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Step 4 in the 12-Step Process

[vc_row][vc_column][vc_column_text]“Made a searching and fearless moral inventory of ourselves.”

In the first three steps of the twelve-step program, we are asked to recognize that our lives have become unmanageable, to identify and believe in a Power greater than ourselves, and to decide to turn our will over to this higher Power. In step four, however, we begin to engage in deep, intentional self-reflection. In essence, we ask, ‘Who am I?’

At first glance, this question is seemingly simple. We might answer with such things as where we live, what our name is, how old we are, our ethnicity, heritage, race, religion, and hobbies, among others. While these pieces of our identity are an important part of us, it is not exactly what step four is asking of us. Step four focuses on taking a moral inventory.
In a moral inventory, we reflect on our lives, assessing for and recording our perceived character deficits, strengths, and weaknesses. Topics that typically arise in moral inventories include resentments, anger, fears, pride, self-will, self-pity, guilt, shame, relationships, and sex. The purpose of this exercise is to gain more clarity and awareness on who we are, such that we can develop an awareness of how our understanding of ourselves both contributes to our problematic substance use and may aid us in the recovery process.

In taking a moral inventory, we will surely encounter negative thought patterns, destructive self-talk, overwhelming emotions, and value incongruent behaviors that have fueled the continuance of our addictions. In so long as we keep our shame, regrets, anger, and resentments secret, our problematic substance use will persist in efforts to cope with these unpleasant feelings. As uncomfortable and painful as it may be to connect with these feelings, studies have shown, time and time again, that reflecting upon and sharing these feelings with a trusted individual (i.e. sponsor, therapist, partner, friend) can be incredibly healing. Positive effects on an individual’s mental, emotional, physical, and spiritual health, are ultimately to be expected. The moral inventory is an essential component of recovery.

In step four, we gain a better understanding of who we are, how our affective experiences and behavioral patterns contribute to our addiction, and how our strengths may aid us in recovery.

We begin to take accountability for our problematic use as we redirect our blame for others towards curiosity about ourselves.

By Jonathan Fricke, MA[/vc_column_text][/vc_column][/vc_row]

Step 5 in the 12-Step Process

[vc_row][vc_column][vc_column_text]“Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.”

I want you to think of a time that you kept something secret. Maybe it was a bigger secret, such as an affair or a time that you hurt someone, or maybe it was a smaller secret, such as a time that you were embarrassed. Whatever the case is, I want you to remember that secret. I want you to think about what drove you to keep this thing under wraps. I want you to reflect on how doing so impacted you. Really, take a moment to reflect before reading on.

Often times, we keep secrets in efforts to protect our egos. We think that if others were to know what it is we have done, they would see us as the person that we so desperately fear becoming. For example, if a partner were to find out about an affair, we fear they will see us as untrustworthy. If a friend were to find out about how we spoke ill of them behind their back, we fear they will see us as a bad person. Or, if a parent were to find out about our struggles with substance use, we fear they will see us as flawed. Therefore, we may elect to keep actions, feelings, and thoughts to ourselves in hopes that others will not see us in the same negative light we fear seeing ourselves in.

Makes sense, right? I mean, if we can hold onto our secrets, thus preventing others from knowing us fully, what is the problem?

Well, unfortunately secrets come with a toll. A toll that tethers irritability, anxiety, remorse, and depression, among others, to our lives. When we hide our wrongdoings from the world, we decide that we will carry the burden alone. We keep others away and place ourselves on an island where no one can get to us; we isolate. When we isolate, we do not even give others the chance to respond to our secrets. We cut off any possibility for compassion or love before we even have the opportunity to receive it. We cement in ourselves the very wretched feelings that we had hoped to avoid. For the addict, the toll means continued substance use or relapse.

Fortunately, there is another path to take. This is the path of connection, admission, and confession to another. Instead of putting ourselves on the island of isolation, we draw upon our moral inventory to share our secrets and wrongdoings with a trusted individual, whether that be a sponsor, friend, or therapist. In doing so, we share ourselves. We allow ourselves to be seen and understood. We open up the doors for compassion and love to enter. Often, we then begin to experience ourselves differently. Not as flawed creatures, but as a human beings.

Although this path is not a cakewalk, it is essential. It is perhaps the most important part of recovery.

By Jonathan Fricke, MA[/vc_column_text][/vc_column][/vc_row]

Step 3 in the 12-Step Process

[vc_row][vc_column][vc_column_text]“Made a decision to turn our will and our lives over to the care of God as we understood Him.

