Dwight Hurst: Welcome back. The Waismann Method podcast. I’m your co-host, Dwight Hurst. I’m joined as always today by Clare Waismann, founder of the Waismann Method. We’re also really lucky today to have David Livingston, who is the hospital psychotherapist here as well.
Dwight Hurst: Clare and David are going to help to answer some really important questions. One of the issues that actually comes up a lot in the world of treatment for opiate dependence and any real issues that have to do with addictive behaviors is the term “recovery” itself. Am I able to recover from addiction? Am I ever truly recovered or do I spend my life “in recovery”, as many people might say? We’re going to talk about some of that terminology. What’s useful about it? What might be problematic about it? Clare and David are here to offer some really good insights into that and also to help us sort of sort out what really is “addiction”. What do we mean when we say that? And as far as getting started in that conversation. Well, there’s really no time like the present.
David Bricker Livingston, LMFT: I knew I’d delay that David Livingston here. Hi, David. Hi. Nice to meet you.
Dwight Hurst: Today we’re talking about really the term and the concept of “being in recovery” or versus “recovering”, right, “from addiction”. Am I saying that in a good way? Clare, as far as those two contrasting ideas or?
Clare Waismann, CATC: Absolutely no, that’s. Yeah, that’s perfectly said.
Dwight Hurst: It’s become such a different concept in and of itself. “Recovery” versus “being in Recovery”. What are have those definitions become and what’s useful or problematic about them?
Clare Waismann, CATC: You know, I think because it took it takes such an effort and such Danelle strength to get through treatment and, you know, achieve sobriety. Having people saying that they are “in recovery endlessly”, I think, someway somehow makes them feel a bit hopeless, you know, like they have not achieved full success. When I search the term being in recovery, I see a lot of definitions making progress, even though he or she is not cured. Sometimes used as being in remission. It’s an unfair description for somebody that have overcome an issue. So as much as they can be, you know, fragile to that issue, you know, the same as if you had an injury at one point and, you know, you’re aware of that part of your body that can get re-injured. I think it’s OK to say, “You’ve recovered!”
Dwight Hurst: Yeah. It seems like the old school thinking is that there’s a fear that if I say I’m recovered, then I’m going to let my guard down and start drinking again or start using drugs again.
Clare Waismann, CATC: You know, I think that’s called awareness, responsibility. I mean, you can call it a million other things, but because some people, you know, did not do their due diligence to maintain a healthy life, regardless if there was drugs, alcohol, obesity, you know, whatever it is, it doesn’t mean everybody that has succeeded can not get the rewards of being considered a success.
Dwight Hurst: And that’s a focus that I am learning more about from you as you’ve been talking about this focus on a healthy lifestyle. It’s the idea of a healthy lifestyle as applied to addiction. One of the things that’s very consistent with the medical model is you’re applying that the same way you do to any other medical problem. And it does seem like that’s where a lot of problems can come from, is splintering away from the idea that addiction is a medical situation and going more towards it being its own sort of, I don’t know what I would call it, almost as quasi-magical thinking that exists in its own world. And I think a lot of your focus is pulling that back in and saying, no, this is a medical situation, it’s a medical problem to treat.
Clare Waismann, CATC: I think addiction is actually a consequence of a physiological condition that was not treated. So addiction is a behavioral issue, but it is a consequence and is not the root of the problem. So we see it as if it is a mental health issue. if it is a physical issue that caused pain, regarded well, regardless, if it was emotional or physical, if he got treated, you know, effective, effectively and appropriately at the right time in the beginning, then addiction would probably be not an issue. But allowing it, allowing the pain and allowing the dependence of whatever the person is using to mask that pain to grow, leads people to addiction behaviors in order to acquire the substance, in order to use the substance and all the things that come with it.
Dwight Hurst: When you talk about that concept of recovering from addiction, I think that’s one of the first things people think about is can you recover from addiction and how can you tell where you’re at? And then if you are recovering or recovered?
