Bulimia Nervosa at a Glance

“For me, the bulimia was about stuffing my emotions. So I stopped suppressing my feelings.” ~Cheryl James

My friend’s dad is a dentist; within the first minute of looking into someone’s mouth, he can tell if the person struggles with bulimia nervosa. This is because bulimia–the binging and purging of food–wreaks havoc on a person’s teeth. The acid from the stomach visibly destroys the enamel of the teeth and causes noticeable discoloration. But this particular side-effect of bulimia is only the tip of the iceberg among much more serious consequences that come from this eating disorder and mental illness. Continue reading to learn what it is, what causes it, as well as the symptoms, consequences, and recovery options for bulimia nervosa. 

Even though Derek Zoolander downplays the significance of bulimia nervosa, it is a very serious, potentially life-threatening eating disorder. People with bulimia secretly binge and then purge to get rid of extra calories in an unhealthy and unnatural way. Binging includes discretely eating a large amount of food, within a small amount of time, accompanied by a lack of control during this episode. Purging methods vary from regularly self-induced vomiting, misusing laxatives, weight-loss supplements, diuretics or even enemas after bingeing. Other ways include denying calories to prevent weight gain through fasting, strict dieting or excessive exercise.  The severity of bulimia is determined by the number of times a week that a person purges, usually at least once a week for at least three months. 

The exact cause of bulimia is unknown. Many factors could play a role in the development of eating disorders, including genetics, biology, emotional health, societal expectations and other issues.  Women are more likely to struggle with bulimia than men, but the latter are still susceptible. Bulimia typically begins in the late teens or early adulthood.

Bulimia shares several symptoms with other mental illnesses: Negative self-esteem, problems with relationships and social functioning, difficulty concentrating, poor sleep patterns, withdrawal from friends, etc. Symptoms specific to bulimia nervosa include extreme preoccupation with self-image, body shape and weight; fear of gaining weight; feeling uncomfortable eating around others; trying to “fill up” by ingesting unsubstantial food (ie. condiments), drinking excessive amounts of water or non-caloric beverages, or trying to chew food for an unnecessarily long amount of time; hoarding food in strange places; disappearing after eating (often to purge in a private place); frequently using mints, mouthwash and gum to cover unnaturally bad breath; and maintaining a rigid exercise regimen to “burn off” calories ingested. 

Bulimia nervosa affects far more than how an individual perceives him- or herself or what he/she eats. This eating disorder truly harms a person’s body in the following ways:

  • Unusual swelling of the cheeks or jaw area  
  • Calluses on the back of the hands and knuckles from self-induced vomiting 
  • Bloating from fluid retention  
  • Stomach cramps and other gastrointestinal issues (constipation, acid reflux, etc.) 
  • Abnormal laboratory findings (anemia, low thyroid and hormone levels, low potassium, low blood cell counts, slow heart rate) 
  • Dizziness 
  • Fainting/syncope 
  • Feeling cold all the time 
  • Dental problems like enamel erosion, cavities, and tooth sensitivity 
  • Dry skin 
  • Dry and brittle nails 
  • Swelling around salivary glands 
  • Thinning of hair on head, dry and brittle hair (lanugo) 
  • Muscle weakness 
  • Yellow skin (in context of eating large amounts of carrots) 
  • Cold, mottled hands and feet or swelling of feet 
  • Menstrual irregularities
  • Poor wound healing 
  • Impaired immune functioning
  • Dehydration (leading to kidney failure)
  • Heart problems, such as an irregular heartbeat or heart failure
  • Severe tooth decay and gum disease
  • Absent or irregular periods in females
  • Digestive problems
  • Anxiety, depression, personality disorders or bipolar disorder
  • Fertility issues (in women)

Many people with bulimia nervosa also struggle with co-occurring conditions, such as self-injury (cutting and other forms of self-harm without suicidal intention), substance abuse, impulsivity (risky sexual behaviors, shoplifting, etc.), and even diabulimia (intentional misuse of insulin for type 1 diabetes). 

While bulimia nervosa is a very serious mental illness, the good news is that it is not a life sentence. There are many options available for treatment, including medication, support groups and group therapy, and individual therapy. By identifying your triggers, I can help you manage stress and avoid the cycle of binging and purging. Getting support and help often gives you extra strength to fight your eating disorder.  Because bulimia is related to self-image–and not just about food–bulimia can be hard to overcome on your own. Effective treatment can help you feel better about yourself, adopt healthier eating patterns and reverse serious complications. Contact me today to get started.

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

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Supporting A Loved One Through Alcohol Addiction

Each Al-Anon Family Group has but one purpose: to help families of alcoholics. We do this by practicing the Twelve Steps of AA ourselves, by encouraging and understanding our alcoholic relatives, and by welcoming and giving comfort to families of alcoholics.

