First Responders

Law Enforcement and Stress

Law Enforcement and Stress

Law enforcement and stress seem to be a forgone conclusion for many people – often writing it off as a normal part of the job. But for many peace officers, fire and rescue and other first responders the events they deal with on a regular basis are anything but normal. Some events are outright traumatic and often, they experience many of these over the course of their service.

“Trauma” refers to the body or mind being overwhelmed by traumatic events. Psychological trauma in particular occurs as a result of a distressing event that leads the sufferer to question their beliefs while destroying their assumptions of trust. If you have experienced a traumatic event, you may feel socially disconnected and somewhat numb, leading to feelings of isolation. On top of this, you may find yourself feeling more afraid and vulnerable than before the event.

Law enforcement has been universally recognized as a stressful profession. Police officers often observe, deal with, or become involved in extremely difficult situations and experiences on a daily basis. A line-of-duty death (LODD) strikingly brings home the risk and vulnerability of all law enforcement officers and affects the officer’s peers, the entire department, the wider police community, and the officer’s family.

Cumulative Stress

These events are inherent to the law enforcement profession and accumulate over time, often producing a cumulative stress that is immeasurable. Men and women who choose law enforcement as a profession are told to prepare to deal with the cumulative stress of the job. When it comes to law enforcement and stress, there is however another form of stress that many officers will face but are unprepared to deal with. This stress is more immediate and intense and is often the result of a singular traumatic event. It can be unsettling to learn just how severely a single event can change a person’s outlook and approach to both his profession and his daily life.

Sense of Invulnerability

The sense of invulnerability is perpetuated in the field training an officer receives once he/she begins working in his/her respective department. New recruits learn from senior officers that police work requires the inhibition of affective or emotive responses. When an officer arrives to the scene of a fatality, they are required to remain emotionless – and manage the situation. Even when confronted with a death of a child, they are expected to push aside any emotional response and immediately take control of the scene and provide order and a sense of safety to the community. Learning to suppress normal human reactions in the face of a crisis is a part of the job. But suppressing them indefinitely, long after the crisis has passed, is destructive to even the strongest of us.

My mission is to provide a professional, confidential and secure platform which is highly responsive to the trauma faced by peace officers and other first responders. Law enforcement and stress are eternally linked – it’s unavoidable and the nature of the profession. Sometimes we need to work problems out in a safe space away from even family and friends. Please allow me to demonstrate to you that the therapy offered here genuinely helps you the police officer to become empowered to feel back in control of your life.

We only get a short time on this planet, but when trauma or personal challenges become overwhelming we can lose sight of life’s pleasure. Through new perspectives, let me help you to ‘Help Yourself’ get back to enjoying life!

Call Now (346)-493-6181


Ben Carrettin is a Nationally Board Certified Counselor (NCC), Licensed Professional Counselor-Supervisor (LPC-S) and Licensed Chemical Dependency Counselor (LCDC). He is the owner of Practice Improvement Resources, LLC; a private business which offers an array of specialized counseling, evidenced-based clinical consultation, Critical Incident Stress Management (CISM) and targeted ESI-based services to individuals and businesses.

Death in Workplace

Death In the Workplace

Death In the Workplace; Counseling for grief of a of co-worker

People go to work expecting things to be business as usual. At the end of the day, they go home to their personal lives, friends, partners and families. The last thing any of us expects is for a co-worker to die in the workplace, either from natural causes, or as a result of a tragic event or industrial/work related incident such as:

rig and refinery

industrial plant

construction site

line of duty (LODD)

fire and disaster

transportation vehicles

murder / suicide

When a death in the workplace happens, workers have to deal with additional concerns in addition to the shock, the death of a co-worker and the loss of safety in the work environment. Workers, Human Resources and Management may be concerned about how and why the incident occurred and what sort of steps are being taken to ensure that another accident will not happen and/or the security is being increased to protect them from future acts of violence. Death in the workplace may result in feelings of anger, guilt, unease, fears for personal safety plus the pervasive need for someone or something to blame.

When a death in the workplace occurs it can send shock waves through the various parts of the organization. Often times, workers do not get a chance to air their thoughts and feelings about what has occurred with their colleagues and managers in any structured process. People respond to loss differently. Some find it very difficult to return to work, whereas others find it helpful to keep busy; their work diverts them away from grieving, sadness and mourning. For other workers, simply getting back to standard routines and avoiding any special activities or remembrances related to the loss or death, may be the best way of putting the event behind them. Moreover, while they want to continue performing at peak levels, it becomes difficult to impossible. Low productivity and absenteeism are unfortunate but common results of unprocessed grief. On the other hand, Human Resources and Managers often do not know what format or mechanism to follow in the aftermath of sudden and unexpected loss in the office.

My services facilitate the beginning of a healthy grief process. Workers feel accounted for and part of a larger effort of empathetic responsiveness on the part of the company when their needs are addressed. As a crucial part of this larger empathetic (and practical) response, the grief counselor becomes your ally and guide through a complicated passage. (*please read the statement below)

Call Now (346)-493-6181

*The above service is for individuals and delivered at our central office. If an incident has occurred at your company and you are calling about onsite services for the employees – please go to the Critical Incident Stress page (under Corporate Services) for further assistance.

Ben Carrettin is a Nationally Board Certified Counselor (NCC), Licensed Professional Counselor-Supervisor (LPC-S) and Licensed Chemical Dependency Counselor (LCDC). He is the owner of Practice Improvement Resources, LLC; a private business which offers an array of specialized counseling, evidenced-based clinical consultation, Critical Incident Stress Management (CISM) and targeted ESI-based services to individuals and businesses.


Death In the Workplace

Executive Social Intelligence

ESI – Leadership and Public Speaking

ESI – Executive Social Intelligence

Why managers need ESI coaching sessions for effective leadership.

The corporate world is both dynamic and demanding. There is an intense focus on both performance and measurable results.  The most effective leaders today exhibit high levels of executive social intelligence. ESI Coaching hone managers and directors to be more adaptive and psychologically strategic in an ever-changing work environment. ESI enhances personal discipline, teaches employee/team management strategies and reinforces a leader’s strategic interpersonal skills.

As a tool, success and growth oriented managers use ESI to effectively add value to their workforce’s abilities, as well as their own. In the simplest situations it effectively helps leaders in dealing with minor issues long before they become major (and often times expensive) ones. More strategically, ESI can be used to prepare new or transitional leaders. In this case, by sharpening their public speaking acumen, facilitation skills and subtle behavioral strategies to strengthen the way they are received by others.

Public Speaking and Presentation Acumen

Communication affects how we relate on a day to day basis.  With our diverse cultural backgrounds, education and training, personality, micro expressions, body language and motivations – poor communication can be detrimental in the workplace. It’s not just about a mediocre delivery, it can actually be damaging to the culture you are trying to grow. ESI helps leaders to effectively build an audience’s confidence in their presented content. It also helps maintain integrity between a speaker’s words and body language while ensuring clear and consistent messaging. Whether a public figure addressing the media or a regional director presenting an annual report to the board – a professional ESI coach provides you with a strategic advantage.

Renewed motivation, vision and organizational commitment

Time has a tendency to wear on anyone. This can make it harder to maintain the highest levels motivation and objectivity. While it may be human to slack off once in a while – a progressive decline in productivity runs counter to your career success. ESI helps you  improve your behavioral strategies. Refining your strategic skills enables you to remain professionally objective, highly effective, and a valued and adaptive leader.

Improvement here is not only a step in the right direction for yourself, it also affects how others view you. This is paramount for leaders wanting to elicit the very best from their teams. ESI coaching sessions offer the professional the ability to work outside of their comfort zones. It doesn’t matter whether you are taking over a new division, just landed a promotion or navigating the  downsizing of your workforce. ESI coaching can help you.

For ESI Coaching and Consulting, Call (346)-493-6181




Critical Incidents

Critical Incident Stress


A critical incident (or traumatic event) is any event outside the usual realm human experience that is markedly distressing (elicits reactions of intense fear, helplessness, dread, panic, horror, etc.) Critical incident stress usually involve the perceived threat to one’s physical integrity/safety or the physical integrity/safety of someone else. Most of all, critical incidents are defined by their undermining of a person’s sense of safety, security and competency in the world.

