Pain is Inevitable; Suffering is Optional

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Mike: Welcome everyone. This is Avoiding The Addiction Affliction, a series brought to you by Westwords Consulting. I'm your host, Mike McGowen. We've had a number of conversations here about the many paths people take in recovery. No two roads are exactly alike and there isn't a script that works for everybody.

My guest today is gonna talk about her recovery, her discovery, and her work. Dr. Laura Petracek is a clinical psychologist and author of the DBT Workbook for Alcohol and Drug Addiction. Dr. Petracek is a certified dialectical behavioral therapist, we're gonna call that DBT for short, who as a recovering person herself, uses her own experiences with recovery and treatment to help others.

Welcome, Laura. I'll do it that way. How are you?

Laura: I'm good. Thank you, Mike. I appreciate it.

Mike: Well, and you're telling me you're in California, so what's it like there today?

Laura: It's rainy, rainy, rainy.

Mike: Yeah.

Laura: You know, it's funny. I'd rather have the snow than rain.

Mike: Well as you know, -4 and sun, which is what we have now, it's a little bit different.

But you know, Laura, before we get into your work, I love the personal stories, and it always leads us to our work, right?

Laura: Yes.

Mike: You know, I know this is a podcast and we don't have a million hours, but give us a little bit of background, because I found your story fascinating.

Laura: Yes, well, I was born in Southern, California, four out of eight kids, good Catholic family. And when I was in eighth grade, the company my father worked for was bought out by 3M in Minnesota, and so we got uprooted and moved there, and it was I think a really difficult transition for my parents, and really all of us.

My parents' drinking really took off when we moved and my mom became alcoholic, my dad, a very heavy drinker. And for myself, I started drinking in ninth grade, smoking pot, but in tenth grade, things really amped up. I got drunk almost every weekend, smoking pot. And you know, it's interesting, now as a parent myself, I don't know how my parents wouldn't have seen it or noticed, but then they were in their own addiction, so I think that was a big part.

Mike: Did the school see it? Did anybody see it?

Laura: You know, I don't think so. I felt invisible, which is interesting that you mentioned it. Did anyone see me? I felt like no one did. And that was very painful. And then going into eleventh grade, that's when my addiction really took up because I started using methamphetamine.

I started working full-time, going to school full-time, even though I was only a junior in high school. And I mean, around the clock I was under the influence of something.

Mike: Wow.

Laura: I got my license. I was driving, you know, just driving people, kids around. We'd all get high. I drove in a blackout so many times, Mike, I don't know how I didn't get in an accident, because I was drunk so many times driving.

And then when I was a senior in high school, you talk about being seen, I went into the kitchen every day, just sobbing at the kitchen table. And after a few days, my mom asked me what was wrong, and I told her I didn't really know, but I needed help. And asking for help, was definitely not encouraged in our family, probably not even our society at that time. And so she made an appointment to psychiatrist, he gave me an antidepressant, not like the ones today, because this is back in the seventies, and I started taking it and I felt a little better, but then I also started feeling suicidal, which is side effective of antidepressant, especially for kids, for adolescents.

Mike: And were you still using alongside of it?

Laura: I was still using, yeah. So all of that put together was not a good combo. And one day I just could not take one more step. I was just up to here with tears, and pain, and despair. And even before I picked up, I was bullied by my family, at school, there was no safe place. And I just kind of shoved down all my feelings, so alcohol and drugs were like, when I found them, oh, this is great. Just shove down all my feelings. And I went into my parents' medicine cabinet, I don't know why I thought there was gonna be sleeping pills, but there were. And so I took the pill bottles back to my room and I laid them out like one at a time, because I didn't wanna freak myself out, and I took probably, I don't know, 200 or something.

Mike: Oh my lord.

Laura: I walked outta my room, then I went and blacked out, I don't remember what happened. But my younger sister told me my dad said, oh, she's high, just put her to bed. I wouldn't be here today if that was the case. My mom went into my room, found the empty bottles, and they called the ambulance.

I coded in the ambulance, I was dead on arrival. I was in a coma, had my last rights. They asked my parents to come back because I had flatlined. So it was really touch and go those first few days when in the ICU. And then after I awoke from my coma, my first thought was just like, oh no, I don't know, like basically, excuse my French, but not this shit again. Like, I had no tools, you know, I didn't know how to live.