It can be so difficult to know your place if you have a friend or family member struggling with an alcohol addiction. You may not know what to say or how to help; you may feel like their addiction is straining your relationship; you may resent their choices. While it is true that you cannot force a person to get help for alcoholism, there are various ways you can support them and encourage them to seek treatment.

You have likely heard of Alcoholics Anonymous (or AA). In April, I wrote a post that detailed the basics of Alcoholics Anonymous. I tried to cover everything from what it is, to how it started, its main tenets, if it works, and how it applies to those who do not believe in God. I detailed the strength that comes from utilizing this specialized support group of complete strangers who understand the path of the alcoholic’s addiction.  This is a program of recovery for specifically for alcoholics; Al-Anon, however, is different. It is a program of recovery for people who are affected by someone else’s drinking, whether that be a friend or family. It is one of many resources available to support those indirectly affected by alcoholism. This post is dedicated to how you can support a loved one through alcohol addiction.

There is no one exact formula that will tell you how to support someone facing an addiction to alcohol. Every person is different and, therefore, each person’s recovery process will be unique. Some people may rely heavily on their support system and want to involve you in each step during treatment; others may be more reserved and may only come to you when they need a listening ear or want to talk. The best thing you can do for a loved one who is recovering is to motivate and support them every step of the way. Here are several specific ideas for how you can get involved and offer support:

  • Learn about his/her condition. Understanding that, over time, alcohol rewires a person’s brain and causes it to function differently, sheds light on why he/she cannot simply choose to stop drinking alcohol.
  • Know the warning signs. Some signs are recognizable while others are subtle. Several telltale signs of a potential drinking problem are irrational behavior, lack of interest in hobbies and ignoring responsibilities. (This step is particularly important for those who have not yet recognized the need for help to overcome an alcohol addiction.)
  • Offer to help research alcohol rehab programs and types of therapy. Deciding on where to go for treatment is one of the most important factors in a person’s recovery journey.
  • Attend support group meetings or counseling sessions with your loved one. This will give you insight to their journey as well as guide you in how to handle different situations. (AA meetings are generally open, which means you can attend with your loved one. These meetings offer a great deal of support and advice for living with someone who has a drinking problem.)
  • Attend Al-Anon meetings. Just as those facing alcohol addiction will attend AA meetings, you should attend Al-Anon meetings. Here you will find support as you meet others who also love someone with an alcohol addiction, and will be able to personally work through the 12 steps of Al-Anon. Visit this website to find a meeting near you.
  • Help with the post-rehab recovery plan. Be constant as your loved one navigates life as a recovering addict.
  • Be optimistic. Addiction recovery is a steady uphill battle that will come with victories and defeats. When setbacks come, try not to be critical and face the future with hope. When progress occurs, celebrate it and continue pushing forward.

Family and friends should understand that the recovery process can come with many ups and downs–for both parties. When things get difficult, remember that having a steady support system will make a profound difference for your loved one. Your support will surely influence whether or not he/she seeks help for their drinking problem, will buoy him/her through treatment, and will increase the likelihood that he/she will maintain sobriety after treatment. Your role is crucial!

More than 15 million people struggle with an alcohol use disorder in the United States, but less than eight percent of those receive treatment.  Alcoholics Anonymous is a free resource available to all that will offer tools to both the individual facing the addiction, as well as his/her loved ones. Alcoholism affects everyone, including family members and friends of the alcoholic. This can damage relationships and cause you to feel a wide range of emotions like disappointment, anger, doubt and denial. Although your primary goal is likely to get your loved one help, be sure to get the help you might also need. In many instances, speaking with a counselor is helpful and even necessary. If you feel you could use professional help, I invite you to contact me today or schedule a session. Whether you are the one facing the addiction, or the one offering support, I am here to help you every step of the way!

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

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Alcohol Anonymous: Strength in Numbers

Alcoholics Anonymous

“When I stopped living in the problem and began living in the answer, the problem went away.”

~ Alcoholics Anonymous

According to the 2015 National Survey on Drug Use and Health, 86.4 percent of people ages 18 or older reported that they drank alcohol at some point in their lifetime. While it may not lead to an addiction for some, it does for others. Alcohol has touched all of our lives in one way or another, whether it is personally or through someone we care about. Because April is Alcohol Awareness month, I want to dedicate a post to one of the most helpful, renowned support groups for those working to overcome an addiction to alcohol: Alcoholics Anonymous.

WHAT IS ALCOHOLICS ANONYMOUS (AA)?

Alcoholics Anonymous is an international group of men and women who have had or are working to conquer a drinking problem. AA is open to all races, politically neutral, self-supporting, and is available almost everywhere. There are no age or education requirements, and membership is open to anyone who wants to do something about his or her drinking problem.

HOW DID AA START?