The result, critical incident stress can be a form of psychiatric injury, also known as traumatic stress. Contrary to some misconceptions out there – a person’s internal fortitude does not prevent this from happening. It is extremely important to respond quickly to a critical incident. The sooner the intervention/response – the less likely more complicated problems such as panic attacks, Post Traumatic Stress Disorder, and similar anxiety spectrum disorders are to arise, as well as a host of other challenges.

Events That May Result In Critical Incident Stress

Automobile accident, or any accident involving serious injury and/or property damage
Industrial accidents involving serious injuries or fatalities
Sudden or unexpected death of a relative, friend or colleague
Sexual assault/abuse
Robbery and violent crimes
Domestic violence
Child abuse and/or injury or death of a child
Psychological/emotional abuse
Suicide or attempted suicide
Line of duty death or injury among emergency/law enforcement personnel
Any life threatening experience
Adverse/negative publicity
Observing or being aware of unethical acts
Observing any of the individual or community critical incidents


  • Fires
  • Floods
  • Earthquakes
  • Hurricanes
  • Tornadoes
  • Multiple injury/fatality accidents
  • Large scale environmental pollution
  • Terrorism
  • Acts of war
  • Child related traumatic events
  • Homicides in the community
  • High publicity crimes of violence or sex
  • Community disasters
  • Being an emergency worker/first responder in critical incidents and disasters*
    • (*Peace Officers, Fire & Rescue, EMT, Triage Nurses & Military)

Point Of Fact:
You do not need to be directly involved to be negatively affected by a critical incident. Generally, the closer you are to the actual event and the people involved, the more severe the impact. However, television and news media coverage, especially excessive and/or graphic depictions, may serve to increase the likelihood of experiencing traumatic impact, especially anxiety and feelings of not being safe.

Traumatic Events, Critical Incident Stress and CISM

What are CISD and CISM?

Critical Traumatogenic Exposure and CISM Incident Stress Debriefings (CISDs) are a specific tool of Critical Incident Stress Management designed to help individuals, groups, or entire organizations cope with the often difficult, overwhelming and stressful emotions associated with critical incidents or traumatic events.

What Employers Should Know About CISM

CISDs helps mitigate post-traumatic symptoms, assess the need for follow-up, and often provides a sense of closure. If prompt trauma intervention is provided at the onset of the crisis, damaging long term effects can be minimized and employees will be better equipped to return to the daily work routine and productivity.

Professional Consulting/CISM for Traumatic Exposure and Critical Incident Stress

Professional consulting and Critical Incident Stress Management (CISM) are not the same thing as psychotherapy or counseling. These are specialized, focused services that are used very specifically for individuals who have been involved in or exposed to unnatural events or conditions. Sometimes exposure occurs while fulfilling the duties of their profession, sometimes due to unforeseen accidents or disasters and even sometimes as a victim of an aggressive crime.

These services are not the same as therapy and in no way are they meant to replace therapy. These services are most effective when used as soon as possible after the event to help normalize the situation and prepare the individual for some other issues that may arise in the short term as a result. CISM is intended to be used promptly to reduce the risk of further distress and more detrimental outcomes later on such as Post-Traumatic Stress Disorder (PTSD).

Critical Incident Stress and Other Issues that may be addressed by CISM include;

Critical Incident Stress Debriefing, Anxiety & Anger Problems, Stress Management, Traumatogenic Exposure, PTSD, Survivor’s Guilt, Grief and Loss, Family Conflict, Significant Life-Change Adjustment, Work/Life Balance, Spiritual/Philosophical Conflicts and Substance Abuse/Dependence.

These services are typically used for :
First Responders
Peace Officers
Fire Department
Hazardous Professions
Oil (Rig/Refinery) Professionals
Industrial Plant Professionals
Airline / Airport
Maritime / Off Shore
Professional Environment
Death in the Workplace
Violence in the Workplace
Crisis Event in the Workplace
Victims & Survivors
Aggressive/Assaultive Crime
Robbery/Random Crime
National Crisis
Natural Disaster

The Top 7 Reasons Your Company Should Use a Licensed and Experienced CISM;

The Top Reasons Your Company Should Use Critical Incident Stress Management
(What Every CEO, Human Resources Manager and Internal EAP Should Know About Critical Incident Stress Management.)

  1. Meet OSHA requirements for General Duty Clause 29 USC 1900 5(a) and for S.E.M.P. Compliance. (Structured Emergency Response Program)
  2. Provide Risk Management for adversarial situations and help decrease litigious responses.
  3. Help prevent job stress and burnout problems and worker injuries/errors and associated costs.
  4. Decrease bottom line expenses for employers. (Studies have shown realized savings of $7 for every $1 spent on CISM).
  5. Promotes employee wellness and decreases utilization of sick time and benefits.
  6. Stabilize crisis situations quickly & effectively when they do occur.
  7. The visible and appropriate action of a company taking care of its employees in a crisis.

Professional Consulting/CISM for Critical Incident Stress

Professional consulting and Critical Incident Stress Management (CISM) are not the same thing as psychotherapy or counseling. These are specialized, focused services that are used very specifically for individuals who have been involved in or exposed to unnatural events or conditions. Sometimes exposure occurs while fulfilling the duties of their profession, sometimes due to unforeseen accidents or disasters and even sometimes as a victim of an aggressive crime.

These services are not the same as therapy and are in no way meant to replace therapy. These services are most effective when used as soon as possible after the event to help normalize the situation and prepare the individual for some other issues that may arise in the short term as a result. CISM is intended to be used promptly to reduce the risk of further distress and more detrimental outcomes later on such as Post-Traumatic Stress Disorder (PTSD).

For Corporate CISM Services, please contact Ben Carrettin at (346)-493-6181

Ben Carrettin is a Nationally Board Certified Counselor (NCC), Licensed Professional Counselor-Supervisor (LPC-S) and Licensed Chemical Dependency Counselor (LCDC). He is the owner of Practice Improvement Resources, LLC; a private business which offers an array of specialized counseling, evidenced-based clinical consultation, Critical Incident Stress Management (CISM) and targeted ESI-based services to individuals and businesses.

Survivors of Suicide

Survivors of Suicide

Survivors of Suicide – SOS

Losing a loved one to suicide is very painful and leaves lasting consequences for the people who are left behind; the survivors of suicide. Suicide is a highly traumatic event and there are many consequences and effects that the survivors of suicide might experience.


Depression, sadness and grief are reactions that might occur after any loss, however, they might be felt more strongly after a loss by suicide. The person might feel crushed by feelings of guilt, shame and worthlessness, as they might feel a degree of responsibility for the suicide.
Depression and grief can be felt very strongly. A person might develop suicidal ideas and ideas that they might rejoin their loved ones by committing suicide. The pain is very strong, so it could be a good idea to reach out to mental health professionals and work with the grief in a more secure setting. Professional help might be especially needed if there are suicidal ideas.


Anger is another emotion that appears after a loss, but might be felt more strongly in a loss by suicide. The suicide survivor might feel anger at the person who committed suicide, but also at themselves, at other people (parents, friends, mental health professional, school authorities, etc.) who did not prevent the suicide. This is an emotion that is related to the grieving process.

Trauma and shock

The person may experience the after-effects of shock and trauma. It’s even possible to develop Post-Traumatic Stress Disorder, for which counseling and therapy might be needed. The effects might be linked to flashbacks, nightmares, excessive adherence or obsession with anything related to the person who committed suicide or related to suicide and that pose severe limitations of the person’s life, hope for the future and relationships.


A possible first reaction to the situation is denial. The person might seemingly have a very subdued emotional reaction, not recognize what has happened or refuse to accept that it was a suicide. This reaction is usually a defense mechanism to protect a person’s mind from the shock and trauma, however, if the denial lasts for a long time, it can prevent the grieving process and lead to serious consequences. Denial might be expressed in different ways, for example, not crying or not getting angry, not touching the things or the room of the person who committed suicide, not visiting the grave, refusing help and refusing to talk about the situation for a long time. Denial might be a part of the grieving process, however, if denial does not give way to other reactions, it might seriously affect the person.

