Anxiety Handout

26 Wednesday Oct 2022

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We all know the uncomfortable feeling of anxiety. Our hearts race, our fingers sweat, and our breathing gets shallow and labored. We experience racing thoughts about a perceived threat we fear will be too much to handle. That’s because our “fight or flight” response has kicked in, resulting in sympathetic arousal and a narrowing of attention and focus on avoiding the threat. We seem to be locked in that state, unable to focus on our daily chores or longer-term goals. Below are six strategies that you can use to help relieve your everyday anxiety:

  • Reevaluate the probability of the threatening event actually happening.

Anxiety makes us feel that a threat is imminent, yet most of the time what we worry most about never happens. By recording our worries—and how few actually came true—we can notice how much we overestimate the prospect of negative events.

  • De-catastrophize.

Even if a bad event happened, we may still be able to handle it by using  coping skills and problem-solving abilities or by enlisting others to help. Although not pleasant, we could still survive encountering a spider, having a panic attack, or losing money. It’s important to realize that very few things are the end of the world.

  • Use deep breathing and relaxation.

By deliberately relaxing our muscles we begin to calm down so we can think clearly. If you practice this at first without a threat present, it can start to become automatic and will be easier to use in the moment when you face a threat. Deep breathing engages the parasympathetic nervous system to put the brakes on sympathetic arousal.

  • Become mindful of your own physical and mental reactions.

The skill of mindfulness involves calmly observing our own reactions, including fear, without panic or feeling compelled to act. It can be taught in therapy and improves with practice.

  • Accept fear and commit to living a life based on core values.

Acceptance and Commitment Therapy (ACT) is an approach that encourages people to accept the inevitability of negative thoughts and feelings and not try to repress or control them. By directing attention away from the fear and back onto life tasks and valued goals, we can live a full life despite the fear.

  • Exposure.

Exposure is the most powerful technique for anxiety and it involves facing what we fear and staying in the situation long enough for the fear to habituate or go down, as it naturally does. Fear makes us avoid or run away, so our minds and bodies never learn that much of what we fear is not truly dangerous.

Opioid Addiction – Brain Functions

19 Wednesday Oct 2022

Posted by in Addiction, brain

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Substance addiction is a perplexing phenomenon for those who fortunately do not suffer from it. Although it is incredible to believe that people would willfully engage in behaviors that create problems with their lives on so many levels, substance addiction is a reality for millions of people. According to data published by NIDA (National Institutes of Drug Abuse) nearly 20 million Americans have undergone opioid de-addiction therapy in 2010. What makes some people so susceptible to substance abuse while others are able to protect themselves? A study of brain images of heroin addicts, conducted by Gold, Liu and colleagues, shows significant differences in brain activity even in resting state, without heroin use. Functional MRI (fMRI) images from opioid addicted patients were compared with similar images from health people.

Resting state fMRI images of men undergoing opioid substitution therapy showed that areas of the brain engaged in reward perception, motivation, memory and self-control show significantly different activity than comparable regions in healthy individuals. Areas like the orbitofrontal cortex, cingulate gyrus and hippocampus show consistently different resting state activities in heroin-dependent and healthy subjects. The prefrontal cortex of dependent patients was less active than that of healthy patients in the resting state, during de-addiction therapy. However, this area which controls motivation as well as degree of inhibition, was observed to be highly active during periods of opioid use. Other areas of the brain like the hippocampus which regulates memory, also showed activity patterns that were different from those in healthy subjects, in the resting state in addicted individuals. These images shed light on the mechanism of addiction in people and the areas of the brain that are engaged, perhaps constitutively, in sustaining addiction.

Given that study participants were enrolled from de-addiction clinics, episodes of heroin abuse had already taken place in their life. It is unclear whether the same areas of the brain would show similar activity in naive individuals. If this possibility is validated by comparative studies, these fMRI imaging techniques may have tremendous diagnostic potential in identifying people who are at high risk for addiction. One drawback of this investigation is that only male patients were included in this study. Therefore, we do not know whether there are gender-based differences in the resting state brain activity of female opioid addicts.

The study does throw up interesting possibilities. It is possible to enroll naive subjects, possibly teenagers or pre-teens, and obtain baseline brain images before these people have tried out any addictive substance like tobacco, heroin or alcohol. Follow-up studies with the same people can indicate whether experience of addictive substances can change the baseline pattern of activity. This kind of long-term and long-range study may help to identify brain markers for specific addiction disorders. The study also indicates why counseling fails to have an impact on some patients. It is likely that profound changes in resting state brain activity resulting from addiction may override the effects of received and processed advice.

Reference

Zhang Y, Tian J, Yuan K, Liu P, Zhuo L, Qin W, Zhao L, Liu J, von Deneen KM, Klahr NJ, Gold MS, & Liu Y (2011). Distinct resting-state brain activities in heroin-dependent individuals. Brain research, 1402, 46-53 PMID: 21669407

Anger Handout

12 Wednesday Oct 2022

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I often work with groups I have never met before. When I walk into group I start to evaluate and access right away. For psych-educational groups I mostly focus on do I need to pull out a handout or not. That decision depends on the openness of the folks. Do they greet me verbally, with postures and/or gestures, eye contact, expressions of thoughts/feelings, where and how they are sitting.

