Herren Wellness Curriculum : simplebooklet.com

About Marijuana Marijuana is complex chemically and not yet fully understood, but it is not a narcotic. Like alcohol, marijuana acts as both stimulant and depressant, but it lingers in body organs longer than alcohol. Smoking marijuana can injure mucosal tissue and may have more carcinogenic potential than tobacco. Research has indicated that marijuana intoxication hinders attention, long-term memory storage, and psychomotor skills involved in driving a car or flying a plane. Expectations and experience with marijuana have often influenced results more than pharmacological aspects have. Marijuana has triggered psychotic episodes in those more vulnerable. Psychological and some instances of physiological dependence on marijuana have been demonstrated. As a psychoactive drug, marijuana surely alters mental functioning. It is possible that chronic use of marijuana produces irreversible damage to mind or brain areas. Marijuana is a preparation of leafy material from the Cannabis plant that is usually smoked ● There are 3 different species found in the US ○ Cannabis sativa - used primarily for production of fibers (hemp) - tall and lanky ○ Cannabis indica - grown for psychoactive resins - shorter and bushier ○ The potency of plant resins (concentration of active ingredient) varies greatly with each plant and the environment in which it grows. Active Ingredient in Action ● THC (delta-9-tetrahydrocannabinol) ○ Concentrated in the resin of the plant, which is mostly found in the flowering tops of the plant (less in leaves and stalks) ○ “Standard” MJ prep is about 3-6% THC ● When concentrated, the resin can be collected to form hashish ○ Percentage THC in hashish about 20% ● Alternate preparation of marijuana: Sinsemilla ○ Remove male plants from fields so female plants aren't pollinated, and no energy is put into seed production (THC at about 11%) Pharmacology ● After smoking ○ THC is absorbed rapidly by the blood and travels to the brain and then the rest of the body ○ Peak mood-altering and cardiovascular effects occur within 5 to 10 minutes ● After oral administration ○ THC is absorbed more slowly ○ Peak effects occur about 90 minutes following ingestion

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● Metabolism ○ THC has a half-life of 19 hours ○ Complete elimination of THC and its metabolites may take 2-3 weeks  Can take up to or over a month depending on body fat ○ Leads to activation of cannabinoid in CNS: many in hippocampus, amygdala, and orbitofrontal cortex: hypothalamus ○ Because it produces relaxation and a “high” it secondarily stimulates the reward circuit. Behavioral Effects ● Subjective effects ○ Euphoria, “high,” mellowness, hunger and stimulation ○ Infrequent users experience similar but more intense effects compared with inexperienced smokers ○ At high THC concentrations, infrequent users may report negative effects such as mild paranoia ● Food Intake ○ Marijuana and oral THC significantly increase total daily calorie intake ● Verbal behavior ○ Verbal exchanges decrease ○ Nonverbal social interactions increase ● Memory Deficits ○ Impaired motor coordination and muscle tone ○ A-motivational syndrome: lack of motivation to engage in productive activities possibly related to cannabis use ○ Studies that investigated this hypothesis either revealed no effects on motivation or found an increase in motivation Cannabinoid Tolerance and Dependence ● Study by Georgotas and Zeidenberg (1979) ○ Tolerance to cannabis ○ Participants increased cannabis usage over four-week span in order to achieve desired effects of drug ● Dependence to cannabis ○ After stopping cannabis use, participants were irritable, uncooperative, resistant, and hostile; also lost appetite and had difficulty sleeping Health ● Cannabis cigarettes share several carcinogens with tobacco cigarettes ● Aside from cancer risk, cannabis smoking may increase the risk of respiratory diseases such as bronchitis and emphysema

