It Always Comes Back To You

[Upbeat Guitar Music]

Mike: Welcome everybody. This is Avoiding the Addiction Affliction, brought to you by Westwords Consulting and the Kenosha County Substance Use Disorder Coalition. I'm Mike McGowan.

Mike: Growing up around addiction doesn't protect you from addiction. Neither do drugs care about where you went to school, what you majored in, how much money you make, what you do for a living.

Mike: But when you develop destructive habits, you have an opportunity to turn your life around by developing new and healthier habits. That is not only the message of our guest today, but it's his life experience as well. Dr. Jason Giles is a graduate of University of California Berkeley. He earned a degree in molecular biology and then obtained his medical degree from University of California Davis.

Mike: Dr. Giles completed an internship in general surgery, residency in anesthesiology and pain medicine, and earn board certifications in anesthesiology and addiction medicine. He was a cardiac anesthesiologist and pain specialist before devoting his full attention to addiction medicine in 2005. He's the author of a new book, the Addiction Doctor's Manual for Behavioral Health Technicians: What to Do When You Don't Know What To Do and a previous book, which is terrific, called Outsmart Your Addiction. Welcome Dr. Giles.

Jason: Thank you very much. Thanks for having me on your show, Mike.

Mike: I always like to start with the story and so let's go backwards. Let's start with your first book, Outsmart Your Addiction.

Mike: Like a lot of us, you grew up around addiction.

Jason: Yeah, that's true. So I'm a Southern California native, and there's a time of knowing that you're growing up around addiction, and this is a time before that, so I grew up around it because my dad liked to drink. I didn't know what that was when I was a kid.

Jason: I knew a couple of things. I knew that if I made him a drink, I knew that if I fixed him for fortunately, he drank a very simple drink, which is, which was gin on the rocks. It was gin and ice. So I could make that from a young age and when he was home and and asked for a drink if I made that yeah, he was pleased.

Jason: And then soon after that he was easier to be around.

Mike: Yep.

Jason: And that's what I knew about it at that time. And the other thing I know about, I think I mentioned this in the book, which is that when he came home at night or in the morning. You could tell what kind of a day you were in for by how the keys went in the lock.

Jason: Right. So if there was fumbling and dropping the keys and evidence of persistent intoxication, we would say now then we were in for good times. 'cause he was still drunk. This is back before all the crackdowns on driving drunk and so forth.

Mike: Yeah.

Jason: And but if the key went in easily.

Jason: Then we're in for a rougher time because it had been longer, since he had a drink. And it's those kinds of things that you pick up as the child growing up in an alcoholic or a substance using home or a home with mental illness that you don't know, that you know that until, until later.

Jason: But looking back and when you get around other people who grew up with that, they're like, yeah, you know, my mom, I could tell. And then they'd start trading stories and you realize that you're not the only one, but later. You know, he got into a couple of those DUIs, a couple of people were interested in him being sober.

Jason: He started to get interested in it himself and went to meetings of Alcoholics Anonymous. And I remember in elementary school going with him. So there was a clubhouse not too far away from where we lived, a mile or two from where we lived. And I remember sitting in the smoke field rooms.

Jason: And seeing these folks, and they were they're good people. And he went to that for a while. My dad went to that for a while. He ultimately did stop drinking just right before I left the house. So, so that was good. And then later when I discovered my own problem, which we can talk more about, we had that thing in common that we had been through that sequentially.

Jason: And that was good. I mean, that gave our relationship a chance. We had common ground from having been through that similar experience together with getting sober. On a chronologic basis, I got sober, much younger, but that has something to do with the particular substance that I chose and also that the ground was prepared.

Jason: So I knew about this world a bit. I knew it wasn't the end of the world, although sometimes it felt like that would be the end of the world, not having something that you could take or drink or use. But yeah, relationships with parents in general can sometimes be tricky and with an alcoholic father and then a mother protecting the kids, sometimes protecting him. Sometimes those sort of dual relationships that go along with the codependence, that complexity. Sometimes it's hard to see the details of God's plan. You know, all of that was on purpose. All of that was the way it was supposed to go.

