Breaking the Cycle of Addiction Starts with Understanding It

[Upbeat Guitar Music]

Mike: Welcome everybody. This is Avoiding the Addiction Affliction, a series brought to you by Westwords Consulting, the Kenosha County Substance Use Disorder Coalition, and by a grant from the state of Wisconsin's Dose of Reality Real Talks reminding you that opioids are powerful drugs and that one pill can kill.

Mike: I'm Mike McGowan.

Mike: When we're going through difficult times, often the tendency is to isolate, to withdraw, to not talk about it. Help is available, but often folks are reluctant to ask for or reach out for it. We're gonna talk about a different approach to helping people get the education, support, and help they need to resolve their life issues with our guest today, Dana Emold.

Mike: Dana is a Licensed Professional Counselor and Clinical Substance Abuse Counselor. She currently works at Intune Collaborative Counseling in Mequon Wisconsin. But is also, and that's what we're gonna talk about today, highlighting a free family education and support group at Wellbrook Recovery in Brookfield, Wisconsin that's gonna provide education on topics like understanding addiction, what makes it a disease, codependency, enabling, you name it. That's the venture we're gonna talk about today. Welcome, Dana.

Dana: Thank you so much for having me back.

Mike: I should say welcome back. It's been a long time though, so it's good to see you again.

Mike: Dana, when folks are struggling, there are so many times there's a reluctance to ask for counseling support or help.

Dana: That is very true, and I see that more and more, not just with the individual themselves struggling with addiction, but certainly their family members and loved ones, support people.

Dana: It's a disease that exists almost entirely in isolation.

Mike: Why do you think people are so reluctant to ask for help?

Dana: There is still so much shame associated with this particular disease. And for the family members, people are often quick to look to the family like, especially when it's parents and children, they're looking to say "What did the parents do or not do?"

Dana: Which is oftentimes not even close to reality as to what is actually going on in the situation, but people feel. They feel the loss.

Mike: I think it's so funny sometimes when I talk to parents who are so embarrassed sometimes unnecessarily so, when they're like teenager develops a substance use issue and they take all the blame, and I'm like, "Oh, are you also taking credit for your honor student?"

Dana: Exactly. Yeah, we definitely don't see a bumper sticker for this though, in their, for their cars.

Mike: (laughs)I'm the not so proud parent of...

Dana: (laughs) Exactly.

Mike: Those of us who have done this for a while know the value of support systems like Al-Anon, but I gotta tell you, and I'm sure you've experienced it, getting people to commit to going to support is not easy.

Dana: It is extremely difficult. Getting them to admit that there would be a benefit in support. Let alone, like even if they could just get that far to say "Yes, there might be a benefit, but here's my hesitation." People are just very quick to say, "It's not for me without having ever tried it."

Mike: Or even knowing what it is.

Dana: Yeah, exactly.

Mike: Have you ever had somebody say, "Oh, is that God stuff?"

Dana: More often I see that with the individuals who are telling me reasons why they won't go to AA or NA. But it definitely comes through on the family side as well. The family's just not usually as well versed about the 12 step program to know that higher power is part of the language.

Mike: Yeah, and it's a 1930s language too. So I know that there's a new plain language, big book. We should do a podcast on that. Have you seen it?

Dana: I do, I have a copy of it and I have, in my office, a very handy like quick to read version of here's the agnostic 12 step.

Mike: Yeah. There's so many different options available now. The program you designed seems to serve as, a bridge of sorts, a less intimidating way for people to take the steps to healing.

Dana: That is the hope with this program. I was finding so often in my own practice that family members were so apprehensive to get additional support.

Dana: So even if they were willing to come and talk to me, which is a huge step, and that's fantastic. There was still this apprehension to get additional support outside of therapy. And just that peer support can be so instrumental in recovery for not just the individual who is struggling with addiction, but also for the family.

Dana: Addiction is a family disease and that everyone needs to recover from.

Mike: So you could literally be seeing someone and then say to their family members, "Hey, go to this thing!"

Dana: Yeah.

