Rethinking Rock Bottom is CMC:FFC’s new 6-part podcast series. The episodes explore the complicated, and often life-altering, experience of loving someone struggling with substance use. Find other episodes at our podcast page.
Treatment providers spend significant amounts of time having vulnerable conversations with people but rarely share their own stories.
On this final episode of the first season of Rethinking Rock Bottom, hosts Dr. Carrie Wilkens and Reverend Jan M. Brown take the opportunity to share their own experiences and some of the personal reasons that they are so passionate about helping families heal. They each navigated very different paths that led to their work of helping people heal, and their deeply personal reasons keep them both motivated to do this important work.
Together they each share their journey to CMC:Foundation for Change, the struggles and realizations they encountered along the way, and how hope has led them to serving and supporting others as they navigate their own paths toward healing.
Carrie: Part of the reason, the podcast came to be was because we realized we needed more time to talk about these things because it can’t happen in a soundbite.
Voiceover: This is Rethinking Rock Bottom, a podcast that explores a complicated experience of loving someone struggling with substance use. Hosted by Reverend Jan Brown and Dr. Carrie Wilkens.
Carrie: As a treatment provider, I spend a lot of time having vulnerable conversations with people, but I’m usually the one listening and trying to provide support. I encourage my clients to be open, honest, and forthcoming about their challenges. While I have the daily privilege to hear other people’s stories, I rarely share my own story because it’s not the point in these conversations.
Jan: So to conclude this season of Rethinking Rock Bottom, Carrie and I are taking the opportunity to share our own stories and some of the personal reasons why we’re passionate about helping families heal.
Carrie: Jan and I took very different paths to our work with people who use substances, but I found that no one in this field got here by accident. There are often deeply personal reasons motivating us to do this work, even if we don’t always hear about them.
Jan: My own experience with substance use disorder and behavior change played a significant role in my career path. For me, substance use began early in my childhood. By the time I was in adolescent, I was using regularly.
For Carrie, her issues started in high school, and revolved around more sporadic binging behaviors. First with alcohol and then with food. At the time, Carrie hadn’t thought of these behaviors as problems, but then again, where Carrie grew up, people didn’t really talk about this kind of thing.
Carrie: So, I grew up in a really small town in Western Kansas. It’s really in the middle of nowhere. Very rural. Grew up on a farm. Very close knit community in lots of ways. You know, just hardworking, pretty religious, conservative, small town. I remember people suffering from substance use, but nobody- nobody really talked about what that was. But the culture at school, like once you got to high school, everybody drank, or that’s what I thought anyway.
That was kind of a rite of passage. The number of times I drank and drove and could have killed somebody is pretty horrifying actually, for me to think about. We would drive out and have parties out in the fields and then drive back home. So lots of kids did it, and unfortunately, some of my peers suffered pretty significant consequences as a result. Life altering significant consequences. So I was a novelty seeking, risk taking kid. I drove too fast. I loved to experiment with things. I think there were probably a lot of people that thought, “oh, if anybody’s gonna get in trouble with substances, it’s gonna be Carrie Wilkens because she’s, you know, constantly pushing that edge.”
And I liked alcohol a lot right out of the gates. Uh, and there was some pride in being able to drink the guys under the table. We were having fun. So that’s all that I would’ve said to you about my younger years was I had a great time. In hindsight, I think, wow, there was a lot of wrong about what was going on, but I didn’t have that. Reflection or the consequences that would’ve tipped me into, “okay, I actually really have to do something about that.”
Jan: Even if Carrie’s binge drinking looked like partying rather than substance use disorder, a lot of unprocessed emotions were churning around underneath. Carrie’s binges offered a temporary release for these feelings, but for that to work, the process had to repeat itself. That’s how sporadic binging can turn into more chronic and compulsive behaviors. Something Carrie experienced, not with alcohol, but with food.
Carrie: In college, what I ended up actually struggling with was an eating disorder. You know, that’s where it ultimately settled in. For me, it was a pretty serious run of bulimia, which for me was way more persistent and way more underground, like nobody knew about it. I mean, I had a couple of friends that I engaged in the behavior with. We would go on the eating binges together, um, and we knew exactly what we were gonna do afterwards, which I think now in hindsight, I’m like, “oh, what a painful shared experience.” It’s akin to going out and drinking with somebody, right? We’re gonna go out and eat a bunch of food that we know is easy to throw up, and that’s what we’re gonna do together. I think for me, the eating disorder, it was just numbing my feelings. I was controlling my feelings.
