Episode 31: Managing Your Expectations after an Addiction Treatment
Dwight Hurst, CMHC: Welcome back to a podcast to answer your questions on addiction recovery and mental health. By Waismann Method advanced treatment for opioid dependence. I’m your co-host, Dwight Hurst, joined as always by Clare Waismann and David Livingston. We’re here to answer your questions about addiction, recovery, mental health treatment.
Dwight Hurst, CMHC: We have a great topic to talk about today, so our question today is how do we cope with the early days of being sober? And just now as we settle down that question, you, you. We could go right into what you were saying, Clare, about how common that question is and how what feelings kind of attend to that kind of a question.
Clare Waismann, RAS/SUDCC: Yes. Um, you know, the amount of anxiety surrounding that question, you know, not just for the patients themselves, but for loved ones that are feeling so insecure about what to do, how to help and all the above. It should start with expectations. They know expectations of what, what, uh, what to expect from the patient or from even, you know, the treatment, what the treatment had offered and life itself. I’m going to let David keep on going here.
David Livingston, LMFT: No, I do a lot of conference calls with family members when they get home and sometimes even beforehand. And just to kind of to set some expectations about what to do. And one of the first things I say is just listen to each other, you know, whoever’s been detox know, they’ll tell you what they can do if you just talk to them and you and you listen to what they have to say, you’re sensitive to how they’re feeling. Often there’s trouble regulating sleep afterwards, and so that can be difficult. So depending on how they’re feeling, it’ll dictate what they can really do. I think it’s common for there to be sort of ups and downs in terms of energy will be pretty good at times and then it’ll decrease at times in general. You don’t want to push people too much too soon that that can be a condition for increasing frustration and at worst, relapse or other problems. You want to create a runway that’s long enough for them to return and kind of land safely and be OK. So in general, I’d say maybe that’s a place to start.
Dwight Hurst, CMHC: It sounds like you’re kind of trying to shape those expectations in a realistic way as well, then, right? I mean, you’re saying. Because having expectations that are too rigid could be a disaster in this scenario, I would think.
David Livingston, LMFT: People often relapse because life is too much or they don’t feel like they can get things done or or they’re trying to cope in some way. The goal isn’t good coping mechanisms. The goal is and not that we don’t need good coping mechanisms. We do. So let me say that. But the goal isn’t to be coping. The goal is to be living well and to be in touch with our are what we’re capable of and to be able to sort of be attuned in a way in which you’re making adjustments so you can rest when you need to rest and you can get things done when you’re need to do that and so forth. And so just in a general way.
Clare Waismann, RAS/SUDCC: There is some kind of unrealistic expectation of what treatment is as well. You know, I hear a lot of people going home and expecting life to be wonderful and, you know, their partners to sound nicer and to be nicer in life, to be less stressful. So I think, um, understanding the goal of treatment in what you have received and when you go back, you know the benefits of that and everything else you need to work with. Um, in time, they know with time, it’s really, really important. I hear a sense of frustration from everybody. You know what? Why did he not wake up early? Why didn’t go to work? Why does my wife expect me to do this or that? Things that didn’t happen before and just because you went through treatment doesn’t mean it’s going to happen when you get back home, if ever. But if that is something that is bothering you is something you will have to work with regardless if you’ve been through treatment or not. We all need to work on ourselves and on our relations, and, as David said, make our lives as good as possible to live in.
Dwight Hurst, CMHC: It goes with that mentality to say that problems sometimes get all thrown under the addiction umbrella, right? In a way to say, “Oh, you know, if you stop using drugs, if you stop abusing opiates, you stop drinking, you stop. whatever it is, then our problem is solved.” And as we often talk about, you know, addiction is typically a it’s a symptomatic of other problems or it sometimes is even an attempt at a solution for a problem more than it is a problem itself. So when you stabilize that problem, all it does is it opens up the healthy avenues and energy to hopefully healthily resolve the other problems that are there that it was maybe being triggered by in the first place. And I think we over identify exactly what you’re saying, which is, well, you’re you know, and particularly in the early days when it’s not even like a destination, it’s just you’ve started a process. And to say, Oh, well, great, you’ve done the detox, right? You’re not you’re not using the meds anymore. And so we’re good, right? I mean, nobody says it that way, but sometimes that expectation sneaks in, right?
Clare Waismann, RAS/SUDCC: I think that expectation is also, you know, uh, um. Happens because, um, most times, um, family members and the patient themselves will blame addiction for everything, everything in their lives. So once there is treatment, there is a thought that the treatment treated everything that was wrong in everybody’s life that is involved with that person themselves. And I think that is unreal and if there is such large expectations, there will be a failure on every level possible.
