Psych Central

Intervention and Addiction Case Management: An interview with Cindy Feinberg

By Robert Weiss LCSW, CSAT-S

Intervention and Addiction Case Management: An interview with Cindy Feinberg Cindy Feinberg is a recovery coach and addiction case manager in New York City. She and her staff are committed to helping addicts and their families move toward recovery and a better life. She coordinates on an ongoing basis referrals to treatment specialists (treatment centers, therapists, interventionists, sober companions, MDs, and the like), at the same time managing all other aspects of care appropriate for a client and the client’s family. I have been so consistently impressed with both her intervention and recovery coaching ability that I wanted to share a bit about her world with you here.

Continue reading… »



A Call to Action: One Way to Make Treatment Feel Safer

By Robert Weiss LCSW, CSAT-S

A Call to Action: One Way to Make Treatment Feel SaferDealing with Shame and Vulnerability

Few places call upon people to be more vulnerable, more often, than addiction and behavioral/mental health treatment settings. Complicating matters is the fact that people who enter treatment for addiction or any other highly destructive psychiatric disorder are nearly always filled with shame – feeling as if they are inherently flawed, defective, less than, and unworthy. Sharing about these feelings and the incidents that led to them is incredibly painful, and, as such, these individuals would usually rather eat dirt than talk about them. As therapists, of course, we understand that shame thrives in darkness but withers in sunlight. In other words, we know that the best way to reduce the power of shameful feelings and incidents is to have them witnessed and understood when surrounded by safe and supportive others.

Continue reading… »



Spotting Active Addiction in Friends, Family, and Clients

By Robert Weiss LCSW, CSAT-S

Addiction: The Myth

Spotting Active Addiction in Friends, Family, and ClientsAddicts are very easy to spot. They are those dirty, smelly, unkempt men hanging out under bridges, in front of convenience stores, in back alleys, and in all the other unsavory places that “healthy” people never go. Addicts sleep in the gutter. Addicts get arrested a lot. Addicts are completely estranged from their families. Addicts definitely do not have jobs. Nor do they have friends.

Addiction: The Reality

Only about 10 percent of addicts fall into the easily identified “low bottom” stereotype described above. The other 90 percent are people that most of us deal with in our day-to-day lives, often regularly, without our knowing about their addiction. This is because the vast majority of addicts work very hard to hide their problem, be it alcoholism, drug addiction, or a behavioral addiction like eating, shopping, gambling, or sex. The simple truth is most addicts are functional for long periods of time, maintaining jobs and even marriages while keeping their problem relatively hidden.

Continue reading… »



Behavioral Addictions: A Basic Understanding

By Robert Weiss LCSW, CSAT-S

Who is the Addict?

Behavioral Addictions: A Basic Understanding

Devon is 22 years old. He started drinking alcohol and smoking pot in his early teens. At first this was a way to socialize, but soon he was isolating in his bedroom with the door locked – getting high, listening to music, and playing video games. His grades dropped, he fell away from his friends, and he lost interest in sports, girls, and other activities. Now he has no money, his family is no longer willing to support his drug habit, and the only people he hangs out with are also heavy drug users.

Jane is 51 years old and married. She first went to a casino while in Las Vegas on her second honeymoon at the age of 49. There, she sat with her new husband Jon at the blackjack table placing $2 bets with him, laughing and joking whether they won or lost. After the honeymoon Jane and Jon returned to the East Coast and he went back to his demanding job, leaving her alone at home during the day. To pass the time she started playing online poker. Before she knew it, she was gambling all the time, ignoring both the household and Jon. Recently, Jon learned that she had depleted their retirement accounts and run up $100,000 in credit card bills. Now he’s threatening to leave her.

Interestingly, Devon’s family knows exactly what to do with him. They want to send him to rehab for substance abuse treatment. Whether Devon is willing to go, and to participate in recovery once there, is another story entirely, and one that is outside the scope of this blog. The point is that it’s clear to everyone (including Devon) that he is an addict and needs outside assistance if he’s ever going to get his life on track. On the other hand, Jane’s husband Jon is completely at a loss. He just can’t understand what has happened to the bright, funny, smart, and sensible woman he married. The best plan he can come up with is to tell her, “If you don’t stop wasting money, I’m leaving you.”