Mike: Oh, I like that, I like that. That I hadn't seen that, but I like that a lot. What's the structure of the program?

Mike: Tell us about it.

Dana: I'll add one more thing and then I'll tell you about the structure. I'll be working with an individual whose spouse or child is struggling with addiction, and I'll say, "You know what? I think you would benefit from Al-Anon". Because they are so convinced that this is not happening in other families, and this is a way for you to see this is happening. This is not unique to you. Your individual situation may be unique for you, but the disease of addiction and the impact it has on a family is not unique. And so getting them to come to terms with that can often be done best through peer support. The structure of this program is that it starts with an education based PowerPoint just on one of the main topics that families are often struggling with.

Dana: There's a certain amount of crossover between the different topics, so that if somebody missed one, you can come in at any time. You're not missing anything, and the six different topics are meant to repeat themselves so that people can continue to come as often as they want, or they could say "I'm gonna commit to six, I'm gonna go to this six times."

Dana: And get this basis of education and then hopefully from there, maybe be willing to consider Al-Anon, maybe be considering individual therapy or family therapy, or even just having greater confidence in a understanding of the disease.

Mike: What are the six topics?

Dana: The six topics are the Disease Model of Addiction, which is more of a science-based "Here is what is happening in somebody's brain when they're struggling with addiction." How Addiction Impacts the Family System, Understanding Codependency, Enabling and Healthy Boundaries, Improving Communication and Emotional Regulation, Relapse Education and Safety Planning, and then Family Recovery, Self-care, and Long-term Healing.

Mike: Oh, I love that. You can make that a 12 week series and break each of those into sub parts, right?

Dana: Yeah. And then the hope is also that, each of these sessions is 90 minutes, and we are hoping to do like maybe 45 minutes of education. But even the education piece is not just me standing and talking, it's meant to be interactive, stopping and asking for questions.

Dana: And if we need to pivot off because that's what the group needs, that's what we'll do. The last 45 minutes then would be more of just open discussion.

Mike: And there's power in that, right?

Dana: There's a lot of power in that. That validation that you're not alone?

Mike: Yeah. When I do educational presentations, there's always people who come with specific needs and questions, but helping them feel comfortable asking questions is not easy.

Mike: I get this a lot, after an hour and a half presentation walking out to the car... "Do you have minute?" And it's not a minute, it's like 45.

Dana: Yeah.

Mike: Yeah.

Dana: I've definitely, in my own calendar, I've definitely set aside a lot of extra time.

Dana: Both before and after, so that I am just there. There's always those individuals that are very brave.

Dana: And are willing to share.

Mike: I love that.

Dana: Very openly in a group, but there's also individuals who are a little bit more reluctant to share in a group. That's okay too. I still want you there, even if you don't speak at all, just so that you're able to hear what's going on.

Mike: Well and to hear somebody say something that you're going through, without you saying it.

Mike: There's that "Really?"

Dana: Yeah.

Mike: So how do you envision like when you discuss the disease of addiction.

Dana: Mm-hmm.

Mike: What is it that you find that people don't know?

Dana: People don't necessarily understand the limbic system. How that survival part of your brain is kicking on when you are struggling with addiction.

Dana: The impact that dopamine has on your brain chemistry. And that piece that I really drive home is, your brain is actually preventing, for the person who's struggling with addiction, your brain is actually preventing you from getting as large of a reward from things you used to enjoy. And it's more gearing you right towards using that substance.

Dana: So it's not that you're person stopped loving you. It's not that they stopped finding joy in being with you. That wasn't a conscious choice that they made. Their brain chemistry switched on 'em,

Mike: And they've gotta now change their behavior to get something back.

Dana: Yeah. So it's letting them understand also that that dopamine reset, that doesn't happen overnight.

Mike: People think it does though.

Dana: Yeah, I know. (laughs) And then helping them to understand what they can control and what they can't control.

Mike: I find people say, "Why don't they just stop?"

Dana: If it was that easy, they would've done it. I think I often mention how we think of recovery as a puzzle that a toddler could do.

