2023-08-30 - Finding Your Best Self by Lisa Najavits ==================================================== I saw this author referenced in an online post and i checked out this book from the local library. The book contains a lot of useful information about healing from addiction and trauma. It dispels quite a few myths, such as the myth that you have to admit you have a problem before you can heal. Since this book contains so much information, i could not summarize it all. Preface ======= > Life will break you. Nobody can protect you from that, and living > alone won't either, for solitude will break you with its yearning. > You have to love. You have to feel. It is the reason you are here > on earth. You are here to risk your heart. You are here to be > swallowed up. And when it happens that you are broken, or > betrayed, or left, or hurt, or death brushes near, let yourself sit > by an apple tree and listen to the apples falling all around you in > heaps, wasting their sweetness. Tell yourself you tasted as many as > you could. > -- From: The Painted Drum by Louise Erdrich, > Native American writer and winner of the National Book Award Chapter 1: Moving forward from addiction, trauma, or both ========================================================= You can heal from trauma and addiction. Emotional pain that you've carried, even for a long time, can become the seed of growth. Trauma comes from the Greek word for wound, which vividly describes what it feels like. It's a serious, unwanted, harmful event that can lead to lasting pain. The wounds may be physical, emotional, or both. Addiction comes from Latin roots for enslavement, which perfectly describes what serious addiction feels like. Broadly, addiction means that you keep engaging in a behavior despite the harm it causes. People without the addiction would stop to preserve their health, finances, or relationships. People with addiction keep repeating their behavior. They may want to stop but can't. They feel more and more out of control. Or they may think it's not a problem, but the facts show that it is. To those who don't understand, addiction is often judged as bad rather than seen at a deeper level as an attempt to cope. The truth is that even though addictive behavior causes problems, it may have been safer in the moment than the alternative. Just as trauma and addiction are linked, so is their recovery. You can apply recovery skills to both at once, which is more powerful than working on each alone. Chapter 2: Starting out ======================= ... you can set your own goals. For example, some people with addiction problems know they need to give up their addictive behavior completely (an abstinence approach); others want to start reducing it (harm reduction); some seek to return to safe levels of use (controlled use); still others aren't sure of their goals and want help figuring out what's best for them. Language is powerful. Use whatever words fit for you. Trauma problems is used in this book but you can substitute post traumatic stress disorder (PTSD) if you have that condition or use a general term such as emotional pain. Addiction occurs throughout, but you may not have a full-blown addiction and may prefer problem behavior, excessive behavior, unsafe behavior, or addictive behavior. Also this book focuses on all types of addiction, not just substances, so addiction and using can relate to any addictive behavior (using alcohol, using gambling, using food, using sex, etc.). This book refers to recovery, but you may prefer healing, growth, progress, or change. Just focus on the behaviors and feelings you want to change. You may want to engage others to support your recovery. Or you may prefer to wait until you have more people you can trust. If you want to involve others, consider a counselor, friend, family member, 12-step sponsor, mentor, spiritual advisor, or peer. Chapter 5: How do people change? ================================ Coping refers to how you respond to problems. [People who have good coping] are responsible, and they manage challenges in positive ways. Trauma and losses can be grieved. You can let yourself feel the emotional pain, moving through it and emerging with new understanding and a sense of peace. Quantum change, also called conversion, is a sudden, dramatic, and permanent change. In addiction, hitting bottom sometimes results in quantum change. Quantum change often has a spiritual component and is described as being reborn... Loving relationships can be one of the most powerful methods of change. The relationships may be with family, friends, a counselor, a spiritual source such as a higher power, or a self-help group. Physically based change occurs through medication, body therapies, or other strong physical experiences. There's growing awareness that mind-body connections promote healing, and for some people the physical realm is more compelling than traditional verbal help such as counseling. [Somatic vs. talk therapy] Coercion refers to forced change such as being legally required to attend treatment ("mandated"). It may surprise you to learn that people who are forced to attend treatment do just as well or better than those who attend