1. Relapse as a Learning Opportunity
2. Learning Self- Forgiveness After Relapse
3. Warnings Signs of a Relapse
4. How to Reduce Relapse Risks
5. Understanding Addictive Behaviors
6. How to Make an Action Plan for Risky Situations
7. How to Identify & Cope with Stressors
8. Lifestyle Changes for a Healthy Recovery
9. How to Live a More Balanced Life

Accompanying Worksheets:

There are lessons accompanying each video that you can access through our recovery portal, Swell or you can download, here. (Lesson 5)

Medically-reviewed articles:

• Common Relapse Triggers
• What to Do if You Have A Relapse or Slip?
• How to Help Someone Who is Experiencing a Relapse

Professional webinars:

• Relapse Prevention: “Doing” Recovery in this Changing World
• Our Staff’s Stories of Recovery

Relapse Workshop: Addictive Behaviors

In this lesson, we’re going to talk about other addictive behaviors.

So as humans, we tend to solve our problems by avoiding them or controlling them. And this works fine with external things, but it typically doesn’t work well with internal processes such as thoughts, feelings, physical sensations or memories.

There are things that we do as humans that we use to deal with our inner world. We tend to want to get rid of unpleasant feelings and thoughts. In other words, we want to avoid. And we tend to want to hold on to pleasant thoughts and feelings. We want to control them.

When we rely on these strategies repeatedly, they can become addictive and unhealthy as a coping mechanism. This may seem a little strange, but stay with me.

This includes seemingly healthy things like working, cleaning or exercising.

So getting to know our other addictive behaviors can really help us to maintain sobriety from drugs and alcohol. The more awareness we have, the less likely we are to react in impulsive ways.

So some potential cross addictions we may have is:

• Using nicotine
• Sex
• Caffeine
• Pornography
• Watching TV
• Masturbation
• Playing video games
• Gambling
• Cleaning
• Organizing
• Working
• Using social media
• Shopping
• Eating when you’re not hungry
• Dieting
• Exercise
• Sleep
• Gossip
• Cutting or harming yourself
• Isolation

Are there any others you can think of? Often we develop addictions as a way of coping with emotions. Now I want you to realize these behaviors that are listed are very normal behaviors that humans do. They aren’t always addictive just because you’re using them. We will work through and talk about how to know when they’re getting to be addictive for you.

When we stop using alcohol or drugs, we can feel overwhelmed by the emotions that we now have more exposure to. It’s common to use these other behaviors in an addictive way to replace the drugs or alcohol that we were using to cope with them. It’s also common that these behaviors were used in conjunction with drugs and alcohol. So we need to get to know all of the ways in which we numb our feelings to begin to develop more effective, less destructive ways of coping with difficult emotions.

For any of the behaviors you identified as a potential cross addiction, I want you to explore the following. This is a way of identifying whether or not this is a harmful behavior for you.

So what would happen if you use this behavior every day for six months? How might it impact your physical health, your mental health, your productivity at work or school, your relationship with friends and family, and your finances?

And if it doesn’t have an impact on these things, then there’s nothing wrong with continuing that behavior. If it does have an impact, it might be something you want to take a look at as a thing you’re using ineffectively or in an addictive manner. And you might also want to ask yourself….. What if you used it every day for 10 years? Would that change anything about it?

And so next we are going to be developing an action plan and an escape plan.

Thank you for choosing The Recovery Village. If you or a loved one are struggling with mental health or substance abuse and would like to find out more about the programs we offer, please reach out to us directly at 855-387-3291.

1. What is an Alcohol Use Disorder?
2. How Alcohol Affects The Brain
3. Physical Effects of Alcohol Use
4. Treatment Options for Alcohol Use Disorder
5. Medication-Assisted Therapies for Alcoholism
6. How Alcohol Affects Our Daily Lives
7. Risk Factors of Developing an Alcohol Use Disorder
8. How Binge Drinking Affects You and Others

Alcohol Use Disorder Part 4

This lesson will be on medical complications of Alcohol Use Disorder and some treatment options.

There are many Alcohol Medical Syndromes, based on data from the National Institute of Health. Alcoholic polyneuropathy is when alcohol affected the nerves and caused a neuro disease.

Alcoholic cardiomyopathy means that alcohol directly affected the heart and caused a heart disease.

Alcoholic gastritis means alcohol contributes to a stomach disease or a liver disease or a fatty liver or even hepatitis, which is inflammation of the liver.

Chronic alcohol use can lead to fibrosis and sclerosis of the liver and cirrhosis of the liver, which is end stage liver disease due to scarring of the liver, which can lead to alcoholic hepatic failure or liver failure.

Alcohol can also cause acute pancreatitis or chronic pancreatitis.

One of the saddest things is for women who have alcohol use disorder and are drinking while they are pregnant. The newborn can have fetal alcohol syndrome, the results are they are born with chronic physical and neurologic problems.

I reviewed some of the syndromes caused by direct consumption of alcohol. And there are more to come.

I mentioned alcohol induced cardiac issues. Alcohol can cause other issues with the heart. One of the most common things is high blood pressure or hypertension. And the research shows that alcohol consumption at any amount for men can affect their blood pressure and really should be at higher consumption levels for women, which would be more than one alcoholic beverage a day.

There is also an increased risk of heart conduction disorders that would lead to an irregular heartbeat. Your heart is a muscle and has an electronic pacemaker built into it. And if alcohol causes damage to the heart and to the pacemaker that is built in, it can cause all kinds of irregular heart rates. These can give you an increased risk of stroke.

Cancers. A lot of different cancers are affiliated or associated with alcohol use disorder.

