Identify Describe and Discuss Addiction, Mental Health, Trauma, Chronic Pain and Process Disorders Identify how Trauma, Shame, Guilt, Humiliation, Embarrassment, Grief and Loss Effect Ones Story about themselves Identify how Growing Up in An Alcoholic Family can effect one Review evidence based strategies

2. Trauma
Mental Health
Addiction
The Uninvited Guests
Oct. 2020

3. About Dr. Louise
-Clinician-Educator- Author
Interventionist
• “Interventionist of the
Year” -2019 DB Resources
and McLean Hospital-An
Affiliate of Harvard
• Woman , Wife, Mother,
Widow, Grandmother
• Adventurer

4. At the end of the presentation
participants will be able to :
Identify Describe and Discuss Addiction, Mental Health,
Trauma ,Chronic Pain and Process Disorders
Identify how Trauma, Shame , Guilt , Humiliation,
Embarrassment, Grief and Loss Effect Ones Story about
themselves
Identify how Growing Up in An Alcoholic Family can effect one
Review evidence based strategies

5. At the end of the presentation
Participants will be able to:
Identify and Differentiate trauma as both objective and
subjective and how it effects people over the life span
Recognize how trauma can be precipitating factor which leads to
a substance use disorder and vice versa the activities one
engages in the midst of a substance use disorder can be
traumatic
Identify and Describe Addiction per ASAM new definition
Describe and Discuss Qualitative Methods of Inquiry and Family
Mapping as a Way into Story

6. Your Objectives !!!!

8. Are We Living ?

11. What is your
Philosophy of
Treatment ?

12. Who Am I ?
“I am the mirror who reflects back their pain, their fears their
voices. I am the inquirer who asks difficult questions, who searches
for evidence and patterns. I am the companion on the journey
bringing my own story to the encounter, making possible an
interpretive co"aboration, I am the audience who listens , laughs ,
weeps an applauds. I am the spider women spinning their tales.. I
am the therapist who offers cathaersis support and cha"enge… I am
also the stage manager coordinating the intersection of three plays-
the story te"er, the narrator and the readers inviting your voice to
the drama”

14. 2020
How do your clients arrive?

16. Trauma
Overwhelming experiencing that
cannot be integrated and elicit
animal defensive mechanisms and
dysregulated arousal
“A stress that causes physical or
emotional harm that you cannot
remove yourself %om”
Larke Huang , Director of Health
Care Equity at SAMSHA

17. –Unknown
Our Brains are wired for
connection, Trauma rewires them
for protection

19. Types of Trauma
Acute Trauma - Results from a single incident
Chronic Trauma is repeated such as verbal, domestic
violence or abuse
Complex Trauma is exposed to varied muklltiple events,
often invasive interpersonal nature.
Collective Trauma -shared experience of helplessness,
disorientation and loss amongst a group of people

20. Epigenetic Trauma
UCLA Studies Of Civil War Pows
2016
Epigenetic explores how changes occurred as a result of
gene expression and may be changing the way we look
at inherited disorders
Epigenetic is showing that trauma can alter the
biological behavior of cells that can be passed down to
future generations
Father -son-grandson showed higher mortality rates

22. Collectiive Trauma
Racism
Covid 19
Natural Disasters
Unemployment
School Closures
Confusion and Anxiety

24. Issues
Unlucky Graduates- No Commencement-No New
Beginning
Want to Launch -Yet Can’t Launch-Feel Like a Failure To
Launch
Birthdays in lockdowns
Lack of faith in the administration

25. Held Hostage at Home
Zoom birthdays, graduations
Become Tic tok stars
Lose a summer job
Rethink plans for the future
Increase digital use
Anxiety and dEpression
Increase
It feels like we are trapped

26. Collective Trauma
Shared experience which is
imprinted in a generation
though their cam be different
responses
Recognition, Remeberance,
Solidarity, Communal Therapy
and Massive Coperation

29. More Stressors
Children at Home
Social Distancing
Social Lockdown
Wearing Masks
Alcohol Up- Marijuana Up

31. Subjective and Objective
Trauma

32. It Can Feel like You Are Whirling Thru a
Tornado

33. I Met Trauma at a Young Age

36. Story

38. Humiliation- Embarrassment
The Act of Making
Someone Inferior or
Foolish
You have Bad table
manners.
“ Your Father Committed
Suicide!”

