It’s Legal, So Now What? Cannabis in the Age of the Corner Pot Store

Like so many things in life Cannabis is a duality. It can be valuable as a tool for healing and pleasure, or a catalyst for aimlessness and mental illness. It can provide an occasional evening of enjoyment with friends, or become a lonely prison that saps motivation, adds to depression and ruins your life. It is useful as a treatment for pain and nausea, and components of it can treat seizure disorders untreatable by other means, and it can also become an addiction fraught with all the hallmarks of despair addiction brings with it.

Yes, Cannabis is many things to many people. And, now that it is legally available to the masses, it is important to have accurate information to guide use or determine abstinence.

The purpose of this post is to raise awareness about the possible negative effects of a drug that we still know too little about, due to draconian federal laws that have hampered scientific research. But there is data out there, much of it from other countries such as Israel and the UK where more inquiry has been supported. So what do we know so far? Here are some of the concerns that are backed up by substantial research:

Cannabis is much stronger these days: Experts say it contains 2-3 times the active agent THC than in times past, (due to a genetic selection process that favors more THC) and creates a more intense, quick acting and long lasting high. It is also more likely, in its current strength, to induce hallucinations, paranoia and other temporary psychotic symptoms. For many people these experiences are short lived. However, Cannabis, like alcohol, has many troubling long-term consequences when it is used regularly and in excess:

Anxiety: Many people use Cannabis to relax. It is true that in small amounts it works. Unfortunately, in higher doses it has the opposite effect, creating often dramatically increased anxiety. In my counseling practice, I have worked with clients who began using Cannabis to ease their nervousness but after a while instead of helping them, their anxious symptoms increased to the point where they can barely drive, interact with people in public or even leave the house. According to much research, this is a common occurrence amongst heavy, long term users of Cannabis.

Thinking and Motivation: We now have considerable evidence too that Cannabis use over a long period of time has a depressant effect and can significantly reduce motivation and cause cognitive deficits. It can also affect memory and the ability to organize, integrate and use information.

Mental Illness: There is more and more research pointing to a strong link between use of Cannabis, (particularly in adolescence) and schizophrenia, bi-polar disorder and other psychotic illnesses. The link seems to be “dose related”, in other words the more used the more likely it is to develop such an illness.   Read more about it here.

Problems in Living: In the past it was thought that Cannabis is not addictive. But recent research demonstrates that it is. How do they know? Addiction is present when tolerance develops and withdrawal symptoms appear when use is reduced or ended. (Tolerance is defined as a having to use more and more to get the same effect.) Cannabis withdrawal symptoms include:

• Craving
• Decreased appetite
• Sleep difficulty
• Weight loss
• Aggression or increased irritability
• Restlessness
• Strange dreams

These withdrawal symptoms usually appear about 10 hours after last use and peak at about a week after use is discontinued. Another strong indication of addiction is a compulsion to use, and life being taken over by the need to seek, buy, and use Cannabis, even when these activities are damaging relationships, work, health and well-being.

Cancer and Breathing Problems: If Cannabis is used by inhaling its smoke, some of the same health problems can occur as with cigarette smoking. Like cigarettes, Cannabis is a carbon based substance that when inhaled regularly has the potential to create lung cancer, COPD or other breathing problems. If you are using Cannabis to relieve pain or for another medical problem, consider switching to a topical application or other delivery system. Talk to your health care provider about the safest way to use it.

Join me next week when the topic will be getting help when Cannabis use is a problem.

Posted in Uncategorized | Tagged , , , , , , , , , , , , , , , , , , , , | Leave a comment

Find a Counselor That is Right for You

• Look for a good fit. Many practitioners offer a free 30 minute consultation. Take advantage of this by setting up appointments with two or three different therapists. Meet and talk with them about their approach to counseling and typical length of treatment for your situation. What is their training and experience? What are their strengths? How do they collaborate with others on your health care team?

• Ask lots of questions. For example if you are interested in treatment for anxiety, ask your therapist if they provide an evidence based approach. (This is a treatment that has been researched and shown to be effective.) Ask how much experience and training the therapist has in providing the treatment you are interested in.