The most common, of course, is where you think, which is where alcohol touches. It touches your mouth. It touches your esophagus. It touches your pharynx, which is part of your voice box and larynx. It goes into your GI tract and affects your stomach. It can affect your colon, which is at the end, and your rectum and your liver. So virtually everything that alcohol touches from your mouth to your rectum could be subject to cancer.

In addition, females, there is an increased risk of breast cancer from alcohol use disorder.

In the last lesson, I did talk about symptoms of alcohol withdrawal. And that there are individuals who will continue drinking to avoid withdrawal. And by drinking more, they may feel euphoria or pleasure. And I do want to emphasize that we do offer safe medical detox. That is probably the first step for someone with mild to severe alcohol use disorder. They need to get off the alcohol safely and we do offer safe medical detox. We also offer medications, there is another lesson that is not part of this series on medication assisted therapy.

We have three main medications to help with alcohol use disorder.

The first one is Disulfiram, also known as Antabuse. Disulfiram is the generic name and Antabuse is the brand name and how this works is it affects the metabolism of alcohol and basically makes you pretty sick if you even touch alcohol or consume it. How it works long term is that, you know, if you know you’re taking Antabuse and you have that urge to drink, you’re going to think twice about it because you don’t want to get sick.

Acamprosate is another medication that seems to help stabilize the neurotransmitters and not give you as much of a buzz when you drink. It can be very helpful with alcohol use disorder.

The third one is Naltrexone. It also works by slowing down the “buzz—or intoxicating effects” that you might get from alcohol. And a nice thing with naltrexone is that you get it monthly in shot form. That helps you maintain sobriety quite a bit easier. They also have tablets of naltrexone available that you can take instead of the shot.

Treatment for your mental health issues is a very important part of recovery. Virtually every patient that is going through withdrawal has some depression and some anxiety. It is a major life event to give up alcohol, especially if it has been so much part of their life for 5, 10, 15 years or more. Many social and personal things will need to change to be successful in recovery. Often there has been a critical event in their life. Loss of job, loss of a life partner due to alcohol use disorder. It is really important to have a psychiatrist and or engage in psychotherapy if you have depression or anxiety that does not improve with sobriety.

Medications can be very helpful for the treatment of depression and anxiety. It is extremely important that your medical provider prescribing medications for mental health issues knows that you are in recovery. No opioid should be prescribed, which are potentially dependent and habit-forming. No stimulants should be prescribed and no benzodiazepines, which are tranquilizers. All three of these classes are potentially addictive and habit-forming and should not be prescribed to anyone who is in recovery from alcohol use disorder or any substance use disorder for that matter.

In addition to medications, self-help programs are very beneficial. The Recovery Village does not endorse a specific self-help program, but we do feel they are beneficial. Some names you may be familiar with are Alcoholics Anonymous. Narcotics Anonymous or Celebrate Recovery. They all are excellent programs; they are free and available nationally and we support patients going to them.

CBT or Cognitive Behavioral Therapy is a type of cognitive thought-based therapy to work through issues. Motivational interviewing is another therapy working with getting people engaged in recovery and working through the obstacles they may have in wanting to get a recovery process going.

Group therapy can be very helpful. Your peers can be some of your greatest assets for the recovery process. And, of course, family therapy and individual therapy can help with the recovery process.

In summary, alcohol use disorder is a chronic disease. The Recovery Village has treatment programs to help you understand the consequences of alcohol use disorder, we have detox available and then medication assisted therapy while supporting your participation in self-help programs and evidence based clinical therapies.

Thank you for choosing The Recovery Village. If you or a loved one are struggling with mental health or substance abuse and would like to find out more about the programs we offer, please reach out to us directly at 855-387-3291.

• What is Anxiety?
• What Causes Anxiety?
• What are Anxiety Triggers?
• How to Identify Anxiety Triggers?
• How to Cope with Anxiety?
• How to Get Help for Anxiety?

• Types of Anxiety Disorders
• Is Anxiety Genetic?
• Is Anxiety Linked to Addiction?

• Critical Events and Stress Management

In this lesson we’re going to discuss anxiety triggers.

What are anxiety triggers?

Anxiety triggers are an action, object, or situation that can cause symptoms of anxiety to appear. It is important to note that triggers are not the actual cause of anxiety disorders. They only bring on or trigger the symptoms to arise. We discussed in the previous lesson that anxiety disorders are caused by a combination of factors including environmental, genetic, medical, and the use of drugs or alcohol.

Triggers can bring on episodes of anxiety or make existing feelings of anxiety even worse. Feelings of anxiety can be triggered by a number of factors. For instance, everyday situations, or they can have intuitive causes, or they can appear to have no cause at all. Let’s talk about these in more detail.

Individuals who have an anxiety disorder may notice their symptoms escalating and not be able to identify why.  These feelings seemed to come out of nowhere as the person goes about their daily life.

Intuitive triggers are those experiences and situations where most people would expect to feel anxious. Such as high stress situations, having a serious illness, or being involved in an abusive relationship.

Everyday situations.  There are situations that affect individuals differently. Certain life patterns tend to increase anxiety for those who already have an anxiety disorder. These daily life patterns include drug and alcohol use, smoking, and caffeine intake. It is common for individuals to abuse drugs or alcohol or smoke in an attempt to cope with feelings of anxiety. In reality, the use of these chemicals is more likely to increase feelings of anxiety as well as lead to other, even more serious physical and emotional consequences.

Individuals who regularly drink coffee or other caffeinated beverages tend to do so for its effect as a stimulant to help themselves be more alert in the morning or throughout the day. For those with an anxiety disorder, however, caffeine will likely trigger or worsen their feelings of anxiety. Other factors of daily life that influence anxiety are medication, nutrition, and sleep. Certain prescribed or over-the-counter medications may contain compounds that trigger anxiety in some individuals. It is important to see your medical professional should you experience unpleasant side effects.

