Dwight Hurst, CMHC: I’m talking you’re listening. You’re listening and I’m talking. That’s how this works. If you weren’t listening and I was just talking, that wouldn’t be a podcast so much as it would be a guy talking if you were listening. And I wasn’t talking. You’d have nothing to listen to. And we still wouldn’t have a show. If you refuse to listen, I refuse to talk, then we don’t have anything at all. If we come together, though, we are having a healthy dependence to help make the show happen. That’s the only way that a podcast or any other type of program can possibly exist is if we have a healthy dependence and reliance upon each other. Well, that’s what we’re going to talk about today.
Today’s recording found me, Dwight and David Livingston together talking about the healthy role that dependence can play in healing from addiction and developing sobriety from opiate dependence. David has a lot of really interesting things to say about this and how a healthy vulnerability and healthy dependence can really play a role in becoming more healthy.
So we’re going to discuss that. And depending on how it goes, you might find yourself more healthy at the end. Or more dependent? Put in a good way. Well, you’ll see what I mean.
David Livingston, LMFT: From my perspective, just to boil it down a little bit. Ultimately needs drives everything. And that turns out to be in some ways simple and other ways seemingly complex. And so if you think about it in terms of needs. Right. So if you begin with a baby. Right? So you get a baby who’s in distress and their needs are pretty basic. They need to be held changed, fed, you know, played wth, stimulated in some way. And their needs at that point are really basic and the parents need to see, you know, are they hungry? Do they need to be changed? Do they need to be held and do they need to sleep? But they’re pretty basic needs. And as we get older and leave and go through stages, our needs become more diverse. So most distress, though, has to do with people not getting their needs met. So if you look at a baby as kind of a template of that, what you’ll see is people come in with anxiety and depression. And so you begin to sort of figure out what is it that’s not met? What needs are overlooked, what needs are not happening? And what happens is when you can articulate it and begin to help them understand what it is, which is always a need to be understood. So first aid the baby has is a scene. Can somebody actually see what I need? And once there’s actually a treatment that starts to happen, there’s a movement. You’ll see the distress go down almost immediately. And you can just articulate what the need is. And then you can begin to sort of parse as a beginning and say, “That that’s how I approach it”.
Dwight Hurst, CMHC: A baby in need is really one of the more abrasive sounds, if you will. I’m not calling the baby embrace of the baby’s cries. In fact, we’re evolved to feel that way. When we hear a baby cry, we’re supposed to be turned off by that enough that we want to do something to help. Right? That’s that’s. I think. I think that’s it. It reminds me of a therapist I worked with a long time ago who would talk about that in terms of. He’d say that our emotions inside of us were often like a nursery of like newborn babies. And when we hear a cry over here, do they need something, some just loving attention? Do they need something to eat? Do they need a diaper change? Is there a discomfort? And how if you go to that baby and you write the situation, it seems if you’ve never seen a baby before, it would seem like a miracle. Worst noise in the world, the worst crisis in the world. Now it’s fine. And if we have all these emotions inside us, they’re like these little crying babies. If we feed them and we help them. I like the way you put that, that it starts to feel better almost right away.
David Livingston, LMFT: Right. Right. One of our most basic needs is to is just to be understood and heard well. And when that happens and I think this has a lot to do with people who struggle with chemical dependency, that there are deficits. And often, you know, conflicts around what it means to have their dependency needs met. And culturally, I take we don’t. We were such an independently oriented culture.
David Livingston, LMFT: And, you know, independence matters. You have to grow up and be able to take responsibility and manage things on your own. So it’s it’s not binary. But the ability to have healthy dependency is is essential to being a healthy and strong human being. And I think, you know, so I think what happens is when someone feels really well seen and heard and you can articulate that in a way, immediately, they begin to relax and feel like, you know, that need is getting met. And there’s something therapeutic in that, you know, immediately. So it’s a starting place.
