SEEKING SAFETY

SAFETY

100

WHAT IS THE FIRST STAGE OF HEALING FROM BOTH PTSD AND SUBSTANCE ABUSE?

SAFETY

200

WHAT ARE THE THREE STAGES OF HEALING FROM PTSD AND SUBSTANCE ABUSE?

1.  SAFETY _{The foundation for all therapeutic work.  The goals are to achieve abstinence from substances, eliminate self-harm, acquire trustworthy relationships, gain control over overwhelming symptoms, attain healthy self-care, and remove oneself from dangerous situations.}

2.  MOURNING _{After achieving safety, the patient needs to delve into the past in detail and face the extreme feelings of pain and mourning that result.}

3. RECONNECTION _{After working through mourning, the patient is emotionally able to reconnect with joy and productive activity in the world.}

300

WHAT ARE 3 EXAMPLES OF UNSAFE COPING SKILLS?

Using substances, hurting yourself, hurting someone else, letting someone hurt you, impulsive actions, avoidance, isolation, emotional numbing, risky behaviors, excessive work/busyness, negative thinking patterns (self-blame, catastrophizing, etc.).

400

WHAT ARE 5 EXAMPLES OF SAFE COPING SKILLS?

Asking for help, leaving a bad situation, being honest, crying, boundary setting, self-compassion, getting organized, attending support groups, work the program, focus on now, "fight" the trigger, use community resources, notice what you CAN control, do the right thing, prioritize healing/recovery

500

WHAT ARE 2 SIGNS THAT YOU ARE IN "RECOVERY"?

^{Can talk about the trauma without feeling very upset or very numb; Can function well in daily life (such as holding a job); Are safe (not using substances, no SI); Are able to be in healthy relationships without feeling completely isolated or vulnerable; Are able to find joy in life; Taking good care of your body; Can rely on yourself and others; Can control/manage your most overwhelming symptoms; Believe that you deserve to take good care of yourself; Have confidence that you can protect yourself}

WHEN SUBSTANCES CONTROL YOU

100

WHAT IS THE DEFINITION OF "SUBSTANCE ABUSE"?

The simplest definition is that a substance has control over your life.  The American Medical Association defines it as, "the compulsive use of a substance resulting in physical, psychological, or social harm... AND continued use despite that harm."

200

WHAT IS THE DIFFERENCE BETWEEN SUBSTANCE ABUSE AND SUBSTANCE DEPENDANCE?

Substance abuse refers to patterns of substance use that lead to medical, social, and psychological problems ^{(results in failure to fulfill obligations like work or parenting, repeated substance use in situations that are physically dangerous like use while driving, repeated legal problems, and continued use despite repeated problems)}

Substance dependance is when one is faced with a compulsion to use coupled with a loss of control--it is the inability of the individual to function normally in the absence of the drug.

300

HOW DOES SUBSTANCE USE PREVENT HEALING FROM PTSD?

It makes PTSD symptoms worse, prevents you from knowing yourself, does not meet your needs, stalls emotional development, isolates you, keeps you from coping with feelings, takes away your control, makes you hate yourself, is a way of neglecting yourself

400

WHAT ARE THE 3 WAYS TO GIVE UP SUBSTANCES?

1.  Quit all at once

2.  Try an experiment ("warm turkey"- try stopping for a period of time and then reevaluate)

3.  Cut down gradually

500

WHAT SUBSTANCES ARE DANGEROUS TO STOP "COLD TURKEY" AND NEED MEDICAL ASSISTANCE AND SUPERVISION?

Alcohol, pain killers ^{(oxy, hydrocodone, fentanyl, etc.)}, sedatives and tranquilizers ^{(benzos, sleep aids, etc.)}, and Heroin

SELF-CARE

100

WHAT ARE THE 6 CATEGORIES/DOMAINS OF SELF-CARE?

Physical, Emotional, Mental/Psychological, Social, Spiritual, and Professional/Practical.  (Some will also add environmental and financial domains).

200

THIS MENTAL SELF-CARE ACTIVITY INVOLVES FOCUSING ON YOUR BREATHING AND FOCUSING OR CLEARING YOUR MIND USING MENTAL AND PHYSICAL TECHNIQUES.  

