With so many crises happening in the world, it can be easy to feel overwhelmed. Stress overload, emotional fatigue, and hopelessness can be huge triggers for substance abuse and relapse to symptoms of dependence. Clare Waismann, RAS/SUDCC and David Livingston, LMFT discuss the emotional and psychological impact of exposure to crisis-related trauma, and ways to process these feelings in a healthy way.
Dwight Hurst, LPC: Hello, everyone, and welcome back to Addiction, Recovery and Mental Health, a podcast by Waismann Method Opioid Treatment Specialists. I’m your host, Dwight Hurst. You may have noticed either visually or just now, as I said it, that we have a new name for the show. We’re always tweaking the ways that we make the show and the way that we describe it and label it so that it can get out there and be a little bit easier for you to find, for you to share and for you to love. I mean, you might say that we’re already pretty easy to love. And speaking of lovable, I’m joined today by Clare Waismann and David Livingston to talk about another fascinating subject in the world of addiction and recovery. Essentially the deadly effects of multiple crises is the title for today of our topic. And with all the things that have been going on in the world with the war and of course, coming into the out of or hopefully out of the pandemic times and just basically everything that we’re bombarded with and hearing about all the time, there’s been so many effects in the way that interacts with addiction and the way people are coping. One of the things that prompted this, it sounds like, Clare, you here at Waismann, we’ve seen a real decline in the number of people that are calling to seek treatment or even just calling for information, right?
Clare Waismann, RAS/SUDCC: Correct. So I was thinking, you know, the last two, three weeks, there has been a decline, not just on the phone calls, but on people researching the Internet for treatment, period. And, you know, I start thinking about all the reasons, you know, this could be happening. And my thought was, you know, we’re just coming out of COVID. People had a bit of a light to follow. There was some hope. And suddenly the whole world, you know, fall into another crisis, a crisis of start with gasoline prices that became a financial crisis, a crisis of inflation, and now the Ukraine war. That is something that I think any human being watching on TV is beyond, something that we should be able to handle, not just living through it, but just looking at it. So I think it gives people such instability, mental health instability. It takes away hope, it makes the unknown feel so scary. So there’s fear of. What tomorrow might be if there is a tomorrow. And, you know, how vulnerable are we as human beings? You know, the value of life, all the above. The second thing that I was thinking is, well, unfortunately, because we’re going from one crisis to another crisis, the media itself put the fentanyl crisis and the overdose, those crises. Truth is, people are dying at rapid, rapid rates also in this country because of fentanyl and the overdose, the overdose crisis, the last three weeks have been forgotten, though it’s a combination of factors that is leading to a lot of deaths, unnecessary, preventable deaths.
Dwight Hurst, LPC: And you know, you also see where if we get into general and generally accepted relapse triggers, we have a lot of those that you’re talking about, financial crisis. That’s a huge trigger for people, you know, uncertainty. And there’s kind of a general trigger for people when it feels like the world is going to hell or it feels like there’s no hope. Well, why not get high? I mean, just that’s what I hear very simplistically. But a lot of times that that can be a trigger for trouble in relationships or for career problems. And by the way, career problems, there’s another trigger that’s happening to a lot of people right now, which ties in with finances and with everything getting more expensive. So there’s relapse triggers at the same time where we have the most dangerous types of opiates out there in types of drugs.
Clare Waismann, RAS/SUDCC: It’s it’s a combination of factors going on. At the same time, you know, that creates, you know, the perfect tragic moment. I mean, it’s, you know, a combination of crises creating a much bigger crisis. And I think I agree with everything you said other than, you know, just wanting to get high. I think it’s it’s not that simple. It’s most people that use substances if it’s drugs or alcohol or people that have usually high levels of fear or anxiety and very few tools to handle it.
Dwight Hurst, LPC: More of self-medication, I guess not. Yeah. I was being a bit reductive when I said.