Continue reading… »



The Dynamic Duo of Sex and Money: An Interview with Debra L. Kaplan

By Robert Weiss LCSW, CSAT-S

The Dynamic Duo of Sex and Money: An Interview with Debra L. KaplanDebra Kaplan, a psychotherapist working in Tucson, AZ who specializes in trauma, intimacy, and sex addiction treatment has published a new book entitled For Love and Money: Exploring Sexual & Financial Betrayal in Relationships. I recently spoke with Debra about the book, and I wanted to share her thoughts here.

RW: The concept of financial betrayal is not often discussed. Could you explain what financial betrayal is and give some examples?

DK: You’re correct, Rob. Financial betrayal is not often discussed yet it stands as a significant area of discord between couples. Financial betrayal speaks to the hidden use of money, currency, and/or “relational tender” to deceive, exploit, control, and/or manipulate a partner in a committed relationship or marriage. An example might include using a couple’s resources on addictions. When we are speaking about a sex addiction, for instance, the monies or resources might be spent on prostitutes, affairs, the support of an affair partner, and massage parlors.

Continue reading… »



The Small Gifts of Connection

By Robert Weiss LCSW, CSAT-S

The Small Gifts of ConnectionThe Season Everyone Can Be Jolly…

Could the holidays possibly present us with a more of a confusing mish-mash of messages, expectations, and emotions? Sadly, that seems to be the nature of the beast. We turn on the TV and there’s George Bailey saving his depression-era town from financial ruin while simultaneously making new angels every time a bell rings. Change the channel and there’s little Virginia learning that there really is a Santa Clause. Switch the station again and we’ve got Charlie Brown’s friends deciding the woeful tree he chose for the Christmas play isn’t such a bad little tree after all. And while viewing these shows we can’t help but think: “Yes, this really is a wonderful time of the year.” But thinking this is not the same as experiencing it, and, given all the cooking, shopping, work, emails, bills, lists, gifts, etc., that we have to deal with throughout the holidays, what most adults seem to actually feel is, in no particular order: tired, overwhelmed, restless, stressed-out, impatient, and pressured. Did I mention tired? As adults, instead of focusing on the twinkling lights and pretty figure skaters like we should, we tend to mull over things like mortgages, taxes, and credit card bills, not to mention our snarling in-laws, while the whole world shrieks: “Give and now receive. Receive and now give. Now repeat.” By mid-December, even the most optimistic among us can find ourselves thinking, while waiting in yet another line in yet another store, “Gee, this kind of sucks,” or, employing the language of a bygone era, “Bah, Humbug!”

Continue reading… »



Developing a New Understanding of Shame

By Robert Weiss LCSW, CSAT-S

Developing a New Understanding of ShameShame is the intensely painful feeling or experience of believing that we are flawed and therefore unworthy of love and belonging.
 - Dr. Brené Brown

Rethinking Shame

In the past, numerous writers including John Bradshaw, Pia Mellody, and Claudia Black, to name just a few, have developed the terms healthy shame and toxic shame. In most respects these definitions make good sense – the term healthy shame defining the feeling that occurs when a person has done something that goes against his or her values and beliefs, leaving that person feeling badly, and toxic shame being the festering internal belief that one is inherently flawed or defective. More current terminology developed and described by Dr. Brené Brown re-labels what most of us have been calling healthy shame as what it actually is, which is healthy guilt. Guilt implies: I did something regrettable and I feel badly (or guilty) about my actions. What has heretofore been termed toxic shame is what Brown simply calls shame, a term that seems a bit less shaming, n’est ce pas?

