Monday, May 31, 2010

The human brain has long been hard . . .

The human brain has long been hard-wired to be afraid of Being Attacked and Having Lack.

It has allowed us to evolve and survive. The reptilian (old brain) was constantly alert for saber toothed tigers and other predators; it was always guiding toward more food, more water, better shelter, and procreation.

As our brains have further evolved, humans are capable of creating, planning, analyzing, writing, understanding….and yet, it has been proven that the old—reptilian—brain, wrapped tightly around our brain stems is here to stay.

The ramifications of this are great job security for those of us in health care. Although most of my patients do not have saber toothed tigers after them, many lay fearfully in their beds for hours a night, overwhelmed by the Lack and Attack fears taking up space in their minds. Driving here in their SUVs after stopping for lunch at Subway, they describe their concerns about who is out to get them at work, their impending financial doom, fears about diseases they may eventually get. Many request medication for anxiety or depression.

I’m not saying that medication isn’t sometimes effective, especially for people who are severely depressed. What I am saying, and what I try to communicate to my patients in our 15 minute primary care “slots” is to sit back, look at the fears your brain is spouting off. It could be that the old reptilian brain, which is continually broadcasting Lack and Attack fears isn’t serving you anymore. Maybe, just maybe, you can feel your flannel sheets, realize there’s a roof over your head, food in your fridge, no saber toothed tigers, then sigh deeply and happily and get some sleep.

It’s the topic at our next free monthly workshop. Hope to see you there…check out http://www.hamiltonfamilypractice.com/ for details.

Joan Shepherd - FNP

Friday, May 28, 2010

Beyond the Mountains

As my wonderful yoga teacher Ellie (check out www.yokid.org) is fond of quoting:

“Beyond the mountains, there are mountains.”


Although I'm pretty sure the great yoga sages weren't referring to a desk top disaster with this quote, I still think it's pretty applicable.


If I'm bogged down by clutter, in my mind or in my physical space, I'm less likely to get to the things that really matter to me.


Some people (amazingly) are automatically organized. I'm not.


One of the best strategies I've learned to use is to combine the concepts of the 4 Day Win and Turtle Steps.


Here's an example.


In the winter time I 'nest' at a desk in my living room that has close proximity to our heat source, my beloved wood stove.


During the rest of the year I make my office in an adjoining room with bookshelves and huge windows, looking over my front porch. My desk is a big old hand made pine table I found at a consignment shop.


While I'm 'wintering' in the front room, the 'summer-office' becomes the receptacle for everything about which I've procrastinated on making a decision, mostly paper stuff.
It is spring time, and although I've had a couple delicious mid-April fires on some chilly mornings, it is time to make the move.


And I am overwhelmed. Beyond my mountains there are mountains.


Here are a few things that have accumulated on the desk in the last several months:


Cute note from daughter that I don't want to pitch, a few quotes I've calligraphied, a baggie with a lone earring, whose partner may even show up when I get through this task, bank statements, a Time magazine with an article someone specifically saved for me that I haven't made time to read (Dec 7 2009), sketches of my garden plot, several hanging folders, a gift certificate for a pedicure, various pens, markers, wires that go to God knows what, 1/8th role of toilet paper....you get the idea. It's been worse, but it's pretty stacked up.


The idea behind the 4 Day Win is to choose a behavior that you want to change, and-using Turtle Steps-break it into the tiniest increments possible so success will be assured. There's a little magic in choosing 4 day chunks: change happens. You must reward yourself at the end of the 4 days. Tweak the turtle step as needed or choose the next 5 minute commitment and repeat for 4 more days.


Thus, I am committing to a mere 5 minutes a day to transition from my winter office. It's amazing what I can get done in that amount of time, and there is no resistance from my mind when I know this is such a bite-sized task. The way I time myself? Either an old-fashioned egg timer, or playing a song that's approximately 5 minutes long.


If the spirit moves you and you want to do more, feel free; just don't do less.


And don't forget the reward. There's a book I've been wanting, and a used copy is available on Amazon. That's what I'll be ordering on Thursday. Dishtowels at Target, an hour in Byrd Park with cell phone off and a juicy book, cashing in on that gift certificate mentioned earlier, carving out a couple hours to calligraphy, blocking out a ½ hour for a phone visit with a dear friend across the country...these are all examples of ways to reward myself.


OK, gotta go. The Mountains are calling and Gillian Welch just started singing Miss Ohio!