• Get recommendations. For example, ask your primary care physician, your chiropractor, family and friends to recommend a counselor. Ask them why they believe in that person’s abilities and how they know about them.

• Confirm eligibility. If you will be using insurance check to make sure the counselor you have chosen can accept your insurance.

• Ask about sliding scale. Many counselors offer a reduced rate to clients paying out of pocket.

• Trust your gut. If it doesn’t feel right, it probably isn’t. While it is normal to feel some anxiety when beginning counseling, the counselor’s task is to put you at ease and build trust and rapport. If that isn’t happening consider switching to a different practitioner.

• Advocate for yourself. If you are not getting what you want from counseling but have developed a string relationship with your therapist, ask for what you need. Most counselors will be happy you have spoken up and given them the opportunity to be more effective.

Posted in Uncategorized | Tagged , , , , , , , , , , , | Leave a comment

Why Go to Counseling?

Many people think that you have to be “crazy” or extremely dysfunctional to seek out the services of a mental health counselor. The truth is that most people can benefit. Here are some of the best reasons to see a counselor:

• Manage anxiety. Everyone experiences stress and anxiety. In therapy you can learn ways to reduce the potency of stressful experiences. This improves both your emotional well being and physical health.

• Understand yourself. Sometimes our motivations and feelings can be mysterious. A skilled counselor can help you unearth the origins of your behaviors and emotions. Insight can lead to positive change.

• Gain clarity about your purpose. What do you want out of life? What is meaningful to you? How do you balance freedom and responsibility? Counseling can help you discover what is truly important and help you focus your energies towards those goals.

• Learn to grieve. Sadness is a normal part of the human experience. Counseling can help normalize your reactions to difficult events and losses and help you express and move through the darkness.

• Develop new skills. Counseling can help you learn more effective ways to communicate, to ask for what you need, express feelings and understand the feelings and needs of your family and friends. You can create self-care strategies that include self-compassion and self-forgiveness. In counseling you can learn what healthy boundaries look like and how to stand-up for yourself.

• Improve relationships. Many people wait until their marriage or primary relationship is in serious trouble before seeking help. But by then, it can be too late. Counseling early in a relationship or when problems first appear can help set the stage for healthy communication, create understanding of our partner’s personality and needs and help develop realistic expectations of the relationship.

Join me next week when I will discuss how to choose a therapist that is right for you.

Posted in Uncategorized | Tagged , , , , , , , , , , , | Leave a comment

How Our Thoughts Create Depression & Anxiety & How to Fix It

Awareness is the first step towards changing any behavior or pattern of thinking. Last week we discussed a method designed to heighten your awareness of negative self-talk by writing it down. Now that you have recorded some of the thinking errors that are undermining your mood, confidence and self-esteem, it is time to create rational responses to those damaging thoughts.

What is a rational response? It is a way to respond to a cognitive distortion that dissipates its power. For example, suppose you are running late to work and your cognitive distortions go something like this:

“I’m never on time. People at work will think I’m useless.”

There are several cognitive distortions at play here. The first statement is an overgeneralization. The second includes mind-reading and fortune telling with a dash of all-or nothing thinking and overgeneralization thrown in for good measure.

Rational responses might be:

• I am not always late. There have been many times I have made it to work right on time.
• Some people I work with might be frustrated if I’m late today, but it is not the end of the world. Everyone is late sometimes.

A rational response must be believable. It won’t help us to replace a negative cognitive distortion with a grandiose or overly optimistic one.

Rational responses only improve mood if we use them. It can help to write out rational responses to your most frequent distortions. In his seminal book, Feeling Good: The New Mood Therapy, David Burns suggests using a triple column method to track thoughts, identify types of distortions and create rational responses.

Continue to track your negative self-talk. At the end of the day, read through what you have written down. Identify the types of distortions and write out rational responses to each one. Defend yourself.