Dana: Here's a four piece puzzle. Put the pieces together. Very simple. You could probably do it with your eyes closed. That's the, "Why don't they just stop?" "Okay, I'll just stop. Great. Didn't think of that." That's that model. But in reality, this disease is a thousand piece puzzle of the night sky. It's round and we're missing half of the pieces, and so we're slowly gaining information as to how it's going to be manipulating this person's brain over time.

Mike: That's not easy.

Dana: No, it's definitely, it's not easy, but it helps families to understand here's the things that you can control. Here's the things that they can control. Here's just the reality of the disease.

Mike: Yeah. There's that the bumper sticker or the AA slogan, first the old version.

Mike: First the man takes a drink. Then the, drink takes the drink. Then the drink takes the man. I think people don't understand the progression either.

Dana: Yeah, they definitely don't. And it's a hard, I think it's a lot of the things that we say, it's the same message said in 10 different ways, to find the way that resonates most with the person.

Mike: Yeah. I want you to invite me 'cause I wanna be there in the back of the room when you discuss codependency and enabling.

Dana: I'm looking forward to it. It's an important conversation. I find myself having, not having, I choose to say over and over in that particular model that this is very simple, but it is not easy.

Dana: Everything related to codependency and enabling and enmeshment, these are very, this is simple, but what I'm asking you to do, or what I'm saying might be beneficial is not going to be easy. That we have to give ourselves grace in trying to make this separation between helping the person and not the addiction.

Dana: And just how uncomfortable that's going to be.

Mike: Yeah. Can we talk about that for a minute?

Dana: Sure.

Mike: As hard as addiction is, there's a moment where the individual goes "I need help."

Dana: Yeah.

Mike: I think, in my career, I think codependency is much... it's at least as difficult, if not more so because you play that roundabout game.

Mike: " What about that one?" "What about her?" "What about him?" They're, " How are you doing?" "Well, he..." And getting them to focus on taking care of themselves when it's the addiction is so prevalent in the family, is so difficult.

Dana: Yep.

Mike: And a lot of times they think it's a waste of time.

Dana: In trying to get someone to take care of themselves? Or in...

Mike: Yes!

Mike: Yes. They think why am I focusing on me?

Dana: Yeah.

Mike: "He's the problem." or "She's the problem." "My kid is the problem. I'm doing fine."

Dana: Yeah.

Mike: Without realizing that if you take care of yourself, the whole system changes.

Dana: Yep. It's the only thing you have control over.

Mike: Yes.

Dana: And there's so much energy being spent on trying to control what another person says, does, thinks, and feels. And it might be for your own comfort, because that person might get really dysregulated i f I don't give them what they want or if I feel like I'm not helping in this situation. But it's being able to take that step back and say, is that helping? How is this helping? Especially if this is a pattern that's repeating, take a look at the pattern. If you keep doing something you don't wanna be doing, what happens if you stop?

Mike: And how many people have you met with over the years where it's a multi-generational issue and it's also the way they grew up?

Dana: Yeah.

Mike: Getting them to focus on themselves is painfully difficult to do.

Dana: Yes, extremely. And we can be sensitive to the idea that if this is multi-generational, the idea that you are going to take a complete 180 and switch gears.

Dana: I get that's probably not gonna happen. But what's one thing you can do.

Dana: And let's just start there. It doesn't have to be all or nothing.

Mike: Yeah, no kidding. Where do you think, besides the shame. Why do people, I'm gonna put this poorly, choose to stay stuck.

Mike: Where does the resistance come from when it seems to all of the world around them that doing anything is better than what you're currently doing?

Dana: For the family member or for the person struggling?

Mike: For any of them. For any of them.

Dana: There's an extreme discomfort in what we don't know.

Dana: For the person who's struggling with addiction, depending on how severe their addiction is at that point in time, your brain is sending you a message saying "You're gonna die if you stop doing this substance." So that's a hard thing for that person to combat without support.