Alcoholics Anonymous was founded by Bill Wilson and Dr. Bob Smith, who were both recovering alcoholics. In 1935, Alcoholics Anonymous began as a community-based fellowship which encouraged sobriety for other recovering alcoholics. These two men developed the 12 steps to aid their attendees, and later introduced the 12 traditions to help further define the group’s purpose and achieve continuity for AA groups across the country (and later around the globe). AA paved the way for other support groups; today Narcotics Anonymous, Gamblers Anonymous, and Overeaters Anonymous are just three of the many groups that have modeled themselves after the AA meeting concept.

WHAT ARE THE MAIN TENETS OF AA?

The original steps are still intact and many former addicts credit the group with helping them through recovery. The 12 steps that govern all AA group meetings are presented in linear fashion, but participants see them as an ongoing circle. The following steps may be revisited until the recovering addict is comfortable in that stage of their recovery process:

  1. Admit powerless over alcohol
  2. Accept that a higher power, in whatever form, will restore your sanity
  3. Make a decision to turn your will and life over to a higher power
  4. Take a moral inventory of yourself
  5. Admit to a higher power, another human, and yourself the nature of your wrongdoings
  6. Accept that a higher power will remove your character defects
  7. Humbly request the higher power remove your shortcomings
  8. List people you hurt during your addiction and be willing to make amends
  9. Make amends to those people unless it would harm them
  10. Continue to take a personal inventory, and when you’re wrong, admit it
  11. Use prayer and meditation to connect with the higher power
  12. Carry the message of AA to other alcoholics and continue to practice the principles of the 12 steps in your daily life

DOES AA WORK?

Because AA is anonymous, some members of the group do not participate in studies since it could breach anonymity. Many want their participation in AA to remain unidentified, in line with the group’s original intention. Additionally, participants might not want to admit to relapse. A New York Times article stated that AA claims that up to 75% of its members stay abstinent.  Alcoholics Anonymous’ Big Book touts about a 50% success rate, stating that another 25% remain sober after some relapses. Though it is difficult to know just how effective it is, it is safe to say that many people have been helped by regularly attending AA. Just how effective depends on the participant.

CAN AA WORK FOR THOSE WHO DON’T BELIEVE IN GOD?

The first time I read through the twelve steps, I was surprised how often God was referred to. While the faith-based program of AA may be effective for some, it does not work for everyone — particularly those who do not subscribe to God as a higher power.  Might I offer a solution: AA founder, Bill Wilson, encountered the term “higher power” in the book, Varieties of Religious Experience, by William James. In this book, James offers many examples from Christian traditions, as well as non-Christian examples. One of the best examples of “higher and friendly power” is borrowed from Henry David Thoreau walking in the midst at Walden Pond feeling a sense of connection to pine needles. He cited other examples of a “higher power” to potentially include moral principles, patriotism, civic engagement, and even a higher or better self. Therefore, the term “higher power” does not have to be a faith-based term and thus varies from participant to participant.

You could go to an AA meeting in Los Angeles, London or Lima and each one would be carried out in a similar fashion. This is because the steps and traditions of Alcoholics Anonymous are the foundation for every meeting. In each meeting, members will get to know one another, discuss progress and relapses, and support each other through sponsor programs. Although it can be difficult going to an AA meeting with complete strangers and admitting to such a personal issue, it is the only place where every participant knows exactly how you feel. They have been where you are and can support you in your journey. That is powerful. To quote AA literature: “The feeling of having shared in a common peril is one element in the powerful cement which binds us.”  This instantaneous bond cultivates a unique feeling of community and understanding that is incredibly helpful to those recovering from alcohol addiction.

The only real way to find out if Alcoholics Anonymous can help you is to give it a try. See for yourself if you think the help and support from others struggling with the same problem can help you stay sober. As Alcoholics Anonymous has no dues or fees, you have nothing to lose in choosing to visit a few meetings. I strongly encourage it. Call now at 877-600-9205 or go online and use a meeting finder to find a meeting in your area. Click here if you are local to the Dallas/Ft. Worth area and could benefit from community resources. In like manner, if you feel you could use professional help, I invite you to contact me today or schedule a session to begin your journey toward recovery. I am here to help you along the uphill road of addiction recovery!

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

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Emotional Support Animals At a Glance

Emotional Support Animals - Cluff Counseling - Lewisville TherapistEmotional Support Animals (ESA) are no ordinary pets! They serve to stabilize and/or maintain the emotional or mental health of their owner and their role is vital! I am a proponent for emotional support animals when they can truly fill an individual’s needs. Read on to learn more!

It is estimated that 68% of U.S. households (or 85 million families) own a pet. There are some instances, however, where the animal is more than just a “pet.” In these cases, the individuals rely heavily on their animal for mental and/or emotional support. Their animals are called Emotional Support Animals, and they play an important role in the very livelihood and stability of their owner(s). This post will be all about Emotional Support Animals and hopefully will answer your basic questions about Emotional Support Animals.