Dwight Hurst, CMHC: I wonder if it’s kind of worthwhile for people to talk about those expectations, what they are beforehand. David, it sounds like that’s something that you do with people is maybe try to air out those expectations and say, OK, what are we expecting? That’s unrealistic here? What are we setting ourselves up for here?
David Livingston, LMFT: Whenever possible, I think it helps, because it’s confusing and there’s and there’s hope and there’s, you know, and everybody wants to see people functioning well and doing well. And I think that when we see people active and taking care of things, it puts other family members at ease and they feel like they’re doing well. And it’s not necessarily the case, but it can be. But. So, so you’re right. And that’s why the first thing I say is you talk to each other and listen to each other, you know, because also in a family. So maybe, maybe you know, someone’s partner comes and gets detoxed and they’re, you know, holding down the home and the fort and taking care of everything. And their expectation is, OK, I’m going to get relieved of everything when you get back and you’ve, you know. And so those and you know, and it’s understandable that they would want that. And so it’s parsing those needs and expectations and just kind of trying to create a realistic understanding of what’s possible and, you know, deal with the frustrations and the and it’s just, you know, but that’s an ongoing thing. I think I think one of the important things is that especially when it comes to families or, you know, people in relationships, it’s always an ongoing negotiation of needs. So you’re negotiating each other’s needs based on kind of where the other person’s at, what they can realistically do. And that’s a hard thing. But that goes on forever.
Dwight Hurst, CMHC: Are there things that people do that you’ve seen successfully executed that make people feel really good, like, let’s say someone gets home from detox? Do you ever get that feedback of like, Wow! Here’s what was waiting for me. There’s a warm blanket and a hug. I don’t know. That sounds a little sound, a little overly simplistic the way I just said it. But are there things that you’ve come across in the positive direction where people have had some winds in this area?
Clare Waismann, RAS/SUDCC: I don’t know about David. I see a tremendous amount of, you know, positive feedback, especially how they feel in a relationship, you know, to their kids or to, you know, simple things that could give them, you know, a tremendous amount of pleasure in life. Um. Just not to have that need to speak, you know, the drug or to the concern of where I’m going to get it or what’s going to happen, I think it gives people a sense of relaxation and an ability to enjoy a lot of the things that were around them and they couldn’t see.
Dwight Hurst, CMHC: So if they go with that mentality, then of like, I’m looking for those things, here are those things that I’ve been missing out on. I can start to see those and kind of looking for that as maybe a good mentality to have.
Clare Waismann, RAS/SUDCC: I think in life, looking at the positive, you know, um, you know, blessings we have. Um, and and again, we spoke on off-air a little while ago. You know, things that we know it’s, um, our blessings in our lives, but uh, we kind of see them as things that we should have or, you know, it’s due to us. Um, I think, um. The last two years showed showed us that we shouldn’t rely on anything that should be there or, you know, is due to us and we should be very appreciative of the small things and the blessings that we have around us, you know? And I think once you don’t have the effects of a numbing device like alcohol or opiates or something like this. You are more able to enjoy those simple things, as you know, as almost as a euphoria, you know, of blessings. If that makes any sense.
Dwight Hurst, CMHC: It makes sense to me, I think that sometimes one of the things that happens when we’re trapped in addictive cycles is we miss out on those things and we sometimes think that they don’t apply to us even right. We almost feel like, Oh, I can’t get that enjoyment anymore. And I think that’s a that’s a big mistake that carries over sometimes into getting sober is we somehow think of ourselves as damage to some irreparable point. No, you know, no one will ever forgive me. Do you do you find that people underestimate how much the people in their lives want to forgive them or work with them? I mean, kids, you know, kids usually and close loved ones, oftentimes more than we think really want reconciliation and reconnection.
Clare Waismann, RAS/SUDCC: I think there’s less of an expectation of from kids. All they want is to be loved and want you to be there for them. So I think that’s why I brought up kids before. I think it’s it’s just easier. It’s that first really natural, you know, light connection.
