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Iboga Blog
therapy
7th January 2021
Models of Therapy: Comparing / Contrasting
As our understanding of the mental processes that occur during addiction has evolved, so have our therapeutic approaches in treating this “dis-ease.” Cognitive Behavioral Therapy has become increasingly popular for dealing with addiction, to the point where it now rivals the 12-Step approach as the “go-to” treatment for many clinics and practitioners. But there are numerous other approaches out there, each with their own set of adherents and detractors. Let’s take a look at the models sparking debate in today’s recovery landscape.
12 Steps And Cognitive Behavioral Therapy (CBT)
Since these are the two most well-known and frequently used therapeutic models in addiction therapy, we’ll begin by taking a look at how these approaches differ from each other, and whether they can be used in tandem.
One of the primary differences between the approaches is the “locus of control.” 12-Step models begin by pushing the addict to admit that they are “powerless” in the face of their addiction, while CBT is a method of self-help that aims to teach clients that they have the ability to regulate and control their own behaviors. The two attitudes are seemingly at odds, but as therapists at the Beck Institute note: “Patients sometimes ask us, “How can I take part in Cognitive Behavioral Therapy self-help if I have to admit to being powerless?” Our answer is that the “powerlessness” which they are acknowledging has to do with their prior behavioral and cognitive habits that were maintaining their problems with substances.” So while there is a philosophical difference between the two approaches, they can be reconciled.
Another seemingly large difference between the two methods is their guiding philosophies. The 12 Step program was initially inspired by the Oxford Group, a Christian organization which both Bill W. and Dr. Bob (the program’s founders) belonged to. As a result, spirituality is an essential component of the method, figuring prominently in the 12 Steps, 12 traditions, and Big Book. While strong efforts have been made to become inclusive of members of all faiths, agnostics, and even atheists, the spiritual component remains foundational to the movement. The 12 Step model is also based on the idea that addiction is a life-long condition without a cure, and that an addict will be an addict (hopefully in recovery) forever.
Meanwhile, CBT is based upon scientific principles rather than spiritual ones. It is meant to provide time-sensitive, practical solutions to a patient’s problems, whether with addiction, or any other disorder. It borrows components from a broad range of other therapeutic models but is essentially focused on identifying goals, and working towards them by recognizing and changing harmful patterns of thought and behavior. Simply put, the goal is to develop skills in recognizing what type of situation you’re in, moderating your thoughts and behaviors accordingly, and reacting in the way you desire. CBT models for treatment view addiction as an undesirable behavior that, when eliminated, is cured.
One final difference is the way each approach views harm reduction. The 12 Step model is based on absolute, life-long abstinence. Any slip in sobriety, even a single beer or joint, is viewed as a failure that puts the addict back to square one in treatment. CBT-based models, on the other hand, view their goal as allowing clients to lead healthier lives, and view any decrease in drug use or even a move to safer habits when using, as worthwhile goals and improvements which should be praised, and built upon.
While the differences in philosophy and approach are certainly significant, the two programs are certainly not irreconcilable. As one of our favorite precepts from the world of recovery states: “take what you need and leave the rest.” We’d guess that the majority of those in recovery have used elements of 12 Step programs and CBT in their journey to sobriety, and we’d recommend that you experiment with both and see what works for you.
SMART Recovery and The 12 Steps
Now that we’ve taken a look at the philosophical elements of both programs, let’s take a look at the differences in practice. The principles of CBT have inspired the SMART Recovery program, which can be either an alternative or a complement to 12-Step Programs. 12-Step meetings are led by peers and based on the principle of “sharing”, with participants offering their advice, experience, and struggles. In a 12-Step meeting, there is no “cross-talk”, meaning that you can’t comment on or criticize what someone else has shared. SMART Recovery meetings, on the other hand, are led by professional therapists or counselors, and cross-talk is allowed and encouraged. One powerful tool that the 12-Step model offers is the sponsor, someone who has been in recovery for a while and completed the steps, who provides advice, support, and fellowship with a newcomer. The sponsor is an extremely valuable resource for emotional support and they have proved crucially important for many recovering addicts and alcoholics.
The two approaches also differ in their conception of the addict’s journey to sobriety. In most 12-Step programs, individuals are encouraged to regularly go through the steps again. The idea that anyone in recovery is always in danger of relapse is common, hence the precept “too many years and not enough days,” which roughly means that an alcoholic or addict has become complacent, stopped actively practicing the steps, and relapsed. SMART Recovery, on the other hand, feels that those in recovery can become cured. As they write:
For many sincere participants there will come a time when attending our groups, or participating in our other services, is more in conflict with the pursuit of their life goals than enhancing them. Although these participants will always be welcome back if they want to come, this conflict signals that the time for graduation has arrived.
Other Alternatives
Existential Therapy
This form of therapy is based on the principles of existential philosophy as developed by thinkers such as Jean-Paul Sartre and Albert Camus. Treatment focuses on identifying questions relating to the meaning of life, the responsibilities, and freedom individuals have to make choices, and the individual’s place in the universe and society. This method of treatment is probably more valuable to individuals who are already on their way in recovery and are looking to find meaning in their lives and make positive choices.
Gestalt Therapy
Gestalt Therapy is based on the goal of pushing the patient towards an understanding of the present based on their current reality, rather than preconceptions based on what has happened in the past. The goal is to eliminate negative thought patterns and build awareness of the control and responsibility individuals have over situations and emotions. Gestalt Therapy employs guided visualizations to promote self-awareness and personal ownership while emphasizing that recollections of the past are inherently unreliable. The guiding philosophy is that self-awareness in the present will result in more positive choices relating to physical and mental health. Gestalt Therapy is a good option for those looking to move on from past traumas.