What exactly is an Emotional Support Animal (ESA)?

An emotional support animal (ESA) is a companion animal that a medical professional has determined provides benefit for an individual with a disability or mental illness. The goal is for the ESA to help with or improve at least one characteristic of the disability.

Who can have an ESA?

In order to be prescribed an Emotional Support Animal, the person must have a) A verifiable disability, and b) A note from a physician or other medical professional (stating that the person has that disability and that the emotional support animal provides a benefit for the individual with the disability). ESA are typically used when the owner struggles with depression, mental health issues, autism, aspergers, psychotic disorders, or is a veteran/military individual dealing with PTSD.

When applying for housing with an ESA, the U.S. Department of Housing and Urban Development (HUD) asks two questions:

  1. Does the person seeking to use and live with the animal have a disability — i.e., a physical or mental impairment that substantially limits one or more major life activities?
  2. Does the person making the request have a disability-related need for an assistance animal? In other words, does the animal work, provide assistance, perform tasks or services for the benefit of a person with a disability, or provide emotional support that alleviates one or more of the identified symptoms or effects of a person’s existing disability?

Answering “no” to either of these questions means that a housing provider is not obligated to make a reasonable accommodation according to HUD. This may mean that the person does not meet the definition of disability or that the assistance animal does not help with symptoms of the disability. If the answer is “yes” to both, then HUD states the FHA requires an exception to a ‘no pets’ rule.

How does an animal become an ESA?

An animal does not need specific training to become an emotional support animal. There are several websites online where you can go to register your animal. Some organizations will send you a card, a bib for the animal, and/or packets of information (depending on how much you pay). Many of these organizations are not monitored by the government, however, so I recommend choosing one carefully so as to not get scammed.

Are Emotional Support Animals ONLY dogs?

While dogs are the most common type of assistance animal, other animals can also be used for this purpose. Sometimes cats or other animals may be used by people with a range of physical, psychiatric, or intellectual disabilities. There was a case in 2012 where a guinea pig was used as an ESA, and another in 2015 where a miniature horse was filed as an ESA. All that matters is that the animal needs to alleviate the burdens that come from physical, emotional or mental illness. Obviously, any animal that poses a direct threat to the health and safety of others would be questionable (a wild or exotic animal that poses a greater risk of attack or disease to other residents could be denied based on this reason). The key indicator is whether or not the animal alleviates some part of the disability or mental illness.

Is there a difference between an Emotional Support Animal and a Service Dog?

Emotional Support Animals are animals that provide therapeutic benefits to their owner through affection and companionship, where a Service Dog is specially trained to perform a task to help someone with a disability. For example, a blind individual will likely have a seeing eye dog–a Service Dog with training and a very specific function. Other examples include pulling a wheelchair or responding to seizures. Emotional Support Animals, however, do not need specialized training to handle a task. Further, Emotional Support Animals come in different breeds and animal types and are not just limited to dogs, while Service Animals are either dogs or horses.

Can I have more than one ESA?

Although I have not seen any cases dealing with the issue of multiple emotional support animals, the basic requirements for this reasonable accommodation would be the same. If a person were to claim the need for multiple emotional support animals, he/she would need documentation supporting this need from his or her physician or medical professional. The practitioner would need to provide documentation that each support animal alleviated some symptom of the disability.

WARNING

Unfortunately, people sometimes take advantage of the Emotional Support Animal system… using their “ESA” to get out of paying pet deposits, getting into certain housing where animals typically are not allowed, or even trying to fly for free with them. In an article, from The New Yorker, the author takes a turtle, a snake, a turkey, an alpaca, and a pig (separately!) all over New York and was allowed access to all things “non-pet” because she claimed (and showed fake letters from her “therapist”–an online reference who sent a letter over after she paid $140 to be evaluated) that these were here Emotional Support Animals. I want to be clear–while there are benefits of having an Emotional Support Animal, those should not be the driving force behind having an ESA. The intended use for these animals is to alleviate discomfort and provide meaningful companionship to those who truly need it. I do not condone cheating the system, but I fully support the idea behind and purpose of having an Emotional Support Animal.

It is possible that you or someone you care about could find an Emotional Support Animal extremely helpful in dealing with mental illness or disability. I urge you to contact me with questions or schedule an appointment today and we can discuss whether or not an ESA could meet your needs. I have seen Emotional Support Animals do great work and provide much needed comfort and stability to those grasping at straws for relief. Animals are smart and intuitive, and having an ESA can add much needed comfort and stability in the lives of those who so desperately need it.

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

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Life After Trauma

A traumatic experience can leave a person feeling broken, angry, hateful, useless, and/or depressed. With time and the appropriate therapy, survivors of trauma can go on to feel strength, forgiveness, empathy, purpose and happiness. Recovery is possible, and lessons learned in the furnace of affliction can go on to be a great strength in a survivor’s life.