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Joan Shepherd - FNP

Tuesday, May 25, 2010

Got Glum? Nope!

xxxxxxxxxxxxxxxxxxxxxxxxxxx (TAKEN FROM RECOVERYSWAG.COM) **

I love the internet! There is so much information right at your fingertips. No flipping pages, no Dewey Decimal System, just straight up imagination and inquisitiveness that gets you were you need to be and gives you what you want to learn! So, today in the spirit of inquisitiveness, I am going to review a few recovery-related websites.

The first site is www.recoveryswag.com. The Big Book in A.A. states, “But we aren’t a glum lot…we are sure God wants us to be happy, joyous, and free.” (pg. 132-133) This website is definitely created in that spirit! Recoveryswag.com specializes in gifts, clothing, and other collectibles that are recovery-related but with a humorous twist. My personal favorite is the “Bill W. Gang” t-shirt. Everyone likes to belong to something because we are social creatures. This is the t-shirt to playfully proclaim your allegiance to A.A. and its founder Bill W.!

Be sure to check out the myriad of great products from this hilarious website!

The second site I would like to review is www.sobermusicians.com. It’s no secret that drugs and alcohol are pervasive in the music community. The list of musicians who died too young includes Jimi Hendrix, Janis Joplin, John Bonham, Keith Moon, and many, many more. I love the tag line of this website which reads, “Addiction plays for keeps…so do we”. Part of recovery is learning to adopt healthy habits and hobbies. This is a great site for veteran musicians or wanna-be rock stars who never took the time to learn how to play because drugs and alcohol were too time consuming. Go ahead, unleash your inner rock star, you know you want to!!!

The last site I would like to review is www.soberteensonline.com. Drug and alcohol use now start as early as 12 years old (some even younger) in today’s youth. It is so prevalent among college students that The Princeton Review releases an annual “Top Twenty Party Schools” list for the discerning higher education party-goers! Thus, soberteensonline.com! It is a safe place in cyberspace for tweens, teens, and twenty-something’s to network, chat, support, and learn about drug and alcohol addiction. This age group lives through the internet so it is great that such a resource exists. Help spread the word!

I like to close our time together with this quote. It comes from the Sober Teens Online website. It is very simple but so powerful. It is, “Living Life Lucid.” The word lucid is defined as, “characterized by clear perception or understanding; rational or sane” (dictionary.com). The idea is that life is meant to be lived in full awareness, full perception, and full understanding. DUH! But for many addicts that idea is not so obvious due to the pain that life has thrown their way. For many of them, being lucid equals being in pain and suffering. However, if they are willing to take a step of faith into recovery, they will find the joy of being aware of, perceiving, and understanding all the good that life has for them if they will stay sober one day at a time with the help of others!

Chris Newcomb – Aftercare Coordinator

Sunday, May 23, 2010

VCNP Conference

Dr. Coleman spoke to a packed audience at the Virginia Coalition of Nurse Practitioners in Reston, Virginia a few weeks ago. His topic was Addiction and Substance Abuse in Primary Care. He highlighted recognition of the disease using available screening tools, making a diagnosis, then followed with an overview of treatment options.

I was struck by a couple things.

First of all, I was impressed at the numbers present. Substance abuse is a ubiquitous condition. Clearly these practitioners are seeing the problem frequently in their various practice settings.

A major point that Dr. Coleman made was that addiction is a Primary disease; in other words, depression and anxiety are not the cause of substance abuse. Drug and alcohol abuse stands alone as a diagnosis. That being said, it can certainly exacerbate many other mental and physical conditions. (Check the archives to see his newsletter article on this very topic.)

Another interesting thing I noticed is that virtually no one knows about naltrexone therapy. This generated many questions from the audience, since most people are only familiar with using long term opiates such as methadone and suboxone as treatment. Few people are aware of the problem many people have when they attempt to stop these treatments.

A final thought: it is most helpful to a patient to give him a firm diagnosis about a drinking or drug problem. Until the problem is identified, healing cannot begin.

If you or a loved one is concerned about substance abuse, please inquire at The Coleman Institute. We have Accelerated Opiate, Alcohol and Benzodiazepene treatments, all done in the out-patient setting.

