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EMDR Therapy What is EMDR therapy and how does it work? BALTIMORE STATION RESOURCE GUIDE Link The Missing CRY No NO Woman

Born

BOOMING PROBLEM

with it Scientists Discover Possible “Meth Gene”

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EMDR Therapy What is EMDR therapy and how does it work? EMDR is the acronym for Eye Movement Desensitization and

Reprocessing. It was created by Francine Shapiro in 1987 and is now recommended by the Department of Veteran’s Affairs, the American Psychiatric Association, and most recently World Health Organization as very effective and efficient at helping people process traumatic events. Here is a list of typical problems that people seek EMDR therapy for: • Childhood or Adult Abuse • Extreme Illness or Grief • Post Traumatic Stress Disorder • Anger • Car Accidents • Sexual Traumas • Assault Trauma • Emotional Pain, Emotional Outbursts • Relationship problems • Phobias (including social ones) • Low Self-Confidence or Self Image • Sadness, Depression & Anxiety • Sleep Problems

EMDR is the acronym for Eye Movement Desensitization and Reprocessing.

• Intrusive thoughts, flashbacks • Being “on guard” all the time • Being Jumpy or Irritable • Substance abuse • Numbed Emotions

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Fortunately not everyone has experienced extreme neglect or trauma, however, we have all experienced being humiliated, feeling rejected, unimportant, having our emotions hurt one way or another and all of these incidences are what we call “little t-trauma” that “help” reinforce the negative beliefs we have created in our minds usually from childhood experiences.These negative beliefs (negative cognitions as we call them in EMDR) lead to automatic responses every time we get “triggered” and we react in ways that is not authentic to who we are now or how we WANT to respond.

These negative beliefs (negative cognitions as we call them in EMDR) lead to automatic responses every time we get “triggered” and we react in ways that is not authentic to who we are now or how we WANT to respond.

When we do EMDR we use bilateral stimulation, which could be eye- movements from side to side, wearing headphones that produce a tone going from one ear to the other, or holding small paddles in your hands that vibrate slightly and produce bilateral stimulation kinetically.There is a specific 8 step protocol that the EMDR trained therapist guides you through which “untangles” the memory and finally allows your brain to store it properly so that it no longer creates those knee-jerk reactions from you that do not serve you well. If you are feeling “stuck” and unable to move beyond the things that are holding you back, call me at (386) 492-0778 and let us discuss how we can get you where you want to be.

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BORN WITH IT Scientists Discover Possible 'Meth Gene’

Researchers have recently identified a gene that may play a role in meth addiction. New findings by Boston University School of Medicine researchers, published in PLOS Genetics, spotlight a gene called heterogeneous nuclear ribonucleoprotein H1 (Hn- rnph1). The research uncovered a link between this gene and how it effects behavior when stimulants are introduced. This new insight can help scientists understand genetic risk factors for addiction, along with some neuropsychiatric disorders. Also, this new understanding about how Hnrnph1 works could lead to the development of a prescription drug to help treat meth ad- diction, researchers say.

Need To Ident i fy Targets

other findings to improve the treatment of both dopamine- related problems like attention- deficit hyperactivity disorder, schizophrenia, and bipolar disor- der, along with dopaminerelated neurodegenerative disorders like Parkinson’s or Huntington’s diseases. Scientists say the genetic epide- miology of meth use disorders is very complex. Efforts to under- stand the biological processes that increase susceptibility to meth use disorders (i.e., abuse, dependence and psychosis) have uncovered several genetic variants. However, more research needs to be done. Though gene research can led to breakthroughs in treatment, Boston University points out in its news release that genetics alone are not responsible for addiction. Environmental and social factors also play an im- portant role.

The BU scientists discovered that Hnrnph1 “codes” for an RNA protein that regulates how other genes are processed in the brain. To better understand the genetic basis of meth addiction, the next step is to figure out the exact genetic targets of Hnrnph1. “A better understanding of the brain region and cell type-specific binding targets of Hnrnph1 will tell us more about the function of this gene and possibly identify new therapeutic strategies for minimizing risk and treating psycho-stimulant addiction — a disorder for which there is currently no FDA-approved drug,” says study co-author Dr. Camron Bryant in a news release from Boston University.

The study could also lead to

Other factors in addict ion According to the National Institute on Drug Abuse (NIDA), these are some of the environmental factors that come into play with ad- diction: • Friends and people addicts spend time with • Age when a person begins using drugs or alcohol • Neighborhood

“A better understanding

of the brain region and

cell typespecific binding

targets of Hnrnph 1 will

tell us more about the

function of this gene.” — Dr. Camron Bryant, study co-author

• Availability of drugs and alcohol • Presence of mental health issues • Gender

These environmental influences interact with genetic factors to influ- ence an individual’s susceptibility to addiction. While scientists hope to better understand the role genetics plays in addiction to meth and other drugs, much more research needs to be done to solve the puzzle.

Genetics alone are not responsible for addiction. Environmental and social factors also play an important role.