Jason: Much of it as I was going through it, I wished were different, but that's one of the gifts of being in recovery and being older is seeing all the things along the way. You know, seeing that my story, although it was unique for me is pretty generic. There's so many similarities.

Jason: People get hung up on, or, or, it's interesting, I suppose it's probably interesting to your audience that, you know, I was an anesthesia still, I guess, but I just don't do it anymore. Anesthesiologist trauma level one, trauma center hospital, high flying transplant, surgery, all the like, movie and TV kind of intense stuff.

Jason: But in many ways I was still that kid from, you know, from the, from the same house. I still had those self doubts. I still had that sense of insecurity. I still had that... I f only I, and this is, gets back to making the, the gin, if only I perform well then I can deserve to be here. And that's messed up.

Jason: That's a messed up way of thinking.

Mike: Well, you talk about it in your book, and I think that's fascinating. The parallels, you're right. Every time you talk to somebody, it's like this substitute gin for beer in the fridge.

Jason: Yep.

Mike: Substitute keys in the door to watching my dad's pickup truck. And our story's the same.

Mike: But as you move forward, even though you grew up around it, then you get to be a teenager and I think we divide up, don't you? Into two. You have the...

Jason: How do you mean? What do you mean?

Mike: Well, you have those group people say, I'm never gonna be around it. And then some people go, well, I'll just use, and...

Jason: I'll be careful!

Mike: Yeah.

Jason: I was in the group. Yeah. I'll be, I'll be, I'm not gonna end up like him. I'll be careful.

Mike: And how'd that work out for you?

Jason: Well, you know, here we are, right?

Mike: Yeah.

Jason: Here we are.

Mike: Right.

Jason: That's how it worked out. I had to go through all of that to understand.

Jason: There's an intellectual understanding. I saw a bumper sticker once that said what, what did it say that recovery is for people who been to hell? Something like that. There's not, I'm trying to remember, trying to remember how it, how it goes. It's like church is for people who want to go to heaven.

Jason: And recoveries for people who been to hell, I think it's something, something like, something like that, you know look ostensibly on paper based on the, the you know, degrees and whatever and tests I've passed and things like that. I'm, I'm allegedly supposed to be a smart guy, but that was completely worthless when I said.

Jason: I'm gonna be careful and make sure that I don't develop a problem with whatever the substance was.

Mike: I gotta ask you, 'cause this is the part where I had to read it twice. And, and I couldn't wait to ask you this. So you're an anesthesiologist at some point, and you actually start your book with a story that's familiar to me because my dad actually died of the same operation that you were operating on when you start your...

Jason: Aorta surgery.

Mike: Yes. And um...

Jason: Oh wow. oh wow.

Mike: But, but his inside there was nothing to attach it to because of his lifetime of abuse. So, and I'm sure you've seen that, right. But you said you deliberately. Set out to, maybe I'm putting this wrong. You started to experiment with the drugs that you were giving people to see what they were like.

Jason: Yes, yes. Curiosity, and so that was a blind spot for, for me, if you said, I dunno, we have to, we have to imagine a scenario that couldn't possibly have taken place, but let, let's say you and I are friends back then. And and I say, Mike, I'm gonna try out these drugs in the, in the drawer that we use for all the patients.

Mike: Yeah.

Jason: Just to see what they're like. You would probably have a look of horror, right. It's just, it, it's outrageous that idea. And yet this is where the smarts do me no good. And yet that sounded to me like a very reasonable thing. I'll take it even further, which is to say. Who else should be experimenting with these drugs than somebody who really understands exactly how they work?

Jason: Good. There's one thing to understand exactly how they work in the textbook or in practice with giving them to other people for surgery and so forth. It's a whole different thing, taking them yourself, right? So if you take 'em yourself, now the, this is sort of obvious, but the person that's gonna be doing the analysis and say, whoa, how is this working?

Jason: And is this. That person is under the influence of the drug.

Mike: Mm-hmm.

Jason: And that may be the crux of what the susceptibility to chemicals is, is that you make a plan, and I did this before, you make a plan. You're only going to use this much or only on this day or only at this time, or only with these people, or only in this circumstance.

