by Hope Rehab Team
Taking Care of the Things We Love
Suppose a generous friend gifts you with an expensive pet you’ve been wanting for a long time. You instantly fall in love with it, vowing to yourself and the world to take good care of it. As such, you would make sure your new companion gets good and sufficient food, liquids and movement. You ensure it gets all recommended supplements and preventative vaccinations, and you would call the vet at the first and slightest sign of ill health. No brainer, right?
It seems simply logical to take care of the things and people we value and love. Women in particular are experts at just that – we care about others. Some of us in fact are so good at this that we forget about ourselves, and we seem surprised when our minds fail, our bodies break down and our souls suffer.
Self-care, or caring about and for ourselves, is seen as something we do when we have to cold or the flu, or some similar time limited ailment. Then, and only then, are we allowing ourselves to rest, drink fluid and eat nourishing chicken soup, as per our granny’s wise and tested advice. As soon as symptoms subside, however, we expect ourselves to quickly and energetically jump back into life with both feet to resume our responsibilities.
Treatment, whether for addiction, mental or physical health problems, tends to reinforce this idea. Usually time limited, it promises to restore us to previous levels of functioning. So seductive the notion of a medically administered quick fix followed by lasting cure, that we readily reject the notion of daily self-care of self-management as obsolete or even selfish. And yet, if we fail to pay attention to our physical, emotional or mental needs, we are prone to relapse into the next episode of ill health sooner or later.
Recovery: The Wake Up Call
While the wish to get back to normal self and life, and previous levels of functioning may be understandable, it also bears a strong contradiction: if the ways in which we went about life has gotten us into addiction, mental or physical ill health, why in god’s name are we in such a rush to get back to those ways? Perhaps the descent into the abyss of mental despair or addiction is our wake up call, and an invitation to reconsider how we have been going about life. What is not working for us that prompts repeat necessity to escape from reality in ways often harmful? What do we want and what do we need in order to be well, healthy and happy?
Recovery = Balance
Women tend to have a particularly hard time focusing on themselves, and the notion of self-care. Still socialized and raised to nourish and nurture others rather than themselves, women by and large tend to feel guilty or selfish when encouraged to pay attention to their own needs. As main caregivers for children, ill partners, or the elderly, women easily acknowledge and attend to others’ needs, in the long run risking neglect of their own needs. Research has repeatedly shown a link between a long-term caregiver role and increasing mental health or substance use problems. Finding a balance between attending to others and their own needs is thus crucial not only in the prevention of substance use or mental heath problems for women, but also in the prevention of relapse.
Women’s Recovery: It’s Complicated
Addiction affects women differently than men. Not only do women get addicted much faster while using lesser quantities, women also end up with much more significant and sometimes chronic health problems than male substance users. Women’s ever changing hormonal system shows impact on, and consequences from alcohol and drug use. Studies found that women are much more sensitive to the effects of drugs when estrogen spikes, and they are said to experience stronger cravings. Women may therefore be at heightened risk of relapse during their menstrual cycle, pregnancy, menopause or other times marked by hormonal changes.
Female substance users experience higher rates of mental health problems, and often suffer more often from chronic pain compared to male users. Sexual violence and other forms of interpersonal trauma, often committed by those women trusted, are often common with women seeking treatment for substance use problems. As if all of this was not enough of a challenge, women also face more barriers getting treatment such as finances or lack of alternate childcare arrangements.
Needless to say, all of these compounding factors call for prolonged and multi-faceted treatment. Women will need to pay attention to their fluctuating needs long after initial treatment has ended, if sobriety is to last. A failure to address and seek support for chronic mental or physical health problems is bound to produce recurring symptoms, and with that vulnerability to coping in old and unhelpful ways. In other words, if we do not pay attention to what we need, we risk relapse. In short, women have a multitude of reasons why paying attention to their own needs is not only a good idea, but simply a necessity to create and maintain a life worth living.
Early Recovery: Slow and Steady Wins the Race
We’ve got treatment behind us, and we return to life and our loved ones. We are eager to get back to normal, and to catch up with things left undone. Eyes are on us, and expectations and hopes for a better and sober life are high. In fact, many of us take on early recovery as if it was a race or combat. Granted, some obligations cannot wait. Our children need to eat, get to school. Bills need to get paid, and employment or school resumed. While our drive to get back to normal is understandable, going full force straight after treatment is unfortunately a recipe for relapse. It’s a bit like signing up for a full marathon the day after your full body cast comes off following discharge from hospitalization due to a serious car accident.
