Every family that experiences addiction and mental illness searches endlessly for answers to their pain and hopes to stumble upon a survival guide. Lisa Gennosa discusses her journey as she tried to cope with her son Tyler’s illness. Lisa is the author of Incurable Hope: A Memoir and Survival Guide for Coping with a Loved One’s Addiction. Lisa is a practicing Physician Assistant. She is a dedicated wife and mother who grew up the third child of a liquor and narcotics agent. She discusses how substance use disorder, mental illness, and trauma can collide with the legal, medical, and treatment systems. Lisa’s book, blog, and contact information can be found at www.lisagennosa.com.
[Jaunty Guitar Music]
Mike: Welcome everybody, this is Avoiding the Addiction Affliction, brought to you by Westwords Consulting. I'm Mike McGowan. As you all know, I speak a lot in public and whenever I'm speaking, I'm always asked if I have a moment after my talk for a quick question. Way too often the question is from a friend or relative about someone they love and that person's addiction or mental illness.
Now, as you can imagine, there's nothing quick about any of it, but in every instance the person who is asking for help, is looking for something, anything that's just gonna help them just a little bit. And that is our conversation today. My special guest is Lisa Gennosa. Did I say your name correctly, Lisa?
Lisa: You sure did.
Mike: Well, there you go. I'm lucky sometimes. Lisa is a practicing physician's assistant, a wife, a mom, and an author whose book, Incurable Hope: A Memoir and Survival Guide for Coping with a Loved One's Addiction, chronicles her struggle as her son fought his own battle with addiction, trauma, and mental health, and what she learned from it all.
Lisa: Well, thank you so much for having me, I really appreciate it.
Mike: Yeah, thanks. I think you know this, because I communicated this to you, but it's the best book like this I've read in a very, very long time, so thanks for writing it.
Lisa: Well, that's an enormous compliment and I don't know what to say about, you know, thanks, about that, really.
Mike: That's alright
Lisa: I appreciate it so much.
Mike: Well, let's start here though, because I think this is really helpful, and we'll talk about why in a minute. Before we get into the meat of the conversation, I thought it would be helpful to learn a little bit about your background. As you were growing up, what did your dad do?
Lisa: Well, actually, I grew up in, you know, the non-traditional at that time, because it was many years ago, divorced family. So my stepdad was a draftsman, which again, doesn't exist today, right, because of computers? But he was a draftsman. My mom was, believe it or not, after five children, she was a police officer, and then a detective, and later became a liquor and narcotics agent.
Mike: I love that part. And then you became a PA, a physician's assistant.
Lisa: I did, I did years later.
Mike: And your husband is?
Lisa: He is a family physician.
Mike: Oh, okay. Now there's a reason I mentioned that. In one of the articles I read that you wrote, you made a statement that in spite of your upbringing, which was full of, how did you put it? Knowledge...
Lisa: Education, maturity, information. You know, I did, I had all of that available to me. It didn't matter. I had all of the resources, and education, and financial ability to understand this maybe on some, you know, fictitious level, but the truth is none of us really, really do exactly.
Mike: Well, I thought that was a really important place to start, and I hope that helps frame our entire conversation today and gives people just a tremendous amount of hope. So tell us about your son, Tyler.
Lisa: Well, I'd love to. Well, you know, again, everything being what it was, started out very simple. He's a sweet, sweet little boy. You know, very happy. Slept through the night, very early on. It was, you know, a wonderful time. I did go through a divorce from his father when he was really young, and I think unfortunately that had a lot of implications that we really learned about much, much later.
You know, he did sort of discover that he had a sense of that abandonment many years later, and that was sort of the foundation that was laid in the very beginning. And he had that sense of not being worthy, you know, just that self-doubt. That was kind of cemented in early on.
Of course, you know, you just don't know, you don't feel that, you don't know that as a young child, toddler, you know, young person. But things started to develop a little later as he really got into those teen years.