Jason: And then once the substance gets in your brain, and we take these things in order to change the way we feel, which is another way of saying change the way we think. We take these things to change the way we think and then act surprised when the new thoughts are, Hey, how about another round? Right?

Mike: Yeah.

Jason: I want another pitcher.

Jason: Let's go. And, and, but of course, right, of course. That's how the substances work is they change us from I'm under control. I'm being very thoughtful about this. To what the heck, right? We're here anyway. So yes, that curiosity was the entree. And I, you know, went through all the stuff, tried things that are not necessarily psychoactive in order to feel what epinephrine feels like and and so forth.

Jason: But yeah, once you get into the opiates, they have their own opinion. They have something to say about what you're gonna do next. And that has to do with biology. We make our own endorphins, right? We make our own opiates and we make them to deal with pain and suffering, but also they're neurotransmitters, they're chemicals that the brain uses to communicate with other parts of the body.

Jason: So our engineers, our chemical engineers that made this stuff and extracted these things and put together a drug as potent as fentanyl, that was my particular cup of tea. It's so perfectly created to activate this pathway. This, everything's okay. There's nothing to worry about. And no pain, right?

Jason: No pain of anxiety. No pain of loss. No pain of regret. It's so perfect for that, that once it's in of course you'd wanna do it again. I mean, of course you'd wanna keep going. Of course you'd wanna get after it because it's engineered to create those feelings.

Jason: So, ostensibly, analytically, this makes sense. You want the anesthesiologist to understand how this goes, and yet the substances themselves will not let you get away with that. Very, arm's length analysis. 'cause they get in your brain and have a, have. Change plans.

Mike: Do you find yourself incredibly grateful for your supervisor at that time because you had support to steer you into help rather than throw you on a heap?

Jason: Oh yeah. Yeah. So Peter Moore was the chairman of the department and if it weren't for him... So I got extraordinarily lucky. Not just having somebody to, to be there and help me through this, but there's an unknown person who a few years, not that many years before I joined the department overdosed and died.

Mike: Oh.

Jason: So the department had an experience with another one of the residents who had lost his life behind substance use with, with fentanyl, was found dead at the hospital and. So that experience raised the, I don't know, worry factor or the awareness on the part of my chairman.

Jason: And so he was looking for this, it was part of, it became part of his pattern recognition was looking to see, and I don't know because. We never discussed it per se, but I suspect I was giving off some kind of signals.

Mike: (laughs)

Jason: I was, I was, until that point, I was super careful and, you know, all this activity took place after work.

Jason: When I say activity, I mean the use of the drugs. But let's not kid ourselves, right? So you can't use 'em at all. But if you get to the point where you're using them regularly. Then the next morning, and that's how the book opens with me.

Mike: Mm-hmm. Mm-hmm.

Jason: Really needing some and not, you know, not using it.

Jason: That's the maybe worst spot to be in. And so it was obvious to him, I guess there was some awareness that he was able to muster. Like, Hmm, this formerly sharp kid is now a little ragged around the edges, or. Shiny or, or sweaty or goose bumpy or, I don't know what I talked about in the book, I wore a long sleeve gown, the kind that the surgeons wear, that they put their hands in and their gloves on, and get tied up in the back and do surgery.

Jason: Only I wore it the way you'd put a bathrobe on, which is technically backwards, but looks frontwards. And so I always had that gown on and it's not that unusual 'cause it's chilly in the OR and it's you know, some people do that as a, I don't know. It's what, it's what a lot of anesthesiologists wear is these surgeon gowns over their scrubs.

Jason: But I went from never wearing one because I'm not usually cold in the OR to always wearing one. So then maybe that, maybe that was a giveaway, whatever it was. Thank God because. At one point I got a page, back in pager days. This is the nineties. So I got a, I got a page from the from the chairman, which is weird by itself to get, you know, paged by the boss.

Jason: And so I called back and he said Australian guy said, not, not saying that you not casting any aspersions, but there's a, there's a large amount of fentanyl missing from the hospital supply. And if it's all back there, you know, by tonight, then everything's fine. And which is of course ridiculous, right?

Jason: It's ridiculous. So I said, can I come talk to you? Because the only way for it to be back, you know, would be for me to be standing in there. And I had left the hospital. I got the page after I left the hospital that day. So I went to his house and he said I'm really happy that you, are talking to me.