Continue reading… »



The Complexities of Trauma: A Basic Understanding

By Robert Weiss LCSW, CSAT-S

The Complexities of Trauma: A Basic UnderstandingComplex Client

Jeremy, a 28-year-old commodities trader, enters therapy with the presenting problem that, “I can never seem to maintain an intimate relationship.” Initially, Jeremy’s focus is solely on his struggles with romance, but closer questioning reveals that his friendships and business relationships are also mostly short-lived, and even his family ties run hot and cold. A full assessment shows he has a disorganized attachment style that probably developed, as attachment styles typically do, during infancy and early childhood. Simply put, he intellectually desires and emotionally longs for intimacy, but whenever he gets close to this desired goal, up go his defenses – walls of fear related to childhood abandonment and abuse. As such, Jeremy consistently (albeit unconsciously) engages in patterns of relationship sabotage whenever anyone gets close enough for him to feel emotionally threatened.

Continue reading… »



Shame Resilience and The Daring Way™

By Robert Weiss LCSW, CSAT-S

Shame is the intensely painful feeling or experience of believing that we are flawed and therefore unworthy of love and belonging.
 - Dr. Brené Brown

Training the Trainers

In early November, forty addictions and mental health staff from Elements Behavioral Health facilities nationwide gathered at The Ranch treatment center near Nashville, Tennessee for three days of intense and rigorous professional training. Our goal was to experience and learn the new Daring Way™ shame resilience curriculum, which is based on the extensive research of Dr. Brené Brown. Among the delegation were senior therapeutic staff members from Promises Malibu, Promises Professionals Treatment Program, Promises Young Adult Program (West LA), Malibu Vista, Promises Austin (formerly known as Spirit Lodge), The Ranch, The Sexual Recovery Institute, Lucida, The Right Step, and The Recovery Place. As a result of this effort, each of therapists in attendance is now certified as a Daring Way™ Facilitator Candidate (CDW-C). In short order these clinicians will become fully certified Daring Way™ Facilitators, and the Elements family of treatment centers will wholeheartedly incorporate the Daring Way™ shame resilience curriculum into its ever-growing family of treatment programs.

Continue reading… »



Men and Depression: Not Just the Same Sad Face

By Robert Weiss LCSW, CSAT-S

Men and Depression: Not Just the Same Sad FaceFeeling Down?

Scenario 1: Joan, a 32-year-old working mother of two young children

Joan arrives in therapy complaining that over the past six to eight months she has experienced growing feelings of both sadness and fatigue. She admits to frequent crying jags over what she accurately describes as relatively minor incidents. She also reports difficulty falling asleep, usually because she’s worrying that her children need more from her than time allows. As a result she is fatigued, easily prompted to tears, spaced out, and increasingly forgetful. The final straw for Joan was when she inadvertently locked her toddler son in the family car with the keys inside (requiring a visit from the local AAA truck to free both her son and her SUV). The following day, after a long talk with her husband, who encouraged her to seek help for her general unhappiness, she reached out to a local psychotherapist. After reviewing Joan’s history and stated symptoms over the course of several sessions, Joan’s therapist diagnosed her as being in the middle of a moderate depressive episode. The therapist gave her a referral for medication evaluation, and continued to work with her in therapy – focusing on helping her to better manage stress and to feel more confident as a mother.

Continue reading… »



 
Purchase Cruise Control now Purchase Untangling the Web now

Check out Robert Weiss' books today.

Subscribe to this Blog:
Feed


Or Get a Single, Daily Email (enter email address):

via FeedBurner



Recent Comments
  • Harrison M: Very nice article! I’ve always been aware of genetics being a huge factor in higher risks of...
  • polargirl360: “transgender people (also called transsexuals)… Eeehhh…no! Transsexual is a smaller...
  • Ilana Podgurski: I intended to create you one little word so as to thank you so much the moment again about the...
  • edsermac: I agree with this article that shame is one of the most pervasive underlying factors in a range of...
  • TPG: I can safely say that I’ve never met a human being who doesn’t struggle with emotional and personal...
Subscribe to Our Weekly Newsletter

Find a Therapist
Enter ZIP or postal code



Users Online: 12240
Join Us Now!