39. The Brain & Memory
Amygdala - Alarm circuit
Prefrontal cortex
(Conscious thinking)
Walking down the Street
and think you see a snake

40. Trauma and Memory

42. Folks Are More Then Their Trauma
Questions about life role
Your place in life
Coupled with a sense of loss
Perhaps we have lost a core
part of ourselves
Sometimes we become still
and quiet

43. Reflective Questions

44. Self Reflection Questions
What is your life’s role?
What do you believe is the main core of your identity
(Family Member, partner, work, home , pet, health and
why??
What has been your greatest experience of loss? (loved
one , job, health etc) ?

45. Addiction -Attachment Disorder
Values are lost as we attach to substances and other unhealthy behaviors

46. Definition of Addiction
ASAM, Sept. 15, 2019
Addiction is a treatable, chronic medical disease
involving complex interactions among brain circuits,
genetic, the environment and an individuals life
experiences. People with addiction use substances or
engage in behaviors that become compulsive and often
continue despite harmful consequences
Prevention efforts and treatment approaches for
addiction are generally as successful ann for other
chronic diseases

47. Mental Health Issues
Anxiety
Depression
Grief and Loss
Narcissism
PTSD
Bi-Polar
Personality
Psychosis
Phobias

48. Theraputic Goals
Develop
Attunement
Increase Empathy
Process Shame
Empower Change

49. Modalities Used To Join Up
MI-Motivational Interviewing
CBT-Cognitive Behavoorial
DBT- Dialectical
ACT-Acceptance and
commitment
SFT-Solution Focused
12 step or self support

51. Start Where Your Client Is

52. Client is the
expert - Give
them Control
Over Their
Recovery

55. Have you earned the right yo
hear another story?

57. CDC Guiding Principles
Safety
Trustworthiness and
Transparency
Peer Support
Collaboration and Mutuality
Empowerment and choice
Cultural, historical , gender
issues

58. Benefits of Trauma Focused
Therapy
Reestablish safety
Identify Triggers
Develop Healthy Coping Skills
Decrease in Traumatic Stress Symptoms
Practice Trauma Processing or Integration

59. Family Mapping
A Way into Story

60. Conversations will be non-linear

61. Qualitative Questions
Tell Me about ………..
Tell me about your
Family..
Tell me about your
children, family,
Grandparents etc

63. Whats most important ?
To Establish Safety
To Reframe Actions as Survivor Mechanisms Reduces
Shame and Guilt
Recognize the centrality of affect-regulation ability to
self sooth
Clear Boundaries

64. Evidenced Based Strategies
EDMR
Mindfulness
Buddah
META
Breathing
Somatic
Psychodrama
Yoga

65. Evidenced Based Therapy
CBT
ACT
MI
SFT
DBT

66. Evidenced Based Strategies
Music Therapy
Art Therapy
Sand Jungian Therapy
Equine Therapy

67. Trauma a can also be Related
to Pain Body

69. Meet Robert

70. Sheila

71. Meet Tommy

72. Combat Photographer

73. Meet Heidi

75. www.allaboutinterventions.com
619-507-1699
Dr. Louise Stanger

76. Coming
November 19
Rockridge Press,
Emeryville, Ca
available on Amazon

77. The Definitve
Guide To
Addiction
Interventions
2018 Routledge
Available on Multiple
Sites Amazon,
Routledge etc

78. Falling Up A
Memoir of
Renewal 2016
Available on Amazon

79. Resources
Stanger, Louise https://thriveglobal.com/stories/are-you-the-adult-child-of-an-
alcoholic-did-you-grow-up-in-a-confusing-family/
Stanger, Louisehttps://www.a"aboutinterventions.com/2020/01/31/today-i-am-
relieved-being-an-adult-child-of-alcoholic-informs-me/
Stanger, Louisehttps://www.a"aboutinterventions.com/2020/01/30/what-
happens-to-a-child-in-an-alcoholic-family/
https://www.a"aboutinterventions.com/2019/10/08/inside-the-goldfinchhow-
sudden-deathandtrauma-influences-addiction-louise-stanger-ed-d-lcswcdwf-cip-
and-james-flowers-phd-lpc-s/
Stanger, Louise, Fa"ing Up:A Memoir of Renewal , 2016 available onAmazon