In the first two steps of the twelve-step program, we are asked to reflect on our own lives. In step one, we are asked to reflect on our powerlessness and the unmanageability in our lives. In step two, we are asked to reflect on what our higher power looks like; what we believe in. In step three, however, we shift from a stance of reflection to a stance of action. Step three is all about pushing away from our self-will and welcoming in a sense of willingness.

So, what does self-will and willingness mean? Self-will is all about stubbornness. It is about doing what an individual wants without regard for the wishes of others. It is a belief that you are right and will argue with anyone who disagrees. It is about a desire for independence, control, and is typically rooted in egotism. On the other hand, willingness is all about readiness and flexibility. It is rooted in trust outside the self.

Before continuing, I feel it is important to address the religious influence in step three with the use of the word “God.” As I had previously mentioned in my discussion of step two, twelve-step programs are not inherently religious and there is no requirement that the individual practice religion or believe in God. Rather, the important piece of step three is the last part, “…as we understood Him.” This piece reminds us that it is not about God, but about whatever the individual has identified as their higher power. Perhaps that higher power resides in nature, science, or the twelve-step program itself. In this step, the individual is asked to loosen their grip on the desire to control their lives and instead places faith, trust, and hope in their higher power. It is about aligning the will of the individual with their higher power. In this step the individual begins to experience serenity.

Step three also introduces a component of the twelve-step program that countless individuals have found monumental to their recovery: the Serenity Prayer.

God grant me the serenity to accept the things I cannot change, courage to change the things I can, and the wisdom to know the difference. Thy will, not mine, be done.

The Serenity Prayer introduces a key concept that extends far beyond recovery and has useful applications across life. In it, we examine and recognize the limits of our control. The prayer highlights the notion that there are some things we can control and some things we cannot. For example, we cannot control the behaviors of others but do have control over how we react to any given situation. When we attempt to control something that is uncontrollable, we are often left feeling angry or dejected when things don’t go our way. The Serenity Prayer encourages us to ask ourselves, ‘Is this situation something worth getting upset over or is it out of my control?’

By Jonathan Fricke, MA[/vc_column_text][/vc_column][/vc_row]

Step 1 in the 12-Step Process

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STEP ONE
“We admitted we were powerless over our addiction – that our lives had become unmanageable.”

What does the word ‘powerless’ mean to you? What images or feelings does it conjure up? In my experience, it often brings about associations of weakness, inadequacy, and incapability. For those of us familiar with Greek mythology, perhaps you think of Sisyphus’ powerlessness in his eternal struggle of pushing the boulder up the hill, only for it to roll down every time that he approached the top of the hill. He was a prisoner to this task and, as such, the ensuing feelings of weakness, inadequacy, and incapability that came with it. That is exactly why Zeus punished Sisyphus with this hopeless task. Well, what if Sisyphus had realized and accepted his own powerlessness in this task? What if he accepted the hopelessness in getting the boulder to the top of the hill? How might that have changed things for him?

In step one of the twelve-step program, we are asked to admit a powerlessness over our substance or behavior, recognizing that our lives are currently ungovernable. Given the aforementioned associations to ‘powerlessness’, it is entirely understandable to respond to this step with resistance. Perhaps we think we can simply work harder to control our use. Or perhaps we deny the extent to which the substance or behavior influences our lives. (How many times have you said or heard the phrase: “I could stop my use if I really wanted to”?)

When we feel powerless, there is a natural and instinctual drive to tighten our grip, clamp down, and attempt to secure power and control. However, step one contends that, paradoxically, there is a certain power in admitting our powerlessness; that we are granted a hope in admitting our hopelessness. In recognizing our inability to control our use, we actually form a solid bedrock and foundation for working towards happy, fulfilling, and meaningful lives. In recognizing and accepting our own limitations, only then do we enable ourselves to look beyond our own beliefs. Only then do we open our minds to different ways of thinking. Only then are we truly willing to listen. Only then are we truly willing to try something different. Only then are we truly willing to change.

By Jonathan Fricke, MA[/vc_column_text][/vc_column][/vc_row]

12-Steps Overview

[vc_row][vc_column][vc_column_text]Often times, people think of recovery synonymously with twelve-step programs. While there are a variety of different approaches to recovery, the twelve-step program has certainly held its place as a staple in addiction recovery. Given the popularity and notoriety of the twelve-step program, it seems appropriate to do a brief review of the program’s philosophy and current applications.

