Ten Percent Happier with Dan Harris - A Controversial New Way To Think About Addiction | Carrie Wilkens

Episode Date: September 20, 2023

Wilkens talks about the stigma around substance abuse, potential alternatives to abstinence, and the role of meditation in recovery.  Carrie Wilkens, PhD, is the Co-founder, Co-president and CEO of the Center for Motivation and Change: Foundation for Change, a nonprofit organization with the mission of improving the dissemination of evidence-based ideas and strategies to professionals and loved ones of persons struggling with substance use through the Invitation to Change approach. She is co-author of the book, The Beyond Addiction Workbook for Family and Friends: Evidence-Based Skills to Help a Loved One Make Positive Change and Beyond Addiction: How Science and Kindness Help People Change.In this episode we talk about:The stigma around substance abuseDefining terms: addiction vs. substance use disorder and why it mattersHow substance use disorder affects our brainHow to diagnose a substance abuse disorderWhether there is an alternative to abstinenceHow we all need to be thoughtful about the relationship we want with substancesHow and why a substantial percentage of people naturally recover without going to treatment The strategies to use if you have someone in your life who you think is on a destructive path What positive communication is and how to practice itHow we live in a quick fix society and recovery from substance abuse disorder is a slow processWhat actually makes people changeThe role of meditation in recovery—for the patient and the familyAnd the importance of taking care of yourself so you can take care of othersFull Shownotes: https://www.tenpercent.com/tph/podcast-episode/carrie-wilkensSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

This is the 10% Happier Podcast. I'm your host, your boy Dan Harris. Hello, everybody. As you may know, the statistics on addiction and substance abuse these days are straight up dire. And even if you're not directly impacted by this, the odds are high, very high, that you know somebody who is. For decades, there have been some pretty widely accepted cultural norms around addiction and substance abuse, specifically I'm talking about things like tough love, codependency, hitting rock bottom, and then there's the big one, abstinence.

If you want to get your act together, you need to fully stay away from whatever substance it is that you've been abusing. My guest today takes a rather iconoclastic and possibly for some of you controversial approach. Kerry Wilkins is the co-founder and clinical director at the Center for Motivation and Change. She's also co-founder, co-president and CEO

of CMC Foundation for Change, which is a nonprofit that provides evidence-based ideas and strategies both to professionals and also to the loved ones of people struggling with substance use. Kerry has also co-authored two books, Beyond Addiction, and the Beyond Addiction Workbook for Family and friends. In this conversation, we talk about the stigma around substance abuse.

We define some key terms like addiction and substance use disorder and we talk about why those definitions matter. We talk about how substance use disorder affects the brain, how to diagnose it, whether there's an alternative to abstinence, how we all need to be thoughtful about whatever relationship it is we want with substances, how and why a substantial percentage of people naturally recover without going to treatment. The strategy is to use if somebody in your life is going down a destructive path in your opinion, what positive communication is and how to practice it, what actually makes people

change and the role of meditation, both for the patient and the family. Just to say I am not an expert in this subject, although I have abused many substances in my time, also I don't have a dog in the fight in terms of what are the right approaches to use here. I have a suspicion that it's pretty individual. I do think Carrie makes a lot of sense, but I also in the course of this interview,

try my best to represent the critics. I suspect I'll be hearing a lot about this episode. I do want the feedback. You can hit me up on Twitter or X or whatever it's called now. You can also find me on Instagram and TikTok where I've been experimenting with posting more videos or hit me up through the website 10%.com. Emily, do you remember when one direction called it a day?

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You can binge all episodes at free right now by joining Wondry Plus. Carrie Wilkins, welcome to the show. Hello, Dan Harris. Thank you for having me. Pleasure. Let's talk about the overall addiction picture at the beginning here, at least in the United

States. As I understand it, the numbers are not good. Can you paint the picture for us? Yeah, they're not good. And in some groups, they're extremely concerning, depending on what study you're looking at. They think that one in 10 Americans struggle with a significant substance use disorder of some sort. And right now, I mean, in the last three to five years, the fentanyl crisis has become increasingly problematic. And the overdose rates are shocking and painful. There's

100,000 people dying of overdose in this country every single year and 250 a day. I just read that the stats for teens and young adults overdose has become the single biggest cause of death in teens and young adults. It's repressed suicide. So those are some pretty disturbing numbers. Yes. And that's a lot of families being impacted. You know, a lot of people being impacted with a problem and then their families are suffering immensely. Yes. It ripples out. We're now talking about addiction and much more sort of urgent ways than we did during the crack epidemic,

which mostly involved black people and the opioid addiction involves a lot of white people. Do you think that's a factor in the urgency of the current discussion around addiction? I absolutely think it's a factor. Yes, very much so. I think white young men started to die

and thankfully parents became very activated but there's definitely been a shift in the openness to discuss substance use problems. I mean, it's such an incredibly stigmatized problem to have, like people don't wanna talk about it and families don't wanna talk about it. And I think there was enough activation around the opioid crisis from white people

and people with privilege that the conversation got into the media in a completely different way than it has in other epidemics. I mean, where we didn't want to talk about it and we were able to really other the people with the problem and say, that's not us. Now it's us. And I think that's shifted things dramatically.

I'm going with the thank God we're talking about it. Now it's unfortunate. And I think that's shifted things dramatically. I'm going with the thank God we're talking about it. Now it's unfortunate, but let's be thankful that we're talking about. You were talking about the stigma. I give a lot of public speeches. And it's amazing. Even though the stigma is around mental health, generally have really been reduced in the last five, 10, 15 years. Every time I mentioned that I had trouble with cocaine, you know, it's an awkward moment in the room. It's still a really tough thing to talk about. And I think that's shifting a little bit because of people like yourself who are being open

about it. But there is something about substance use problems and behavior issues where people feel like you're out of control. You're doing something that is scary. You're doing something that is destructive. You're out of control, you're doing something that is scary, you're doing something that is destructive, you're out of control, so I wanna push that away. I don't wanna look at that, I don't wanna understand that. You're scaring me, and then I get mad, and then I get mad at you,

because you're causing lots of problems, right? So there's a lot of emotional responses we have to people when they have substance use issues, and then I think just the way we talk about it, I mean, you look at the word choices we use when we talk about people with substance use issues. And then I think just the way we talk about it, I mean, you look at the word choices we use when we talk about people with substance use issues. I mean, we have a video that we show when we do trainings and we blast on the screen,

all the words that people use, junky, addict, alcoholic, rock bottom, codependent, you know, character defects. I mean, there's all these phrases that just roll off people's tongues and you think about, okay, you're actually talking about a person on the other side of that. You're talking about a person whose behavior makes sense in some way. They're not using drugs because they're crazy or just morally bad people. They're using drugs because they work in some way

for them. How do we actually understand that? Which then allows us to be able to understand what's driving the problem and potentially help it. But if we just label them as problematic, bad people, and in this country, we tend to like to lock them up, which is one of the biggest problems is we just want to punish it instead of understanding it. And that's why I think it's getting worse. So instead of talking about this as a moral failing, I think you're saying that we should think about it as a sickness. Is that a correct summation?