Posted in Uncategorized | Tagged , , , , , , , , , , , | Leave a comment

How Our Thoughts Create Depression & Anxiety

In the 1960’s and 70’s when the baby boom generation was coming of age the motto was, “If it feels good do it”. During that time of awakening, a whole swath of society, got in touch with feelings. Unlike the more repressed generations that came before, this cohort, and those who have come after, often rely on emotions as the primary guideposts in their lives, using them to make decisions, shape relationships and determine self-worth. Though being in touch with emotions is important, this approach can also lead to problems.

Problems start when we believe the negative self-talk that often loops in our brain. From this dark script our feelings about the world and ourselves are created. We tell ourselves that that our situation is hopeless or that we never do anything right when we make a mistake. We see the world in black and white and catastrophize when things go awry. These cognitive distortions are what contribute to depression and anxiety. Then, we often act on those feelings. Our poor choices, made in the midst of fear and sadness, perpetuate negative thinking and the cycle continues.

How we think about our situation, ourselves and our lives really does dramatically affect mood. Much clinical research has pointed to the idea that even hearing or reading negative words or seeing negative images can subtly color our feelings and thus our behavior. So imagine what it is like to have blaming, shaming, guilt-inducing self-talk cycling inside our heads 24/7.

Most of my clients know exactly what I mean when I explain about negative self-talk. It is that insidious voice in our heads that tells us only perfection is worthwhile, so if you can’t do something perfectly, the first time, why bother. It tells us that since something has happened a certain way once, it is bound to happen that way again.

This voice only focuses on our negative attributes and mistakes and blows them way out of proportion. The clever and successful things we have done shrink to nothing in comparison. This part of us believes it can predict what will happen next, and knows without a doubt what other people are thinking and why they do the things they do. This part of us shouts constantly about all the things we should be doing and tells us that if you feel something such as guilt or shame you must be guilty or shameful. This voice often keep us locked in habitual ruminating about the past or planning and plotting about the future, so we can never enjoy or be fully present right now.

These cognitive distortions or thinking mistakes can cause a great deal of pain and suffering. They erode self-esteem and confidence and create or worsen depression. So, what can we do to begin changing this thinking and feel more positive about ourselves and our lives? The first step is awareness. To begin changing anything we must first notice what is happening and when it is happening. Much negative thinking is habitual and almost unconscious. But with patience and awareness we can begin to unravel it.

Start by carrying a small notebook in your purse or pocket (or use the memo function  in your phone) and begin recording the negative self- talk you are aware of. What are you telling yourself? How do you talk to yourself internally? When something goes wrong what do you decide is true about you or your situation? Do you believe that when bad things happen it is always your fault? Do you call yourself names such as, “stupid”, “lazy” or “fat”? Write these thoughts down. Don’t worry about capturing every single negative thought, just write down the ones you notice, and jot down the situation you were in when it crossed your mind. You don’t have to do this perfectly.

Visit my blog again next week when we explore how to use the thoughts you have recorded to talk back to the tyrant in our heads and begin repairing and rebuilding self-worth and lessening depression and anxiety.

Posted in Uncategorized | Tagged , , , , , , , , , , , , , , | Leave a comment

Five Drug-Free Ways to Defeat Depression

For the past 30 years whenever someone seems depressed, the answer has been an antidepressant. Most people get this prescription from their doctor after a 15 minute assessment.
But is that really the best approach? Antidepressants often have unwanted side effects, are expensive and may even contribute to a life-long cycle of depression. (See studies from the book, Anatomy of an Epidemic by Robert Whitaker for more information.) So, what to do instead? Here are five alternative strategies for easing depression.

1. Exercise. In double blind studies, patients who exercised regularly and took a placebo were compared to those who didn’t exercise and were given an antidepressant. Surprise! Those who exercised improved their mood significantly more than those taking the drug.

2. Take supplements. Many people are Vitamin D deficient. This can cause or worsen depression. Get a little (15 minutes is enough) sunlight on your skin a day, or take a supplement.
Omega 3 fatty acids (the kind found in fish oil) has been shown to effectively treat depression. Read about it in this study, or in the book The Omega 3 Connection, by Andrew Stoll.