Dwight Hurst, CMHC: We never really get over the need for other people, but sometimes I think the maybe a misinterpretation of what it means to be independent. I think that often sets us up for lots of negative experiences because we then will invest in a kind of independence that is essentially unhealthy. Where I should take care of everything myself. And I feel like that’s very connected to the addiction model and addictive or compulsive influences in our life. Right. As if no one’s going to meet my needs or if I have to meet all of them myself or heaven forbid, if I really embrace both of those and that’s internalized inside of me, then I’m going to go to whatever means I need to to make sure that I don’t hurt or to make sure that I feel OK. And if I can’t network well with other people for that, I’m going to manage it myself.
David Livingston, LMFT: The four things that are present at the end of successful therapy is you have success at work, success in your relationships, you have the capacity to play and you can accept your dependence needs. And if you think of the verbiage about laughs, you can accept your dependency moves. It’s a need like hunger’s move, right. It doesn’t disappear to just to, you know, speak to what you’re saying. It doesn’t disappear. It’s an ongoing need in order to be healthy. We come out into the world with that need and we lead the world with that need. And the people who can accomplish those four things have, I think, the potential for a happy and meaningful life. And, you know, which it’s basic and in a sense, but it’s also what you get into the complexity of what it takes for those things. There’s a lot that goes into it. But I’d like to sort of start with a template of what it might look like.
Dwight Hurst, CMHC: That’s really interesting four areas. You say and you brought this, talked a little bit about this before and some of our other shows that work relationships, a sense of play and pleasure. And then also accepting our dependency need. Each one of those is very deep in a way. In fact, that would be an interesting four ways for any of us to measure our own health and say, how am I doing in those four areas? Because, you know, you think about that, that covers your career, covers your family, covers your relationship with your children, if you have any, or friendships, the kinds of things that make life enjoyable. It kind of feels to me like that last one is in some ways, our dependency needs are kind of the glue for the other three in a way, aren’t they?
David Livingston, LMFT: I think that’s it. It’s things like people here in therapy a lot. Is that their dependency needs are so… It’s a confusing place. One of the things that you’ll see in therapy when it’s going well is you’ll see that there’s a period where the therapist and the client are getting to know each other. I mean, you’ll see at a certain point in time that there’s a relaxation and that a lot of what’s been in the background for the clients starts to move to the foreground and get digested and understood. And you start to see a type of relaxation in relatedness. And in that kind of sets the tone because it’s it’s playful. The relationship starts to take a different depth where, you know, you feel like you know each other in a different way. And so it begins to be a template for success at work because you have to be able to relate on multiple levels with people to play. You have to be able to relate in different ways. Like you’re saying, they all kind of are intertwined. Dependency is, as you pointed out, is kind of the glue of all of them.
Dwight Hurst, CMHC: It’s a big balancing act, isn’t it? Because I’m just thinking of the therapy relationship and particularly you bring up you want to have the independence of the person being able to take care of their needs. Not being overly dependent on the therapy relationship or the therapist. But at the same time, you also want there to be vulnerability to say I am here to get help. And I guess then on the other side of the room, so to speak. You’ve got a therapist who they’re contributing with. They’re contributing independently with their own boundaries. But then to also be honest with the client, to say, I can’t actually help you or do these things for you, and I can do very little without your own expertise and investment in the process as the client. So, you know, you’ve got this two-way balancing act of appreciating dependents needs and having those independent matters at the same time.
Dwight Hurst, CMHC: You put out really well. I see my work as kind of an art. You know, everybody is trying to solve it through science. And certainly there’s merit to that to look at things and see what’s healthy and what’s not helping this much. So I understand that. But really, what you’re doing is you’re a team, right? Sometimes people need to be reminded of their responsibilities and that they need to be able to handle things and confronted a little bit. So that end it forms them up in a way in which they actually feel and are reminded that their capacities and that and their responsibilities and other times they need to let go. They need to feel like taking, you know, at least for a little bit of time, come apart and be understood. And so it’s just balancing act of letting go and then taking responsibility. And, you know, and that’s indicative. And the ability to play, the ability to be successful at work, you know. And it’s that we can sort of move in and out, like we can, we can care and not care and can take responsibility. And we can let go and we can forget about things for a while.