Most people know that neglecting proper nutrition and not getting enough sleep can prevent a person from functioning as well as they could. Skipping meals, not maintaining proper hydration, and consuming an unbalanced diet can also make a person more prone to increased symptoms of anxiety.

Social situations such as parties and other gatherings, as well as experiencing financial difficulties, can trigger a person with an anxiety disorder more intensely than would a person without an anxiety disorder who may only be mildly nervous about such things.

Negative thinking.  The way we think and what we say to ourselves while experiencing anxiety can influence how severely the anxiety is experienced.

Conflict itself tends to cause anxiety. If a person tends to deal poorly with conflict and has trouble resolving it in a healthy way, anxiety is likely to get worse.

In summary, we have discussed a variety of triggers that can bring on or exacerbate symptoms of anxiety. Some triggers are predictable, while at other times a person may be left wondering why they are experiencing feelings of anxiety at a given time.

In the next lesson we will discuss strategies to identify your own personal triggers.

Thank you for choosing The Recovery Village.  If you or a loved one are struggling with mental health or substance abuse and would like to find out more about the programs we offer, please reach out to us directly at 855-387-3291.

1. Relapse as a Learning Opportunity
2. Learning Self- Forgiveness After Relapse
3. Warnings Signs of a Relapse
4. How to Reduce Relapse Risks
5. Understanding Addictive Behaviors
6. How to Make an Action Plan for Risky Situations
7. How to Identify & Cope with Stressors
8. Lifestyle Changes for a Healthy Recovery
9. How to Live a More Balanced Life

Accompanying Worksheets:

There are lessons accompanying each video that you can access through our recovery portal, Swell or you can download, here. (Lesson 9)

Medically-reviewed articles:

• Common Relapse Triggers
• What to Do if You Have A Relapse or Slip?
• How to Help Someone Who is Experiencing a Relapse

Professional webinars:

• Relapse Prevention: “Doing” Recovery in this Changing World
• Our Staff’s Stories of Recovery

Relapse Workshop: Balanced Living

This lesson is about balanced living.

Stress can be directly related to having your basic areas in your life out of balance, and the more balance we can keep, we can decrease our stress and make it less likely that we will relapse, we will be less vulnerable to relapse.

So we can build our resilience by keeping the following things in balance. Exercise. Nutrition. Sleep. Social connection. Pleasure and rest. And keep in mind that we’re just trying to make tiny improvements in each of these areas in order to bring little by little, a little more balance to our life.

Exercise and movement releases endorphins and other feel good chemicals in your brain. It’s an energy booster. It improves circulation and improves the quality and regulation of your sleep.

So you want to look for ways that you enjoy moving your body. You don’t want exercise to be something you dread or don’t like doing, but you want it to be something that you enjoy and have fun with. So it can be something as simple as walking a few days a week. Play a sport if you like. Do some yoga. Join your local YMCA. There’s all kinds of fitness apps. If there’s something on there you like and you want to make sure you don’t really need rules, you just want to add some movement and enjoyment to your days.

Nutrition. You want a healthy diet. Which means that you’re eating fresh whole foods whenever possible with a balance of protein, carbohydrates and healthy fats. Now, keep in mind that if you keep your food balanced, you’re going to keep your moods more balanced. You want to learn to listen to your body’s cues for hunger, fullness and satisfaction.

It is very easy to start over eating when you’re trying to get sober. You want to take note about how you feel after eating certain foods. Everybody’s a little bit different. But do you feel better after eating it or do you feel worse? Or do you feel better for a little while? And then you start to feel uncomfortable in some way? Pay attention to your relationship with food and recognize whether you reach for certain foods when you’re not really hungry. And this can happen when we’re trying to satisfy an emotional need and we might want to use one of our coping strategies instead of food.

Diets that are high in sugar and processed foods can create a lot of imbalance in our emotions. They can bring depression and anxiety and they can impact our ability to maintain sobriety. So the more we can stay away from high sugar and processed foods, the more stable emotionally we will be.

Sleep is vital to recovery. When you are sleep-deprived, you are more prone to feeling irritable, critical of yourself and others, and impulsive, and you may have a harder time controlling your behavior. Most people need somewhere between seven and nine hours of sleep each night.

So some things that you can do to help you sleep. Eliminate light in your bedroom, especially from electronics. Eliminate sound if it bothers you. There might be noises better soothing and there might be noises that are bothersome and keeping you awake.

Limit the use of any screen for two hours before going to bed. This includes your phone, tablet readers and televisions.

Stay nourished and hydrated through the day. Exercise regularly, but not within three hours of bedtime, it’s too invigorating. No caffeine after 2:00 p.m. Everyone is a little bit different on this, but you should know your time.

Establish a relaxing bedtime ritual. Meditating, reading, yoga. The truth is just having the same thing that you do every night for 20 or 30 minutes before you go to bed can help your mind know that it’s time to relax.

Comfortable temperature. The ideal temperature is actually between 62 and 67 degrees for sleep. And if repetitive thoughts keep you awake, you should journal before bed so you can put them down and put them to rest.

Social supports. Research has shown that social supports may be as important to recovery as eating healthy and exercise is. Think about your relationships. They should fill you up rather than drain you. So do you genuinely enjoy the company of the people you’re spending time with? Or do you feel distracted by other things going on in your life? Are there other activities you’d prefer to be doing with your friends or loved ones? And if so, you can invite them to do that. Are you craving some alone time but pushing yourself to be social? We all have different needs in terms of being alone or being social. And you should honor that. And if you find yourself getting irritable because you’re around people too much, then give yourself a little more alone time. And if you find yourself irritable because you’re alone too much, then give yourself some more time with social connections. You want to take an honest look at what you need from your social supports, and that will help you to be able to take some time to make some needed adjustments.

