Ep 49 Beyond Addiction How Science and Kindness Help People Change author Nicole Kosanke PhD

Living While Loving Your Child Through Addiction
Living While Loving Your Child Through Addiction
Ep 49 Beyond Addiction How Science and Kindness Help People Change author Nicole Kosanke PhD

Guest Nicole Kosanke, one of the authors of the book Beyond Addiction How Science And Kindness Help People Change and I talk about the book. Hear powerful insights about using CRAFT (Community Reinforcement and Family Training), positive reinforcement, and other strategies to help yourself and your child that’s struggling with addiction.

In this episode we discuss:

  • What’s happening in your child’s brain during active addiction & during recovery.
  • What CRAFT is and what people struggle with the most to implement it in their life.
  • Enabling and tough love.
  • Is relapse a part of recovery?
  • Is using a choice?
  • How we can mitigate the risks of fentanyl.

More resources about CRAFT:




Resources From Heather Ross Coaching

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GUIDE ABOUT ENABLING – If you’ve ever worried about enabling, this guide is for you! https://heatherrosscoaching.com/perspective-about-enabling/


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This transcript has not been formatted or edited.


I’m Heather after many wasted years, trying outdated, approaches to my daughter’s addiction, that felt wrong to me harmed.

Our relationship and didn’t help my daughter.

I finally found an effective evidence-based approach.


That repair my relationship with her helped me.

Create my own peace of mind and made me an ally in my daughter’s recovery.

I teach you a loving and compassionate approach to help you encourage change.

And create connection addiction impacts the entire family system.


Family recovery is the answer.

There are a few defining moments in my road to my own recovery and repairing my relationship with my daughter.

When I found the book beyond addiction how science and kindness help people change.


It was one of those defining moments that book was the first thing I found specifically about addiction that helped me before that.

I’ve been working with a coach and gone through coach training but those things All focused on me.


I wasn’t learning more about addiction.

I hadn’t found the resource there that I was looking for yet.

Once I found the Beyond addiction book.

I was able to lean into repairing.

My relationship with Alana build a strong belief Foundation about addiction that served me.


And I was able to create strategies that worked for me and her Lana.

It got me out of that rigid black and white thinking about Addiction and got me into the gray area where all the infinite possibilities are.

And as I think back to that time where I was making these huge changes, I am so grateful for the impact that this book has had on my life and the impact that it had on my daughter’s life.


Especially, since my time with her was cut.

So short, I read the book but it changed her life, too.

Do you really think about that?

I read that book but it changed her life.

We really do have so much more power than we realize.


We can change our experience of our kids addiction through focus on our own healing and recovery.

But we can also take actions that create an environment that make it easier for our kids to find their own healing and Recovery.

This book, contributed to me creating a beautiful, loving relationship with my daughter for the last year’s of her life.


I can’t emphasize enough.

How important your work on yourself is and how grateful you will be that.

You did it as you look back at the changes you’ve made and how far you’ve come the book beyond addictions for author’s, work for the center for motivation and change their approach to treating substance abuse involves evidence base.


Treatments that include the whole family, they conduct workshops and training and craft which is community reinforcement and family training.

So by the book, read it embody it.

Let it lead you to become the person.


You’ve been looking for to help you.

I’ll be putting some links to CMC and other resources in the show notes, they have some guides and other resources you can download for free but by the book so that you You can write in it and so you can support them.


And like me, I am constantly referring to the book and highlighting in it and writing in it.

So I really hope if you haven’t read it yet that you do download there other resources, they’re amazing.

And I hope that you enjoy my interview with one of the authors of the book.


So I’m so excited about today’s episode.

Having one of the authors of my favorite book beyond addiction, how science and kindness help people change on the podcast today really has me full of gratitude and this book was my lighthouse when it came to dealing with my daughter’s addiction and really, finally forming a foundation of a belief system, that served me.


Me in how I approach supporting her in my relationship with her.

So I’m so excited that we get to share this information with the audience today.

And Nicole, I just want to thank you for generously, you know, giving us your time today to do this interview.


And can you go ahead and introduce yourself please?

Alright, thanks for that.

That’s so lovely to hear about the role of that book for you because boy turns out writing a book is an enormous job.

Yeah, I feel like I put so much into that book, so it’s lovely to hear.


Thank you.

So my name is Nicole kiseki.

I’m the director of Family Services at the center for motivation and change in New York where I’ve been for almost 20 years I guess.

So that’s who I am.

I do a lot of work with families and parents in particular who have kids who are teenagers or adults.


And often dual diagnosed with substance use disorder and something else, some other psychiatric conditions.

So there’s a lot of complicated situations that trying to help families manage taking care of themselves and helping their loved one.