David Livingston, LMFT: And so it really is an art and of this back and forth, it’s like you’re pointing out.
Dwight Hurst, CMHC: One of the pieces of research that I think about a lot as a therapist is the curative factors of therapy and how they found that the therapeutic relationship is the most important thing of whether or not you’re going to be successful in therapy. Kind of what you’re talking about. And as that gets stronger, it’s actually measurably more important than what the therapist does. And that makes a lot of sense now, as you’re talking about the psychological importance of this balance of vulnerability and independence. I keep thinking of it as vulnerability because to feel like I can let my guard down, I have to feel safe. And I think when you’re dealing with dependence, an addiction, there’s so much that influences where if I’m really going to tell you the way that my addictive tendencies rule way, I think and when I do, I need to have a pretty fair amount of trust to be able to be dependent on you honoring that trust and us being able to work together, right?
David Livingston, LMFT: Right. To talk about the areas in our lives in which we feel vulnerable or to be able to put that support is a vote of confidence and how that handles and the ability to give responses that are useful and caring and you and help the person feel more solid afterwards. You know, all of that tends to create a greater level of trust when done well. And so. Yeah. And then it reinforces that feeling of dependency that’s healthy, that actually strengthens us so that the idea of “dependency” is that it makes it stronger. Same way going to school was supposed to make us smarter. Right. That’s the same idea.
Dwight Hurst, CMHC: What do you think are some of the big differences between an unhealthy sense of dependence and a healthy sense of dependence?
David Livingston, LMFT: When we regress in a way in which we are expecting somebody to look after us when we’re an adult and we’re acting in a way in which we’re not taking responsibility. There’s a difference between taking responsibility for ourselves and really, you know, being courageous and trying to get stronger and better. And do we need to learn through a sense of relying on someone who can who knows how to help us with that and where there’s a back and forth with being able to kind of regress in a way that is benign. Right. It’s sort of like taking a break and looking at things that are hard, you know, intensive, suspending our responsibilities and ourselves for a short period of time in order to kind of reorganize ourselves and move forward again differently. You know, as compared to a relationship where we’re just expecting to be taken care of, like, that’s such a different mode. And there are elements of it that go that you need to have for a period of time. It can’t be the goal. The goal is, is to learn how to move back and forth. But ultimately know when we need to step forward and when it’s time to take a break.
Dwight Hurst, CMHC: So just hearing you talk about the healthy dependence makes me think some of the actions of unhealthy dependence and some of the actions of healthy dependence are probably very similar. But one big difference that I’d see is in my being vulnerable with the right people. Am I being dependent on the right people in the right way? Because if somebody is unsafe, I might learn bad lessons from that kind of interpersonal dependence.
David Livingston, LMFT: No doubt about it. We have to be discerning. Many times, especially when “I just need an invitation,” and so forth, they’ll say, you know, I don’t trust you. I don’t trust therapy or this or that. And maybe they’ve had bad experiences or it could be that they’re just meeting me for the first time. What I’ve seen so say is you shouldn’t trust me. Trust is earned and lost. And so, you know, it helps to keep an open mind so we can see and explore. But it’s my job to be solid. It’s my job to earn trust. It shouldn’t be given to me. And so it should be a slow process.
Dwight Hurst, CMHC: Because over trust can be just as dangerous as under trust. If I don’t trust anybody, that’s bad. But if I leap into unsafe relationships too quickly, that’s also dangerous.
David Livingston, LMFT: No doubt. No doubt. It’s good not to trust. And it’s good to stay open-minded. It’s earned and lost.