Guilt (the G word)

Guilt is commonly misidentified as a reaction among suicide survivors. Individuals might feel that they could have done more to prevent the suicide or that it was their fault that the person made that choice. But in truth, looking to ourselves for fault is an attempt to make sense or find a cause for the the senseless. Often times, the reason(s) is never fully revealed to anyone left behind. It is important to work with this emotion, because it can lead the person to act in self-destructive ways or to develop a strong depression.

Crisis of faith

This is a reaction that religious suicide survivors might experience. They might have a strong crisis and seek answers about why did someone close to them committed suicide or why their faith did not prevent what happened. The person might also feel anxious and worried about ideas related to suicide and hell or punishment. Some individuals might feel more drawn to religion for support in their grief, however, religious practices often do not substitute grief counseling.

Stigmatization by the community and blaming others

The aftermath of a suicide can be a difficult time, however, it can be made worse by the reactions other people have. Others might blame the person for allowing the suicide to happen or dismiss the reactions the person have. They might also discuss sensitive topics in an insensitive manner, for instance, saying that the person who committed suicide is surely in hell or that they were weak, in more extreme cases. Others might blame the family and friends and consider them to be dysfunctional or mentally ill as well. These reactions can worsen the state of the suicide survivor, especially if the person already feels guilty or responsible for what happened. In the aftermath of a suicide, some people might engage in finding someone or something to blame so as not to feel guilty, for example, family members might blame the friends or visa versa. This is usually not a constructive approach, as it often has to do with denial and with ignoring the pain different people are feeling at this time.

Seeking support and offering support

Individuals who are reeling from the loss of a loved one by suicide might look for support groups and communities where they can share their story with others who have had similar experiences. It’s a healthy way of coping with the situation, to be supported by others who can be truly empathetic, and to learn ways to move through the grief. Other individuals might choose to continue to participate in these groups to help others with their grieving process and make new support networks. Working a seasoned grief counselor who specializes in working with survivors of suicide can also be extremely helpful.

One last thought

There are many difficult stages to the grieving process after the loss of a loved one and many different ways to grieve. A suicide can be shocking, unexpected and more difficult to deal with than other types of losses. The person might feel guilty, angry and sad, experiencing many negative emotions and living through very difficult times. However, it’s possible to have a grieving process that will allow the person to move forward with their life, especially if the process is done with professional help and support.


Ben Carrettin is a nationally board certified and licensed professional counselor who specializes in traumatic loss; including working with the loved ones of someone who has commit suicide. He is a lay chaplain with advanced training in pastoral care as well as in many therapeutic processes that help to guide you through your own unique and personal, grief journey.

If you or someone you know has lost a loved one and is hurting right now. Please know, support is here.

Call Now (346)-493-6181



Children & Grief

Children and Grief

Children and Grief; Teaching Children What Death and Dying is All About

Death happens all the time. It can come slowly as in the case of those with terminal illnesses, or it can happen unexpectedly. Adults already have the ability and eventually accept the death of a loved one but for children, the concept of being on one’s deathbed or not waking up one day can be difficult to process. Children and grief is a territory that many adults will stumble through or even try to avoid altogether. But there is a healthier, healing way to approach this.

Parents have a hard time broaching this subject because they want to shield their children from the agony and grief that comes with death. But death is just part of life and one that should be discussed as much as possible in order to prepare them when such a crisis arises.

Whether parents like it or not, children and grief are joined – kids are exposed to death all the time. They see dead plants, dead insects, and dead animals from time to time. Even the TV programs that they see every day tackle death at one point or another although subtly. They even read about death and even perform death at school too. So you see the concept is being woven into their young life. It is just a matter of how you’re going to teach them idea of dying and death fully for them to understand.


Why Death is Difficult to Talk About – Talking With Kids About Death and Dying

The top 3 reasons why discussing death is a challenge for many parents.

Lack of answers. Children are inquisitive by nature and will always ask why. They expect their parents to provide them with the answers because they believe that adults know everything. As flattering as this is, it is better to be honest about death especially when you know your answer is not sufficient to what they’re asking. Instead of being embarrassed that you lack the right answer, be honest.

In some family cultures talking about it is taboo. For some cultures, death is interwoven into their daily lives, for others it is a topic very actively avoided. Some family members prefer to die at home with loved ones looking over them including children. Today, however, there are many who die alone, away from family, which can be a cause for concern for children. What we don’t talk about or acknowledge can be scary and very confusing for kids.

Some parents and families avoid upsetting topics. Parents have this tendency to bottle their emotions up to show their children that everything is alright. However, kids are attuned to their parents’ emotions including body language. When children feel that their parents are keen on discussing a death in the household, they hesitate to ask questions which leave them vulnerable as well.

childLossDiscussing Death with Children – Talking With Kids About Death and Dying

Children have different levels of understanding death which means you need to know what the best approach is based on the age and understanding of the child. For example, preschoolers assume that death is just temporary and that the one who died will magically rise. This is acceptable at this age. At the ages, five to nine, children are aware of death as they see insects, plants, and animals die, but they don’t connect it with them. They can associate death with the image of a skeleton and may even have trouble sleeping because of it. By the time they reach adolescence, they are more aware of what death is, and that is not irreversible and can even happen to them as well.

Based on these ages, parents will be able to find the best approach to this sensitive topic.

Here are a couple of quick tips that you can use:

For preschoolers, explaining death requires the use of simple terms that they will easily understand. Giving examples makes the concept of death more concrete such as death means losing the ability to move, think, and feel.

For children aged five to nine, repetition should be employed. There are some children who have an endless supply of questions, which can feel overwhelming while others simply listen then come back later to discuss the topic further. The best action to take here is to be ready to answer your children’s question no matter when it suddenly crops up.


Keep in Mind: It will take children time to really process the concept of dying and death. Some children will still ask as to why their Aunt is crying even when she knows that her Uncle Ted is dead. Others may feel indifferent on the concept of dying and death and may be ruthless in their questions such as, “When will you die?” And still others may act out or engage in silly antics or humor. Instead of getting annoyed or hurt with their questions or behavior, it is best that you practice patience and understanding. After all death is a big concept that they still need to understand.

Opportunities to Take Advantage Of – Talking With Kids About Death and Dying

Sometimes broaching the topic of dying or death to young children is necessary in order to prepare them. Just like it was mentioned before, kids encounter death in so many ways such as death of a pet, an animal they come across, or even a dead plant. This can open a floodgate of questions about death so you need to be ready to provide answers that they can easily digest. Tell them that death is a natural thing and that all living things eventually die.

If your child needs to be present in a funeral, you should explain to them what goes on in a funeral service so they will not be overwhelmed with what they see or hear. Tell them that there will be people who will be crying and that funerals are usually a sad occasion.

Children will mourn in their own way especially when someone close to them is dying or recently died. Children and grief do not necessarily “look” as many adults might expect. They will feel lost, angry, and confused all at the same time. It is important that you make them feel safe and secured with the knowledge that they are never alone and that they are always loved and cared for.


Death is always synonymous with life. What’s important is to convey to children that death happens all the time and to be there for them when they feel the pain and loss. Patience and understanding is important when discussing the concept of dying and death to children and the acceptance that children have a deeper understanding of life. They just need someone to guide them through this challenging phase to emerge with minimal scars.

If your family is facing the death of a loved one and you need help to guide you in your discussions and support of children through this time, I’d like to help you. I am also available to support a child in your family that is struggling with the loss or coming loss of a family member or friend.

Call Now (346)-493-6181

Ben Carrettin is Nationally Board Certified, a Licensed Professional Counselor and has worked in the arena of addiction/emotional health and the corporate world for many years. He is trained in Critical Incident Stress Management (CISM) and is also a lay chaplain with advanced training in pastoral care as well as cross-cultural communication.


Cancer & Medical Uncategorized

Heart Disease and Depression

Heart Disease and Depression

I am feeling depressed after my heart attack. What can I do?
Don’t be ashamed or surprised if you are having some depressed feelings after your heart attack, heart surgery or stroke. Heart disease and depression are more common than you might think.

