While this is a public page, it is intended for clients. This content is for informational purposes only and is not a substitute for medical or professional advice. Consult a qualified health care professional for personalized medical and professional advice.
After Our Initial Appointment
To review, these exercises were suggested for completion prior to our initial appointment.
– Since treatment for substance use issues, according to research, needs to begin with medical care, please:
- Consider sharing during our next session what medical appointments and medical care you have arranged for yourself, AND/OR
- Consider filling out this medical care request form, or a version of your own, to discuss with your counselor in preparation for sharing it at your next medical care appointment.
– Please review the list of frequently asked questions and bring any questions or comments you have to our next session.
– I am working with a co-author on writing an evidence-informed, self-help guide to recovery from substance use issues in tandem with medical care. While it is too cumbersome to publish portions of the draft as we write the manuscript, this is a brief overview, dated 1/4/18, of what we are intending. You are welcome to read all, part, or none of the overview. It can serve, for now, as an abbreviated table of contents for the exercises I will share with you here.
– Consider taking a look at the purposes substances might serve for you and what might replace them (.pdf opens in new tab). Please prepare to share your observations and insights at our next session.
– Consider taking a look at your current needs and ranking them in priority order (.pdf opens in new tab). Please prepare to share your observations and insights at our next session.
– Consider doing an assessment of your self-care. You can take this assessment often to measure your progress and help you see additional small steps you can take to support yourself.
– One of the primary challenges facing people with substance issues is emotion dysregulation – an altered brain function, usually resulting from adverse childhood experiences (ACEs), trauma, or neurodevelopmental disorders. Experienced at the individual level, when something happens, the intensity – or “volume” – on one’s inner state goes way up, very fast, and subsides slowly. This is over-simplified, but because of the way the brain works, the amygdala, home of emotions, overrides the prefrontal cortex, home of decision-making. On the individual level, emotion dysregulation is experienced as I feel, I do.
If emotion dysregulation is a problem, emotion regulation can be a solution. In people with emotion regulation skills, when something happens, the amygdala is activated, but the person consciously engages the prefrontal cortex. It’s experienced as I feel, I think, then I do.
Most people are quite skilled at emotion regulation and just need to use it more consciously.
Here’s how to do that.
First, become aware that you are feeling feelings. This is usually cued by awareness of physical sensations – changes in breathing and heart rate, perhaps beginning to sweat or having a sense of heat in the face or skin.
Second, name the feelings. This simple act of naming feelings activates the prefrontal cortex, bringing to the reality of one’s feelings the addition of one’s mind. The presence of both heart and mind is what Marsha Linehan, founder of dialectical behavior therapy, terms “Wise Mind.”
To work with the idea of “Wise Mind,” you can download this .pdf coloring page which opens in a new tab here.
In an urgent situation, naming one of “the big four feelings” can be helpful – mad, sad, glad, afraid. See which of these diagrams appeals to you to help identify nuances in your feelings:
- Plutchik’s Wheel of Emotions (Here’s a further explanation of Plutchik’s Wheel.)
- The Feeling Wheel by Dr. Gloria Wilcox
Here’s a “volume control” exercise you can do to help yourself become aware of the intensity of your inner feelings state. If you care to share, I would welcome seeing what you create.
More to come! Last updated 10/13/18
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If you are not yet a client of my private practice, and would like to become one, and are a resident of Virginia, please register as a new client to request an appointment.
This content is for informational purposes only and is not a substitute for medical or professional advice. Consult a qualified health care professional for personalized medical and professional advice.