Well, it's a behavior and it's different for different people, right? So every single person who uses substances uses them for different reasons. They get some different effect from them. Some people have a little bit of a genetic loading where, wow, a couple drinks for me feels really good, right? I feel it. I feel that and I like how that feels. The person next to me who has no genetic redisposition

just doesn't even particularly like the effect of it just doesn't feel it and so doesn't want to have another drink. Maybe I'm having a drink because I'm also a little anxious and alcohol is a really good anti-anxiety. Like it helps with anxiety. Combs nerves, right? It has problems down the road, but the immediate effect is that it has Something I like about it. So one thing that we humans tend to do is repeat things that work in some way, right?

So if it works for us, we're gonna do it again Like I've heard you talk about your cocaine use like it worked in some way for you at that time You know, it ultimately had some consequences that weren't great, but that's not what got you into it, right? So I think to be able to pause and be curious about like, okay, how does that behavior make sense? Because then we can go and be like, okay, is there another way to get that need met? Is there something in your environment that needs to change

so that you're not drawn to it or it's not your only outlet? It's not your only way to connect with other people. I mean, there's so many different ways that people develop the problem and there's so many different ways that people get out of the problem, but in this country, we tend to talk about it in a very black and white. You either have it or you don't. You're either in recovery or you're not. You know, I mean, it's like very black and white, which I think just excludes people and keeps it underground and keeps it stigmatized.

And that's what we're really hoping to change. So we're going to talk a great length about some of the strategies to use here. But before we go there, let me ask them just very basic question. What is addiction? So there's the formal medical version of substance use disorder. I don't even use a word addiction that much anymore

because again, I think it pushes people away. We're so wired to automatically not want to be an addict that if you sprinkle addiction in a sentence, people will stop listening. So we use substance use disorder. We use struggle with substance use because I just want to catch as many people in this discussion as possible or pull them into the conversation as more how it would rather say it. But there's 11 symptoms that cause you to meet criteria

for a substance use disorder. And people can fall anywhere on that list of symptoms. And you can have two or three. And you kind of have a mild version of a substance use disorder. You have four or five, you're in the moderate zone. And if you have more than six, you have a severe substance problem.

And studies show that people can cycle in and out of extremely problematic substance use. They can cycle in and out of it. Maybe you're really struggling for several months and then you stop and you don't use again for two years and then it comes back in another way. You know, I mean, you see it move around in people's lives and sometimes it shifts substances and maybe it moves to another behavior. I mean, people kind of come in and out of this and all sorts of different ways. What do we know about how substance use disorder shows up on the level of the brain?

So that would probably be a whole podcast in and of itself. And we're learning more about it all the time. I mean, to just be super simplistic about it for the audience, you know, we have our reward pathways. And the dopamine one is one that is most talked about. I mean, it's way more complex than that. And there's multiple neurotransmitters involved. And different substances affect different parts of the brain. So it also depends on which substance you're using. So alcohol affects

the different parts of the brain than people who are using cannabis, than people who are using opioids. But again, it goes back to those reward centers where you have the experience of a reward. It works. You like it. You do it again. So then you start to establish the memory pathway of like, oh, when I have this drink, I feel relaxed. Now I start to have a drink every night when I come home from work because I start to feel

stress. Now my brain says, oh, alcohol helps when I'm stressed. So I drink every night that becomes a habit. And then on the weekends, three o'clock in the afternoon, when I feel stressed, I think, oh, a drink would make me feel better, right? So it affects the memory pathways.

It's involved in emotional, like, you know, we start to like not be able to regulate our emotions without substances. I get upset, but I want to have a substance to calm myself down. I don't feel anything. I have a substance to calm myself down. I don't feel anything. I want a substance to pick myself up. So, I starts to over time, like, really merge into people's lives

in quite complex and long-lasting ways. That then when you say, okay, you need to stop using now, because it's causing all these problems, you take the substance out, and they have all these things they have to relearn, or maybe learn in a new way. So if you started using as an adolescent and you don't know how to regulate your feelings because you've been smoking pot every single time you have a feeling, you stop smoking pot when you're 25, you're going to have to learn how to deal with your feelings and you've

never done that before. So that's a lot of learning. So it affects the emotional parts of the brain, it affects the neurotransmitters on a very chemical level, you know, you can end up having increased tolerance, so you need more and more to have the same effect. So you're going to have withdrawal symptoms when you stop, so we're going to have to deal with that. So there's physiological, there's emotional, you know, it's again different for different

people. Is it your view that if somebody has a substance use disorder, they should cut that substance out entirely, or is there an alternative to abstinence? I think for lots of people, there's alternative stabs to abstinence. And I think anybody who's gotten themselves to the point of abstinence, most of them, that's a process for they've tried different things along the way. And they've collected the evidence of, you know what, every single time I've tried to moderate, every single time I've tried to stop using cocaine and keep alcohol in my life, I go back to cocaine.

And so, you know what, I've just decided I can't do it anymore. I've never met anybody who just said, you know what, I want to abstain. There's a lot of learning that got them to that point where they were like, this just is not working for me. And I've collected the evidence and I need to stop. Then they have to figure out how to stay stopped, right? Because we forget, we forget negative things

and we'll forget what wasn't working so well. So we also have to find ways to remind ourselves of that. You can make changes and then you got to sustain them, which is a whole different process. Are you saying that it's possible to have a healthy relationship with any kind of substance? Like can I be at one weekend a month cocaine user? What's the healthy level of substance use?

Well, so in terms of diagnosing a substance use problem, one of the things that you're asking somebody is, are there negative consequences being caused by this behavior that you wish you could avoid? Right? And if you're persisting in engaging in the behavior, even though you've got a bunch of negative consequences that are really affecting your life, that's when you've moved into, you're having a hard time stopping, right?

So if we're engaging in something that on one level, we really feel like, okay, this works for me, and my marriage is crumbling, you know, or my doctor's saying, I have fatty liver, and I'm persisting in doing that, that's somebody who probably needs to abstain because they can't navigate those middle waters, but there's a lot of people who moderate.

You know, I think part of what happens in the press is that people who are abstinent are very open about it. People who are in 12 step recovery are very open about it. They talk about it openly, they want other people to hear these stories, and that's all wonderful. There's a lot of people who change, and they don't talk about it.

You know, they stop one thing and continue another, and they don't go on and have negative problems. So maybe a guy can use cocaine once a weekend, once a month, and not have any problems with that. It's his job to assess that for himself, of like, do I like how I feel in the morning? Am I doing anything that night that I regret and feel bad about the next day? Am I not paying attention to my kids in the morning and the way that I would?