Clare Waismann, CATC: Well, I think if you if you were living a productive life, a healthy life, you’ve recovered. Can you relapse? Of course, you can relapse, you know, but you can relapse some anything in life, anything bad behaviors, no substance abuse. It doesn’t matter what it is, is I think we all have to do our due diligence every day when we wake up to live a productive, healthy life. So getting people that have suffered from addiction and putting them in this box as “You, this group is incurable.” “This group is always going to have this issue.” “This group will never be fully recovered”. I think it’s unfair. I think it’s cruel. More than unfair. Addiction is a condition. And I think we look at it. We give a life of its own.
Dwight Hurst: So when there was the phrase that popped in my head just then when you said that was a life sentence, like I’m sentenced, always have something.
Clare Waismann, CATC: I see it also almost as a coping mechanism to get what you need when the dependence has become overwhelming. Or when the pain has become overwhelming.
David Bricker Livingston, LMFT: I never liked the word addiction. It’s really unclear as to what that actually means. And it can. And how it lives in somebody. And the meaning seems to it seems to be more of a stamp than it is, you know, a process. So really, when I think of addiction or what I believe people mean by it, I think a compulsivity. And if you think of what compulsivity is, ultimately it is tension driven by needs. OK. So speak it to what Clare’s saying. Basically, most of the people I know who are living good lives are pretty intense people, but they’re spreading it out. They exercise. They have good relationships with people. They have meaningful work. They know how to play and enjoy themselves. And so you take that intensity and you spread it out. And that’s the opposite of an addiction. That’s a creative life. OK. So the goal for treating addiction, the goal for the end of recovery to be recovered should mean that you’re living a life. Like Clare said, it should be one in which people are taking all of those needs and all of that energy and moving it, you know, into a balanced life, whatever that might mean for them.
David Bricker Livingston, LMFT: And and while that sounds simple, that’s extremely difficult. But in the end, that’s kind of my idea of the treatment. And then what can happen and really can happen because people are in and out of this state. Even people who are really vulnerable or in and out levels of compulsivity all the time. And there’s a lot of people who don’t feel compulsive at all for years. And so that’s a recovered state, that’s for sure. You know, and does it help? Like Clare’s saying, like, you know, I can’t go jogging anymore. So but I can go hiking and go play tennis and do a whole bunch of things. So I do that. I don’t even miss that the jogging anymore. So I have to remember that because, you know, I got a bad knee if I do. So you have to be aware, like Clare was suggesting, you have to be aware of the vulnerability. You can’t forget about it, but you don’t need to live in a compulsive state.
Dwight Hurst: It sounds like you’re talking more about getting to a purposeful mindset as opposed to compulsive. At least that’s the word I might use for what you’re saying. Is energy going in the direction you want it to, and are not just driven to it.
David Bricker Livingston, LMFT: I’m sorry.
Dwight Hurst: Energy going where you would like it to go rather than driven there by compulsion.
David Bricker Livingston, LMFT: Right. I mean, I think what happens is because you have the brain and then you have the personality or the psyche, you know, which are which operate and affect each other, but which are also separate things. You know, addiction, because it affects our physiology and the brain. I mean, when you’re talking about chemicals, you know, it can take a different hold and the brain tends to remember things. And so there’s a process of needing to kind of work out of that, you know, and expand your life. But I don’t think you have to live in a compulsive state. That’s a painful state for anyone. But you can live in a creative state in which that intensity is being moved in multiple directions.
Dwight Hurst: One of the things I really think that, too…
Clare Waismann, CATC: You know, I’m sorry. I think also because the word “addiction”, the word, you know, “being an addict”, has had such a tremendous, you know, negative connotation, you know, and even association at this point, is it’s harmful to people to be tagged as one. Sadly enough, we have used sentences to describe a group of people that have actually hurt them and impaired them from getting full recovery. I think once an addict, always an addict, you know you know, addiction is part of your DNA.
Dwight Hurst: You find those to be destructive labels.