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STUDY METHODOLOGY Studying mice genetically modified to be without the Nav1.7 channel, Wood found that such mice had bodies that dis- played a large increase in certain genes responsible for creating opioid peptides. Opioid peptides occur naturally in the body as the body’s painkiller and have a similar effect as opioids. In making more of the opioid pep- tides, the mice were blocking any feelings of pain, which might be the reason people suffering from CIP also don't feel pain. Wood thought that if he gave mice a medicine that reversed the effect of the opioid peptides, it may reverse the disorder. He gave the mice naloxone—a medication used to reverse opioid overdoses—and it worked. Wood figured the same could be done for humans. “After a decade of rather disap- pointing drug trials, we now have confirmation that Nav1.7 is a key element in human pain,” Woods says. “The secret ingredient turned out to be good old-fashioned opioid peptides, and we have now filed a patent for combining low dose opioids with Nav1.7 blockers. This should replicate the pain- lessness experienced by people with rare mutations, and we have already successfully tested this approach in unmodified mice.” CONGENITAL INSEN- SITIVITY TO PAIN (CIP) is a very rare genetic mu- tation that prevents mes- sages of physical pain from reaching the brain.

Research researcher and his team of researchers studied a 39-year-old woman with CIP. Using a laser beam and a dose of naloxone, Wood helped the woman, who elected to partici- pate anonymously, feel pain for the first time in her life. “Used in combination with Nav1.7 blockers, the dose of opioid needed to prevent pain is very low,” says Wood in an UCL release. “People

Using a test subject with a ge- netic mutation that prevents her from feeling pain, scientists have conducted research that shows promise in creating more effec- tive painkillers—and potentially decreasing the need for addictive opioids. Congenital insensitivity to pain (CIP) is a very rare genetic muta- tion that prevents messages of physical pain from reaching the brain. Sufferers of the disorder, as babies, will chew their lips until they bleed. Toddlers have to deal with more potential for falls, bumps and being hurt by hot or sharp things. Adults are at a high- er risk of dying prematurely. The disorder leaves those afflict- ed without channels known as Nav1.7, which carry sodium to sensory nerves. Understanding this disorder and channels of pain reception and delivery has led re- searchers to study the disorder for ways to block pain in those who don't have the disorder. Research- ers thought they could block pain transporting channels in people without CIP so they can help those with chronic and painful ailments like arthritis. HELPING A WOMAN CRY In a study published by the journal Nature, John Wood, a University College London (UCL) Wolfson Institute for Biomedical

with nonfunctioning Nav1.7 produce low levels of opioids throughout their lives without de- veloping tolerance or experiencing unpleasant side effects.”

As for this work leading to com- plete cessation of pain, Wood tells the New Scientist that some research has found success, but nothing has led to the complete pain loss found in those that are naturally without Nav1.7 channels.

who doesn’t feel the Woman WHAT THE FUTURE HOLDS.... As for people with CIP, Woods says he doesn't know if treatment using nalox- one is an option. Long-term use of naloxone could have side effects. What Woods can say, definitively, is that the mice in the experiment felt as little pain as mice who did not have the Nav1.7 channel naturally. Woods, his team, and the rest of the field are working to fill in the re- search gaps to start answering these questions for humans. “We hope to see our approach tested in human trials by 2017 and we can then start looking into drug combinations to help the millions of chronic pain patients around the world,” Woods says. Imperial College London professor Kenji Okuse reacted to Wood’s findings to the New Scientist, saying that the research will provide more information to doc- tors about pain.

Could help in making better painkillers.

We hope to see our

“Opioids and Nav1.7 blockers could provide much stronger analgesics, but they will not necessarily be better for patients,” Okuse says. “If we take the combination therapy route, people would have to take opioids throughout the lifetime, which is not a welcome thing.”

approach tested in human trials by 2017 and we can then start looking

into drug combinations to help the millions of chronic pain patients around the world. — John Wood, University College London Wolfson Institute for Biomedical Research researcher

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“Everythingwe knowabout older adults and substance abuse probably doesn’t apply to Baby Boomers.” - Dr. Alexis Kuerbis, CUNY - Hunter College

overall numbers present a problem. “We’re grossly understaffed in being able to handle these problems,” says Dr. Dan Blazer, a psychiatrist at Duke University who has studied the issue extensive­ ly. “It’s a problem. I think it’s a problem that’s going to get larger as time goes on and we’re probably already seeing evidence of that.” But there’s also an issue of attitude. Baby Boomers, in general, have a more relaxed view of substance use, and experts fear they may carry those behaviors later into life. “There’s no evidence that they’re going to automati­ cally stop when they hit 65 years old,” Dr. Blazer says. “They’ve used them all their life, they say, ‘Why shouldn’t I use them now?’”