David Livingston, LMFT: But that’s I mean, I people talk so much about the messages they’re getting from loved ones or friends when they’re here and they talk about who hasn’t contacted them and supported them, it’s so important to just even send a, you know, a message like, I’m thinking of you and wishing you the best. And you know, and I think it really helps the process of getting better. I think it helps the return for everyone and like you’re both talking about the gratitude and the feeling of being supported during a difficult time. You know, there’s a desire to sort of return and repay people and be there for them. And there’s a good feeling that that is created. And you know, when people are talking about that, if I’m doing a conference call, one of the first things I always do when they’ve been telling me, yeah, getting all the support from my families, the first things I always do is say, you know, is is say, you know, such and such is so been so grateful for all the support you’ve been giving them. It’s meant so much, and it’s helped them in their treatment and so forth. And I just want to let you know that’s been, you know, I’ve been hearing about it and how important that is because it’s critical that that whole process starts to get reinstated as you’re both talking about. And probably I focus at times on, you know, the things that are wrong in these conversations. But the other side of it is probably as important and maybe even more important that, you know, there’s just the support and just the feeling that there are people you know who’ve got your back and care about you is so, so important.
Dwight Hurst, CMHC: I like that you’re taking a minute then to highlight it. And it’s also good reinforcement. I mean, if you look at it, not to be the guy to take down the nuts and bolts of a really just like beautiful interaction, but to say it also reinforces it right? That behavior modification, we tend to do things more if they’re rewarded or reinforced. And I think by stopping to highlight and say, Hey, what you’re doing is really helping. They told me it was and they’re in a bad place right now. They wouldn’t say that unless it really was. It’s like, Wow, that feels good. That’s like a little bit of a reward and also helps me know I’m on the right direction because many times her loved ones, what we really want is I want to do something effective. I want to do something that’s going to actually help my loved one in their treatment and we get so much. We’ve done episodes where we’ve talked about this, about some of the problems with the language we use with enabling or codependent, or it’s all so poorly defined. And I think it is important to do what you’re describing, which is to take a minute and take a minute and explain to people exactly what they’re doing. That is healthy, you know, very I think that’s very powerful.
David Livingston, LMFT: No question. It’s you know, and so, you know, in fact, it might be the most useful part of the whole thing because really what they want to know and need to understand is how they can support each other. And, you know, and how the person coming home can be supportive to and help them understand and how they can talk to each other and really like you’re both talking about, you know, create it, move it, move it into a different type of process where there’s a feeling of, you know, we’re OK. We’re I’m back home and like, how can we do everything better for each other?
David Livingston, LMFT: Absolutely. And it triggers more of that communication too, it’s good modeling for the person to know that they can talk about that. I think that in some cases, some people are really naturally good at this and some just aren’t talking about things openly that are uncomfortable to talk about is obviously one of the first ways to heal or fix anything when it comes to relationship issues, right? But some people are like, Well, I don’t want to mention something that’s going to make you feel bad. Well, I don’t want to mention someone’s going to make you feel bad either. And so we just never mention anything. When we’re talking about this kind of thing, we sometimes have to be willing to make that a little bit a step to say, Hey, this makes us both uncomfortable. Why don’t we talk about it for just a minute? And if we’re approaching it and we know that the goal is some kind of healing or that we’re trying to encourage success, then I think it becomes easier to talk about things. I’m talking about things as a sort of a project management perspective, as a team, as a family. Those kinds of things can. I think that’s one of the early steps that can set up people for tremendous success. Or I guess if they don’t, it sets them up the other direction for relapse and struggles, you know?
Clare Waismann, RAS/SUDCC: I think learning how to communicate is much more complicated than just communicating. You know, it’s, uh, where people are coming from, you know, um, their frustration levels, their reasons for communicating, how they’re communicating. I mean, there’s so much past and history on, you know, every sentence. It’s not that simple and it’s a process. It’s it’s a healing process, I think not just for the person, but you know, just how to learn to, grow that relationship in a way that is healthy for everybody involved. So, yeah, learning to communicate. I think you have to take a lot of stones from that, you know, from the weight of that communication in order to make it, um, at least for the person that just became drug-free or substance-free for them to be able to respond in an effective way, in a productive way. I think a lot of weight has to be taken off that conversation. It has to be light, at least in the beginning.
Dwight Hurst, CMHC: One huge part of a relationship is being able to have like meaningful work-throughs when it comes to like big problems and hefty things and setting goals and life plans. But if you think of it, at least half, if not more of what we want from a relationship is to enjoy being in the relationship for a certain amount of time. We may want to say the serious conversations in the very early days. We may need to determine that some of that needs to be on hold for a minute. And I don’t know, I have mixed feelings on this. This is probably topic for a whole nother show, but when you get people that get into court-ordered treatment or they get into criminal charges, one of the really big problems with that a lot of times is that they have to deal with big, hefty decisions while at the same time terminating their unhealthy coping skills at the same exact time. So I’ve got to be talking to a lawyer or making legal decisions or looking at how my life’s impacted practically and making those huge decisions, while at the same time ostensibly getting off the drugs right now and it is not conducive. It’d be much better if we could say, let’s do some treatment for a while and then worry about major life decisions.