So they, transferred me to analysis psych unit. They did, as you well know, Minnesota's very progressive with chemical dependency, and I had a chemical dependency eval, and this is in '74, and they called someone in from AA to come talk to me. And she goes, you know, I don't think you're crazy, I think you're alcoholic. And I said, really?

And I started writing in my journal, my junior year that I thought I was chemically dependent, and I wanted to go to treatment, my parents were like, no. And I think there was a couple of reasons. One was because it might expose their own drinking problems.

Mike: Yep.

Laura: And I think the second one was, at that time there was like heroin addict type of rehabs, and then, I don't know what you call it, not a soft rehab, but anyway, there weren't that many rehabs for adolescents.

Most of them were for hardcore drug addicts, which I wasn't. I mean, I was a hardcore addict, but not that type. But anyway, so this lady helped me go through the emancipation process and I became an adult and I saw myself in treatment. And since I was only 17, the court paid for the treatment because I didn't have basically a dime in my name, which I don't know if that would happen today, but I was very, very lucky.

And, you know, I was very grateful or, am very grateful, not too long after my parents kinda came around, but the biggest reason I didn't want to go home was I was really afraid I would try to commit suicide again, and this time I wouldn't fail. That's the main reason I did not want to go home because of the neglect, and not seeing me and all my pain.

So I went to rehab. When I was in rehab, they introduced you, they gave you a journal, everyone had a journal. And like on the second day I wrote, I think I'm a lesbian.

Mike: Did you, did you write it and whisper too?

Laura: Yeah, yeah. And this is '74, so gay rights? Forget it. . So that was a huge like secret, but it was also a source of despair, because like most people, I wanted to get married, have a family, and so that definitely threw a wrench in things at least as I saw.

And I came out of rehab, I had about eleven sober, and I thought, I'm only 18, I just can't be alcoholic.

Mike: Mm-hmm.

Laura: And I went back using again, I tried controlled using. And then about a year later, I mean controlled using was a joke, you know, it would be like I'm talking to you now and my control would be, let's say I'd only drink on Saturday. I wouldn't hear a thing you said, because I'm just thinking about Saturday at five. So I knew what I needed to do, I went back to AA, got into therapy, and then about three years into my recovery, I started really just crashing in a way I've never felt, I mean, my bottom the second time was worse than when I had tried to commit suicide.

I was speaking so fast, they call it 'word salad.' My best friend in recovery said, I don't understand half of what you're saying. I couldn't sleep. And then I called my sponsor like three in the morning and I didn't wanna go to a psych ward, but she took me to a rehab, like she took me to a safe place. And they gave me a bunch of psychological tests and my diagnosis was, at that time, manic depressive, now it's bipolar disorder. And so they started me on lithium, which I was really resistant to, because back then in AA, if you took any kind of pill, you're not sober. But they told me I couldn't leave unless, you know, I started.

And then, during this time, I guess my whole family moved back to California. No one told me. So, there by myself.

Mike: That's an invisible.

Laura: Yeah, right. That's a good point, I didn't think about that. And so the women in my Tuesday women's group, they went to family therapy. They were my family.

Mike: Right.

Laura: And it was just so lovely, you know, that I had them. But I was really, still resistant. I took the lithium for about, I don't know, a year, and then I felt like I didn't need it anymore. And you know, it was much easier for me to accept my being an alcoholic and drug addict, because I have 46 years of recovery, continued sobriety. But I've had a really challenging time accepting bipolar and accepting the challenges and the difficulties that came with it. And so, when I went off lithium, it wasn't until probably, I don't know, five or six years ago, it was a new therapist, no, I guess it was on ten years ago now. He asked what kind of mood stabler I was on, and I was like, mood stabilizer? And he goes, well, how long ago were you on one? And I said, well, what's today, Thursday? I said, like 30 years ago. And he was like, what? And it just like, put a lot of things together. I mean, I was on antidepressants throughout most of my recovery, but those really aren't the medication of choice if you have bipolar disorder.

So, I mean, it affected my marriage, I got married to a woman, had a daughter, and affected my relationship with her and really everybody.

Mike: Sure.