Clare Waismann, RAS/SUDCC: That and I and I think the situation in the world right now affects everybody on so many different levels that people that already have a hard time dealing with just the day-to-day stresses are just unable to, you know, go forward at this point. And they are not seeking treatment or help because they just don’t believe they can handle life and life’s terms right now. It’s just too much. I think it’s too much for people that don’t have mental health issues. I can imagine, you know, for those that do.
Dwight Hurst, LPC: And I know this is something that some people are finally talking about a little bit more, but I feel like if not a full diagnosis of PTSD, many, if not most of us are walking around with some level of trauma. And so even though maybe haven’t had mental health issues before, trauma is a mental health issue. It’s an anxiety related issue and disorder if it’s full blown.
Clare Waismann, RAS/SUDCC: Listen, just looking at the Ukraine war, pictures could cause anybody trauma. Well, I mean, pictures that you cannot erase from your mind ever.
David Livingston, LMFT: Which then begs the question, you know, how much should we be looking and listening? Our emotional life can’t distinguish the difference between fantasy and reality. So when we hear or see something, the emotional response is an automatic process. And because it’s an automatic process, part of our responsibility in taking care of our mental health is understanding how much stimulation, particularly traumatic stimulation is good for us. And I can tell you for myself and I’ve had this conversation with a lot of people, you know, that what I hear in response is, well, I want to be informed. And my response is, I understand. I understand that. But you also and more importantly, want to be healthy. And I know my own nervous system has limits to what it can handle. And I’ve got in my own life and work and everything, I have enough responsibilities enough to handle that. I do not listen to or watch much news. I know what’s happening. I don’t need to know or see the details of it. And I know it’s happening, but it isn’t good for me to see much of that. And I think that you know, I think prioritizing and it kind of goes back to the beginning of what you started with Clare is that we have to remember what we have control over and what we can do to stay healthy. And if we’re struggling, if you’re struggling with, you know, opioids or other things, that’s far more important. And, you know, and to stay connected to the things that we have some ability to affect. And, you know, and I think people should minimize and really consider, unless there’s some reason how much of, you know, particularly the news these days you’re watching.
Dwight Hurst, LPC: Sort of moderating our consumption.
David Livingston, LMFT: Big time. Right. It’s built to shock you. And the whole tone of it is is is such you know, it can become addictive. You know, again, our emotional lives can’t distinguish the difference between fantasy and reality. Intellectually, we know the difference. So we can think it through and say, well, that’s not happening to me. But if you see things like you’re saying, Clare, or you hear things, you still have an emotional response that can ramp up your anxiety.
Clare Waismann, RAS/SUDCC: But I think, again, you are probably speaking specifically of, you know, the Ukraine war and the Ukraine pictures as I gave as an example. But that is not all the crisis that is existing right now. So we just again, went through, you know, COVID and we were coming out of it. And again, you know, there are people with financial issues. There are people that have to change their jobs now because there are people that are having a hard time dealing with inflation. When you say, you know about the war itself, and I understand and trust me, I think the media causes panic and stress that is beyond what is healthy for the public. And I think they should have a limit of how much of that they can do as well.
Dwight Hurst, LPC: There’s a real issue with information becoming a product. My dad used to work for a newspaper when I was a kid. It was a weekly local newspaper and so he’s always been a news junkie. But I remember it was when I was a kid somewhere in there, the teenager where the 24-hour news cycle became a thing on cable news. And I remember him talking about that and saying, like, everything now is a breaking story because you’ve got to scoop the next channel. And now that there are 50 million and all 24 hours, seven news channels and online, you know, I just remember him predicting that and saying, like, they’re going to need to manufacture or repeat rather the same things over and over and over. And so there are those of us who who benefit from knowing a certain amount. Right. There’s a different threshold for different people saying, I feel a little better if I know something. Some are a little better if they tune out, some are a little better if they know a lot. And we have to judge who we are. But but watching the same story repeated within a two or three-hour period becomes problematic. I think it’s like here we got to keep this product fresh and every story is a breaking news story. Whereas I remember that used to be very, very rare to say breaking news. It was only when something new happened.