Dwight Hurst, CMHC: When you see people who get really caught up into the real throes of an addiction, do you tend to see and under trust and over trust or just messy relationship with trust independents? What do you see come up usually?
David Livingston, LMFT: I mean, first of all, you’ve got to get somebody out of, you know, off of whatever the substance is so that they’re not, you know, the chemistry and all of the effects of that on happening. But then further down the road. In my experience, what you’ll see is confusion around how to regress and relax and play, when to not care. How did not care? And at the same time, when and how to take responsibility. So there’s a lot of confusion. A lot of addiction has to do with the need for regression. A need to kind of not care and let go. But not knowing how to do it. Well, say it’s the ability. Right. That’s where play comes into all of this. But we can we can’t. What is the what’s the Greek word? “Agon”. Agon means to be in the competition or to be in the arena. It also means agony. So what happens is in this world, constantly in the arena and, you know, going there some type of agony. So people a part of addiction is this desire to get out of that. Right? To take a break. To not care. To forget about things. That’s where play comes into the first part of what I was saying. So. That’s essential.
David Livingston, LMFT: But there’s confusion because the adult part of us, the part of us that needs to build a life, have solid friends, be responsible. It can’t come in and add to that the extent of what we built and who you want to be. So the idea is to be able to relax and play and forget about things in a way that doesn’t jeopardize, you know, your adult part in responsibilities. And so, you know, that’s the art of that of those two principals.
Dwight Hurst, CMHC: I often like to look at what is the sum of the underlying goals and as you put it, the chance to escape from responsibility or the chance to relax or those kinds of things, the underlying goals often are really good. Actually, it’s very healthy. Goal. And then what? Addiction comes into it and dependence comes into it when we are using something to get there that is long term unhealthy or ineffective, actually, even to where it becomes its own stressor. But it’s like there’s an old saying that addiction is thought to be a problem, but it’s really a solution. And I know we talk a lot about that. And if you don’t stabilize the underlying problem, then why? How would we get sober? Right. And then trying to look at it, the fact that oftentimes people are motivated by something healthy that they need. And then we end up doing something unhealthy to try to get that. But then we forget, as we’re trying to treat the unhealthy part, that what we were trying to do in the first place was actually probably pretty healthy.
David Livingston, LMFT: That’s right. That’s needed. Addiction is a real need. The need to be able to let go and forget about things and all kinds of things. Right. It’s different in how it goes with, you know, which lives each person’s needs specifically. But it’s not the right way to do it. It’s unsustainable or ultimately it leads to more problems and dangers. So it’s not the right way. It’s not the right way to meet the needs. Right. Like eating a box of candy every day for nutrition. It’s just not going to get you there.
David Livingston, LMFT: But nutrition is good, right? See, so, yeah, there’s the underlying need, our eating, which we do need to do. And then we’re not getting the nutrition even though we’re doing a thing. And it would be like if someone said, hey, just knock off all that candy and you’re fine. But that person doesn’t, in his analogy, doesn’t know what to eat yet. So, yeah, exactly. So that leaves us without a box of candy. In other words, I’m still hungry, but I’ve nothing to eat now. I am back to my own devices. And so. So that’s like learning. What do I eat? Well, whatever the version is of that.
David Livingston, LMFT: That’s right. That’s right. They have to discover and find other ways to get the needs met. Find other foods they like to eat that are nutritious that they can enjoy. I mean, it is a simple solution. But the reason addiction continues is because needs continue. Right or need to eat is going to go on forever. So the question is, how are we? Are we addressing it? So, you know, that’s why I’d like to start with those four ideas of because those sort of cover our basic needs, both as adults and, you know, and the more child part of ourselves. So the child in the adult is there forever. Right? And how do we operate with those aspects of ourselves that, you know, so that they’re not in conflict? So that. We can be a grown up and handle things and take care of responsibilities and make our way in the world that we need to. And we can also let go, forget about things and feel some joy and relaxation. So we’re not in the arena all the time.