Laura: And then my daughter went off to college and I just sunk into this huge despair. So my psychiatrist recommended this treatment called TMS, Transcranial Magnetic Stimulation.

And from the beginning, I had a bad reaction. I would cry, you know, but I like one of my, it's a positive trait, I think being persistent, like not giving up. But here it was negative.

Mike: Mm-hmm.

Laura: And so, my partner and I in Baltimore for my daughter, was in college on a volleyball scholarship. And we went to the auditorium and I told her, something's wrong. I need to go back to the hotel room. And then I called my best friend in recovery, Helene, and she's in Minnesota still. Anyway, I told her something's wrong and then I just went into a full-blown manic and it was horrible, because here I was 3,000 miles away from my therapist, from all my support system, you know, my partner had never seen me in a manic episode, because I had always, I mean, I've only had one other one, which is when I was 21.

So it was just really stressful and scary. And then when we got back to California, I started increasing my therapy I think to like three times a week. There was a waiting list for the DBT group. They had another group, bipolar group, I went to that for a few weeks till I got in the DBT group. And while I was there, one of the therapists said, pain is inevitable, suffering is optional. I said, oh, that's what they say in AA all the time. But the how to always kind of eluded me. I mean, there was a couple of slogans that helped like, you know, pause and breathe, but there wasn't a lot of tools for me. You know, just my trajectory in recovery did not mirror a lot of people I knew.

I was like, okay, I don't feel like I'm getting the promises here. Maybe a few, but I see you folks over here, and not realizing that having a mental illness was really what was getting in my way of getting all the gifts from recovery.

Mike: Well, and the gifts from in recovery, you know, when you talk in your book about finding DBT and the skills from there, and I think it's in your forward, where the gentleman who wrote your forward, a doctor from Harvard, I think, right?

Laura: Yes. Yes.

Mike: He made a great point, he said, I am so surprised that this book hasn't been written before. That kind of marries the philosophy of AA with DBT. And actually you lay it out in a incredibly logical way using the 12 steps.

Laura: Oh, thank you.

Mike: Yeah, and basically building the skills. And he makes the reference. He says, I can see this being used, and I would say, even built upon for a long time to come. So what did you discover in DBT that helped work stabilize things?

Laura: Well, DBT has like 200 tools.

Mike: Mm-hmm.

Laura: There are so many tools and skills. Whereas AA, maybe there's 20. You know, so there's so many more tools that are helpful and specific.

So instead of just pause or breathe, you know, there's the DBT section of interpersonal relationships, and then below that, there's like 10 different skills. So it's much more specific to the problem that you're dealing with, whereas a lot of the tools in AA are more general, you know, like, okay, whatever the problem, just pause or -

Mike: Let go, let God.

Laura: Yeah. But DBT is much more specific. Like, going back to the relationship category, you look at, okay, what's the pluses and minuses of this relationship? What's the value I have? Like is this a really close friend or is this really more of an acquaintance? So the tool I'm gonna use is different than if it's a real intimate relationship.

So it's not, you know, AA is more of a one size fits all, but DBT isn't. They're like, okay, you have this whole like banquet full of tools, and to choose them for whatever issue you're dealing with. So I started practicing them. I mean, that's a big part of it is the homework.

Mike: Mm-hmm.

Laura: And I started practicing the tools in all areas of my life. I mean, one that I have is meditation, which AA does have, but I didn't really have a regular meditation practice, which is no fault of AA, but the group helped me to build one.

Mike: Well, and you know, when you used the phrase you said, it just was a Aha! The pain is inevitable, suffering is optional. There's tons of people that go exactly what you said, okay, right. How?

Laura: Right. Yeah, because most of my recovery, I mean, I'm sure you've heard the platitudes or I don't, I'm not sure if you're in recovery or not, but like I brought up on one meeting not too long ago, someone said, oh, well if I'm miserable being sober, I might as well go out and drink.

Mike: Yeah. Mm-hmm.

Laura: And I know this must be (inaudble) and I didn't, but I just said for myself, unfortunately, I've been miserable most of my recovery because of an untreated mental illness. But I'm so glad I didn't go out and drink, because that just would've compounded the whole issue.