Last summer, I wrote a post about being a secondary survivor: those who are the family or loved ones of someone who suffers a traumatic experience. I wrote about how difficult it can be for secondary survivors to watch their loved one struggle and deal with the aftermath of the trauma. I wrote about ways that secondary survivors can help their loved ones as he/she works to overcome their trauma, and offered specific suggestions for things to say to those who have experienced trauma. This post is dedicated to the survivor; although you may feel bruised and broken from the storm you have endured, as you look ahead, you can find your rainbow.

Let’s first define trauma. Trauma is broadly defined as something that produces psychological injury or pain. A traumatic experience can include (but is not limited to) divorce, rape, kidnapping, abuse (physical or emotional), natural disasters, fires, accidents, illness, bereavement, war, etc. Common reactions to trauma include anxiety, trouble sleeping, nightmares, flashbacks, OCD, PTSD (post-traumatic stress disorder), strained relationships, and unpredictable behaviors. In short, the aftermath of a traumatic experience can affect a person’s very being–including his/her daily walk and talk.

Although it may not feel like it immediately after the event, there is life after trauma. In fact, a difficult event can often lead to growth! We see this modeled in nature–majestic rainbows appear after torrential rainfall; butterflies emerge from their cocoon only after the caterpillar disappears as if dead in the cocoon; and even after the coldest of winters, flora and fauna reemerge or blossom for springtime. There are positive outcomes to come out of the wake of trauma; allow me to enumerate a few:

  • Recognizing strength. One of my friends experienced a horrible car accident where not only was she physically injured, but her friend’s life was lost. My friend’s rehabilitation took time, but she summoned the strength to face each day, took the time for both physical and emotional therapy, and is flourishing today. Trauma can teach us about our strength–how much we can endure and withstand giving in. Not only that, but once that strength is found, it is difficult to refrain from applying said strength to other situations. Survivors of traumatic situations tend to use their enhanced resilience to bounce back from opposition better than their pre-trauma selves.
  • Extending forgiveness. It takes incredible courage to be able to forgive the person who rapes you, abuses you, or crashes into you. But holding on to anger, hate, and frustration cankers the soul; when we let go of being wronged, we release bitterness and resentment that is poison to us. It is liberating to forgive, and often the forgiver receives more benefits than the person who is forgiven!
  • Feeling empathy. Experiencing trauma firsthand connects us to so many others who have faced hardship. Until we experience trauma, it can be difficult to really understand what other people are going through, what they are thinking, or what they really need to heal. The connection and compassion a trauma survivor gains provides a further source of strength, as well as, the ability to strengthen, connect with, and comfort others.
  • Finding purpose. Many survivors find that living through a traumatic experience awakens a passion or a deep purpose within them. Elizabeth Smart–who was kidnapped at age 14 and survived nine months in captivity–has used her horrifying experiences to become advocate and published author, traveling around the world bringing awareness to others. Sometimes, the darkest moments of our lives can inspire us to serve others.
  • Enjoying life. One of my clients has survived two deployments to Afghanistan. Although he faces understandable bouts of PTSD, he has found such vigor for living, and gratitude for life. To be alive in a functioning body is an amazing thing. Sometimes traumatic experiences help us enjoy aspects of life we had previously taken for granted.

Trauma is hard, scary, overwhelming. Surviving trauma, however, can teach you things you never knew about yourself, can help you comfort those similarly struggling, can awaken purpose and gratitude for living, and so much more. You may walk away from your trauma a better, changed person. As Viktor Frankl said, “When we are no longer able to change a situation, we are challenged to change ourselves.” Often, those changes can result in positive growth.  If you can wade through the storm your trauma puts you in, you will be able to look around after the storm passes to see how far you’ve come, see the beauty in your struggle, and see all the more clearly where you are going. You may even see that hopeful spectrum of light Issac Newton classified as a rainbow.

It takes time and work–sometimes both physical and emotional–to get to the other side of trauma. I am a qualified and experienced advocate; I can help you work through the effects of trauma. Please contact me today or schedule your first session and let me guide you as you write your story of life after trauma.

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

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Willpower: The Powerful Pre-Step in Addiction Recovery

Willpower - The Powerful Pre-Step in Addiction Recovery - Cluff Counseling, Denton Marriage & Family TherapyAccording to the National Institute on Drug Abuse (NIDA) in 2007, 20.8 million persons (8.4 percent of the population aged 12 or older) needed treatment for a substance problem, but did not receive it. As addicts try to stop their addictive behaviors, they may cut ties with their friends, avoid certain establishments, and purge themselves of their addictive substances or actions. But, more often than not, their actions do not last and the addict falls back into the cycle of addiction. Willpower needs to be coupled with additional resources in order to lead to lasting change.