Unlike fractured bones, much of the damage done in addiction remains unseen. We look ok on the outside, therefore others may think we are ok. Expectations are accordingly high, both our own and those of others. Problem is, we are far from ok. Addiction takes a significant toll on our entire system. Depending on type of drug(s), ways of ingesting and length and severity of use, our brain chemistry is scrambled our hormonal and endocrine system off kilter. Our moods are fluctuating; we may be irritable, reactive, depressed or anxious. Mentally, we may have a hard time concentrating, retaining information, make decisions or solve problems. Physically, we can feel easily fatigued and most of us suffer from insomnia.
All of these symptoms are well-documented aspects of post acute withdrawal (paws), which starts following detoxification and lasts up to two years (!!). While the extent to which individuals experience any or all of these symptoms, they are existent to some degree. PAWS are a reflection of our bodies and brains attempt to –regain some sort of healthy equilibrium, to find balance. Early recovery is thus a time to consider what nourishes and nurtures our bodies, our minds, our emotional self and our spirit, rather than further depleting our systems by doing too much too quickly.
It is crucially important that we remember we are recovering from a life threatening condition. Just as our bodies need time to heal after a life threatening illness or accident, recovery from addiction takes time and requires patience. Rather than pushing ourselves beyond our limit in an effort to meet our or others unrealistic expectations, early recovery is a time to drop negative judgment and develop self -compassion.
Continued Recovery: Applying Aristotle’s Wisdom- “Know Thyself”
Taking care of ourselves implies that we know what we need in order to be well; physically, emotionally, mentally and spiritually. In stark contrast, addiction is the disease of self-neglect. Many addicts, and especially women, arrive in treatment plagued by multiple physical problems, mentally and emotionally anguished exhausted, and spiritually disconnected from self and others. This time then, is not only a time to recover what is buried and lost, but also a time of discovery as to what we need in order to get and retain individual wellness and balance.
Practical Self Care: Exploring What it Means to Be and Stay Well
First Nations communities have long incorporated these concepts into their healing practices, and philosophy of life. When all areas of self are attended to, and thus well, then we are in balance. Dis-ease, addiction or ill health is a consequence of imbalance in these areas of self rather than a sign of pathology, personal weakness or failure. Restoring health from this perspective then involves responsibility on our part for creating awareness of our vulnerabilities, and a commitment to attending to our needs. It involves a holistic focus on the whole person, rather than facilitating concentration on, and identification with the problem.
‘Know Thyself’: The Invitation to Explore
Relationships are key to women’s emotional and psychological well-being. Conversely, interpersonal problems tend to contribute to escalating substance use, and are a crucial factor in relapse. Creating and maintaining healthy and supportive relationships is therefore an important aspect in women’s recovery.
Below are some questions women can explore and answer for themselves as part of moving towards increased well-being:
Am I able to name my emotions, and express them in ways that are healthy and helpful to myself, and my loved ones?
Can I endure difficult emotions, such as sadness, boredom or anger, without needing to find ways to escape this temporary discomfort? Can I embrace all emotions as an expression of being healthy and vibrantly alive?
Do my relationships reflect a healthy give and take? Do I feel that my needs and opinions are as valid as others’?
How comfortable am I making requests or asking for support when I need it?
Is my happiness dependent on others’ happiness?
Do my relationships show healthy boundaries, or are there signs of codependency or rigidity?
Women in recovery may greatly benefit from joining a recovery group focused on self care and empowerment, as compared to traditional male oriented AA or NA fellowships.
Mental Health, Mental Self
For substance using women who also suffer from mental health issues, treatment ideally focuses on both disorders simultaneously. Mental health issues can trigger, mimic or exacerbate substance use problems, and vice versa. Sustained recovery thus requires paying attention to both, and this often involves ongoing professionalsupport and/or maintenance therapy. It is also important that women know exactly what first indicators of a relapse into mental health problems are, as these are likely to trigger relapse into substance use.