And that’s a lot right?

To do both of those, that’s both equally important but I think sometimes we miss out on how the parents, how we need to take care of ourselves.

So how did the book come about?

Because Is this is a collaboration of a few people, it seems like, and it’s such a fresh I think approach something that’s really needed.


So, how did you guys end up writing this book together?

Yeah, I wrote the book.

Collaboratively, with my colleagues, Jeff, Foote and Carrie Wilkins and we got some help from an editor, Stephanie, Higgs.

And we have been working together at the center for motivation and change for a long time and actually worked together before.


Before c MC got started.

So we get along while and we have the same sort of commitment to using strategies as psychologists that are effective in research studies and looking at the whole person in a compassionate and humanistic way.


And so there’s a lot of that in that book we Came across craft the community reinforcement and family training approach.

And we’re using those strategies with family members, a lot, and also finding that the books that had been written on Craft thus far, weren’t always accessible or meeting the needs of the clients that we were seeing and wanting more of a frame around the strategies.


Like what is motivation?

How do you define Fine substance use, what about treatment?

What are the options?

How about medications?

Like that’s sort of beyond the scope of craft and yet it was a lot of the questions that we were answering and sort of work that we were helping people with.


So that’s why we decided to write Beyond addiction as because those are the needs.

We were seeing but also, because as a therapist, you see, like one person, two people, five people a day, a people a day like there’s a finite amount.


My own of people that you can contact and help and it became clear that so many people need these strategies, so many people could really benefit from it and it’s not something that people hear about.


So it didn’t make any sense to us.

There is this really effective research proven approach for family members to help and nobody knows that it so So why is that, what can we do about it?


How can we get this information and two more hands?

Yeah, I can’t remember how I actually found the book Because I had just been Googling and Googling and everything.

I was Finding only really was helpful.

If your person that was struggling was ready to change right?


There was nothing.

I could find that told me what to do when my daughter did not want to change at all and that was left me feeling.

Being so empty.

So like this is what I love about it is this is what you do even if they don’t want to change and having that framework is I mean, it’s a Lifeline.


When you feel like you’re drowning, your child is drowning.

Your family is, I mean, it is a bleak place to be.

So you’re so right and what you’re saying about that?

But so before we talk about crafts for a minute, I want to just talk about addiction because that’s really important to just understand like what’s happening in a person.


Ins brain and what do they need to do?

What needs to change in order for them to move into recovery now.

So, what’s happening in the brain?

I mean, it is such an important question because I think part of how I think about this is to expand sort of out from the specifics of substance use disorders to.


Like, how do we form Habits?

Like how does this work in the brain?

All together and I think that’s something that in general we try to help families do because it gives you more empathy.


If I think our culture in general like really stigmatizes substance use disorders, like there is such a feeling of like oh those people or I could never be like that or Bowery people know about it.


Like there’s some like other ring that Happens very quickly around substitutes and so there is I think real value and thinking about like, okay, so what happens in my brain when I have habits and maybe they’re not such healthy ones, like why is that happening?


Rather than thinking about like the defective brain of someone who’s addicted.

So when we think about habits and general and what happens in the brain when we think about, Earth weighs in the brain.


So you think about, okay?

Everybody’s had the experience of being in their car or walking down, walking somewhere and you sort of stopped paying attention, you’re listening.


You’re talking to somebody on the phone or whatever.

And next thing you know, you’re either arrived, and you don’t remember how you got there or you arrived at the wrong place because you’re used to going to one place, and you weren’t like really paying attention along the way and so, You just went to that place that you normally go to and that is habit, right?


That’s how the brain gets really efficient at helping us do things and not having to, like, think every step of the road, you just automate things and that’s what happens with addiction.

Is that, okay?


I feel uncomfortable and before I know it, I have medicated that away with a substance that I have grown accustomed.

Item to knowing is going to be effective for alleviating that discomfort.

So that’s sort of like what the brain does to automate things.


And it goes like overboard with substance use because substances are an unnatural way that the brain is flooded by like wow that feels amazing.

So I’m going to make sure I get that again and so that pathway in the brain.


It becomes like a super highway and it’s literally, you know, you talked about the brain, its it is Pathways like there’s a neuron and it goes here and then it’s connected to that.

And then there are myelin sheaths that protect it from being intruded upon from other signals that might come along the way.


So it gets really efficient going in that direction and it’s kind of stubborn to change.

Doesn’t go anywhere, so that path.

Hue of substance use when it becomes very well protected.

And fast is really stubborn to change and so you have to build up other Pathways.


That’s the, what does it have to do quest?

Part of your question?

Like, this is unfortunate that we can’t just dig up that pathway and get rid of it.