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CBD vs.THC Cannabidiol, or CBD, is a non-psychoactive chemical compound found in cannabis. It is derived from hemp or marijuana, but more commonly derived from hemp. CBD binds very weakly to CB1 receptors. CBD needs THC to bind to the CB1 receptor and can reduce some unwanted psychoactive effects of THC, such as paranoia and anxiety. Delta-9-tetrahydrocannabinol, or THC, is the psychoactive ingredient in cannabis. THC binds to the CB1 receptors in the brain activating the brain’s reward system by signaling the release of the brain chemical dopamine. Dopamine is a neurotransmitter related to mood and pleasure. THC releases higher than normal amounts of dopamine, resulting in the feelings of euphoria. Cannabis compounds engage with these receptors, but that doesn't mean they were designed specifically for cannabis. We have these receptors because the human body creates its own version of cannabis compounds called endocannabinoids which are a part of the endocannabinoid system. This system maintains homeostasis and encompasses the brain, endocrine, and immune systems, allowing it to be a “master regulator” in the body. THC blocks the cannabinoid receptors, disrupting the natural production of neurotransmitters and delivering messages that are almost the same, but not quite. This disruption is crucial for overall functioning- helping us think, move, feel, breathe, regulate emotions, and process surroundings.

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Rising Potency in THC Marijuana Although marijuana may be legal, advocates for legalization of medical and retail marijuana are unaware of the current high potency and the effects on the mind and body. THC levels in the 1960’s to 1980’s was less than 2%, where the current content has increased 212% between 1995 and 2015. We now have products (oil, dabs, edibles) containing 95% concentration. No research has indicated any benefit for medical use at this level of potency. The new agenda: create a product to produce a high, impacting the brain’s reward system resulting in the potentiality for addiction to arise. Marijuana is perceived as “organic” and “healthy” because society has normalized it’s use. Significant long-term consequences can arise with the use of marijuana in adolescence due to the brain’s development process. The prefrontal cortex takes approximately 25 to 30 years to fully develop and impacts impulse control and judgment. The long term and heavy use of high potency marijuana will hinder this crucial developmental process. The hippocampus is also affected which reinforces learning and memory. THC causes shrinkage of the hippocampus and impairs the ability to learn new information. However, recovery is possible and in a recovery environment, voluntary exercise will improve neurogenesis and allow the ability to learn new things. Exposure to THC during adolescence negatively impacts glutamate receptors during synaptic pruning, an important role in cognition and IQ levels. Multiple studies have shown an average loss of IQ points from exposure to persistent use of marijuana in teenage years. These points can mean the difference between making letter grades or more drastically, significant difficulty in mental functioning. “A study out of Yale University tracked 1,142 students who achieved similar SAT scores and were enrolled in college. They found that those who used menial alcohol or cannabis had an average GPA of 3.1 at the end of the semester. Those who drank alcohol without using marijuana had an average GPA of 3.03 and those who used both alcohol and marijuana had an average GPA of 2.66” Marijuana use is correlated with the worsening of mental health problem such as anxiety, depression, psychosis and suicidal ideation. The use of cannabis once a week is shown to double your chances of depression and anxiety compared to non-users. Using THC as a coping mechanism for depression and anxiety resulted in worsening symptoms of depression and anxiety and overall mental health. The risk of developing psychosis and other psychotic symptoms increase with the use of marijuana from ages 15 to 18 years of age. With high potency THC, you are three times more likely to develop psychosis and five times more likely with everyday use.

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Longitudinal studies show daily marijuana users were seven times more likely to attempt suicide compared to non-users. Colorado Health Department shows marijuana as the most frequent drug in toxicology reports in adolescence between ages 10 and 19 who have committed suicide. There is also evidence that the exposure of cannabis can alter opioid gene function in humans. What does this mean? The possibility of being exposed to opioids may result in higher drug seeking behaviors and more likely to become easily addicted if exposed to opioids. The “studies” show that marijuana is helpful for those suffering from PTSD and other traumatic life events. Marijuana is not the answer for PTSD just like benzodiazepines and alcohol are not the answer for PTSD. Much like marijuana used to “help” anxiety or depression, it is a band-aid offering temporary relief by numbing and disconnecting the individual from the emotional event, but does nothing to resolve the trauma. In reality, you get worsening symptoms; increased and worsening psychosis, addiction potential, withdrawal symptoms, cognitive impairment, memory distortions, and a-motivational syndrome. No research has found any benefit of any medical use of THC and marijuana at the potency that we are seeing today.