The twelve-step program is most commonly associated with Alcoholics Anonymous. However, other more targeted twelve-step programs have emerged over the years to include other drug addictions (i.e. Narcotics Anonymous, Cocaine Anonymous, Crystal Meth Anonymous, etc.) and behavioral addictions (Gamblers Anonymous, Food Addicts Anonymous, Co-Dependents Anonymous, etc.). Regardless of the substance or problem behavior in focus, all twelve-step programs rely on adaptations to the original twelve steps developed for Alcoholics Anonymous, which was the first twelve-step program. Those twelve steps may be boiled down to the following ideas:

  1. An honest admission of powerlessness over the substance or problem behavior
  2. A belief that a higher power can assist in recovery
  3. A recognition that you must include others in your recovery
  4. An inventory of current problems and how substance use or the problem behavior affected them
  5. An admission of wrongdoings to their higher power and another person
  6. An acceptance of flaws in personal character
  7. The humility to ask a higher power to assist in recovery
  8. Constructing a list of those you have harmed through your substance use or problem behavior
  9. Making amends to those you have harmed
  10. Continually taking an inventory of current problems and wrongdoings, and being willing to admit when wrong
  11. Fostering a sense of awareness through connection and engagement with your higher power
  12. Engage in service activities to assist others in recovery and daily life

The twelve steps listed above may be broken down into three domains: physical, mental, and spiritual. These three dimensions were intentionally developed and included in the twelve-steps to be a reflection of the physical, mental, and spiritual aspects of the human experience. The philosophy underwriting this design is that the problems that arise in addiction present themselves in physical, mental, and spiritual domains. Thus, the path to recovery must include these same elements.
Twelve-step programs continue to be popular due to the success that many individuals have experienced in their recovery journeys. Additionally, many individuals enjoy the sense of community at meetings, the availability of a concrete plan towards recovery, and the accessibility (twelve-step groups operate all over the world free of charge), among other reasons. Further, many of these meetings are now offered virtually over Zoom. If you are even the slightest bit curious about a twelve-step program, I would encourage you to attend an open meeting. You never know what the tide will bring.

By Jonathan Fricke, MA[/vc_column_text][/vc_column][/vc_row]

VERIFY INSURANCE

Cortland Mathers-Suter

MSSA
Managing Partner

Cortland Mathers-Suter entered the treatment space after his own battle with addiction. He first worked as a peer mentor, before starting clinical work while completing his Masters of Science in social administration from Case Western Reserve University where he focused on policy and direct practice. Cortland moved to Colorado in 2015 to start his first addiction treatment program, AspenRidge Recovery. Under his tenure, AspenRidge Recovery became a two-location, nationally accredited organization. He has since spent the last two years researching and developing what is now Colorado Medication Assisted Recovery (CMAR).

According to Cortland, “Colorado Medication Assisted Recovery is the most important organization I have had the honor to help build. We’re offering a service that seeks to not only improve the lives of our patients but also evolve how we look at medication-assisted treatment in Colorado entirely. Most individuals receiving medication-assisted care only receive medication and urinalysis. Sure you can call that ‘treatment,’ but you can’t call that ‘recovery.’ Our model is about adding the missing recovery component, and thus affords an opportunity to achieve lasting change for each patient and the industry.”

Cortland and his treatment programs have received numerous honors. These include Colorado Business Magazine’s “GenXYZ” award, the 2020 “Titan 100” award, and his program AspenRidge Recovery was both a finalist for “Best Healthcare Company” and named in the “Company’s to Watch” by Colorado Business Magazine as well. He has been interviewed and quoted by numerous publications for his “addiction expertise”, including News Week, 5280 Magazine, the Denver Post, Elephant Journal, Colorado Biz Mag, and TheRecoverySource.org.

Tyler Whitman

Compliance/HR Administrator

Tyler is originally from Omaha, Nebraska. He worked in manufacturing administration for 18 years until he chose to pursue recovery from alcohol addiction, which led him to Chicago, Illinois. Since then, Tyler gained experience in retail, retail pharmacy, and healthcare as a vaccine coordinator for a local Colorado clinic. At the clinic, Tyler discovered that healthcare was the career change he had been looking for. His newfound passion for healthcare, combined with his lived experience with addiction, brought him to Colorado Medication Assisted Recovery as an Office Administrator.