Pointers for further exploration:
Observe the quality of your thoughts; how are you talking to yourself? Increased negative or judgmental self-talk, the resurfacing of suicidal thoughts or rumination are all potential signs of impending relapse into mental health problems.
Watch for high expectations, perfectionism and other variations of the “I am not good enough” tape that tends to run like a broken record in our heads, particularly when we are unwell. While it is important that we challenge ourselves and thus move towards improvement in identified areas, perfectionism will stifle and eventually paralyze us. Most important, as we are likely to be unable to live up to inflated expectations, we may end up pressing the ‘f….. it’ button eventually when feeling that we’ve failed yet again.
Am I comparing and despairing? Stay away from comparing yourself to others: you are you, and your needs are unique. Instead, notice improvements, how little or minor they may be. Pay attention to yourself, and tune into your changing needs. Remember that recovery takes time.
What are my first red flags indicating that a relapse into mental health problems may be on the way? If I notice any of these, how can I best take care of myself so I can nip them in the bud? What help or support do I need, and who is the best possible person to provide this support to me?
Addiction depletes our body. Like an empty bank account, we will need to focus on replenishing our body’s resources so we can function well in the long-term. In addition to symptoms of post acute withdrawal, women may experience hormonal fluctuations throughout their cycle and their lifespan that can impact how well they can keep themselves safe and sober. As previously mentioned, women are particularly sensitive to cravings and the effects of drugs during menses, and this may therefore be a time to increase self-care.
Early recovery is also a time of recovering brain health, and the following may be ways in which we can support our brain’s healing:
Consider changing your diet to ensure high levels of proteins. These form the foundation for amino acids, and amino acids are building blocks for our depleted neurotransmitters. Eat regularly, and limit the amount of sugar, caffeine and other mood altering ingredients
Exercise: Getting your heart beat up to about 75% of your maximum capacity, even just for one minute at a time, is said to kick start emission of BDNF (brain derived neurotropic factor), our brain’s natural miracle growth. If you are not yet fit enough to join a gym or an intensive class, start slow and build up your stamina.
Restful sleep is important for brain health; without it, we tend not to function very well. Insomnia is also said to play a role in relapse, and thus needs to be addressed. To learn more about the function of sleep, and to make first steps towards creating a healthy sleep hygiene, check this link: please link to my article on sleep
Meditate regularly. Meditation has been shown to increase gray and white brain cell growth, and this part of the brain provides a balance to our emotional brain. The latter is responsible for the impulsive behavior we see in addiction. Meditating thus helps us to become less reactive, and less driven by our fluctuating moods.
Women may also greatly benefit from body-centered mindfulness practices such as yoga or Tai Chi, particularly if trauma-focused. This allows a reconnection with their bodies, and thus increases awareness about fluctuating needs, distress, or impeding ill health.
Let’s be clear with this one: spirituality has nothing to do with religion, or any specified deity. Instead, consider spirituality as the rituals that keep you connected to yourself, and that which is important to you. This can, but by no means should include your definition of god; you decide. The point is that spirituality is an area often forgotten and neglected in Western care. Yet, research has shown that spiritual practices can be helpful in recovery from addiction.
Exploring this area may help to understand better who we are, and what a life worth living looks like for us.
Questions to consider:
What are my values, and how does my life reflect these values? How does addiction impact my ability to live according to these important things?
Spirituality entails the practice of rituals; these can include prayer, meditation, yoga, nature walks or any other nourishing practices that grounds us and helps to connect with something larger than ourselves. What meaningful rituals can I include in my self-care practices?
Can I let go of problem-saturated stories and identities, and instead find ways of connecting to those parts of myself that are healthy, whole and untouched by my difficulties?
Lastly, a holistic recovery and self-care plan needs to include time for fun, lightness and laughter. No one wants to be sober if sobriety translates only into boredom, restrictions, have-to-do’s and being good. Successful recovery involves a focus on the whole person, and a departure from identification with the problem as if we are the problem. For women, then, addictions recovery is a bit like the Chinese symbol for crisis: it entails challenge and opportunity. A unique time, it comes with the invitation to listen to our soul’s whispers and heal old wounds. Recovery means that we can bounce back from whatever kicked us in the groin: we can get back in touch and reconnect with what’s important, and ready to define who we really are. It reminds us that we are survivors, not victims, ready to take charge of our lives in the way we see fit.