Title: Empowering Women Toward Long-Term Recovery
1Empowering Women Toward Long-Term Recovery
Kathleen Tavenner Mitchell, MHS, LCADC Vice
President and International Spokesperson National
Organization on Fetal Alcohol Syndrome (NOFAS)
2- 2 Things Necessary for Life
- water
- women
3FASD AN UNEXAMINED CAUSE OF RELAPSE IN WOMEN
- Women that have used during pregnancy have severe
guilt and shame that needs to be addressed in
order to prevent relapse - Women that have children with unidentified FASD
are at high risk for relapse due to the behaviors
of their children and the belief that they are
poor parents - Women that were exposed to alcohol prenatally may
have FASD putting them at high risk for relapse
4Key Clinical Practices
- Ask
- All women of childbearing age about alcohol use
- All pregnant women about alcohol use
- Advise
- All women planning a pregnancy that no alcohol is
the safest choice - All pregnant women that no alcohol is the safest
choice - women who consumed alcohol during their pregnancy
to contact local resources and services - Assist
- assist women to stop drinking through
information, counseling, care and referral to
appropriate programs and services
5Opportunity
- Pregnancy is an opportunity for change
- Women who are pregnant are more receptive to
intervention programs and treatment than women
who are not currently pregnant
6Discuss Birth Experiences with Women
- Red Flags
- Two or more miscarriages?
- Stillbirths?
- Infant/child deaths (SIDS)?
- Children with LD, ADHD, MH or behavioral
disorders ? - Children diagnosed with FASD?
-
-
- Positive response to any of the above questions
should warrant a screening of all children for
possible FASD (where substance use is known or
suspected) -
-
K Mitchell,
2004
7During Screening
- Follow up the screening questions with probes
- Be non-judgmental
- Listen attentively to her concerns
- Refrain from negative comments or reactions
- Focus on your patient as well as her baby
- Be sensitive to broader issues and contexts such
as poverty or abuse - Make positive statements about the woman seeking
prenatal care - Make positive statements about progress during
each visit
8 9Locate Treatment that provides Feminine Focused
Recovery
- Address the unthinkable
- Sexuality
- Biological differences
- Menstruation
- Abuse
- Substance use during pregnancy and possible
consequences - Secrets
- Desires, dreams and fantasies
-
103 Things that Keep and Addict Using
- Stigma
- Family Enabling (Guilt)
- Defense Mechanisms
11Women and Addiction
- The center of the addicts life is no longer God,
the family, and/or her job/career, it is her
addiction - All of her behavior has the ultimate goal of
feeding the addiction - The family members become objects, means to an
end, rather than real people - This causes the alcoholic to become their entire
focus and center, or they abandon her
12Progression of Alcoholism
Stage 1 Tolerance Stage 2 Physical Dependency Stage 3 Major Organ Change
high tolerance with occasional use increased tolerance/possible a.m. use possible daily or maintenance use (reduced tolerance)
occasional hangovers withdrawal headaches/nausea (anorexia, high BP, loss of concentration, weakness) migraines Vomiting rapid pulse, BP disorientation
disrupted sleep patterns sleeplessness insomnia
Colds/ infections disease pathology developing major organ damage
Irritability-mood swings-mild depression-isolation MH diagnosis (depression, anxiety, panic) institutions and rx suicidal ideation or attempts K. Mitchell, 2004
13Stage 1 Tolerance Stage 2 Physical Dependency Stage 3 Major Organ Change
memories of how nice use was preoccupation/ craving use despite consequences
one-two gateway drugs variety of drug use multiple drug addictions
mild tremors intentional tremors seizures or D.Ts
sexual pleasure sexual problems impotence
family problems school work problems loss of family, job school
trouble with the law (close calls) DWI-DUI / possession incarcerations K. Mitchell, 2004
14Empowering and Honoring the Feminine
- Intuitive wisdom
- Motherhood / life-giving
- Healers
- Caretakers
- Artisans
- Visionaries
15The Natural Order of the Universe
- To live in tune with the Earth we need to
remember that we too are a precious natural
resource to be cared for and valued just as we
value the trees or the sea. Like them we live in
the rhythms of the seasons and the days. - Addiction is a hurricane an earthquake These
events can bring balance to Mother Nature
16Feminine and Masculine Balance
- Yin and Yang
- Shakti and Shiva
- The basis for harmony in all of life.
17Change Perception linear to circular
18Yin Energy
- Taoist term for the Feminine force.
- The receptive, the watery, the earth.
- Associated with the negative magnetic pole, with
the moon, with coolness, with attraction rather
than assertion. - The power of Yin comes from natural
responsiveness, nurturing and support not direct
independent action. - The receptive force is sensual, flowing,
accepting and allowing. - Yin energy moves through feelings rather than
thoughts, it is diffuse, spacious, and open.
19The Feminine represents fertility, and is often
seen symbolically as a chalice, cup, container,
valley or womb.
- She is the earth, the ground, the mother, the
maiden, and the crone.
20Honoring the Feminine
- The essence of the Feminine is Love.