Mike: Yeah. Now for those of you who have heard some of these podcasts before, I'll let the other shoe drop, Tyler is still with us. But it doesn't mean, well, you'll get it in a second. So it blew up quickly when he went away to college.
Lisa: Yeah. Well, actually it really escalated in college, but he had started drinking at his father's house around the age of twelve.
Mike: know that?
Lisa: Had no idea. We had no idea. And it wouldn't even occur to us to say, you know, call over there and say, hey, don't let Tyler drink over there, it wouldn't, you know, it just didn't occur to us. So but he did, and it was really just to, you know, he was dealing with, we had moved, he had new friends, it was those early years, and all that insecurity and you know, all those changing, milestones we'll say in the beginning years, were a little too much for him. And he said he found God in a bottle in the very beginning, you know, a term I've heard a number of times before, but it gave him sort of that confidence and that, you know, fortitude to feel like, okay, I can fit in with anything.
A lot of us, you know, do that even today, we go to a bar, you feel a little bit better if you, if you have a drink or two, right? You feel a little more confident. Well, he found that confidence at a very young age, and that was, you know, not a good thing that set him up really for everything that happened, that ensued. As you know, you read.
Mike: When did you notice that he was drinking? How old was he?
Lisa: I actually, we didn't. He said he was at times like pouring, you know, he would drink if we had a wine bottle in the house or, other bottles, although we didn't have any addiction in our families, nothing like that at all.
But if we had a party or something, he would pour a good portion of it out and fill it with water and be drinking a lot of that over. But again, we didn't know that for a decade or more when he decided to tell us how it kind of all happened. Or he would be at friend's house and stealing their parents' wine or you know, whatever. You know, there were some signs, but they were things like you know, sleep difficulties, and irritability, and mood swings and, you know, things that are somewhat typical in young teenage years, right? There's nothing there that stands out too much for any parent.
And there wasn't anything when he'd come home from his father's house that was just overwhelmingly apparent and it wouldn't even, again, it wouldn't occur to us to say, you know, well, are you drinking? You know, he's 13, 14, 15. You know, maybe when they're 17 or 18 in high school, you start to think about those things.
And of course, at that time in high school, there's some expectation, right, that they're gonna at least experiment a little bit with maybe marijuana and alcohol, although we don't encourage that, and we didn't encourage that in our home at all. He was doing that and it was escalating. But then he went to college and I think just the freedom and also the fear of being in school, and, you know, there's no safety net there, there's nothing. It really imploded. I mean, he was kicked out after only three and a half months.
Mike: Was he outta state?
Lisa: No, he wasn't. He was a couple of hours away, but he was in North Carolina.
Mike: Mm-hmm. And so, had you seen him in that three and a half months?
Lisa: We saw him one time, like on a parents' weekend.
Lisa: And he was masterful at making sure that we thought that he was in good shape, always. I mean, for years and years, for even well after that, he was really skilled at making us believe that he had things working for him. And that he was happy and doing well.
And the schools had changed a little bit as far as being able to look in on grades, and
Lisa: You know, once they're adults, once they go off to college, you don't have that ability.
Mike: And so, you got a phone call, or did he just drop back in at three and a half months?
Lisa: Well, actually he did get kicked out, he did have to call us at that point. The school talked to us as well, said, you know, there's a problem here.
Lisa: And you might want to look into this. And he was on his way home from college after three and a half months and got a DUI on his way home, his first one.
Mike: And shortly after that, you tried rehab, or he did?
Lisa: Well. No. No, because this is the part where parents are thinking, oh, this is still, because we didn't know that he had been drinking for a decade before that, right, or nearly. So we're thinking, this is just outta hand and look, you gotta get it together and let's talk about what, you know, what we're gonna do.
Thinking that everything's okay. Not really realizing that there is a really, severely brewing addiction underneath all of it. So we talked to him about what his plans were, what he wanted to do, and he decided he wanted to go to Texas and live there, I have family living there and he was gonna go there and work. So we agreed and within about, I think it was about six months or less, he had already gotten into a lot more trouble.