3. Write. One study found that people who wrote about their troubles every day for three days felt better and had shifted to a more positive perspective on their lives and their problems.

4. Change your thinking. We are taught that circumstances dictate mood. But the truth is, how we think about our situation is more important than the situation itself. In Man’s Search for Meaning, Victor Frankl describes how even in a concentration camp, the way we think about our circumstances matters. He said, “We who lived in concentration camps can remember the men who walked through the huts comforting others, giving away their last piece of bread. They may have been few in number, but they offer sufficient proof that everything can be taken from a man but one thing: the last of human freedoms—to choose one’s own attitude in any given set of circumstances—to choose one’s own way.”

5. Service. When we help others, our own problems fade into the background. Service offers meaning and purpose as well as validation and connection.  There are many opportunities to help.  Volunteer for a organization you believe in or help your neighbor.  Making a difference in someone’s life can be the most powerful antidepressant of all.


Posted in Uncategorized | Tagged , , , , , , , , , , , , , , , , | Leave a comment

A Time for Kindness

It is hard to find words that offer any comfort in the midst of the painful time we are immersed in after the senseless killings in Roseburg. All I could think of to share is this poem, which doesn’t so much comfort, but instead reminds that we are all connected, that we all suffer, and that we can choose to use our suffering to learn compassion. As the poet so aptly says, kindness is the only thing that makes sense anymore.


Before you know what kindness really is
you must lose things,
feel the future dissolve in a moment
like salt in a weakened broth.
What you held in your hand,
what you counted and carefully saved,
all this must go so you know
how desolate the landscape can be
between the regions of kindness.
How you ride and ride
thinking the bus will never stop,
the passengers eating maize and chicken
will stare out the window forever.

Before you learn the tender gravity of kindness,
you must travel where the Indian in a white poncho
lies dead by the side of the road.
You must see how this could be you,
how he too was someone
who journeyed through the night with plans
and the simple breath that kept him alive.

Before you know kindness as the deepest thing inside,
you must know sorrow as the other deepest thing.
You must wake up with sorrow.
You must speak to it till your voice
catches the thread of all sorrows
and you see the size of the cloth.

Then it is only kindness that makes sense anymore,
only kindness that ties your shoes
and sends you out into the day to mail letters and
purchase bread,
only kindness that raises its head
from the crowd of the world to say
it is I you have been looking for,
and then goes with you every where
like a shadow or a friend.

by Naomi Shihab Nye from “Words Under the Words”

Posted in Uncategorized | Tagged , , , , , , , | Leave a comment

Weeping For Our Delight: The powerful link between love and grief

When I was 26, my mother died. It was a difficult death. She suffered and longed to leave, but lingered, in pain and semi-consciousness.

My last act as a daughter was to give her sips of water and promise to miss her…and to finish my education. I have accomplished both. The education part came in starts and spurts, with long breaks in between, when my resolve waned. But eventually, I ended up with two master’s degrees. The missing her, however, has been near constant.

We are often taught that the pain of losing someone eventually dissolves, and all we are left with is memories, devoid of sadness or longing. But the truth is we are forever changed by significant loss, and the pain of that loss can revisit us again and again, albeit in more tempered doses.

For me, each phase of life has brought renewed awareness of my mother’s absence and pain in the realization of that void. When I got married, when I graduated from college, when I began a new career, I felt the loss again acutely. When I am struggling, confused or lonely, I long for her. But always, I am aware that I am motherless, and always, I miss her.

Grief is a reflection of how much we have loved. When we love deeply, the loss will stay with us, for the rest of our lives. This is not dysfunction, but a manifestation of our ability to bond with and love another.

Khalil Gibran expresses this idea with grace in his master work, The Prophet:

“When you are sorrowful look again in your heart, and you shall see that in truth you are weeping for that which has been your delight.

Some of you say, “Joy is greater than sorrow,” and others say, “Nay, sorrow is the greater.”

