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Trick , Treat or Trauma
Dr. Louise A Stanger LCSW, CDWF, CIP, CSAT-1
Oct. 2021
The Uninvited Guests
Trauma
Mental Health
Addiction
About Dr. Louise
-Clinician-Educator-Interventionist
• “Interventionist of the Year” -2019 DB
Resources and McLean Hospital-An
Affiliate of Harvard
• Addiction in The Family, Helping Families
navigate Challenges, Emotions and
Recovery 2020, Rockridge Press
• Falling Up A Memoir of Renewal- Amazon
• The Clinicians Guide to Addiction
Interventions-Routhledge, 2018
• Widow, Wife, Mother, Grandmother
• Adventurer
Has Been a Tough Year
Final trick, treat, trauma
7
Final trick, treat, trauma
Major Assumption
9
Assumptions
We are emerging from or still in a
Trauma Bubble
Mental Health and SUD are at an all
time high
Sleep is challenging
Decision fatigue and Reentry
Anxiety are high
Complex clients and families are the
Norm Abundant
Yes it is possible to survive Yes it is
possible toThrive
10
At the end of the presentation
participants will be able to :
Identify, Describe and Discuss , How Clients and Families
Come to your Practice
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
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
Facts
1 in 12 American Adults (18.7
million) have SUD
1 in 5 (46.6 Million) have Mental
illness
8.5 Million have SUD and
Mental Illness
Do You Know?
Spending on Alcohol has Increased
Marijuana Sales Doubled in Covid
“Cannabis sales increased in all four states coinciding with state stay-at-home orders.”
Center for Disease Control
U.S. Had Most Drug Overdose Deaths on Record
Suicide Has Increased
Addiction is a treatable , chronic medical
disease involving complex interactions
among brain circuits , genetics , the
environment and an individual’s life
experiences
2021
19
12 Common Myths About Addiction
Addiction can’t happen to be or my
family
Addiction is just really a lack of
willpower
Addiction is not treatable
In order for someone to want
treatment , they have to hit bottom
If someone you love had a substance
abuse problem you would easily
recognize and solve it.
More Myths
My loved one has a great job and appears
functional and happy. Things must be ok.
Prescription drugs are safe and THC isn’t
addictive
Interventions do not work
If you can handle your liquor then you don’t
have a problem
Addiction is a moral failure
Detox is all you need to fight addiction
You need religion to get sober
22
23
Family Roles
The Problem Child or Adult
Chief Caretaker-Enabler
The Hero
The Scapegoat
The Mascot
The Lost Child
Families learn
Roles they have unconsciously
played
Learn how to use “I” Terms and how
to share feelings
Respond without reacting
Not to Threaten, preach, nag control
How to talk
To Breathe
Addictions Arsenal
Denial
Manipulation
Shame
Blame
Secrets
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 from”
Larke Huang , Director of
Health Care Equity at
SAMSHA
–Unknown
Our Brains are wired for connection,
Trauma rewires them for protection
Final trick, treat, trauma
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 mlltiple
events, often invasive interpersonal nature.
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
Final trick, treat, trauma
Final trick, treat, trauma
Subjective and Objective
Trauma
New Your Times Feb. 24,2020
It Can Feel like You Are Whirling Thru a Tornado
As if You’re Living in a Hauted House
I Met Trauma at a Young Age
Final trick, treat, trauma
Final trick, treat, trauma
Humiliation-
Embarrassment
The Act of Making
Someone Inferior or
Foolish
You have Bad table
manners.
“ Your Father
Committed Suicide!”
Final trick, treat, trauma
Final trick, treat, trauma
Final trick, treat, trauma
Final trick, treat, trauma
Addiction -Attachment Disorder
Values are lost as we attach to substances and other unhealthy behaviors
Mental Health Issues
Anxiety
Depression
Grief and Loss
Narcissism
PTSD
Bi-Polar
Personality
Psychosis
Phobias
Lets talk about Henry
35 years old
Lives at home
Third DUI
Mother makes his lunch and
Father cleans his room
Bullied as a Child OCD
Lets talk about Julie
Beautiful , Bright, Creative
Shame based Mom of a 6 year
old
Family of 5
Entitled
Cocaine, Ketamine, prescription
drugs
Early Childhood Trauma
Anxiety , Depression
Grief ,Loss, Addiction, Chronic Pain
Harry and Anna
Joseph
Combat Photographer
Final trick, treat, trauma
Meet Robert
Trauma a can also be Related to Pain
Body
Chole
Start Where Your Client Is
Client is the expert -
Give them Control
Over Their
Recovery
Final trick, treat, trauma
Final trick, treat, trauma
Have you earned the right to hear
another’s story?
Final trick, treat, trauma
CDC Guiding Principles
Safety
Trustworthiness and
Transparency
Peer Support
Collaboration and Mutuality
Empowerment and choice
Cultural, historical , gender
issues
Benefits of Trauma Focused Therapy
Reestablish safety
Identify Triggers
Develop Healthy Coping Skills
Decrease in Traumatic Stress Symptoms
Practice Trauma Processing or Integration
Final trick, treat, trauma
Final trick, treat, trauma
Final trick, treat, trauma
Final trick, treat, trauma
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
Evidenced Based Strategies
EDMR
Mindfulness
Buddah
META
Breathing
Somatic
Psychodrama
Yoga
Evidenced Based Therapy
CBT
ACT
MI
SFT
DBT
Evidenced Based Strategies
Music Therapy
Art Therapy
Sand Jungian Therapy
Equine Therapy
Epigenetic Research & The Science
of Inheritance
Promising way off also helping
to explain why: some family
members will experience
trauma other do not
can potentially improve ,
minimize PTSD and the
treatment plans
Mindfulness and CBT have
been found to increase brain
plastic and establish new
neural pathways
Meet Heidi
Thank you
Final trick, treat, trauma
Final trick, treat, trauma
Final trick, treat, trauma
www.allaboutinterventions.com
619-507-1699
Dr. Louise Stanger
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.allaboutinterventions.com/2020/01/31/today-i-am-
relieved-being-an-adult-child-of-alcoholic-informs-me/
Stanger,
Louisehttps://www.allaboutinterventions.com/2020/01/30/what-
happens-to-a-child-in-an-alcoholic-family/
https://www.allaboutinterventions.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, Falling Up: A Memoir of Renewal , 2016 available on
Amazon
Resources
Stanger, L & Weber, L. 2018. The Definitive Guide to Addiction Interventions-
Collective Strategies . NY . Routhledge.
Stanger, L. 2016. Falling Up-A memoir of Renewal. Ca. WZY Press. available
on Amazon
Stanger, L 2016. Learn to Thrive : An Intervention Guidebook (available at
www.allaboutinterventions.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.AllaboutInterventions.com
Resources
Kopp, Sheldon- If You Meet The Buddah on the Road , Kill
Him, 1982. Penguin House Random House, NY, NY
Stanger, Louise. Falling 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.allaboutinterventions.com
Resources
Brown, Brene- Rising Strong . Speiegel & Grau International
2015 NYC NY
Brown, Brene, DaringGreatly. Gothom Books 2012
Lawrence Lightfoot,Sarah & Hoffman Jessica .The Art 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
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
Resources
Kopp, Sheldon- If You Meet The Buddah on the Road , Kill
Him, 1982. Penguin House Random House, NY, NY
Stanger, Louise. Falling 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.allaboutinterventions.com
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/
Resources
http://cctasi.northwestern.edu, Center for Child
Trauma, Assessment Services and Interventions
https://www.integration.samhsa.gov/clinical-
practice/trauma

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