Holistic Therapy
Holistic Therapy is a broad umbrella that contains a wide range of treatments that are generally personalized for the patient. These treatments are most effective as a complement to other forms of therapy, working to rebuild the overall well-being of those in recovery and also deal with the symptoms of withdrawal. Yoga, Tai Chi, mindfulness practice, art therapy, equine therapy, exercise, nutrition, breathwork, and music are all examples of holistic therapy. While the benefits of holistic therapy may seem peripheral to treating addiction, rebuilding overall health, learning to practice self-care, and creating positive patterns of behavior are all extremely important elements of learning to live a healthy and sober life.
Naikan Therapy
Naikan is the Japanese term for “looking inside” or “seeing oneself through the mind’s eye.” The therapy was pioneered by Ishin Yoshimoto, a devout Buddhist who sought to offer a more accessible opportunity for everyone to benefit from the arduous self-reflection demanded by many Buddhist sects.
Naikan is designed to allow us to investigate and gain perspective on our relationships with ourselves, the other people in our lives, and the nature of existence. It is focused on three fundamental questions that define interpersonal relationships:
What have I received from ______?
What have I given to ______?
What troubles and difficulties have I caused ______?
Naikan has proved useful for those dealing with addiction because it allows the patient to let go of resentments, a source of emotional pain that is particularly damaging for those dealing with addiction. Many of those who practice Naikan come to realize how much others have contributed to their lives and cultivate an invaluable sense of gratitude towards those around them.
Person-Centered Therapy
Person-centered therapy is a form of treatment where the client takes the lead, and the therapist acts as a “compassionate facilitator.” In this form of therapy, the therapist refrains from steering conversations and judging or interpreting what is said. They’re meant to exhibit empathy and encouragement while encouraging you to listen to yourself and take control of your own life. Their role is to simply guide you through the process of self-exploration, allowing you to draw your own conclusions and grow on your own. This form of therapy is recommended for highly motivated people, as well as people who struggle with trust and self-confidence issues.
Therapeutic Communities
Therapeutic communities are generally long-term residences (though outpatient options do exist) that aim to use fellowship and peer-support to combat addiction. There are many different forms of TCs, some catering to individuals with dual diagnosis, the LGBTQ+ community, adolescents, and various other issues and populations. TCs leverage the power of many, and as clients progress through them they often are given positions of responsibility and even employment. The approach taken at these facilities is often described as “community as method”, where active participation in a household, and the responsibilities of social life “drive individual change and the attainment of therapeutic goals.” Therapeutic communities are especially beneficial to young people, those with severe addiction problems, and at-risk groups. They have also proven effective at boosting participation in aftercare. However, the structured, regimented nature of life in TCs and the time commitment involved mean that they aren’t the right solution for everyone.
Trauma-Informed Therapy
Trauma-informed therapy is a method developed by Dr. Stephanie Covington, among others, as a way to offer more effective treatment for health issues, particularly for women and girls. The American Department of Health and Human Services estimates that up to 99% of women in substance abuse treatment have suffered trauma, and both males and females who have suffered Adverse Childhood Experiences are far, far more likely to develop substance abuse issues. Trauma-informed therapy essentially entails that your treatment provider will have an awareness of how trauma reshapes the brain and alters responses to stressors, and uses that knowledge not to address the trauma, but its symptoms. Utilizing the strategies and techniques of trauma-informed therapy can be a game-changer in treating addiction, as it works to establish safety (defined as stability, adequate supports, and coping skills) before addressing serious issues and processing the roots of trauma. This approach minimizes the harms that can be caused by diving into painful memories and emotions before the patient has the coping skills to deal with them.
Next Steps
As you can see, there are myriad options for dealing with the pain which has driven your addiction, and the pain which your addiction has caused. We strongly recommend looking at all of them, and honestly assessing your personality and your needs before deciding on a course of treatment. Remember, there’s no harm in experimenting with different forms of therapy. If you have any questions about Naikan, kundalini yoga, or any of the other holistic options offered at Tabula Rasa Retreat, don’t hesitate to get in touch!
2nd December 2020 • Sticky Post
Equine-Assisted Therapy: 5 Benefits You Might Not Know About
The bond between humans and horses has always been strong. People and horses have shared mutual understanding and sympathy over the centuries. Because horses are naturally sensitive and intuitive animals, their ability to mirror moods and behavior can make them ideal companions. Ancient authorities going as far back as Hippocrates have touted the health benefits that can be obtained by regular interactions with horses, and the science behind Equine-Assisted Therapy dates back to French neurologist Charles Chassaignac, whose 1875 study found a variety of benefits derived from regular riding, including improved balance, joint function, muscle tone, and mood. The practice continued to gain steam in the years following the First World War when Oxford Hospital introduced a therapeutic riding program for those injured in the Great War. Equine-Assisted Therapy has continued to develop since then. Let’s take a look at 5 benefits Equine-Assisted Therapy can offer to those suffering from a variety of ailments.
1) Equine-Assisted Exercise
Riding a horse moves the body in a way that’s physically similar to the human gait. It is wonderful exercise for people with physical challenges that limit their ability to partake in vigorous physical activity. PATH (Professional Association of Therapeutic Horsemanship) has found that equine therapy can create improvement in flexibility, balance, and muscle strength. Scientific studies have shown a host of physical benefits from riding for individuals with cerebral palsy, Down syndrome, multiple sclerosis, spinal cord injuries, amputees, and those recovering from strokes. A host of studies have illustrated the benefits Equine Assisted Therapy can offer in terms of gaining or recovering mobility and motor skills.