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2020-21 NCAA SUPPLEMENTS BANNED DRUG CLASSES The NCAA bans the following classes of drugs: a. Stimulants b. Anabolic agents c. Alcohol and beta blockers (banned for rifle only) d. Diuretics and other masking agents e. Narcotics f. Cannabinoids g. Peptide hormones, growth factors, related substances and mimetics h. Hormone and metabolic modulators i. Beta-2 agonists NOTE: Any substance that is chemically related to these classes is also banned. Examples in each banned substance class can be found at ncaa.org/drug testing. Substances and Methods Subject to Restrictions: A. Blood and gene doping. B. Local anesthetics (under some conditions) C. Manipulation of urine samples D. Tampering of urine samples E. Beta-2 agonists permitted only by prescription and inhalation. Commonly abused substances and their impact on athletic performance and eligibility. ALCOHOL: Alcohol is a nervous system depressant. At high dosages, effects include mood swings, impaired judgment and inability to control motor functions. Alcohol can impair an athlete’s performance through dehydration, depleting vital nutrients and interfering with restful sleep and recovery. TOBACCO: Tobacco contains nicotine, a stimulant, and a multitude of damaging chemicals. Smoking tobacco damages lung tissue and reduces lung capacity. Spit tobacco use contributes to soft-tissue inflammation in the mouth and increases the risk of oral cancer. Tobacco use in all forms is prohibited during practice and competition by student-athletes and game personnel, and may result in ejection from the game. CANNABINOIDS: Cannabinoids include cannabis and cannabinoid (CBD). Cannabis use is linked to anxiety, panic reactions, respiratory damage, short-term memory impairment and a decreased focus on goals and personal achievement. Cannabinoids are banned by the NCAA and can result in suspension.

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COCAINE: Cocaine is a stimulant that can contribute to agitation, elevated heart rate and increased blood pressure; toxic levels can result in respiratory failure and heart attack. Cocaine is an illegal substance and is banned by the NCAA. ANABOLIC STEROIDS: Anabolic steroids are synthetic versions of the male hormone testosterone. Anabolic steroid use changes the body’s hormonal balance, exaggerating male sex characteristics, and can contribute to increased acne, mood swings, secondary sex characteristic changes and violent behavior. Long-term heavy use has been implicated in organ damage. All anabolic steroids are banned by the NCAA. NARCOTICS: Narcotics 9pain killers0 block pain and cause sleepiness, and at higher doses affect breathing, heart rate and blood pressure. Narcotics are controlled substances banned by the NCAA and should be obtained only from qualified medical personnel through a prescription. STIMULANTS: This group of drugs includes a wide variety of chemicals, ranging from caffeine and ephedrine to Ritalin and Adderall (amphetamine). Stimulant misuse can cause anxiety, panic, paranoia and delusions. Stimulant use during exercise can contribute to increased body temperature and dehydration. Stimulants are banned by the

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Stress and Stress Management Stress exposure is a well-known risk factor in the development of addiction and relapse in addiction and enhances the possibility of self-drug administration. Signs that you're self-medicating from stress or pressure 1. You use to cope- when you are feeling anxious, stressed or depressed to improve how you feel, relieve boredom, or to “prepare” yourself for a social engagement. 2. Drugs and alcohol make you feel worse- temporary fixes- once the numbing effects have worn off you may feel worse resulting in worsening mood or increased substance use. 3. More and more self-medicating to gain relief- where once it took just one or two to ease your anxiety or de-stress, now it takes three, four or even more. Increased tolerance meaning you need more to experience the same. 4. Your problems are multiplying- drinking to cope with the stress but now you’ve got health, relationship, and financial problems to cope with as well. The more you self-medicate, the more problems it creates. 5. You worry when you do not have access to substances- uncomfortable when being separated from your substance of choice; anxious when the prescription is running low or worrying how to cope in a social situation without said substance. 6. Your friends and family worry- has anyone expressed their concern that you seem off? Changes in your personality, behavior, or social life. It’s easy to dismiss others' concerns and pretend everything is ok. Recognize your patterns of use. Be honest with yourself. In order to find healthier and more effective ways of dealing with your problems and managing your emotions you must become self-aware. Find healthier ways to cope- social support, exercise, relation practice (meditation, deep breathing, yoga), improve your sleep pattern, eating healthier. Find something you enjoy doing. Find a hobby- don’t make you sport your only life