Some other legal things started to come up, and it was at that point, like he couldn't get a job, he couldn't keep a job, he couldn't find a place to live, and again, we didn't really fully understand, but he started to reveal a little bit on his side of what was happening. So we said, okay, the stipulation is you can come home, but you've gotta go to rehab. And again, he had started communicating and letting us know. So, we brought him home and dropped him off in Asheville, North Carolina.
Mike: And what was that like?
Lisa: Well, it was really tough. I mean, it was the first one, and as a parent, you're taking your child to rehabilitation, which you know, if they were going through, you know, if they broke their legs in a skiing accident or something, and they had to go to rehab, right? You would stay there with them. You'd be there with them the whole time, this is something where you're dropping your child off and you have no idea what's gonna happen. You don't really know, especially going through this as someone new to it, which is again, why I started putting all this stuff in the book.
You have no idea what they're up against. Are they gonna be locked down? Are they gonna be screamed at, are they gonna be put in confinement? I mean, can they leave? Will we be notified? You know, you have all these questions. But the truth is, it was a wilderness program and it was actually an excellent program, but they did shut down years later.
Mike: Well, I also really liked your description of the family weekend, and as I was reading I thought, well, at least they had one, because you can't believe how many places don't include the family.
Mike: With something like that. So what did you experience during the family weekend?
Lisa: So that was both extremely rewarding and eye-opening and it was incredibly emotional. The most emotional thing I had gone through up to that point, but it also left us kind of hanging with, okay, what are we gonna do?
Lisa: What I mean by that is you meet everybody that's going through what you are for the very first time and you can finally say, oh my gosh, like this is my life, you don't have to lie anymore, you don't have to hide, you can cry in front of other people. And so you get together in this group and everybody's talking the same language, everybody's feeling the same way, everybody's sharing with one another. And it is group therapy. It is wonderful. And you feel, okay, like I can do this here.
Well, that was wonderful, but the problem was we really left again, this was, gosh, almost ten years ago now, I think. Yeah, about ten years ago, we left without knowing, we didn't have a plan. We didn't have the guidance about what we were going to do next. When he came home, what do you do? And I don't think the discharge planner concept was fully in place at that time, and it's getting better. Because you know, my son ended up in rehab nine times. Nine times. So yeah, the discharge part of it got a lot better over time, and it was partially because I would be involved in saying, please help us with the discharge portion of this, because you can do all of the counseling, and the mentoring, and the rehabilitation in there, but what happens when they're out of that safety bubble and they're coming back into the family or back into the old environment where everything was happening, right?
Mike: Well, and you speak about that. You talk about denial and boundaries. At some point, you know, while reading it, I'm hollering to myself, stop it! Let him do it! But you know, you don't know at the time, right? Like, what belongs to who. And so, you learn a little bit along the way about who belongs to what.
Lisa: There's, oh gosh, you're so right. So the denial part, you know, when I was going through edits and stuff would read back and yell at myself, like, where was I? Like, what? We have a way of, you know, living with our expectations, and our expectations are never to have these horrible things happening. Right now you hear people talking about it, I can't believe that, you know, there's a mass shooting or a major tornado that comes through, right? And you'll hear people on the news, I can't believe that happened to me, because our expectations are nothing bad is really ever going to happen.
Lisa: So you naturally stay in a state of denial just because it's not in your pool of expectations naturally. So, there was that part of it, but also to preserve and protect your heart, and your life, and what is going on.
My marriage, for example, like, if this is this bad, then that means that it's going to affect everything. Everything. And so if I just deny it and don't accept it, or just pretend that it's gonna get better, maybe it will and we can just keep going, we can just keep trucking and it'll be fine. And you know, that was foolish.
Mike: And, let's fast forward a little bit December 5th, 2017.