Jason: We know what's going on, and and there's help for you and it's going to be okay, and then you're gonna come back to the hospital when you're all done with your treatment and you're gonna work here. Everybody loves you and, and you're terrific at your job, and you just got this problem and we want you to come back.

Jason: Those are the words he said, but that's not what it sounded like. It sounded like we've got you. You're never coming back here. You're, you know. 'cause I felt so low, right? I felt, I felt like I had let him down. That's what, that's what I felt like.

Mike: Well, you know, you just, you made it sound like you could go right back.

Mike: I don't, I think people aren't, doctors don't understand this. Like, you, you got into recovery, they got you help. But the road back to getting your status back.

Jason: Not right back.

Mike: Right. I mean, well, how long back? Because a lot of people don't understand it.

Jason: It was three years. It was three years,

Mike: Yeah.

Jason: Yeah. Three years.

Jason: Three years. Three year interruption and...

Mike: And how many and how many hoops?

Jason: Oh boy. Yeah, boy. Like LeBron level hoops. I think the Ringling brothers that many hoops.

Mike: (laughs)

Jason: It was, yeah. You know, in the very beginning, and this turns out to be classic and or in ordinary as well. I didn't know 'cause it was happening to me, but in the beginning all I wanted do is hurry up and get better so I could better get 'em off my back so that I could go back and do what I was doing because Okay.

Jason: All right. Don't use, don't use drugs. I got that. Okay. Let's just have a do over. But what, what I didn't know and what I realize a lot of people don't know. Is that the substances are not the actual problem. The substances are the late finding. They're the solution that then turns into a problem.

Jason: They're the solution that then becomes its own problem. Okay? So you deal with the substances. Let's say you magically never use again. They cut out the part of you that wants to drink, right? Or they cut out the part of you that uses drugs. Not possible, but let's say it were. You still are that person.

Jason: I'm still without the substances. I'm still the guy who needs something in order to manage his feelings, to be in the world, to deal with my history, to deal with my family of origin story to deal with all, all that, all that crap. And, and now without, without drugs, I, what are you gonna do? We gotta find a different solution because I couldn't live, and this is where people come in, is they.

Jason: They can't live like they were, but they don't know what to do next. And that, and that was me. So my real problem was the way I felt about myself and the way I behaved in the world. That that was my, that was my real problem. The substances were a failed solution, but I needed a new one. I needed a new solution, and that's what the hoops were.

Jason: The hoop, they felt like hoops, but eventually it's, I don't know. It's like any of these great. Superhero movies where when they're going through the part that just sucks. And then you start to get a little traction. You're like, all right, Captain America's gonna make it right? Or, or, this is where Thor picks up the hammer.

Jason: And, and, and so each one of those things, so I, you know, left, went to treatment, found there were other doctors who'd been through this. There are other an, you know, where I went to treatment over the three months that I was there, there were a hundred days there were. There were eight other anesthesiologists over that time.

Jason: Now there were hundreds of guys in the three, in the three, several hundred guys in the three months, but there were eight other anesthesiologists, which seemed really important to me at the time that someone else had been through this problem. They had a very similar story. I wasn't the only like fallen angel.

Jason: I wasn't the only one who did this. They're like, oh yeah. And then I, you know, then I started using more often. I'm like, and I started using more often. They're like, oh yeah. And then I, you know, then this happened. I'm like, that's what happened to me. And you start to realize, because I thought I was the only one, right?

Jason: I thought nothing could help me. And then when I found something that did temporarily, I, I thought I couldn't talk about it. And then when everything was you know, I'm on this Bronco and I can't get off, who are you gonna ask? Who are you gonna talk to? Well, turns out that experience is also generic.

Jason: And then when you here when you add the beer and the vodka and the marijuana and then whatever else anybody else is doing, that turns out to be very, very, very common. Like, oh, okay. So I have that thing that several other, several 70 million other people have in the us, probably 2 billion people have worldwide.

Jason: So I have that thing that they have. Okay. No. That's all right. That's actually hopeful. Maybe I'm not the only one. And then some of the other hoops were this family stuff I talked about.