Dwight Hurst, CMHC: It’s a real interesting when you have the arena and the agony part going on there. It’s a lot of times you see everybody struggle with this idea of how do I, you know, make it through the world special right now. Things feel kind of crazy. And I’ve noticed, you know, I see it on social media and stuff. People. They start to even use the word adult as a verb. I’m sure you see that right where they go. I just don’t feel like I can adult today or I think I’m done adult thing for today. And I think that that gives us kind of a feel. Some of these expressions and the way we talk, it’s kind of like taking society’s pulse in a way to say, boy, you know, we’re all feeling a little overwhelmed here, aren’t we? There’s a lot of this in the arena kind of agony feeling that is propelling just a lot of stress and a yet, to be honest, sometimes I look at some of these things when people are looking down upon someone with addiction problems and things first, I think, well, how could we not have, you know, more it seems like we ought to have more problems like that because of the stress in society. And then I also then look at and say, but actually, you know, we do have a lot of those are just that some of the ways that we handle them aren’t unhealthy enough that they put our life at risk or they don’t happen to be illegal or those types of things are there and don’t have a stigma attached to them as much. But we still do them compulsively. So there’s really it’s a dynamic that everybody faces.
David Livingston, LMFT: There is no doubt that there really is a difference between a healthy, active, creative life. And one that’s narrowed by addiction. It’s just, you know, the degree to which were overly invested in one way of doing things rather than sort of creatively figuring out how to get our needs met in multiple ways. Yeah, so so what you’re saying, I think is makes a lot of sense. Spread it around, get your needs met in many ways. And that’s, you know, ultimately the, you know, being able to be more creative. Like figuring things out. And that should be a big part of what therapy is. Is it having someone who can sit there and we’ve got a space that’s kind of what a benign regression is about, like, oh, you’re doing it this way, but. Okay. Yeah. So here’s what you need. You want to forget about things. You’re tired of being in adult for now. But you know, when you take a walk. Oh yeah. I love taking walks. I love going for hikes. Since the last time you did that. It’s been six months. Well, you got doing that twice a week. You’re right. I should do it right. And then you get into the reasons people don’t. And that actually gets interesting because people don’t feel deserving of it. They don’t even think of it. And. Right. So all of a sudden, you have this process of kind of working that through so that you start to have behaviors, you know, you have insight and behaviors that support one another. And really, from my perspective, you know, that’s where these two schools of psychology really need to be is unless people really understand what they’re meeting and could see it and then have behaviors that reinforce it, that what needs to get better.
Dwight Hurst, CMHC: Yeah. Yeah. That I’ve often noticed that we don’t do healthy things. And the reasons we usually list are. I got too busy or I have too many responsibilities or I had to do this for someone else or I had to do this for my job or whatever. And the interesting thing is that when we go to unhealthy ways to meet those needs, they end up interfering with all of those things a lot more. Our relationships, our job, our family, our responsibilities. They get interfered with much more once we have an addictive problem. But we don’t think of it that way. And I think I think one of the reasons is, is because addictive practices don’t take at least they don’t feel like they take as much time. They do actually take a lot of time and effort to maintain. And I’m often the almost kind of impressed by the smarts and the efforts that it takes and the energy it takes to maintain an addiction, actually, when you look at that. But but it is sort of immediately reinforcing. It’s distracting. And I think in some ways, one of the main parts is it’s secret. And so I don’t have to tell everyone, hey, I need 20 minutes right now. I’m gonna go get high. Right. And I’ll say that because getting high is my secret. Right. But if I was to say, hey, I need 20, 30 minutes, I’m going for a walk. And if anybody goes like, boy, you really can’t help me right now. And if I know that, I’m going to say, you’re right, I’ll do a walk later. Let me just help you, because I’m embarrassed to stand up for that need that I can go disappear for 20 minutes. And I is like, where are you? Where are you? And it’s like, I’m back. And now I feel different.
