Welcome To Syrona
Short-Term Intensive, Treatment For Addictions
To Therapists: Do you have a client struggling to stay clean and sober? Do you believe that your client needs to address the underlying issues driving their addiction to achieve lasting sobriety?
To Clients: Are you struggling with addiction? Do you find that despite your ability to get clean and sober, you keep relapsing? Do you feel you need to look, really look, at the issues behind your addiction?
Read the following, and see if you relate:
- Are you tired of relapsing?
- Do you keep going back to alcohol or drugs to distract or numb yourself from painful feelings and/or memories?
- Do you know why you use but don’t want to talk about it?
- Do you want to have more meaning and purpose in your life than just sobriety?
If you are looking for a approach to addiction that you haven’t tried before, we may be an option. We have worked with many clients suffering from addiction, especially addiction stemming from trauma and PTSD. In a Syrona Intensive, we work to uncover the powerful, emotional dynamics that often lie underneath awareness, driving your addiction. Our focus is on developing not just your emotional tolerance but to help you develop emotional mastery. Expanding your “comfort zone” for emotional experience allows life and it’s vissitudes to not trigger constant relapses.
- Please Note: The Syrona Intensive is an outpatient therapy program. Clients need to be clean and sober throughout the Intensive, and be self-sufficient enough to manage and function after hours/evenings on their own (or with appropriate support).
We Can Help You Get to the Root of Your Addiction
The following case study can show you more about how we work in an Intensive. Please note that, in order to share this information on a website and protect client confidentially, all significant events and identifying information have been altered, but the essence of the treatment and the information has remained true.
The Case of Tom
Tom is a 35-year-old divorced Caucasian male who presented himself for treatment to learn how to protect his sobriety and figure out why, in spite of multiple rehab and outpatient psychotherapy experiences over the past 15 years, he has consistently relapsed every six months or so. Like many who begin their addiction process in adolescence, Tom engaged in occasional alcohol and marijuana use in high school. Although he recognized a trend developing toward more and more frequent use, he rejected the idea that he was becoming an addict since he continued to function adequately at school, and after he had graduated, he worked hard on his way toward getting his MBA. He loved graduate school. However at some point in his mid-20’s he was introduced to crack cocaine. After this, he generally quit drinking and using marijuana and he began smoking crack regularly.
Within short order, Tom’s life orbited around two goals: securing access to crack cocaine and abusing sex. During episodes of use, he dropped out of the responsibilities of his life and spent his time with local prostitutes, developing relationships with them and establishing a separate life on the street. As such, he lost his job and the support of his friends. Eventually, his family intervened and pressured him to go into treatment.
Tom was introduced to the 12-step model, started attending NA, and in due course, began working again. He was discharged to outpatient treatment for positive completion of his residential goals. However, about six months later, he relapsed and disappeared once more. This process repeated itself in spite of recurrent job losses and worsening health. By the time Tom reached us, he had experienced no less than five residential and outpatient treatment programs, leaving him both burnt out and depressed from failed recovery. Considering his track record with consistent relapse, it was recommended that Tom join our intensive program in the hopes of ensuring that he could better protect his newly established sobriety.
Tom had been sober for four months prior to admission to the Syrona Intensive program. Although drug-free, he presented with the following symptoms:
- Chronic and acute Depression: It was discovered that Tom struggled with symptoms of depression since childhood. He was struggling acutely at the time of admission to the program because he had lost many of the supports he had been relying on prior to his most recent relapse.
- Chronic untreated PTSD: Tom had a history of being violently physically abused by his father and unprotected by his codependent mother, as well as periodically exposed to episodes of extreme violence while living on the street.
- Intense feelings of shame and guilt: He felt personally responsible for the relapse and untimely death of a girlfriend who was murdered in front of him.
- Emotion dysregulation and low affect tolerance marked by intense feelings of rage, grief, fear & loneliness: Tom’s life was a cycle of approach-avoidance impulses competing for his attention, self-medicated by drug use and sex, and temporarily suppressed in sobriety.
Tom’s initial presentation in treatment was primarily that of hopelessness, anxiety and depression. Although glad to be sober again, his prior experiences left him anticipating a period of relative peace that would only be followed by yet another relapse. He reported feeling confused and defeated.
The first day of Tom’s intensive focused on his effort to tell his life’s story. The “life story” is the person’s self-portrait of their experience. The Syrona Intensive process uses the life story like a projective test, through which, the person’s narrative approach emerges as his or her “emotional fingerprints,” revealing motivations, drives, underlying conflicts, and most especially, adapted solutions to perceived problems and the nature of the relationship with self and other.