At least, we don’t know how to do that yet.

All we know how to do is build new Pathways so that I can become more conscious of when I’m uncomfortable and have some skills around managing that as soon as possible so that I don’t end up sort of unconsciously going into that – pathway again.


So I can build up other Pathways in my brain to have more options for that and make them Speedy highways, and I doing it over and over and over again and associating, positive things with it.

So that my whole being is more interested in those Other Pathways?


Yeah, I think what you said about the stigma that goes with it and really we have to see like that you, you know, called it a habit, like everybody has unhealthy habits and I started really comparing a lot of my habits to my daughters and if I wasn’t like, ranking them as better or worse, but just seeing them as meeting my needs in a healthy way or not.


Then I realized we were so much more similar than when I was just focused on our differences.

And so that’s what’s helped me a lot like to have more my beliefs around addiction initially were so painful for me believing that it was some kind of failing on my part and I my daughter’s part.


So seeing it in such a more that just kind of like simplified way really helped me support her better and myself.


Yeah, I mean, I think that’s so true that there’s a natural impulse as a parent to wonder like, did I do something wrong or what could I have done differently?


And because that’s our whole job as parents is to like Usher them through life and try and help their path be as less painful and arduous as possible.

But actually, that’s not the job that’s their job.


But I Our society has a lot of messages about parents needing to do this and that, and all these things that are really kind of misguided.

And it’s that transition from the child to the adult to that is so tricky.


And I think not well enunciated in our culture in general, but this piece that you’re mentioning about how it is that we can really Lee identify with somebody who is struggling and making these choices that seem from the outside just completely insane.


Like so irrational and self-destructive and other destructive and hurtful like how is it that these choices are being made and when you identify what the need is, what the wish is, then you can empathize right then Can think realize us just wants to breathe that?


She just wants to feel uneasy breath and that wish, what could be more human like that is just such an understandable need wish desire, but I’m all of us can identify with that and then you really break down those barriers of understanding.


Yes, there are consequences that are unintended but That wish that urge is really understandable.

Yeah, and it makes compassion so much easier.


So I’m going to share a quick summary about crafts and then ask you a question about that.


So craft stands for Community reinforcement, and family training.

It’s designed to empower families.

It teaches them how to take control of their lives and change their interactions with their substance user to promote positive behavioral change.


And the three goals are one to teach you skills.

To take care of yourself to teach skills, to help your loved one change and three reduce substance use with or without treatment.

It’s behavioral and that in employ strategies for real-world observable change.


Its motivational drawing its strength from collaboration and kindness rather than confrontation and conflict.

So, I’m curious like what people struggle with the most Just when they’re trying to implement craft.

Like, for me, I listen to the book and then I bought it and then I read it again.


And now I still look at it constantly like, but I’m surprised it looks as good as it does.

It’s helped it held up really well for as often as I use it.

But for me, it was the mindset shift of like, no.

But there’s no answer.

Like, you know, you’re not going to just tell me.


This is what you do when this happens and this is what you do when that happens for me, it was figuring out a new If system.

But what do you find that most people struggle with the most implement it?

I think that for parents, in particular, the self-care piece of compassion is really tough because of the things that we’ve been discussing this far, you know, that there is a real pressure on parents, you know, this phrase, you’re only as happy as your unhappiest childlike is just Killer was just a killer like what does that mean?


That you your source of happiness is in someone else’s hands?

Like that is really painful and I think a lot of people identify with that and so a lot of the parents that I meet with Will essentially tell me like yeah, I know how to take care of myself, like I’ll get there.


Just help me fix my kid and then I’ll figure that out.

Like that’s on the back burner.

This is the fire in the house.

We have to put that out and then I will deal with like going to the doctor or talking to a friend or walking around the block or something, like the any attention to like, what they, how they’re managing things is really feel secondary and it isn’t secondary it.


I think it’s part of the problem that Our society has in general sometimes of like, either or like, I’m either really mad at my kid or I love them.

I’m like either going to pay attention to their needs or mine and actually these things all need to be happening at the same time.


Like yes, you do need to recognize that are angry and it’s a totally valid feeling to have and your love for them hasn’t gone anywhere in that process and your compassion.

Passion and your desire to help.

And so, those two things can happen at the same time, I am feeling infuriated and I may not be able to talk to you right now.


But I love you.

I’m glad you’re okay, let’s talk after dinner or tomorrow morning or whatever.

That is a skill actually, to be able to hold those two things at the same time and practice that skill of acknowledging.


Those things are coexisting.

This time.


And I don’t know if there’s like a real name for that, but I started calling it 3D emotion.

Like, because I didn’t know what I was developing, but I started noticing like, I can be sad about what my daughter is experiencing.