In most places I have worked I would facilitate an anger management group. I used a variety of handouts and activities to have a process oriented group interaction. One of the handouts I use is below. I use it in 1 of 2 ways. I have folks fill it out first and then we discuss or we discuss while filling it out. Both ways we explore as a group, learning from each other.

ANGER WORDS

anger disgust grumpiness rage  aggravation dislike hate resentment  agitation envy hostility revulsion  annoyance exasperation irritation scorn  bitterness ferocity jealousy spite  contempt frustration loathing torment  cruelty fury mean-spiritedness vengefulness  destructiveness grouchiness outrage wrath

Other:_________________________

Prompting Events for Feeling Anger

Losing power.

Losing status.

Losing respect.

Being insulted.

Not having things turn out the way you expected.

Experiencing physical pain.

Experiencing emotional pain.

Being threatened with physical or emotional pain by someone or something.

Having an important or pleasurable activity interrupted, postponed, or stopped.

Not obtaining something you want (which another person has).

Other:_______________________________

Interpretations That Prompt Feelings of Anger

Expecting pain.

Feeling that you have been treated unfairly.

Believing that things should be different.

Rigidly thinking “I’m right.”

Judging that the situation is illegitimate, wrong, or unfair.

Ruminating about the event that set off the anger in the first place, or in the past.

Other:____________________________

Experiencing the Emotion of Anger

Feeling incoherent.

Feeling out of control.

Feeling extremely emotional.

Feeling tightness or rigidity in your body.

Feeling your face flush or get hot.

Feeling nervous tension, anxiety or discomfort.

Feeling like you are going to explode.

Muscles tightening. .

Teeth clamping together, mouth tightening.

Crying; being unable to stop tears.

Wanting to hit, bang the wall, throw something, blow up.

Other:__________________________

Expressing and Acting on Anger

Frowning or not smiling; mean or unpleasant facial expression.

Gritting or showing your teeth in an unfriendly manner.

Grinning.

A red or flushed face.

Verbally attacking the cause of your anger; criticizing.

Physically attacking the cause of your anger.

Using obscenities or cursing.

U sing a loud voice, yelling, screaming, or shouting.

Complaining or bitching; talking about how lousy things are.

Clenching your hands or fists.

Making aggressive or threatening gestures.

Pounding on something, throwing things, breaking things.

Walking heavily or stomping; slamming doors, walking out.

Brooding or withdrawing from contract with others.

Other:_____________________

After effects of Anger

Narrowing of attention.

Attending only to the situation making you angry.

Ruminating about the situation making you angry and not being able to think of anything else.

Remembering and ruminating about other situations that have made you angry in the past.

Imagining future situations that will make you angry.

Depersonalization, dissociative experience, numbness.

Intense shame, fear, or other negative emotions.

Other:______________________

AP News: First public global database of fossil fuels launches

07 Friday Oct 2022

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“A first-of-its-kind database for tracking the world’s fossil fuel production, reserves and emissions launches on Monday to coincide with climate talks taking place at the United Nations General Assembly in New York.

The Global Registry of Fossil Fuels includes data from over 50,000 oil, gas and coal fields in 89 countries. That covers 75% of global reserves, production and emissions, and is available for public use, a first for a collection of this size.”

Link to full article from the AP.

Research Identifies How Stress Triggers Relapse

05 Wednesday Oct 2022

Posted by in Addiction, brain, Stress

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Recent research from Brown University could pave the way for new methods of treatment for those recovering from addiction. Researchers identified an exact brain region in rats where the neural steps leading to drug relapse take place, allowing them to block a crucial step in the process that leads to stress-induced relapse.

Prior research has established that acute stress can lead to drug abuse in vulnerable individuals and increase the risk of relapse in recovering addicts. But the exact way that stress triggers the neural processes leading to relapse is still not clearly understood. The Brown study provides new insights on how stress triggers drug abuse and could lead to more effective treatments for addiction.

According to the study, stress has significant effects on plasticity of the synapses on dopamine neurons in the ventral tegmental area (VTA), the brain region where the neural activities leading to a stress-induced drug relapse take place.

Stress activates kappa opioid receptors (KORs) in the VTA, and the researchers found that by blocking the KORs, they could prevent the rats from relapsing to cocaine use while under stress.

Published in the journal Neuron, the study shows blocking these receptors may be a critical step in preventing stress-related drug relapses in humans, as well. The chemical used to block the receptor, “nor-BMI,” may eventually be tested on humans, according to the study’s authors.

“If we understand how kappa opioid receptor antagonists are interfering with the reinstatement of drug seeking, we can target that process,” senior study author Julie Kauer said in a statement. “We’re at the point of coming to understand the processes and possible therapeutic targets. Remarkably, this has worked.”

Kauer noted that the study builds upon over a decade of research on how changes in brain synapses relate to behaviors like addiction. The advance is significant and could accelerate progress towards a medication for those struggling to recover from addiction.

“If we can figure out how not only stress, but the whole system works, then we’ll potentially have a way to tune it down in a person who needs that,” Kauer said.