Also, it turns out Dr. Coleman is a great speaker. If youd like him to present a lecture to your group, give me a call. When the session ended he was encircled by Nurse Practitioners. I assume they were questioning him on aspects of his speech, although I think couple may have been after his phone number.
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Joan Shepherd - FNP

Thursday, May 20, 2010

Watching patients change at Williamsville Wellness

For the last three months I have had the pleasure of being the Medical Director at an inpatient rehab program called Williamsville Wellness. It is a fabulous program in a beautiful setting out in Hanover County. What has been the best experience for me has been seeing the changes that the patients make over the 4 weeks that they are there…

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Four weeks is such a short time of course, but the changes I have seen have usually been dramatic. Patients come in at a point in their lives that things are going horribly wrong. They are hurt and angry and usually very afraid. They are confused. They don’t really know what they need to change; they just know that things are not going well.

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They usually have a lot of denial. Often this takes the form of minimizing their problems and believing that their problems are really not too bad. The denial often shows up as blaming others or blaming the system. Frequently they are there because of pressure from others around them: family, friends or the court system. It is easy for people to see themselves as the victim instead of taking full responsibility for their problems.

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During the first week, the patients start to wake up and start the inevitable process of questioning their old beliefs to see if they really make sense and if those old beliefs really work well. The therapists at Williamsville Wellness are fantastic at helping patients with this process. There is some group therapy, but a large part of the program is individual therapy. Each of the therapists has a slightly different style, each of which complements the others. There is cognitive behavioral therapy, hypnosis, neuro-linguistic programming, experiential therapy, substance abuse therapy and family therapy. In addition, the patients get exercise therapy, art therapy and yoga. The staff also spends a lot of time helping the patients deal with the immediate wreckage of their past so they can relax and move on with their therapy. There is even a professional chef on site cooking gourmet meals, so their nutritional needs are well taken care of!

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Over the course of the four weeks, the patients start to move into acceptance. They start to really internalize the belief that they have this addiction problem and that it is their responsibility to deal with it. They come to understand that they are not alone and that there is a lot of help available. They start to also be able to identify what issues they will need to continue to work on after discharge. By the time they leave they have usually developed a comprehensive discharge plan and have committed to following it.

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It is wonderful for me to watch this growth unfolding in such a short time. The changes are dramatic, and I know that, if the patients continue on this path, the joy they will experience and the joy they will bring to those around them will be profound.

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Of course one of the truths of substance abuse recovery is that while these changes are powerful and very meaningful, they truly are only the first steps at the start of a long journey.

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Dr Peter Coleman

Spiders on Drugs

Those of you who have come to The Coleman Institute for Accelerated Suboxone Detox, Accelerated Opiate Detox, Accelerated Benzo Detox or Alcohol Detox know that besides staying up to date on the latest treatment modalities in the field of substance abuse, we are always learning from and teaching students. Most semesters we have students from the Medical College of VCU participating with our patients, both in the family practice and addiction venues. Their presence contributes to our warm, dynamic atmosphere.

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Following is a link to a fascinating bit of research one of my students told me about. It’s amazing to see how drugs affect our arachnid brothers and sisters:

This video published on youtube by "apeman888" under teh title "Spiders on Drugs"

Dead Man Walking

“Dead Man Walking!” These are the words used by the prison guards during the movie of the same name when Sean Penn begins his final walk to the lethal injection chamber where he will be executed for the crime of murder. Based on a true story, the film chronicles an unlikely relationship between Penn’s character inmate Matthew Poncelet a young, rebellious man and Susan Sarandon’s character Sister Helen Prejean who is an aging nun fighting the death penalty. The two form a relationship that eventually leads to a change of heart, a confession of the soul, and a symbolic redemption of Penn’s character before his execution.

Last month, we looked at Step 4 wherein the recovering addict is asked to make a searching and fearless moral inventory of their past mistakes towards themselves and others. This tool is very useful in helping the addict to begin to see, understand, and own the fact that their treatment of themselves and other people were chief components leading to their addictive behavior. It is a hard process but one that is indispensible in the recovery process.

This month we will look at Step 5 which is, “Admitted to God, to ourselves, and to another human being the exact nature of our wrongs”. If Step 4 was the key that unlocked the door to future freedom, Step 5 is the first step in that direction. The purpose of Step 5 is confession through vulnerability resulting in acceptance and affirmation. It is NOT easy. This step calls for the addict to be brutally honest about all the skeletons piled high in their moral closet. It is a purposeful exposure of the deep, dark places of their lives that no one but they know about.
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Thankfully, through the wisdom of the program, Step 5 occurs in the safety of a sponsor, trusted friend, or clergyperson. It is also occurs in the presence of the addicts Higher Power. This safety and trust allows the addict to be real and unload the burden they have carried for so long.