But yeah, I can also experience Joy because something good is happening in my life at the same time.

So, I started calling it 3d motion.

Like, I’m noticing this ability coming up, as I’m practicing all the things that you were talking about.

About like taking that leap into self care and taking the microscope off of my daughter, even though it felt totally wrong, but I just had to acknowledge that.


Nothing that I had done until that point work.

So I had to be willing to try anything different and yeah.

Is there a name for that I’ve always been curious?


That’s 3D.

Sounds good to me.


I mean in DBT dialectical behavioral therapy.


They talk about the dialectic Saying that there are multiple feelings that can co-exist and not buying into the myth for yourself.

That only one is happening at the same time because it’s just not true and it’s something that serves Us in every area of our life.


Like all the way through this process of it enabled me to enjoy my daughter more during the times that she was sober because we had done so much work and like when I say, Enjoy Her more.

I mean, enjoy your more because she was available to be enjoyed more, not because I had come to the place where I loved and accepted her so much.


It didn’t matter she was in active addiction or sobriety, I loved her the same.

But when I say enjoyed her more, it was like she was available for more of the kind of relationship.

I wanted to have with her and so I was able to just work through the fears as they came up to opening up to her and because you have to kind of learn to live a different way kind of without I am being as available and then it takes a lot of vulnerability to go back into having a really open relationship with them and sobriety.


So, that ability to experience, all the full spectrum of emotions and multiple emotions at the same time.

Served me.

And now it’s serving me and dealing with grief and experiencing the grief for her.


But also experiencing joy and the other Ins that are appropriate for the other things that I am experiencing in my life to it, helped me to build that multiple, dimensions of who I am, not just a mom defined by one thing and I think that.


So, let’s move on to enabling because I think that that’s so it’s such a roadblock and it brings up so much fear.

You know, I know that like a lot of my clients get stuck there and I’m like, just like throw that word out of your vocabulary because As it makes us feel like everything that we’re doing is wrong.


So is there like a better word for that or maybe just a healthier way to look at it.

Like how do you look at it?

Yeah, I mean I tell people that I just don’t use that word because it’s not possible in our society to use that word.


Even if we redefine it.

Because right now what it means is, I’m Using someone of something or accusing myself of something, it’s really a condemnation that work and so I just don’t use it.


But technically speaking, right enabling is doing something that promotes or encourages substance use so if you are enabling positive things, I’m enabling exercise.


I’m enabling healthy eating.

Enabling, we don’t say it that way, but technically that should be the meaning but in our lingo like enabling is really encouraging or promoting or increasing the likelihood that someone is going to use drugs or drink.


So if you we don’t live in a world that’s black and white and simple.

But if we did and you could sort of divide it up like these, He’s our actions that really encouraged substance use.

And these are actions that really encourage healthier, behaviors, and do not encourage substance use, then that would be fine.


And then we could label, those enabling behaviors, and label all of these things.

Either enabling positive behaviors or enabling are just healthy positive reinforcement, right?

But in the real world, those sort of categories.


Get really messy.

Okay, so if I give my kid money for lunch and they use it for drugs, is that enabling?

Well, it wasn’t when I gave them the money, but if I do it over and over again, I realized this is what’s happening then I can identify.


Okay, that’s not a helping behavior for me to give them that money.

I’m going to figure out a different thing that is more likely to encourage the A healthy way of eating lunch and set up a plan with the school or a way for them to use a credit card, that only allows them to buy certain things with it.


Can kids get around that definitely.

So it would just like go into the Cascade of how confusing and complicated this gets but I agree with you 100% that the word is so condemning that It it’s really not possible to use it without like that corrosive, internal experience, which is so unhelpful for everyone else.


It’s just awful and people hurl it as accusations even from professionals.

Like, I’m not happy to say that but that’s true.

I mean, my field is full of people that will tell family members that they’re being enabling and the real tragedy there.


Or is that they’re not being told what to do.

Like, very easy to like point fingers but let’s encourage people and what to do differently.

So that’s a real real lacking place in the field I think.




And then I asked some parents in my group like, what some questions were they wanted me to ask him?

One of them was like about like what do I do when it comes to paying rent and I want to pee.

Directly to the landlord because I don’t want my child to be homeless or I want to keep helping my child, but they’re not able to really string together, much sobriety.


But again, I don’t want them to be.

I don’t think that them being homeless is the answer either.

So, money specifically is a really tough one, especially in both of these cases, they were talking about paying directly to the landlord.


Like, we’re what’s a good way to approach that?

Well, I mean, I think it makes a lot of sense that there is what I call a seat, a floor, like a floor and a ceiling to the support that you might offer a kid.