voluntarily, according to research. And some people say being forced into treatment was the best thing that ever happened to them. People who do best in recovery pay attention to consequences. They observe the impact of their behavior and try to stay on the good side of consequences as much as possible. They hear the feedback life is offering. Creativity and healing are directly related. Creativity helps you access parts of yourself you can't access otherwise. It allows you to convert emotional pain into authentic expressions of your truth that inspire others or contribute to the world. [Creative outlets] open up your inner world and let you play with possibilities through different perspectives and ways of expression. The more ways you try, the better your chances of lasting change. Chapter 6: The World Is Your School =================================== Be inspired by others. Various websites offer stories of recovery by those who lived it, in their own words. All of the following are nonprofit, free, reputable resources. You can find others by searching online for "personal stories" and a keyword such as "trauma, "PTSD," "addiction," "homelessness," or "domestic violence." Military veterans in recovery from trauma, their family members --------------------------------------------------------------- and counselors -------------- Videos People with substance abuse, mental health issues, or both ---------------------------------------------------------- Brief written accounts People with PTSD ---------------- Brief written accounts Videos People with addiction --------------------- Brief written accounts Videos People with addiction and/or mental health problems --------------------------------------------------- Brief written accounts Chapter 9: Find your way ======================== Addiction and trauma are both rooted in powerlessness. If your addiction and trauma problems are severe, they undermine your personal power in the world. Empowerment is thus hugely important. It's about having options, choosing what's best for you, saying yes to what helps and no to what doesn't. It's about becoming aware of what you really need and want. Empowerment is especially important when you're confronted with strong or conflicting advice. The same advice may have positive impact on one person but negative impact on another. Research shows that there are many ways that work. In the end, it's your life and up to you to decide what works for you. Surprises --------- You don't have to admit you have a problem to get help. You may be questioning whether you really have addiction or trauma problems. You don't have to be convinced of it on the front end. The key is to reach out sooner rather than later so you can figure it out. Some people get better on their own. Not everyone has to get formal help. Some people are able to do what is called "natural recovery" (they get better on their own). They may be using their existing network of supports such as friends, family, or faith-based communities. They may have strong self-discipline and motivation. But the more severe your problems and the more types of problems you have, the more likely you are to need structured help. If you are trying to get better without formal help, remember to keep observing whether you're getting better or worse. Old-style harsh confrontation of addiction is not recommended. The classic image of in-your-face addiction treatment ("Tear 'em down to build 'em up") is no longer recommended. Now the idea is compassionate support plus accountability. You still have to do what it takes to get better, but the approach shouldn't involve belittling or berating you. Telling your trauma story isn't enough. Many people believe that if they can just purge or spill their story they'll feel better. But it's not a toxin to expel and then it's gone. It's more than just the facts of what happened; it's also about the meanings it holds for you, feelings that come up, and how it relates to other problems, including addiction. You don't have to feel motivated for treatment to work. You just have to show up. Motivation sometimes happens along the way rather than at the start. If you feel hopeless or depressed, it can take a while to get energized toward recovery goals. Good care, whether professional or self-help, starts where you're at and helps inspire your motivation. Start early; don't wait to "hit bottom." Just like physical problems such as cancer or diabetes, early care is best. Hitting bottom can lead to change but is not required. The sooner you start, the better. There's no addictive personality. It's now understood, based on decades of research, that people with addiction have many types of personalities. Addiction isn't a personality problem, it's a medical illness that arises from genes and life experiences... How you feel by the third session of counseling predicts how you'll feel about it months and even years later. Do you feel a positive bond with the counselor and the treatment? If it's not there by the third session, discuss it with the counselor and/or shop around. You can combine any mix of help that you choose. There's often benefit, and no known harm, from getting different types