It’s not uncommon at all and you are definitely not alone. Your attentive physician will likely have you evaluated for depression after a heart attack and further direct you for appropriate treatment if it is determined that you have clinically significant symptoms of depression. Be open about this assessment. Depression is a treatable condition. Reducing your suffering and increasing your zest and enjoyment of life is good for you. Quality of life is everything. Part of your recovery includes taking care of the depression that can follow.

“When it comes to a heart attack or stroke – people typically think of the physical challenges. But the emotional taxing of our well-being that commonly follows is often overlooked, but very real.”
– Benjamin W. Carrettin, 2011 –


Be active in your cardiac recovery!

Follow your physicians plan for you, take your medications as your physician prescribed, adopt the diet and exercise recommendations, be vigilant in your attendance to your cardiac rehab program, and of course, spend time with your trusted friends and family. And if your physician feels that counseling is warranted – welcome the suggestion. Patients with heart disease who have a trusted confidant with whom they can share distressing thoughts and feelings have been found in prior research to have lower mortality rates. Even though there is no guarantee that counseling after a heart attack or surgery will prolong your life we do know that effective treatment of depression can reduce suffering and improve your quality of life.

I’ve never been to a counselor before. How does it work?
Breathe. Initially, you may be a bit nervous, but counseling should seem in many ways just like having a conversation with a trusted friend. I will ask questions, listen carefully to you and make suggestions. I consider my clients to be the reigning authority on the details of their own lives and as experts, together, we work to improve the quality of yours. While I am diligent and dedicated to my profession, I am also committed to ensuring that my clients are treated with the utmost dignity and respect. Please feel welcome to call me anytime with your questions or concerns. I’d be happy to talk with you.

Heart Disease and Depression: The Undeniable Link and How to Deal With It

The relationship between heart disease and depression can be seen as a two-way street. According to several studies that have been conducted in the past, around 15% of people with cardiovascular disease and 20% of those who have undergone heart surgery are suffering from major depression. In the same way, a high percentage of people with depression show symptoms of heart disease even if they do not seem to have any cardiovascular problem in the past. With this, it is important to recognize the problem as soon as possible, and consequently, identify the courses of action that will prove to be necessary before it becomes too late.

What is Depression?

For most of us, feeling sad and moody is a common occurrence. If you remember a sad event in your life or if you miss someone, you will most possibly delve into negative emotions. However, for some people, this sadness is experienced in a manner that is more intense and longer, such as for several weeks. In some cases, they experience being sad with no significant reason at all. This is most probably one of the most obvious signs of depression. It is a condition that goes beyond having a low mood as it can have a significant impact on one’s overall state of health.

Depressive disorders can be a result of different factors, such as physical health, family history, stress, imbalance in the chemicals in the body, and environment, among others. When a person is experiencing depression, it is common to feel bad about one self, to lose productivity at work, to forget about loved ones, and to have a change in attitude. Behaviors and attitudes will be the basis of diagnosing if a person is possibly depressed or not. The good news, however, is that there are depression treatments that are promising in terms of being able to resolve the problem.

Among others, the following are some of the most common symptoms of depression:

Loss of interest in socialization

Dependence on drugs and alcohol

Inability to concentrate

Lack of productivity at work

Difficulty sleeping

Feeling invaluable

Having suicidal thoughts

Loss of appetite


Heart Disease and Psychological Impacts

For people who have recently had a heart attack or any other cardiovascular disease, it is apparent that their life is being affected in ways more than one. For instance, following such occurrence, it is normal for the patient to have a change in mood and attitude, have embarrassment and self-doubt, feel worthless, especially if the disease renders one of being incapable to work, and feeling guilty about having a bad lifestyle in the past that has resulted into such condition. Most people become filled with anxiety and uncertainty, which, consequently, can be one of the most common symptoms of depression.

The Relationship between Heart Disease and Depression

In many studies in the past, the link between these common health problems have been explored, and without any surprise, many of them have concluded how the two are indeed related to each other. For instance, in one study, it has been asserted that the presence of depression even after recovery from a heart attack can increase the chance of mortality by as much as 17%, as against the 3% rate of mortality among people who are no longer showing signs of depression. In addition, it has also been asserted that people who are suffering from depressive symptoms show an increase in platelet reactivity, which is one of the factors that trigger cardiovascular diseases. More so, another study has revealed that people who are suffering from heart disease and depression noted a lower quality of life. It is also worth noting that a person who is suffering from depression may be more likely to resort to negative habits, such as smoking and drinking alcohol, both of which will make one at higher risk of having heart disease.

Treatment Options

One of the most common options for the treatment of depression is through the use of medications,  which are prescribed by a doctor. (Remember, do not simply go to taking medicines if they are not prescribed by your physician as doing this can worsen the problem rather than having it resolved.) The most common would be anti-depressant medicines, including selective serotonin uptake inhibitors. Doctors will know best which one will work for you. A careful assessment of your health condition will be required to avoid possible side effects. *If you have more than one doctor providing care for you and prescribing medication – be sure they all have a release to be able to speak to one another and make certain every one of them have a complete and accurate list of all your medications.

Providing social support is also necessary for people who are suffering from heart disease and depression. According to several studies in the past, patients should create an effort to re-engage with their social network. In the same way, friends and family should never make the patient feel isolated because of the condition. Providing support will be effective in the prevention of depressive symptoms.

Taking medications is more commonly complemented with psychological treatments. This is important not only for the purpose of treating the current condition, but also to make sure that the signs of depression will not continue to burden you in the future. Through mindfulness cognitive behavior therapy (M-CBT) and interpersonal therapy, a seasoned and experienced professional therapist or counselor will help you to change your perspective in life, and hence, providing you with a more optimistic attitude to fight depression.

10 Common Symptoms Of Depression

Every year approximately 10 per cent of the American population suffers from depression. Depression is a grave illness that affects day to day life and destroys families. It is a disorder that controls the mind and its functions causing loss of appetite, sleeplessness, mood swings, and a deep sense of despair.

The symptoms of depression are varied and the severity changes with time. And, according to experts depression can be an inherited disorder, or caused by life threatening illnesses, or stress. Other causes are certain diseases, medicines, drugs, alcohol, chronic exposure to high stress environments or mental illnesses. Women have been seen to experience depression more than men and this is attributed to hormonal swings, menstrual cycle changes, pregnancy, miscarriage, pre-menopause, and post-menopause. But male depression in the U.S. is on the rise for a variety reasons.

Common symptoms are:

1. An unshakable sadness, anxiety, or emptiness.

2. Overwhelming hopelessness accompanied by pessimistic feelings.

3. Extreme guilt, feelings of helplessness, and no sense of self worth.

4. Loss of energy, a slowing down of metabolism, and activity levels. Being plagued by constant fatigue.

5. A sense of helplessness along with an increasing inability to focus and indecisiveness.

6. Loss of sound sleep and development of extreme insomnia.

7. Inexplicable weight loss or weight gain. Triggered by loss of appetite or eating binges.

8. Brooding and suicidal inclinations.

9. Irritability, short temper, as well as restlessness.

10. Physical afflictions like headaches, digestive disorders, and chronic pain for no particular reason.


If you experience any of the above along with a marked change in behavior do consult your doctor. They will give you a thorough examination to rule out physical causes for depression as well as any underlying medical problems. Then if needed they will recommend you for counseling or other supportive services.

Here are some quick tips for dealing with Mild to Moderate Depression:

Take matters in hand and try and erase negativity from your mind. Cut out from you life terms like exhaustion, worthlessness, and hopelessness. Change your life by setting yourself a few goals. Try and relax, meditate, and enjoy music. Start new activities that absorb your time as well as interests. Go out and meet people and participate in group activities. Avoid the company of negative people – this is huge, but isolation is not the answer. You have to add positive, communal experiences. Make up your mind to enjoy a movie, ballgame, family outing, picnic, or trek. Be positive, self confident, and have faith in yourself. Faith is itself can be a great healer. Decide to change your world for the better. However do follow the doctor’s advice. Treatment options can include: anti-depressant medicines, psychotherapy, as well as lifestyle changes.

