This- is the ten percent happier pat cast your host? You boy dan Harris hello, buddy. As you may know, the statistics on addiction and substance abuse these days are straight up. Dire even if you're not directly impacted by this. The odds are high, very high, that you know somebody who is for decades. There have been some pretty widely. Did cultural norms around addiction and substance. Abuse specifically I'm talking about things like tough love, co, dependency, hitting rock bottom and then there's the big one abstinence. If you wanna get their act together, you need to feel we stay away from whatever substance it is that you ve been

abusing by guest today takes a rather iconoclastic can possibly for some view. Controversial approach, carry wilkins is the co founder and clear we'll director at the center for motivation and change, she's, also co, founder co, president and ceo of m c foundation for change, which is a nonprofit that provides evidence based ideas and strategies both to professionals and also to the loved ones of people struggling with substance use care has also co author to books beyond addiction and the beyond addiction, workbook for family and friends. In this conversation, we talk about the stigma around substance abuse. We define some key terms like addiction and substance use disorder, and we talk about why those definitions, matter which are about how substance use disorder affects the brain, how to diagnose it, whether there is an alternative to abstinence, how we all need to be thoughtful, but whatever relationship it is. We want with

since as how and why a substantial percentage of people naturally recover without going to treatment the strategies to use if somebody in your life is going down a destructive path. In your opinion, what positive communication isn't how to practice it? What actually- people change and the role of meditation both for the patient and the family. Just to say, I am not an expert in the subject, although I have abused many substances in my time. Dont have a dog in the fight in terms of what are the right approach is to use here. I have a suspicion that it's pretty individual, I do think carry, makes a lot of sense, but also in the course of this interview. Try my best to represent the next, I suspect, I'll, be hearing a lot about this episode. I do want the feedback you can hit me up on twitter or acts or whatever it's called now. You can also find me on instagram and tiktok, where I've been experimenting with posting more videos or hit me up through the website. Ten percent dot com- there's something I hear from a lot of people who listen to this show and care about to

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well that calm slash ten percent or text, ten percent to five hundred five hundred, that's audible, dot com, slash ten percent or text, ten percent to five hundred five hundred to try audible, free for thirty days, audible that come slash. Ten percent. Carrie wilkens welcome to the show hello dan Harris. Thank you for having me pleasure. Let's about the overall addiction picture. But the beginning here at least in the united states. As I understand it, the numbers are not good. Can you paint a picture for the other, not and in some groups, their extremely concerning, depending on what studier looking out. They think that one in ten americans struggle with a significant substance use disorder. Some sorts, and right now I mean in the last three to five years, the fat,

Crisis has spent come increasingly problematic and the overdose rates are shocking and painful. There's a hundred thousand people dying of overdose, this country every single year and two hundred and fifty a day. I just read that the stats for. Teens and young adults overdose has become the single biggest cause of death in teens and young. Sid surpassed suicide, so those are two pretty disturbing numbers. Yes and that's a lot of families being impact, people are being impacted with the problem and in their families, are suffering immensely. Yes, the ripples out were now talk about addiction and much more sure of urgent ways than we did during the crack. Abbot mac but which mostly involved black people and the opulent addiction involves a lot of white people. Do you think? That's a factory the urgency of the current discussion around addiction. I absolutely think it's a factor bs very much, so I think weight

young men started to die and, and thankfully parents became very activated, but there is definitely been a shift in the open. to discuss substance problems. I mean if such an incredibly stigmatized problem to have like people. Don't wanna talk about it. I'm in families don't wanna talk about anything. There was enough activation around the opium crisis from white people and people with privilege. that the conversation that got into the media in a completely different way than it has in other epidemics amene, where we didn't we talk about it and we were able to really other the people with the problem and say: that's not us. Now it's us and I think that's shifted things dramatically. I'm going with you think I'd we're talking about it. Now it's unfortunate, but let's be thankful that we're talking about me. You were talking the stigma, and I give a lot of public speeches It's amazing it or even though the stigmas around mental health generally have really been reduced. In the last five ten,

ten years every time I mention that I have trouble with cocaine. You know it's an awkward mom in the rome. It still really tough thing to talk about an I think, shifting a little bit because of people like yourself for being open about it. But there is something about substance, use problems and behaviour, issues where people feel like you're out of control you're, doing something that is scary, you're doing something that is destructive. Your outer control. So I push that away. I don't want to look at that. I don't want to understand that you're scaring me and then I get mad, and then I get mad at you because you're causing lots of problems right so there's a lot of emotional responses. We have to people when they have since use issues and then I think, just We talk about it. I mean you look at the word choices we use. When we talk about people, a substance, use issues, I mean that we have a video that we show when we do trainings and we blast. Screen all the words that people use junkie, attic, alcoholic rock bottom