of help at the same time, such as counseling, self-help groups, and medication. In general, the more the better. If you're forced into addiction treatment, you're just as likely to succeed as those who attend on their own. It's often believed that people have to want help or it won't work. But research shows that people who are forced to attend, such as by the courts or an employer, do just as well as those to choose to attend. However, the same is not true for trauma treatment--in general, it's not recommended to force a person into that. Twelve-step groups can be great, but other approaches also work. Twelve-step groups help millions of people and are an extraordinary free resource. But there are also other paths for successful recovery, including nonspiritual methods such as SMART Recovery. Most formal help performs equally well--so choose what you like. "Formal help" here refers to specific models that have been scientifically tested. You may be surprised to hear that although there are different brand names, they all perform about equally well. This is called "distinctions without a difference"--although the names of the approaches differ, their power to help you is basically the same. Yet they may differ in other important ways such as cost, appeal, and access. For example, 12-step models do as well as professional therapies in their results. Twelve questions to ask when seeking help ----------------------------------------- 1. If I were to relapse in my addiction, what would happen? (Some programs may ask you to leave while others will let you stay.) 2. How long will it take? 3. How much does it cost? Do you accept my insurance? 4. How will I know if I am getting better? 5. Does your approach have a name? Can I read more about it online? 6. Will I be required to share my trauma story in detail? What if I prefer not to? 7. What is your perspective on working on trauma and addiction at the same time? 8. Is there any research on your type of help? (There may not be research, but if it exists it's good to know about.) 9. How will you identify what types of problems I have? 10. Will I have a choice who I work with? Can I switch if it doesn't feel like a good fit? 11. If I don't improve or worsen, what are my options? 12. Are there any requirements, such as attending AA or anything else? Chapter 12: Safe Coping Skills ============================== 1. Ask for help--Reach out to someone safe. 2. Inspire yourself--Carry something positive (e.g., poem) or negative (photo of a friend who overdosed). 3. Leave a bad scene--When things go wrong, get out. 4. Persist--Never, never, never, never, never, never, never, never, never give up. 5. Honesty--Secrets and lying are at the core of PTSD and substance abuse; honesty heals them. 6. Cry--Let yourself cry; it will not last forever. 7. Choose self-respect--Choose whatever will make you like yourself tomorrow. 8. Take good care of your body--Eat right, exercise, sleep, safe sex. 9. List your options--In any situation, you have choices. 10. Creating meaning--Remind yourself what you are living for: your children? Love? Truth? Justice? God? 11. Do the best you can with what you have--Make the most of available opportunities. 12. Set a boundary--Say "no" to protect yourself. 13. Compassion--Listen to yourself with respect and care. 14. When in doubt, do what is hardest--The most difficult path is invariably the right one. 15. Talk yourself through it--Self-talk helps in difficult times. 16. Imagine--Create a mental picture that helps you feel different (e.g., remember a safe place). 17. Notice the choice point--In slow motion, notice the exact moment when you chose a substance. 18. Pace yourself--If overwhelmed, go slower; if stagnant, go faster. 19. Stay safe--Do whatever you need to put your safety above all. 20. Seek understanding, not blame--Listen to your behavior; blaming prevents growth. 21. If one way does not work, try another--As if in a maze, turn a corner and try a new path. 22. Link PTSD and substance abuse--Recognize substances as an attempt to self-medicate. 23. Alone is better than a bad relationship--If only people who are receiving help are safe for now, that is okay. 24. Create a new story--You are the author of your life; be the hero who overcomes adversity. 25. Avoid avoidable suffering--Prevent bad situations in advance. 26. Ask others--Ask others if your belief is accurate. 27. Get organized--You will feel more in control with lists, "to do's" and a clean house. 28. Watch for danger signs--Face a problem before it becomes huge; notice red flags. 29. Healing above all--Focus on what matters. 30. Try something, anything--A good plan today is better than a perfect one tomorrow. 31. Discovery--Find out whether your assumption is true rather than staying "in your head". 32. Attend treatment--AA, self-help, therapy, medications, groups--anything that keeps you going. 33. Create a buffer--Put something between you and danger (e.g., time, distance). 34. Say what you really think--You will feel closer to others (but only do this with safe people). 35. Listen to your needs--No more neglect--really hear what you need. 36. Move toward your opposite--For example, if you are too dependent, try being more independent. 