Willpower is defined as control of one’s impulses and actions. In the context of addiction recovery, willpower is the choices and the efforts the addict makes to break addictive habits. Examples of exercising willpower to get on the road of addiction recovery could be avoiding certain people or places that encourage deviant behavior, discarding any substances or items that promote further addiction, and getting outside support for addiction recovery. Willpower is an essential step to get you started in the addiction recovery process, but it is not enough, on its own, for lasting change.

When my friend was little, she fell off the high beam at gymnastics and broke her arm. She was unable to go to class, let alone tumble or do anything active for several months. As much as she wanted to be well and healed, she could not make that happen on her own. She had to rely on doctors to prescribe proper methods for healing, a cast to set the boundaries, and time to allow her bones to transition back into place. Her willpower was not enough to heal her.

This example may seem quite obvious and somewhat silly in the context of a broken arm, but the same principle applies in the context of addiction recovery–outside help is needed. There will be times when more is needed than just our willpower. Sometimes, healing and recovery is out of our control and we need help. Sometimes we need to rely on qualified doctors or therapists to help us find balance and proper health. Sometimes we need a cast–or set rules/boundaries–to keep us out of harm’s way. Sometimes we need to rely on a support system of family and friends so we are not alone in recovery and can fall back on and be accountable to them. When these tools are used in unison with your willpower, lasting addiction recovery can occur.

All recovery programs that I know of call on the addict to recognize his/her powerlessness and to ask for help. Ironically enough, by surrendering his/her will and recognizing that he/she does not have all the answers, addicts find the will to recover. Asking for help is key. Let me highlight two resources that can bolster your willpower:

  1. Family and close friends. They love you and want what is best for you. Not only that, but your family and closest friends are the people who see you most, who are in regular contact with you, and can help you during moments of weakness. They can provide accountability and are readily available to help during those especially tough days.
  2. A licensed, qualified therapist. When my friend broke her arm, she received help from a professional who was experienced, knowledgeable, and had tools to properly diagnose her injury and give her a personalized plan for recovery. A therapist is your emotional doctor; I have spent years working with those struggling with addiction. I can help you.

By letting family and close friends, and a therapist help you in your journey, you will find strength in numbers, which will aid you greatly as you continue to seek recovery.

Many of my clients battle with some form of addiction. Whether they are addicted to drugs, food, substances, pornography, sex, or something else, I greatly admire them for seeking help. Their desire to change is the essential pre-step to addiction recovery. The desire to improve, to make lasting changes, and to leave behind destructive habits and behaviors must come from the addict him/herself in order for it to be lasting. Your willpower will carry you through those moments of weakness, push you attend counseling sessions, and keep you away from people or places that could threaten your progress. Willpower is just that–POWER. Make that step today and channel your willpower to help you overcome addiction.

Now is the time to channel your willpower and use the resources around you–namely your support system of family and close friends, as well as the help of an experienced counselor. Contact me today or set up your first session to get yourself onto the path of addiction recovery that will help you make lasting changes.

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

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Are You Addicted to Your Phone?

Cell Phone Addiction - Cluff Counseling, Addiction TherapyWhen the topic of addiction arises, we often think of drugs, sex, alcohol or gambling.  What we neglect to see, however, is our own dependence on everyday things. Anderson Cooper did an incredibly interesting segment on 60 Minutes where he discussed how major companies are not creating programs for people, but instead programming people. Watching this made me think about how much time I spend on my phone. I realized that we are programm-able; the developers of major software companies in Silicon Valley have literally conditioned us to constantly use our phones…it is like an addiction for some of us! Using our phones gives us satisfaction, but repeatedly using our phones makes us need them more. Although this may seem less serious than other addictions, it shares many commonalities with more severe addictions, and deserves some attention and self-reflection.

Defined simply, addiction is the consistent repeated use of a substance or an activity, despite the harm it has on self or others. Addiction is often accompanied by cravings–a recurring need to be filled–withdrawals, and an increased need of the substance, thing, or activity. Have you ever thought about your smartphone usage in this light? Former Google product manager, Tristan Harris, compares our smartphones to slot machines; every time we pick it up, we are wondering, what did I get? And I can relate to this! I will admit that I feel different when I have a well-liked photo versus one with less likes. Getting likes, messages, texts, or comments on posts is powerful reinforcement to stay on our phones. for example, I recently learned Snapchat has a feature called a “streak” that builds as you consistently send messages; if you are unable to consistently send snaps, your “streak” goes down. If you have ever felt panicked by a lack of access to your phone, you may want to reflect on whether or not you are addicted to your smartphone. Although they are incredibly useful, and can be used for beneficial purposes, smartphones can be addictive if we can develop an unhealthy reliance on them.