For Severe Depression

If your depression escalates, seek help from your family physician or health care provider. If you are suicidal, call the emergency response, suicide hotline or go to your nearest emergency room. Do call a local health department, a community mental health center, or hospital or clinic. Someone will extend a helping hand and talk you through the crisis.

More Information on Heart Disease and Depression

Cardiac events, surgery, heart disease and depression. These are all familiar, often feared and typically held as foreign to us personally. But for many of us or those we love – these can become all too real very quickly.

When someone experiences a heart-attack, heart surgery or stroke, the immediate concerns obviously are physical health and management of the immediate situation. But when they survive and move on with their day to day activities, it is important to manage their mental health as well.
According to several studies done by researchers, it has been clear that about 40% of the patients with heart diseases and cardiac events suffer from depression. Depression has become very common after a heart attack. About 20% of post cardiac patients who suffer from depression have the severe form of it, while the others have it mildly. The good news is that this can be treated, but, this has been temporary most of the time. Long term survivors of cardiac events fall into depression in the rate of one out of three every year.


Also the researchers have shown that physical inactivity has become an independent risk factor for increased depressive symptoms after a cardiac event. Of course, it is understandable that getting diagnosed with a heart disease is really sad. But the process of this sadness and how the person copes with it is also important. Some accept the health status of their own selves, and focus on rehabilitation and regaining the health which he has lost or to recover as much as possible. But some find it hard to accept and the early sadness converts to depression over time.

One of the main things a person should be concerned about is that if the patient mood or outlook has changed significantly or they are not enjoying life as they did before. Do not dismiss apathy and malaise  – these are concerns and should be discussed with a professional. Below are the main symptoms which will hint that the patient has not recovered from the psychological effects which he had suffered due to this health state. If you are having a loved one or you yourself are suffering from such a situation, it is best to go to a doctor. Counseling can help you come out of the depressive state you are in.

Depressive state after a cardiac event is not a normal thing and sometimes, your cardiologist may not understand that you have depression. To understand and to save yourself or your loved one from this state, you will have to observe them carefully.

A person with depression will likely have five or more of the following symptoms;

• Frequent feelings of sadness or emptiness

• Loss of interest in pleasurable activities

• Strange eating or sleeping patterns

• Excessive crying

• Thoughts of suicide and death

• Fatigue

• Difficulty concentrating or remembering

• Feelings of worthlessness or helplessness

• Irritability

• Unexplained aches and pains that don’t respond to treatment

Depression is not the only matter, after a cardiac surgery. Some people also suffer from Post Traumatic Stress Disorder (PSTD) or anxiety. Even though the relationship between heart and mind are not understood, it is evident that a major surgery in the heart can cause some chemical changes in the brain. Doctors say that it is good to talk to a patient who has undergone a heart surgery, before you do your surgery. Also, they recommend that, a post cardiac surgery patient should do counseling after the major surgery.

Without treatment, depression can be fatal. For heart patients, depression can cause increased risk of heart attacks and coronary artery diseases. That is why you need to be careful about your psychological status, in order to have a full recovery and an effective rehabilitation.
If you feel like having depression and that something is disturbing your day-to-day work and social relationships, then it is necessary to get treated by a mental health specialist.

If you want to be more specific, here are some reasons to seek help;

• If you have low mood and lack of happiness daily, for about two weeks.

• If you find it very difficult to recover from your heart disease and if you feel a lack of motivation and confidence. This is a symptom of depression being settled in your brain.

• If you have difficulties carrying out your daily work, such as marketing, having good neighborhood, having a good relationship with family and etc.

• Low social activeness can also suspect that the patient is finding it hard to move with others and is also one of the symptoms of depression.

• If a person has suicidal thoughts and feelings.


Suicide is not a solution for any problem and it can harm not only the person who tries to commit suicide, but the loved ones as well. If you have any suicidal thoughts, call your physician or 24 hour suicide hotline right away.

The symptoms and a proper history can help a doctor predict or diagnose the prognosis of a patient. How long the psychological affects last and how often it occurs help us understand whether the patient is processing this health state in a natural way or whether he is slipping into depression. Diagnosing this status wholly depend on the patients attitude and behavior and not by the lab reports and others.

There are many treatment methods for depression; medications, psychotherapy or a combination of both can be used. Among medications new antidepressants such as Selective Serotonin Re-uptake Inhibitors (SSRI) are safe to be used for cardiac patients.

Psychotherapy can help a person to regain the normal thoughts and activities. It helps to provide social support and help the patient develop positive thinking. Supportive models of talk therapy appear to be the most effective in treating post cardiac surgery depression. Talking about the surgery and the experience the patient had can remove the fear, depression and sadness they have had after surgery.

Furthermore, a healthy lifestyle, regular exercises, proper sleep and a healthy diet together with a relaxation technique which will help to remove the stress after the surgery will help the patient manage psychological negativity which comes after surgery.

Early diagnosis and treatment of post cardiac surgery depression is important to gain effective rehabilitation and to prevent recurrent heart attacks. If left untreated, it increases the risk of mortality, depression and heart attacks.

As always a proper support system and a helpful background are important in helping a depressed person come out of the situation.

If you are family or a loved one of a patient who has undergone a cardiac surgery, here are some tips and suggestions;

• Encourage the patient to seek medical help and follow the therapy as asked. Make sure that he is consulted by a proper medical professional so that the diagnosis can be made as soon as possible and treated effectively.

• Educate yourself and family about post cardiac surgery depression. This will help you and your family to understand the patient’s situation. There are many support groups and organization which will provide you with enough information.

• You should know that depression is not a person’s attitude, weakness or quality and that it is a disorder with biological, psychological and interpersonal components.

• Help your family member follow the prescribed treatment plan and practice the coping techniques and problem-solving skills he or she is learning during psychotherapy. Following the doctor’s instructions will help him recover soon.

• Make sure medications are available if prescribed, attend therapy sessions together with a family member if the patient feels that it is needed, encourage the patient to follow recommended lifestyle changes and follow up with the proper health care providers.

• Recognize that depression is often expressed as hostility, rejection and irritability. Offer consistent support to your loved one. This can be daring, but it is one of the most important parts of a treatment plan. People with depression can feel alone and isolated. Giving consistent support and understanding are critical. Making them feel that you are with him, helps a lot more than you think.

• Adopt an interaction style that puts the depressed person in charge. For example, instead of suggesting, “Let’s go to the movies tonight,” try this: “I’d like to see a movie tonight. Which one of these do you want to see with me?” When he is in charge, he feels that he can manage things and this will help the negativity vanish away. (Remember that treatment is effective and your loved one will start to improve in 2 to 3 weeks, achieving full improvement in a couple of months. Notice and praise any significant improvement.)

• Reward your family member with opportunities such as visiting friends or going out for activities. Don’t force these, though. Suggestions and requested would be the best option.

• Take breaks from the depressed person from time to time. It will help both of you. A break will help you regain your active mind as well as the patient will feel that he is not forced.

• Consider family or marital therapy: these forms of therapy bring together all those affected by depression and help them learn effective ways to cope together.

• Consider support of community support groups, either for the depressed person, or for you as the family member, or better yet for both of you.

Outpatient Professional Counseling For Heart Disease and Depression

If you are looking for the best way to deal with heart disease and depression in Houston, Texas, I can extend a helping hand through private, outpatient professional counseling. With my extensive experience and knowledge in working specifically with the emotional challenges that often complicate serious medical issues, I provide services that preserve the dignity and privacy of my clients and that are customized to their specific needs. Compared to other local treatment options, outpatient counseling delivers a wide array of benefits, such as giving you the freedom to do the things you normally do while undergoing treatment. My professional services will help you and your loved ones live a normal, healthier, and happier life even if you have heart disease and are showing signs of depression.

Call Now (346)-493-6181


Ben Carrettin is a Nationally Board Certified Counselor (NCC), Licensed Professional Counselor-Supervisor (LPC-S) and Licensed Chemical Dependency Counselor (LCDC). He is the owner of Practice Improvement Resources, LLC; a private business which offers an array of specialized counseling, evidenced-based clinical consultation, Critical Incident Stress Management (CISM) and targeted ESI-based services to individuals and businesses.