Clare Waismann, RAS/SUDCC: It’s true. It’s true. When we were young, breaking news was really breaking news. Now, breaking news is whatever the news is going to talk about that moment, you’re absolutely right.
Dwight Hurst, LPC: It was big enough to interrupt cartoons and be annoying to a little child.
Clare Waismann, RAS/SUDCC: It was big we could trust. It was really big. You’re right. And again and we have our, you know, smartphones that are, you know, constantly updating us on whatever they want to update us on. That is constant information as well. That also creates a certain level of anxiety.
Dwight Hurst, LPC: And so what are some of the things, David, you mentioned limiting our consumption with information to to whatever is the healthy threshold. What are other things that we can do to try to survive this in a healthy way to say, well, there is a lot of crisis, there is a lot of reporting of it, there’s a lot of knowledge of it. You know, what are some ways we can approach that, either cognitively or things we can do any ideas?
David Livingston, LMFT: I think it’s it’s to pay attention. I think part of what Clare is bringing up and you know, and noticing there’s probably not a downturn in the epidemic that’s going on in terms of opioid use and overdose. And yet when you start to see that that attention is being drawn away from things that can be profoundly dangerous, you know, because there’s other stuff going on that’s worth considering, is are you paying attention to the things that matter most in your life?
Clare Waismann, RAS/SUDCC: And I think what you said too, David, that is important, paying attention to the things that you have control. So getting, getting, getting well is something you have control over. And, you know, the inflation and the gas prices and the crisis in Ukraine and COVID in China, all those things are things that are way beyond your control. But I think, you know, if somebody is doing something positive and, you know, keep on being productive, you know. On seeking a healthier way of living. Whatever that is within the situation we’re leaving is going to make somebody feel better as well because it will give them a sense of control somewhere in some level in their lives.
Dwight Hurst, LPC: Yeah, I’ve noticed that even just doing something like sitting down and writing a list, if it’s like here on this piece of paper, I’m going to write all the things going on that I’m worried about that I cannot control over here. I’m going to write down anything that I can control or that I can do something about. Even just categorizing them, even without doing anything yet sometimes starts us on the path towards feeling more in control of our lives or a little bit better.
Clare Waismann, RAS/SUDCC: Also, it is not like, you know, people overdosing is something that is just being forgotten and not going away is something that in the moment of crisis like this is actually increasing. You know, overdoses become much more, people get much higher, you know, uses use a lot more. So it actually, you know, evolves very fast. Yeah. This is a good time right now for us to help people, you know, do things that are not taking them to the next level of risk.
David Livingston, LMFT: Right. Right. That when things are when there are problems you don’t want, it’s easy to take a more fatalistic approach, like what’s you know and feel like the world is out of control with. The reality also is that it doesn’t help me to live in a state of panic or distress and it doesn’t help anybody else. And but so take care of the things you can. And there is an opioid epidemic still going on in this country that’s costing lives every day. And so let’s stay focused on the things we can do something about.
Dwight Hurst, LPC: And action, of course, action is a form of self-care, right? If we can find something that we can do that’s healthy to do, then that’s it’s sort of what we’re trying to do then is satisfy in a healthy way the same part of us that self-medicate. I believe the self-medication dynamic is often a result of feeling out of control and I need to do something. So if we can find anything that we can do, even if it’s small in a healthy way, even if it’s I can share a tweet about here’s a tweet or something that somebody posted about maybe a helpful charity that could benefit people in Ukraine or maybe something about the epidemic and something about seeking treatment. And I can forward that if that’s all I can think of to do today. That little bit of action will sometimes make me feel a little bit better, and sometimes that’s enough to stay on a healthy path.
Clare Waismann, RAS/SUDCC: I 1,000% agree with you. There are so many little things that we can do, you know, throughout the day, throughout the week that makes us feel, you know, that we help, even if it’s a tiny little bit. We put a smile on somebody’s face that read that tweet and, you know, gave them a little hope just for that second. So I think, yeah, using social media, you know, to almost combat what the big social media is, you know, providing us with all the anxiety and stress and giving back hope and words of encouragement, I think it’s actually a great idea.