This addiction is literally caused by a chemicals in our bodies. When we hear our phone going off, we become anxious. A hormone called cortisol is produced (best known for its involvement in the ‘fight-or-flight’ response), and the only antidote is to check the phone. Once we do so, the molecule dopamine is released–which aids in the creation of desire and pleasure. This cycle will repeat itself over and over again. To demonstrate this in the 60 Minutes segment, a researcher applies electrodes to Cooper to track his heart rate and perspiration while he was distracted by the computer. Unbeknownst to Cooper, another researcher was sending text messages to his phone–which was just out of his reach. Every time his phone went off with a bing!, the line measuring Anderson’s anxiety peaked on the tracking device. This informal experiment mimicked what other formal experiments have shown: there is an identifiable chemical change that takes place in our brain which fuels our need to check our phones. Fact: the typical person checks their phone every 15 minutes or less, and 50% of the time there is no alert or notification triggering our need to do so! Our need to check our phones is impulsive–it is coming from the brain–and the only instantaneous cure is more phone. Recognizing our dependence on our phones and then setting parameters for our smartphone intake is a more long-lasting solution.

Although some may say this “addiction” is not problematic, from my point of view it IS for the following two reasons: 1) even being hooked to a smartphone for innocent reasons can easily lead to being hooked to a smartphone for very serious reasons (read: pornography, gambling, chatrooms, online shopping addiction); and 2) the more time we are staring at our screens means less time we are interacting with and having meaningful relationships with those around us (read: a spouse, children, family, friends, neighbors, colleagues, etc.) and ourselves!

Of course there are many positive ways to use our smartphones. I am not suggesting we all revert back to the flip-phone or abandon our cell phones altogether. What I am simply suggesting is that we recognize when we are potentially feeding an addiction by being glued to our phones; admit that you are not being present in an important conversation or relationship because the cyber-world has you hooked. Set limits and boundaries about when you will be on your phone, for how long, and what you will do with that time. I encourage you to delete certain addictive or time-consuming apps off your phone. You know what works for you. Set healthy limits and stick to them.

Let us put the phones down and tune into the important people and things in our lives. If you need assistance formulating a plan to break up with your phone, as always, my door is wide open. Contact me today to set up your first session.

Additional resources:

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Self-care: Is it Selfish?

Self-care | Cluff Counseling, Dallas Marriage and Family TherapistLife can be draining. We are constantly surrounded by a barrage of common, everyday stressors like financial strain; employment, unemployment or deployment; addiction; sickness; or familial discord. If we are not careful, life’s demands can overwhelm, frustrate, or discourage us. Self-care is a tried-and-true method prescribed by therapists, and other professionals, to help clients improve their overall health. In this post, I will explain how self-care is not a selfish use of time, but actually one of the best ways to improve your overall health. Keep reading and I will give a few ideas for how you can improve your self-care today!

Any string instrumentalist can tell you the importance of loosening the strings of your instrument when it is not in use. When a violin, viola, cello, or double bass is put in its case to be stored, the strings need to be loosened; then, when it is time to play again, the musician will tighten the strings and adjust the tuneage. This ensures that there is not constant, damaging pressure on the strings or the instrument itself that would impede it from playing optimally. Self-care is to humans what “loosening the strings” is to a string instrument–a rest, a break, a reprieve. It is not selfish, self-indulgence or self-pampering. It is care provided for you, by you. It is taking the time to do some of the activities that nurture you. It is about identifying your own needs and taking steps to meet them. Self care is about taking proper care of yourself and treating yourself as kindly as you treat others. It is vitally important to our overall health, yet we often fail to make time for it.

Most of us, myself included, could improve on how we take care of ourselves. We run ourselves ragged fulfilling our responsibilities and obligations at work, at home, at church, or with our family and friends. We neglect ourselves! When we do this, we see the things that are most important to us–such as our health, our relationships, our career and our life goals–negatively affected. When we live a balanced life, we are able to accomplish our to-do list and not feel emotionally drained, depleted of energy, and lacking in motivation at the end of the day.

So how well are you treating yourself? Use the following questions to identify areas of self-care you are successful in and areas you could improve in:

  • Am I getting between 6-8 hours of sleep a night?
  • Am I eating 3 balanced meals a day?
  • Am I saying “no” to extraneous responsibilities (when applicable)?
  • Am I exercising 2-3 times a week?
  • Am I making and maintaining meaningful relationships with those in my circle of support?
  • Am I making time for hobbies?
  • Am I taking time to relax?
  • Am I keeping my mind sharp by reading good books, playing word puzzles or seeking to educate myself further in areas that interest me?
  • Do I know what triggers my bad moods and am I actively working to remove those triggers?
  • Do I know how to express my emotions in healthy ways that don’t hurt myself or others?
  • Have I established spiritual or religious practices and do I practice them consistently?