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Stress Management: P.E.R.F.E.C.T Positive Self Talk- “You’ve got this.” “No problem, keep going.” Negative thinking has become our native tongue; however, positive talk can improve overall performance and helps reduce nerves and performance anxieties. Embrace Adversity- Sometimes life gets tough, but rather than succumb to adversity we should embrace the difficulty, excellence requires effort, keep pushing when training gets tough, those are the moments where we improve. Reverse Engineer- Recall moments when you performed at your best and then work backwards to discover simple behaviors you can employ in the future. What made you feel confident? Focus on the Now- Be in the moment, everything else can wait. Distracting yourself with the last three pointers you missed or the exam you have on Monday can become overwhelming mentally. Be mindful of your thoughts as your train and focus on steering your attention to the task at hand. Evolve- Diversifying your life will allow you to grow. If one area of your performance or life isn’t going particularly well, it’s not the end of the world. Chill Out- Your body needs both physical and mental restoration. Find something healthy and personal that will rejuvenate you and allow you to mentally reset and release tension. Talk it Out- “When in doubt, talk it out”. Sport psychologists, coaches, counselors, or friends can guide you through your struggles. Parents too. Drop the stigma–reaching out to others is not weakness, it is a sign of strength, confidence, and resourcefulness.

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Practice Choosing the Opposite Now think of five situations in your life where your usual responses aren't getting you where you want to go. They could be little things that seem to mess up your day (like not being able to find a parking space or being woken up early by a noisy neighbor), problems at work, or maybe trouble in one of your relationships. Basically, you’ll want to choose areas of your life that don't seem to be running smoothly. Use the following space to think about these situations and the feelings they bring up in you. Next, note the results of your usual behavior, what your behavior would be if you chose the opposite response, and the likely results of the opposite behavior. 1. Situation: Emotions: Usual response or behavior: Result: Opposite behavior: Likely result: Likely emotions: 2. Situation: Emotions: Usual response or behavior: Result: Opposite behavior: Likely result: Likely emotions: 3. Situation: Emotions: Usual response or behavior: Result: Opposite behavior: Likely result: Likely emotions: 4. Situation: Emotions: Usual response or behavior: Result: Opposite behavior: Likely result: Likely emotions:

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Values To figure out whether your behaviors are getting you where you want to go, or whether it’s time to start choosing the opposite action, you must first get a clear idea of your values. Keeping focused on your values is a key component of acceptance and commitment therapy (ACT). Created by Steven Hayes (2005), ACT is designed to help people live a life based on their values, despite difficult thoughts and feelings. The next part of this chapter is devoted to helping you uncover and clarify your values. Knowing what you view as most important will keep you grounded and on track; it will guide your life every step of the way. This is your chance to figure out who you really want to be and what kind of life you are working toward, so take your time and really think things through as you work through the next few pages. The Birthday Toast If you find it especially difficult to see clearly where your values lie, you might want to start with this exercise. Imagine that you have lived a long, full life. It was a life that you are deeply proud to have lived. Now that you are well into old age, a birthday party is being thrown in your honor. Imagine yourself there, surrounded by family and friends. Someone stands up, moves to the front of the crowd, and begins to deliver a speech. This person will describe the way that you have lived, the people you have loved, the experiences you have shared, and what you mean to people. This person will tell the story of who you are. What do you hope the person would say? How would you want to be described? What kind of life would you want to have lived? It would be helpful to use your journal to write the speech yourself. What does this exercise tell you about what you really value? Use the following space to jot down your thoughts: Uncover Your Values As you work through this exercise, remember that this is all about creating the life you want. You may have let many of these parts of your life fall by the wayside, especially when you’ve been trapped in the disease of addiction. That doesn’t mean you don’t value them. For example, you may have lied again and again to the people you love when you were doing the things you were addicted to. That does not mean you don’t value honesty! You are in the process of committing to a new way of life, and you are learning how to make that new life happen. This is your chance to map out for yourself what’s most important to you and what you value most in your new life. Use the space below each of the value categories to write down what each value means in your own life. For example, under “health” you might writer, “Remembering to take my medication every day”, “Going to the dentist,” or “exercising.” Under “Family” you might write, “Playing with the kids on the weekends” or “calling my mom once a week.’ Under “Faith” you might write, “Reading the Bible” or “Daily meditation.” Remember, this does not have to be what you have been doing. This is based on how you plan to structure your new life around your values.