Lisa: Yeah. Yeah. That was my son and my family's perceived rock bottom. And that was so far from it at that point. However, it sort of cemented in exactly what we were dealing with. Believe it or not, I still struggled after that, just being able to accept it. But that night he was suicidal, he was living in his car, and his blood alcohol content was over 0.4, which can be deadly. And ultimately, you know, he reached out with his suicidal thoughts and we got him to the hospital. So I was in North Carolina and my mom was in Texas, so she got him to the hospital.
There were many events, but the bottom line was he came in suicidal. He had hit his head, which is really kind of why he went to the hospital. But then they did document obviously his suicidal intentions, his head injury, and the alcohol intoxication. So he was there for multiple reasons.
So it was a good thing he was there. However, the outcome that night was that they called in a mental health deputy because they felt, because he was suicidal, that he needed to be taken to a mental health facility. And that's really the guidelines. The emergency room physician, the psychiatrist on call, the social worker at the hospital, they all concurred that that was without exception, this young man should be taken to mental health, he is suicidal, he's asked officers to shoot him, there's something going on. Of course, we didn't know about the trauma at that time. He was hurting because of the trauma, and we didn't know about it, and they didn't know about it, but it didn't matter.
He was unarmed, he was not a danger to anyone in the hospital. And ultimately, a mental health deputy came in in the middle of the night. He was not happy that he had to be there. There was another, you know, drunk that he had to deal with. There were a couple of instances that were controversial while he was tied up in the hospital bed, he was yelling and screaming and, you know, scared out of his mind.
He was on all kinds of drugs. They had injected many, many different drugs. And ultimately, they took him to jail. We didn't know until the next day they had taken him with his hospital gown completely open and no clothing on underneath. So he was exposed. And they took him in, left him sitting there for quite some time. Eventually they took his handcuffs off and he was able to cover himself. That devastated him, that one thing was more traumatic than even I think the solitary confinement.
But about 12 hours later, they did put him in solitary confinement. They said it was because, of the suicidal ideation, which is really counterintuitive, right? Because when you're suicidal, the last thing in the whole world you should ever be is completely alone. So you would think that that night would be anybody's lowest, lowest point. And honestly, he did have two years of sobriety after that experience. But he didn't maintain that. He did relapse after two years. So it was a critical point. And it's part of the story, part of his story, and a part of our story because we all suffered. We went through hell and back with that night.
Mike: All of us, I think in this spot believe that the helping systems, for lack of a better word, are set up to help. And this is where we sometimes run into stuff, and this is part of your book as well. And so how did you get him out of the jail into someplace? Or did he just get sober on his own? Which number rehab was? -
Lisa: This was number, I think, gosh. This might have been three or four. Number three or four. Yeah, I didn't get him out of jail. He had to stay longer in jail. In the hospital when he was yelling, spit came out and landed on the officer's shirtcuff. And they gave him a felony charge for that. And so because of that, that night, he was made to stay in jail for an extended amount of time.
And he was put in a psychiatric portion of the jail for about, I think it was a couple of months. I wrote about that as well, it was a horrifying experience. But if you talk to him, he said, he deserved it, because he felt like he deserved every bad thing that happened to him. He always did, but I knew he didn't. And it was a horrifying, horrifying experience for all of us. But then I tried to work with an attorney and you know, the legal system, there was so much red tape. Just trying to communicate with anybody in this. And they even told me, I remember them distinctly saying that it was unusual for anybody like myself, like a parent, to care as much as I did.
Yeah, they said, people just don't call, they don't involve themselves, they don't care. And I said, that's really hard for me to believe, but I was gonna do anything I could. I had started writing the senators and the legislators and I was like, please, you know, can somebody pay attention to this situation? This is not right.
I called everybody I could, and eventually We did get him to an additional rehab, which in the legal system, if they go to rehab, their sentence or their time in jail is shortened. So at least we got him into that transitional position after a couple of months. So he went to rehab, we didn't think he was gonna do well, but he ended up doing exceptionally well for about two years.