And do what you love when you focus your energy on the things you care about. You experience life in a much richer and fuller way than when you focus on things that bother you. The kindest thing you can do for yourself and others around you is to live life in a meaningful and purposeful way. When you think about your favorite memories from when you weren’t using, what were you doing? Where were you? Who were you with? And what made that memory joyful?

And lastly, when it comes to your health, it’s important to take time to recharge and relax. It’s just as important as spending time doing activities. Allowing yourself to do nothing from time to time takes self compassion and awareness of your limits. We burn out when we push ourselves to be busy all the time. It’s important. If you need a nap, take a nap. Watch some mindless television shows. Lounge around in your PJ’s. Or lay outside in the sunshine. Relaxing helps you return to your daily activities with more energy and enthusiasm.

Thank you very much for joining us for this relapse prevention workshop.

Thank you for choosing The Recovery Village. If you or a loved one are struggling with mental health or substance abuse and would like to find out more about the programs we offer, please reach out to us directly at 855-387-3291.

1. Using Cognitive Behavior Therapy (CBT) to Reduce Anxiety
2. Reducing Avoidance with Cognitive Behavior Therapy
3. Using Cognitive Behavior Therapy (CBT) to Reduce Worry

Exercises:

There will be exercises associated with each lesson that you will be able to download here or access through our portal.

Medically-reviewed articles:

• Types of Anxiety Disorders
• Is Anxiety Genetic?
• Is Anxiety Linked to Addiction?

Professional Webinars:

• Critical Events and Stress Management

Other Clinical Videos:

1. What is Anxiety?
2. What Causes Anxiety?
3. What are Anxiety Triggers?
4. How to Identify Anxiety Triggers?
5. How to Cope with Anxiety?
6. How to Get Help for Anxiety?

Using Cognitive Behavior Therapy (CBT) to Reduce Anxiety

Welcome to this series on Cognitive Behavioral Therapy, commonly referred to as CBT, for anxiety. In this lesson we will discuss how to use cognitive behavioral therapy to reduce anxiety.

CBT helps you understand how your thoughts, feelings and behavior interact to maintain anxiety.

Imagine you have an invitation to a party. As it draws nearer, you start to feel anxious about going. You think you won’t have a good time. You decide not to go.

CBT offers a different approach.

Instead of being on autopilot, that’s where you make a decision without awareness of the thinking behind the decision, CBT techniques shed light on your thought process.

If you stop for a moment, you can listen to your internal dialogue.

Take the party example. Do you think that there might be someone there you do not want to see? That there might not be many people there you know? Do you think about that first cringey moment when everyone stops and looks at you? About negative things they may think of you?

These thoughts raise your anxiety. They make it easy to decide not to go. The same thing can happen when you decide whether to take on a new project at work, call a friend, or go to the store.

Anything that raises your anxiety, making you question moving forward, has a set of thoughts behind it.

CBT helps you notice how your internal dialogue can raise, or lower, your anxiety.

The first step is to notice the anxious feeling. Next, notice the internal dialogue. Once you can hear your internal dialogue, you can start to work on changing it. There are specific distortions, or biases, in our thinking that raise anxiety. These are some of the distortions that raise anxiety, and how you can combat them.

Catastrophizing. Catastrophizing is when you automatically think the worst possible thing is going to happen.

In the party example, you think you’ll run into someone you’d rather not see and it’s going to be a disaster.

When you take the time to think it through, maybe you have made a mountain out of a mole hill. You can always walk away from an uncomfortable encounter. That person may not even be there.

Counter the irrational thinking, instead of letting the anxiety make your decision for you.

All or nothing thinking. All or nothing thinking is when you miss the middle ground.

You make a snap decision not to go to the party because you decide you won’t know anyone there and it will be awkward.

Instead, take time to think. You might not know many people there, but you know the person who invited you. One five-minute conversation with an interesting person is a win. You may feel a little uncomfortable, but it’s good to get out. You may have an opportunity to meet someone new or talk to an old friend.

Perfectionism and the need for approval. You decide you can’t go to the party because people will look at you and judge you—your hair, your clothes. They’ll talk to you and judge you—your intellect, how interesting you are, and so forth.

Instead, ask yourself why your standards are so high that you assume you will fall short. Does everyone at a party care about how you look? Do you care about what everyone thinks? And if you do, why? Will you ever see those people again? Do you always have to look and be perfect? Do you always need everyone’s approval?

Acknowledge that you do not have to be perfect, that you do not need everyone’s approval. Plan to relax and enjoy yourself.

Need for control. The experience of doing something new or making a change requires letting go of control. We simply do not ever know how things are going to turn out.

Whether it’s a party, a new job or a new partner. We can put on our party shoes. We can try to be prepared. We can be our best selves. But when your internal dialogue says you need to have control, gently remind yourself that you can’t control the future. And that’s okay.

These thinking distortions raise your anxiety. They do not serve you well. Anxiety doesn’t feel good. It frequently keeps you from doing things you want to do.

Instead, when you feel anxious, notice your internal dialogue, notice the distortions in the thoughts you’re having, and dispute those patterns.

Thank you for choosing The Recovery Village. If you or a loved one are struggling with mental health or substance abuse and would like to find out more about the programs we offer, please reach out to us directly at 855-387-3291.

1. Cognitive Behavior Therapy (CBT) for Depression
2. Using CBT to Identify and Challenge Negative Thinking in Depression
3. CBT Strategies to Get Moving When You’re Feeling Depressed

Exercises:

There will be exercises associated with each lesson that you will be able to download here or access through our portal.