It’s a way that you feel very out of control and in control at the same time. And I actually think I was somebody who, like, I was pretty out of control in some ways and I was very in control other ways. You know, I was a good student, I had a great social life, nice relationships with my family, so I- everything looked okay on the outside. On the inside I was pretty jumbled up, you know, just in terms of not totally knowing how to deal with all my feelings, so I found a way to get rid of them and numb them out.
Jan: Bulimia became a coping mechanism for Carrie to manage the stress and expectations of college. Eating became a way to feel like she was in control of her emotional and physical state. However, the shame around this behavior was so intense that even when she went into therapy, Carrie was reluctant to address her eating disorder directly.
Carrie: When I started graduate school, I made the commitment because that’s the other thing about growing up and where I did, there was no therapy. Nobody- nobody went to therapy.
So when I decided to be a psychologist, I kind of had the thought of like, “doesn’t seem to be wise to be a therapist and have never been in therapy.” So I started therapy, but I wasn’t honest about it. I didn’t talk about the- what I was doing. I mean, I acknowledged that I was doing it occasionally, but I didn’t talk about it, ’cause I had so much shame about it.
I mean, bulimia is a very shameful- I mean, it’s- it’s- it’s pretty gross to throw up lots of food, right? So, you know, you just, that’s not a nice thing to talk about. So we didn’t necessarily target it in therapy, but what therapy did was help me learn to talk about my feelings and learn to ask for help. Which is the other thing that I think is just a very strong cultural message that I grew up with, is that you need to be self-sufficient. You can get help here and there, but really you need to be self-sufficient, and you need to be able to take care of yourself. And so I thought that’s what I was doing, you know, by being miss independent, but turns out we need people and turns out I need people. And once I started to kind of learn that I could get that by talking about things, then the behavior kind of fell away.
Jan: Talk therapy was an important vehicle for change for Carrie, even if she didn’t work on her eating disorder directly. Sometimes problematic behaviors just kind of fall away without specific treatment, a byproduct of personal growth and development. My own story of treatment and change is a bit different than Carrie’s, more complicated. It involves more systems, more substances, and more countries. I grew up- my father was in the military, career, military officer. I was born in Syracuse, New York, but as a military brat, we moved throughout the United States. I lived in Korea for a period of time, lived in Germany for a bit of time.
Alcohol was absolutely a part of the culture growing up. My parents had a full bar in their basement. They did lots of entertaining. I come from a big extended family and there was always alcohol at any family gathering. I can remember at a very young age, going behind the bar and- and making myself- my- my mother used to drink pride of the Finger Lakes wine, and I think because I had the example of watching the grownups drinking, you know, I thought I was doing something right alongside them, so I started tasting, if you will, alcohol probably when I was about four or five. I was introduced to marijuana, I think I was probably third grade and very quickly wanted to protect my use of marijuana.
I drank Listerine as a young kid thinking that if it makes your breath smell clean, it’ll make your insides clean, only to learn many years later in- in recovery that you know, there’s a great deal of alcohol. And- and I can remember the progression of having a little bottle that I would carry with me and then pouring the bigger bottle into the little bottle. And, you know, you could drink Listerine in- in class. And for a time when I lived in Korea, ether was kind of a- a thing, so that would’ve been eighth grade. I was an ether sniffer. Nowadays they call them huffers, but we- we didn’t have that language back then. And I- I didn’t associate any of these things with getting high. It was just what I was doing.
Carrie: Drug use in the very young has an additional layer of complexity, since the users of these substances aren’t mature enough to fully understand what it even means to be impaired, let alone addicted. What kids understand is that something feels better, and so they move towards it. For Jan, being the child of a two star general came with a lot of pressure and a lot of moving around. Substances were simply a means to have a good time wherever she found herself. Even once she became physically reliant on alcohol, the idea of addiction didn’t cross Jan’s mind until she was in high school.