Do you have to actually honestly assess the consequences for yourself? Are you doing things that are consistent with your values? Are you being the person that you want to be? Those are all very individual choices. I think we'd like to label things as problematic when I thought for you to figure out. Those are the conversations we're trying to help people have. It's to really look inside and be curious about,

is this working for me? It's such an interesting and it's a touchy subject because anytime we've talked about alternatives to abstinence on the show, I've gotten a lot of angry letters from people who've, you know, had so much success in AA and other abstinence-oriented programs and those stories are important and real. And yet, I remember in the years after I quit doing drugs. I mean, I personally can't have a, I don't think, healthy relationship to cocaine. Also, I'm 51 and not

in the market for, you know, a voluntary heart attack. But I remember in the years after I quit doing drugs and so this would have been the mid to late odds. I was sober, but I was kind of conflicted about it and my wife got me into see some therapists who specialized in this stuff. And I remember kind of arguing with him about this and saying, well, like, you know, humans have used substances since there have been humans, you know, I mean, magic mushrooms, peyote, ayahuasca, alcohol. I mean, the cocoa plant is not like a new invention. And caffeine, sugar, and protein. Right.

So it can't be that there's no healthy relationship to substances. Yeah. And so part of what gets Bullock's stuff in talking about this and why you get angry letters is because people are scared, right? So people who've gotten better through the 12 steps or have really gotten to the point where they're like, I have to abstain. This is the only way I will thrive and be able to live. There's so much fear behind that that they've gotten themselves and probably horrible experiences, right? So they're very invested in that. And so I'm not saying that's a

bad place to come from, but it shuts the conversation down for other people who are open to change, who can make changes, who can have reasonable relationships with substances in their lives. And it's shaming people who maybe have a different path and maybe want to have substances used in their life. That's a choice that people get to make. I had a supervisor once who said people get to make their own bad decisions. That's actually just something we humans get to do, but can we create an environment where people can openly talk about it instead of going underground and feeling ashamed.

And I think that's what happens in recovery a lot, where people will hear the message, I'm not doing it like that, or I don't believe in that strategy, so I must be doing something wrong. Or this isn't real recovery. I mean, the number of times where I've heard treatment providers say, that's not real recovery. Well, who are you to judge? First of all. And it's the person's not real recovery. Well, who are you to judge, first of all?

And it's the person's life to live. And so part of what we're trying to do is help people, and there's ways to talk about it. That treatment provider that probably backed you in a corner a little bit and got you, say, and wait a minute, like, there's all these other ways that possibly can work, right? Like we can back people in corners and shut them down and stop them from self-reflecting

on what's going on with them. Or we can have conversations where they can be curious, where they can run experiments of like, I want to try this or that, but I'm willing to keep looking at it and assessing whether or not it's working for me. One of the evidence-based strategies that we use is something called motivational interviewing where you're really trying to help people have a conversation where they can look internally and activate their own internal motivations for change. You can have a conversation that turns that on,

or you can have a conversation that shuts that down. I'd rather turn it on. And not labeling people or telling them, there's only one way to do this. And if you're not doing this way, you're doing something scary and dangerous, and harming people, shutting the conversation down has been harming people for decades in this country.

We have not been talking about it and people have been harmed as a result of that. So I'd rather keep the conversation open. I want to put a pin in motivational interviewing because that sounds very interesting. But I think there are a lot of people right now, especially since we did see usage of substances go up during the pandemic. I think there are a lot of people right now are asking themselves, what is the relationship I wanna have with substances?

I hear this a lot around alcohol. And my family, we have pretty devastating alcoholism. Just to say, I don't drink not because of that actually, but just because I have some sort of weird allergy, where if I take a sip, I just feel awful. And it lasts for 24 hours. So I'm pretty strongly disincentivized. I'm just gonna say, lucky you and some wasted. Yeah, well, I totally, absolutely.

Although, you know, I do miss it. I love the taste of wine and beer, and I love the social aspect of it. And I have problems with some substances, not really with alcohol. But anyway, that's neither here nor there. The point I'm trying to make is that I was talking to a family member the other day who was trying to figure out what their relationship to alcohol is going to be. And you know, I could hear a real struggle. You know, there was a recognition that there was too much drinking going on here to four and actually some real changes had been made of late. But also this person was recounting a story where they were

out to dinner with a bunch of people and they had a wonderful bottle of wine and it was a bonding experience. And so I think that a lot of people feel this real tension between wanting to have the substance, often it's alcohol in their lives, but also not wanting to have it ruin their lives. And I know you can't give one size fits all advice, but what are some general guidelines you can give to people who are confronting these questions? Well, so that example makes me want to talk about multiple things there because that is such a good example

of you talking to a loved one, right? They're sharing their experience, they're giving you the benefits of like what they love about it and some of the stuff that they're struggling with. Had you in that conversation said, well, you know, Joe, whatever your family member's name is, I really think you have a very serious problem and you should stop. You're probably in alcoholic and you should stop and you might die because you've been drinking, right? That will send the conversation off the rails and they'll end up saying,

it's not that bad, right? It's really not that bad. And they'll probably start talking about some of the things that they liked about it more than they'll talk about the things that they're concerned about. So just how we talk about it when somebody's sharing information can pull them closer to examining it or set them back from looking at it anymore. The other piece of that, what they were describing is something that we talk about is the cost and benefits.

We do an exercise with people where it's really, look at the cost and benefits of the substance or your relationship with it, like all the things you get out of it. Like, what do you like about it in terms of how it shows up in your relationships? Do you think you're a funnier when you've had a couple of drinks? Are you able to have sex more comfortably when you've had a couple of drinks? Do you, like, say things in a conversation that might otherwise be something that you would avoid? So you might hear a couple of drinks, do you say things in a conversation that might otherwise be something that you would avoid? So you might hear those as like,

well, those are things that they should be able to do without the substance, right? But the reality is the substance helps them do that. Maybe it reduces stress, maybe it helps them stay focused, whatever it is. So there's all these benefits. Then there's the cost, all the things that they don't like. Of course, that's worth paying attention to.

The value of looking at the benefits is that gives you a window into, okay, are there alternative pathways? Are there other ways that you can bond with your family? Does it actually have to be overbought all wine? Or are there other things that can happen that make that bonding feel as joyful and great as it did in that? It's probably not the wine, but we're so conditioned to have expectancies of like the wine made it so much better, right? Probably not, if you weren't so conditioned to think that way.

And like, can you just work on identifying the things that you are getting from that, but learning different skills in order to achieve those same effects? And then you have all sorts of ways to change the behavior and become less dependent on it because people become dependent on the wine being the pathway or the substance being the pathway. Instead of feeling like I can take it or leave it,

I want somebody to be able to take it or leave it. It's interesting to hear you talk about other ways to get your needs met. I mean, I'm just kind of thinking back on my own life. I quit doing drugs in the mid-2000s and I computed it as devastating to my social life, you know, because I told myself I was having a lot of fun being out late and with my friends and bonding and I couldn't really do that anymore. I told myself and I ended up kind of withdrawing into work and in a healthier way into my marriage. And woke up 15, 16 years later realizing that,

you know, I still had those friends, but the relationships had atrophied a little bit and have in this last year or two really made a big investment in seeing people and upping the cadence were socializing and I mean, I still don't do drugs or drink. And I realize it's really, it's just the camaraderie that I wanted. You know, I mean, it's not just a camaraderie. I mean, actually, I'm not,

I don't want to degrade the value of drugs in that way because I actually do think substances can be additive in the right circumstances. But mostly what I wanted was the dopamine and oxytocin from hanging out with other people. Yeah, being able to laugh, share stories, share experiences, that's what you were enjoying. But we are really conditioned to think an alcohol in particular to think that it is, like you said, additive. I mean, the alcohol industry and the marketing, like sports events, just everything has alcohol weddings.

