t want to bother anyone else with my problems. Or, I’m ashamed of my actions. Or maybe, I’ve leaned on my friends and family too much, I need to handle this by myself. For a person struggling with addiction, this is a dangerous time.

One of the main principals of ARISE® is that by empowering families and communities to access their resilience, they can overcome even the worst crisis and not only survive, but thrive.

Here are 5 Ted Talks that share why it’s better to surround yourself with community, instead of hiding in our pain and struggles. Everyone can learn how to access their resilience.

1. Family Stories, Secrets and Survival

Dr. Judith Landau at TEDxVailWomen

Dr. Judith Landau tells the story of trauma and recovery through generations and gives clues along the way for healthier families. Trauma is inherent to the human condition. The key to whether one experiences destruction or empowerment in the wake of trauma lies in how we relate to our trauma — the intergenerational stories we tell, the secrets we keep, and the way those stories are framed. The health of future generations is more dependent on the stories we tell today than we may be aware. At this crucial juncture in the human story, the choice to draw upon feminine values and principles in relating to our stories, could be the difference that saves our children.

2. Everything You Know About Addiction is Wrong

Johann Hari

Johann started his research because he was wondering how he could help his own family members struggling with addiction. What he discovered coincides with what we at the ARISE® Network talk about. When a person has an addiction, the worst thing you can do for them is to put them into seclusion. Evidence shows that when supported by a community and being reconnected with society more people are able to get clean and live a happy and healthy life.

3. How Childhood Trauma Affects Health Across a Lifetime

Nadine Burke Harris

Pediatrician Nadine Burke Harris talks about the science behind trauma and overall health, including mental disorders, substance abuse and even heart disease. She noticed that the children she was seeing in her clinic, who were predominantly exposed to higher doses of adversity, were dealing with serious health issues. “[She] explains that the repeated stress of abuse, neglect and parents struggling with mental health or substance abuse issues has real, tangible effects on the development of the brain. This unfolds across a lifetime, to the point where those who’ve experienced high levels of trauma are at triple the risk for heart disease and lung cancer.” She talks about the need to get to the root of the problem early so these children can break the cycle.

4. What Trauma Taught Me About Resilience

Charles Hunt

Charles is no stranger to trauma. He openly shares his personal experiences of growing up with a father in prison, a mother addicted to drugs and the loss of many family and friends. Charles believes that resilience is one of the most important traits to have and that everyone has it, we just need to learn how to access it. And we agree, it’s one of the core beliefs of the ARISE® Network!

5. How to Practice Emotional First Aid

Guy Winch

Guy believes that many of us know how to take care of ourselves when we have a physical problem, but when it comes to problems of the mind, we don’t take it seriously. When we get a cut, we put a band-aid on it. But when we experience a psychological injury, we tend to ignore it, allowing it to get worse. Guy says “how many times have you heard someone say, “Oh you’re feeling depressed? Just shake it off, it’s all in your head.” Would they say the same thing to someone who broke their leg? “Oh shake it off, it’s all in your leg”. Guy believes we need to start practicing emotional hygiene and take care of our minds as well as we take care of our bodies.

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