Jan: I had no frame of reference for what an alcoholic was. I had no idea that I had a problem. I didn’t have a name for it. And I think in high school it became obvious to others that I had a problem and that the behaviors that I was engaged in were extremely risky, harmful. I was pretty outta control and just kind of did whatever I wanted to.
And if somebody told me, “Jan, if you try this, it will, you know, make you feel something,” I was gonna try it. I would otherwise have really big feelings, you know. When my father would leave going somewhere, rightly so, I didn’t know how to manage the feeling of- of him going to somewhere else. And so I would drink, or I would use drugs, or I would behave badly. That would mean that I wouldn’t have to feel and process things that I had no idea how to do. Part of my story is this righteous indignation. It’s like, “don’t you know who I am?” But it really wasn’t who I was. I was kind of living vicariously through who my father was, really thinking that I was untouchable, and frankly, that I could do whatever I wanted to.
Carrie: Over the course of high school, Jan’s substance use escalated, and prescription pain pills now entered the mix. Jan would do things like intentionally sprain her ankle or have a tooth pulled in order to get a prescription. Throughout her school years, Jan had managed to get by on her considerable talents as a student and as an athlete, but over time, the consequences of her problematic behavior started to add up. When she was admitted into West Point as a cadet, she temporarily swore off drugs, but her reliance on alcohol increased to the point that it could no longer be ignored.
Jan: When I was a cadet at the military academy, I had a professor who took interest in me, discovered that I had been an athlete in high school, and- and encouraged me to start playing team handball. And as much as I wanted to only play team handball, at that point, I had to drink. And so it- it got in the way of me playing sports. When I went to the Olympic training center to train, I worked hard during the day and I would sneak out and go under the fence to the bars in the night. And so, you know, it really- it wrecked that.
So there were a lot of losses all along the way, that were alcohol and other drug related. One time at West Point, somebody said, “you know, why are you doing the things that you’re doing?” And it was followed by “might you have a drinking problem?” And, and I- I will never forget, I kind of paused and it was like, “huh. Yeah, may- maybe that’s what it is.”
You know, at that point there was a bit of desperation. I knew I didn’t wanna keep doing what I was doing, but I didn’t know anything else. And so even back then, which is many, many years ago, the West Point sent me to treatment and I went for 48 days, which seemed like a very random number. And I went to 12 step meetings. And I was in treatment with general officers, naval officers, congressmen, senators and me and two other- two other of my cadet friends who had also gotten in trouble with our use of alcohol. But I didn’t- I didn’t get it, nor did I really want to stop using, so I was very dishonest, very guarded. Certainly rode around on the “druggie buggy,” as we would call it.
Carrie: At this point, even though Jan had begun to understand that she had a problem, she didn’t have the willingness yet to make real change. As a result, when she left her first stint in treatment, her sobriety didn’t last long. As Jan would say, she was drinking out the door and West Point deemed her unfit to serve. With the military behind her, Jan moved back home and her alcohol use settled down for a bit, but she was still using prescription pills. Eventually, her mom gave her an ultimatum. She could either get back to school or get a job. Jan didn’t want a job, so she opted for college.
Jan: So I went back to college and very quickly was kind of off and running again with alcohol. Then it turned to drugs. Then I had to leave college. I fell down a flight of stairs, was left for dead. And then that was when I entered into to treatment for, God willing, the last time. And that was over 36 years ago. I didn’t wanna die. And- and at one point when I went into- at the beginning of the detox, you know, my doctor had said, “if you keep doing what you’re doing, you’ll be dead within- within two weeks.”
And I needed, of course, one last hurrah, so I convinced somebody to give me money and went to New York City. Now they call these things “pharm parties.” And before you know, what it looked like was stealing pills out of people’s bathroom cabinets and- and just eating ’em and having no idea what I was taking. It could have been anything, but it didn’t matter to me at that point. I had also sustained a pretty significant traumatic brain injury from my fall. And so, I was pretty impaired from my use, but I was equally impaired from the brain injury. And you know, come to find out many years later that the brain injury, the fall down the stairs, probably saved my life. Even though if I hadn’t been drinking, it wouldn’t have happened in the first place.