dependence, you know character, defects and there's all these phrases that just role of people's tongues, and you think about ok, you're, actually talk about a person on the other side of that we're talking about a person whose behaviour makes sense in some way there not using drugs, because our crazier just morally bad people they're using drugs because they work in some way for them. How do we actually, we're stand that which then allows us to be able to understand what striving the problem and potentially help it. But if we just label them as problematic bad people and in this country would tend to like to lock them up, which is one of them guess problems as we just want to punish it, instead of understanding that, that's why I think it's getting worse so instead of talking about this is a moral, I think, you're saying that we should think about it as a sickness. Is that a correct summation

Well, it's a behavior and it's different for different people right. So every single person who uses substances uses them for different reasons. They get some different effect from them. Some people have a little bit of a genetic loading where, while a couple Thanks for me feels really good right. I feel it I feel that, and I like how that feels. The person to me you as no genetic predisposition doesn't even tickly, like the effect of it just doesn't. feel it and so doesn't want to have another drink maybe I'm having a drink. I am also a little anxious and alcohol is a really good, anxiety, forget with anxiety? It harms right. It has down the road, but the immediate effect is that it has some I like about it so one thing that we humans to do is repeat things at work in some way: the works for us we're gonna. Do it again like I've heard you talk,

you're cocaine use like it worked in some way for you at that time. We know it ultimately had some consequences there weren't great, but that's not what got you into it right, so I think to be able to pause and be curious. about a cook hey. How does a behavior makes sense, because then we can go and billy. Ok. Is there another way to get that need matt? something in your environment. The needs to change so that you're not drawn to it or it's not your only outlet. It's not your only way to connect with other people, I mean there's so many different ways of people develop the problem in theirs, many different ways. The people get out of the problem, but in this country we tend to talk about it. In a very black and white you either have it or you don't you're, either in recovery or you're. Not you know, I mean it's like very black and white, which I think just excludes people and keeps it underground and keeps it stigmatized man, that's what we're really hoping to change. So we're going to talk at great length about some of the strategies to use here, but before we go there. Let me ask him just very basic question: what is

addiction. So there's the formal medical version of It's use disorder. I don't even use the word addiction that much any more because again, I think it pushes people away were so wired to automatically not want to be an addict that if you sprinkle addiction in a sentence, people will stop listening. So we use substance use disorder. We used to struggle with substance use cause. I just want to catch as many people in this discussion as possible or pull them into the conversation is more how I'd rather say it, but the as you know, eleven symptoms that costs. You took me, criteria for a substance, use disorder and people can fall anywhere on that list of symptoms and you can have two or three and you gotta have a mild version of a substance. Use disorder here for I view the moderate zone and if you have more than six gabby severe substance problem and studies, show that people can cycle in and out of extremely problematic substance use they can cycle in and out of it. Maybe you,

billy struggling for several months and then you stop and you dont use again for two years and then comes back in another way. You know when you see it move around and people's lives in something the chief substances and maybe it moves to another behaviour. Ermine people can I come in another dozen all sorts of different ways What do we know about how substance use disorder shows up on the level of the brain, so that would pay the whole package in and of itself, and I'm force learning more about it all the time I mean to just be super simplistic about it for the audience. You know we have our reward path. Ways and the dopamine wine is one that is most talked about and minutes way more complex than that. There's multiple, nora, transmitters involve and different substances affect different. the brain, so it also depends on which substance you're using so alcohol effects are different so the brain and people who are using cannabis than people who are using of lloyd's, but I gotta go,

those reward centres where you have the experience of a reward. It works you like you do it again? So then you hard to establish the memory pathway of like oh. When I have this drink, I feel relaxed I start to have a drink every night They come home from work because I start to feel stress is now my brain says: oh alcohol, well, I'm stressed so drink every night that becomes a habit and then on the weekends, three clapping afternoon, when I feel stress I think I'll drink would make me better right, so it affects the member pathways, its involved in emotional, like either. We started like now we are able to regulate our emotions without substances I get upset. I want to have a substance to calm myself down. I don't feel anything. I want a substance to pick myself up so it starts to. over time, like really merge into people's lives and quite complex, and long lasting ways that then, when you say okay, you need to stop using now because is causing all these problems. You take this option.

out and they have all these things. They have to re learning or maybe learn in a new way. Brain disorders are using as an adolescent, and you don't know how to regulate your feelings, because you ve been spoken pot areas I have a feeling you stop talking pot when you're twenty five you're can have to learn, how to deal with your feelings- and you ve, never done that before I had a lot of learning, so it affects the emotional parts of the brain and effects on earth transmitters on a very chemical level. You know you can end up having increased tolerance, so you need more and more to have the same effect so you're going to have withdrawal symptoms when you stop sort and have to deal with that, so there's physiologic Well, there's emotional! We know it's again different for different people, is it your view that if somebody has a substance use disorder, they should cut that substance out entirely or is there an alternative to abstinence heading for lots of people theirs?