Dwight Hurst, LPC: I wanted to ask David something and really for all of us. But David, when you’re doing therapy with people, are you an advocate of like mindfulness like that? Live in the present? It reminded me of that, of what you were saying about my day-to-day life and focusing on how it hasn’t changed and trying to keep the normal. Do you talk a lot about that, that present focus thinking?
David Livingston, LMFT: I’m a big fan of mindfulness in general. I think it has. It’s a type of that under stress, the ability to kind of move into a process level inside yourself and in the world and just stay really focused and stay embodied. Is is something that we should all develop in ourselves because it there are times that it’s. It’s probably the best type of consciousness to live in. It’s only one perspective. It’s it’s valid. It’s a valid perspective for what it is. It’s a limited perspective because it doesn’t necessarily address other things that, you know, that are necessary to live effectively in the world to in terms of relationships and other things. But. But in terms of a strategy, when you’re overwhelmed, the ability to sort of stay mindful and notice the, you know, the process and be able to have sort of an observing ego that can allow things to kind of unfold without getting too entangled in it is a great skill. We should all be developing that at some point.
Dwight Hurst, LPC: And I feel like that there are ways to bring future planning or consequence-based thinking into a mindful attitude. It’s to me one of the big elements of mindfulness is that we do it purposefully. If it’s like, okay, I want to worry, I am worrying about the future, I can try to distract myself to the present and get involved in something here and now. Or if I’m worried about the future, maybe I need to sit down and say if I’m choosing to worry about it, let me set an amount of time and actually do it on purpose and try to do something with it. I think that’s still mindful. You know, if we do it, if we do it on purpose instead of just being prey to the anxiety.
David Livingston, LMFT: Yes, that’s I like the way you put that, because like you’re saying, I think that we’re kind of talking about is that you’ve got to take some responsibility for your own life always. Does it matter what’s going on and that we’re all better off. And actually, it helps the world. You know, the more we take care of ourselves and the more that we’re handling things well and doing well, it helps not only ourselves but the people around us. And so, like you’re saying, that’s a good strategy, you know, and especially at times like this, where there’s so many different things happening.
Clare Waismann, RAS/SUDCC: Taking responsibility, if you’re concerned about the world, definitely will make a better world. Taking responsibility for your own health and well-being and those around you. It’s always a nice way to look at it. David on not just being able to control your life, but to make better the lives around you.
Dwight Hurst, LPC: That’s interesting to think of it as a relationship type of thing, too. I wonder if one of the forms of action we can take is to say, you know, I can look around me in my own circle and say, can I invite people in my family or friend group to maybe spend some time together, make a phone call, talk, do something. You know, especially as it’s becoming hopeful, I’m going to say hopefully, you know, I’m not giving anyone out there medical advice, but it’s becoming a little safer to be around each other with vaccines or whatever. And just as you’re having a little more chance to have an experience together and say, you know, maybe we just have dinner with a branch of our family or a friend and maybe we, you know, have a game night or something that we’re doing to remind ourselves that with all the bad in the world, there’s some good, too. And you can look at that as an act of service to help include those you love and care about. But then you’re also benefiting from it, too.
Dwight Hurst, LPC: And we’re going to leave it there for today. Thank you so much for being here today. This show is a product of the Waismann Method Opioid Treatment Specialists. You can learn more about the work we do at www.opiates.com or follow us on Twitter @opiates. We’d love to hear from you as well to know what kinds of questions you’d like us to address on the show. Email us at [email protected] The music for this and all of our episodes is the song Medical by Clean Mind Sounds. This show is produced by Popped Collar Productions, a company that helps you to set up and maintain your podcast. For David Livingston and Clare Waismann. I’ve been Dwight Hurst and just reminding you once again to continue asking questions as you face these things out there in your life of addiction, recovery and mental health issues. If you’re asking questions, you’re closer to finding answers. And if you find answers, you can find hope. Thanks again for listening. We’ll see you again soon.