Dana: Although people like to try to white knuckle that all the time. It's like, could you? Yes. Do you have to? No, you don't have to. Could a family recover from addiction without any help? Sure. But you don't have to. Why would you do that? There's all this support available.

Dana: I think if the question is like, why do people stay stuck? It's familiar.

Mike: I should ask 'cause people will be wondering at this, what's the cost?

Dana: This is free.

Mike: I'm sorry. There's a four letter word we don't hear that often anymore.

Dana: Yes. Yeah. I think they oftentimes I hear about like AA and NA referred to as this is the only free lunch still in town.

Mike: Yeah.

Dana: This is free. We don't want there to be any reason for someone not to come. How often can you, have in an evening or an afternoon or a morning depending on what time you come, how often can you go to something that was completely free and that you hopefully gain something from?

Dana: We're not trying to take anything from you, we just want to give you something. It's when I'm encouraging people to try to go to meetings or this, it's. I rarely meet the person who leaves a meeting or leaves anything self-care related. So I will broaden that to say anything self-care related where they leave the experience and say: That was a total waste of my time."

Dana: It's here, this is something that is free and it will not be a total waste of your time. You will benefit from this.

Mike: You probably want people to at least let you know they may be coming. We're gonna put links to your contact information. Is that, would that be the best way to let,

Dana: That's the best way.

Dana: We may in the future have some separate informational pieces that have additional pages they can go to RSVP. You don't have to RSVP for this, but it is nice if we know who's coming.

Mike: Yeah. For those of you who are older, like me, you're probably thinking "Wait a minute. Don't all of the treatment hospitals already have this?"

Mike: And we would answer back to you: "What treatment hospitals?" Back in the Halcion days, most treatment facilities had programs similar to this. But let's be honest, Dana, there are many less treatment alternatives for people. And every time I run into somebody who says I went through treatment, I will say: "How long?"

Mike: And sometimes the answer is: "Oh, three days."

Dana: Yep.

Mike: And where did you go? Just, "It was a little bit of a detox." "What family program? Did they have family program? This has been lacking for a while.

Dana: There is still a lot of confusion in the community as to what are the different treatment options.

Mike: Yeah.

Dana: Like the idea of inpatient versus residential. People use those terms interchangeably and they're extraordinarily different things. Inpatient is a hospital setting, it is a detox. Residential is you're going and you're living there for 30 days, hopefully, maybe a little bit less, maybe longer, and it's a more all encompassing 24/7 treatment program.

Dana: And then there's the step down programs. If there is one locally that offers this, I am unfamiliar with it. They do offer like a family session, but that's not what this is. The closest I know, that offers it that routinely provides it, is Hazelden up in Minnesota,

Mike: Which is a bit of a drive if you live in southeastern Wisconsin.

Dana: Yeah. And they do offer, I think if they have an online one, there is a fee for it.

Mike: Yeah.

Dana: It might be free if you have a family member currently in their program, but if you are like a family. Like a loved one, there might be a cost for that program i'm not certain on that. You can do it virtually, but I think there is a lot of power in being in person with people.

Dana: You can feel it.

Mike: Yeah. Are you doing this alone?

Dana: I am doing this in, I'm the person who is facilitating it alone. Yes.

Mike: Oh. Let's talk about that power in a group, because when you talked about the family session, I flashed on many of the family sessions I had. The first family session, which was, and for those of you not watching, but listening, I'm crossing my arms with a scowl, right?

Mike: Which is like, why am I here? I'm not the problem! So there's a power in listening to people. So you're going to allow, for those of you familiar with AA, you're going to allow crosstalk and asking questions I would think.

Dana: There is going to be crosstalk. People are allowed to ask questions, because there's somebody facilitating.

Mike: Yeah.

Dana: It's important, I think, that AA doesn't allow for that crosstalk.

Dana: It keeps things moving, but it also provides a safe space in that, you know that you can say whatever it is you need to say, and someone isn't going to give you their input on your situation and tell you what you need to do.