Clare Waismann, CATC: If addiction is always going to be part of who I am, not of where I’ve been. Then why am I trying another path? And so I think those statements are cruel.
Dwight Hurst: I’m going to circle back on something you said. David, when you were talking about being conscious and being being purposeful, you mentioned the example of you may not be supporting you jogging anymore. And so you switch over to other things. And the interesting thing about that is I don’t know that a lot of people would say that as the first thing comes to their mind if they said relapse prevention or sobriety maintenance. But yet what you’re describing probably has a lot more to do with maintaining my sobriety even than talking about what my sobriety does.
David Bricker Livingston, LMFT: Ultimately, you’ve got to recognize the need. With my need… It’s it’s obvious, my need is to exercise, you know. And so if I can’t do it that way, I find other ways to do it. Luckily, I can. You know, and I think when people find other ways that are satisfying enough, it really does relieve that the need.
David Bricker Livingston, LMFT: Once we’ve had the meal we need and we’re no longer hungry. We move on to the next thing. Correct. And until that’s happening, though, there’s a tension. And if you haven’t eaten in a long time, you’ll begin to become potentially compulsive in some way. And a lot of needs are just unrecognized. And as they are recognized, I think people can move further and further into a state of recovery. So I should say being recovered, they’re not going to feel compulsive.
Dwight Hurst: I like when you mentioned compulsion because that’s a measurable behavioral symptom that puts it in a new light, when you say it that way, and I think it gets away a little bit from the labeling that you’re talking about, Clare, escaping from that.
Clare Waismann, CATC: It is! We have to look at the person behind the addiction, first and foremost. It has all become too basic. “This is what everybody needs.” One size fits all. It just doesn’t work for everyone.
Dwight Hurst: And that’s a downside of labeling in general.
Clare Waismann, CATC: And it becomes damaging to so many because, not because the person failed treatment, but the treatment failed the person. But because the person is considered an addict, they put their head down and they believe that’s just the course of their “disease”.
David Bricker Livingston, LMFT: Problem with the word “addiction”. And I think maybe this is helping me understand it better. The reason I don’t like it is health is a fluid state. Right. So a healthy individual is somebody who is able to be sad when they’re sad, happy when they’re happy, you know, angry when they’re angry and know how to and know what it is they need. Right. And within these states and know what to do and have some flexibility. But, you know, we’re fluid and health is a fluid state. In fact, what depression is is a congealing, right? Depression is a congealing of feelings and needs. And the way you treat depression is you go into the depression and you find out what the feelings and needs are and you get them moving again because health is a fluid state and the word addiction is a static state. You’re an addict. OK. And so when people put that on people, it is as Clare’s saying, it is where we’re confusing what actually a state of health is as to what a state of being congealed is like depression. It’s not good for us. It’s good to understand our vulnerabilities along the way. And, you know, assess that well, you know, so that we don’t, you know, bite off more than we can handle.
Dwight Hurst: Both of you have referenced if you go enough time without compulsion or without symptoms, that’s how you’d say that’s how we tell we’re recovered or we’re in that state of health. Counting time has always been a big part of mentality or the 12-step groups that count every day. Someone might say, here’s how many days I’ve been sober. Do you have any kind of guidance or issues with how people count their sobriety time? What is helpful?
Clare Waismann, CATC: What are we really counting? Are we counting the days that we have been healthy because we have to hold on so hard or is it because we’re so scared that we’re going to fall tomorrow? It’s the same idea of let’s all sit in a room and hold each other’s hands because we’re not strong enough to be out there. I think it’s one point when we did not understand how our brain works. Now we can actually clearly see it in a scan so people that are depressed can actually take an antidepressant and don’t feel the gloom and doom all day long. They can be productive members of society and laugh and have a good life. Also, patients that did use substance. We have medications that can control cravings and to chemically they regulate. So there is a neurological regulation due to physiological issues. There is also social issues that cause dysregulations.
