“Who are you?” A question posed to a small group of five women suffering from Substance Use Disorder (SUD) and Trauma were met with totally blank stares. Not one of the women had even the faintest idea how to answer the question. When treating women suffering from SUD and Trauma, the foundation for creating a safe and secure environment in which to thrive begins with education. Intensive education for women on the definitions of self-esteem, boundaries and emotions through an intensive curriculum of individual and group based therapy on communicating those boundaries and exploring what it is to have self- esteem is vital. This is a powerful baseline to begin identifying long-term recovery goals, both as an active member of the recovery community and in a wider societal context as well. The correlation between the ability to effectively navigate emotions, implement boundaries, communicate these effectively, and maintain strong recovery while increasing self-esteem has proved to be incredibly high in the treatment of both Substance Use Disorders (SUD) and Trauma.
The importance of the correlation between the above components in program development has proved to be crucial in establishing a three phase approach for treating addiction and trauma for the long term; Educate, Motivate, and Activate.
The baseline of the recovery process begins by creating a safe environment to start educating women on several different levels. First, with an in depth education on the physical and mental effects of alcohol and drugs; and how this disease causes alcoholics and addicts to behave differently than others in regards to mood and mind altering substances. This allows women to recognize and accept what happens to them both physically and mentally as a disease concept rather than a moral malfunction. Secondly, it has been found that most women initially are only able to identify one emotion: Anger. It appears that most women have never been educated on the many different types of emotions, the actual definitions of these emotions, or what different emotions can feel like in different situations. Thirdly, women entering the recovery process generally express mindsets of extremely low self-esteem. Yet, most women are not taught the meaning of self-esteem, the difference between self-esteem and ego, or the actual process
of building self-esteem outside of the treatment setting. Once armed with the information and facts about addiction, emotional awareness, and how to build self-esteem through writing, role-playing, and intense conflict resolution practice, women are greatly motivated to practice these tools outside of the clinical setting- if made to be accountable.
The importance of practicing these invaluable communication skills has been continuously stated by these women as part of the core set of tools used in the maintenance of their daily SUD recovery.
The communication skills that women need to succeed, both within sobriety and in society, have shown to build up in three levels; personal, community, and society. On a personal level, or communicating with themselves, these women have learned to be aware of emotions they are feeling, how to process these emotions, and then react. The process of learning to set boundaries has also begun with personal communication. As women become more aware and in tune with their daily needs, both physical and emotional, they begin to learn to develop an inner voice that did not exist before, and most importantly, to own the right to express their feelings and opinions with themselves and with others. The ability to practice both of these tools on a personal level has created the needed foundational building blocks of self-esteem to begin communicating effectively with the outside community (relationships, family and work). Women have often found this to be the hardest obstacle as they felt unworthy or undeserving of a voice of their own because of their traumatic past or the stigma associated with SUD. The practice of community communication can be implemented through identifying a conflict for the women that needs to be addressed, processing the emotions involved, role-playing within the group, being required to address the source of the conflict outside of group, and then process the results once accomplished. This has shown to be highly effective in both developing the individual voice for boundary settings and continuously cementing building blocks of self-esteem.
In a wider societal context, the development of the individual voice through the awareness of emotions, boundary setting and self-esteem building has come through encouraging women to identify long-term goals, and discussing the limitations and fears surrounding these goals. Often times it is at this level that the most unique skills, ideas, and goals have been identified. The need to teach these women to develop these goals through the process of discovering a core-identity which has been lost through SUD and Trauma is paramount to successful long-term recovery. The development and encouragement of this identity is essential to communicate the needs, wants, and desires of these women to the rest of society and not just within the recovery community. Social integration has shown to be one of the largest fears, however, once the personal and community communication and self-esteem building blocks have been set in place, the activation of motivation for social integration has been shown to be very powerful. The realization that they are not limited by their past and encouraged to believe in the idea of unlimited possibilities for achievement in the future can be an eye opening experience for women suffering from SUD and trauma. It is not just identifying and communicating these ideas within the group setting, but setting in motion and activating a plan with each woman to begin the journey to achieve their goals. The wrap around intensive management and accountability of a strong recovery program and personal, community, and societal communication skills is a practice that should be implemented to develop a foundation for long-term recovery within a short-term recovery program.
The self-identification and communication learning process has shown to increase emotional intelligence scores by a considerable amount, while actively engaged in all components of the recovery process. This has shown to produce happier, healthier and higher functioning women in recovery and in society in general. The need to create a space where learning and trust is held to the highest standard is essential, and this life changing learning process begins with the simple but powerful question, “Who Are You?”
Rebecca Apperson is the Program Director for Helping Hands Recovery Center in Fort Lauderdale, FL. She holds a Masters in International Relations and Diplomacy. Rebecca previously worked as a program case manager for Keystone Halls’ Department of Veterans Affairs Grant Per Diem Program and as a research assistant for the United Nations on the Global Education Sector Response to Substance Use Among Young People.