Dana: It avoids that. And so by having something that is facilitator led, we are able to both manage the crosstalk. Manage the discussion, but also be able to provide some sense of security for people who might be a little apprehensive to say: "Listen, there's somebody who's running it, and if you have questions before you go, reach out to her, she'll be happy to talk to you."

Mike: Do you envision this being a funnel?

Mike: Like if people say: "Where can I get more to either therapy or to Al-Anon or AA?"

Dana: Yeah, that is the hope. Just to be able to provide more education about what is available. It can be either for the individual or for the family. And there's a number of different therapists that specialize in this.

Dana: There's a number of different AA, Al-Anon options, giving people that sort of resource without them having to go searching for it on their own.

Mike: Yeah. When you talk about it, information and education and stigma for that matter. We're still dealing with so much. I find that when people turn to their family and friends, which is always the first place they turn.

Dana: Yep.

Mike: That family and friends may not have the most accurate information.

Dana: Correct.

Mike: I'm being kind.

Dana: Yeah. Basically they're on their own experience. Or something that they saw or read. And unfortunately a lot of information comes from people's watching of the show Intervention when that was still on.

Mike: Oh my gosh! I gotta tell you, if anybody ever did an intervention on me and they were willing to pay for a first class flight to Malibu, I could come up with something.

Dana: Yeah. (laughs)

Mike: But it's television, people think that's accurate.

Dana: Yeah. People really felt that was accurate. And for a long time people would come in and say we need to do an intervention. And I'm like,

Mike: Oh, I know.

Dana: We can intervene, but we don't ever wanna like surprise intervention on people.

Mike: Yeah. Especially I think that show was, you know what it was back in the day because there were places to go, right?

Dana: Yeah.

Mike: You know when people would say: " Can we do an intervention?" I'm like: "What's the end game? What do you want? Where are they gonna go? Who has the insurance? Who's gonna pay for it?"

Mike: Yeah. Because you can't get to the person to the end and person go, "Okay, I'll get help, where?", "We'll look into that. We'll get back to you in six months." You gotta get a goal.

Dana: Yeah. Take them, fix 'em.

Mike: Yeah. You're also dealing with grandma Wilma, right? Or Uncle Fred. There's a lot of people who have misconceptions about support groups, therapy, treatment, and they spread that disease to the whole family. So you're going to have to overcome some of those misconceptions as well, and negative expectations.

Dana: It's interesting that this is, again, one of those diseases that we treat it so differently than other things get handled.

Dana: So it's saying: " I tried running once. I didn't like it. I'm done. Running's not for me." It's like "You tried it once?" Or "I went to this one meeting and there was this one guy and he spoke too much about God. I didn't like it. I'm never going back!" Find a different meeting!

Mike: Yeah.

Dana: Or even when it comes to therapists: "I found this one therapist. They didn't tell me what I wanted to hear, so I'm done." M aybe seek out a different therapist. It's like they make that first step, and if it doesn't go exactly as they had anticipated it was going to go, that's it, I'm out.

Dana: But if it was any other disease, they would be far more proactive for themselves and for their family member to get the help they needed.

Mike: Yeah. And I don't think anything's wrong with looking for a second opinion. So long as the second, I'm not going to the, tomorrow I have an appointment with the back doctor, right?

Mike: So after the back doctor tells me what they think is wrong with my back, I'm not gonna get my second opinion from my cousin who's a welder.

Dana: Yeah.

Mike: Just 'cause his back hurts.

Dana: And it would also be, it's the disease of addiction, it's not black and white.

Mike: No.

Dana: It's so nuanced. There's so many factors going into it.

Dana: There's oftentimes that co-occurring mental health, either anxiety, depression, trauma, and if it wasn't there before, is it there now? What proceeded what? These are all factors that impact it.

Dana: The family's typically been struggling for a very long time.

Mike: Yeah. I'm always skeptical of the person who gives me an absolute, like I can envision a room that you're in front of, or in a circle, however you're gonna do it.

Mike: And somebody talks about, let's say, their kid discovering drugs with their kid. You might have five other opinions in the group about how they should handle that. I don't have a definitive what's the best way to handle it. I have a menu of ways you could handle it. Let's see what works.