Like everything we go is supposed to be better with a few drinks. And we start to expect that when if we take it out and actually work on those relationships and have those experiences sober, you do over time realize alcohol had nothing to do with it. And fact, it was probably making things worse because I was sane and doing things that I regret. So I do want to fact check myself because I said something that wasn't entirely true. I do not drink just because, as I said, before it makes me sick. And I don't do drugs with one asterisk, which is once in a very long while, I might do a substance, but it's quite rare. So I just want to be fully honest with everybody here, which leads me to a question I wrote down that I

had for you, which you may not want to answer, which is where are you? Are there substances you use? Yeah, I'm a social drinker, and lately have tried what's happening in the cannabis field now that it's legal in Massachusetts, and I hadn't tried any cannabis since I was a teenager. So I just felt like I needed to understand what was happening. And again, running my own experiment, I'm like, it's actually not really that great for me. It makes me, I don't feel so great.

And speaking of behaviors makes sense. I struggled with eating issues as a kid. So my early 20s, it was bulimia and a eating disorder was the way I was struggling with my emotions and expressing myself. And when I stopped doing that, alcohol popped up. Suddenly, I was binge eating, and then all of a sudden, I was binge drinking.

I started to work on those issues, was in therapy, and resolved some of the underlying things that were driving that. And I don't ever feel like bingeing on alcohol. Like, it's just not a thing that I would ever consider doing now. It had looked at me when I was 19 years old. I was completely out of control.

And doing really scary and risky things. But they were being driven by things that were happening to me at that period of my life. And I did the work, took deal with my emotions in a different way. And it's just not a thing. It's just not even something I would want to do at this point. So I think there's a lot of people. When you go back and assess them at different stages of their life,

they really look like they had a serious substance use problem of some sort. And it just resolved on its own. They did some other work. They never went to formal treatment. They never went to AA. They never did anything specific around the alcohol or substance use, and it just changed because they dealt with

some of the underlying things. And I think that's so much of what your audience is focused on in terms of self-compassion, mindfulness, meditation, all of the strategies are ways to deal with our emotions and our thoughts in a different way. And people use substances to manage their emotions and manage their thoughts.

So those are perfect examples of alternatives that if you practice and develop, you just may feel like substances are just not something you wanna do anymore. Just to be clear, you are not saying AA or intensive rehab are bad. You're just saying that there are other ways to go about. There's a huge proponent of self-help meetings

and I have a rehab, a huge proponent of self-help meetings. And I have a rehab, so I'm not against rehab. But it's just the black and white way that people talk about it. That's, you know, when they hear a family member talking about a substance use or somebody saying, oh, my husband's struggling or my partner's struggling, they'll be like, you need to do an intervention. Maybe they need to go to rehab. Maybe they need to go to meetings.

Studies have been done that like 70% of people who meet criteria for substance use problem at some point naturally recover. They never seek treatment. They just get better. And some of the things that they do to get better are all the things that we've been talking about, which is they find alternative strategies. You've said it, that you just decided this doesn't work for me anymore. It's ruining my life.

I don't like it. So I'm going to stop. I might shift into something else and have more work to do, but I'm just not going to work for me anymore. I just, it's ruining my life. I don't like it. So I'm going to stop. I might shift into something else and have more work to do, but I'm just not going to engage in this behavior anymore. And then they develop other interests, other hobbies, and their life is different. Coming up, Kerry Wilkins talks about why there's so much shame around substance use,

how meditation can help, and what actually motivates people to change. As a small business owner, you do a lot and RBC is here to help. For $6 a month, save money on unlimited business banking features with an RBC business bank account. Receive business payments the next day, every day with Monaris, and set your business up for success with convenient banking and business solutions. Visit www.rbc.com forward slash your business to learn more. Register, bank, and grow your business.

I'm Rob Briden and welcome to my podcast, Briden and we are now in our third series. Among those still to come is some Michael Paling, the comedy duo Egg and Robbie Williams. The list goes on, so do sit back and enjoy. Briden and on Amazon Music, Wondery Plus, or wherever, you get your podcasts. I just want to circle back and get you to talk about something that I talked about earlier. And I hesitate to say this because I feel like some people are going to react poorly to this. But I really do think that many substances, you know, we've had Michael Pollan on the show to talk about psychedelics

and also things like caffeine, but from alcohol to cannabis, many of these substances have beautiful applications. So it makes these conversations around substance abuse or substance use disorder complicated because I don't actually fall on the side of vilifying the substance. And I'm grateful that you're not falling on that side because again, it just shuts the conversation down.

And to be able to have these conversations knowing that you're going to get a bunch of inflammatory emails saying what a terrible person you are that we have this conversation, those are the people that they're just panicked. They're scared. These are scary conversations. We like to control things. We don't like uncertainty. And when you say like people actually have the choice to make around their substances and to establish what is healthy for them or not, let's actually create room for them to talk about that and think about that. Instead of saying there's only one way to do this. It just scares people who got better in that pathway, you know, of the 12 step in abstinence only.

They just get scared because bad things happen to them along that way. And so I just try to understand it's, it's okay, you're scared. I get it. And I want to be able to have this conversation with this person over here who is trying to have some sort of relationship with substance and they're willing to talk about it. I want them to talk about it. I want them to be able to explore it. I want them to be able to talk about what's working and not working and be curious about

it. And if I just say it's terrible that you're thinking that or terrible that you're considering that, they're just going to stay inside of themselves and try to work it out. They're going to do it anyway. I'd rather be involved in that process and potentially try to help them speed up that learning process because I'm creating a space where they can talk about it and be curious about it. And I have actually limitless compassion for people who are scared and who have saved their own lives or had their lives saved through abstinence. I'm really, I think, that is we keep saying it. It's just a huge avenue for so many people.

But I guess what I'm trying to say on top of it is that I think there are many, many, many, very healthy people who are using substances in healthy ways. And that's actually a thing I don't think gets talked about that much. No, very seldom gets talked about because there's so much shame in stigma, right?

About being able to even say that out loud. No, very seldom gets talked about because there's so much shame in stigma, right, about being able to even say that out loud. Because there's all this fear and all this judgment about substances and relationships with substances. One of the things that's happening, thankfully in the treatment field, is something called harm reduction and more and more states and local governments and treatment programs or acknowledging, we actually have to meet people where they're at. We have to work with people at varying levels of motivation to change behaviors and maybe they really want to change their relationship with opioids, but they want to keep cannabis in their life.