Likewise, in the film, Sean Penn’s character Matthew Poncelet goes through his own Step 4 and Step 5 through his relationship with Susan Sarandon’s character Sister Helen Prejean. At first he is arrogant and dismissive of Prejean’s attempts to form a relationship but later capitulates after he sees Prejean’s persistence. As the film progresses, Poncelet begins to soften in his demeanor and attitude. Prejean supports him as a human being regardless of his guilt. This support makes it safe for Poncelet to eventually confess his guilt and try to make restitution.

Here is the dialogue that occurs near the end of the film:


Prison guard: “Do you have any last words, Poncelet?”
Matthew Poncelet: “Yes, I do. “[pauses]
Matthew Poncelet: “Mr. Delacroix, I don't wanna leave this world with any hate in my heart. I ask your forgiveness for what I done. It was a terrible thing I done, taking your son away from you.”
Clyde Percy: [Softly to his wife] “How about us? “
Matthew Poncelet: “Mr. and Mrs. Percy, I hope my death gives you some relief.”


While it may seem like a typical “jailhouse confession”, Poncelet’s words comprise a basic Step 5. They point to the reality of his crime, those who were affected by it, his intentions with the crime, and his hope for restitution through his death. Obviously, this can be considered an extreme example however a lot can be learned from it. Penn’s character is open and honest with Sister Prejean and the victim’s family. He owns his crimes admitting their exact nature.

Likewise, in recovery, honesty and accountability go along way. When an addict shares their Step 5 with a trusted confidante, they become free on the inside. They no longer have to carry their past alone. They can take it off their shoulders and set it down once and for all. That is the joy of Step 5.

So this month, let me encourage you to be bold and take a step out of the darkness and into the light of vulnerability and confession which yields acceptance and affirmation and give up the title of “Dead Man [Woman] Walking”!

Chris Newcomb - Aftercare Coach / Coordinator

Monday, May 17, 2010

Chronic Pain

Nurse practitioners long before I started my career did the hard work of legitimizing our profession. In most states Nurse Practitioners are able to write for controlled substances. Many choose not to exercise this privilege, for it opens the doors to potential problems.

Thank God there are medicines available to people with pain. Some acute injuries, post-surgical pain, and certain chronic conditions are helped by narcotics. For people with addiction issues and chronic pain, the situation becomes much more complex.

Anyone who takes pain medication for a certain period of time can develop a physical dependency. That is, when the drug is not taken, he or she will experience withdrawal symptoms. It is not comfortable, to say the least, and many of the patients we care for at The Coleman Institute fall into this category. An accelerated opiate detox can comfortably help them get through this.

People with the disease of addiction can also be helped to get off narcotics, but they will likely want to continue to use. Until they deal with the reasons and behaviors that drive them to choosing to use drugs or alcohol, getting a detox is just a quick fix—albeit often a life saving intervention.

After significant research, Julie Smyser, one of our staff Nurse Practitioners has developed a tool to help us determine whether a patient receiving chronic pain medications is also at risk for abusing them. Based on a detailed questionnaire, and comprehensive history and physical, she has come up with a rating system that allows us to set follow up schedules and monitoring criteria. With this tool and our extensive experience with these situations, we can more effectively serve not only our chronic pain patients, but also to help identify people at risk for addiction and substance abuse.

The beauty of this for many people is they can have this consultation done through our Hamilton Family Practice office at the same location. Should the client and our staff determine that he or she is a candidate for an accelerated opiate detox, they can immediately schedule this through our intake coordinator, Jennifer Pius.

If you are a PCP, a person suffering with chronic pain or a concerned family member, please give us a call. Check us out at wwwTheColemanInstitute.com and wwwHamiltonFamilyPractice.com

Joan Shepherd - FNP

Friday, May 14, 2010

“One of Us?”

Spring is in the air! Flowers are budding, the ground is thawing, and nature is waking up from a long winters nap. Many people are doing some spring cleaning to get rid of the old and bring in the new as summer approaches. This is a time of change, of rebirth. In a another sense, it is reminds me of how many of the world’s religions speak of death and rebirth, being lost and found, and rising from the ashes like the proverbial phoenix.