Carrie: While this might sound like Jan had reached a turning point, it would still take a while before she finally got sober. Whether it’s changing your relationship with substances or like me, a relationship with food, change happens in different ways for different people. That’s why it’s important to have patience with people as they explore what kind of support works best for them. I think it’s interesting to think what causes people to change and you know, Jan’s describing really, really painful consequences that caused her to ultimately decide to change.
Mine were more subtle way underground, you know, but just how I felt about myself. I just got sick of that behavior and I’m sick of everybody thinking I’m fine and I’m doing this thing that is so awful. I just don’t wanna do this anymore. I can’t stand to feel that way about myself anymore. And in therapy had started kind of realizing this wonderful thing called asking for help and talking about your feelings. And I realized, oh, maybe if I tell who is now my husband now that I feel like, “well, I’m not in such a great head space. I don’t actually wanna go engage in this behavior. Don’t let me go to the bathroom.” You know, he started to help me. And the behavior got less and less. I mean, it had already really gone down by that point, but still, I think that was kind of the end of it, was when I finally really started saying, “Hey, I need help with this. This is a behavior that I can’t quite manage on my own.” And my husband’s so sweet. He’s like, “will you just ask for help, please?” And every time I would do it works out just fine. But you know, 29 years into a marriage, he still has to remind me to ask for help. So, I mean, I think it’s a lifelong journey for some of us, right?
Jan: Carrie’s story of change shows just how effective loved ones can be in the healing process and how support looks different depending upon the problem you’re trying to solve. For Carrie, her husband’s support was subtle and private, yet still an essential part of her healing. For me, the process was time consuming, messy, and required a multifaceted approach due to my brain injury. I was not a model patient. And part of that was because of my brain injury, that I broke every rule that existed. And a lot of it came from I didn’t understand. And you know, they’d say, “well Jan, you can’t do that.” And I’d say, “well, gosh, I just did.” And- and I still had that thread of- of entitlement and- and military brat in me. And so, you know, my- my self-righteous nature, you know, demanded all kinds of things.
And I would be on the treatment side of the building and- and doing my drug treatment. And then my behavior would become unmanageable and uncontrollable, and they’d send me down to the psychiatric side, give me medication, and they would allow me to resume my addiction treatment. And then I would do something, and I would be returned to the psych unit. And for me, the psych unit wasn’t where I belonged, and I mean, we now know it was brain injury. And so, you know, I found myself, at one point I had moved my college dorm into the psych unit and I’d play my music as loud as I wanted and, you know, just do whatever I wanted. I would take cigarettes and trade people for their medication. And so I used. I went into treatment in September and my sobriety date isn’t until January 1st. So I used throughout my- my time period early on in treatment.
Carrie: At this point in Jan’s story, it’s easy to think, surely she’s reached rock bottom and wants to change. The problem is there’s two sides when it comes to making changes. On one side of the equation are all the consequences that are slowly adding up. Some of those consequences can be quite dramatic and life altering. On the other side are the benefits of the substance use that the person has to say goodbye to, and all the new behaviors they have to learn in order to make the changes. That learning process can take a long time, and this was made even more complicated by Jan’s brain injury. This learning process deserves our compassion.
Jan: My final, how I changed in a moment was I had decided I was gonna leave and that I- I was better and I could do this. And I told the people that that was my discharge plan and they tried to convince me to just kind of wait out that 72 hours, and I refused to do that.
And so at some point they bring in this person who’s a magistrate, and I can remember him saying, you know, “gosh, this has been your life and you’ve done all of these things and now you’ve been in treatment for all of this time and you’re not getting better. What’s up? Are you trying to kill yourself?” And I said- I said, “no, sir, your Honor, I would- I wouldn’t ever try to kill myself. I- I was just trying to get high.” And he said to me, “if you keep doing what you’re doing, I’m gonna put you in jail.” And I looked at him and I said, “oh, no sir, your Honor, you couldn’t put me in jail. I’m too cute to go to jail. Those ladies will do nasty things to me.” And I have not used drugs since then.
So for me, it was more of what I wasn’t willing to have happen than what I wanted. So I wasn’t moving towards anything really, ’cause I had nothing. But I knew what I didn’t want.
Carrie: For Jan, who had suffered so many consequences of her use already, it was the threat of jail time that gave her the final push to make real change. But even as a willing participant in her own healing process, treatment would continue to be difficult and time consuming due to her brain injury. Ultimately, it wasn’t so much the clinicians, but the staff at the treatment center that Jan credits for supporting her eventual change in behavior.