37. Replay the scene--Review a negative event; what can you do differently next time? 38. Notice the cost--What is the price of substance abuse in your life? 39. Structure your day--A productive schedule keeps you on track and connected to the world. 40. Set an action plan--Be specific, set a deadline, and let others know about it. 41. Protect yourself - Put up a shield against destructive people, bad environments, and substances. 42. Soothing talk--Talk to yourself very gently as if to a friend or small child. 43. Think of the consequences--Really see the impact for tomorrow, next week, next year. 44. Trust the process--Just keep moving forward; the only way out is through. 45. Work the material--The more you practice and participate, the quicker the healing. 46. Integrate the split self--Accept all sides of yourself- they are there for a reason. 47. Expect growth to feel uncomfortable--If it feels awkward or difficult you're doing it right. 48. Replace destructive activities--eat candy instead of getting high. 49. Pretend you like yourself--See how different the day feels. 50. Focus on now--Do what you can to make today better; do not get overwhelmed by the past or future. 51. Praise yourself--Notice what you did right; this is the most powerful method of growth. 52. Observe repeating patterns--Try to notice and understand your re-enactments. 53. Self-nurture--Do something that you enjoy (e.g., take a walk, see a movie). 54. Practice delay--If you cannot totally prevent a self-destructive act, at least delay it as long as possible. 55. Let go of destructive relationships--If it cannot be fixed, detach. 56. Take responsibility--Take an active, not a passive, approach. 57. Set a deadline--Make it happen by setting a date. 58. Make a commitment--Promise yourself to do what is right to help your recovery. 59. Rethink--Think in a way that helps you feel better. 60. Detach from emotional pain (grounding)--Distract, walk away, change the channel. 61. Learn from experience--Seek wisdom that can help you next time. 62. Solve the problem--Do not take it personally when things go wrong--try to just seek a solution. 63. Use kinder language--Make your language less harsh. 64. Examine the evidence--Evaluate both sides of the picture. 65. Plan it out--Take the time to think ahead--it is the opposite of impulsivity. 66. Identify the belief--For example, shoulds, deprivation reasoning. 67. Reward yourself--Find a healthy way to celebrate anything you do right. 68. Create new "tapes"--Literally! Take a tape recorder and record a new way of thinking to play back. 69. Find rules to live by--Remember a phrase that works for you (e.g., "Stay real"). 70. Setbacks are not failures--A setback is just a setback, nothing more. 71. Tolerate the feeling--"No feeling is final", just get through it safely. 72. Actions first and feelings will follow--Do not wait until you feel motivated; just start now. 73. Create positive addictions--Sports, hobbies, AA... 74. When in doubt, don't--If you suspect danger, stay away. 75. Fight the trigger--Take an active approach to protect yourself. 76. Notice the source--Before you accept criticism or advice, notice who is telling it to you. 77. Make a decision--If you are stuck, try choosing the best solution you can right now; do not wait. 78. Do the right thing--Do what you know will help you, even if you don't feel like it. 79. Go to a meeting--Feet first; just get there and let the rest happen. 80. Protect your body from HIV--This is truly a life-or-death issue. 81. Prioritize healing--Make healing your most urgent and important goal, above all else. 82. Reach for community resources--Lean on them! They can be a source of great support. 83. Get others to support your recovery--Tell people what you need. 84. Notice what you can control--List the aspects of your life you do control (e.g., job, friends...) YOU CAN DO IT! Material adapted by Suzanne Welstead (2016) from Seeking Safety: Cognitive-Behavioral Therapy for PTSD and Substance Abuse by Lisa M. Najavits, Ph.D. Chapter 14: True self-compassion ================================ Compassion allows you to stop blaming yourself and instead understand yourself. But it's not a simplistic view of compassion. The ultimate test of compassion is whether it helps you change unhealthy behavior. Compassion without behavior changes means it's not deep enough. Compassion toward others can also be healing and can strengthen your recovery. But you never have to take a compassionate view toward people who harmed you. If you want to develop compassion for them, you can, but it's a choice, not a requirement--you can recover without it. Know, too, that compassion and forgiveness aren't the same. You can have compassion for people without forgiving them. You may understand why someone harmed you, how it was rooted in pain or their own trauma--but that doesn't mean you have to forgive. You don't have to forgive to heal. Chapter 16: Forgiving yourself ============================== Forgiving yourself means coming to terms with what happened and doing your best to make the future better than the past. It doesn't mean you like what happened, that it was right, or