2) Emotional Healing
As anyone who has interacted with horses knows, they are sensitive, intuitive animals capable of picking up on our emotional state and responding to it appropriately. As EAGALA, one of the leading Equine-Assisted Therapy organizations notes, horses can intuitively read our body language, behavior, and tone of voice to determine our emotional state. Their responses are often more honest and instinctive than what other human beings offer in response to our behavior. This can give us valuable feedback on our own emotional states, and the ways in which our emotions affect those around us.
Riding can also teach us how to co-operate and engage more fully with the people in our lives. Horses are large and powerful creatures. They also all have different personalities, traits, and desires that we must learn in order to have successful relationships with them. When we interact with horses, we quickly learn the limits of our ability to control them, and we enter into a dialogue where we must engage and persuade rather than simply command. This experience can offer us valuable insights into our relationships with the people in our lives.
3) Overcoming PTSD
PTSD is a crippling ailment that often goes hand in hand with addiction. Anxiety, panic attacks, insomnia, nightmares, and depression are just some of the symptoms of this disorder. But recent studies have discovered that, like household pets, horses can have a strong positive effect on PTSD sufferers. Researchers in the UK discovered that Equine-Assisted Therapy reduced the PTSD scores for 87.5% of those studied after just six weeks. Both horses and PTSD sufferers are hyper-vigilant to their environments, and learning to build a shared sense of trust is incredibly helpful for those with PTSD. As Margaret Steele, wife of an American military officer and advocate for EAT who has watched many combat veterans benefit from the therapy notes: “It is impossible for an individual suffering from PTSD to work with a horse since the horse reads all of these emotions in you and will start to emulate them. This causes the client to have to work on their own issues to make progress with the horse. In a sense, the horse works like a mirror.”
4) Coping With Anxiety
Millions of people around the world suffer from anxiety, and most of them suffer from intense worries about the past, and fears about their future. We’ve written before about how focusing on mindfulness and the present moment can offer relief from these symptoms of anxiety disorders. Equine therapy is a fantastic tool for learning how to be mindful, since interactions with horses force the patient to focus intently on the animal’s actions and reactions rather than their own thoughts. Because horses are hyper-alert, and always instinctively prepared to flee from danger, a natural sense of sympathy arises. As experts note, “Processing challenges through the behavior of the horse can be easier for clients than speaking directly about their own personal experiences with anxiety.” Equine therapy often allows the anxious to process experiences and practice vulnerability in a safe and trusting environment.
5) Healing Addictions
We’ve written before about the close relationships between trauma, anxiety, and addiction. Equine-Assisted Therapy can help the addicted by helping to ease their suffering from past trauma and present anxiety. But it has another massive benefit in that it can rebuild the sense of trust and feelings of self-worth that have been eroded by the isolating, debilitating affliction. Most addicts have isolated themselves from loved ones and destroyed their self-esteem through years of destructive behavior and negative thoughts. In order to heal, they must learn how to conduct healthy relationships with others, and horses can be an ideal teacher for these lessons.
In many cases, non-verbal communication is an easier place to start re-learning how to express yourself honestly and build trust with others. Because horses are intuitive, non-judgmental, and honest creatures, they will always provide excellent feedback on what you’re communicating to the world. If you’re tense, jumpy, or irritable, they’ll let you know. They can offer extremely valuable advice on how to communicate effectively, regulate moods and emotions, and build positive communication skills.
At Iboga Tree Healing House we believe that Equine-Assisted Therapy can offer invaluable benefits to people suffering from a great many disorders. It’s a wonderful complement to addiction treatment and traditional psychotherapy because it offers clients the ability to learn through experience and develop emotional skills that can’t be cultivated by mere words. If you have any questions about exploring the power of this form of therapy, don’t hesitate to get in touch!
6th November 2020 • Sticky Post
Understanding Psilocybin Therapy
The use of psychedelics in treating all manner of mental illnesses has been a hot topic in recent years. Scientists at prestigious institutions such as Johns Hopkins, New York University, the University of New Mexico, and Imperial College in London have conducted small but rigorous and controlled studies which have shown the immense potential of psilocybin therapy in dealing with depression, anxiety, and addiction. These studies have led to numerous books exploring the history and medical potential of psychedelics to change and heal the mind, most notably best-selling American author Michael Pollan’s “How To Change Your Mind.”
As momentum has built, a number of jurisdictions have decriminalized the cultivation and possession of psilocybin (the active ingredient in “magic mushrooms”), notably the major American cities of Oakland, California, and Denver, Colorado. 2020 will also see voters in Oregon and California decide on whether to legalize the substance throughout their states. Many psychologists, physicians, and people afflicted with mental illnesses are eager to take advantage of the benefits offered by this remarkable plant. As Mr. Pollan puts it:
a single psilocybin trip guided by trained professionals has the potential to relieve “existential distress” in cancer patients; break addictions to cigarettes, alcohol, and cocaine; and bring relief to people struggling with depression. Psychiatry’s current drugs for treating these disorders are limited in their effectiveness, often addictive, address only symptoms, and can come with serious side effects. Thus, the prospect of psychedelic medicine is raising hopes of a badly needed revolution in mental health care.
Psilocybin Treatment: The Process
Understanding Psilocybin Treatment
While there isn’t currently an established model for psilocybin treatment, most of the studies conducted thus far have patients use the substance in a controlled environment, supervised by a psychologist who guides them through the experience. The Imperial College study on depression offered patients a 25-milligram capsule of psilocybin, which is a substantial dose. They were placed in a room with a bed, surrounded with flowers and candles, and guided through traumas, significant past events, and formative memories.
A study at the University of New Mexico on psilocybin therapy for alcohol addiction offered participants four weeks of traditional psychotherapy, before giving them a dose of psilocybin in a quiet, comfortable room with male and female “co-therapists.” In this study, the therapists did little more than direct patients to “turn their attention inward” and go where their minds took them. This was followed by four more weeks of psychotherapy, another psilocybin session, and a final bout of traditional therapy.