Meditation

300

HOW MANY HOURS OF SLEEP DO ADULTS NEED EACH NIGHT?

Most adults need 7-9 hours of QUALITY sleep per night, though individual needs can vary.  Generally, less than 7 hours is insufficient.

400

TAKING A BREAK FROM THIS CAN BE BENEFICIAL FOR EASING FEELINGS OF LOW SELF-ESTEEM AND DEPRESSION.  LIMITING EXPOSURE HAS BEEN SHOWN TO INCREASE WELL-BEING AND REDUCE THE OCCURENCE OF COMPARISON TO OTHERS.

 

Social Media

500

NAME 5 SELF-CARE ACTIVITIES

Journaling, meditation, exercising, expressing gratitude, yoga, staying hydrated, prioritize sleep, nap, eating a balanced diet, mani/pedi, practice deep breathing, reading, listen to music, draw/art, cook, crafting, call a friend, volunteer, prayer, organize, etc.

COPING WITH TRIGGERS

100

WHAT IS THE DEFINITION OF TRIGGER?

A trigger is a stimulus that causes a painful memory to resurface.  It is a sensory reminder of a traumatic event (a sound, sight, smell, physical sensation, or even time of day or season).  It is also anything that activates or worsens the symptoms of a mental health condition.

200

WHAT ARE 2 EXAMPLES OF INTERNAL TRIGGERS?

Sadness, guilt, shame, fear, frustration, jealousy, feeling unsafe, fatigue, pain, low self-esteem, overthinking 

Internal triggers are feelings, thoughts, memories, or physical states originating from WITHIN you that spark cravings or urges, often for substances.

300

WHAT ARE 5 EXAMPLES OF EXTERNAL TRIGGERS?

Bars; clubs; old hangout spots; old friends, family members or acquaintances from your using days; specific neighborhoods or street corners; alcohol bottles; drug paraphernalia; advertisements; specific music or songs; smells; sounds;

400

WHAT ARE 4 COPING STRATEGIES FOR MANAGING TRIGGERS?

Step away from the situation, call a friend, practice mindfulness, deep breathing, grounding techniques, practicing self-care, name the emotion, journaling, exercise, challenge thoughts, patience, self-compassion

500

THIS TERM REFERS TO THE ABILITY TO BOUNCE BACK AND RECOVER QUICKLY FROM TRIGGERING SITUATIONS OR SETBACKS IN RECOVERY.

 

Resilience

RELATIONSHIPS

100

WHAT ARE 3 EXAMPLES OR QUALITIES OF A HEALTHY RELATIONSHIP? 

Open, calm communication; individuality is maintained; honesty and privacy coexist; mutual, earned trust; respect for each other; consensual; equal

200

WHAT ARE 5 EXAMPLES OR QUALITIES OF AN UNHEALTHY RELATIONSHIP?

Physical violence; verbal violence; disrespect; controlling; lack of communication; dishonesty; lack of trust; arguments are frequent; boundaries are not respected

300

WHAT ARE THE 4 STYLES OF COMMUNICATION?  WHICH ONE IS HEALTHY?

Passive, Passive-aggressive, Aggressive, and Assertive

Assertive communication is the most healthy

400

LETTING PEOPLE IN TOO MUCH OR NOT LETTING PEOPLE IN ENOUGH - THESE ARE EXAMPLES OF BOUNDARIES THAT ARE EITHER TOO ________ OR TOO _______.  

Close or Distant

Examples of boundaries that are too close: ^{have difficulty saying "no"; give too much; get involved too quickly; trust to easily; intrude on others; stay in relationships too long}

Examples of boundaries that are too distant: ^{have difficulty saying "yes"; isolation; distrust too easily; feel lonely; brief relationships}

500

DESCRIBE THE DIFFERENCE BETWEEN A RULE AND A BOUNDARY.

BOUNDARIES ^{Focus is on YOUR own needs and well-being; YOU take ownership of YOUR emotions and choices; allows autonomy for both people; creates trust and closeness; when crossed, the BOUNDARY-SETTER takes action to protect well-being.}

RULES ^{Aim to restrict and control the other person; makes the other person responsible for how you feel; restricts the other's autonomy; causes resentment and rebellion; breaking rules results in punishment}