Jan: For me, it’s like, gosh, when people say, “well, how’d you get well?” They loved me well. The- the two most influential people in the treatment center for me was the lady who cleaned my room and the lady who made my food, because I wouldn’t talk to the therapist or anything like that.
And so what I learned was that the way my therapist knew how I was doing, was she would talk to them, because I talked to them. The one woman would come in my room and I would be a mess, and she’d say, “you’re gonna be okay.” And I came to believe that I was gonna be okay and she’d come back the next day and I’d curse at her and she’d say, “it’s okay. I’m here to help you. You’re gonna be okay.” And then the lady who was in the cafeteria who was making the food, I would of course, ask for something that wasn’t on the food line and she’d get it for me. And so they were just always there and convinced me that I was gonna be okay, and it was okay.
Carrie: I’m a treatment provider and I’m always telling people in the scheme of things, the therapists, the clinicians, like I’m shocked we can get anything done in the 50 minutes that we have with people or the time that we have with people. I’m always constantly thinking, “wow, how does change happen?” But it’s really the people in the community. And the woman bringing you food that was your community. And they’re the ones that saw you every day and they noticed you every day and they gave you that little bit of positive attention and affirmation. And that’s ultimately sounds like what- feels like it pulled you through a really incredibly painful, difficult time.
Jan: Absolutely. Ultimately, I was in treatment for 16 months, which was a really long time, and I needed every single day of that. And when I got out, I had to figure out how to navigate my way beyond the walls of treatment. And so, it’s- it’s hard, but this is the place where we get to do it.
Carrie: As Jan’s story shows, treatment is such a small part of the healing journey. Sustaining behavior change requires ongoing support, and that means the families can play a crucial role for those struggling. Loved ones can be powerful allies for treatment providers too, but they often remain an untapped resource because clinicians struggle to integrate them within the current treatment system. Even though I eventually co-wrote a book on the incredible impact that families can have in the change process, it took me a while to recognize that families could be an asset in a clinical setting. When I think about how much I care about helping families now, I have a little bit of shame about how much I didn’t want to have anything to do with them in the beginning.
When I first started this work, I only wanted to work with the person with the problem. I felt like I’m not a family therapist. And then we got trained in CRAFT Community Reinforcement And Family Training and you know, had a few light bulb moments of like, “oh wow, we really- we should be helping families.” And started to do it. You know, it’s just funny, you have these “aha” moments where you’re like, “of course you should. Like, why have you been so resistant?” And I think actually in hindsight, I was probably intimidated and scared, because family members are really having their own process and their own suffering, and it’s a lot to take on. I just felt insecure and didn’t feel like I had the skills. But then once we got trained in an approach that made a lot of sense to me, I was like, “okay, this I can do,” and then realized and working with now what feels like hundreds of families, just realizing how important that is and how much was missed before I did it.
I say this to my therapist now, like, if you’re only working with a person with a problem, you are missing so much information. And being able to kind of think through for each family and each person that I’m working with, “what does your family need and what is your community? What are the resources that you have accessible to you?”
And some families are very resourced, other families are not. Um, and that’s true for different communities. So to really be able to think to a pretty granular level actually, like “what- what does this family need?” “What does each member of the family bringing to the table as they try to embrace change or understand the change process and how do we set them up for success?” The change process, and you can hear in Jan’s story, and to some extent mine, the change process is a long fricking haul. Everybody needs to buckle up. Everybody needs to get on board and go on the journey together and not think it’s just gonna be a quick pit stop, ’cause it’s not.
Jan: Not only is change a long haul, it is a unique journey. For many, sustaining change involves mutual support meetings like AA, but I struggled with them. For me, at that time, these were smoky rooms full of white men using black and white thinking around substance use. I needed things to make sense, and the language I heard in these meetings was very different from what I’d experienced in brain injury support groups, where people were treated with respect and dignity. In the substance use world, I discovered that shaming language was the norm, and for me, that was a big problem. One day I decided to do something about it, and so I went to talk to the clinical director of my old treatment center to let her know my thoughts.