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To begin this exercise, look at the following list of value categories. Use the examples for each category to jump- start your thinking. After thinking carefully about each value, choose the top three most important values in your life. They can all be of equal value; you don’t need to rank them in order. Next, rank the rest of the value categories from second most important (2) to least important (11). You probably value many, if not all, of these parts of life. The goal here is to get clear about what’s most important to you. This will help you to stay focused. Value Categories Family ● Spending time with family often, putting needs of family members first, creating a healthy and happy home life, working to keep and improve family relationships ● What is means for me: Work Ethic/Success at Work or School ● Showing up on time, working hard, taking pride in my work, gaining success. ● What it means for me: Financial Responsibility ● Paying bills on time, paying off debt, making good financial choices, saving money, not buying things I don’t need. ● What it means for me: Learning/Growth/Development ● Continuing to learn new things, improve myself, and grow as a person. ● What it means for me:

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Honesty ● Telling the truth, no matter what, being honest with myself and others. ● What it means for me: Faith ● Keeping up my spiritual life, staying active in my spiritual community, feeling spirituality sound and fulfilled. ● What it means for me: Sobriety ● Keeping away from the things I’ve been addicted to. ● What it means for me: Respect ● Being treated with respect by those around me, feeling respected, respecting others. ● What it means for me: Friendships/Social Connection ● Making time to nurture important relationships, spending time with friends, making the needs of friends a priority. ● What it means for me: Romantic Love/Intimate Relationships/Marriage ● Finding, maintaining, or improving a healthy relationship with a partner. ● What is means for me:

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Service Work/Volunteerism ● Giving back to the world, being of service to my community, contributing to society. ● What it means for me: Community ● Spending time as part of a community, such as my church or temple, sports teams, and other community gatherings. ● What it means for me: Adventure/Spontaneity/Fun ● Taking time to smell the roses, placing a high importance on enjoying life, trying new things, making time for fun activities. ● What it means for me: Health ● Eating right, exercising, getting enough sleep, keeping up with fitness, going to the doctor as needed, placing a high importance on my physical well-being. ● What it means for me: Reflecting on Values Look at the top three value categories you selected as most important in your life and respond to the following questions for each one. As always, you may want to expand on your reflections even further by writing in your journal. 1. What actions have you taken in the past that show that this is valuable to you? Action A: Action B: Action C: 2. How can you change your life today to place focus on these things that you value? Action A: Action B: Action C:

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3. In thinking about times in the past when you behaved in ways that took you off course, what actions would you have chosen instead that would have been in line with your values? Action A: Action B: Action C: Kyle’s Story Kyle has reached his sixty-third day of sobriety when he loses his job. Getting laid off is completely unexpected. Finding out that his boss has known for weeks that this was probably coming infuriates Kyle even more. Kyle’s usual response would be to curse out his boss, throw his chair to the ground on his way out the door, and then head for the bar. This would be a situation where Kyle would probably drink all night, close the bar, stumble to a buddy’s house to rag on the boss, and drink some more. It’s all Kyle can do to stand up and walk out of his boss’s office without saying a word. He just keeps repeating to himself, “Stay calm, stay calm; you need a letter of recommendation from this guy; stay calm.” Not reacting in his usual way gives Kyle a sense of control that he isn’t used to feeling, and it feels great. But he still doesn’t know how he will get through the night, let alone the next few days, without drinking. Kyle sits down on the couch when he gets home, turns on the TV, and starts wondering how bad it would really be to just have a couple of beers. Maybe it will not be like before. And besides, who could blame him on a day like today? Kyle notices his workbook sitting on the coffee table under some magazines. It has been a while since he worked on his recovery, long enough for the book to be a little dusty. Still, he has filled in a lot of the pages already. Kyle flips though the workbook casually until he gets to the section on values. Something comes over him strongly as he rereads all that he wrote about valuing his family: how if he had more time, he would drive out to see his nephews, how important those kids are to him. “It all comes down to choices” he thinks. I might be craving some beer right now, and yeah that is the action I would always take before: go to the bar. But I can do something different. I can call my sister tonight and schedule a visit. I do not have to act in the same old ways. I can be the guy I want to be, instead of the guy I was.

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Learning More about Choosing the Opposite Now that you have a better understanding of your values, let us revisit the concept of choosing the opposite. Remember, choosing the opposite is a skill you will use when your automatic response to an emotion or thought would not be in line with your values. When your usual behavior would take you away from the life you want- the aspects of life you value most- choosing the opposite is the best course of action. Let us consider skydiving as an example. When you think about jumping out of a plane, you may experience a strong emotion: fear. Most people respond to fear with avoidance, staying far away from whatever is causing the fear. Avoidance is the instinctual behavior for most people who are afraid. Choosing the opposite of fear, therefore, would mean heading right for the source of your fear. How do you know which is the right course of action? Let’s look at two examples, James and Stewart, to figure that out. EXAMPLE: JAMES Trigger: Skydiving Emotion: Fear Usual response to this emotion: Avoidance Opposite response to this emotion: Approach Vales involved: Family (just had a new baby, wife does not want me to go), Health (recent heart problems), Friendship/Social Connection (seems like a good bonding experience with my friends; will get teased if I do not go), Adventure/Fun/Spontaneity (could be a great experience, not sure it is for me). Decision in keeping with values: Listen to my instincts; do not go. EXAMPLE: STEWART Trigger: Skydiving Emotion: Fear. Usual response to this emotion: Avoidance. Opposite response to this emotion: Approach Values involved: Friends (always wanted to share something like this with my best friend), Learning/Growth/Development (a new way to challenge myself), Adventure/Fun/Spontaneity (wouldn’t hurt to have more excitement in my life and experience something new even if it scares me). Decision in keeping with values: Choose the opposite, move through the fear, and go for it! As you can see, James and Stewart had to make a choice about the same thing (to go skydiving or not) and had the same feeling about it (fear) but, in the end, made two different decisions. By sorting out his values, each man was able to pick the path that was right for him.

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Making Decisions Based on Values Now use this worksheet to sort through choices that you need to make in your own life. This is a chance to practice thinking about your values and what you can do to stay on track toward the life you want. EXAMPLE: Choice to make: Let my sister-in-law stay with us while she looks for a job, or not. Value categories involved and how: Family (I think families should take care of each other; I also want to make sure that our family is happy, so I need to know she is not going to bring too much stress into our home), Financial Responsibility (we are just getting out of debt, and that is so important to me; would helping her strain us too much?) Respect (I will feel used and that she does not respect me if she does not try hard to find a job; I need her to help around the house and to show that she is serious about getting back on her feet). Possible behaviors: Agree to let her move in but resent it and end up making her feel she is not welcome; tell her she cannot stay with us; agree to let her move in after talking to her about how I expect her to help out, look for work, and get along with the family. Behavior you choose based on your values: I choose to let her move in after having an honest talk with her about my worries, what I value, and what I expect from her. That way, if it is not working out and I need her to leave, at least I will know that I was clear and honest from the start. Your Responses Choice to make: Value categories involved and how: Possible Behaviors: Behavior you choose based on your values:

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Conclusion Remember, it will be up to you to decide if a certain behavior fits your values or not. You have every right to choose what kind of life you want for yourself. As you worked through this chapter, you got a good sense of the ways you normally respond to emotions. You got a clear idea of whether those behaviors are getting you where you want to go. You got a clear sense of your values and began to see how important your behavior really is in shaping the course of your life. The goal of the next chapter, “Mindfulness,” is to give you skills that will help you cope with painful feelings and stress. As you read, do the writing exercises, and try the suggested activities in chapter 4, you will find a sense of calm that will keep you going when times get tough. You will be able to choose your responses, instead of being driven to respond to emotions in a way that hurts you. You will be able to make the right choices even in hard times. With these skills in place, you will be even better prepared to make choices that lead you to the life you value.

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Values Value System: The moral, social, aesthetic, economic, and religious concepts accepted either explicitly or implicitly by an individual or society. Values are fundamental attitudes guiding our mental processes and behavior that produce the belief that life is meaningful and serve as a measure of how meaningful one “s actions are, that is, consistent with that person’s value system. 1. Personal Values- traits we see as worth aspiring to, and that define our character 2. Spiritual Values- connection to a Higher Power that gives a sense of purpose 3. Family Values- love and care for those we are close to; children, parents, other family members and friends 4. Career Values- the best use and expression of our talents and skills for the purposes of contributing to society. Characteristics we value: 1. Integrity- trustworthiness, honesty, and uprightness of character 2. Respect- honoring worth and dignity of all people 3. Loyalty- commitment and faithfulness to a person or cause 4. Responsibility- reliability, dependable, and willing to take accountability for who they are and what they do Substance use and/or addiction takes people away from their values in a quest to get what they want, be accepted by others, or feel good and better. No matter how positive or healthy these values are, they are eventually crowded out and disregarded by the obsessive thinking related to substance use, the compulsive need to use, and the self-absorbed attitudes that are dominant during active use and addiction. ● You may value honesty, but in order to use and avoid consequences you are dishonest with your family, partner, employer, coach, etc. ● You may value responsibility, but the progression of active use renders you increasingly less capable of acting responsibly. ● You may value education, sports, or a job and want to get a college degree, make it to the big leagues, or get that promotion, but using kept you from completing that degree, keeping your position on the team or in the office. ● You may value being healthy and physically fit, but active use makes that less and less important. Goal: What do I want to happen? Behavior: What am I going to do about it? Example: VALUE- Family Value GOAL- I do not want to let my family down or argue over my drinking/use BEHAVIOR- stick to my resolution not to drink/u

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Peer Influence Large body of evidence shows that individuals who initiate substance use and develop problems with it are more likely to have peers who also use. Social influence vs. Selection: is it the peers who cause a person to consider use when they would not have otherwise OR is it a matter of selection-that is-does a person who already has interest in using select friends who will also want to use? Factors in terms of who we select: ● Location (neighborhood, school) ● Availability (people who make themselves available to us) ● Perceived similarity (age, interests, background, values, beliefs, experiences) ● Aspiration- who we see as desirable How do peer influences work? 1. Directly through offers of drug for use 2. Indirectly a. Modeling b. Indirect expression of “normative” drug use behaviors c. Development of expectancies Social Learning Theory suggests that all social groups have norms and expectations about behaviors that they convey through a variety of means. Differential association reinforcement theory: groups we choose to associate with are likely to reinforce or not reinforce certain behaviors, meaning we are likely to engage in behaviors reinforced by our group. We learn definitions of what behaviors are good or bad explicitly from our reference group. Emerging adults are more likely to drink or take drugs if they believe that it is a normative (common) in the peer group. The problem with this is that most teenagers and young adults overestimate how many people their age are drinking and using drugs, and how much their peers use when drinking or drugging. Norms maybe gender specific- women being influenced by such norms than men, although certain subgroups of men, such as athletes on teams and fraternity members, may be strongly influence by gender-based expectations. Most “peer pressure” is normative and indirect- that is, no one is actually saying “you have to do this” or forcing use. It is the desire to fit in, avoid exclusion, and gain acceptance.