Mike: People say here's what you should do, it's what you wanna stay away from right?

Dana: And the minute, like in, in any setting, the minute I hear the word should, it's the, there is no should.

Mike: Mm-hmm.

Dana: Here's what you could do. Here are some options, but there is no should. Should implies that I have some control over something that is actually not mine to control.

Mike: Yeah. I've never shared this, but it changed my perception about that very question I heard long ago now, Carroll O'Connor, the actor who played Archie Bunker.

Dana: Yes.

Mike: And his son had addiction issues and died from them.

Dana: Okay.

Mike: And he said in an interview that I heard, he said he followed all of the advice he was given about tough love and setting boundaries and blank.

Mike: And then he looks and he goes, I wish I would've done something different.

Mike: And I remember thinking, wow, that's some of the same advice I would've given him.

Mike: " What could you do?" I think is much more important than: "Here's what we know works."

Dana: Yeah.

Mike: Not everything works for everybody.

Dana: No, it's what are you comfortable doing that you can stick to?

Mike: Oh, that's great. That's a great parameter.

Dana: Yeah. Because getting somebody to do something just once, especially like when we're talking about like that codependency piece, it's, "I want you to be successful in your attempt to set a boundary." or "Communicate differently." But let's start with " I'm gonna meet you where you're at". "What are you comfortable with?" And "Maybe today the thing that you're comfortable with is just coming to this meeting and that's it. Okay. That's great. I'm so happy you were here."

Mike: And go through the menu, right?

Mike: "I'm uncomfortable lying for you."

Dana: Yep.

Mike: "I'm uncomfortable lying to your parents." "I'm uncomfortable calling in to work."

Dana: Yeah.

Mike: "I'm not gonna sleep with you." "I'm gonna leave you."

Dana: Yeah.

Mike: Don't say them if you don't mean 'em.

Dana: Exactly.

Mike: Figure out what you mean and say what you mean.

Dana: Yeah.

Mike: Wow. What do you envision is the best possible outcome to this?

Dana: The best possible outcome to this, is that the community gains another resource.

Mike: Oh, that's great.

Dana: Yeah. When some therapist who doesn't know me at all, has somebody sitting in front of them that could really use this support, and they say "I won't go to Al-Anon, and here's why."

Dana: That they are able to say: "Here's another resource."

Mike: So this today is part of getting the word out.

Dana: Yeah, exactly.

Mike: How else are you gonna do that?

Dana: We will do that through social media. Wellbrook will do this via their website as well as their social media. They're very generous in allowing use of their, like they have a community room on site, and so this is a resource for them as well.

Dana: And then just networking, talking to other therapists, letting 'em know that this exists.

Mike: Do you know the coolest thing that will happen, right?

Dana: What's that?

Mike: I'll predict it now, right? Because if it's successful, when it's successful, right? Other people will look at this and go: "We should do that." And then they will, which is terrific 'cause, I gotta tell you, it's not like we only have a need for nine people across a metropolitan area, right?

Dana: Exactly think it's, what is it? Like "Copying is the highest form of flattery."

Mike: Yeah.

Dana: I t's not a problem, but let that be the worst problem in the world, that other people want to replicate this model.

Mike: Yeah. That's great.

Dana: That's fantastic.

Mike: Terrific. Dana, all the success in the world, can we contact you later and see how it's going?

Dana: Absolutely. I'd love it.

Mike: Yeah. I'd love to know some of the surprises or interesting parts that you end up with it. This is important. The reason why we wanted to do this is because education, I think is the foundation of getting healthy.

Dana: Yes.

Mike: If you don't know what you got. It's hard to treat it right.

Mike: I already said it, but you all know that there's contact information, Dana's contact information for both her practice as well as for this new venture through Wellbrook.

Mike: For those of you listening, watching, we hope you find hope, insight, education, courage, support, wherever you are.

Mike: As always, thank you for listening. We want you to be safe. We want you to be well and reach out.