Clare Waismann, RAS/SUDCC: But that’s not. But that’s what we did. That’s what we spoke in the beginning is the expectations. Yeah. So the court is expecting a person that has not been able to make, you know, healthy decisions for a long time to suddenly make all the right decisions for their lifetime. Legally, you know, emotionally, health-wise, everything. So obviously, those expectations are not going to be met, right? So it’s um, what what should you expect of, you know, again, treatment of which treatment? Is it a physical detox, what you expect from psychological treatment, what you expect, you know, from social assistance, I mean, is it’s there are several factors that cannot be included under one umbrella because that doesn’t work. I mean, patients, you know, we hear all the time parents asking, how much therapy are they going to get at Domus, that’s our aftercare. Are they going to be assessed for psychiatric issues and they want everything to be solved and that week over there? And we often tell them it’s, you know, there’s a reason why people use substances because they can’t handle too much, so you can’t just remove it, then just throw everything at them, because now you’re giving them a reason to go back. We have to be really, really honest with ourselves and with families and patients of what we are providing and what is our ability to provide not overextend, you know, because absolutely everybody wants to help everybody as much as they can and give you the know as many solutions as we can, but we cannot. We have to be very aware of our limitations so others don’t feel like they failed.
David Livingston, LMFT: The development of a life. You don’t. You don’t think that somebody goes and takes, you know, four or five classes in something and or takes, you know, goes to take four or five classes and playing the flute and they’re going to walk out, you know, completely competent and, you know, Virtuosa, but the feeling is like at times the expectation is as things have been solved and. Um, I think like you’re both saying, it’s it is an ongoing process, it’s a beginning and there can be some real understanding and insight. And a course can be set that people feel and believe in. I think that’s if that happens it’s been a hugely successful treatment for what it is, but that’s an ongoing thing. And. I think the thing that surprises me so much is that and maybe that’s why we’re all talking about it is that that doesn’t seem to be the normal perspective. It’s the normal perspective as you go away and then you’re done and that you’ve solved it. And that is really, you know, and not always, but really, you’ve got to get into ongoing treatment because your needs and the difficulties of the world and everything else just continues and continues and continues, you’ve got to be working on it, you know, for everybody in some way, you, you know, you get to decide how you want to do that, but you know, challenges come.
Dwight Hurst, CMHC: I wonder what you think of. There’s a sort of commonality of thought that people talk about a lot, which is trying to avoid not only major life decisions during the first while of becoming sober, but also even avoiding new life situations, if possible, as much as possible. For example, I have a friend of mine who’s a nurse practitioner who does prescriptions for mostly for psychiatric conditions, and he’s been through recovery process and helped a lot of people with addiction. And he always says, you know, they say you shouldn’t date anybody for a year after getting sober. And he said, I don’t know about that. But he said, I will say that during the first first six months of being sober, I don’t even suggest anybody buy a new plant for their house. So if you look at that and say there’s this feeling of be careful in the first steps not to change your life too dramatically before you have landed on your feet securely. And I know, you know, none of us, none of the three of us are big fans of making general blanket statements about what everyone…
Clare Waismann, RAS/SUDCC: That’s where I was going right now.
Dwight Hurst, CMHC: And so that’s where that’s why I wanted to bring it up and see what people think about this.
Clare Waismann, RAS/SUDCC: I think general statements or radical statements are as damaging. So yes, you can buy a plant and maybe you’re going to hate the plant. Yeah, give it to your neighbor. Uh, so um, I think a general statement is, um. Not healthy, but I think radical statements are even unhealthier, right?
Dwight Hurst, CMHC: Yeah, reinforcing that kind of doubling down on that process, right?
Clare Waismann, RAS/SUDCC: Even David said something right now, that, uh, you know, ongoing treatment. I think the word ongoing treatment makes people hopeless of what’s the point of going to treatment if I’m going to have a lifetime of treatment? I don’t think it’s necessarily, um, you know, ongoing treatment forever. I think we have to work on ourselves, the rest of our lives, period. We have to better ourselves. We’ve got to make ourselves healthier. But it doesn’t mean you have to be in treatment, you know, forever. And if you could clarify that, I think it’s just going to help people reach out for treatment.