Dwight Hurst: It looks like when we talk about then measuring success, you’re looking at once again more individualized measuring not just how many days it has been since I’ve ingested an intoxicant.
Clare Waismann, CATC: Learning tools to deal with anger, dealing with frustration, dealing with sadness. You know, it is very different from one person, that had had this supportive family, this intellectual family, this, you know, this strong core growing up to somebody that both parents were working, got divorced, never had anybody to discuss their fears, their insecurities. So obviously, one is going to recover a lot faster because they have the tools to deal with the craving, to deal with, you know, coming off that negative situation, where the other has none. So for them, it’s going to be a lot longer process.
Dwight Hurst: So do you feel like there is a place for the 12-step-model and the support groups, or do you feel like we’ve outgrown that in treatment?
Clare Waismann, CATC: I think for support there is always a space for support. There is also there is always a place for hope. There is always a place for a friend that understands where you are. We can’t confuse support with treatment. It’s that simple.
Dwight Hurst: Yeah, I remember when I worked in a substance abuse clinic was primarily most of what we did was court-ordered treatment and the probation program required people to go to a lot of 12-Step meetings. And we had quite a few people who were therapists and counselors that had worked and gone through twelve steps. And I remember one day my supervisor was talking to everybody and he said, “OK, when you’re doing group therapy with people, remember…” And he writes this on the board and underlines the word therapy. And he said, “It’s group therapy. We’re not doing we’re not having people come in here and pay for medical treatment to have another 12-Step group.” And he was very big on drawing a distinction – what is the therapy that I’m coming in and paying for? And then what am I going out and getting support from? And as you put it, friends or sponsors or people who’ve been there is valuable, but not to confuse that with treatment. I think it’s a good concept.
Clare Waismann, CATC: It can be for some, Dwight, but it might be harmful for others. We have patients that are constantly telling us that they know the place that caused them more craving was sitting in meetings, by the time they leave the meetings, that’s all they think about.
Dwight Hurst: I think yeah, people do have that experience. Yeah. Definitely.
Clare Waismann, CATC: Of course. So if you have not solved, you know, the root issue. If that is misdiagnosed depression, anxiety issue, trauma, whatever led you to use a substance and you sit in a group talking about the substance that gives you a break from that constant emotional pain when you leave there, that’s that’s what you’re gonna be thinking of. So that’s what I’m saying to you. If the person gets help to learn tools or whatever it is that they need to deal with the root issue. Whatever form of support they get, that’s productive. But you can’t forget that the person needs treatment for their individual issue, whatever that is. And that could be a psychiatrist. That could be a physician. That could be a psychotherapist. Everybody’s different. There is no set rule and there shouldn’t be. Because, again, we’re not dealing with the addiction. We’re dealing with an individual human-being that is complex, that has a different makeup, that has a different history.
Dwight Hurst: And sometimes people coming into treatment aren’t used to being treated individually. I mean, you’ve talked about, I mean, just in general, how they can be viewed as like you’re one big group and all of you are like this. I think that’s even more so when people are coming into treatment because of either a legal problem or some other form of rock bottom. I’m getting dumped by my spouse or I’m getting threatened with jail time. I think that’s even more demoralizing and dehumanizing and that can kind of amplify the effect you’re talking about.
Clare Waismann, CATC: Yeah. And I and we were talking about, me and David yesterday, about this. You know, I see a lot of people that have never really dealt with their feelings, although they have a tremendous amount of emotions. They have not learned the tools to deal with their own feelings. They grow up learning how to deal with responses to other people, but not to theirs. So they are overwhelmed of emotions that they have no tools to work with them.
Dwight Hurst: As time goes by, do you see that there tends to be a correlation with time away from use and the likelihood of relapse going down?
Clare Waismann, CATC: Yes, just spoke to somebody that got treated fifteen years ago, they just called me out of the blue. I’m going to let David answer that question.