If you were able to answer yes to the majority of these questions, then you are well on your way to practicing good self-care. If you answered no to any of them, you know where to start. Be intentional about your self-care–literally schedule it into your day! And please, start small with behaviors you can reasonably implement without overwhelming yourself. Remember, self-care should leave you feeling relaxed and rejuvenated, not more stressed with one more thing on your plate!

I have seen clients make remarkable progress in their sessions with me when they correctly and consistently practice self-care. If your figurative strings are loosened at the appropriate times, you will be able to perform to the best of your ability when you need to. We can all improve our self-care. Let’s start today and give ourselves a little bit of a break from the rigorous lives we lead.

If you have any questions on how you can implement self-care into your life, please feel free to contact me. Similarly, if you would like help formulating an effective and personalized self-care plan, schedule your first session with me today!

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Addiction 101: Analogy of the Driver’s Seat

Addiction Therapy | Cluff Counseling, Dallas Fort WorthWhat do you think of when you hear the word “addict”? Often when I ask this question, I hear responses like weak, lazy, broken, drunk, homeless, selfish, loser.   In my years of treating clients with varying addictions, I have realized that those struggling with addiction are largely misunderstood. I have learned words like resourceful, shame-based, creative, hard-working, tender-hearted, fearful, and powerless are more appropriate adjectives. Through my blog posts, I hope to remedy some of the misunderstandings around addicts and addiction. If you have questions about addiction or about a loved one dealing with addiction, contact me–I would love to help you find some answers.

Addicts are good, ordinary people, like you and me, who have relied on certain behaviors to escape dealing with painful situations or relationships. Truth: we all have appetites that need to be fed–ranging from the food we eat, the entertainment we view, to the sexual needs we have. There is nothing inherently wrong with engaging in a pleasurable activity! Watching Netflix, drinking alcohol, perusing social media accounts, working out, planning your food intake, having sex, shopping, or playing video games in moderation can be used as healthy outlets. But when any of these activities go from something enjoyable we choose, to something we need to escape reality…addiction can occur. In this post, I will focus on the basics of addiction–beginning with defining addiction.

Addiction defined
Simply stated, addiction is defined as having a dependence on, obsession with or being enslaved to something. According to The American Society of Addiction Medicine (ASAM), addiction is commonly characterized by impairment in behavioral control, the presence of cravings, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response. Although substance addiction is the most widely known form of addiction, behavioral addiction is another type of addiction that is formed through repetitive processes and habits. The International Journal of Preventive Medicine explains the difference between these two types of addiction:

“Contrary to the commonly held belief that holds addiction to be a particular kind of dependence on drugs and chemical substances such alcohol, nicotine and heroin, behavior science experts believe that any source which is capable of stimulating an individual, could become addictive. The change of behaviors such as gambling, drug abuse, computer gaming or chatting and internet browsing from habits into obligatory behavior, can be considered as the development of addiction.”

Imagine you are driving your parents car with your high school friends. One of your inexperienced, underaged, uninsured friends, begs you to let him take the wheel. You know there could be some serious negative consequences, but you don’t want to be a “party pooper”, so you give him the keys. After a little while of touch and go/figuring out the pedals, he goes nuts! He starts cutting off other cars, speeding excessively, weaving dangerously through traffic… Addictive behaviors are like the friend who took over the driver’s seat; not only can they start innocently, but they can quickly escalate and take full control of your life. Although the behavior was invited (by your initial consumption of the behavior), it is quickly unwelcome because you lose complete control of where, how fast, and how far you will go. Unless you take back control of the driver’s seat (through therapy, support groups, healthy coping skills), your addiction can negatively impact every aspect of your life.  Imagine if your friend crashed the car–your financial life would take a downward dip. If one of your other friends in the car got hurt, your social and relational life would suffer.  If you were penalized by the law, your future occupational goals could be severely hindered by having a record. If you got seriously injured in the accident, your physical, mental, and emotional life would forever be changed!

Where to go for help to overcome addiction
Addiction does not have to be a dead end–as portrayed in this analogy. It is possible to take back the drivers seat and avoid a host of negative consequences that can accompany addiction. Please refer to the resources at the end of this post, as well as the “Resources” section of my website.  While those resources can be incredibly informative and helpful, meeting with a highly trained and skilled addiction therapist can be invaluable to your recovery or to your healing process. If you are exhausted from struggling with an addiction, or with a loved one’s addiction, schedule your first session with me today. It’s time to take back the driver’s seat.

And be sure to stay tuned for future blog posts on relationships, mental health, and self care. I’ll be posting each Saturday!

Resources:
YouTube, “The Opposite of Addiction”
Addictions and Recovery, “What is Addiction?”
American Society of Addiction Medicine, “Definition of Addiction”
International Journal of Preventive Medicine, “Behavioral Addiction versus Substance Addiction: Correspondence of Psychiatric and Psychological Views”
Addiction Recovery Guide (12 Step Program)
Psychology Today, “Living a Healthy Life”