that you would make the same choices again. It doesn't mean you forgive others for what they did to you. It only means that you make peace with your part in what happened. It's letting go of the resentments toward yourself, knowing that even if flawed, you can respect that you were who you were at the time and you always have the capacity to grow going forward. Forgiving others is an option, never a requirement. An you never have to forgive someone who hurt you unless you arrive at it in a genuine way. It can't be forced, and it's NOT necessary for healing despite what people may tell you. Indeed, it can be damaging to be pushed into forgiveness that you don't feel. It's a personal choice and it may take years or decades to decide whether you want to forgive people who hurt you. In the trauma field, it's well established that forgiveness is a choice, not a requirement. In the addiction field, you're more likely to hear that you must forgive, but that idea developed before the addiction field focused on trauma. Now the idea is that forgiveness is always a personal choice. You can make progress with or without it. But forgiving yourself is key. Otherwise, there may be some part of the past always holding you back. Chapter 17: Body and biology ============================ Trauma and addiction are experienced in the body. It means that you need to pay strong attention to your body as part of recovery. You may need to "hear" your body more--noticing when you feel pain or discomfort rather than ignoring it. It may mean making more effort to take care of your body, such as eating healthily and getting exercise. It may involve forging a new relationship with your body based on respecting it. No matter how much trauma or addiction you've had, you can learn to live in harmony with your body. Trauma and addiction can decrease body awareness. You may dissociate, which means that your mind detaches for a while in response to stress; during these times, you may feel unaware of body sensations. Chapter 18: Grounding ===================== All feelings are normal; they're part of being human. But if you have trauma or addiction, they can be too much or too little. Grounding helps you get them back to a healthy mid-level. Grounding means focusing outward on the external world--rather than inward toward the self. You can also think of it as centering, calming, a safe place, looking outward, peacefulness, or healthy detachment. Three types of grounding are described in this chapter: mental, physical, and soothing. You can see which types work best for you. By rating your feelings before and after, you can also test how well grounding works. Many religious and spiritual traditions focus on healthy detachment. Healthy detachment... is being in touch with the present, centered and calm. Various methods such as meditation, mindfulness, and relaxation training can also bring forth such feelings. But those methods weren't designed to handle intense and dangerous impulses. Grounding is more active than those other approaches, and the eyes are kept open to keep you in touch with your environment. Guidelines ---------- * Grounding can be done any time, anywhere, and no one has to know. * Use grounding when you're faced with a trigger, having a flashback, dissociating, having a substance craving, or when your distress goes above 6 (on a 0-10 scale). Grounding puts healthy distance between you and these negative feelings. * Keep your eyes open, scan the room, and turn the light on to stay in touch with the present. * Rate your mood before and after to test whether it worked. Before grounding, rate your level of distress (0-10, where 10 means "intense distress"). Then rerate it afterward. Has it gone down? * Stay neutral--no judgments of good and bad. For example, "The walls are blue; I dislike blue because it reminds me of depression." Simply say "The walls are blue" and move on. * Focus on the present, not the past or future. Step 1: Think of something moderately distressing--not the worst thing you can think of, but something that brings up some negative feelings. On a 0-10 scale, where 10 is the most intense distress, think of something between 5 and 7. Step 2: Rate your level of distress from 0 (none) to 10 (intense distress). The goal will be to see if grounding helps to reduce the distress. Step 3: Use as many of the following strategies as you can, in any order, until you reach 10 minutes total. And just do them; don't add in comments or judgments of good or bad. Examples of mental grounding ---------------------------- * Describe your environment in detail using all your senses. For example, "The walls are white, there are five pink chairs, there's a wooden bookshelf against the wall. ..." Describe objects, sounds, textures, colors, smells, shapes, numbers, and temperatures. * Play a categories game with yourself. Try to think of "types of dogs," "jazz musicians," "states that begin with A," "cars," "TV shows," "writers," "sports," "songs," "cities." * Describe an everyday activity in great detail. For example, describe a meal that you cook (e.g., "First I peel the potatoes, then I boil the water..."). * Imagine. Use an image: glide along on skates away