10 years ago, 5 years ago, if you said that to a treatment provider, they would say, sorry, come back when you're ready to be absent from everything. It can't do anything for you. Now people are saying, okay, let's talk about that. Let's try to help you figure that out. Let's really help you get the tools you need to not use opiates and let's help you figure out what your relationship with cannabis is gonna be. That's a really healthy, important conversation to have. And I think that's what you're saying,

which is like, have all sorts of relationships with substances. And we're too embarrassed to talk about it because we're gonna get shamed. We're gonna get shamed by people who are gonna say you're a bad person for suggesting that and bad things are gonna happen. They're happening anyway. Let's just have a conversation about it.

Yes, that is what I'm saying, but I'm going a little bit further than harm reduction. I'm saying there's the argument that people in the jazz and hip hop and rock communities have been using cannabis for creative purposes for a long time. And that's great. So yes, you can have a dysfunctional relationship with this substance, but you can also have a

really functional relationship that is way more positive than even harm reduction. For sure. So there may be all sorts of ways that they were used in helpful ways around creativity and in their work and whether or not their relationships suffered at all or whether or not their health suffered at all. So that's why I think these are just nuanced conversations that is for each person assessing. Maybe it works for 80% of my life and I'm willing to take the 20% where I know it's not great for my relationship. It's just so important to me in this other area. I'm going to keep doing it. Because that's what matters to me.

Okay, you get to live your life. And I think if we can shift the conversation to having more compassion and understanding and curiosity for each person as they make their decision, then we've just got a bigger platform to talk about what people struggle with and be able to be like, okay, so it's not working in this 20%. Let's talk about that 20% and make that better. Maybe you can have the substance in your life and let's work on your relationship so that it's better and not being hurt by your substance use. But if they're just feeling like I can't talk about it because I'm going to be told I have to give

it all up. What are we doing? That's just not helpful. It's not helpful in therapy relationships and it's not helpful in just friend relationships and family relationships. Yeah, I agree with what you're saying. I think we need this middle ground because on the one hand, we've got an entire multi-billion dollar industry, the alcoholic beverage industry, sort of selling us a glorified version and then we have the absentee's community telling us that you're playing with fire, which actually isn't not entirely untrue, if you're having a relationship with these substances. And so what we want to have is a nuance to use your word discussion about

the pros and cons of all of this. And this is going to be very tough to do and highly individualized. And yet, if we don't have the conversation, we're stuck with the polls. Yeah, very much so. And the shame. I mean, our main point is, why is there so much shame? You've said it multiple times in this interview, like there's a lot of people using substances in a lot of different ways, and it's not all bad. But we all hesitate to talk about it because there is so much shame and so much stigma.

And people are just geared up to feel like, if I talk about this openly, somebody's gonna tell me, I'm doing something bad, somebody's gonna tell me I should change, somebody's gonna tell me that I'm an addict, and so I'm just going to not talk about it. Or I'm going to pretend like everything's fine even though part of it might not be. I might actually be kind of worried about parts of it, but I'm for sure not going to disclose that because just the way people talk about it is so judgmental. And

it'd be great if we could bring more compassion and curiosity to the whole exchange rather than judgment. I mean, just going back to that fear. I mean, that's where the judgment is coming from. Absolutely. And again, we both have compassion for that fear. So you mentioned earlier, mindfulness and self-compassion is important tools that I talk about on the show with my guests. And you use them too in your work.

So if I'm in the situation where I'm struggling with my use of substances, how would meditation and or self-compassion help? So there's helping with understanding, which is what we've talked about so far, which is just understanding these behaviors make sense. They work in some way. Let's understand what draws you to them so we can be curious about that and think are there other ways you might be able to get those needs met, right? There's the one size doesn't fit all, which is like maybe meetings are going to be helpful to you. Maybe yoga class is going to be helpful to you. Maybe meditation is going to be helpful to you. Let's really open the door if you're somebody wants to

make change. And maybe it's not going to be treatment. Maybe you're never going to cross the door of a therapist office. That's okay. So one size doesn't fit all. Embevelence is normal, like really accepting like when you make any sort of behavior change, you're going to be wrestling with ambivalence and how you wrestle with your own ambivalence and how the loved ones and the people in your life respond to your ambivalence can really tip it one way or the other. And that's another thing people don't talk about so much. And then helping with self-awareness, and that's where the mindfulness and meditation and self-compassion come in, because if you're ruminating about all your past mistakes,

if you're launching yourself into the future, about how can you possibly live without the substance or you're never gonna be the same if you don't have this in your life, if you're in the future worried about things, you're really gonna have a hard time with the present moment stuff that you have to face in order to make behavior changes.

So we spend a lot of time trying to help people find mindfulness strategies that just keep them in the present moment, because the present moment when you're making significant life changes is hard. You're facing a lot of unknown things, right? There's probably a lot of stuff that you feel bad about. And if you're in the past, you're going to have less energy to deal with

what you're facing that particular day. So mindfulness strategies are really helpful and self-compassion is, I think, key to helping people stay on the learning process because if you have a setback, if you're like, okay, I want to stop drinking or whatever it is. And you have a slip. If you instantly fall into, I wasn't taking that seriously. Maybe I don't really need this. Maybe I am just a screwed up alcoholic, whatever it is that internal critic is saying to you, you're gonna have a hard time getting back on that path

of wanting to change versus being able to say to yourself, wow, this was really hard. I didn't actually know what I was doing. You know, I thought I could go to that party or that event and be okay and I wasn't. It was way harder for me than I anticipated the cravings were worse. If you can compassionately be kind to yourself in that moment and be like, I'm really suffering.

I miss my friends. This is hard. You can then bring some kindness to it, which helps you stay in the willingness to keep learning to be like, okay, maybe I need more support. Maybe I need to slow things down. Maybe I need to expect a little less of myself right now. If we're just in the internal critic, chatter of, I'm so screwed up, I can't do this.

You're not gonna persist in all the things that you have to learn. And one of the things I say to people all the time is like, when you see somebody who's given up substances and you've given me enough examples today that I think that's probably true for you too, you gave something up and then you had to learn all this other new stuff, right? You had to learn how to be social.

You had to learn how to deal with some of your feelings and that learning process takes a lot of time and takes trial and error and takes practice. And I think self-compassion in the, I have to learn, I have new learning to do here and I'm not going to be perfect at it and I'm going to screw it up and I'm going to have setbacks and I'm going to keep trying and I'm going to be kind to myself in that learning process. And that's one of the things that we say to family members is you can't expect your loved one to just give it up just because it's bad for them and have made that decision and then be able to do it. They've got to learn how to be sober or whatever it is their goal is and that takes time and that's

where I think self-compassion is key. I can completely see that. The mindfulness would help you get out of the swirling stories and the fearful projections and the self-compassion would help you take it easier on yourself, get out of the inner critic and not be so caught up in shame that you're paralyzed. You've talked about motivation quite a bit. Generally speaking, what motivates people to change and how do we figure out what our motivation is? So one of the easiest ways to think about it, again, it's different for different people, but when you're looking at behavior change,

really when something has enough costs that it starts to, like you said, it stopped working, like it's just not working as well. So I'm not getting as many benefits from it. And having reasons that are important to you that tip you in the other direction. So we're constantly wrestling with that edge. And the problem with substances is they work fast, right?