In his free time, Tyler enjoys cooking, hiking, and skiing. He is currently pursuing a master’s degree in Health Services Administration from Regis University.

Simmeren Boanvala

BA
Outreach and Admissions Representative

Simmeren comes to CMAR after several years working admissions in inpatient psychiatry and addiction. A first-generation Colorado Native, Simmeren attended CU Boulder, where she earned a BA in psychology. Simmeren is currently completing her CAC III while working toward her master’s degree in marriage and family therapy.

According to Simmeren, “I joined CMAR because I believe in the quality and importance of the program whole-heartedly. My goal at CMAR is to guide each prospect who calls CMAR to find the best possible pathway to their recovery”. Simmeren currently lives in her hometown with her dog and cat.

Tyler Hale

Tyler Hale

Community Partnership Lead

Tyler Hale began his career in addiction treatment following a decades-long fight with his own substance abuse issues. Since achieving long-term recovery, Tyler has held various positions in direct care, client services, admissions and outreach departments at various addiction treatment organizations. From sober living program director to outreach director to admissions director at a drug and alcohol treatment program, Tyler consistently finds himself in leadership roles within the addiction treatment space.

Tyler is originally from Chicago, IL, where he graduated from Loyola University Chicago with a Bachelor of Arts in Sociology and Bioethics. Thereafter, Tyler built a successful career in the tech industry, before finding sobriety and a subsequent calling to help others. Tyler joined the team at CMAR because he believes in the efficacy of comprehensive and patient-centered outpatient treatment. In his free time Tyler enjoys camping, hiking and spending time with his newborn son.

Kirstin O’Carroll

MSW
Engagement and Relations Director

Kirstin O’Carroll started her career in addiction and mental health services 23 years ago after graduating with an MSW from The Oho State University. Hired directly from an internship program, she served as a case manager and vocational specialist on a community treatment team in Columbus, OH, working to help severely mentally ill adults remain at home and in a community setting. Within the same organization, she later transitioned to clinical assessment and crisis intervention services with children, adolescents, and adults. Through these experiences, she learned the importance of providing empathetic, high-quality care and the need to “start wherever the patient is” with regard to finding the best treatment & solutions for her patients.

After seven years, Kirstin made a career change to diagnostic sales and worked for several Fortune 500 companies as an acute care sales specialist. She is delighted to return “home” to her passion for helping others and believes her new role as community engagement coordinator for CMAR is the perfect alignment of both her clinical and sales skills. When not promoting CMAR, she can be found reading, running, hiking, watching movies, and spending time with her husband Dennis and senior canine son Reggie.

Thomas Mazzarella

LAC
Primary Therapist

Thomas is a Licensed Addiction Counselor (LAC) in the State of Colorado and a Licensed Addictions Specialist (LCAS) in the State of North Carolina with particular expertise in the treatment of chronic Substance Abuse Addiction and Dependency.

Thomas is dedicated to Individual, Couples, Family, and Group Counseling and Therapy for individuals with Substance Use and Mental Health issues and concerns.

James Jackman

CAS
Primary Therapist

James Jackman is a Certified Addiction Specialist and has been practicing addiction treatment in Colorado since 2015. James is pursuing his bachelor’s degree in psychology from Metropolitan State University Denver. James is a traditional CBT therapist specializing in childhood events that lead to adult addictions.

James has received special training in Family Systems, Inner Child, Maladaptive Schemas, and Adverse Childhood Experiences. James has worked in many treatment settings throughout his career and uses a client-centered treatment approach to help one recover from destructive patterns that facilitate addiction. In addition, James enjoys working with rescue animals and advocates for several local rescue organizations outside of work.

Outside of the office, Megan enjoys spending time with her two German Shepherds and her cat. She is passionate about fostering animals through various local rescues to find adoptive homes for dogs and cats in need.

Megan Hanekom

LPC, LAC, NCC
Therapist & Clinical Compliance Officer

Megan is a licensed counselor who has worked in various mental health and addiction treatment environments. She practices cognitive behavioral therapy and motivational interviewing and believes in pulling from various therapeutic approaches to best support each individual. Megan received her bachelor’s in psychology and Spanish from Concordia College. She relocated from North Dakota to Colorado where she earned a master’s in counseling psychology from the University of Denver.

Outside of the office, Megan enjoys spending time with her two German Shepherds and her cat. She is passionate about fostering animals through various local rescues to find adoptive homes for dogs and cats in need.