Mike: Mm-hmm.

Jason: Some of the other hoops were the belief that if I... Book talks about, it's one of my favorite lines that I was a victim of the delusion that I could rest satisfaction from life if only I managed well.

Jason: And that line pierced me like nothing else. Because if only I can get it all going, then I deserve to be here. And that thinking turns out to be very common in our cohort. Right? Very common among the addicts and alcoholics and the source of all of my discomfort, source of all, all of my pain.

Jason: I don't belong here, or there's something wrong with me that's ordinary. Everyone thinks that, you know, I don't fit in weird at the party. I want the new guy, whatever. Everyone has that, that's all. That's all normal. Why is she with me? She could do better. That stuff. That's not pathologic. That's normal.

Jason: What's pathologic is thinking, I can fix this. That's where the problem is. Instead of saying, Hey, Mike, you ever feel like you don't fit in? You're like, yeah, I feel like that all the time. Oh wait, mean that's normal? Well, I don't know. I feel it. Okay. I don't need to fix that. I don't need to repair that feeling.

Jason: I don't need to change. That's just, it passes by. I don't need a drug to fix it. So that, that was the big hoop, or the tiniest hoop, I guess, to get through, which is, there's nothing wrong with you. There isn't anything wrong. There's nothing to fix! Stop trying to fix it!

Mike: I think that those statements lead to the thrust of your work since then, right?

Jason: Yes.

Mike: You clearly come down on the behavioral side, and I've spent a long, long time, my professional career working with youth, right?

Jason: Mm-hmm.

Mike: And learning the skills to cope with your feelings, to problem solve. I mean, it's a skill. It's just repetitive habits.

Jason: And then it becomes a habit!

Jason: How did you know how to do that? I don't know. And just do, do it all the time. I watched I watched the Dodgers last night.

Mike: Oh. Oh God. I'm a Brewer fan, so watch out.

Jason: Well, the brewers are struggling right now, aren't they?

Mike: Yes, yes they are.

Jason: Yeah. Yeah, they're struggling. But the I watched the Dodgers last night and you know, this, this guy that they've got Shohei Ohtani, he, may, maybe, maybe the greatest player ever, certainly one of the greatest players ever. He he practices a lot, you know, he hit a lot of baseballs. He threw a lot of baseballs. He ran between the bases a lot and, and he hits a lot of baseballs, and that's on display. So, yes, it's impressive. Of course, you know, that that end to that game was, was great for us and bad for Atlanta.

Jason: But the results of it are that he is in the habit of hitting baseballs. He has talent, he has ability. He has strength. He has size, he has all those things. But, but you know that that's not why he's so good. Why he's so good is he practiced and practiced and practiced and practiced until he sees the game differently than somebody who hasn't played, hasn't, hasn't taken it to that depth.

Jason: I was, you know, getting close to Shohei Ohtani level, good at being a drug addict. I had all this training, I had all this practice, I had all this experience, had all this expertise, and the reason I make a joke about that is that, is that it, the habit becomes its own, has its own momentum, right? It has its own momentum.

Jason: If you go to the gym and if you go often enough and consistently enough, you become a gym goer. And if you're a gym goer. If you go to the gym, 'cause you go to the gym. 'cause I don't know, I always go to the gym. If you go to the gym, you just go and if you don't go, you don't feel right. It's not that the gym is fun, it's not that it feels good to do the, do the exercise and go through whatever you, whatever your routine is.

Jason: But the habit, we're, we're built to do things repetitively. We, that's what learning is, right? That's what proficiency is. So we, so we say Shohei Ohtani is in the habit of hitting home runs. And if you think about it, well, gosh, he is, you know, Aaron Judge is in the habit of hitting home runs. Buki Bets is in the habit of hitting home runs.

Jason: Christian Yellich, there we go, is in the habit of, of hitting home runs and, and so I. Everything is habits. Our relationships are habits. Our, our waking routines are habits, the food we eat, and then the cumulative effects of that, whether we're healthy or not, those are habits.