As one participant noted, his experience wasn’t focused on his dependence on alcohol, but rather on the stresses, guilt, and happiness which his relationship with family members created. His recovery wasn’t motivated by a desire to avoid alcohol, but rather by the prospect of improving his relationships with loved ones. He reported being effortlessly abstinent for months afterward, before beginning to drink moderately once again but with “a conscientiousness he had never experienced with alcohol before.” Two years after the study his drinking remained under control, and he had repaired his marriage and relationships with his children.
Why is Psilocybin Treatment Effective?
Why is Psilocybin Treatment Effective?
While many countries are accelerating research into psilocybin therapy, no one is exactly sure why the treatment has proven to be so effective. Nonetheless, there are a number of compelling theories as to why it works. Serotonin is often cited as one possible key to the effects of psilocybin, as the substance causes “downregulation” of the serotonin system, which can result in reduced impulsivity and improved mood. But changes to serotonin typically last for just one week, so the longer-term benefits of the treatment must derive from a different source.
Michael Bogenschutz, the lead investigator in the University of New Mexico alcohol trial, posits the view that exposure to psychedelics and oneirogenics can create a phenomenon that mirrors the long-tail effects of PTSD. As he puts it:
"there's a whole process that happens when a toxic memory is seared into the brain. The only physical effect is probably light hitting the eyes. It's the meaning made of that memory, and the brain and body's reaction to the meaning, that can cause lasting damage. So if there are experiences that are so toxic and so horrible that they can cause physical and psychological damage, it's not a crazy idea that there are some experiences that are so positive, so beneficial that they can have a healing effect."
Other researchers point to the concept of “ego death” that has long been associated with psychedelics. Robin Carhartt-Harris, a researcher at Imperial College, notes that psilocybin reduces activity in the brain’s “default mode network”, a collection of brain regions and neurotransmitters that are believed to construct an independent self and place it at the center of perceptions and experiences. Psychedelics help individuals to pay less attention to the self, breaking down walls and facilitating connections. Since many depressed and addicted people are plagued with a deep and abiding sense of isolation from others, this can feel like a dramatic escape from a mental prison. Many of the participants in these studies reported that psilocybin dramatically reduced their sense of alienation.
Another theory is that the therapy increases neuroplasticity, changing and reshaping neurons in the brain. This remodeling of cells is the basis of all learning, and substances like psilocybin and iboga have been proven to improve neuroplasticity. Addiction, anxiety, trauma, and depression can create negative changes in brain chemistry, as the mind learns to take pleasure or stress from external cues. Psilocybin seems to help restore the brain to a pre-addicted state.
Psilocybin Treatment: Safety Concerns
Psilocybin Treatment: Safety Concerns
While psilocybin therapy has shown immense promise to heal mental wounds, we would strongly recommend restricting its use to a clinical setting. There are physical and psychological risks that go hand in hand with the benefits of psychedelic therapies, and in many jurisdictions, you can be arrested and incarcerated for use or possession of these substances. Michael Pollan notes that in all societies that used psychedelic substances, ranging from the Amazon to ancient Greece, they were always used with “deliberateness and care.” He writes that these substances “were not taken alone but usually in a group under the direction of an elder or shaman familiar with the mental territory, and they were used only on certain occasions, surrounded by ritual and with a clear intention. There was nothing casual about it.” All would be wise to maintain this level of caution as they experiment with their immense potential.
To find out more about what psilocybin therapy can do for you, contact us now!
2nd September 2020 • Sticky Post
Group Therapy, and Why It Works
The idea that human beings are social creatures who can only find fulfillment by connecting with others is at least 2500 years old. The idea that “society precedes the individual”, or that the group is greater than its individual members is a part of most spiritual traditions, including Buddhism, Confucianism, and Hinduism. In the West, Aristotle first popularized the idea that an individual who didn’t need the society of his fellows was either something more - or less - than human. These ideas are reflected in the importance of the family as a building block for society, which is a component of practically every religion, philosophy, and sociological theory. We are stronger, happier, and healthier together than we are in isolation. Some of life’s greatest blessings are, as the poet William Cowper put it “Society friendship and love/Divinely bestow’d upon man.”
Group Therapy: Theory And Benefits
The benefits of fellowship and belonging are undeniable, and group therapy is an attempt to bring those benefits to people suffering from a variety of mental illnesses. For those recovering from addictions, the need for such support and fellowship is even more pressing. That’s why here at Tabula Rasa Retreat we have built our own ibogaine-specific fellowship community, known as the Ibogaine recovery Movement, or IRM. The therapeutic benefits of fellowship and community support for those coping with addiction and mental illness cannot be overstated. Irvin D. Yalom, author of the seminal 1970 work “The Theory and Practice of Group Psychotherapy”, outlines the key therapeutic principles at work:
- Instilling hope: Groups will contain members at various stages of the treatment process. Encountering people who have learned to cope or recover offers hope to those beginning the process.
- Universality: Joining a group of people who have shared similar experiences helps individuals to see that what they are dealing with is universal and that they are not uniquely troubled or isolated.
- Imparting information: Members of the group can help each other by sharing useful information and strategies.
- Giving back: Members of the group can share their strengths to help others, boosting confidence and self-esteem.
- Exploring the role of family, and dealing with family issues: Therapy groups are like a family in many ways. Within the group, members will explore how formative experiences contribute to personality and behavior. This can teach members to avoid habits, patterns, and behaviors that are destructive and self-defeating in life.
- Learning healthy ways to socialize: The group is an ideal place to work on new habits and behaviors. In a safe and supportive setting, group members can experiment without the fear of failure.