Even though elderly people show substance abuse issues in a much lower percentage than other age groups, the problem is more prevalent than many realize. And it appears it’s only going to get worse. Studies vary, but generally show between 2.2 and 9 percent of older adults have an alcohol use disor­ der, and experts say they’re already seeing a rise in marijuana and opioid abuse issues. With the large population of Baby Boomers aging, substance abuse numbers in the elderly population are expected to continue to rise, presenting serious problems for treat­ ment providers and family members. Researchers say the problem is twofold: part is sheer numbers, the other is attitude. With the number of older adults in the U.S. expected to increase from 40.3 million to 72.1 million between 2010 and 2030,

HIDDEN DANGERS

Experts say the lifestyle of elderly people presents a unique challenge for physicians and treatment providers. For example, because retired people don’t work, substance use doesn’t present a problem at their jobs, a typical red flag for younger people. Experts also say too often doctors fall victim to their own prejudices and don’t ask the right questions that could lead to a diagnosis.

Although success rates in treat­ ment can be better for older adults, the way they’re treated isn’t necessarily the same. Dr. Sacco says older adults respond better to more collaborative treat­ ment programs that give them options. “For so long it was trying to fit older adults into these programs, but now it might be chang­ ing these programs to fit older adults,” Dr. Sacco says.

“People think this person doesn’t look like a substance user,” says Dr. Paul Sacco, an expert on substance abuse in older adults. “Sometimes physical problems associated with alcohol abuse are assumed to have a different cause in older adults.” Substance abuse can be even risk­ ier for older adults as their bodies become less resistant to the stress­ es brought on by substance use.

PLANNING AHEAD

To mitigate the expected problems as much as possi­ ble, experts say we need to train more counselors and physicians on how to best treat older adults, and how to spot potential problems in the first place. “With just a little bit of education about older adults, I think you could make a very big impact,” says Dr. Alexis Kuerbis, a researcher who also works with older adults. “The first step is awareness on what might be

different for an older adult.” But because Baby Boomers use substances more than previous senior groups have, experts say treatment providers may have to find new ways to treat an old problem. “Everything we know about older adults and substance abuse probably doesn’t apply to Baby Boomers,” Dr. Kuerbis says. “All bets are off.”

“We’re grossly understaffed in being able to handle these problems.” - Dr. Dan Blazer, Duke University

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Integrated treatment works best for victims of sexual abuse who are also addicts. Researchers have found a dramatic link between the

“ 1 out of every

INSERT 4 occurrence of sexual abuse and substance abuse. According to alcoholrehab.com, “sexual abuse victims are three times more likely to suffer depression, six times more likely to suffer PTSD, 13 times more likely to abuse alcohol and 26 times more likely to abuse drugs than those who have not been sexually abused.” They go on to say that one out of every six women and one in 33 men in America have been the victim of sexual assault or rape in their lifetime.

6 women and one in 33 men in America have been the victim of sexual assault or rape in their lifetime. ” -alcoholrehab.com

Integrated treatment

Treatment centers are beginning to recognize the need for integrated treatment techniques for victims undergoing substance abuse recovery. Since there’s such a high prevalence of sexual abuse among addicts, integrated treatment offers a fuller recovery for sexual abuse victims. Trauma-focused Cognitive Behavior Therapy (CBT) is one common form of treatment. In CBT, individuals are offered psychoeducation, therapy instructing and empowering them to deal with their condition in an optimal way. Stress management tools are also helpful. Individuals can be taught to change their situations or their reactions and how to maintain appropriate personal boundaries. The regulation of emotions can be a challenge for a person who has been sexually abused. In CBT, clients learn what emotions are socially tolerable and they learn how to be flexible enough to permit some spontaneity. Survivors are also taught how to delay emotional reactions as necessary. 30

Individuals can be taught to change their situations or their reactions, and how to take good care of themselves.

 Integrated treatment for those suffering from substance abuse addiction and sexual abuse greatly increases the chance that this person will remain sober for the long haul.They can also experience greater joy and healing than if they were treated for substance abuse alone. Telling their story One effective aspect of CBT is for the person to do a “trauma narrative.” In addition to telling their story by the spoken word or writing it down, they can also use drawing, painting or other art forms to communicate the trauma.The narrative can then be shared with a safe person, like a trained therapist or substance abuse counselor.The hope is that the survivor will be able to let go of some of the trauma. Healing can then take place. Another facet of CBT is behavior management training. Clients are encouraged to stay calm in an emotionally charged situation, manage their own responses, learn what limits are appropriate, handle challenging questions and learn how to prevent physical confrontations with others. According to the Rape, Abuse and Incest National Network (RAINN), survivors are also encouraged to do what they can to heal themselves. Good sleep and nutrition, exercise, and regular routines like starting and ending the day in a peaceful way are a good place to start for people from this background. Those in recovery are also urged to write down leisure activities they find enjoyable and engage in those activities regularly. Clients are also encouraged to use journaling and inspirational reading to further grow in their recovery. Finally, having a supportive group of friends and family will help an individual recover emotionally from this kind of trauma.

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THE BALTIMORE STATION

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