Mike: I like that because even before he hits a home, run his, his routine is consistently the same. He wipes the bat the same way he waits, he bows to the umpire the same way so that it's second. So that the action, and to use your words, I think, I don't want the action of then staying in recovery is just a continuation of routine and habits.

Jason: Exactly. Exactly.

Jason: And you, you know, and so the life I have now does not look at all, like the life I had back then, they're not even in the same universe in terms of what my, my daily schedule looks like and my internal thoughts. But, but that did not come easily.

Jason: And that's why it's so hard to get sober because you, you're dragging these automatic behaviors with you. Like, well, this is the time when we have a drink. Like, okay, why? We always do, oh, that's not a really good reason to keep. To keep drinking. Right? Because we always do. And, and, and so when you first learn a new skill, if you think, if you think about an analogy I like to think is about driving.

Jason: Probably most, most of your listeners know how to drive or, or ride a bicycle. It's even simpler when you, when you first learn how to ride a bicycle, it's the hard, right? It's hard, but what do we say like learning to ride a bike? Now you, once you have the skill, you don't have to relearn it.

Mike: Mm-hmm.

Jason: Most people don't ride a bike for long intervals.

Jason: They hop back on, might be a tiny bit unsteady. Oh yeah, that's right. Now I remember this. And then they go. So the habit of continuing to use substances to manage your feelings is also like riding a bike. It's not easy in the beginning. The alcohol burns when you first drink it. The you smoke too much weed the first time you try it, or you don't know what these effects of these drugs are.

Jason: It's, it's a disorienting, but you practice like the gym goer. And you get better at it. And then you have that as the skill. But the skill is not the drug use. The skill is when I feel a way I don't want to, I can take this substance and change the way I feel. And that's what addiction is. It's the habit of managing your feelings.

Jason: It's a shortcut using a substance as a shortcut to, to changing your internal world, changing how you feel. And so we say, okay, stop doing that. Well, but I, what do I do? And I need to change my internal world. How do I, how do I manage when I, what do you do when you don't know what to do? Right? How do I feel differently?

Jason: I don't like the way I feel. Well, there's ways to do that. Meditation, exercise, helping others. Pursuing your mission, whatever you're supposed to be doing spiritual connection, connecting with things bigger than you. The, the, the higher power journaling, CBT, all kinds of behavior modification things.

Jason: Taking a few deep breaths will change the way you feel. Doing some pushups will change the way you feel, right? Taking a nap will change the way you feel. There are many things that are not substances that have great follow on benefits instead of bad follow on problems, but you don't know how to do them yet.

Jason: And you're not in the automatic habit. You're not in the automatic habit. So that's why it's so hard 'cause you've got this old system. We're like, Hey, make a new system that's even more likely to be automatic when you need to activate it. It takes time. It takes time. It takes time.

Mike: Well, that's relapse, right?

Mike: That peoples give up on the time.

Jason: Yeah.

Mike: And aren't patient enough. And how long at times do I have to wait to do it? It's learning new skills is not easy.

Jason: No, no. A friend of mine's a really famous guitar player and he's playing this huge concert last summer and he's playing his piece that he's played a hundred times before.

Jason: On shows and thousands of times in practice. And and he was playing somebody else's guitar and he hit a wrong note on the, on the guitar. And the guitar. It was somebody else's guitar 'cause it was a special thing and he looked down at it and it wasn't his. And so he, he moved to play the next note correctly, but he hit the wrong note again.

Jason: And thousands of people in the audience, you know, one of the greatest guitar players of all time and. He was focused on the wrong notes, was thinking about the wrong notes. Now, think about as a fraction of right notes versus wrong notes. That rounds off to zero, right? But our minds go to this, right? Like a, like a, like a paper cut or like a right or that, that hole in your tongue or what in your tooth, which should keep poking at it.

Jason: We focus on the things that, that are messed up. So somebody, somebody has a wicked drug problem or a wicked drinking problem, they get sober and they slip back a couple of times over years. I mean, on a percentage basis, we would say that's, that's pretty amazing. Pretty amazing. We don't have, this is what I, one of the things that if I were, if I were doing AA over or creating it from scratch, if I were Bill Wilson.

Mike: Oh, watch out here!

Jason: I would've a third category because there's, okay, there's the newcomer.