Like, many people feel that way, like, okay, might my child relapse or start using, and support meant that I’m paying for, yes, but I’m willing to pay for that anyway, because I need them to have a floor to sleep on, I need them to have shelter.


A very least so I yes I am going to do that if I come over and fill their fridge once a week and their friends come over and pay them money for the food that’s in there and go eat it.


And now my kid has money to buy drugs with.

Am I going to stop bringing the food over there?

Probably not.

Because I want them to have food to eat and probably some of that food is going down their gullets.

There’s a sort of a balancing act to figure out like, okay, pros and cons of this.


Like, what are the consequences if I don’t get this?

The other piece is that there’s so much in the delivery of this, right?

Like, so, there’s the concrete question.

I’m, like, do I give money to the landlord so that I could have somewhere to sleep?


And then there is the question of like, how do I have that conversation with my kid?

Did and how do I convey the support?

Then I am giving financially and what else is happening in the relationship.


If that’s all, I’m giving if that with no contact whatsoever, then it does feel very weighty this decision.

But if there’s many other things going on, then it has begins to feel like part of a fabric, right?


And so I think that’s the piece that Encourage people to think about is like, okay, there are a lot of different ways to look at the elephant.

And how is it that we can?

Like, pay attention to this side and do a little bit over here and make sure we’re doing some positive reinforcement of healthy, behaviors setting limits here, taking care of ourselves.


Like, do a little bit of all these pieces and not expect too much of any one piece.

So I’m paying the rent now.

I might not.

On peut next month because I learned something on that is so upsetting that I can’t support that anymore.


The drug dealer moved in, I don’t know.

There are certainly limits, right?

So there’s less pressure on anyone decision.

I think when you think from a multiple perspective of like the different efforts that you can be putting into the situation, Yeah, and I think that also, what, that brought up for me listening to what you were saying was that we need to be as parents really clear about what we’re giving and why and knowing that part of the reason we’re doing it is for our own Comfort to so that because a lot of times we give because we want relief.


But then we feel used.

So we have to be really clear what we expect in return, for what we’re giving and why we’re doing it.

And that a lot of times we are, It for ourselves as much as that we’re doing it for them, so that we aren’t holding it over their head and damaging the relationship when we’re really trying to do something healthy.


And the other thing that came up is for me when you were saying, that was the act of always feeding my daughter and giving, like giving her rides when it was convenient for me to do that, helped me to build a relationship where I was able to move into a place of having.


Some influence, right?

I didn’t have control like I want to get rid of that and but I had some influence she would at least ask me my opinion about things that opened the door for us to have conversations.

So I think that like you said I like the way you said that about looking at the whole big picture, not just that one piece of paying the rent but the whole piece of what that’s doing for them.


I think that we forget that sometimes we get, so fearful and caught in the each little Tail that we forget to kind of zoom out.

And look at the big picture is that because those moments of doing what you can not, if it’s going to break the bank, not if it’s gonna make you late to work, not if it’s going to like really tie you in knots.


But doing what you can, when you can do it and noticing and really taking seriously, the influence that you can have and your kid asking you questions is a great example.

Apple of like that might easily come in and out of your awareness of having an influence.


But it’s a clear influence asking.

A question means that she values your opinion.

She wants a relationship, she’s willing to engage.

Like all of those things are happening and they’re being fed by your willingness and availability to be present and that is actually a pretty big deal.


Could miss it easily, if you are, so resentful that, you’re driving her somewhere, right?

Because you’d be walled off and irritable and angry and maybe late somewhere and resentful.

That’s not a good place to do those things from.


If you can be available to having that influence and noticing it when it happens great, but if it’s going to really put you off and you’re not going to be available for that.

That anyways, then you shouldn’t be doing them.


You know.

It’s not going to have the desired effect.


And that goes back to what you said in the very beginning about taking care of ourselves.



And then, you know, our limits a lot better.


Because people swing from one and so, the other when it comes to, like setting limits, right?


So if you are giving giving giving giving giving then you end up being resentful and you slammed, On the other side right?

Like screw this never mind your cutoff, I’m not talking to you again and then regret regret and moving back and forth.


And so when you’re at those ends of the Continuum, it’s very clear that it’s not, right?


And you know, that it’s not right, it’s not right to be giving giving giving giving without getting anything in return and it’s also not right to Pletely, shut off, like in your bones, you know, it’s not right.


And recognizing that before you get to those extremes will allow you the sort of flexibility to stay a sort of more towards the center, rather than, like, snapping back for the other end, which is natural.


If you giving too much, you’re not setting any limits, you’re at some point going to snap and that is not a place you On a be like, bouncing from one extreme to the other.