While listening to his narrative, the mystery surrounding Tom’s pattern of recurrent relapse was revealed by his casual observation that he never used drugs by himself. When he later confirmed the sincerity of this statement, he was unaware that his experience placed his drug use in the context of relationships and pointed to the nature of a uniquely adapted solution to the problem of trauma, particularly related to unresolved support failure*.
In other words, every instance of his drug use occurred in the context of sharing it with or buying it for women in exchange for companionship. Although he did acknowledge that sex was part of most exchanges, as we explored his relapse experiences, it became clear that typical motivating triggers were worsening feelings of loneliness and isolation.
*Note on “support failure”: In the context of physical, sexual, and emotional trauma there are always two kinds of damage to be accounted for: damage related to the event itself (which is expressed in the form of the typical intrusive re-experiencing, avoidance, and emotional reactivity/hypervigilance symptoms of PTSD), and damage associated with support failure. Support failure refers to the experience of the person after the event and the context in which it occurred. Research has well established that the presence of at least one loving, supportive, and validating person greatly reduces the severity of subsequent coping problems. The absence of such support, however, increases the likelihood of enduring experiences of social-emotional isolation, self-esteem damage, and the promotion of maladaptive coping strategies, including the development of chemical and behavioral addictions.
In the context of Tom’s abuse history, he was clear that while his dad was frequently violent with him, he understood that his father had serious emotional problems of his own. However, the fact that his mother either seemed to disappear at these times or blame him for his own beatings (rather than offer comfort or support) left him feeling that she agreed with the way his dad treated him. Indeed, he shared that as recently as a month before this intensive, he made the decision to live in his car until he could find an apartment rather than continuing to stay with his parents. He had been staying with them for a few weeks while waiting for an apartment to become available, but his dad routinely berated him for being a “crybaby weakling” for having to go to therapy. Tom’s brother later confronted their mother about allowing her husband to abuse her son, especially so soon after his release from treatment. Her mother’s response was that she understood it was bad, but she’d been with her husband for 37 years and she needed to look after him.
After breaking for lunch on this first day of the intensive, we reviewed Tom’s life story and looked at the process of his emotional development concerning his experiences of abuse and his enduring confusion about the predictability of his relapses. Most especially, we explored the role of support failure and its associated vulnerability to feelings of chronic emotional deprivation/isolation for their connection to his enduring and seemingly intractable vulnerability to relapse.
The remains of this first day were spent connecting the dots between his abuse history and his relationships with his parents. At this point, we introduced the use of experiential strategies for getting at the most essential unresolved emotional conflicts. The specific strategy entailed inviting Tom to step into the experience/memories of the little boy
who struggled with his dad’s violence and his mother’s lack of protection. He was invited to consider what he wished he had been able to say to his parents, had he felt supported in speaking the truth. What followed was a mild reflection on his anger toward them (particularly his dad). Tom also had a strong guilt reaction for “talking bad” about them, considering his many failures and their willingness to pay for all of his treatment. And, he felt an intensely painful expression of sadness and grief as he reflected on how confused and alone he felt by his mother’s apparent unwillingness to protect him “or even tell me it wasn’t my fault.” He wept bitterly for over 20 minutes and later acknowledged that before this, he never let himself remember how alone he felt growing up.
The following day, Tom shared that he went home from the session, ate, and collapsed in bed until this morning. Although he denied having any dreams through the evening, and actively avoided thinking about yesterday’s events, he reported feeling increasingly anxious and disturbed by what he shared the day before.
He affirmed once again that he felt guilty for feeling so hurt and angry with his parents after all they’d done for him. When asked whether his guilt feelings made his hurt and sad feelings feel untrue, he acknowledged he still felt hurt regardless, but he had never been free to talk about it without feeling like he was betraying them. He always just suppressed his feelings until he learned to escape them with drugs.