Mike: At what point did someplace, somebody correctly diagnosed some of the mental health issues along with it?
Lisa: There. It was in Texas at this place. And that's because it was a dual diagnosis facility. It's something I really emphasize in making sure that when you're picking - I dedicated an entire chapter to picking a rehab facility, because it's really hard. It's really hard. And there is a difference between someone going just because they have a substance use disorder and someone going because they have underlying mental health along with their substance use disorder or trauma. In his case, he had all three, and so it was really important that he finally got to a place that was addressing the mental health, which for him was anxiety, depression, which was brought on again by the trauma. And then exacerbated by the substance. So it was, it was coming from every angle.
Mike: How's he doing today?
Lisa: He's doing great today.
Mike: Well, what a smile. That's a great smile.
Lisa: Thank you. He is, I'm smiling because he's alive and because he actually started working in behavioral health and he is really good at it, go figure. He's really good at it. He's always had an innate understanding of psychology and philosophy and he's, you know, like I've said in the words, we connected on that level and he can connect with those individuals where he works on a unique level and it's been really rewarding for him and very purposeful, and that's something that's important, right? Finding your purpose. But he's also an incredibly creative and artistic young man and he really loves videography and photography and actually has his commercial drone license and does that on the side.
Mike: I have to ask you, since you're so open about boundaries now. So as a parent, anybody who's listening, we all know how this goes. How do you draw the line between worrying, asking, assigning to him, assigning to you, or how do you worry about yourself?
Lisa: Yeah. Well, that's the main thing is in the book, I really talk about, you know, taking care of yourself. The more you take care of yourself, it has this amazing way of helping to take care of them. But the boundary part of it, boy, that's important because, and parents need to know that it's okay if you trip and fall and stumble through it over the years because those boundary lines are so unclear so often, right? And it took me probably a good decade, long, hard decade, to get to where I understood what the boundaries needed to be. Well, for his boundaries, while he was going through the rehabs, they teach them, they trained them to start establishing their own boundaries.
So he got really good about it with me and sort of started teaching me what I needed to know to be able to work with him. And so it was a universal learning while he was in rehab for all of us. But I would find ways to make sure, like for example, simple, simple: money. Money is really, really an easy one to use as an example, but one of the hardest ones to decipher where the boundary is.
And so for a long time, you know, we would give him money for help with his rent, or help with food, and didn't realize that he needed it for that, but then whatever money that he had coming in, he would use for his substance. And that may seem obvious now, but at the time, I wasn't getting it.
And so I started to realize the boundary was he would have to be sober if we were going to help him with any finances. We would be happy to help him, not do it for him, but help him, assist. That's probably the best way. While he was sober, but if we were gonna give him money, it had to go direct to the source that needed that.
So if it was for rent, and he needed a little bit of help with rent, he only had a portion of it, I would say that part of the money will go directly to, you know, the owner of the apartment, not to you. And he was fine with it. He understood that. And we worked together on that over the years, and that actually worked out great.
So I encourage parents to never give them money in their hands. And, you know, I talk to my patients about this every day, and I can assure you that we are all guilty of giving our children money in hand all day long, right? Just hand it over, Mom, I'm really hurting, I need some help, gimme some money. But you have to really define that, when they're sober, explaining when and why you will and won't. And recognizing, you know, why that's not a good idea.
Lisa: And how to work with it.
Mike: Well, and you also do something interesting too, and probably because of your professional background, you spend a lot of time obviously speaking, but you're also training healthcare and police workers.
I know it's just your opinion, but you've lived it. What do we need to get better at?
Lisa: Yes. Well, I'll tell you why I went into the training, and it was because of what happened to my son. Right? I said, okay, there's a problem here, why was he treated like that? You know, where was the critical thinking that night? Where was the crisis intervention? What happened to the deescalation? Where was the empathy that night? Right? What happened to all of that? So I sort of examined that and I said, let me go in and try and make that change. Let me help with crisis intervention.