You really want to try and pull yourself in and doing.


That means really staying tuned to your own.

Needs your own reality.

Like I can’t do this today because I don’t have the resources internally tomorrow.


Let’s talk about it tomorrow, because maybe yesterday I can’t do it.

You don’t, you can only say that in there.

Kind compassionate but clear way if you really know, that’s true.

Yeah, I love that.


Yeah, because that does change in the beginning for me when I was, when I needed my daughter to change so that I could be okay.

And when I was confused and overwhelmed I was swinging from one extreme to the other always wanting to show up differently, always wanting to have more love and compassion but always ending up not liking my reaction because I Get so overwhelmed and because I wasn’t taking care of myself and I was always at the end of my rope or just by, you know, near it.


So, once I was taking care of myself, I was really able to regulate myself here.

I wanted my daughter to regulate, right?

But I’m not even able to regulate myself.

So, how is my 14 year old at the time?

Supposed to be able to figure that out on her own?


And that really gave me some compassion to when I was like, oh, I’m not even doing what I want her to do.

That’s a great observation and so hard to acknowledge that as a parent because there are so many things you’re doing really well, and that you’re juggling and you’ve got, like, all these balls in the air that you’re doing really well with to be able to really acknowledge.


And there’s this piece.

I’m really struggling with and that gives me compassion for my kid.

Like, let me try and be the role model.

I want to be Her.

And that will allow me to be a better Problem.


No more creative because I’ll just have more resources available to me.


Yeah, I love that.

So, something else that somebody asked me about was relapse, being a part of recovery and I hear I’m one hand where that comforting because it happens so often.


But then on the other hand, like, is that really a part of recovery?

Like what is the Science behind that is relapse really a part of recovery.

Well as with many sayings substance use disorders kind of exists on a curve, right?


So you have like most people and then you have the normal curve kind of has like a bell and then boards the end you have like these outliers and unfortunately most of the research that has been done on substance use disorders and people in treatment is on that tail.


And of People who really have struggled and have gone in and out of recovery and had lots of remitting relapsing-remitting experiences with their substance use.

So we don’t really have a great answer to that question because so much of the research has been studied on the folks who have kind of the most extreme version of these problems.


However, if we step back Back from substance use again and think about habits in general.

If you’ve ever tried to make a big change as we all have, you’ll notice that you go back and forth, you have some motivation and then you have less motivation and then you do a live really well and then not so well.


And then you have some, you know, momentum around.

Like now this is really better in this direction and then something unforeseen.

In happens or you know, some emotional.

So there are it’s really understand about that people’s motivations shifts.


So when do we Mark the beginning and where do we Mark the end?

So people naturally have this kind of Shifting motivation with ambivalence and lack of clarity about what should happen if we start looking at that behavior.


Her in the very beginning of that, ambivalence and noticing that, then there’s going to be a lot of variability.

A lot of relapsing or lapsing, or back and forth, kinds of behavior that we’re going to notice before we get to anything like abstinence for harm reduction or moderation, like there’s going to be a lot of mess.


So it kind of depends on where you decide to focus your attention.

And Jim, but I would say that once you have gotten to a place of like really consistent use and then stopped, like, if we’re just looking at people that have been using regularly and then are in a period of abstinence, most people have some experience of a slip but not all people.


And this is part of the sort of tricky thing about Out statistics.

Well, twenty percent of people that have developed substance use disorder are able to moderate.

That’s a number from some research.


Well, that’s not a bad number.

Like if you really want to moderate like I can imagine that.

Feels like a pretty big number but 80 is a much bigger number.

I don’t have to so somebody has to be those 20 people out of 100 And is it possible?


Yes, it’s possible to moderate but what are the biggest chance is the biggest chances are, it’s going to be really hard.

Now, we have a society which is legalizing one substance, and not another or legalizing marijuana, and alcohol.


Even alcohol is like, a worst drug, we have available but it’s legal, has that?

I mean, it’s gets very complicated.

So the picture around like, okay, I’m going to be a Absent from this.

But I’m going to keep using that is very, very confusing and hard to track.


Like okay, so how am I even defining abstinence now if this is the state of the world.

So I think the thing to remember about abstinence and relapse and lapsing is that it is not the end of the world, it is a learning experience, and anytime you make a big change, In your life.


You go back and forth.

It is normal.

Ambivalence is normal, it is to be expected.

It is not a road sign that you’re in a different country.

It is to be expected, it’s just part of the journey.


And when you have ambivalence, if you then use in response that’s elapsed, and if you keep doing that, that’s a relapse and at Any moment you can turn back around, but ideally, you have learned something from that experience, you have learned.


What made you vulnerable to that, ambivalence?