Cancer Resilience

Counseling for Cancer Patients and their Loved Ones

Counseling for Cancer Patients and their Loved Ones

A patient who is first diagnosed with cancer is usually overwhelmed and frightened. Feelings of sadness, confusion, worry, and anger are completely natural. The patient’s psychological and social well-being are impacted, and a patient’s relationship with family and friends can be affected by this as well. The physical/medical hurdles, adjusting relationships and changes in personal philosophy may lead to feelings of hopelessness and helplessness, and it is really important to find ways to address these feelings. Counseling for cancer patients and their loved ones can be a great help during this time.

Counseling can help the patient to better cope with the side effects and the pain that evolves from treatment. It may also help the patient and his family better deal with and express these common feelings, as well as provide a safe place to discuss their concerns.
Most cancer patients have to grieve the loss of their previous lifestyle, learn to accept their new reality, and make the most of their new situation. Many will experience an evolution of their view on life and likely re-assess their priorities. The process of living with cancer is life-changing; for the patient and for those who love them. Facing cancer is an experience that often leads the patient to re-examine his core values and passions and can motivate them to pursue new goals of great personal importance.

Here are some of the ways counseling can help the person facing cancer and their loved ones too:

For Newly Diagnosed
1. A safe place to deal with the emotional impact, worry, and fear
2. Working on addressing feelings of depression, guilt and self-doubt
3. Openly discussing the effects and the impact of surgery, radiation, and chemotherapy
4. Developing skills to assist with the side effects of treatment                                                         5. Strategies to manage the stress and pain

For Loved Ones / Caregivers
1. Dealing with feelings of lack of control, anxiety and stress
2. Addressing new obligations and loss of previous lifestyle
3. Helping to gain a new perspective and deal with the new challenges in a healthy manner

For Beyond Treatment
1. Going through the process of grieving the loss of the old self and accepting the new self
2. Living with the uncertainty of long term survival
3. Adapting to the physical changes and limitations
4. Addressing challenges related to intimacy, reproduction, and employment
5. Addressing feelings of low self-esteem, anxiety, depression, and mood fluctuations


Challenges and struggles in response to chemo and radiation therapy

Cancer is not a disease which will only affect a person physically. It is also something which will affect a person emotionally and psychologically. This has always been the hardest to handle and that’s why counseling for cancer patients and their loved ones is recommended for many oncology patients by their physicians.

Getting to know that a person has cancer is a really hard thing for the patient as well as for the loved onew. Even though people are happy to get treated and healed. There are many times the treatment itself have greatly affected the patients, psychologically. It is hard to say whether it is the side effect of medications alone or a phase of psychological acceptance of the disease. Anyhow, what has become clear is that counseling for a patient should be carried out throughout the whole time of treatment and sometimes even after a full recovery. This might help a patient develop confidence, self esteem and resilience. Whether you admit it or not, all cancer patients are fighters… GREAT fighters. Their confidence goes down only because, at times, they don’t accept it.

Many psychiatrists believe that the transitional period after an intensive cancer treatment is the most likely period to cause psychological distress. For some patients this period may be as stressful, or even moreso, as it was to initially undergo the treatment itself.

Further, the people around the patient might expect the patient to be ‘completely normal’ after the successful treatment and may not appreciate what the patient has already gone through…and is still going through. But, many people do not understand that the cancer patients become more sensitive, anxious and uncertain about things around him. It is very easy to understand. A person who has lived for months in the sorrow, fear and uncertainty of leaving the loved once and all the other things takes some time to get back to who he was. Even though a doctor may confirm their full recovery many patients stay uncertain for a while.

How a cancer patient is affected psychologically depends on many factors. Some of these are:
Overall temperament in normal
Coping skills
Social supports
Type of cancer
Family/ friends support
Memory and thinking after chemotherapy



Chemotherapy has many side effects. It does not only kill cancer cells, but it also affects many other normal cells in the body. Among these are the brain cells. About 20% – 60% of cancer patients who undergo standard doses of chemotherapy, experience some degree of cognitive dysfunction and memory problems.

The affected brain is casually often called ‘chemo brain’. The main cause of the chemobrain is presumed to be the neurotoxic effects of chemotherapy. The chemobrain causes diffused mental cloudiness and may affect a person’s cognition, social and occupational behaviors, sense of his own self and the quality of life. Moreover, it affects concentration, memory, comprehension and reasoning as well. And the common byproduct of these is our favorite “S” word; stress.

The studies have shown that many people undergoing this type of cancer treatment have problems with short term memory and difficulty recalling words. Some patients are not acknowledged about these changes and are alarmed at the presence of it and misunderstanding it as a spread or worsening of the disease. But, when people know what they are going through, even when scary, painful or difficult they often experience a much lower stress level and consequently are able to prepare and face these symptoms quite bravely.

The effects of chemobrain may exist during chemotherapy and even afterwards up to 10 years, in some cases. These changes may be subtle in most patients, while for some it can be more profound. At the moment there are no specific treatments and preventive measures known, but, if the patients have problems with thinking or memory, which interferes with the daily work, he/she may seek help from a doctor.

There are different memory training exercises and programs and also many other treatments which will improve the brain function such as problem solving abilities and logical thinking. Finding a counselor and being familiar with this situation is a brave step for the patient as well as the loved ones.

As all the other drugs, chemotherapy has its side effects too. But every person does not face the same experience during chemotherapy. Some have really less amount of side effects while the others find it very hard to face the treatment.


Other psychological issues after chemotherapy and radiotherapy

People, who suffer from cancer for a long time, deal with a lot of stress. Moreover, they face problems with sleep, concentration and appetite together with physical symptoms such as palpitations, due to the intensive treatment which they go through. Some oncologists also mention that they find patients fearful and hyper-vigilant.

According to many recent studies, one third of cancer survivors have suffered from symptoms of post traumatic stress disorder, which are;

Recurrent, unwanted distressing memories of the event(cancer treatment)
Reliving the event as if it were happening again (flashbacks)
Upsetting dreams about the having cancer and getting treated
Severe emotional distress or physical reactions to something that reminds you of the event
Negative feelings about yourself or other people
Inability to experience positive emotions
Feeling emotionally numb
Lack of interest in activities you once enjoyed
Hopelessness about the future
Memory problems, including not remembering important aspects of the event
Difficulty maintaining close relationships


Counseling Support For Cancer Patients And Their Loved Ones Is Needed

This shows us the huge need of counseling and psychological support for cancer patients together with the cancer treatment. (And caregivers and loved ones also need support during this time.) Even though being alive is something to be happy about, there are some patients who feel guilty about it. This happens mainly if they have a friend or family member who has died with a cancer. As we know some patients join support groups where there are many cancer patients. Here these patients make very close friendship with each other most of the time. Yes, this is a great support to face cancer than fighting it alone. But, with the time, when members pass away the other patients might experience loss, grief and then guilt of being alive. Support and counseling for cancer patients and their loved ones can make a big difference here as well.

Cancer Resilience is one of my areas of specialty and is a personal passion. I am a nationally board certified and licensed professional counselor who is dedicated to my clients. My approach is based on several counseling styles and I tailor them to each patient according to their unique situation. If you are facing this journey, or love someone who is, please call. I’d like to help.

Ben Carrettin is Nationally Board Certified and Licensed Professional Counselor who has worked in the field for many years. His areas of specialty include counseling cancer, cardiac and serious medical patients and their families, as well as other select areas. Ben is also a Lay Chaplain with advanced training in pastoral care and is personally passionate about his work and his commitment to his clients.

Call Now (346)-493-6181


Ben Carrettin is a Nationally Board Certified Counselor (NCC), Licensed Professional Counselor-Supervisor (LPC-S) and Licensed Chemical Dependency Counselor (LCDC). He is the owner of Practice Improvement Resources, LLC; a private business which offers an array of specialized counseling, evidenced-based clinical consultation, Critical Incident Stress Management (CISM) and targeted ESI-based services to individuals and businesses.