So they may not be working for me in the longterm way. Like my spouse is gonna be really mad at me tomorrow. But how it's affecting me right now is really fast and it works really well. Right? So my memory pathways are going to be like, just do this, it's quicker and it's easier because we're always looking for the short circuit, right? And the, okay, I got to slow down, I've got to try a new skill, I've got to try to do this new thing, that's harder work. So we've got to try to help people kind of wrestle with these moments when they feel ambivalent and be able to be like, okay, what's happening in my environment that is

contributing to me wanting to go back to an old behavior. Because I'm probably going to have to shift something in my environment. And like you said, maybe your friends like maybe needed to distance yourself from some of those friends in the beginning of making changes because if you'd been hanging out with them, it just puts it around you, everybody's doing it and so it makes it harder to make that decision. So maybe you have to remove yourself for a period of time and step away from it while you learn all these other ways

and learn that you don't need it and learn that you can have it and manage your mood without it and then reintroduce those friends. So things in our environment can make us ambivalent because it pulls us back into old behaviors. Our emotions, our thoughts can make us ambivalent because it pulls us back into old behaviors. You know, our emotions, our thoughts can pull us back into old behaviors. So being able to identify the things within yourself of like, these are the things that start to pull me to this old behavior that I don't want and then start to work on those things. And that's

again, a whole host of strategies that will help you with those emotions and thoughts, and that's different for each person. So, let's go back to motivational interviewing and how to talk to people, because I've been forcing you to focus on, you know, individual relationships, substances, but a big focus of your work is talking to loved ones and family members of people who are struggling in pretty acute ways. What is the importance of motivational interviewing? What is that and how could we put it to work in our own lives?

As a journalist and an interviewer, you're probably better at this than you realize. I mean, we know how to make people defensive and we know how to get people to talk, right? So in therapy, the motivational interviewing strategies are about trying to create an environment and a relationship with somebody where they feel comfortable and safe to talk to you openly about how they really think

and feel because you don't have an agenda. So part of it is just really not having an agenda of like, I don't have the right way here. My job with you is to try to actually create space for you to talk out loud to get some of your thoughts and feelings out, with another person, and have me reflect. And it's a lot of it's actually just reflecting what they've already said back to them, to strengthen the things that they've said about themselves, because one of the things that

happens in therapy, and in particular in the addiction treatment world, where people will disclose things, and then the therapist will say, yes, but this is what you need to do. Or like you have a very serious problem and these are the things you need to do to get out of it. Which again, shuts that conversation down versus saying, hey, Dan, what is it? You said you're concerned about X, Y, and Z. What is it that you feel like might be helpful?

What have you tried? So I'm asking you open-ended questions that get you to share what you've tried, what you're thinking, how did that work for you? So all the open-ended questions, how, what, why, versus questions that elicit a yes-and-no response, or are agenda-driven. And so we're teaching family members to have those conversations, because parents in particular will just get into lecture mode, right? You just want to tell your kid what to do and tell them to stop doing the scary stuff and do more of the practice and their piano lessons, right?

First, it's being able to say, hey, I noticed you're hanging out with your friends and I'm concerned you're smoking some pot and I'd love for you to tell me how that affects you. You know, what makes you want to do that? Parents will think, if I have that open conversation and my son how can donating it, right? If I have a conversation with my kid

about what they like about their substance use, does that mean I'm condoning it? And it doesn't. You can say, I'm really uncomfortable with it, but I actually really want to understand it. I want to know what you get out of it. Because as a parent, that's going to give you a ton of information. If you can get your teenager to tell you about their experiences and what they're struggling with and what they like about substances, it allows you to step away from that conversation and think, okay, if they're using it for social anxiety, what can I do to make their social interactions easier? Can I make it easier for them to get to X, Y, and Z group

or club or can I have people over at my house to make it, you know, it just allows you to problem solve instead of just telling them, don't do this and having them go underground with a behavior anyway. We want to keep the behavior above ground and we want to keep talking about it. You do a lot of myth busting about the appropriate avenues and levers available to those of us who might be dealing with people in our lives who we believe have problematic relationship to substances. Some of the things you talk about include interventions being the right way, tough love, mandatory rehab, letting people hit rock bottom, the notion that if you're in any way

understanding, you're enabling, is that list exhaustive and can you just sort of tick through why some of these may not be the right roots? If you can help me eliminate people saying they got a hit rock bottom, that phrase just makes me crazy. It's cruel. It's not true. And people are really dying because that's the belief. Family members get told all the time, well, there's nothing you can do to help your loved one.

They've just got a hit rock bottom in order to change. And especially with the opioid, so that really is a result in a death. And we really need to stop saying that because you can affect people's motivation at any stage. And you can have a positive influence on it at any stage. It takes a fair amount of strategy and it takes some thoughtfulness and it takes you. The family member probably learning some new skills that you might not have. So it's not an easy route. I mean, if you're panicked, stricken, doing an intervention feels like a quicker fix, you know, and that's a part of I also think what we're struggling with is everybody wants a quick fix They want the problem to be gone fast when you have a loved one with a substance use problem

It's scary and it's probably causing a lot of problems So you just want that problem to go away as soon as possible, right? The idea of I'm gonna have to slow down I'm gonna have to learn some new ways to talk about this I'm gonna have have to slow down. I'm going to have to learn some new ways to talk about this. I'm going to have to think about my environment. I'm going to have to think about my emotions. Family members don't really want to do that, right? They want their loved one to get fixed. So it's just really changing that whole idea. Family members also get told that they're codependent. That's not in the diagnostic manual. There's no such thing as codependency. It's a label that gets tossed around, which is equally problematic as telling somebody

that are an addict or an alcoholic. You know, if somebody self-identifies as an alcoholic or an addict, like if they're like, yeah, this is me, and I'm a part of this community, and I relate to that concept. Great, use the word, it's fine, that's yours, but me telling you that's what you are,

that is a very different effect. And we label people all the time. And so the labeling, it's a reason why people push away from help. And it's a reason why people say, I'm not that. So I'm a big advocate of just eliminate those words. You don't need those words unless you self-identify. The tough love, I think, is just confusing.

You know, parents get told that all the time and they have no idea what it means. You know, like for some people, it gives them license to be tough and lecture and yell and do all sorts of things that just make them feel like they're having an impact when they're just creating more friction

and their relationship and it feels bad to them and it feels bad to their loved one. So the tough love thing I think is just a confusing metaphor. And telling a parent they have to distance themselves from their kid, I've never met a parent who feels like they can do that without ripping their heart out. They may really need to use some strategies to set boundaries and set limits and possibly cut some things off that they're supporting and again think through that strategically.

But we just say these catch phrases as if they mean something and they really don't when you try to unpack them. Coming up, Kerry talks about the strategies to use if you've got somebody in your life who thinks it's going down a dangerous path, what positive communication is and how to practice it, and the problem with bringing a quick fix mentality, which is very common these days, to something like substance use disorder. substances used to sort. Deep in the enchanted forest, from the whimsical world of Disney Frozen, something is wrong.