What made you vulnerable to that action and that takes you into a more sustainable path down the road?

Yeah, I would like to think about dieting because what most people die it, like, how often, you know, it’s like a choice, you make all day every day.


A, when you think about our kids making that choice all day every day and then it does seem a little bit easier to understand why it’s such a struggle for them.

But like you said, I do think about my daughter looking back.


Like, the first time, she went to rehab, she really, really struggled, and then she was barely able to stay obstinate, and then the second time totally different experience.

Once and then she was willing to go to sober living.

And so, she was always building on in learning like you said.


But one thing she still just struggled with though every day I think at that, she had had been like a year and a half and she was still struggling with really wanting to live and loving life and knowing that she needed to love herself but still struggling with cravings and you know, I wanted to talk about Fenton A little bit because now that it’s like the number one killer of people, ages, 18 to 45 and honestly, the did when I knew that my daughter had relapsed, I wasn’t even thinking about it.


My main fear when I when we were talking about it was that she would just say f it and give up.

And but I had this false sense of security because the way she could use was a real harm reduction, she had only snorted it rather than injecting it like she used to.


And that told me like, okay, she just needed some relief and she’s going to go back to abstinence again because it’s so much harder to get off the needle.

And so I knew that since she was snorting, it that that was her thought process and we had a plan in place, but she bought from somebody that she didn’t know and got fentanyl instead of heroin and died as soon as she used it.


And so I think it’s important For us to take that into consideration but we also can’t live in fear of it.

But is there anything that we should do differently in light of that painful?


So painful.

I mean, it’s first of all, I’m so sorry for your loss.

Of course, and horrible.

Horrible experiences apparent, just awful, especially in the journey that you’re describing.

This is so painful.

And in your right is, Just you.


Thank goodness.

It’s so frightening.

How and it’s the drug Supply in general.

It’s not even just heroin the Pressed pills.

People feel like oh I I’m safer because this is a pill, it came from a pharmacy.


Well, know lots of people can press pills.

You know, it doesn’t have to be from a pharmacy and that’s got Fentanyl and the system and cocaine has been stolen.

This is so it’s really And everywhere.

He cannot feel certain that you have you don’t have something in your supplies so there are test strips available.


They are also not like foolproof but they’re available.

They give you some amount of knowledge about what’s in your drug Supply.

So, that’s a true harm reduction strategy, right is to test your drugs and see if they was like Like a drugs, I hope party safe or something.


There’s a couple different websites that help people to have these test strips and be able to test their drug Supply.

Again, they’re not foolproof, but that’s one thing to consider.

Obviously, having naloxone around is a good idea.


I encourage they say that if you are overdosing with fentanyl that you off, I need two shots of it so that’s good to know as a family member to just have those around.

Have them in your kids, purse in the car at their friend’s house, it really communicates something serious.


Like nobody has a kitchen without a fire extinguisher in it.

It’s a law.

This is the deal.

If you’re gonna To cook with fire.

You have to have this thing in case, something bad happens.


I know that you’re not done using.

And so this is in your closet, two of them.

And I’m going to resupply them whenever you need them, because this is how serious it is.

You’re taking your life into your hands.


So it is a really serious issue.

How do we live with fear and move forward?

I mean, that is the perennial Question.

I mean it’s sort of what we were talking about before.

Like, how do you have anger and still love them?

How do you treat people with kindness but also feel hurt by them.


Like these are the things that we as humans have to continue to live with.

I mean, I mean, the last couple of years is perfect example, and sort of existential crisis like, without knowing, you know, what is around the corner?

How do we move forward?


Anyway, do we keep making plans?

For the future.

Even though I don’t know that it’s going to look the way I think it is, I guess, but it’s hard sometimes.

And so really checking in with yourself about that, there are times when the community gets alerts, there’s more fentanyl on the streets right now, that’s something that people can know about and you can share that information, that might be a time that you would pay more attention to that fear other Times you might recognize like, I need to move forward but it’s a really important individualized decision about how you move forward, but it’s not different from the one that people need to deal with.


It’s just more sort of pronounced, right?

It’s more extreme.

Heroin, is dangerous.

Alcohol is dangerous.

Sentinel is dangerous faster, but it’s all dangerous.

There is always a chance, but it’s sort of like, people will often feel like, well, I have to keep them at home because what if they overdose somewhere else being at home, doesn’t keep them from overdosing.


Like, it actually doesn’t.

So that’s not the sort of end-all be-all of safety.

She is keeping them near you bad things happen whether they’re near you or they’re not near you.

So the really kind of examining what you’re afraid of and what you think is keeping you safe and being honest about that is I think really important and tricky and changes with time and behavior and what’s happening in the community.