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As people move through recovery, one important step they must take is Step 3 which is essentially a decision to, “turn our will and our life over to the care of God as we understand God.” And for many people, all progress halts at this step. Talking about religion can be scary to many people. It brings up bad images of mean nuns, overbearing priests, powerful caliphs, and esoteric monks. Consequently, many people avoid the discussion like the plague. It is intimidating. It is irritating. It is downright difficult.

For some, belief in a high power was how they were raised so the decision is not a huge stretch. For others, they have never considered the concept of a power greater than themselves or find the entire idea anti-scientific and stupid from the get go. This poses a problem for many when they arrive at Step 3.

Without waxing “theologic” (i.e. thinking Higher Power type stuff), I’d like us to take a look at a pop song called “One of Us” written in 1995 and made a hit by Joan Osbourne. We’ll look at the words of the song in light of the decision that Step 3 requires.

Osbourne sings a series of questions for the listener to cogitate asking, “If God had a name what would it be? If God had a face what would it look like?” Certainly huge questions for a pop song to ask! In the catchy chorus, she continues,

“What if god was one of us,
Just a slob like one of us,
Just a stranger on the bus,
Trying to make his way home.”

The song never really gives a direct answer but it hints at the idea that perhaps the divine is closer than we think, available to talk to, desiring relationship, and more understanding of our plight than we once thought or imagined. The writers of the A.A. Big Book hinted at the same thing, “When we drew near to God, God disclosed himself to us” (p. 57).

As winter turns to spring, lets us embrace the newness of the season. Let us turn away from the old and embrace the new. Let us open our hearts to the questions we must ask in order to recover. Maybe the important question is not is God one of us? Perhaps the question is who are we to God? Finally, may you take Step 3 and find it’s just the step you’ve always been looking for and never knew would feel so right.

Chris Newcomb

Tuesday, May 11, 2010

Stuffing Your Feelings

I’ve just come back from a remarkable conference in Phoenix Arizona. Although the content was geared around helping clients with weight loss, the main presenter, Dr. Martha Beck, is doing extensive work with people addicted to heroin. It’s not such a stretch to see the connection between using food and using any other substance (or behavior) to separate one’s mind from one’s body.

Choosing not to feel is a protective mechanism that human’s have perfected beautifully. Constant avoidance of unpleasant emotions is easily dealt with by putting anything between the painful thought and the subsequent emotion.

The pesky little problem with doing that is that it consumes an inordinate amount of energy to always be in Avoidance Mode. Not only that, stuffing in food or shooting up dope has its own set of pretty nasty consequences.

What I want you to believe is that at the very core of your being, you can know peace. It is there, waiting for you. The process of finding it is simple, but not necessarily easy.

It begins with acknowledging, accepting and stopping one’s addictive behavior. Not medicating with food, drugs, sex, gambling or whatever--may seem terrifying, especially if you’ve been doing this behavior for a long time to cover up some painful experiences. Believe me, we have heard some truly tough stories. But once you choose to own and embrace your painful story, you can start to move forward.

There really is a beautiful life waiting for you; it’s called Reality, and there is nothing funnier, more joyful or more rewarding than living in it.

At The Coleman Institute we love helping people take that first step and ushering you to the next.

Joan Shepherd - FNP

Saturday, May 8, 2010

Anna and Robbie

Robbie was receiving chronic pain treatment and when he started coming up short on his meds his PCP knew there was a problem. Sure enough, he brought his wife, Anna, into the office, both of them embarrassed to admit that he was giving a portion of his medication to her. Apparently she had had a surgery 2 years ago, was placed on medication and was never able to stop. Her doctor cut her off rather abruptly and she went into severe withdrawal.

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Anna and Robbie are devoted parents who are both struggling with opiate addiction issues, and possibly chronic pain issues. Until they stop using the opiates they won’t be able to know for sure about their pain.

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Anna was weeping with shame and struggling with physical symptoms. She was humiliated that she had become dependent on these medications.

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I was very clear with Anna, as I am with all of our patients: physical dependence isn’t a choice; it’s going to happen if a person takes enough narcotics long enough. A choice is originally made to use the medications in the first place, but many of our patients have been started on pain medications by well meaning physicians who continue to prescribe. If they stop prescribing, many patients will go to the ER for meds, find another physician or start buying drugs ‘off the street’.

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Anna is going to be fine. With our Accelerated Opiate Detox at The Coleman Institute she’ll be opiate free in 3 days and she plans to follow up with an Intensive Outpatient Program. Call if we can help you.