Medically-reviewed articles:

• Risk Factors For Depression
• 9 Common Depression Triggers
• Do I Have Depression? (Quiz)

Other Clinical Videos:

1. Causes & Symptoms of Depression
2. How is Depression Diagnosed?
3. How is Depression Treated?

Using Cognitive Behavior Therapy to Identify and Challenge Negative Thinking in Depression

In this lesson we will discuss using cognitive behavioral therapy to identify and challenge negative thinking in depression.

Negative, distorted thinking maintains depression.

When you hold distorted beliefs about yourself, the world, and the future, there are negative consequences or costs. The antidote to cognitive distortions is questioning the assumptions you make. Helpful questions include:

• How likely is this to be true?
• Is there an alternative explanation?
• Is it always true?

These are some of the common distortions in thinking associated with depression. Identify the ones you rely on and think about the logical comebacks and reframes you can make.

Overgeneralization is taking one small bit of information and applying it to everything.

You see a friend out in public. They don’t stop to talk with you. You conclude they hate you, that everyone hates you. You stop calling your friends because everyone hates you. You ignore the next friend you see because everyone hates you. People start to notice you’re ignoring them and stop calling.

Dispute the overgeneralization by questioning the truth of assumptions you have made. Is the conclusion you have drawn always true? What’s an alternate explanation?

It’s highly unlikely that my friend, who I’ve talked to twice a week for many years, suddenly hates me. Maybe they just didn’t see me. Maybe they were upset with me but I’m sure we can work it out. Even if they hate me, that doesn’t mean that everyone hates me.

Discounting is minimizing something positive. When you’re feeling depressed, you miss positives and hyperfocus on negatives. Even though your supervisor gave you positive feedback, you focus on the small thing you got wrong, or the thought that you’re not productive enough, and decide that you’re probably going to lose your job.

Dispute this with:

It’s unlikely I’m losing my job after getting positive feedback from my supervisor. Maybe, because I’m feeling down, I’m focusing on the negatives and discounting the positives. Even though I made some mistakes, the feedback was largely positive. I’m probably not in danger of getting fired.

Applying a mental filter is like looking at one eye in the Mona Lisa and deciding it’s not much of a painting. You select one arbitrary data point and draw conclusions based on it.

You’ve cooked Thanksgiving dinner for your family for years. One year you make one dish that doesn’t quite turn out as you planned. You conclude that people will not want to come next year because of that one dish.

Asking whether this outcome is likely, and whether there might be an alternate view of the situation, helps you sort out the fact from the fiction you’ve created. Even though you weren’t happy with that dish, it was eaten. Of course they’ll come next year — your meals are always great. And, you do all the work.

Hopelessness is the belief that you have no control over a situation, that external forces are at work, and that there is nothing you can do to change it.

Having a disappointing performance and assuming your performance will always be disappointing because there is nothing you can do to change it, reflects the unwarranted beliefs that you cannot do better if you prepare more or try harder. There is no evidence to support the truth of those beliefs. Practice doesn’t make you perfect, but it does make you better.

Pessimism is a close friend of hopelessness. The pessimist always expects the worst. The next job I take is going to be worse than the last. I might as well not bother looking for a job. The antidote for this thinking is allowing for the alternative explanation that you were unlucky, you’ve had good jobs in the past and the next job could be better.

Notice the cost of distorted thinking.

There is a cost to you. Distorted thinking limits what you’re willing to do and to try, things that are just what you need to pull you out of depression.

There is a cost to others. Your beliefs make you want to isolate and remain inactive. People are hurt by your withdrawal and difficulty meeting your responsibilities. They feel they’ve lost support, or a partner or a friend.

Experiment with noticing negative thinking and making the changes you’ve identified. Notice the benefits to you and to others.

Keep track of the changes you are making so that you can refer to them when you feel down in the future or get caught up in the cycle of negative thinking.

Thank you for choosing The Recovery Village. If you or a loved one are struggling with mental health or substance abuse and would like to find out more about the programs we offer, please reach out to us directly at 855-387-3291.

1. Cognitive Behavior Therapy (CBT) for Depression
2. Using CBT to Identify and Challenge Negative Thinking in Depression
3. CBT Strategies to Get Moving When You’re Feeling Depressed

Exercises:

There will be exercises associated with each lesson that you will be able to download here or access through our portal.

Medically-reviewed articles:

• Risk Factors For Depression
• 9 Common Depression Triggers
• Do I Have Depression? (Quiz)

Other Clinical Videos:

1. Causes & Symptoms of Depression
2. How is Depression Diagnosed?
3. How is Depression Treated?

Cognitive Behavior Therapy (CBT) for Depression 101

Welcome to this series on Cognitive Behavioral Therapy, commonly referred to as CBT, for depression. In this lesson we will go over depression.

Everyone gets sad sometimes and needs something to help them get back on track. Maybe you’ve had a serious bout of depression in the past, or bouts of depression, and now you’re starting to feel a little down. Unmotivated. Tired. You notice the glass is always half-empty.

CBT for depression offers useful strategies to help you reset your thinking and your behavior.

The cognitive part of CBT concerns the thoughts you have when you feel depression coming on. Those thoughts usually center around the helpless, hopeless feeling that nothing you do is right, that nothing is going to work out and there’s nothing you can do about it.

The first step is to identify the cognitive triad. Your typical, depressive thoughts probably fall into one or more of three categories.

They are negative thoughts about yourself, the world and the future. Thoughts like:

I’m a bad person — a thought about the self.

No one loves me — a thought about the world.

Nothing will ever get better — a thought about the future.