David Livingston, LMFT: And absolutely it’s so much easier in some ways, at least it seems easier for for for a minute.
Dwight Hurst, CMHC: I think that sometimes when we think about living a healthy life, we tend to think about throwing the good out with the bad. We don’t have a strength-based kind of thought process sometimes to say, you know, if what I needed was to check out of stress and to relax, for example, people usually look at it and say, oh, man, you did this these terrible things to try to get that. And so then I just try to give up on my need to relax and to unplug and say I just need to be more responsible somehow and double down on I’m not relaxing. I think I think there’s that danger sometimes of people trying to get rid of their needs as they’re trying to get rid of their addiction.
David Livingston, LMFT: That’s why I started out with saying that needs drive everything. Like you’re saying, you can’t get rid of meat or you have to do is understand what needs are. And then you find creative ways to get them met. So they’re not getting you know, limited into this intense space of of of a of an addiction that doesn’t really meet the needs in the way that that you need.
Dwight Hurst, CMHC: Yeah, and I think that’s the power of trying to understand why we do what we do right is to say if I’m doing this in order to meet this need, this need is probably important to me if I’m willing to, on some level, even subconsciously go to this great extent of maybe even learning what I need to do to get high, procuring whatever drugs I need, you know, maintaining relationships and finding finances and all of the stuff, evading legal detection or trying to all of those steps that go into, you know, opiate dependence. If I’m doing all those things, I probably really do need what I’m pursuing. And so there’s some part of me that’s trying to get something that is probably very legitimate. And so if I can stabilize the addictive part, it’s still very important, even maybe more important, to find healthy ways to do that. Or else I’m just going to find myself right back in the throes of the addiction later on.
David Livingston, LMFT: Right. Right. So so it’s going to add to what you’re saying, because that’s exactly right. So, you know, I can’t tell you how many people I’ve met with who are successful and full of life. You know, something happened and they end up on opioids. So they’re immensely responsibility driven. But they can’t get off the opiate because when they get on it, finally they start to get a break. They feel better to start to relax. The nervous system feels better. But the rub is when you start teaching them about their life, their success and what they feel is all done based on the idea that they will take responsibility. So their addiction is secret. You feel ashamed about it because it’s one way they don’t feel like they are OK. But there’s a need to relax to like go, to feel good. To have some commensurate benefit to all the responsibility. So so that there’s a balance there and that is initially an opiate helps that balance and then it worsens it. But the interesting part is of the treatment is how much they will cling to the need to not give up any responsibility. They will act as if the world revolves around their need to be on top of everything. And eventually what happens is as they let go, if they do rise, as they bring other people in to help them, they find out that what they thought was true is not nearly as true as they thought. So, you know, there are the things that have worked for us. We hold onto so dearly so that to me, that’s kind of where the therapy happens. And it’s different with everyone. Right? Different strengths and pain and places in life.
Dwight Hurst, CMHC: The Waismann Method podcast is a product of Waismann Method® Treatment Specialists. You can follow us on Twitter at opiates or learn more about us at opiates dot com. Shoot us an e-mail at [email protected] as well. Please consider giving us a review on Apple Podcasts, Spotify, Stitcher or wherever you get your podcasts. Our music is Medical by clean mind sounds. This show is edited and produced by Popped Collar Productions, which is a company specializing in helping health care, nonprofits and others to find creative solutions through podcasting.
Dwight Hurst, CMHC: You can learn more about our production services at www.poppedcollar.net. Thanks for joining David Livingston and me today. Next episode, Claire, David and I are going to join to discuss what family members can do to help those that are struggling with addiction. Keep asking questions. Whenever you ask questions, you’re liable to find answers. And if you can find answers, you can find some hope. Thanks again for listening. Bye-bye for now.