- Imitating behaviors: Participants can model the actions, habits, and behaviors of other members, or watch and attempt to mimic the behavior of the therapist.
- Interpersonal learning: By conversing and interacting with other people while receiving feedback from their fellows and the therapist, those in the group can reach a greater knowledge of themselves.
- Group cohesion: Because members in a group are united in striving towards a common goal, members will benefit from a sense of acceptance and belonging.
- Catharsis: Sharing difficult emotions and traumatic experiences with a group of one’s peers can help one to let go of pain, guilt, or stress.
- Existential development: Being a member of a group can offer support and guidance, but group therapy also helps participants realize that they are ultimately responsible for their own lives, actions, and choices.
Group Therapy and Addiction
Addiction isolates the addict from friends, family, and the rest of society. It also alienates sufferers from their own true selves. One of the most powerful and fundamental benefits of group therapy is that it offers a respite from this isolation. Fellowships like the Anonymous family of 12 Step groups or the Cognitive Behavioral Therapy oriented Smart Recovery can offer addicts an easy path towards building intimate and meaningful connections with others, a vital building block towards recovering lost senses of self-awareness and self-esteem.
Building bonds and friendships based on trust and mutual support is, we would argue, necessary for recovery. Working with others restores our strength, offers us insight into our own struggles, and allows us to reawaken the qualities, skills, and compassion that have long lain dormant. There’s a reason why 12 Step fellowships are ubiquitous with recovery: there truly is strength in numbers.
Alternatives to Traditional Group Therapy
12 Step groups are amazing, but they don’t work for every single person struggling with addiction. And it’s important to be aware of the alternatives that are out there, particularly if you’ve already struggled within the confines of their rules and strictures. In Smart Recovery, the locus of control is placed on the individual, rather than a higher power, and the participant is encouraged to tailor the program to their own emotional, psychological, and other needs. The meetings also differ in that Smart Recovery Meetings are led by a professional therapist, while AA and NA meetings are led by a variety of peers. Also, “cross-talk” (the discussion of what another member has shared with the group) isn’t allowed in AA and NA meetings, but is encouraged in Smart Recovery. In spite of significant differences in approach, each system offers those in recovery a myriad of benefits. We’d recommend that everyone experiment with each, and choose the one that suits them.
But meetings and fellowships aren’t the only ways to access the power of the many. At Iboga Tree Healing House, we take a holistic approach to therapy, and we’ve seen our clients respond positively to a number of practices and activities which unlock the benefits of group therapy. Daily check-ins and sharing circles are a great way to help our clients realize that many of the seemingly intractable problems caused by addiction can be overcome and that the struggles they’re experiencing are universal. Breathwork and daily mindfulness practice also help to foster a sense of connection and community among those in treatment, while teaching the skills that enable us to listen to others and to ourselves.
Treatment and group therapy can offer those in recovery a surrogate family, a group where they can re-learn communication skills, and co-operate to overcome the difficulties of withdrawal and the struggle to remain sober. We’re also committed to bringing the families of our clients on board throughout the treatment process, in order to provide support, facilitate reconciliation, and allow individuals in recovery to use all that they’ve learned about healthy relationships to cultivate them with the people most important in their lives!
4th October 2019 • Sticky Post
What is Cognitive Behavioral Therapy?
When we picture psychotherapy or counseling, we often tend to conjure up a Freudian therapist in our mind’s eye. The patient lying on a leather couch and delving deep into their childhood memories and traumas. The psychiatrist asking in a sonorous baritone, “How did that make you feel?”. But for most patients, particularly those partaking in therapy as part of an addiction recovery program, the reality of addiction treatment is completely different from our preconceived notions. Today we’ll be taking a look at Cognitive Behavioral Therapy (CBT), and the benefits it can offer to individuals struggling with addiction.
The History Of CBT
CBT has its roots in two intellectual traditions. The first, Stoicism, has been cited as an inspiration by two of the pioneering psychologists whose theories and findings led to the creation of modern CBT (Dr. Albert Ellis and Dr. Aaron Beck). A quote from the ancient Roman philosopher Epictetus sums up a core belief: “men are disturbed not by things, but the view they take of them,” meaning that the way in which we think (cognition) determines the way we react, feel, and behave.
The second intellectual tradition to inspire CBT was Behaviorism, a school popularized by Pavlov and Skinner. The behaviorists would claim that behavior could be learned or unlearned depending on the consequences associated with it and that the best method of intervening with psychological problems was to focus on shaping healthier behavioral patterns.
In the 1960s Drs. Ellis (Rational Emotive Behavior Therapy or REBT) and Beck (Cognitive Therapy or CT) developed therapeutic approaches that would gain popularity throughout the coming decades. Both psychologists “emphasized the role of cognitions or beliefs as underlying emotional and behavioral disturbance”, and a movement was born. By the 1990s, elements of each system had been woven together by therapy practitioners under the umbrella of cognitive behavioral therapy.
How Cognitive Behavioral Therapy Works
One of the first steps in cognitive behavioral therapy, according to the NHS, is to “help you deal with overwhelming problems in a more positive way by breaking them down into smaller parts.” A cognitive behavioral therapy practitioner will try to guide you through the process of changing negative patterns in both thought and behavior to improve the way you feel. Rather than focusing on painful memories or past traumas, cognitive behavioral therapy aims to deal with your current problems and behaviors on a daily basis.
Most patients who partake in cognitive behavioral therapy will have a treatment session lasting from 30-60 minutes once every week or two. The NHS recommends 5-20 sessions during the course of treatment, depending on the severity of your problems. During treatment, your therapist will work with you to isolate the components of your psychological or physical issue, separating thoughts, physical feelings, and actions. Your therapist will then work with you to determine the interactions between these separate parts of your issue, and try to distinguish between thoughts and behaviors that are realistic and helpful and those that are not.