- The pure white light of the Divine Mothers
unconditional love for all her children. - The Feminine is also the power of unity, of
connection, of relatedness, which weaves all of
creation together. - The Feminine emphasizes togetherness,
similarities, correspondences, and Oneness.
21Biological Differences
- Womens bodies have less body water than men of
similar body weight - Achieve higher concentrations of alcohol in the
blood with equivalent amounts of alcohol - NIAAA Alcohol Alert 1999
-
22Biological Differences
- Women experience major organ complications more
rapidly than men
- Liver damage
- Cirrhosis
- Brain damage
- Heart disease
- High blood pressure
- Stroke
- Breast cancer
- Gastrointestinal hemorrhage
- Anemia
- Malnutrition
- Colon cancer
- NIAAA, Alcohol Alert 1999
23Menstrual Cycle
- Calendar to chart bleeding, cravings, moods,
behavioral reactions, depression - Discuss ovulation
- Half-way through cycle
- Increase in vaginal discharge
- Slight cramping in abdomen
- May augment moods
24PMS Emotional Symptoms(Relapse Vulnerability)
- Mood swings
- Critical of loved ones
- Negative thinking
- Crying spells
- Depression
- Controlling attitudes/behaviors
- Forgetfulness
- Indecision
- Panic attacks-Suicidal ideation
25PMS Wellness
- Reduce sugar salt (diet sodas)
- Reduce or eliminate caffeine
- Increase soy
- Consider natural hormones (perimenapause or
menopause) - Good Quality Multi-vitamin
- Vitamin B compound vitamin E
- Calcium with magnesium
- Limit dairy/increase green leafy vegetables
- More AA, naps, relaxation, yoga
26Honoring our cycle
- Let others know what your needs are.
- Indulge your creativity it is keenest now.
- Take a nap.
- Have a piece of chocolate.
- Cook if you want to, or dont.
- If you need to crygo ahead (set a time limit
though, no all night pity parties allowed!) - Wear loose comfortable clothes.
- Listen to your body, your inner wisdom knows best.
27Honor Thy Bitch!
- All women have a dark goddess she holds the
power of the feminine! - The dark goddess is the creator and the
destroyer. She is depicted as one who cuts off
the heads of men. This is a symbolic
representation of her challenging the Ego. - Embrace her POWER.She will lead her to
Healing.to Recovery!
28Menapause The Crone
- Wisdom
- Knowing arises from direct experiences
- This is a valuable natural resource a teachera
healer - Brings balance to the family
29Women with Addictive Disease
- Many have lost their voice have turned off
their inner wisdom - Have low self-esteem
- Have little self-confidence
- Feel powerless
- Majority have been physically and/or sexually
abused - Are codependent
- Have been living in secrecy
30Traits of Codependency
- Over developed sense of responsibility
- Stuff feelings from traumatic childhood
- Lost ability to express feelings
- Isolated/afraid people and authority figures
- Addicted to approval/excitement (crisis)
- Frightened by angry people or personal criticism
- See themselves as victims
- Judge themselves harshly
31Traits of Codependency
- Abandonment issues
- Feelings of guilt when they stand up for selves
- Confuse love and pity, love people they pity
(rescuers)
32Ways to Destroy the Culprit ( Codependency)
- Perfectionism
- 3 Ps (perfectionism, procrastination, paralysis)
- Vocabulary
- Change I cant to I choose not to or I
wont - Decision making
- Make everyday decisions
- Choices
- Every action is a chosen action
33Other Methods to Rescue Women from Addiction
- Relationships
- Consider physically separating from partner
- Detachment skills
- Enabling
- Remove client from enabling family members
- Investigate love verses enabling
- ACOA issues
- Educate on effects on family
- Treat childhood issues with relapse clients
34Women need Women
- " How might your life have been different if
there had been a place for you to go.. a place of
women, to help you learn the ways of women, .. a
place where you were nurtured from an ancient
flow sustaining you and steadying you as you
sought to become yourself. A place of women to
help you find and trust the ancient flow already
there within yourself. . waiting to be released.
. How might your life be different?"