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If you don't want to wait for more episodes, join Wendery Plus today to listen exclusively and add free. So what is the right strategy if you've got somebody in your life who you think is on a self-destructive path here? What does work? In the treatment world for two decades, there is a very effective strategy called craft,

which is community reinforcement and family training. It's a terrible acronym, but that's what we have. And it was designed for family members who had a loved one with a significant substance use problem that was resistant to treatment. And they did lots of studies with this, it's one of the best well-researched approaches. And so they compared it to assigning people to an intervention or to

Alonun. So they took families and they put them in three pathways and said, you learn craft, you can go do an intervention or you can go to Alonun. And when they compared the outcomes, family members who learned craft got their loved one into treatment 60 to 70% of the time. It's pretty high numbers, right? And when they got them into treatment, their loved one's substance use was down, and the family members' mental health was up. They were less depressed, they were less anxious, and that they felt like their family was more cohesive. So those are great outcomes in terms of an intervention, having a positive impact. When they compared that to interventions,

what they found is like interventions get people into treatment about 30% of the time, which is contrary to what interventionists will tell you, they'll say, I get 100% of people into treatment, 80%, at what cost? But in the studies, it's actually around 30%. And the problem with interventions is there's enormous high dropout rate.

So family members, about two thirds of family members drop out of doing the intervention because it's too painful. And they're like, I actually just don't want to do this to my loved one. It makes me feel bad. I don't want to do it. And then the problem with interventions is people go into treatment and they're pissed. They're mad at their loved ones for doing that intervention. And then they come out and there's a fracture there with the family.

And the family is potentially the biggest resource when they leave treatment, right? So that's not a great outcome. And then the Alonon strategy gets about 10% of people into treatment, but Alonon's not designed to get people into treatment. Alonons, I got a really nice self-help support group for family members. So craft is a set of strategies that help families learn how to reinforce positive change. Like really how do I support the things that are going to help my loved one change and how do I keep things positive so that my loved one wants to be close to me, not disconnected from me. Like it's okay to be connected.

We're social creatures and one thing that competes with substance use is positive relationships. So if I'm distancing myself, there's no connection there. And that's potentially the life-saving thing. So craft gives family members permission to stay connected, but it gives them a set of strategies to do that effectively. So they're not inadvertently supporting substance use. It's helping them take natural consequences

and let them play a role. So natural consequences are the things that are a direct outcome of your substance use. So if you're not getting out of bed in the morning, I'm not gonna get you out of bed. I'm not gonna help you get out of bed, right? So I'm gonna actually let you feel some of the consequences that are a result

of your substance use because that's what's gonna turn your motivation on. Cause you're gonna be like, oh wow, it's not working for me. I can't get up and I'm gonna lose my job versus if my partner's getting me up, I'm getting to work, but my partner's mad at me, right? Then I think my partner's the problem, my partner's mad at me all the time.

I'm not actually connecting the dots that I drank too much and I'm having a hard time getting up. So we help family members let natural consequences play a role. There's communication strategies that, again, lower defensiveness, keep the conversations going, give the family members more information to work with, and then there's the self-care component, which is like, you've got to take care of yourself through this process because it's incredibly stressful to care about somebody with a significant substance use problem. It's

scary, it's maddening, it's confusing, and so you've got to take care of yourself if you're going to be a effective helper. You really do have a huge emphasis on to use the cliche here, putting your own oxygen mask on first. Yeah, you have to. I mean, I have to do it, and the work that I do, and you just see family members, they're so burned out, I'm working with a mom right now. She wants so desperately to connect with her son, and she's not sleeping. She's so anxious that she's not sleeping. So every single time she tries to have a conversation with her son, she kind of either falls into tears or she gets really mad and loses her temper. So it's not going well.

She literally can't use the skills that we're trying to learn around the communication strategy. So I've got to back her up and we've got to really work on how do I help you manage your stress so that you can sleep, so that you can go into these conversations and actually be effective. So, you know, you've got to really try to help people take care of themselves first so that you can stay regulated

as you try to use these skills and use communication tools. One of the phrases you use that I think may sound a little flip at first, but it's actually quite enlightened is your loved one isn't crazy. Right, I don't mean that in a flip way at all. And even if your loved one does have severe mental health issues,

that might be contributing, you know, if I worked with a family for a long time, who really thought their kid was just defiant and against the family and all these kind of things, and it turns out he was actually hearing voices, and he was self-medicating the voices, and the father for years thought he was just disrespecting the family's culture and the kid just was terrified to tell anybody that he was hearing voices. So, you know, even if there are kind of mental health issues, those are worth understanding

and being curious about. You gave us a nice overview. Let's, as the nerds say, double-click on some of these. One of the things you talk about is positive communication. What does that entail? So those are the open-ended questions. So we can get conversations going. It's a really subtle, like when you say things in a negative, like if you say to somebody, I don't want you to drink tonight versus, I'd love it if you came home sober tonight.

Those are just a little half step switch, right? Of telling somebody what you don't want versus what you do want. That really can shift the tenor in a conversation and in a relationship, so helping people frame things in a positive way versus a negative way. There's all sorts of strategies around making requests, you know, to ask permission before you make a request. Be like, hey Dan, like, I have an idea, like, to run it by you or you're open to hearing about it. If you say no, not up for it right now, being able to be like, okay, I'll come back tomorrow. I'll try again tomorrow, whatever. You know, so it's kind of like knocking on the door, asking permission and then saying whatever it is that you have to say and then following up with a wrap up of, so that I get that right,

and reflecting back using a lot of reflection and validation, the thing that gets really sideways and families with substance use problems is everything just becomes so negative. It becomes all about the problems, right? And everything that the other person is doing wrong. So we spend a lot of time trying to help people start to validate more and validate emotions

and being able to notice when the person is doing something positive that you want to sprinkle some fairy dust on that. Like, I see that. I see you made a really positive change here. You might be doing all these other things that are really concerning, but I see this little sprout of green

that I want to pour some water on so that it grows more. And that's especially true for people who have kids with attentional issues. You know, it just becomes all the things that they're not doing versus the moments that they get it right and being able to really be like, yeah, you're really struggling. You were awesome on that one thing. So let's pay attention to that too.

So I believe what you're describing there is reinforcement. Yes, so communication can be a reinforcement. We can give compliments, we can notice, we can give affection. There's all sorts of free communication strategies that act as reinforcement, but reinforcement can also be, hey, you just told me that you're struggling with stress.

You're using substances because you're having a hard time with stress. Can I help you with a gym membership? Can I help you download the 10% happier app and practice mindfulness because that might be really helpful? So those are reinforcing alternative behaviors and really kind of helping the person gain access to those things. Or you don't have a car, you need me to take care of your kids while you go to treatment.

Or can I pay for treatment? So those are reinforcing the behaviors that you want to see more of. And then setting limits around some of the behaviors that you want to discourage. So I might not give you money, I might not give you cash for your rent because I know you're going to spend it on substances. So I'm not going to do that, but I'll support you in these other things. So helping a family be very strategic in what they're going to support and what they're not going to support.