Cancer & Medical

Counseling Medical Patients

Counseling Medical Patients

Are Medical Treatments Or Procedures Causing You To Feel Down, Depressed, Angry Or Anxious? Are you struggling to feel healthy and whole while in the midst of cancer treatments or following a surgery? Are you beginning to wonder if you may be suffering from some form of medical trauma? Perhaps you recently had heart surgery and are suddenly experiencing depression. Or maybe a succession of cancer treatments or a recent kidney or liver transplant surgery has you questioning if you can live a normal, healthy life. Have chemotherapy treatments worn you down, making it difficult to cultivate energy, hope and joy? Are you tired of feeling like a victim, stuck in suffering? Do you wish you could let go of negative thoughts and feel positive and focused on a healthy and effective recovery? Counseling medical patients can provide the help you need to move back from merely surviving each day to really living your life fully.

Medical trauma can affect anyone experiencing a life-changing medical issue or who has undergone invasive surgery. Prolonged physically and mentally intensive treatments and post-operation recovery can feel overwhelming and sometimes frightening. And, when the physical body is in distress, it’s not uncommon to neglect the needs of the emotional body and the mind. Depression, anxiety and cumulative stress can take hold and erode at emotional and mental well-being. You may want to find your way back to emotional strength, but feel too tired, stressed or confused to. You may also wonder if you will ever be able to lead a normal, healthy life and worry about how your medical condition is affecting the people you love.

Counseling for cancer and medical patients

What Is Medical Trauma?

Medical trauma can be caused by medical events, such as cancer treatments, organ transplant procedures or heart surgeries that create heightened stress or fear. While in the midst of cancer treatments and following invasive surgeries, many patients experience trauma symptoms, such as depression, anxiety, mistrust and relationship issues. Transplant donors and recipients can experience major anxiety and depression that can inhibit the patients from following their doctor’s medical advice. Even family members and spouses of patients undergoing cancer treatments and surgeries can experience changes in behavior and mental well-being.

If you’re suffering from medical trauma, you are not alone. Forty percent of all heart surgery patients suffer from some form of depression within six months following their operation, and up to 25 percent of patients diagnosed with cancer experience clinical depression. In families of patients, 20-30 percent of spouses of cancer patients experience some form of psychological distress and behavioral change.

Medical trauma can affect anyone who has undergone, is about to undergo or is currently receiving medical treatment. The anticipation of a diagnosis or the inevitable decline of a loved one’s health can elicit racing, anxious thoughts and cause patients and their families to feel helpless or even hopeless. While symptoms can sometimes be obvious, at other times, trauma goes unnoticed due to prevailing concerns, such as taking care of the family, maintaining a job or trying to heal yourself. Dealing with those external factors can create more stress and even slow the healing process.

Whether you are apprehensive about an upcoming diagnosis, fearful for a loved one’s future or are dealing with the effects of invasive surgery, there is hope and help. An experienced and compassionate therapist can help improve your sense of well-being and manage traumatic stress.

Counseling for cancer and medical patients

Counseling For Cancer Patients And Medical Trauma Can Help You Process Trauma And Experience Relief

Impermanence is frequently at the core of the fears and anxieties we experience when dealing with medical issues. The loss of mobility, energy and ability to participate in everyday activities can create symptoms of anxiety and depression and further complicate an already complicated situation. The idea of the impermanence and the possible decline of health or death can rattle even the boldest and most spiritual of people. The good news is that even in the midst of a difficult situation, it is possible to work through challenging thoughts and feelings, cultivate a positive perspective and feel more at peace.

In safe, confidential sessions, we can work through your medical trauma by addressing fears around impermanence, attachment, loss and grief. Using a combination of Western medicine practices and Eastern philosophies, I will create a mindfulness-based approach and help you cultivate courage, strength and happiness in the midst of the uncertainty you face. I can help you manage this sensitive and vulnerable time by approaching your unique situation with compassion and openness. It is my privilege to work with people at a most sensitive and vulnerable time, and I always endeavor to preserve dignity and honor trust.

While many people undergo similar diseases, symptoms and procedures, the experience is never the same from one person to another. I understand that each of my clients is unique, which is why I will tailor-create a therapy strategy that best addresses and supports your specific medical condition, needs, history, personality and therapy goals. In medical trauma therapy sessions, I can help you identify and re-frame negative thinking patterns, learn relaxation techniques and find grounding and perspective in the present moment. By re-contextualizing your pain and suffering I can help you find joy and peace within the moment.

For over 23 years, I have been counseling medical patients; providing guidance and support to people experiencing medical trauma and their loved ones. I understand the challenges that can come with invasive medical procedures and the mental and emotional toll they can take. But, I also know that there is always help and hope for healing. With support, guidance and an approach tailored to meet your specific needs, you can work through feelings of uncertainty and cultivate happiness, confidence and a sense of peace.
Although you may understand the benefits of counseling for cancer patients and medical trauma, you still may have questions and concerns about the process…

I’m too tired and taxed to add anything—even therapy—to my schedule.

Constant visits to doctors and treatment centers can be emotionally overwhelming and physically difficult to manage. It’s understandable that you may not want to visit yet another office, especially if you’ve been poked and prodded and fear exposing yourself even more. That said, counseling for cancer patients and medical trauma can help you process trauma and work through challenging thoughts and feelings. We will work at a pace that feels comfortable for you, which can keep you from feeling overwhelmed in sessions. Also, often when clients let go of heavy thoughts and feelings, they often experience increased energy and a more positive perspective on their recovery process.

Counseling for cancer and medical patients

I’m not mentally ill. Why do I need therapy?

We like to think that we can tackle the world by ourselves. The reality is, however, that humans are meant to live and heal in community, and we can all benefit from help. Seeking help is a sign of strength, and I find my clients are ordinary people trying to navigate extraordinary circumstances. Furthermore, a healthy mental outlook is a critical part of the healing process. Elevated stress and apathetic feelings can interfere with your ability and desire to follow your doctor’s orders and can even affect your body’s response to surgery or medical treatments. An experienced therapist can help you manage your mental health, process trauma and feel more empowered in your recovery.

My loved one is suffering medical trauma, and I’m struggling to cope. Can this kind of therapy help me, too?

Those who are supporting another through a medical crisis are often the ones who benefit from counseling the most. It’s not uncommon for spouses, family members and friends of those suffering from medical trauma to feel afraid, frustrated and overwhelmed. If you are struggling to understand or process your loved one’s medical situation, trauma therapy can provide you with guidance and support. In sessions, you can focus on your personal experience and work through challenging thoughts and emotions. When you feel mentally and emotionally balanced, you’re best able to care for yourself and provide care for the people you love.

You Can Live With Greater Ease And More Joy

You don’t have to navigate this challenging time on your own. I invite you to contact me at (713) 489-3329 for a free 15-minute consultation. I’m happy to discuss your specific needs and answer any questions you have about counseling for cancer patients and medical trauma and my practice.

Counseling for cancer and medical patients

Call Now (346)-493-6181

Ben Carrettin is a Nationally Board Certified Counselor (NCC), Licensed Professional Counselor-Supervisor (LPC-S) and Licensed Chemical Dependency Counselor (LCDC). He is the owner of Practice Improvement Resources, LLC; a private business which offers an array of specialized counseling, evidenced-based clinical consultation, Critical Incident Stress Management (CISM) and targeted ESI-based services to individuals and businesses.

Opiates (Heroin and Prescription Pain Pills)

Opiate Addiction and the Brain

Opiate Addiction and the Brain

As human beings we have a long history of using opiates, such as morphine. And if a person gains unlimited access to opiates, they can easily and quickly become tolerant and addicted to it. The drugs have an intense effect on the human brain. Prescription opiates are after all intentionally designed and created to make a person feel good within a short period of time. The drugs increase the level of dopamine released in the brain and copy the effects of endogenous opioids. More often than not, people who have taken opiates with consistency often have difficulty feeling normal without taking the drugs and little or no knowledge of what really happens with opiate addiction and the brain.

Our brains produce a natural morphine known as endorphins. They stimulate the opioid receptors to lift our mood when we are under stress; helping us feel more motivated and relieving pain when there is an injury. These hormones are produced during excitement, exercise, feeling loved, orgasm, pain, or even eating spicy food.