So I went in and- and I was telling her about how badly they were doing and that people continued to have occurrences and relapses and they were taking people’s money. And so she said, well, “if you think you can do better, you need to join us.” And I was like, “no way.” You know, because the messaging that the- the mutual support groups and many of the treatment centers were giving people is, you know, “you’re a liar, a cheater, and a thief, and you’re not ready.” I mean, just all of these negative messages. It was always the patient’s fault, you know, and- and there was always this distance between the clinicians and- and the patients. And that didn’t make a whole lot of sense to me either, ’cause I joined the clinical team and a lot of the things that we did didn’t make sense. And then at some point I just couldn’t reconcile it anymore, and I started compromising my own values to remain engaged in the treatment system that I was working for. And so I decided that it was time for me to go, and- and I wanted to create a place in the community that would essentially catch people as they were leaving formal treatment. And so I started Spirit Works.
Carrie: Even though her center has “Spirit” in its name, Jan wasn’t particularly religious when she started it. That all came later. In fact, the programming at Spirit Works offered a secular counterpoint to the heavy handedness Jan had encountered in mutual support pathways like AA. When Jan discovered CRAFT and the Invitation to Change approach and our book Beyond Addiction, she finally found the tool she needed to offer the kind of alternative care she envisioned for Spirit Works.
Jan: I mean, I’m a Christian, I’m a clergy person, but I don’t think Faith re- recovery or read the Bible over and over and over, there’s- there’s no evidence-based practicing there. I- I guess it continues to enrage me, but bigger than that, I know that it can be different because my experience was different. And compassion and love was what got me well, and has kept me well, and continues to keep me well. And when I encountered Carrie and Beyond Addiction, it just made sense. It was the way that I spoke and I worked, but I didn’t have the language that I do now as a result of- of working with- with Carrie and colleagues.
And I had gone back to school at that point and got an International Master’s of Science degree in Addiction Studies. And I had decided to do so, because it takes about 20 years to go from- from research and science to the community, and people are dying out here. We didn’t- we don’t have 20 years. You know, really then working with families who- whose children were dying or- or were on the verge of dying. So part of it was like, okay, how can we translate this science in a way that makes sense to them and then equip them for their own lives and situations, but equip them to be able to- to get treatment that makes sense for their loved and for themselves.
Carrie: I love that it resonated because part of what we were doing for years was trying to help family members support other family members. A peer-to-peer model, training them in CRAFT, which is this evidence-based approach. And we did that for years and some family members really got it and were able to do it and made sense to them and they were able to run with it. But more often than not, we would have this difficulty of, okay, we’re trying to give you this very effective strategy, but it’s running into all of these cultural ideas about addiction that you’ve soaked up as a lay person, which of course you have. I mean, it’s how people talk about addiction, right? They say all sorts of things like “person has to bottom out before they’re gonna get better.” “All addicts are the same.” “You gotta use tough love.” “You’re codependent if you wanna help them.”
You know, there’s all these phrases that get tossed around that really whitewash and simplify really complex issues. So we were training people in CRAFT and realizing, “ugh, you’re having a hard time picking up this skill, because you’ve got all this other stuff in your head,” so we really have to change and help you shift your perspective and understand the problem through a different lens and so part of the Invitation to Change approach is “Hey, let’s- let’s help with understanding” and really help you understand how those behaviors make sense and be curious about them, instead of instantly judgmental and thinking that they’re a moral issue. It’s actually probably a pretty complex behavioral issue, and let’s try to understand that.
Let’s give people this idea of one size doesn’t fit all and really mean it, and understanding ambivalence that everybody’s- everybody struggles with ambivalence, not just people with substance use problems. But we get mad. We get mad at people, but we all struggle with it. So it’s normal. Let’s work with it.
So we tried to add these concepts that people could readily make sense of, and that would actually help keep them kind of with this shift in their perspective, which, you know, when you say like it really gave you a framework that you could hang on to when you encounter different families and different people and you’re able to say, okay, so this person, their behavior makes sense in X, Y, and Z way, and this family next to them makes sense in a whole bunch of different other ways, you know? So what’s gonna help that person and that family, it’s gonna be completely different. And that’s okay. And I think that’s a really powerful shift for lay people to really hear and grasp, which is your loved one may never seek treatment. In fact, most people don’t. And they can still get better and your family can get better.