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Joan Shpherd, FNP

Wednesday, May 5, 2010

“Squirrels make choices?”

Apparently so! There is an old saying that is both hilarious and true at the same time. The saying is, “Indecision killed the squirrel”. Short and sweet but what a powerful point it makes!

Recovery from drugs and alcohol addiction can be a lot like the squirrel stuck in the middle of the proverbial road. Does he go backwards or forwards? Can he weave through the traffic to safely arrive at his destination yonder across the road? Similarly, the addict is navigating a new direction by starting down (or in this case across) the road to recovery. During the journey, there is temptation to go back, temptation to stop in the middle and hang out, and even fear of what is on the other side.


Recovery is premised upon action. It is, in fact, all about choices. Actions, of course, are just the result of choices made. If that is true, than our choices become a very important factor in the outcome of our lives.


It is fairly evident that people have a freedom to choose one course of action over another. We are not automatons although we may feel hemmed in, trapped, and powerless by the power of a drug/alcohol addiction. With this in mind, it is very hard to make the case that we just “become” addicted. Sure that is what happens BUT it is AFTER we make the decision NOT before. Therefore, it is incumbent upon the addict to embrace a life of positive choices in order to stay recovered. That, of course, requires a plan!


To choose one path is, by default, to not choose another path. That’s obvious, right? Not so fast! Most people miss the obvious when it comes to decision making. Therefore, whenever you make a decision to forego recovery work, you are, in fact, making a decision to head toward relapse. It may not be intentional and you certainly may not have a future relapse on your mind, however, to not build up your defenses is akin to what Darth Vader said to Luke during their epic battle… “You are unwise to lower your defenses!”


Therefore, it is wise to make a recovery plan to live out each day. Good questions to ask yourself include the following: What types of people will you associate with now that you are sober? What places are safe for you to go and which will you avoid? Are there relationships you need to sever or at least put on hold for the time being?


Furthermore, it is wise to consider what positive choices you can make each day to ensure your sobriety. Do you need to alter your behaviors in more positive ways (i.e. avoid bars; attend “sober parties”, start a hobby, etc.)? How many program people do you need to call a day? Do you check-in with your sponsor every day? Will exercising be of benefit to you today? How about journaling your feelings so that you are not “emotionally constipated”?


Finally, life is all about choices. The lure of alcohol and drugs can be overwhelming at times but remember you always have a choice. If curiosity killed the cat, then indecision definitely killed the squirrel. So, remember kids, look both ways when crossing but don’t stop ‘til you get to the other side or the Mack Truck of Addiction will flatten your progress in recovery!


Chris Newcomb

Sunday, May 2, 2010

Saving Birds

It’s funny how a person can get an idea in their head and feed that thought until it becomes their Truth.

Yesterday my daughter and I went to hear Daniel Pink, author of A Whole New Mind give a lecture. On the way there, I did the unthinkable: I rolled down my window on a stretch of isolated country road and spit my gum out. My daughter looked at me, horrified, and said she has NEVER thrown gum out of a window because I taught her early on that a bird could get stuck in the gum and hit by a car. I almost had to pull over because I was laughing so hard. The idea that a bird could get stuck in a little wad of gum was just so ridiculous—and the fact that she had kept this ‘sacred truth’ for a good 15 years was so funny to me!

While I honestly don’t recall ever dreaming up that urban legend, the truth is, I see people every day who have adopted certain thoughts and beliefs in their lives, and now those thoughts rule their every action. In my coaching class, we call thoughts that prevent a person from achieving his or her dream a Limiting Belief.

Once a person holds onto a thought and continues to feed it, the brain will constantly gather evidence to substantiate it.

I will often talk to my clients about ways to examine their thoughts; just step back a bit and ask, “Is this thought really true for me? Is it serving me in my life now?”

Last week a recurring theme among clients was fear that leaving their homes meant they would seek former drug using friends. We examined these thoughts and came up with some thoughts that proved to be even truer: I will continue to seek people who are in Recovery.

This seems simple, and it is. This idea can be reinforced so the brain will gather evidence to support it. ‘Seeking friends in recovery’ can become the truth.

I don’t know how many birds have been saved over the years because my daughter refrained from tossing her gum out the window. I know that examining the thoughts and having a giant belly laugh with her felt amazingly good.

That’s a common experience among people who examine their silly thoughts.

Joan Shepherd - FNP