But I say unto you, they are inseparable.”

It is true that the intense, all-encompassing pain of grief does diminish with time when we allow ourselves to experience it rather than pushing it away. Eventually, grief’s physical symptoms (lack of energy, nausea, crying, lump in the throat, etc.), the inability to concentrate, the anger, (even rage sometimes), the guilt (often unjustified), the isolation, the hazy feeling of unreality, all these will fade and you will return your energies to life and other relationships.

But, there is no cure for grief. It is only converted from the acute to the chronic. And, this is really chronic love, manifesting as sorrow, which clings throughout the years. You have loved and so you mourn. You are human and so you grieve.

Here is one of my favorite poems about embracing and accepting grief.

Talking to grief

Ah, grief, I should not treat you
like a homeless dog
who comes to the back door
for a crust, for a meatless bone.
I should trust you.

I should coax you
into the house and give you
your own corner,
a worn mat to lie on,
your own water dish.

You think I don’t know you’ve been living
under my porch.
You long for your real place to be readied
before winter comes. You need
your name,
your collar and tag. You need
the right to warn off intruders,
to consider my house your own
and me your person
and yourself
my own dog.

By: Denise Levertov

For more information about grief or to find support contact Winterspring Center for Loss and Grief.

Posted in Uncategorized | Tagged , , , , , , , , , , , , , , | Leave a comment

Why We Blame the Parents

I don’t know about you, but I often hear people say things like, “His parents really raised him right,” when good things happen for a young person. Or, “Her parents must have let her run wild,” when a teen or adult child gets into trouble. But is that really true? Are parents mostly to blame when something goes wrong and can they take the credit when their child grows up to be successful?

In my work as a therapist and social worker, and in my own life, I have seen much to contradict this belief. I have known kids from broken, abusive and chaotic families, become, by all accounts, successful people: loving, engaged, happy in relationships. On the other hand, I have witnessed kids addicted, depressed and suicidal, who were loved and given structure and security from the time they were born. So what gives? How can it be that one child in dire circumstances will flourish, while another with many advantages becomes addicted and takes their own life? I don’t have all the answers, but here are some things to consider.

We often believe parent’s are responsible for how a child turns out because:

1. We don’t understand genetics. Genetics are a powerful thing. Scientists differ on how much of a person’s temperament, intelligence and motivation is in-born, but most agree a significant portion is. When mental illness or addiction is a factor in a child’s success or failure, genetics often becomes even more important.

Many dysfunctions of the mind are passed to children through their DNA and when it comes to addiction, geneticists have determined that genes play a significant role. The National Council for Alcoholism and Drug Dependence puts it this way, “Research has shown conclusively that family history of alcoholism or drug addiction is in part genetic and not just the result of the family environment.”

Acknowledging the role of genetics can be challenging, because it implies, rightly so, that some things are out of our control. Whether our child becomes addicted to a substance or mentally ill is often not something we can prevent. In Al-Anon, one short hand way to embrace this truth as it relates to alcoholism goes like this, “I didn’t cause it. I can’t control it. And, I can’t cure it.”

2. We don’t understand the power of peers and culture outside the home. Judith Rich Harris is a science writer and researcher who spent most of her career writing college text books. She wrote a lot of psychology texts and all of them said the same things about why kids turn out the way they do: it was “nature (genetics) and nurture (parents)” that dictated the outcomes. But after years of writing about all this Harris realized that something crucial was missing in this discussion and a huge assumption was being made that “nurture” was the same as environment and that parents were all that contributed to the environment. “What about peers and the culture outside the walls of the home?” she thought.

This began her investigation into the role of the peer group and culture in a child’s life.  Peers and the larger culture as a whole, it turns out, have a profound impact on the development and eventual outcome of a person’s life and can be more powerful than parents in many cases.

Here is how Harris puts it, “There is no question that the adult caregivers play an important role in the baby’s life. It is from these older people that babies learn their first language, have their first experiences in forming and maintaining relationships, and get their first lessons in following rules. But the socialization researchers go on to draw other conclusions: that what children learn in the early years about relationships and rules sets the pattern for later relationships and later rule-following, and hence determines the entire course of their lives.