Jan: Once Carrie began to recognize the untapped potential of families and communities, it transformed her work as a clinician. She, along with her colleagues, took the powerful components of the CRAFT model and created the Invitation to Change approach, which includes other important evidence-based ideas that support change and made sense to family members. For those of us working in the field, many of these ideas were different from how we were trained to address Substance Use Disorders. I remember, you know, wor- working with- with you and- and hearing that “you don’t have to not experience pain,” and I was like, “what is this lady talking about?”
You know, that pain is normal and natural and 30 some odd years later, I still wasn’t quite convinced of that, you know, but you all taught us to lean into it and it’s like, okay, well it, it really isn’t so bad and that it is a part of- of getting through this. It’s been a game changer for us personally and professionally and I mean, Carrie, I can’t thank you enough. I don’t know what we would do here and the changes that we’re able to make at our center, but then the rippling effect that has gone out as a result of it is pretty amazing.
Carrie: We gotta thank all the smart researchers and clinicians who are toiling away developing these things and rolling them out and doing research on them. But then just bringing it into these communities and giving it to families and then saying, “tell us whether or not this works for you or not.” “Does it make sense to you” and family members being really a part of the process and telling us that, “yeah. Like, we don’t know what to do with that pain. I- I hear what you’re saying. These strategies sound great and my heart is breaking. I don’t know what to do about that.” Or “I try these skills and I can’t do them quite right, and I screw it up all the time and I’m such a bad parent.”
So there’s all this pain that is part of the helping process and we- I feel this as a treatment provider. I mean, there’s times where I’m like, “Ugh, God, I’m the worst therapist on the planet. I can’t help this person.” And you just have to be able to feel that and keep it in perspective and then turn to what you care about, which is, yep, I really wanna help this person. It’s really hard right now, I think I’m not doing such a good job. And I really wanna try to help this person. I’m gonna take care of myself, get myself balanced and organized again, and I’m gonna turn myself back to it when I can. And I think that figuring out what to do with the pain that comes along with helping and the pain that comes along with helping is often because it feels like what I’m doing isn’t working. This person is still suffering, this person is still doing destructive things. That’s a really painful part of the helping process, and we have to help people see that and relate to it in a way that is sustainable and they can take care of themselves in the process. ‘Cause otherwise, if you don’t take care of that pain, that’s when people shut down.
That’s when people give up. That’s when people experience burnout. That’s when people experience their own collapse and there’s so many family members that just are suffering so much because they don’t have any way to take care of that pain. And that’s part of what is in the Invitation to Change model is really just honoring that and then bringing the compassion to it of- we actually need a lot of self-compassion in this process as the helper and- and for the person with the problem that we’re ultimately trying to help, that person’s suffering. They need a lot of compassion, so it’s just we gotta infuse compassion in everything.
Jan: That compassion is what drives this podcast too. Compassion for the families that continue to suffer and who are silenced by the stigma and shame of Substance Use Disorder. Often we hear these stories from the perspective of the person who is using, but the experience the family is going through isn’t recognized. By sharing these conversations, we bring hope and understanding to what can be an incredibly isolating and lonely experience.
Carrie: Part of the reason I think the podcast came to be, was because we realized we needed more time to talk about these things. We needed to be able to have people share their stories and talk about the arc of where things started and where things are now, because it can’t happen in a soundbite. And I do think people are looking for sound bites and they’re looking for these quick fixes. And this podcast and everything we’re doing is trying to give people more permission to tell the full story and really learn from each other and learn about ourselves through listening and connecting with other people who have similar or completely different lived experiences.
Jan and I have very different lived experiences, and here we are deeply connected in work that we both really care about. That’s freaking cool. But I think that being able to connect and share pain, and I think this work is painful. For me, being able to be with that, it’s also what brings all the joy to the work too. Just being able to be fully connected to all of your emotional experience. You can’t shave off one end. You can’t shave off the pain and expect to only find happiness. You actually have to have the whole arc, and I think that’s part of what we’re trying to help people give themselves permission to do.