To support clarification of Tom’s feelings, we introduced emotion/action theory. We demonstrated that his ambivalence, and not knowing how to deal with it, isn’t unique to him but rather is the way of things for all of us. To cope with overwhelming experience, our survival instinct chooses our course of action regardless of cost or consequence. This usually means that in the crowded space of conflicting emotions, the action that is taken is what promotes survival or maintains emotional equilibrium even as our other simultaneously felt emotions pull for alternative or contradicting actions. These remaining emotions exist as unexpressed action potentials and remain in the unconscious, indirectly influencing our actions like magnets pulling or pushing on nearby metal, until or unless they are triggered to consciousness by additional experience. In other words, suppressed or repressed trauma is not the same as healed trauma, and the clichéd notion in psychotherapy of “completing unfinished business” is made tangible by the analysis & resolution of these incomplete emotional action potentials.
In Tom’s case, insufficient completions existed for hurt, sadness, and anger because the intervening emotions of guilt and shame blocked their expression. As a result, he could not overcome these feelings because the act of validating them and following their action impulses made him feel wrong. We discussed this, and he agreed he needed to get past feeling like an ungrateful son.I introduced the experiential process of guilt resolution, demonstrating in particular the relationship between the perceived wrong and the necessary amends needed for sufficient repair.
For Tom, his struggle with guilt surrounded the meaning of their financial support given his recurrent relapses. We challenged him to look at the fact that his lack of commitment to recovery contributed to the persistence of his guilt. In other words, a commitment to protecting his sobriety translated to a commitment to his integrity. If no betrayal was committed, no money needed to be spent on “fixing” him yet again. It is worth noting that if this realization was made conscious at any other point than when he was earnestly working to protect his sobriety, his ambivalence about being responsible for perpetuating his own guilt may have actually resulted in sabotage. In fact, Tom acknowledged that he has enjoyed a disturbing satisfaction that he was “making them pay” every time he relapsed. Once he understood and accepted the trade-off, Tom decided he needed to commit to never using their money should he ever relapse again.
Putting his renewed commitment to his integrity to work, and to further reinforce his capacity to engage effectively with his own previously overwhelming negative experience, we began to process his crippling feelings of guilt surrounding the death of his girlfriend. To do this, we discussed his experience in general, covering the history of their relationship, their drug use together, and her recovery. Then, we focused on the specifics of her relapse and murder. Tom indicated he met Sara in rehab in Georgia six years ago. She was 28 years old. They got very close, and eventually started dating. Tom reports that he was always honest with her about his history of relapse, which was his way of being clear with her about his long-term struggle. Sara didn’t appear to mind and welcomed the opportunity to make a sober life with one another in spite of it. On the other hand, however clear he was about his past, he knew he would use again and that it would likely hurt her. When he finally relapsed, about seven months after they moved in together, he disappeared. After three days, she found him at a familiar hotel, which he had a history of staying at while he was using. He refused to leave, and they argued. In the end he told her she should leave him and move on with her life. Sara refused and joined him instead.
However, where Tom episodically used crack, binging for periods that last from about three days to a week or two, Sara’s drug of choice was heroin. And, once she relapsed, she continued using. In a terrible irony, she quickly stopped caring about their relationship and only concerned herself with getting her next fix. But Tom, after a week, stopped using and got cleaned up, went to a meeting, and started over in AA. Then he went out to look for Sara.
Struggling to speak in the session, he continued saying that eventually he found her in a drug house with others using with her. He got her out of there, and as he was putting her in his car, a man ran out of the house raving something about Sara stealing from him. Apparently on her way out of the house, she had grabbed someone’s bag, which presumably had the other person’s. The man hit Tom in the head with something and knocked him out. When he came to, Sara was laying halfway out of his car in a pool of blood. He called 911, but she died in his arms before help arrived, without ever regaining consciousness.
Although the horror of it is undeniable, Tom long since lost track of the number of violent episodes he witnessed, having spent years on the street himself. Consequently, the most torturous aspect of this memory was not the violence itself or enduring symptoms associated with PTSD. However, for the past six years since her death, Tom lived every day with the guilt of what happened to her.
As we spoke, it became clear that Tom’s struggle with the guilt of Sara’s death was compounded by two important factors, one of which he was the collection of self-defeating behaviors he engaged in, ranging from multiple relapses to deaden the pain to blatantly reckless and suicidal behavior to punish himself for it. The other problem for Tom, however, were his treatment providers’ multiple efforts to either reframe the situation such that Tom would see that Sara’s death was her own making because of her heroin addiction, or to convince him that forgiving himself would release him from the poison of his guilt. Tom’s response to both of these interventions was usually initial relief because of the shift in or alleviation of blame for his girlfriend’s death. However, he could never escape the feeling he was somehow inappropriately “let off the hook” for what happened.