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Resilience “The process of adapting well in the face of adversity, trauma, tragedy, threats, or even significant sources of stress” Determinants of resilience include a host of biological, psychological, social and cultural factors that interact with one another to determine how one responds to stressful experiences. Resilience involves an active decision, like sobriety, that must be frequently reconfirmed; conceptually, a process of moving forward and not looking back, not succumbing to life’s negative effects. Seven key skills of resilient people 1. Autonomous: internalized center of control; the belief that they, not their circumstances, are in control and affect their achievements, not their circumstances. The ability to recognize that they cannot change others" behaviors only their response to the behavior. 2. Realistic awareness of self: emotional awareness, accurate self-assessment, and self- confidence- knowing your emotions, your personal strengths and weaknesses, and having a strong sense of your own worth. 3. Adaptable: bend rather than break; being able to change how one perceives a situation so it is not just black and white. Recognizing valuable alternatives and not fixating- adapting easily when change is required. 4. Optimistic: knowing that change is inevitable and having a positive outlook on what will happen. Reframing a citation to look for the positives and good. If failure is present, instead of instigating their inner critic, they view events as external, specific and insatiable. Example: “That situation was challenging, this has taught me X so next time I will be able to…” 5. Pragmatic: looking at what they can influence and take practical steps towards completing a task instead of ruminating on things they can do nothing about. Action oriented with the use of past knowledge and experience to find solutions. 6. Socially Connected: foundation and building of strong relationships with people and will readily ask for help, even when under pressure. Many perceive this is a sign of weakness when it is quite the opposite. It shows inner strength to know when you need help the most and ask for it. 7. Self-compassion: readily extend compassion to themselves in instances of perceived inadequacy, failure, or general suffering. Self-critical to realistic- recognizing and supporting own needs.

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Gratitude Questions 1. What do I appreciate? 2. How am I fortunate? 3. What material possessions am I thankful for? 4. What abilities do I have that I’m grateful for? 5. What about my surroundings (home/neighborhood/city/etc.) am I thankful for? 6. What experiences have I had that I am grateful for? 7. What happened today/yesterday/this week/this month/this year that I am grateful for? 8. What opportunities do I have that I am thankful for? 9. What have others in my life done that I am thankful for? 10. What have others done that I am benefiting from in my life (even if I don't know who those people are?) 11. What relationships am I thankful for? 12. What am I taking for granted that, if I stop to think about it, I am grateful for? 13. What are the challenges/difficulties I have experienced (or am currently experiencing) that I can be thankful for? (ex. What have I learned? How have I grown?) 14. What is different today than it was a year ago that I am thankful for? 15. What insights have I gained that I am grateful for?

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Gratitude Worksheet Appreciating all the positive things in our lives can help increase our happiness and decrease our stress. Work through each different area of your life (listed below) and list what you are grateful for? Overlooked blessings: Did you know that 2.4 billion people in the world- one in three- do not have an adequate toilet? And, 663 million people in the world- one in ten- do not have clean water? Happiness is not created by getting something you don't have, but by appreciating what you already have. What overlooked blessings do you have to be grateful for right now? Positive things about my health & body: It is important to keep ourselves on the list of things we are grateful for. Having a good relationship with yourself will help you have healthy relationships with others. What things are you grateful for about yourself? Activities I enjoy: Whether it is preparing a meal, pausing to admire the sunset, or telling a friend your good news- the idea is to linger, take it in and enjoy the experience. What helps you enjoy the moment without thinking of anything else?

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Relationships I am grateful for: While the true benefits of friendships cannot ever be measured (how do you calculate how much joy your best friend has brought to you over the years?) Study after study shows friendships boost our happiness and even our health. Who are you grateful to in your life? After you have completed the worksheet, take the next step, and apply what you learned about gratitude by writing a gratitude letter to someone you care about? Think of someone who had a positive influence in your life. This could be a family member, a teacher or friend or someone else. A great way to show your gratitude is to write this person a thank you letter for their support, kindness, guidance, etc. and commit to mailing or reading your letter to them within the next 48 hours. Do your best to write the letter by hand and not by text or email.

Herren Wellness Curriculum

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