David Bricker Livingston, LMFT: I think that the more time you have away from any habit, the more you’re probably developing other habits and other ways of coping and dealing with life. And if you’ve been doing it like this individual for 15 years, you’ve developed a lot of different ways. It doesn’t mean that you can’t do it at some point become compulsive again. You know, compulsively is a part of life, not just for people who deal with substance abuse, but for everybody. OK. It’s just it’s a normal part of life because people feel stuck and trapped, you know, whatever their coping mechanisms are. Those times, good or bad. They tend to go back to. But the more time you have, the more you almost necessarily develop other ways of managing. A lot of things are going to happen in fifteen years. So it’s a good sign, but it also depends on how people relapse.
David Bricker Livingston, LMFT: Sometimes people relapse in a very short way in which they kind of stumble and then, you know, get a hold of themselves and get out of it really quickly. Their life doesn’t go downhill for a long time. So you’ll see a lot more of that with people who’ve had long periods of sobriety.
David Bricker Livingston, LMFT: Right. And I think it’s good you’re pointing out that all relapse is not are not equal. Relapse is different depending on degree of relapse. And I think that’s important. One of the things that I see sometimes as a downside, when people get really, really into counting day by day by day, is there’s a tendency to think, oh, wow, I’ve been sober for, you know, 9000 days. And then I had a drink now and flushed all that down the toilet. And I think to your point, you’re talking about how I have learned things. That’s all still there. Those lessons are still pertinent, even if I have a relapse or some other setback.
David Bricker Livingston, LMFT: That’s right. One of the reasons I think that this is that that I’ll use a word, even though I don’t like it, that addiction is in talked well, it well about or indepthly about, is because it’s complex. I know people who have tremendous capacities to put the brakes on and other people who really, really struggle. There’re so many variables that come into play. You know, I think to what Clare said, I really agree. I think AA helps a lot of people and it’s been really helpful to a lot of people. And it’s an immense support system. It’s not a treatment because there’s no attunement at the level that would potentially help somebody work out. And AA works well, what you find is there is better and better attunement. You know, so if you go to a meeting and there are people there who know you and like you and you can talk to, you start to get that attunement, and ultimately it’s a therapeutic tool. I mean, it’s a core of psychology, and I think it’s the core of any successful treatment. Is there is a real sense of somebody who knows you and is attuned to you in a way that is good for you? You know, that can happen in different spaces, at different levels.
Dwight Hurst: Yeah. And you and you don’t look for certain kinds of friendship from your doctor. Just just just like you would just look for a certain kind of medical advice from your friends.
David Bricker Livingston, LMFT: Well, that’s it! And you know, so. Right. So there’s benefits and limits to everything.
Clare Waismann, CATC: To any relationship. If there is one sentence that comes to mind is we need to allow people the opportunity to recover.
David Bricker Livingston, LMFT: I agree. And we should listen to where people are at and when they say they’re down with something. We should give them the opportunity to be done with it and to move forward in their lives.
Dwight Hurst: And we’re going to leave it there for today. Thank you, Clare. Thank you, David.
Dwight Hurst: Thank you, all of you, for listening as well. We’re gonna be back at you again in a couple weeks when our topic is going to be what a treatment actually is. We have some insights to really build upon the conversation we started today of some of that terminology around what is treatment. If you have questions either along those lines or other topics you’d like us to address, please email those questions to us at [email protected] or you can hit us up @opiates on Twitter.
Dwight Hurst: So until we’re there with you next time, remember to keep asking questions because whenever you have questions, you get answers. And when you get answers, you get hope. For Clare Waismann and David Livingston, I’ve been Dwight Hearst. Thanks again for being here.
Dwight Hurst: Waismann Method® podcast is a production of the Waismann method, offering medical detox and individualized treatment options for opioid dependence, go to opiates.com to learn more. Our music is the song Medical by Clean Mind Sounds. The show is produced by Popped Collar Productions, a company where we find interesting and exciting solutions to your business goals through podcast. Find out more about us at poppedcollar.net.