At this point, you and your therapist will work to begin the process of changing negative or harmful thoughts and behaviors. The aim of the therapist is to provide you with skills that you can use to manage problematic thoughts and behaviors in real-life. After therapy concludes, you should have the ability to manage your issues and stop them from having substantial negative impacts.
Cognitive Behavioral Therapy and Addiction
Addiction in itself is a negative and self-destructive form of behavior. It is self-reinforcing, creates anxiety and depression, and leads the addict to the self-defeating conclusion that they cannot function without the substance that they habitually use. Cognitive behavioral therapy helps those in recovery to break free from these harmful patterns of thought and action. It breaks down the seemingly insurmountable affliction into individual parts and offers skills and strategies for dealing with them in positive ways.
Cognitive behavioral therapyoffers addicts tools for assessing the accuracy and reliability of their thoughts. Practically, this is an excellent way to build your ability to resist cravings. Sometimes, asking yourself if a drink or drug is actually the best way to deal with a trigger or stressful situation is all it takes to avoid using. Similarly, as you develop mental skills for handling triggers, you can become confident in your ability to deal with cravings and bouts of anxiety, rather than attempting to make them go away with substance use. Cognitive behavioral therapy employs “habituation”, the idea that experiencing difficult feelings and situations without compensating (having a drink or using a drug) or fleeing can teach you that your anxieties are manageable and will become less intense over time.
Cognitive behavioral therapy also helps you to explore your emotions. Through it, you can come to terms with the way you’re feeling, and how those feelings impact thoughts and actions. Knowing that you’re scared, angry or sad can help you to recognize that the thoughts currently running through your mind should be handled with care, and not immediately acted upon. A key facet of cognitive behavioral therapy is “emotional regulation,” a concept defined by some practitioners as “ 1) the ability to shift attention away from the things that are likely to kick up intense negative emotions, such as sadness, anger, shame, and anxiety; 2) the ability to inhibit acting on an emotion when desired; and 3) the ability to decrease the intensity of emotions without drugs and alcohol.” This skill is exceptionally helpful for individuals in recovery!
Following detox and withdrawal, we would strongly recommend that you explore Cognitive behavioral therapy as a way to build the skills you need on the journey to recovery. One way to take advantage of what it can offer is to try out SMART Recovery programs, based on the REBT methodology. Along with evidence-backed holistic practices such as mindfulness and meditation, Cognitive behavioral therapy is a way to get in touch with your true self and learn to manage the stresses and trials of sober living. If you’re interested in putting these principles to work, get in touch with Iboga Tree Healing House today!
5th September 2019 • Sticky Post
Iboga Therapy: Here's What We've Learned
Back in January of this year, experienced iboga aficionado and Global Ibogaine Therapy Alliance Executive Director Jeremy Weate sat down with Third Wave to discuss important lessons learned during the opening of our premiere ibogaine treatment facility in Portugal.
Having experienced the realities of providing Iboga treatment to persons in varied states of physical/mental health, and knowing the dangers inherent in our chosen field, we felt, it was worth recounting the hard-won lessons we’ve learned for all those who might follow in our footsteps.
That’s why we’ve decided to revisit 7 of the most important lessons we’ve learned with Iboga Tree Healing House Founder Alvaro De Ferranti to delve a little bit deeper into what administering iboga to dozens of clients has taught us thus far, and how we have learned to address each issue to minimize the risk.
1) Safety
Nothing is more important than the safety of our clients. There are often difficult choices to be faced in determining iboga dosage. Experience has taught us that conservative dosing is a must, even if clients are sometimes disappointed in the lack of a visionary experience. We feel that every death associated with Iboga use has been preventable, and we will do whatever it takes to keep our clients alive and well.
How do we at Iboga Tree Healing House determine ibogaine dosage for our clients? We’ll let Alvaro take it from here:
“There are recommended doses in the GITA literature (www.ibogainealliance.com) which we use as a guideline. We tend to dose women less than men, and clients in poor physical shape less than those who are in good form. However, dosing has a lot to do with factors that go well beyond body weight which tends to be the standard marker for dosing. We look at the individual holistically. We aim to understand their whole physical condition, their medical history, their family medical history, their experience (if any, with entheogens), the substance(s) they consume, and of course their psychological state. Safety being our priority, dosing, although medical in its approach, is intuitive, and only experience can forge this relationship with our dosing regimen."
2) Emergency Planning
Emergency planning is vital. We at ITHH quickly learned the importance of thoroughly going through our emergency plan before treating every single client. If a cardiac incident occurs, every second is vital, and we need to be ready to jump into action. It doesn’t feel good to call an ambulance, but we’d rather call a million ambulances than a single hearse. The Iboga community is understandably anxious about publicizing adverse health outcomes, but medicalization, regulation, and legitimization should be our goals, and transparency is the best way to achieve them.
Here’s how Alvaro and Iboga Tree Healing House's medical staff have planned for potential emergencies to ensure that we are prepared for any medical eventuality:
“Safety being our primary concern, we take emergency planning very seriously. On treatment day, we undertake an emergency drill as if it were our very first drill. We do this without fail. The on-duty team get together, each person is handed a role, and we act out our emergency plan. Whenever we have had any issues, our emergency plan has kicked in and we have managed to avert disaster. We will never compromise on the importance of our emergency plan. The planning is client-centric and starts well before this drill. By this time, we understand the client fully, and are clear on what issues we may face, and as a result, we prepare accordingly.