Jan: For both Carrie and I, learning to process all of our emotions, especially the difficult ones, has been a key part of our healing. As providers, we encounter so much heartbreak, loss, and injustice. It is critical to continually integrate the emotional experience of our daily work. For Carrie, that’s meant learning how to turn her anger and frustration into productive action. For me, that’s meant channeling my self righteousness into community service. When I started Spirit Works, I was not- religion, none of those things were- were a part of who I was. And- and- and then I started, you know, looking at some of the- the literature which grew out of Christianity, especially with- with 12 Steps. And it was like, “oh, this is starting to make some sense” and I wanted to have, you know, additional- additional rules to live by. And so I started exploring, “well, who is this Jesus person?” And-and then it just continued to grow from there and- and I think the recognition that for me, I need something.
This- this higher power, you know, that- that is for me is God, because I can go back to that self righteous place in an instant, you know? What’s wonderful is they call people who are self-righteous, some people call us bigheaded. Others call us visionaries, right? So we- I get paid to be a visionary, which is just a fancy way of saying that I have entitlement issues. But- but that’s okay because I use them for good now.
And, um, somebody asked me yesterday about hope and what keeps me going and- and it’s that I know that it can be better. And even in the hard times and the hard days, I mean, being with these families, it’s- it’s humbling. It’s a privilege. You know, it really just doesn’t get any better than that. And now having family in a different way of my own, it- you know, there’s nothing I wouldn’t do for my kids. So I get it in a way that I’ve never gotten it before. And there’s no need to call these families names, you know, “codependent” or whatever. “You’re enabling.” They’re doing the best they can and-and they love fiercely. And so, we- we need to start giving ’em some credit and some grace.
Carrie: Jan and I love our work. We are hopeful every day and are rewarded by seeing the people we work with make small daily changes and over time, deeply meaningful life changes. We know though, that the journey is hard and that people often lose hope that things can change. We like to end each episode with a question about hope to sustain us in these moments. We all have them. My hope is that people believe us, that people get better and that things can get better. It may not look like you think it’s gonna look when you start the journey, and you may have to be very patient for it to happen, but things get better. And it’s really wonderful to see that happen and to see people make just these significant, profound changes. And I think the overarching desire to bring some kindness and compassion to this discussion and, you know, really wanting people to feel like they can talk about the vulnerability that comes with just trying to change.
Jan: For me, the hope is in connection. It’s in the sense of belonging. One of the things I often talk to people, “I will go to hell and back with you. All’s I ask that you to do is to show up.” So for me that- that piece of “our- our hearts are with you,” is-is along those lines. I know for some people when folks die, it’s almost like a- a condolence, you know, “our hearts are with you.” No. It’s like, “no, our hearts are with you.” “We’re- we’re in here with you.” And- and so I mean it in a very different way.
Carrie: As a treatment provider, when I think big picture, I never wanna talk about treatment. I wanna talk about preventing the problems that are causing the need for treatment in the first place. People use substances and engage in a variety of behaviors, because they change how we feel. They help us cope with trauma, physical pain, emotional distress, and a whole host of other things.
Jan: We need to find ways to prevent that pain from happening in the first place, and that means addressing inequities and injustices in our education, healthcare, and criminal justice systems. Creating meaningful social change is a tall order, and we can aspire to it. We can also work together to bring compassion to people who struggle, instead of shaming and blaming them and their families.
Carrie: Jan and I want to thank our families and the communities that we are part of. We wouldn’t be here without you. I also want to thank everyone in the treatment world who’s contributed to the Invitation to Change approach. There are researchers and clinicians who’ve poured their hearts into it, but even more important, I want to thank the passionate family members who have told us what works for them and what they need.
Jan: I’d like to give a shout out to CMC: Foundation for Change and their generous donors who made this show possible. I also want to thank everyone at Spirit Works, especially the children and families I’ve worked with through the years, as well as express our sincere gratitude to all the guests who have shared their stories this season.
Now, speaking from experience, it’s a bit nerve wracking to tell these kinds of stories into a microphone, but I think it’s worth it. Because these stories can become a powerful source of support for families who are struggling and feel like they’re all alone. We are here to remind you that you are not alone and that there is community out here.
Carrie: Together we heal.
Jan: Our hearts are with you.
Voiceover: Rethinking Rock Bottom is a production of CMC: Foundation for Change. If you’re looking for more support, visit cmcffc.org