Duerck
35Identify or Create Natural Connections
- Re-Connecting Women
- Family
- sisters, mothers, grandmothers, daughters, grand
daughters - AA/NA
- Womens meetings, womens retreats
- Women Circles/Clubs/Meetings
- Artist way meetings, inner child groups, quilting
- Spiritual Communities
- Social Activities
- Health Club/Physical Activities/County
Recreation - Art or yoga classes
36Communication SkillsSetting
BoundariesnoAssertivenessnot passive-not
aggressiveHonesty I cant to I wont
37Confrontation IS
- A challenge to both parties to stay open
- An attempt to communicate honestly
- A courageous act of good intent to state ones
feelings and thoughts - An effort to keep relationship growing
- Misunderstood It is not yelling, screaming, or
guilt making - Part of healthy intimate relationships
- An act of self-affirmation
- Sets a boundary
38Confrontation IS NOT
- An attack
- An effort to hurt
- Verbal abuse when done carefully
- A thing to fear or avoid
- The same as criticism
39Non-assertive Assertive Aggressive
Verbal Apologetic word, rambling, failure to say what you really mean Statement of wants/ needs, I messages, honest statement of feeling Loaded words, accusations, You messages, superior words
Non-verbal Hoping someone will guess what you want Active listening behavior, caring, communication and strength Flippant sarcastic style
Voice Eyes Weak, hesitate, soft Downcast, teary, pleading Firm, warm, relaxed Open, direct eye to eye contact, not staring Loud, authoritative, or deadly quiet Staring, not really seeing you
Stance Posture Lean for support, twisted Stooped, sagging, head nodding Well balanced, at ease Facing, relaxed Hands on hips, feet apart Stiff and ridged, rude, head bobbing
40Non-Assertive behavior Assertive Behavior Aggressive
Characteristics of the behavior Allows others to choose for her Permits others to infringe on her needs Chooses for self Expresses and asserts own needs Emotional honest direct Chooses for others Expresses needs at expense of others Inappropriate outburst
Feeling when you engage in behavior Hurt, anxious, disappointment, and anger Confident, self-respecting, feels good about self Angry, righteous, superior, then guilty
Outcome Payoff Doesnt achieve desired goal Avoids conflict May achieve desired goal Honest relationships Achieve desired goal by hurting others Justifies resentment
41Parenting Issues
- Guilt/shame
- Child neglect and/or abuse
- Feelings of inadequacy
- Difficult past with care-taking of family
- Legal/foster care
42Sexuality
- Promiscuity
- Prostitution
- Rape
- Fear of sex
- Incest and/or sexual abuse
- Loss of orgasm
- Painful sex
- Sexual orientation
- Value conflicts
- Sexuality as a relapse trigger
43Use Spiritual Concepts (No longer in charge)
Breathe God in and me out
44Developing a Sense of Self
- Kill the critics Whose voice is that?
- Discover the rule makers Whose rules are those?
45Meet the Committee
- Have client focus on childhood (i.e. year 0 to 3)
- Who were the people who nurtured you and
supported you? - Who were the people that were not kind to you,
hurt your feelings or hurt you in other ways? - List them, list the behaviors
46Meeting Yourself
- Investigate accomplishments Things I do really
well list - Long term goals- Do not let client limit
themselves in reality - Short term goals- achievable, measurable, simple
- Lists of needs/wants/likes
47Clearing Negativity Releasing Attachments
- Stuff
- Everything is borrowed, I own nothing
- People
- Its okay to love someone and celebrate
connectedness - Wanting to possess another misery
- The less you try to control, the closer you
become
48Releasing Attachments
- Past
- ? living in shoulds
- ? living in what ifs?
- ? self pity
- ? criticism
- Form
- ? preoccupation with appearance
- ? guilt
- ? cant- they wont
- ? never- have to
49Releasing Attachments
- Being right
- prevents communication
- inability to listen
- competitive
- aggressive
- dont answer every remark
- dont give opinion unless asked
50When life gives you lemons
Make lemonade
51Lemons to Lemonade
- Self centered fear..ability to work a
selfish program - Self reliance.independence
- Self doubtwillingness to listen to
others - Self pity..ability to self
nurture - People pleaser.successful, wants to excel,
desire for approval - Sneaky..opportunity seeker
- Manipulative.ability to obtain trust,
people listen - Experiences..wisdom
- Extreme negativity.extreme
positivists - Chameleon...chameleon
- Liar....creativity
- Con artistinnovative, thinker
52Achieving Abundance
- Abundance does not mean having and wanting
things. It means understanding that eternity and
the universe are endless
53Achieving Abundance
- Be thankful for each experience
- Repeat and surround yourself with daily
affirmations - Go the extra mile
- Suspend thoughts of separateness
- Be for things and people
- Be conscious and selfish with your daily time
- Identify goals (write them) intention converts to
conscious action - Trust your intuition
- Spend time with nature
- Walk and eat
54You are responsible for your own recovery!
H.A.L.T.HUNGRYANGRYLONELYTIRED
- 3-6 Meals a Day
- Exercise (walking)
- 8-9 Hours of Sleep (naps okay!)
- Practice Prayer and meditation
- Talk to sponsor, be around positive people
55Children with FASD are a blessing, but they will
always need a sober mom to advocate for them.
56Recovery is Honoring the Feminine
- Dance like no-one is watching!
- Play-create-dress-up!
- Immerse yourself in water, play in the snow, lay
in the sunshine, and jump in the leaves. - Open your heart, help othersit is the way of the
feminine. - Allow the tears come, so that the sun will shine
brightly. - Meditate, listenyour inner wisdom is speaking to
you. - Sing, hug trees, scream with the wind, and howl
at the moon. - Fill your house with flowers.
- Paint your walls in colors.
- Make love scream and howl if you want to!
57Contact Info
- Kathy Mitchell
- 202-785-4585 x 205
- mitchell_at_nofas.org
- www.nofas.org