80. Resources
Stanger, L & Weber, L. 2018. The Definitive Guide toAddiction Interventions-Co"ective
Strategies . NY . Routhledge.
Stanger, L. 2016. Fa"ing Up-A memoir of Renewal. Ca. WZY Press. available onAmazon
Stanger, L 2016. Learn to Thrive :An Intervention Guidebook (available at
www.a"aboutinterventions.com)
Stanger, L & Roger P. 2016-present Huffington Post, Thrive Global, The Sober World, Renew,
Recovery View, DB Resources, Counselor Magazine etc.
Stanger, L .& Flowers, J. 2016-present. Huffington Post, Thrive Global,The Sober World.
Stanger, L & Holsomback, J. 2016-present. Huffington Post, Thrive Global, The Sober World.
Stanger, L. WWW.A"aboutInterventions.com

81. Resources
Kopp, Sheldon- If You Meet The Buddah on the Road , Ki" Him,
1982. Penguin House Random House, NY, NY
Stanger, Louise. Fa"ing Up-A Memoir of Renewal 2015, WZY Press
Stanger,http://www.huffingtonpost.com/entry/tricksters-addiction-
you_us_592f0f7ee4b0d80e3a8a329e
Stanger http://www.huffingtonpost.com/entry/what-are-the-
differences-between-trauma-addiction_us_58f4e7aee4b048372700da27
www.a"aboutinterventions.com

82. Resources
Brown, Brene- Rising Strong . Speiegel & Grau International 2015 NYC NY
Brown, Brene, DaringGreatly. Gothom Books 2012
Lawrence Lightfoot,Sarah & Hoffman Jessica .TheArt and Science of
Portraiture. Joey Bass. 1997
LawrenceLightfoot, S. Respect , 1998. Press Books, Mass.
Lawrence, Lightfoot,S. I’ve Known Rivers , Penguin Publishing. Ny 1995
Lawrence, Lightfoot, S Growing Each Other Up, University of Chicago Press.
2016

83. Resources
What’s Love Got to do with it -Boundaries and Relationships -Stanger Huffington
Post
The Sober World- Grandmother I have Something to Tell You, Stanger& Porter
The Sober World-Parents and Teens in the Midst of an Opioid Crisis, Holomback&
Stanger
The Sober World: Parents , Teens, Marijuana , Stanger & Porter
Recovery Campus-Freshman 101, Stanger& Porter
Recovery Campus-Adulting It’s Hard to do , Stanger& Porter
All articles and more are available on http:www.allaboutinterventions.com

84. Resources
Kopp, Sheldon- If You Meet The Buddah on the Road , Ki" Him,
1982. Penguin House Random House, NY, NY
Stanger, Louise. Fa"ing Up-A Memoir of Renewal 2015, WZY Press
Stanger,http://www.huffingtonpost.com/entry/tricksters-addiction-
you_us_592f0f7ee4b0d80e3a8a329e
Stanger http://www.huffingtonpost.com/entry/what-are-the-
differences-between-trauma-addiction_us_58f4e7aee4b048372700da27
www.a"aboutinterventions.com

85. Resources
Stanger articles https://www.allaboutinterventions.com/pain-
management-and-opioid-addiction/http://
www.huffingtonpost.com/entry/
Stanger, Porter, Flowers Huffington Post-Trauma and
Addiction http://www.huffingtonpost.com/entry/trauma-
addiction-whats-the-difference_us_58d14912e4b0e0d348b347f3
Flowers Articles,https://www.thriveglobal.com/authors/3611-
james-s-flowers-phd-lpc-s-and-angela-harris-msw-candidate
Stanger,https://www.allaboutinterventions.com/current-news/

86. Resources
http://cctasi.northwestern.edu, Center for Child Trauma,
Assessment Services and Interventions
https://www.integration.samhsa.gov/clinical-practice/
trauma