from your pain; change the TV channel to get a better show. * Make a safety statement. "My name is _____; I am safe right now. I am in the present, not the past. I am located in _____; the date is _____." * Use humor. Think of something funny to jolt yourself out of your mood. Or read or watch some comedy. Examples of physical grounding ------------------------------ * Run cool or warm water over your hands. * Grab tightly on to your chair and notice what it feels like. * Touch various objects around you: a pen, keys, your clothing, the table, the walls. Notice textures, colors, materials, weight, temperature. Compare objects you touch. Is one colder? Lighter? * Dig your heels into the floor--literally "grounding" them! Notice the tension centered in your heels as you do this. Remind yourself that you're connected to the ground. * Carry a grounding object in your pocket--a small object (a small rock, clay, ring, piece of cloth or yarn) that you can touch whenever you feel triggered. [A fidget spinner.] * Jump up and down. Examples of soothing grounding ------------------------------ * Speak kindly to yourself as if talking to a small child: "You're a good person going through a hard time. You'll get through this." * Think of favorites: favorite color, animal, season, food, time of day, TV show, person, movie, activity, place, quotation, song, and scent. Also add other favorites you can think of. * Picture people you care about, such as your children, and look at photographs of them. * Remember the words to an inspiring song, quotation, or poem that makes you feel better, such as the Serenity Prayer. * Remember a safe place. Describe a place that you find soothing (perhaps the beach or mountains or a favorite room). * Create a coping statement. "I can handle it." "This feeling will pass." * Think of what you're looking forward to in the next week, perhaps time with a friend or going to a movie. Step 4: Afterward, rerate your negative feelings on the same scale from 0 (no distress) to 10 (intense distress). Did the number go down even a little? Do you feel even just a bit better than when you started? If not, try grounding again for 10 minutes. Then rerate your negative feelings again. If you try it long enough with enough different methods, it will work. Chapter 26: Identity: How you view yourself =========================================== Identity is your mental model of yourself. It's how you answer the question "Who are you?" There's no one way to answer it and, in fact, how you answer it says a lot about who you are. Who you are is a kaleidoscope of your age, gender, nationality, religion, ethnicity, social class, temperament, relationships, how you spend your time, where you live, what you value, what you survived, and so on. Identity goes to the core of your experience of life. Trauma and addiction may be as much a part of your identity as other aspects. They influence you even if you don't want them to. Finally, both trauma and addiction are associated with splitting, which is a fragmented identity in which you're only aware of part of yourself at a given time. Everyone has sides they're aware of at different times, but in trauma and addiction the splits tend to be more extreme, less conscious, and more likely to lead to unsafe behavior. With recovery comes integration--balanced awareness of all sides of the self and greater control over them. Some aspects of identity are more fixed, such as age, gender, and ethnicity. Others are more malleable. For example, personalty traits are part of your identity and can be expressed in healthy or unhealthy ways. Usually the unhealthy version is too extreme or directed toward unworthy goals. It's about accepting who you are and directing the traits that define you so they don't cause problems but instead become a source of your success. Chapter 29: Dark feelings: Rage, hatred, revenge, bitterness ============================================================ Trauma and addiction can evoke dark feelings such as rage, hatred, bitterness, desire for revenge, and sadism. You may have your own language for them--cruel, monstrous, ugly, unforgiving, vengeful, furious, spiteful. Everyone has these feelings at times, but with trauma and addiction they may be so intense and out of control that they scare you or others. Many dark feelings are rooted in anger that has mutated into an unhealthy form. The term anger is used in this chapter because it's at the core of many other feelings, but choose whatever language fits for you. Dark feelings are there for a reason. You may want to get rid of them... but anger isn't bad in and of itself. It's built into the biology of humans as protection against predators in the wild. Respect that it's there to protect you. In fact, not being able to feel anger can keep you just as stuck as too much anger. But when anger is too persistent or too intense, it's not healthy. The goal is to respond to your dark feelings. This means you use active methods to transform your relationship with them; you become less consumed by them. Responding also means that you don't go to unhealthy extremes: too little or too much. Trauma and addiction come with many losses: loss of