I used to think so too. I still believe that children need to learn about relationships and rules in their early years…But I no longer believe that this early learning, which in our society generally takes place within the home, sets the pattern for what is to follow. Although the learning itself serves a purpose, the content of what children learn may be irrelevant to the world outside their home. They may cast it off when they step outside as easily as the dorky sweater their mother made them wear.”

3. We are afraid. Another reason we blame parents when things go awry with their children has to do with our own fear. If it was their poor parenting that is to blame, then we can avoid the same things happening to our kids if we just do things “right”. It is analogous to the way we often blame a rape victim for the way she dressed, her choice to visit “that” place or her other “poor choices”. If we believe it is her fault then we can also believe that we will be safe if we just dress conservatively, stay away from dangerous places (whatever those are) and never have a drink in public.

When we blame parents we also distance ourselves from any responsibility we have to their children. We don’t have to think about how the economy, the schools, popular culture or politics are impacting them, or what we could do about any of that if we thought it was our problem too.

4. Sometimes we are right. Sometimes, parents are completely to blame. Sometimes the things parents have done and not done, the things they have said and not said, are all that matters to a child, and these choices, if they be negative, can devastate a human being. But, rarely, is it that simple.

Posted in Uncategorized | Tagged , , , , , , , , , , , | Leave a comment

Three Keys to Coping with Change

“Change is the inherent and absolute characteristic of reality.” A few years ago while listening to the radio, I wrote down this quote and put it on my refrigerator. Now, I’m not sure who said it, and a Google search for the originator of the phrase turns up nothing. But no matter, the little green note card with those words written in my grade-school cursive, has traveled with me through several moves, an almost divorce and eventual reunion, the end of graduate school, and the start of my counseling practice. It has also comforted me somehow through several significant personal losses, people leaving my life, others coming into it, relationships changing.

Yes, change seems to be the only thing that can truly be counted on. And yet, we humans mostly cringe when change is upon us. Even positive change can be difficult, anxiety provoking and stretch our internal resources. We attempt to avoid it. We try to predict and control it, but reality forces its will upon us. Change happens.

I have discovered three keys for coping that have helped me and may help you too.

1. Accept it. Nothing makes change more difficult than our struggle against it. This can lead to denial and procrastination. My mom had a sign in her office that read, “Not to decide, is to decide.” She would often point to it when one of her customers was stuck in indecision. Even in the midst of change forced upon us, we often have important choices to make. When we accept the change, we have the ability to make them. When we accept we take back a little of our power, and then can see the choices we do have.

2. Be here now. Change often focuses our mind on past regrets: If only I had done thus and so, I wouldn’t be in this predicament, or fears and longings about the future: What if? These ruminations keep us from being in this moment, this one right now, when things are often okay. If we are safe and warm and have food in our belly, being in this moment can be a comfort. The past is gone and the future is yet to be, embracing this moment can set us free.

3. Grieve. Change often involves loss. Even when most would describe a change as positive, the things, people and experiences we leave behind are still lost. A colleague of mine is sending her five year old daughter to kindergarten next week, and of course she is happy that the moment for her child to go out into the world on her own has arrived. At the same time, I imagine she is grieving the child that no longer exists, the two year old, the three year old, the four year old, who needed her mommy so much, and all the sweet, loving times they shared before she became a big girl going off to school.

Let yourself grieve. Let yourself acknowledge what is passing away: cry, weep, feel, get angry even, because change is the inherent and absolute characteristic of reality, and sometimes it is very, very hard.

Posted in Uncategorized | Tagged , , , , , , , , , , | Leave a comment
  • About The Author

    Lois Schlegel

    Lois Schlegel, MFA, MS, mental health therapist at Life in Bloom Counseling in Medford and Ashland, has 20 years of experience providing services to individuals and families. She has taught parent education and life skills classes to adults and ... Full Profile
  • Categories

  • Archives