Jason: That's the person who's new to AA. There's the AA member slash old timer who, who's got it? Who's got it. But what about the person who comes for some time slips back to the old habit. Comes back to AA. What do we, what do we do with that person? If they're in the very beginning, we're like, ah, try it again. Not So a few weeks.

Jason: Oh, you got a trip? 90 days. Okay, try it again. Try it again. But if you've got somebody who's sober a long time and they. Whatever, have a bad day or decide to get curious or try something that gets outta hand or who knows, right? They don't, don't say, Hey, you know, I need a little help here. And they keep to themselves and they, and they have a relapse and don't die and get back.

Jason: You know? Okay. Actually, I don't wanna do that. I want to, I wanna be sober. That still doesn't work. I wanna be sober. What do we call, what do we do with that guy? We call him a newcomer, right? We say you're a newcomer, but that's not really fair. It's not, it's not exactly right. So we need, I don't know what it is.

Jason: I don't have a suggestion, but we need, we need some other way to, to regard this spectrum of life that sometimes with our eye on the ball, it's a little easier and sometimes we go into a slump and sometimes we recognize, right? It's the first time we strike out that maybe the beginning of the slump or might not be.

Jason: So we don't know. Oh gosh, actually, yeah. You know, these things changed and my kids moved out and my, you know, whatever, or my. We had a third kid and I, whatever life changed, or we moved cities or had a new job, or I got, you know, fired from my HHS job or other things happen, right? Life happens and I went to a different meeting or I stopped going, or I, and then we looking back, oh, that's when, that's when this began.

Jason: It's habits. It's it's habits. So we need to do another category. Well, I don't know, maybe you could, your listeners will come up with what, with what that is. It's, it's, it's not a newcomer. That's not fair to say these 20 years, or these eight years, or these four years that you lived under a different set of rules and then slid back into the old set of rules briefly or for a period of time.

Jason: It's not, not really new.

Mike: No. They counted.

Jason: They counted. And the reason I think it matters is if we don't count those, well what about why? What does, what is this new period of sobriety then? Does that not count also? So it's I don't know, it's time, like time in grade or something.

Jason: We need some other way to recognize the fact. And you hear guys say, well, I used to have eight years and now I'm back another six years, so I would've had four. You know, it's a problem. I would've had 14. Anyhow.

Mike: Well, I, I wanna let you go with this because I think for the people who listen to this, who work in the field and your, a new book is designed for them. We don't always speak the same language.

Jason: Mm-hmm.

Mike: So, you know, if, if we're practitioners in your, you know, the, the drug and alcohol therapist is talking to the psychologist, who's talking to the psychiatrist. You know, I have this conversation with a good friend of mine. We're not even in the same field on the same page when it comes to language working as a team together.

Mike: And sometimes we argue over these little things or big things.

Jason: Yeah, harm reduction. That's my, that's my favorite one right now. Harm reduction. What's, you know, what's that? Light beer or, or, just half a joint. Is that harm reduction or, or? There's a, there's a doc, I was at a conference last year and she's, she's prescribing fentanyl to people with a history of opiate use dis or fentanyl use disorder.

Jason: She's prescribing it under the, under the banner of harm reduction. And I can't get behind that. I don't think that reduces harm because what we're playing for is something bigger, right? We're playing for not just dealing with the particular substance use disorder, but dealing as I, as we were talking about earlier with the underlying situation.

Jason: What, why, what's a nice guy like you doing in a rehab like this? How did you wind up here? And that's the real problem. That's, that's the actual problem. The longer we keep people or, or allow people, or facilitate people to be separate from taking responsibility for their own lives, the longer they're gonna be miserable.

Jason: So, I mean, that's, that's my message is, is take responsibility. You don't take responsibility for your dad. That's not your fault, right? You're not, you're not responsible for the, for the avalanche. You're not responsible for the tides or the seasons. But you are responsible for your personal conduct.

Jason: I saw this, I thought it was this, I did this. It's just that it doesn't mean you're supposed to be perfect all the time or, or, or get it right all the time. But that's ironically the freedom is in, in personal responsibility. That's when you become an adult is when you stop looking for someone else to be responsible for your life.