And going back to your question, how? That's where the DBT skills come in. Okay, so, you know, again, depending on the particular issue coming up, like maybe you're getting triggered to use, here's some tools. Maybe they're relationship issues or interpersonal relationships, here's some tools. And like I said, if you get the full DBT handbook, there's 200 at least skills in there they teach and they break it up into four modules. And then, but for me, I have it side by side with the steps, so I don't lay it out the same way. But I kind of put skills to each step that I think would help in working with that step.

And so I just started working with a sponsee using my book, and it has been really exciting. I dunno if you remember that commercial, "Let's get Mikey to do it!" You know?

Mike: How can I not know that commercial?

Laura: So I feel like she's my Mikey, you know, because I wanna see, well, does this really work? Is it helpful? And she said it's really helpful. I was speaking at a meeting and disclosed that I have bipolar disorder and she came up afterwards and said, I do too. Will you be my sponsor? I'm like, sure. And I said, you know, usually I go through the step book, but how'd you feel going through my book? And it's a step book, but it's expanded and so far so good that she said it's really been helpful and especially that it's addressing more than just alcohol because see, a lot of us, you know, the mental illness and alcohol and drug addiction, they're all tied.

Mike: Mm-hmm.

Laura: They're tied together, so I don't really think you could separate them.

Mike: Well, tell her next time you see her that the tagline of that commercial is, "He likes it!" Mikey liked it. You know, one of the reasons I liked your book and what you said, and part of your story was the lady from AA came down and talked to you and said, you're not crazy. You know, at the time, we didn't marry mental illness or mental health and addiction. They were on separate floors of hospitals with the maternity ward in between. And of course, now as we look back, right? It just makes such logical sense that if you're drinking every day, you're probably clinically depressed. If you're going through all of this stuff, you're going to have some mental health issues. And there needs to be a way of marrying those and working through them.

Laura: Yeah. Well, so going back to that, in the seventies there was so much shame about being alcoholic. Like for me to tell someone I was an alcoholic, they look at me like, wow. You know, similar to like coming out to someone, there was so much shame, judgment.

But it's taken a lot longer for mental health or mental illness to be talked about.

Mike: Right.

Laura: You know, now the past few years, there's all this explosion of nonprofit and ads, like, Let's Talk About It, or the Trevor Project.

Mike: Well, you know, you're right about that, we're still working on the stigma.

Laura: Yes. So that's taken a long time. It took me a long time to share that in a meeting, disclosed I had bipolar disorder, and I remember the first time I did, a woman came up to me and said, you seem to be apologizing during most of your qualification for having a mental illness. And you know, that was interesting feedback because in a way I was because I still was experiencing shame about it.

Like, this is why my recovery has not been as great as yours or as good as yours because, I had my own, of course, judgments. But that was interesting feedback for me to realize, wow. Yeah, I'm really being judgmental and how is that gonna help someone else?

Mike: Well, which is interesting because your education and your background is as a psychologist and sometimes it's hard to see, right? It's hard to see in the world.

Laura: Yes. Very hard. I mean, when it's so close to you, it's very hard to see. Because for the longest time, I just saw the depression, my depression, and so did the therapist I worked with until I started with this new therapist, like over 10 years ago, who said you have bipolar disorder, what's your medication? And I guess the other therapist, I don't know what the story was there. I've thought about going back to them and asking them, but yeah. I remember when I went to a bipolar training, I was like, oh my God, this is me, like irritability, short-tempered, all that. And I thought, oh, that's just because I'm still stressed out all the time.

Mike: Mm-hmm.

Laura: But no, those are all symptoms of bipolar disorder. Trouble sleeping, you know, all of these symptoms. So yeah, I was in denial. I mean, I knew I had it, but I was in denial that I needed to treat it with different medication. And it's like, when I got back on Lithium, when I was in the DBT program, it was like hand-in-glove, like, you know, no, this totally fits together. Yeah.

Mike: Well, I mean, if you think about what you were using and when you were using it, through your brain development back when you were in middle school and high school.

Laura: Yeah.

Mike: You know, that's a connection I think we still haven't made total in our research, what happens to us when we're younger?

I did wanna ask you what you think, because we do have a lot of therapists that listen to this podcast. What do we miss? Like what can we do so that we don't miss people?

We had a lady on over a year ago, Glen Close's sister, Jessie.