What are your negative beliefs about yourself, the world and the future? Take a minute to identify those thoughts.

The next step is to dispute those thoughts.

Disputing negative thinking requires you to get out of your head for a moment. Instead, imagine what someone else might say to you. Or be a scientist and examine facts and evidence.

Are you really a bad person? What would the person who loves you best in the world say to that? What would a therapist or counselor say to that? A mentor? A sponsor?

Can you dispute negative thoughts with facts and evidence, like:

I’m really not a bad person. I’m a good partner, professional or parent. I give to charity and help others. I’m a hard worker. I’m trying to get better every day.

The ABCs help you identify your thoughts and behaviors when you’re feeling depressed.

Think about something that has triggered depressed feelings and go through the ABCs.

A is for the activating event, or trigger. Something happens, the activating event, that triggers unhappiness or dissatisfaction.

Activating events are things like loss (a job, relationship, money), perceived criticism or disrespect (from a friend, child, partner, boss), not getting enough sleep or feeling sick.

B is for the beliefs that follow the trigger. Identify the thoughts and beliefs that come up after the activating event.

You get laid off from a job. Remember the cognitive triad? You may think you are worthless (self), useless to your family (world) and you will never get another job (future).

C is for the consequences that come about after the event. The negative triad activates and maintains depression. You decide to stay in bed all day instead of getting up and looking for a job. You’re feeling irritable and get into a conflict with your partner.

Now that you’ve identified the pattern, move on to experimenting with changes in your thoughts and behavior.

Try to dispute and modify the beliefs you identified in the ABCs.

Examine the evidence. Are you really worthless? Aren’t there a lot of things you have going for you? Things that other people can identify. Are you useless to your family? Aren’t you doing things for the family you can’t do when you’re out working? Have you ever been without a job for long? Hasn’t something always come up?

Work on re-attribution, reframing and putting things in perspective.

I’m not worthless because I got laid off. Other people in the company were laid off. I have a great work history. This is a good opportunity to get things done around the house. I’ll spend time networking and get some help sprucing up my resume. I can always take a small pay cut or try something a little different. I’m a quick learner. I think I’d enjoy trying something new.

Keep track of the way you have reframed things and disputed your negativity. Use it in the future when you feel down, to remind yourself of positive ways of thinking.

The behavioral part of CBT refers to taking the next step. When your thinking doesn’t get in the way, you can make use of the time you have while you’re laid off to look for a job and plan for your future. You think more clearly when you can check the negativity that goes along with depressed feelings.

Thank you for choosing The Recovery Village.  If you or a loved one are struggling with mental health or substance abuse and would like to find out more about the programs we offer, please reach out to us directly at 855-387-3291.

1. Using Cognitive Behavior Therapy (CBT) to Reduce Anxiety
2. Reducing Avoidance with Cognitive Behavior Therapy
3. Using Cognitive Behavior Therapy (CBT) to Reduce Worry

Exercises:

There will be exercises associated with each lesson that you will be able to download here or access through our portal.

Medically-reviewed articles:

• Types of Anxiety Disorders
• Is Anxiety Genetic?
• Is Anxiety Linked to Addiction?

Professional Webinars:

• Critical Events and Stress Management

Other Clinical Videos:

1. What is Anxiety?
2. What Causes Anxiety?
3. What are Anxiety Triggers?
4. How to Identify Anxiety Triggers?
5. How to Cope with Anxiety?
6. How to Get Help for Anxiety?

Using Cognitive Behavior Therapy (CBT) to Reduce Worry

In this lesson we will discuss using cognitive behavioral therapy to reduce worry.

One of the most common symptoms of anxiety is worry. Everyone worries. If you’re interested in reducing worry, it’s probably because you’ve decided your worry is excessive. That it intrudes in your life and keeps you from feeling happy.

CBT techniques are based on the premise that we don’t actually need worry to keep our lives afloat.

Problem-solving and letting go of needless worries are more effective approaches to healthy living.

Identify your typical worries. These are the things that interfere with your concentration during the day and keep you up at night.

Things like: Am I going to lose my job? Is my best friend mad at me? Is my partner cheating on me? Will my bills get paid this month?

Examine the cost versus the benefit of those worries.

The cost of excessive worry usually includes things like poor concentration, impaired focus and lost sleep. You may exasperate your friends and alienate colleagues with your constant worries.

It’s not that worry is irrational. In most cases, there is a kernel of truth to the worry. You might lose your job, your best friend may be mad at you, your partner could be cheating and your bills may not get paid. These things are theoretically possible, though probably highly unlikely.

That kernel of truth provides the benefit when you take time to examine it. Instead of worrying, you may have a problem you can solve.

What’s the likelihood that the worry is true?

What’s the probability on a scale of 1 to 100 that you’ll lose our job? Your friend is mad? Your partner is cheating? You can’t pay your bills? Often you can see that the likelihood is very low, maybe 5% or less that any of these things are likely. We don’t usually worry about rain when the chances are 5%. See if you can remind yourself of the low likelihood.

What’s the evidence in support of the worry?

Is there evidence your best friend is mad or your partner is cheating?

If there is literally no evidence your worry is realistic, it’s time to try to let go of that worry. When the worry comes, and it will, you must remind yourself that you’ve determined there is no evidence to support your worry. Then return to what you were doing. Keep reminding yourself of the facts and redirecting, allowing the worry to fade.

Remember, everyone worries. It’s not the worry that’s the problem, it’s hanging onto a worry that’s baseless.

Use problem-solving to address your worry.

Let’s say you’ve identified a reasonably high likelihood that the event is possible, or decided your worry has some validity. Then it’s time to see if you can come up with a way to solve the problem.

