Stefan sandstrom recovery process Power Point iCAAD Stockholm

1. Recovery process
stefan sandström 2019
www.spfab.se

2. Three conclusions about
substance abuse
 People abuse drugs because they have
intolerable feelings (self-medication).
 These feelings generally stem from trauma.
 When acting out is dramatic it is almost always
the result of a flash-back.

3. Trauma is probably the most
common co-morbidity.
 Research on Trauma and PTSD
 Includes ACE studies
 EX: Between 36-50 % of those seeking
treatment for substance abuse suffered from
life-long PTSD (Brady et alt 2004)
 Around 50 % of those seeking help for
dependency problems in Sweden suffered from
PTSD. (Persson and Magnusson 2014)

4. How common is trauma
PTSD according to DSM V
 ” Exposure to actual or
threatened death, serious
injury, or sexual violence.”
 Or that you witness it.
 Other early traumas:
 Bullying
 Physical punishment (child)
 Psychological abuse
 Physical neglect
 Psychological neglect
 Parents taking drugs
 Parent mentally ill
 Parents fighting (not physical)
 Experiencing severe shame
 Early abandonment

5. A viscious cirkle
Trauma
(violence, incest,
abandonment,
negligence etc.)
Substance abuse
(to regulate feelings)
Resulting life-style
(criminality, violence,
prostitution etc.)

6. Flash-backs/ Acting out
 Fight-mode:
 Hits someone
 Slams door
 Anger tantrum
 Destroys furniture, etc.
 Threatening behaviour
 Flight-mode:
 Runs away
 Anxiety attack
 Drug craving
 Freezes
 Faints
Q: Lack of Boundaries or Flash-backs

7. 2 problems that must be solved
Trauma
 Need for self-medication
 Risk for relapse
 Life-long suffering from trauma
Disorganised attachment:
 No trusting relationships
 Living in a hostile environment
 Lack of support
 Inability to form functioning
relationships:
 Work (colleagues, bosses)
 Home (neighbours)
 Family (partner, children)
Social rehabilitation means to get your relationships to function!

8. After-care: Constructing a life
 Occupation: Work, Internship, Study
 Economy, debts etc.
 Residence
 Interests
 Social networks, friends
Something to do
A place to live Friends &
interests