In the room, we have a continuous heart monitor, defibrillator, pacer, oxygen, oximeter, blood pressure measuring machine, supporting oral and iv medication (like diazepam), crash cart, and all ACLS medication and supporting items like geddels for non-invasive assisted breathing.
We have safety covered.”
3) Cautious Dosing
Flood dosing does not work for everyone. Some brains and bodies can withstand a heavy dose of iboga (20mg/kg and up) but others can’t. Re-setting the addicted brain doesn’t require a flood dose, and you can experience the benefits of treatment without taking unnecessary risks.
Here’s why we at Iboga Tree Healing House always defer to qualified medical staff when determining iboga dosage, regardless of what clients might request:
“Clients do not determine doses. This is a medical decision. I must stress, that even if a client has had an iboga flood in the past, it doesn’t necessarily mean they will react the same way as their previous time, and they may well not be suitable for a flood the next time around. Again, experience will determine what is best.”
4) Honesty
It’s important to be realistic and honest about what Iboga can and can’t do. Like many in the community, we’ve been outspoken advocates for Iboga’s utility in treating addiction. But we’ve learned that it’s essential to let our clients know that Iboga is an addiction interrupter and not a cure. We always emphasize that other tools are necessary to maintain recovery over the long term. We are also aware that the iboga journey is not widely understood, and that misinformation about iboga is all too common. While skepticism is often indeed a healthy reaction to a new idea, it can also hold one back at times. At Iboga Tree Healing House, we’ve learned to provide all the information we can and let our prospective clients make their own decisions about whether our program is right for them.
Here’s how we address fear-based skepticism about iboga treatment:
“Skepticism is often based on fear. Fear of the unknown. We provide tools and information to help clients get over their fears. By the time we have helped the client understand their pending ‘initiation’, skepticism is a faded memory. We have never treated anyone who was a skeptic by the time they entered the doors of Iboga Tree Healing House. We have several testimonials online to vouch for the effectiveness of our program. Iboga is one of many tools we use to help people move forward in their lives, to help them discover the deep-rooted issues that trigger their addictions, and their self-limiting beliefs, and help remove those blockages to open up the door to the ‘good life’.”
5) The Holistic Way
Experience has taught us that we can fight addiction most effectively by combining Iboga treatment with holistic therapies and conventional modalities. We’ve seen firsthand the benefits of talk therapy and peer support, and while we’re enthusiastic proponents of energetic, holistic treatments and Iboga therapy, we feel that combining all three methods is the most effective way to end the cycle of addiction. Taking iboga by itself and shirking the other aspects of a robust, holistic recovery plan will accomplish very little.
Here’s how a holistic program of recovery can help to ensure long-term recovery:
“Often, the lingering memories of a client’s stay at Iboga Tree Healing House revolve around what happened in the therapy room and beyond. Our therapies, even if there may have been resistance at the beginning, are the disciplines clients take home with them, not just as memories, but to implement into their essential daily practice, their lifeline.”
6) Preparation
Pre-treatment is an essential building block for success. We’ve learned that postponing treatment when our clients aren’t ready is a necessary step for achieving positive results. We employ a narrative approach to lead our clients away from their addicted selves and portray the iboga experience as a hero’s journey. We feel this helps clients establish and entrench their vision of a substance-free life and gives them their best chance at success.
Here’s why Alvaro believes pre-treatment to be an integral aspect of any successful iboga treatment experience:
“Pre-treatment therapy, although not a mandatory prerequisite to join our program, it is an essential component for the client to get the most out of their Iboga treatment. As we’ve said many times, Iboga is not an instant cure-all but is the most profound catalyst to change. It is unrivaled in its ability to take away withdrawals and create a pre-addicted state brain reset, however, its success is dependent on how one prepares for and integrates the ibogaine experience. Pre-therapy is conducted by our in-house therapy team. We know, those that undertake pre-treatment, are more likely to benefit from the experience.”
7) Aftercare
The importance of aftercare for those who’ve completed iboga treatment cannot be overemphasized. One of our favorite parts of conventional addiction treatment is the fellowship and peer support created by 12 Step group meetings and mentorships. We’ve tried to build a similar structure with our own weekly support meetings. Our goal is to build and sustain a self-supporting community of people who have recovered through Iboga.
Here’s how 12-step fellowships can help to keep one’s recovery journey on the right path:
“During their time at Iboga Tree Healing House, clients are informed on what support groups are out there. From 12 Steps to SMART (there are so many these days). We don’t recommend it, we simply inform of what is on offer. Support is support, if it works for you, then great, if it doesn’t, look for another group or organization. We help them research which fellowships are available close to home so they can hit the ground running. Other than this, every client is invited to join the IRM for life. The IRM is our very own online fellowship, the Ibogaine Recovery Movement. And, like all grassroots movements, it is building momentum.”
It’s worth noting, however, that Iboga remains stigmatized in many 12-step circles, something Alvaro hopes will change in the very near future:
“Some of our clients have indeed suffered from skepticism, judgment, and hostility at 12 Step and SMART meetings. Unfortunately, some attendees are rather closed-minded. I’ve found, however, that if you persist, keep showing up, share your story, gradually it all turns to acceptance.
Funnily enough, I got sacked by my one and only NA sponsor for not informing him that I had taken a ‘drug’ to get off drugs. Little did he know, Iboga is not a drug, it’s a medicine. At the time I was full of resentment, but now I understand that education is so important, and slowly slowly, some of the more closed groups will gradually open up. It won’t be long before there is an ‘iboga initiate’ in every meeting! This is why we are exhibiting at the iCCAD conference in London, to educate, to inform, to make some noise!”