Laura: Oh, I've read about her, yeah.

Mike: And her story is remarkably similar to yours in that she struggled for a very, very long time until she finally had the correct diagnosis. What do you think we miss?

Laura: Well, I mean, as a psychologist myself, you know, putting on that hat,

Mike: Mm-hmm.

Laura: Having a really thorough intake is key. So a lot of the intakes I see, or when I talk to previous therapists of a current client, they either miss the alcoholism, or drug addiction, or the mental illness. But seeing both of them or, you know, asking historical questions on both of them is not that common.

And especially with people in recovery. Okay, I'm in recovery, but I'm depressed, or I'm not sleeping, or I'm, you know. Like I had four different deposits on four different apartments, you know, in my main, yeah I just, every place I looked at looked like a good place to live. I said, I'll take it, and then I went to another place and said, I'll take it.

So I think a really thorough diagnosis, dual diagnosis, although not all clients will have that, but very thorough. So I usually spend at least two sessions, sometimes three. A lot of times paperwork is now emailed out to potential client. It's gone over, I think, somewhat briefly, maybe a little bit more so, but there needs to be more in-depth.

And then asking about family history, because like for me, I had an aunt to a bipolar disorder. Unfortunately, she hung herself. So there was mental illness in my family, and when I hear someone say, you know, when I'm doing the intake, oh, I have mental illness, I immediately go into, look at your family tree. And inevitably, I usually find there's a connection, because there's a strong genetic component to mental illness. And so that's like a confirming factor.

Mike: Excellent. And of course, now that you're working with people, as you're working with them, I think you alluded to this before, and part of DBT would do this, you need a strong relapse plan as well, because things are gonna come up, and the tools help you build that as well.

Laura: Yes. DBT has a relapse prevention program in their set of skills. I fleshed it out a lot more because it's a little weak, so to speak. But their skills for relapse prevention plus AA, I think builds for a much stronger platform for relapse prevention. And then again, you know, putting them together.

I wouldn't necessarily say it's a weak, it's not, they don't have a lot of tools for that aspect as opposed to interpersonal relationships. Anger, depression, those feelings. Yeah.

Mike: Well, I brought it up because I really like how you fleshed it out, and I think that helps a great deal.

Laura: Thank you.

Mike: And then lastly, I think the support system, you've mentioned that before. I was really touched with who came to your family meetings. Can I ask? Is it intrusive to ask what happened to your brothers and sisters who went back out to Cal? Did you reconnect with any of them or your parents?

Laura: Yes, I did, story there with a lot of them, but I have five brothers and two sisters, I'm closer to my two sisters, they're both in Nashville. Definitely alcohol use disorder with several of my brothers, one brother died like two years ago and I was really close to him. And he, you know, he was in and outta rehab, wasn't able to find recovery, but also had a mood disorder, so he struggled in that regard too. So I am close to my sisters and my nieces. Yeah.

But there was a time I lived in New York for ten years, and for seven of those years, I had not visited California. I didn't visit my family. But I needed that break, I really did, to establish myself as my own person, separate from my family of origin.

Mike: Well, and then you find out, when you find out who you are, you find out who will accept you for who you are.

Laura: Yes. And that was another issue too. I mean, they eventually came around, like I have a nephew, came out as gay and oh my God, they accepted him in two seconds. But with me, it was -

Mike: Were you raising your hand at that point? Oh, that's great. Well, Laura, this has been delightful. For those of you who work in this field or whatever, we will obviously put links to Dr. Laura's work as well as the book, and I think it's really useful, and you use it exactly the way I would see it being used. People who are in recovery, who go to AA, are used to working the steps, and so add your workbook to work the steps to give you even more tools, I think is really a great gift to the recovering community and thanks for that.

Laura: Oh, well thank you, Mike. I really appreciate it. Yes, and I hope it is helpful. And it's meant to be worked side by side with the steps or in addition to the step work that they're already doing.

Mike: Well, thank you for joining us from rainy California. That makes me feel just a little bit better, I might add.

Laura: Yeah, but you have sun!

Mike: Yeah, that's true, that's true, okay. You're right. I will look on the bright side. How's that? And for those of you who are listening, please listen in again next time. And until then, stay safe, and you also look on the bright side.

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