ATRIUM A.T.R.I.U.M. = Addictions & Trauma Recovery Integrated Model

ATRIUM Published in treatment manual Addiction and Trauma Recovery: Healing the Body, Mind & Spirit, D.Miller & L. Guidry, 2001, WW Norton

ATRIUM Number of sessions = 12 Duration of each session = 1.5hr. Structure and content of the ATRIUM model: Number of sessions = 12 Duration of each session = 1.5hr. Timing or frequency of sessions = weekly or twice per week

ATRIUM Structure of each session = didactic component process component- participants to share own experience relevant to session topic, experiential component teaches participants new ideas and skills a “homework” assignment = handout reviews didactic and experiential content of session; participant creates own mini workbook

ATRIUM Mind Body Spirit Relational Cognitive Behavioral Assessment & Treatment Model

addiction and trauma distress ATRIUM ... For adults and adolescents who struggle with traumatic experiences... ... trapped in the cycle of addiction and trauma distress addiction and trauma distress

ATRIUM ATRIUM model has been successfully adapted for use with Latina women - the manual and handouts have been translated into Spanish. Homeless individuals and families have successfully participated in ATRIUM groups.

ATRIUM ATRIUM has been implemented to meet the needs of disabled women. ATRIUM groups have also been successful in correctional systems and jail diversion programs ATRIUM has been successful in working with populations with AIDS ATRIUM has been implemented with men

ATRIUM Training Who is eligible to become an ATRIUM facilitator? mental health professionals and peer facilitators... ...who understand the impact of addiction and trauma.

Women who hurt themselves: A book of hope and understanding ATRIUM The ATRIUM treatment protocol = sequel to Trauma Reenactment model in Dusty Miller (Basic Books, 1994). Women who hurt themselves: A book of hope and understanding

ATRIUM Which addictions are we talking about? Chemical abuse & dependency Eating disorders Self-injury and Self- sabotage….like...

Self-sabotaging behavior ATRIUM Self-sabotaging behavior compulsive spending gambling sexual addiction cyber addiction self-destructive relationships

Co-occurring diagnoses ATRIUM Co-occurring diagnoses Post-traumatic stress disorder (PTSD) Anxiety Depression Psychotic episodes Personality disorders Relational challenges

ATRIUM The legacy of trauma creates Broken hearts & wounded spirits

ATRIUM Connection in community… Wholeness in relationship… ATRIUM heals the broken spirit through Connection in community… Wholeness in relationship… Mission to help others

Your Surviving Spirit A spiritual workbook for coping with trauma Dusty Miller’s sequel to the ATRIUM manual (New Harbinger, 2003)

ATRIUM Mind Body Spirit Traumatic injury and change happen at 3 levels: Mind Body Spirit

ATRIUM ATRIUM teaches: Understanding connection between trauma reenactment and addictions The theory of trauma reenactment: biological and cognitive/emotional impact of traumatic stress Internalization of early trauma-based relationships

ATRIUM Cognitive & Emotional reenactments of trauma Mental and emotional impact of trauma Addiction and emotional dysregulation Depression, Anger, Fear and Anxiety Dissociation

ATRIUM Trauma re-enactment and the body Re-living trauma through physical pain and illness Body image - how trauma shapes self-image Touch and intimacy: challenges

ATRIUM Healing the Spirit Breaking isolation: Making connections Environmental healing - healing the broken spirit Giving something back - healing through helping others

ATRIUM The Triadic Self = ATRIUM teaches people to recognize and challenge internalized representations of trauma-based relationships

ATRIUM The “triadic self” = internalization of past abusive relationships Victim Abuser Non-protecting Bystander

The Internalized Abuser The inner voice representing self-harmful behavior: Drinking Drug abuse Cutting Binge & purge cycle Self-sabotaging sex, harmful relationships, etc.

The Internalized Victim The inner voice representing the small vulnerable self who experiences getting hurt… ...The “oh no, not this again!” warning message

The Internalized Non-protecting Bystander The inner voice representing the “I can’t help it” part of the self Reenactment of not being protected in childhood and… Current inability to protect one’s own self

Protective Presence Similar to personal understanding of Higher Power or God or Spirit Also the creation of personal sources of comfort the individual holds in her heart & soul.

ATRIUM - principles of trauma recovery recognizing and reinforcing resilience achieving abstinence from addiction healing the wounds of non-protection creating a sacred connection to the Universe learning to help others

REFERENCES Miller, D. (1994). Women Who Hurt Themselves: A Book of Hope and Understanding. N.Y.: Basic Books Miller, D. & Guidry, L. (2001). Addictions and Trauma Recovery: Healing the Body,Mind and Spirit. N.Y.: WW Norton. Miller, D. (April 2003). Your Surviving Spirit: A Workbook of Spiritual Resources for Coping with Trauma. Oakland, CA.: New Harbinger. .

REFERENCES: Miller, D. (2002). Addictions and trauma recovery: An integrated approach. Psychiatric Quarterly. 73, 2. Miller, D. (1996). Challenging self –harm through transformation of the trauma story. Sexual addiction and compulsivity. 3,3. Miller,D., (2003) End of Innocence. Psychotherapy Networker. July/August.

Addiction and Trauma Training ATRIUM Addiction and Trauma Training Healing Retreats ATRIUM Institute - Northampton, MA (413) 584-8404 dustymi@aol.com dustymiller.org