Yeah and it is really important to just address that there.

Is always danger and we can’t just focus on that.

So again, it just goes back to that.


Well-managed well-rounded approach of.

I love the idea of test strips but also remembering that they don’t work 100% and being mindful of it, but that we also cannot control.


If our I had no control over my daughter using there was nothing I could have done, that would have stopped her I’m using that day when they want to use, that’s what they’re going to do.

And so we can’t live in.

If I was in constant fear my last interactions with her, would have been very different so I always like to think about that too.


I’m grateful that I was in a place of Love.

Instead of a place of fear that I had a wonderful last couple of visits and conversations with her.

So I appreciate that idea about how to look at it.

One last thing I wanted to ask Before we wrap up is choice and because I think that that’s something that a lot of stigma comes from is, is it a choice to use or to use again?


Because we think about, we make bad choices all day every day.

But for some reason, when it comes to, if it’s a choice, when somebody uses drugs or not then it gives, you know, opens up all this judgment.

So maybe that’s not the right question to be asking, but what are your thoughts on that?


Yeah, I mean it’s so true.

Ricky, I guess I do feel like choice is so it’s really individual choice.

That is so protected.

I keep saying our society, but I think that there’s something very put on a pedestal about individual Choice as if it were a singular event, as if it were pure in some way, because I became aware why?


You know, when, but that I don’t have like huge emotional experiences.

Like I would have friends when I was a teenager who were, like, really out there and emotional and big expressions.


And I was really drawn to that but I didn’t have like my emotions, like go around like this, they’re sort of in the middle ground, but there are people that have big emotions and For them.

Is it a choice to have those emotions?


Is it a choice to express them in that way?

Is it a choice when they want to bring themselves a little more comfort?

And calm, is it, my choice that I have the emotions that I have?

And so, I just feel like people are so different in their constitution.


It’s not really fair to say, like, well, I never Ever turned to drugs, to manage my intense feelings.

Well, there wasn’t really the same Choice as somebody who had bigger feelings, right?

Like, I didn’t have as much to manage at that time.


And so, I think everybody is in a different situation that is managing different things.

So it’s not really fair to compare one person’s choice to another.

Our brains are very different, they extend to which we The relief.


I mean when you talk to somebody who has developed, I don’t know if your daughter ever said this but like a lot of people who have developed issues with heroin or alcohol will say as soon as I used it I knew this was it for me.


This really I was like key in the lock not everybody has that experience when they have try opiates some people like feel sick and they admit so good.


But they don’t necessarily have the experience of like it’s a key in the lock is that does that make one person?


Good and bad like it’s a different brain.

It’s a different brain everyone.

If you use Percocet for a long enough will become dependent on it, that’s just the way the mechanism Works in our brain, but the experience of it is really different from person to person so just makes the whole question of like to choosing something.


So complicated, some people are medicating.

One thing.

Another person is doing it for increasing Joy or connectivity with peers.

Somebody else’s using it to like manage negative feelings.


Those are different scenarios.

Those are different choices and I just think so when you say like is it the wrong question I guess maybe it’s run question in my mind I just think that it’s not.

It’s like the question is Is too narrow for what we’re looking at with these kinds of decisions.


I love that.

I haven’t ever heard it explained quite that way, and I like the way it just shows that we’re every person is so different and we cannot even begin to compare our experience to somebody else’s and our brains are all so different.


And that, you know, I mean it’s the beauty of what makes humans.

So amazing is our differences and so we need to Liberate those instead of and just in really feel like for me, I have gratitude that I never wanted to try those things or that I was afraid to when they were around or maybe so.


And that was some of the difference.

My daughter just wasn’t ever afraid of much and I had that healthy fear, that kept me from doing some of those things and that was just a difference even though we have a lot of the same DNA, so I love that explanation.

That yeah, that it is just may be too simple of a question for such a complicated issue.


Thank you so much for your time today.

The information that you provided, I know it is going to help anybody who listens to this podcast and I will share links to find out more information about CMC on.


It’ll be in the show notes.

And is there anything important that we miss to the, we need to hit before we end, or do you think we got a good?

I think that is a great sort of cross section of the issues.


That I mean there, we could probably talk all day long about this stuff.

Both of us are so committed and from different angles to the complexity of it all and I just really appreciate your voice in the world.

I’m sure it has a lot of impact for people to really hear your story and your empathy.


Around everyone’s perspective is really like clear in the way You’re describing it so I really appreciate that.

Yeah, thank you so much.

Thank you.

Thank you for listening to this episode.


If you want to learn more about my work, go to Heather.

Ross coaching.com if you want to help other parents who are struggling with a child’s addiction, you can do it two different ways.

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