So reinforcement can be through behaviors, spending time with somebody in things that they enjoy. It can be through communications. It can be through financial ways that we support or don't support things. What about consequences? The craft model is based on really letting natural consequences play a role. So that's, again, those behaviors that

are direct outcome of the person's substance use choices. An example I use a lot is I worked with a woman whose husband would drink a lot and to kind of pass out in his living room chair. And she would get him up, she'd drag him upstairs, and she'd be furious in the morning. And one of the things that she was trying to do was prevent his teenage kids from seeing him

in the chair with the beer bottles all around him because she was embarrassed for him. But he'd get up, go to work, she'd be mad. And so he thought she was the nightmare. They were fighting, and he's like, you're on me all the time, you're mad at me all the time. And he didn't remember passing out. So she started to just leave him in his chair. And the kids came down in the morning, they'd find him. And he started to get embarrassed. He started to feel, I don't know how to lessen kids

seeing me sitting here in the chair, passed out. So it became a consequence that he didn't want to live with, you know, and when she was getting him up, she was being the consequence in some ways. Her anger was the consequence and it just didn't change anything. It made the relationship worse. So things like that, but, you know, there's some natural consequences that you can't allow. I mean, if you love to one's drinking and driving, that's something you want to interfere with, right? You would want to block that from happening.

But maybe you're going to let them walk home from the train or maybe your partner needs to lose their job because you're calling and canceling. But maybe that isn't something your family can tolerate because you need the money. So each family member has to make pretty tough decisions around which natural consequences that they're going to let play out. But there's usually a lot that the family's kind of shaving the rough edges off of, you know, because we ultimately don't want our loved ones to suffer. And so we block things, you know, and if we get out of the way and let the world be the teacher, people start to realize like,

oh, this is some actually working. Is it never appropriate for me to allow one of the consequences to be that I'm pissed at you for X, Y, or Z? Of course, it's not about not being pissed, but it's, you know, she was extra pissed because she had taken him upstairs, she got him in bed, she would clean up the mess, you know, so her anger was way bigger, you know,

than when she just kind of let him sit with it and let him pick up the mess. She was still angry with him, understandably, but it was, it was just less intense, there was less intensity and he was able to see his own behavior because she wasn't picking it up for him. This isn't all about like just be nice all the time

and be kind all the time, right? Your feelings matter, but it's how you express them. It's often when you express them. If you're getting in an argument with your loved one, when they're high or when they're crashing, that's never gonna go well. And you're gonna probably get wounded in that process, just in terms of that conversation going sideways.

So can we help you time that conversation where you tell the person that you're really, really actually angry with them and time it when you're regulated and can say what you wanna say and say it at a time where you can handle it. So actually helping you have more control over the situation because you're thinking about what you need

and not just responding to whatever crisis is in front of you, just really being thoughtful about yourself. And getting the support you need is a loved one. You know, going back to what we were talking about in the beginning of the shame, people don't want to talk about, you know, I'm really worried about my partner's substance use or my kid's substance use. There's actually been studies done about how families are judged by other families. You know, if there's a substance use problem, so people don't want to talk about it. And they need to be able to talk about it so they can get support and brainstorm.

And, you know, if you're super mad or super distraught, be able to go talk to somebody that cares about you and can, again, help you regularly and figure out what you want to do. One of the bottom line points that you make, and I think this goes for family members or loved ones of people who may be struggling with substances

and it goes for people who are struggling with their own struggles with substances. One of the key points you make that I wanna get you to hold forth on now is change is often slow. I think it's incredibly slow and requires a lot of new learning and we are a quick fix society, right? And I think it's getting worse. Our phones can get anything you order on your phone

in two seconds. So why can't I change really quickly? And it's hard work. It's hard work to learn to regulate your emotions in a different way. It's hard work to change your relationships. You might have to change entire friendships. You might have to have some people

that you're like, I can't actually have you in my life anymore. And now I'm lonely and I have to establish new relationships. That takes a lot of time and a lot of trial and error. And so it is quite complex and hard. And you add substances in there where your brain and body are being affected and you're having cravings and your brain saying, this makes perfect sense. Go back and have that cigarette. Like you'll feel better if you have that cigarette, right? You're just having to tolerate a lot of discomfort. One of the strategies that we use a lot is acceptance and commitment therapy, which is

about figuring out how to relate to pain and discomfort in a different way and be able to know, actually, I'm probably going to have to lean into this pain and discomfort in order to achieve my end goal here. I can't avoid feeling uncomfortable. And substance use is kind of by its nature avoidance, right? We're using a substance to avoid something. It changes how we feel. So if we're going to take the substance out, we've got to figure out how to lean into

that discomfort and figure out how to cope with it, tolerate it, move through it, change it, whatever it is. Before I let you go here, can you please plug everything, plug your books, plug your rehab, anything that we should know about? Sure. The thing I would like to plug most is our foundation, CMC foundation for change, because we really started that, because we want family members to have access to these evidence-based ideas to help and to also be able to connect with each other. So beyond addiction, the workbook for family and friends,

that's the invitation to change approach. The foundation website is full of all sorts of free videos and free materials. And you can join Facebook groups to just talk to other family members who are using this approach to try to help. And a lot of these family members are people who have been through so much. We've got family members who are trainers and the invitation to change

approach. And a lot of them have kids who overdosed. And they went through the treatment system, and they went through these horrible experiences. And they just want to give back to other family members and help them not suffer in the same way they did because they got all that really not great advice in terms of letting their kids hit rock bottom and their kid ended up dying. So there's just a huge community of people who are trying to get the word out that there's other ways to approach helping a loved one. So the foundation, I think, is the most important place to go look in the Beyond Addiction Workbook. And then we wrote Beyond Addiction, How Science and Kindness, Help People Change. We wrote that about six years ago, and that's all about craft. It really talks about how to use craft and how to think about behavior change in general, and how to get your loved one into treatment, how to understand the treatment landscape,

which is a pretty messy landscape. So there's lots of different ways to go about treatment and treatment options. And I think if we can help consumers become more educated about that landscape, then everything will get better. Kerry, thank you very much. Really appreciate it. Thank you. Thanks again to Kerry Wilkins. Like I said, hit me up on Twitter, X Instagram, TikTok, wherever with your feedback. You can also find me over on the 10% happier website 10%.com. Thanks to everybody who worked so hard on this show.

10% happier is produced by Gabrielle Zuckerman, Justin Davy Lauren Smith and Tara Anderson. DJ Kagemeer is our senior producer, Marissa Schneiderman is our senior editor and Kimmy Regler is our executive producer, scoring and mixing by ultraviolet audio and Nick Thorburn from the awesome band islands wrote our theme. We'll see you all on Friday for a bonus meditation. Hey, hey, prime members. You can listen to 10% happier early and ad-free on Amazon Music. Download the Amazon Music app today. Or you can listen early and ad-free with 1-3-plus in Apple podcasts.

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