The production of endorphins also leads to the discharge of dopamine, which is the chemical that activates the reward system of our brain. Dopamine acts as natural “go system” that helps humans pursue stuff that we need to survive. Our brain also has a “stop system” found in the prefrontal cortex at the front of our brain. It helps us determine the consequences of our impulses. When a person is addicted to opiates, the “go system” of the brain acts on its own, and the “stop system” can no longer control it.

Some Examples of  Opioids


Codeine – ingredient found in many cough syrups

Hydrocodone – Vicodin, Lortab or Lorcet

Oxycodone – Percocet, OxyContin or Percodan

Hydromorphone – Dilaudid

Morphine – MSContin, MSIR, Avinza or Kadian

Propoxyphene – Darvocet or Darvon

Fentanyl – Duragesic


What Opiates do to a Person’s Brain?

Opiate drugs activate the dopamine pathway (also known as the reward pathway) that sends out a rush of pleasure chemicals to the brain. When talking about opiate addiction and the brain, opiates are much more stimulating than natural endorphins, which is partly why they are so addictive. Once a person uses opiates, the brain stops creating natural endorphins because the body thinks that there are already enough levels of it in the brain. Within six to 12 months of using opiate drugs, the cells that produce endorphins can be significantly reduced in size and even die off.

One of the most commonly abused illegal opiate drugs is heroin. When it is injected into a vein, heroin reaches the brain within 15 to 20 seconds. It then binds itself to the opiate receptors found in the different parts of the brain that include, you guessed it; the reward pathway. When the receptors in the reward pathway are activated, the person feels a brief and very intense rush of euphoria. This is followed by several hours of what many report as a “contented and relaxed” state. This feeling of euphoria is what draws people back to opiates again and again.

The effects of opiates are similar to the ones from naturally occurring opioid peptides. When used for medical purposes, opiates can stop diarrhea, depress breathing, and relieve pain. They come with side effects that include vomiting and nausea. But when used in large doses, they can make breathing shallow or even make it stop altogether. Thousands of opiate addicts have died due to overdose. And mixing alcohol with opiates only increases the risk of death.

Opiate Addiction and the Brain vs. Opiate Dependence

Dependence happens due to the normal adaptations to prolonged exposure to opiates. People should not confuse the term dependence with addiction because they are not the same. Addiction is described to be the compulsive seeking (psychological) and use of the drug that results to deadly consequences. Addiction can include some type of dependence (physical) as well.

Another way to understand it is this: dependence is typically acute and holds the potential to be resolved or cured. Addiction on the other hand can be acute or in remission – but it is always chronic and life long (i.e. it is not cured or removed). This is why we say a clean/sober person is “in recovery” and not that they are “recovered”.

A person who is dependent on opiates will experience some type of withdrawal symptoms when the use of the drug is suddenly stopped or reduced. The symptoms can be mild to severe. Withdrawal symptom includes flu-like discomfort, stomach cramps, unpleasant mood, diarrhea, and severe muscle pain, just to name a few. The withdrawal symptoms are most commonly managed medically through the use of a slow drug taper.

Dependence is often accompanied by tolerance, which is the need to take higher doses of the drug in order to get the same effect. Once a person experiences tolerance, it can be difficult for the health care provider to evaluate whether the patient has a drug problem or if there is really a need for higher doses to control one’s symptoms. This is the reason physicians are attentive and vigilant to their patients’ symptoms, as well as the level of functioning to provide them with the most accurate information needed to prescribe the appropriate treatment.

Connection of Opiate Addiction and Brain Damage

While it has already established that opiate overdose can result to slow breathing, its effects on brain function are still being studied by researchers. Depressed respiration can affect the oxygen level in the brain. Researchers are still trying to determine the long-term effects of opiate addiction on the brain. Previous studies have shown that there is some deterioration of the white matter among heroin users that affect their ability to respond during stress situations, regulate behavior, as well as their decision-making abilities.

“One of the worst health epidemics facing this country is the belief

that successful pain management actually means the absence of any pain at all.”

BW Carrettin, 2003

Getting Off Opiates

Once a person stops using opiates, the natural chemical system of the body can’t turn on right away. It has already been damaged, and it will take a while to recover. The person will go through severe withdrawal that can last up to a week. Then the person will also undergo a long process called post-acute withdrawal syndrome that can last several months or even years.
When the person is suffering from withdrawal, they are typically depressed and with no motivation to do anything. Removing opiates from their system will suddenly bring lots of pain because there is no base level of endorphin found in their system.

Treatment for Opiate Addiction in Houston, Texas

Opioid addiction is a chronic disease, like diabetes or heart disease, and like all chronic diseases it is a medical condition for life. While it can be managed and kept in remission – it cannot be cured and will not go away. However, a person with an addiction can regain a healthy, active and productive life.

There had been a lot of growth and improvement in the field of addiction treatment and one aspect of that is medication-assisted treatment or MAT. Because of a lack of up-to-date training, antiquated ideas about addiction and a general ignorance of neurology and physiology – many people, even those in the addiction treatment field, find the idea of medication-assisted treatment to be controversial. This is sad and detracts from the core intention of recovery work. It’s important to know that the goal of medication-assisted treatment is to recover from addiction. These medications, prescribed and monitored responsibly, do NOT replace one addictive substance with another. They provide a safe and controlled level of medication to overcome the use of a problem opioid. Medication-assisted treatment only works if all three of it’s equally important parts are upheld: medication (monitored and taken as prescribed), counseling (with a seasoned professional who specializes in addiction) and community support (meetings as well as family and friends)

In the past, the standard treatment for opiate addiction involved the use of methadone. (Even in the face of better options methadone is still widely used today for treatment of opiate addiction.) Methadone is a long-acting opioid that is used to keep the withdrawal symptoms at bay. It also controls the craving and relapse of the patient. Whether methadone treatment is actually an effective tool for rehabilitation remains a subject of great controversy.

Another medication used in the rehabilitation of opiate addicts is Buprenorphine. It contains a partial agonist opiate, has a weaker effect on the receptors in the brain than some newer medications and has a limited high, which some health care providers believe can deter the addict from abusing the medication. This medication is also surrounded by controversy – some have suggested it is due to improper use, others suggest negligent monitoring by treating physicians.

Naltrexone and Naloxone are used as antagonists at opioid receptors to block the pleasurable effects of the opiates. These do not contain opiates nor do they produce a high. When coupled with counseling or other therapeutic treatments these blockers have more recently been reported to help people quit their opiate addiction. There is an intramuscular injectable (IM) version called Vivitrol which lasts approximately 30 days and has been reported to successfully block highs and help to control not only opiate cravings but alcohol as well.

Succeeding in Recovery from Opiate Addiction

For addiction recovery to be successful over a lifetime requires a great deal of desire, commitment, persistence, humility and support. One of the most widely available community-based support organizations is 12 Step with meetings across the globe and in nearly every city in the United States. Churches, community centers and many other venues are also available depending on your area.

A seasoned and experienced counselor who specializes in chemical addiction can also help the recovering addict through the challenges that arise in the recovery process. If the counselor is also licensed and experienced in mental health, they can also assist with issues such grief, anxiety or relationship conflicts that may come up during treatment and recovery. Counseling or psychotherapy is helpful not just for the addict but also for the partners, friends and family who love them.

Change is hard and for many it can also be a bit scary. Patience and compassion, but not coddling or excusing, is necessary. Learning how to set good boundaries – new boundaries – is important for everyone involved. Remember – getting better doesn’t mean back to how things were. It will never be the same way it was in the past. That was the past. But it can be better, more than better. It can be really good.

If you or someone you know is struggling with opiates, or any drug or alcohol, reach out and get help. A better life is possible and attainable. I’ve worked in this arena for a long time and I’d like to help you.

Stop.    Take a moment.    Breathe.

You CAN do this.

Call Now (346)-493-6181

For More Resources

Ben Carrettin is a Nationally Board Certified Counselor (NCC), Licensed Professional Counselor-Supervisor (LPC-S) and Licensed Chemical Dependency Counselor (LCDC). He is the owner of Practice Improvement Resources, LLC; a private business which offers an array of specialized counseling, evidenced-based clinical consultation, Critical Incident Stress Management (CISM) and targeted ESI-based services to individuals and businesses.

Opiate Addiction and the Brain