Jason: So that that language of taking responsibility. I don't know. It's difficult in the therapy world also. So I, I work with some great therapists, great clinicians. We have, you know, a, a big telemedicine company that helps lots, lots of people, dozens of treatment centers where, where we're doing the medical care.

Jason: And I want the patients to complete treatment successfully and stay sober forever. That's, that's what I want for them. And sometimes I wonder if the field shares my ambitions. Sometimes it, you know, there's a bit of a dirty secret in the field, which is keep coming back, right?

Mike: Mm-hmm.

Jason: And, and we're starting to get, we're starting to catch onto that idea. We're starting to understand that value-based care is, that is the catchphrase for let, let's reward the helpers. Let's reward the industry for people staying sober rather than coming back to re-fix the same broken arm, so to speak, over and over.

Jason: I don't know. I think, I think I think paradoxically saying, you, you can help yourself here, here are the steps we took, which are suggested as a program of recovery. Recovery doesn't do those things for you. They lay it out, but, but you have to take personal responsibility for your own life and go, I don't wanna live like this anymore.

Jason: I, I, I'm tired of feeling this way. I, I want to have a life that I'm happy in and proud of and can share with others. A life that's not of secrecy, a life that's not of self-defeating. And so, but you have to take responsibility. You have to go. Yeah. No. You know, if you're overweight. You're overweight. If you're smoking cigarettes and you keep smoking cigarettes, who else is, who else is responsible?

Jason: It's not. It's not advertising. Okay? Advertising makes it more likely. Your smoke. It's not your peers. Okay? If you're around smokers, you're probably get more likely to smoke, but, but you are responsible for getting away from the advertising. You are responsible for choosing your peer group. It always comes back to you.

Jason: Always comes back to you. So I think that that is an optimistic and a, and and the most loving position you can take, right? Of course you need help. Of course, of course you need the bicycle to ride, to learn how to ride a bicycle because we forget we get off track. But you are responsible for recognizing that you're off track.

Jason: You're responsible for getting back on track. And, and I think ultimately, and this is what I guess I'm still in rehab, you're ultimately responsible for helping others. That that's for me. Back to your top of your question. The gift that I got by, by getting into this life I have I haven't paid it back yet.

Mike: Mm-hmm.

Jason: I don't, I don't feel, I don't feel, I, I still feel ahead. I still feel like I have work to do too because, because of my family, because of my health, because of my sanity, because of the beautiful things that I've been able to observe, I think. And because of how I feel about myself, I mean, I, I have, I sleep at night.

Jason: I have peace. I'm, I'm not under the lash of. You know, John Barley corn or any or anything else? I don't, I don't have that in my life anymore, so what's that worth? I mean, how can I, how can I say thank you to Dr. Moore who helped, helped me with the confrontation and all the people in between, all the therapists, all the counselors, all the helpers, and most of all, and this is what I, my dedication to the book is to, is to my patients because that's who I learn the most from, right?

Jason: I learn. All these facets of the same problem. Oh, that's another way of saying the same thing. Oh, that's, that's a fresh take on I haven't thought of it that way before, but yeah, I see how that's still, it's still a habit problem. You still have to take responsibility. You still have to, so the last thing I'll say about that is this, which is the Serenity Prayer.

Jason: Most of your listeners probably know this Serenity Prayer, right?

Mike: Yes.

Jason: The, the Serenity Prayer is the greatest filing system ever, ever devised. The Serenity Prayer is it has two drawers. It has the things I can change and the things I can't. Most things are in the second drawer, right?

Jason: The past. Anyone else, the world, the tides, as we mentioned, and the stuff that's in that skinny little folder is your attitude and your behavior. Want my own attitude and my own behavior that that's it. So I can change my attitude. I can change what I do. I. And that's, turns out all I have to do if I do that, it's magic.

Jason: The world, the world will change. Your world will change if you change your attitude.

Mike: Outstanding. Those of you listen, know that we have links to Dr. Giles books, terrific books, as well as some of your socials and other podcasts that you've done. We encourage you to listen whenever you're able, we encourage you to get support wherever you can.

Mike: Thanks for listening. Be safe and, your choices, your habits, your life.