Maggie Coyle

MA, LPC
Primary Therapist

Maggie Coyle, MS, MA, LPP, LPCC has worked in the mental health and addictions counseling field for the past six years. She has extensive experience in working in the varying levels of mental health and addictions treatment as well as with diverse populations.

She practices cognitive-behavioral therapy and dialectical behavior therapy as primary intervention methods. She has earned a bachelor’s degree in sociology as well as a master’s degree in clinical mental health counseling both from Northern State University in Aberdeen, SD. She has also earned a master’s degree in addictions counseling from the University of South Dakota in Vermillion, SD. Maggie moved from South Dakota to Colorado in June 2020 and is excited to be a part of the CMAR team.

Michael Damioli

LCSW, CSAT
Clinical Director

Michael Damioli has been passionately working in the fields of addiction treatment and mental health since 2012. He has held a variety of different roles within the addiction recovery space, ranging from peer support to direct clinical practice. Notably, Michael was part of a leadership group that developed a small therapy practice into a nationally branded addiction treatment program, which offers multiple levels of care to recovering professionals. Michael is a strong believer in the family disease model of addiction and has focused much of his clinical work and training on supporting families impacted by addiction. He also specializes in treating individuals suffering from co-occurring chemical and process addictions.

Michael is honored to be leading the clinical care team at CMAR and believes that excellent clinical care begins by simply treating a patient with dignity and respect. Michael is a strong advocate for ethical reform within the addiction treatment field and is excited to promote CMAR as an ethical and thought leader throughout the treatment & recovery industry. Michael earned his master’s degree in social work from the University of Denver and is independently licensed as a clinical social worker with the state of Colorado. He holds an advanced post-graduate certificate in marriage and family therapy from the Denver Family Institute as well as an advanced certificate in sexual addiction counseling from the International Institute of Trauma and Addiction Professionals.

Dwight-Duncan

Dwight Duncan

Psy.D
Psychologist

Dr. Duncan was born and spent most of his early life in California. He received his doctorate in clinical psychology from the University of Denver in 1987. He is a licensed psychologist as well as a licensed addiction counselor. He has had extensive training and experience throughout his professional career in medical psychology, mindfulness, integrated behavioral healthcare, and substance abuse.

Dr. Duncan is married and has one daughter, a neurologic physical therapist in Los Angeles.

Susan-Miget

Susan Miget

NP
Medical Provider

Susan has been in healthcare for more than 20 years. She was an ICU nurse for nine years, then returned to school and completed her master of nursing and family nurse practitioner degree at the University of Missouri-St. Louis in 2007. She practiced pain management for many years before developing her current passion for addiction treatment.

Susan has transitioned her practice to focus entirely on addiction treatment. She has worked in residential treatment, partial hospitalization (PHP), and intensive outpatient (IOP) programs. Susan most enjoys working with patients one-on-one in a private office to protect their confidentiality and ensure top-rate care. Knowing that addiction can affect anyone, anywhere, and at any time, Susan continues to strive to make treatment more accessible and confidential.

Whitney-Grant

Whitney Grant

MSN, FNP-BC, ARNP, RN, CPN
Medical Provider

Whitney Grant is an experienced family nurse practitioner with experience and expertise in medication-assisted treatment. Whitney earned her BSN at the University of Miami before moving on to achieve a master of science in nursing degree there as well, becoming a nurse practitioner immediately thereafter.

Whitney has since achieved board certification from the ANCC as a family nurse practitioner. After spending her entire formative and educational years in South Florida, Whitney moved to Denver in 2018 to pursue a career as a provider in family practice, sub-specializing in addictions medicine. Whitney has worked under the guidance of Dr. Nathaniel Moore, CMAR’s medical director, since moving to Denver.

Nathaniel Moore

MD
Medical Director

Dr. Nathan Moore is board-certified by the American Board of Family Medicine. Dr. Moore attended Stanford University in Palo Alto, CA for his undergraduate work and then attended Duke University School of Medicine and obtained his M.D. in 1995. Dr. Moore then came to Colorado and completed his residency in family medicine at the University of Colorado’s Family Medicine Program at Rose Medical Center.

Dr. Moore practices primarily at our Aurora location. He provides comprehensive family medicine services and has a special interest in addiction medicine, treating patients with opioid use disorder as well as alcohol addiction.

Dr. Moore is married with three children. He enjoys mountain biking, running, and golf.