So I went in and did those talks, and I recognized very quickly that where sort of the fallout was, was just learning sort of those critical tools about mental health and substance use disorders. I mean, I was learning that language too as a medical practitioner. This is what I do for a living, and I didn't understand it to the degree, right, that it needed to be understood. So I said, let me go in and educate them on what it looks like, what the medicines are, what you can expect, what are the outcomes, what are the resources, where can they get help, where can you find help for them?
How can you make a difference, especially, if you're an officer going into actually being a mental health deputy, or you want to go into to be a crisis intervention specialist. And then what does deescalation look like? Now they are learning this now it's become much more part of the educational package, we'll say, in like basic law enforcement training, but it's still limited, extremely limited.
Mike: Well, and we all assume, well, they must know this stuff, but they don't! I mean, I did a training for county social workers a little while ago, and I made the mistake even in the training, I said something and somebody raised their hand and said, what is vaping? And so,
Mike: You know, I was there to talk about a addiction, so I had to go backwards, you know, and it's not their fault, they only know what they know, but I realize, boy, they'd been to college and they'd not covered this at all. So in law enforcement training, in court training, social work training, even as a PA in medical training, we don't spend time on these illnesses.
Lisa: You can't know everything.
You can't know everything, and that's okay, but you have to be receptive to learning what you can.
Lisa: I think there's a great statement, it was actually by Dr. Rahmen or Raymond, I think it was a female, this was a long time ago, but she said "the expectation that you can be immersed in suffering and loss daily and not be affected is as unrealistic as walking through water without getting wet.
Lisa: It's something that I used in every single talk that I gave because for these officers and medical professionals too, because I worked with EMS and Emergency Room, to do the job that you do and face the amount of suffering, and loss, and trauma that you see on a daily basis and think that that's not going to affect you is like she said, it's like walking through water without getting wet.
You will be affected by it. And what does that effect look like? It looks like burnout, it looks like compassion fatigue, so my talks were always on those specific things. And I will tell you, I had grown narcotics officers, of course they're grown, but you know, like older men.
Lisa: Officers coming to me after the fact with their eyes welled up with tears and saying, I have to do some self-reflection, and that was all I could ask for because that's what I wanted the officer who didn't take care of my son. And I know this is not across the board, and I wanna emphasize there's some incredible officers and incredible medical personnel out there, and there were along our whole path. And I say that in the book, I'm so thankful for them. But the ones that, you know, I see patients too that they're, you know, in law enforcement and medicine and they're not always empathetic.
So it's recognizing why, what is it, desensitization? What has changed?
Mike: That's... it's great. Well, and that leads to the perfect place because your book is called Incurable Hope. I just love that, right? On the cover of your book, there's a lotus flower.
Mike: Go ahead.
Lisa: The lotus flower has had enormous amount of meaning for me and for my son, we both have one tattooed on ourselves, we got it together. Yeah. And the reason is because the lotus you know, it has a lot of meaning, but it grows out of the mud, you know, under the water, in the tragedy, right? In that ugly part. But it rises above and grows out beautiful, like gorgeous, and pure and you know, full of hope.
And that is truly my message. That you can start from really difficult spaces, and places and hard, hard experiences and still rise above all that and things can be okay. I really do believe it.
Mike: Well you're living it.
Lisa: Thank you. Thank you so much.
Mike: Well, and thank you for this and thanks for your book. And you all who are listening should know by now, unless this is the first time you're listening, that we will put links to Lisa's book and contact information at the bottom of this page. You're very generous, please give Tyler and your whole family our well wishes, will you?
Lisa: I sure will, I appreciate it. Thank you so much for having me today, I appreciate that.
Mike: Yeah, thank you. And for those of you who are listening, we invite you to listen in of course, next week. Until then, please stay safe, and if you are wet, grab a towel.
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