Say you’re worried about losing your job because your boss seemed a little cool during the last few weeks and you haven’t gotten any feedback about your performance. Try to come up with a plan to solve the problem of not knowing where you stand at work.

Plan A. Schedule a meeting with your boss to discuss your work, and maybe your concerns. You may get feedback that reassures you or you may receive constructive criticism that you can act on.

If you continue to worry, go to Plan B.

Plan B. Set yourself a reminder 30 days out to follow-up. This way, if the worry resurfaces, you can remind yourself that you put your plan in place and you will be following up in 30 days. Then set aside the worry for now.

The basic structure of problem-solving for worry is to:

• Come up with an action plan or two (Plans A and B) to solve the problem. Try Plan A, assess, try Plan B if necessary, assess, keep going. When the worry returns, remind yourself you have a plan.
• Distract yourself, or use relaxation skills, if a simple reminder isn’t enough.
• Identify your favorite healthy distractions. Common healthy distractions include things like exercise, talking with a friend, listening to, or playing music, or reading.
• Identify ways you can relax. These can include things like abdominal breathing, progressive relaxation, meditation, yoga, a hot bath or a hobby.

You can always come up with another plan. Sometimes you realize there really isn’t much evidence to support the worry and it’s time to work on letting go. Remind yourself that worry isn’t what holds your life together.

Thank you for choosing The Recovery Village.  If you or a loved one are struggling with mental health or substance abuse and would like to find out more about the programs we offer, please reach out to us directly at 855-387-3291.

1. PTSD Part 1: What is PTSD? 
2. PTSD Part 2: How Post-Traumatic Stress Can Lead to PTSD
3. PTSD Part 3: Trauma in the Brain
4. PTSD Part 4: Understanding Self-Regulation
5. PTSD Part 5: Developing Coping Strategies
6. PTSD Part 6: Understanding Post-Traumatic Growth

Worksheets/Lessons:

During this workshop, there will be a series of lessons with accompanying exercises that you will be able to access through our recovery portal, Swell.

Articles:

• Types of PTSD & Related Conditions
• Prevalence of PTSD in Men and Women
• What Does PTSD Feel Like?
• 8 Common Myths About PTSD

Videos/Webinars:

• Critical Events and Stress Management
• What is Secondary Trauma & Vicarious Trauma?
• Coping with Trauma

What are coping skills?

This lesson will focus on coping skills.

Coping skills are strategies that help people deal with mental health challenges in order to achieve positive mental health and wellbeing. Coping skills are also methods a person uses to deal with stressful situations. They may help a person face a situation, take action, and be flexible and persistent in solving problems.

Types of coping skills

The following is a list of coping skills that you may want to explore and apply to your life. Catching negative thoughts and replacing them with healthy ones, setting and maintaining appropriate and healthy boundaries between you and others. De-stressing with soothing activities like:

• Reading
• Puzzles
• Listening to music
• Eating healthy
• Sleeping the right amount
• Finding things that make you grateful
• Creating moments of joy in each day
• Progressive muscle relaxation
• Mindfulness meditation
• Journaling or beginning a gratitude journal
• Grounding techniques such as the five, four, three, two, one method
• Guided imagery or visualization
• Breathing exercises
• Aromatherapy
• Physical activity such as working out, palates, yoga or walking
• Art therapy
• Laughing

How can you incorporate coping skills into your daily schedule? Most people think you have to set aside a large amount of time to meditate, journal, practice mindfulness or exercise. The truth is, you only need to allot a few minutes a day to start. Once you get into the habit of using your newfound coping skills, the rest is easy.

The first step is to recognize that your mental and emotional well-being are important.

The second step is to make the time for yourself. Schedule yourself on the calendar like you would a doctor appointment or important meeting. Think of this as a date with yourself.

The third step is to just do it. Let’s talk about ground techniques…

Grounding is best practiced while you are feeling calm and before you feel you are in crisis mode. Focus on the present moment and be careful to not dwell on past memories or overwhelm yourself with thoughts of the future.

Use the five, four, three, two, one method. Five things you can see. Four things you can touch or feel. Three things you can hear. Two things you can smell. And one thing you can taste.

Many people have difficulty remembering how to breathe when they are stressed, depressed, anxious and the like. Some forget to breathe and they’re breathing slows down and gets stuck. Others breathe too rapidly and they hyperventilate, which could cause them to become lightheaded, dizzy or faint.

I would like for you to allow yourself to be in the moment and focus on your breathing. I’m going to take you through a short breathing exercise.

Take a deep breath in through your nose…………

Then slowly blew it out through your mouth…………

One more time…………….

And as you exhale………

Allow your mind to clear…………

Your eyes to close………..

And feel that this time is just for you……..

Take three deep, abdominal breaths. And feel as if you are releasing all of the thoughts and tension of the day with each exhalation……….

Allow your abdomen to expand on the inhalation. And contract on the exhalation.

Give yourself permission to sit in this moment of stillness and peace.

[Pause 5 seconds]

When you are ready, you can open your eyes feeling relaxed and eager to face the rest of your day.

Practice this several times a day so that it becomes a part of your daily routine.

In our final lesson, we’re going to review the concept of post-traumatic growth.

Thank you for choosing The Recovery Village. If you or a loved one are struggling with mental health or substance abuse and would like to find out more about the programs we offer, please reach out to us directly at 855-387-3291.