hope, innocence, trust, physical integrity, money, relationships, and freedom. You may have no idea how to grieve these. Underneath dark feelings there are often deep layers of hurt and sadness. Release those deeper feelings to convert your anger into a less toxic form. Whatever the reasons for your dark feelings, staying curious about them can reveal new ways to work on them. People with dark feelings are often highly idealistic, valuing respect and fairness. Trauma and addiction erode these ideals, but you can rekindle them by finding some important mission. Chapter 30: Imagination ======================= One of the best tools to bring to recovery is your own imagination--playing with possibilities and envisioning what isn't yet present. Imagination moves you past inner defenses that keep you from your full range of feelings. It taps into wisdom you didn't know was there. You discover fresh perspectives that can spur growth. Chapter 32: Find a good counselor ================================= At some point many people with trauma and addiction find themselves in counseling of some sort. It's important to find a helper who's a good fit for you: someone who's supportive yet also guides you to make real changes in your life. A good professional helper is more than a kind friend; it's someone who: * Sets clear goals. * Understands and monitors your symptoms. * Gives you honest feedback. * Provides options. * Uses methods that produce results. * Knows how to handle emergency situations. * Keeps you on track. * Helps you feel safe so you can say anything without feeling judged. Like most things, the quality of counseling ranges from excellent to poor. How can you tell who's a good counselor for you? There's a simple yet reliable way to evaluate whether your counselor is likely to be helpful in the long run. It's called a helping alliance scale, and it allows you to rate the quality of your counseling experience. Such scales have been tested based on extensive research. Remarkably, ratings by the third session of counseling predict how helpful it's likely to be months and even years later. Even with the best counseling, you need to do the work of showing up, trying new things, being open to feedback, and following through on tasks. Recovery is yours to create. Invest in yourself by finding someone who's a good fit for you. Some people spend more time shopping for a smartphone than for a good counselor. The Helping Alliance Questionnaire ---------------------------------- Patient Version INSTRUCTIONS: These are ways that a person may feel or behave in relation to another person--their therapist. Consider carefully your relationship with your therapist, and then mark each statement according to how strongly you agree or disagree. Please mark every one. Each statement has a score to circle. That score, from left to right, corresponds to the following scale: * strongly disagree * disagree * slightly disagree * slightly agree * agree * strongly agree [Note: This is a version found online, not the exact version from the book.] 1. I feel I can depend upon the therapist. [1] [2] [3] [4] [5] [6] 2. I feel the therapist understands me. [1] [2] [3] [4] [5] [6] 3. I feel the therapist wants me to achieve my goals. [1] [2] [3] [4] [5] [6] 4. At times I distrust the therapist's judgment. [6] [5] [4] [3] [2] [1] 5. I feel I am working together with the therapist in a joint effort. [1] [2] [3] [4] [5] [6] 6. I believe we have similar ideas about the nature of my problems. [1] [2] [3] [4] [5] [6] 7. I generally respect the therapist's views about me. [1] [2] [3] [4] [5] [6] 8. The procedures used in my therapy are not well suited to my needs. [6] [5] [4] [3] [2] [1] 9. I like the therapist as a person. [1] [2] [3] [4] [5] [6] 10. In most sessions, the therapist and I find a way to work on my problems together. [1] [2] [3] [4] [5] [6] 11. The therapist relates to me in ways that slow up the progress of the therapy. [6] [5] [4] [3] [2] [1] 12. A good relationship has formed with my therapist. [1] [2] [3] [4] [5] [6] 13. The therapist appears to be experienced in helping people. [1] [2] [3] [4] [5] [6] 14. I want very much to work out my problems. [1] [2] [3] [4] [5] [6] 15. The therapist and I have meaningful exchanges. [1] [2] [3] [4] [5] [6] 16. The therapist and I sometimes have unprofitable exchanges. [6] [5] [4] [3] [2] [1] 17. From time to time, we both talk about the same important events in my past. [1] [2] [3] [4] [5] [6] 18. I believe the therapist likes me as a person. [1] [2] [3] [4] [5] [6] 19. At times the therapist seems distant. [6] [5] [4] [3] [2] [1] Make sure you have an answer for each statement, then add the total of all the items you circled. Scores range from 19 to 114. The higher your score, the more you feel helped by your counselor. If your score is high, that's great. A total of 85 or below indicates that you have a poor alliance (you don't feel helped enough by your counselor) and suggests a need for further action. You can try talking with your counselor about it (highly recommended)... author: Najavits, Lisa detail: LOC: RC564.29 .N34 tags: book,non-fiction,self-help title: Finding Your Best Self Tags ==== book non-fiction self-help