We explained that trying to recover from some experiences of guilt by reframing it or attempting to soothe it are unsuccessful because they either try to alter the meaning of the event or they seek to alleviate the emotional pain by direct manipulation with positive sounding but nevertheless often empty concepts reliant on dissociation to work. Alternatively, we explained to Tom that since his own emotion-meaning making system declared him guilty of causing Sara’s death, then the only way healing would occur for him was to accept responsibility for it. Consequently, the job involved amending the way he lived and holding this responsibility as a sacred commitment to protecting others from ever again experiencing harm by his hand, including exploiting or influencing their vulnerabilities through his relationship with them.
As we wound down for the day, Tom reflected on his growing awareness that it was only through making a daily commitment to honoring sobriety and Sara’s memory, that he could find relief. We invited him to spend the evening considering the implications of this realization and his willingness to make a commitment to his integrity.
The next morning, we began with a review of the work he had done over the past couple days. Although we only focused on a fairly narrow selection of Tom’s clinical issues during this brief two-day intensive, we “chose” to work on his grief/sadness and guilt issues because these were simultaneously the most present or “active” in the here and now of his experience as well as the core dilemmas responsible for much of his stated problem of chronic relapse. As we turned to his experience of yesterday’s work, Tom shared that he felt “weird.” He stated that he spent all night thinking about Sara, and it was weird because, since her death, he actively avoided it. And, when thoughts of her came up in the past, all he could think of was “I’m going to Hell” and “I am in Hell.” In our session, he said, “Now, I still feel the same way, but I feel like I have something real to do to make things right.”
He shared a letter he wrote to her, in which he owned his failure for abandoning her and contributing to the ruin of her life. He also expressed his commitment to protecting anyone he ever gets close to again from the same betrayal. He said, “As I see it I have two choices. Either I stay away from relationships or I never use again.” In processing this, he reflected on our first day’s discussion about his relapse pattern. He said he felt less apprehension about what to do with himself in the future knowing that his relapses are all reactions to feeling rejected or alone. Then he got quiet and wept.
Afterward, he realized he had just validated why he left her and got high in the first place. He shared that he didn’t want to think negatively about her because of what happened, so he had forgotten about how stuck he felt because she was so attached to him, but he found her to be needy and selfish at times. “I just realized. This is how I’ve always left relationships. I’ve never told them how I felt. I always assumed they wouldn’t listen or would make me feel wrong. So I just left to make myself feel less alone.”
At this, he became aware of a different kind of guilt. An adaptive and necessary one that points to a clear need to be more honest with himself and transparent with others. Through committing to honesty, he could promote better relationships and prevent relapse. He realized the temporary relief he gets from running from his fear of rejection is in no way worth the price of the pain it causes. Tom’s eyes were clear as he said he felt a peace he hadn’t felt before.
Through his participation in the Syrona Intensive, Tom gained greater insight into the reason for his relapse vulnerability and how it fit in the understandable context of his attempt to resolve the crushing loneliness of his childhood. Tom engaged in the hard work of facing his sadness, grief and, crippling guilt, which he could previously only deal with by acting on his addiction. Tom’s work demonstrates how this short-term intensive format can help clients surmount recovery obstacles and develop a pathway forward that is unique to the client’s own experience. When Tom returned to his own therapist, they both had a set of validated, concrete goals to continue working on. For the first time, Tom had hope for a future he could look forward to.
You Too Can Find Clarity and Peace
While everyone’s addiction, and the reasons behind it are unique, it is possible to find a way to live without substances. We hope this case study was interesting and informative. Thank you for taking the time to read it all the way through! If you are interested in finding out what lies behind your substance use, we hope you consider a Syrona Intensive. While most of our clients have been in residential programs, and have had a lot of therapy, what we offer is a treatment that focuses on the underlying, root causes of your addiction so that you can find lasting recovery, and get off the relapse wagon once and for all.
How Do I Get Started?
It’s easy. Just call (407) 542-0035. We are likely to be in session so please leave us a message. We will call you back and talk with you to decide if a Syrona Intensive is right for you.
If you prefer to email, contact us at:
Dr. Kelly: firstname.lastname@example.org
Dr. Mruz: email@example.com
Thank you for reading!
* Please Note: Clients who come to a Syrona Intensive are prepared and ready for the emotionally-focused nature of the process. It is rare that we work with clients who are not, or have not been in therapy. The Syrona Intensives are designed to be an adjunct to ongoing therapy, not a stand alone experience.