Iboga Tree Healing House (Alvaro’s 2 cents) 
“Tabula Rasa Retreat is not just an Ibogaine treatment centre, it is so much more. We have worked tirelessly, from first-hand addiction experiences to in-depth medical research, to speaking to leading experts around the world, to learning on the job, to find that magic formula. We discovered, there is no magic formula! Addiction is a complex disease and requires tackling from multiple angles. As mentioned earlier, Iboga is an important tool in the toolbox of addiction treatment. As we research further and learn more, we will keep adding to that box. Not one client is the same; it makes perfect sense that a bespoke approach is required to help in the best way we can. We never rest on our laurels.”
29th April 2019
What You Need to Know About Iboga Therapy
If you’re here, you’ve probably heard about Iboga’s remarkable utility in treating all manner of addictions. You’re curious about how this substance works, and concerned about the risks associated with a psychoactive substance that’s illegal in some countries.
If you’re looking to know more about the fascinating history of Iboga, click here, but if you’d like to learn everything you need to know about Ibogaine’s use in treating addiction, keep reading!
How It Works
Iboga’s powerful addiction treatment properties were discovered by an American named Howard Lotsof. As a 19-year-old addict, Mr. Lotsof experimented with psychedelic substances to treat his addiction and discovered that a single dose of Iboga brought an end to the physical symptoms of heroin withdrawal, and dramatically reduced his cravings for drugs. What did it feel like? In the words of one recovered addict:
"As it starts to take effect I feel an intense wave of energy emanating from the center of my chest that permeates my entire body. This euphoric state also brings me instantaneous relief from the discomfort I was feeling after going without heroin for almost 24 hours.
With my withdrawal symptoms completely gone, I am perplexed by the state of clarity I am in while seeing the most profound stream of visual phenomena. I am also filled with a sense of awe at the potential for a life free of heroin. Emotional memories force me to deal with some of the deep subconscious guilt I have repressed for years.
This powerful state persisted for over 12 hours. After remaining at the clinic for a week I was allowed to return home and over the next six months felt almost no cravings whatsoever."
While scientists are not exactly sure how Iboga works, they know it interacts with sigma receptors and 5-HT2A receptors in the brain. Sigma receptors are “opioid receptors” that are activated by drugs like heroin. Researchers theorize that Iboga lightly stimulates them, helping to ease withdrawal symptoms, much like how a nicotine patch helps smokers treat nicotine withdrawal. 5-HT2A receptors are the ones typically activated by psychedelic drugs, and it’s believed that activating them helps to treat depression, while also disrupting thought patterns, allowing the user freedom to break free from negative thoughts and self-destructive patterns of behaviour.
Iboga has been proven to successfully disrupt addiction for a period of 3-6 months for individuals who habitually use opioids, opiates, and stimulants. It resets the brain to a pre-addiction state, and helps cleanse all traces of drugs from your body. However, it is not a magic bullet for treating addiction, and those who hope to lead healthy lives must put in the work to prepare themselves for a life free from addiction. For those addicted to Benzos and alcohol, Iboga therapy can provide substantial benefits, but it cannot help with the withdrawal process.
Iboga use: the risks
Iboga use is not without its risks. We certainly don’t want to sugar-coat the fact that there have been some deaths associated with iboga therapy. Between 1990 and 2008 a total of 19 deaths were associated with Iboga use, and the rate of death during treatment episodes was 1 in 427 (for comparison, the rate of death in Methadone treatment was 1 in 364). Deaths during treatment have mainly been associated with bradycardia (slowing of the heart), liver problems, seizures, and lethal interactions with other substances. Another thing to consider is that Iboga therapy generally restores addicts to a “novice state”, meaning that following treatment their tolerance for substances is significantly lower than it had been, thus increasing the risk of overdose.
So yes, Iboga therapy carries significant risks. But should these risks stop people from seeking it out? The first thing to bear in mind is the dangerous nature of addiction. In the United States, 115 people die every day from the misuse of opiates and opioids. And overdoses are on the rise, in fact, they increased a full 54% in American cities during 2017, according to government studies. Not to mention the fact that drug users suffer from diseases like HIV and Hepatitis at far greater rates than the general population. Individuals suffering from a substance use disorder are 4 times more likely to die from unnatural causes than the average person.
The dangers of heroin addiction are so horrifying that the risk of using Methadone, a treatment associated with a higher rate of death than Iboga, is considered acceptable by doctors and governments the world over. And when comparing the risks of Iboga and Methadone, it should be noted that many of the deaths associated with Iboga use have occurred when the drug was self-administered and used without any degree of medical supervision. Methadone treatment, in spite of being prescribed and administered by medical professionals, is still more dangerous than Iboga!
Iboga safety
While risks are inherent in any treatment of addiction, many of them can be minimized, or even eliminated by taking proper precautions. With Iboga, the first step is to find out if it is safe for you.
Individuals suffering from heart defects and other heart problems are at the greatest risk. Those with impaired liver or kidney function, some psychological disorders, and epilepsy should probably avoid using Iboga. You can see our inclusion and exclusion criteria here, and while we are firm believers in the efficacy of Iboga therapy, we recognize that it can’t work for everyone.
At Iboga Tree Healing House, we provide you with the safest possible setting for Iboga therapy. Unlike the vast majority of Iboga clinics, we have a medical doctor in-house, rather than on-call or at a nearby hospital. We have a nursing team that is based on a 1:1 nurse per patient ratio. We insist on taking a full medical history prior to treatment, as well as a full set of lab results including a full blood panel, liver function analysis, ECG/EKG and more. We also monitor our patients with an EKG machine during treatment. Furthermore, every member of our medical team is ACLS certified by the American Heart Association.
The safety of our clients is our number one priority, and we feel that by taking every precaution, we can offer Iboga therapy that minimizes the health problems associated with treatment and eliminates the risk of death.