David Livingston, LMFT: Yeah, it’s not that like nobody, nobody is. In ongoing treatment forever and but. Um, you know, and people get to decide what they need, and some people don’t need for, you know, necessarily ongoing treatment, and some people do need help with it because there are things that they just need to work on more. So it depends, but I think the idea is what you just said is that we have to work on our lives and develop ourselves if we want our lives to develop forever. And, you know, to some degree, and it doesn’t mean that you have to be in anything specifically if you don’t want to. So I’m not suggesting that, but I’m saying that as a way of keeping an open mind that, you know, and in terms of figuring out what you need. So. You need it. It’s a possibility if you’re having trouble sleeping or, you know, you’ve got a history of sleep issues, and that’s a big problem. Go and get some help figuring that out, right? Don’t just assume that. So it’s sometimes the thing that you’re dealing with that’s been most painful is I spoke with someone just recently and they were saying like, the worst thing for me is to not have anything to do or be alone. And and if loneliness and sort of boredom is the thing that is most painful and there’s a history of reasons for that, then not getting a plant and not get, you know, and not seeing other people or getting in a relationship may not be the right thing.
Dwight Hurst, CMHC: The worst thing, right? Terrible idea.
David Livingston, LMFT: Right, right. But make sure it’s the right person, right? You don’t want the loneliness to drive you into something that’s not right for you or not good for you, or be with somebody who’s you know doesn’t know how to support you in the way you need. So there’s a parsing even of that need, you know, to make sure that it’s, you know, some something that’s healthy. So, but yes.
Dwight Hurst, CMHC: Well, and it is something that I think gets wrapped up in the idea of a broken person to say that, OK, now you know you’re working on some treatment stuff, but you know, don’t think you can go making decisions about your life. So the flip of that, the reverse of that and is kind of what we’re saying is instead of maybe taking a mentality that in the early days of my own recovery and treatment rather than say, I’ve got to be super careful, I don’t screw up everything. Maybe I should be looking at it more of like, Oh, actually, I should try to trust and have some confidence that I am a capable person.
Clare Waismann, RAS/SUDCC: And I think, uh oh, also capable person of bettering yourself in every aspect of your life. So it doesn’t mean that addiction should be it, and we’ll solve everything. So I think if we take a lighter approach to treatment, the expectations of what’s going to happen after treatment are going to be more attainable. So I’m going to better not just, you know, uh, my health of not using, uh, you know, illicit drugs or too many drugs or but I’m going to eat better, I’m going to try to exercise so I can sleep better. Um, I’m going to have I try to have, you know, um, a more productive life so I can feel better about myself. And again, it doesn’t need to all happen in the first week. It’s just I think it’s an attitude. It’s a goal. You know, what is the story of the, you know, the people that start it starts a diet that every Monday. I’m going to get into a diet because I’m going to lose weight. You know, it’s so if you keep saying you just want to lose weight, you usually are not going to be able to lose weight. But you know, I’m going to start, you know, eating healthier because I want to be healthier and I don’t want to have all the health issues of being overweight. That’s a different story. So I think is on that overall attitude that curbs expectations. And it is so much wider.
Dwight Hurst, CMHC: Yeah, yeah, it’s kind of like a more positively stated goal. What do I want to add and bring into my life rather than what do I want to eliminate? Such an automatic trap to fall into with addiction. Because if I’m using illicit drugs or using drugs, you know, abusing them, I want to stop abusing them. Of course, I do. But then that becomes enveloping and we focus too much on that being. Essentially, that is a goal of take away a thing rather than add a thing. And adding a thing is always more motivational too.
Clare Waismann, RAS/SUDCC: And again, you’re not adding a thing. You’re adding so many things, you know, you’re adding the ability to feel pleasure to several things that surround you that you don’t even know they’re there.
Dwight Hurst, CMHC: Thank you for being here so much. Please go and rate and review this podcast on your podcatcher of choice. We really appreciated it helps in certain ways to spread the message. There are algorithms and things that help people to find podcasts that have higher ratings. If you would like to share your questions with us so that we can talk about them on the show. Please go on Twitter @opiates or email us anytime at [email protected] Our show is brought to you, of course, by Waismann Method Advanced Treatment for Opioids and Rapid Detox Center. Our music is the song Medical by Clean Mind Sounds. For Clare Waismann and David Livingston. I’ve been to Dwight Hurst joining you today. Our show is produced by Popped Collar Productions, a company that will help you to set up your podcast as well. Until we’re here again with you, please make sure to keep asking questions, because if you’re able to ask questions, then you’ll be able to find answers. And if you can find answers, you can always find hope. Bye-bye for now. Be safe.
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