1. Relapse as a Learning Opportunity
2. Learning Self- Forgiveness After Relapse
3. Warnings Signs of a Relapse
4. How to Reduce Relapse Risks
5. Understanding Addictive Behaviors
6. How to Make an Action Plan for Risky Situations
7. How to Identify & Cope with Stressors
8. Lifestyle Changes for a Healthy Recovery
9. How to Live a More Balanced Life

Accompanying Worksheets:

There are lessons accompanying each video that you can access through our recovery portal, Swell or you can download, here. (Lesson 7)

Medically-reviewed articles:

• Common Relapse Triggers
• What to Do if You Have A Relapse or Slip?
• How to Help Someone Who is Experiencing a Relapse

Professional webinars:

• Relapse Prevention: “Doing” Recovery in this Changing World
• Our Staff’s Stories of Recovery

Relapse Workshop: Stress

In this lesson, we’re going to be talking about stress and how we cope with stress and how we can find healthier ways to cope with stress.

We all have day-to-day stressors that will continue to occur. And we all handle stress in different ways, depending on how long the stress has been going on, how long you expect the stress to continue, how many times in your life you’ve experienced the same type of stress, how many times in your life you’ve experienced other types of stress, how you have learned to cope with the stress, and what resources are available to you for handling the stress.

We will continue to have day-to-day stressors, even in recovery. So by being able to identify what your stressors are and knowing which ones you are most vulnerable to becoming overwhelmed with, you can develop effective coping strategies so that you’re less vulnerable to relapse.

What causes you stress in your home, in your family situations, in your friendships, at work or at school? When it comes to your health and when it comes to your finances?

Now, there are four common responses to stress we all use. Fight, flight, freeze and fawn, and no one of these is better or worse than the other. And we’ve probably all used some of the techniques from each of these at different times. The goal is to understand how you respond to stress and learning to calm yourself during stress, so that you can decide which type of response would be most helpful to you and most effective for the situation. Sometimes the way you respond can help you get through the situation. But at other times, your response can make things worse.

Fight responses. Feeling and expressing anger or rage. Intimidating other people. Shaming or criticizing other people. Speaking in a condescending way. Lashing out verbally or physically. Behaving aggressively towards yourself, others or inanimate objects. Treating others with disgust or contempt. Defending yourself or others physically when you’re attacked, but not initiating an attack yourself. Speaking up and defending your rights or the rights of others and setting boundaries.

Flight responses include running away or quickly leaving a situation. Avoiding a situation that might be stressful or dangerous. Constantly busying yourself. Planning or obsessing over details of a stressful situation. Hanging up on the phone in the middle of a heated conversation. Abruptly leaving the room mid-conversation or blocking someone’s messages. Impulsively ending a stressful situation such as quitting a job or firing an employee without thinking through the decision or breaking up with a partner during a conflict. Staying away from a place you know is dangerous and staying away from people who have hurt you in the past.

Freeze responses include isolating yourself when a situation might involve stress or danger. Disconnecting from other people. Detaching from your emotions in a situation. Feeling numb to any physical or emotional pain in a situation. Feeling paralyzed and unable to choose a response.

And the last is Fawn. This is doing what the other person demands. Doing what you think the other person wants. Going into people-pleaser mode and saying yes to unreasonable requests so the other person asking won’t get angry at you. And staying quiet when you disagree, to avoid a conflict or avoid making a conflict worse.

So there are pros and cons to each response, and the idea is to learn where you may need to develop some more effective skills.

So let’s first take a look at your fight responses to stress. So what situations prompt you to fight in response to stress? When has it been helpful for you to fight in response to stress? Which fight behaviors have helped you? When has it been harmful for you to fight in response to stress and which fight behaviors have been harmful for you? And you’ll want to do this for each of the stress responses.

You will complete the same questions for flight. And for freeze behaviors. And fawn behaviors.

Now, all people cope with stress in different ways. There’s no right or wrong way to cope. It’s not as though some of the ways that you responded are wrong and some of the ways are right and you need to act in right ways. The goal is to evaluate whether the use of your coping strategies is helping you live the life you want to live or if it’s causing further harm.

So in addiction, drinking or using drugs was helpful to manage your stress. But over time, it caused more problems for you than it helped. So the point of a coping strategy is to find ones that help you manage your problems, not ones that create more problems.

So steadying your coping strategies and learning to choose more effective options ensures you cope in the most effective way that leads to alleviation of problems rather than adding to problems.

So the assignment after this lesson can help you to start to identify what’s a coping strategy you’re using, what you used it for, how it worked in the immediate scenario, and then how it worked in the long term. If you start to keep these and journal about these and write down about them, becoming mindful of what you did, what you used it for and how it worked, it will help you to identify whether it was an effective strategy or an ineffective strategy.

Some helpful coping strategies can be to take long, slow, deep breaths. Count to six on the inhale, pause, and count to eight on an exhale. Your heart rate actually increases when you inhale and slows down when you exhale. So learning to deepen your breath naturally calms the body. You should repeat this three to five times. You can take a yoga class or find a YouTube video to guide you through some gentle yoga poses. Yen yoga and restorative yoga are actually quite soothing, although all yoga is soothing. You can listen to a guided meditation geared towards healing, stress and trauma. If you go to your portal, you can find guided meditations, they’re actually quite helpful.

It can be helpful to develop a daily soothing ritual. And it can be as simple as taking five minutes each morning to stretch and relax or do a moving meditation like Taichi. You can talk to a therapist who can help you process your emotions and heal. You can write in a journal about your strengths. You can start a daily gratitude practice where every day you write down three things that went well that day or that you appreciate. We can often use more time and practice focusing on things that are positive rather than the negative. Or you can join a support group to connect with others who have struggled with something similar.

And in our next lesson, we’re going to talk about lifestyle changes that can help you to stay sober.

Thank you for choosing The Recovery Village. If you or a loved one are struggling with mental health or substance abuse and would like to find out more about the programs we offer, please reach out to us directly at 855-387-3291.