Turn it off stew, abstinence, and I think anybody who has gotten themselves to the point of abstinence, most of them that's a process for they ve tried different things along the way and they ve collected the evidence of in a word every no time I've tried to moderate every single time. I've tried to stop using cocaine and keep alcohol. In my life, I go back to cocaine, and so you know what I've just decided. I can't do it anymore. I ve never met anybody who just said you know what I want to abstain There is a lot of learning that got them to that point where they were like this, just as not working for me and I collected the evidence, We need to stop, then they have to figure had to stay stopped. Because we forget, we forget negative things and we forget what wasn't working so well. So we also have to find ways Let us remind ourselves of that began. it changes, and then you gotta sustain them, which is hard from process. Are you saying that, if possible, to have a healthy relationship with any kind of substance like an idea, one week, a month, cocaine user, you know: what's the health

level of substance use without one, cause of diagnosing a substance, use problem, one of the things that you're asking somebody is are: are there negative consequences been caused by this behavior that you wish you could avoid bright and, if you're persistent in engaging behaviour, even though you ve got a bunch of negative consequences that are really affecting your life. That's when you ve moved, so you're having a hard time sopping right. So if we're gauging something that on one level, we really feel like. Ok, this works for me and my marriage is crumbling. You'd have my my doctor saying I have fatty liver and I'm persisting in doing that- somebody who probably needs to abstain because they can't now eight those middle waters. But there's a lot of people who moderate you know, I think part of what happens in the press is that people who are absent are very open about people who are in twelve stock recovery are very open about it. They talk about openly. They want other people tat period, stories and that all wonderful there's a lot of people who chain,

and they don't talk about it. Do you know they said one thing and continue another, and they don't go on and have negative problems, I'm so maybe a guy can use cocaine once a week and once a month and other problems with that. It's his job to assess out for himself of like. Do I like I feel in the morning my doing anything that night that I regret and feel bad about the next day, and I am I not attention to my kids in the morning and the way that I would you have to actually honestly assess the content As for yourself, be doing things that are consistent with your values. You now are you being the person they want to be. Those are all very individual choices and I think we'd like to label things as like problematic when that's for you to figure out those are the conversations we're trying to help people have is to really look inside and be curious about is working for me if such an interesting and It's a touchy subject, because any time we talk about alternatives to absent the show I've gotten a lot of

angry letters from people who you know had so much success in, a and other abstinence oriented programmes, and those stories are important in real and I remember in the years after I quit doing, drugs have been. I personally can't have a I don't think healthy relationship to cocaine. Also, fifty one and not in the market. For me, no voluntary heart attack but I remember in the years after I quit doing drugs, and so this would have been the you know me too late aughts, I was sober, but I was kind of conflicting. and my wife got me in to see some therapist who specialized specialised in this stuff america arguing with him about this insane. Well, you know the humans have use substances since there have been humans. You know mean magic mushrooms. They already. I oscar alcohol. I mean the cocoa plant is not like new invention and

feeling resembles lean right, so I can't be that there is no healthy relationship to substances and so far no one gets bullock step in talking about this and why you get angry letters is because people are scared right, so people who ve gotten better through the twelve steps or you know, have really and the point where there like, I have to abstain. This is the only way I will thrive and be able to live there's so much fear behind that they ve gotten themselves and probably horrible experience rights or their very invested in that, and so I am not saying that bad place to come from it, but it shuts the conversation down for other people who are open to change. Who can make changes Who can have reasonable relationships with substances in their lives and its shaming p, or who may have a different path, and maybe wanna have substances their life. That's a choice that people get to make that had a supervisor. Once you said people get to make their own bat

visions, that's actually just something we humans get to do, but can we create an environment where people can openly talk about it instead of going underground and feeling ashamed, and I think that's what happens in recovery alot, where people appear the message, I'm not doing it like that, or I don't believe in that strategy, so I must be doing something wrong or the Is it real recovery? Amid the number of times where I've heard treatment provider say, that's not real recovery? What were you to judge? First of all, and it's the person's life to live, and so part of what we're trying to do is help people, and there's ways to talk about it, I dream of provider that probably backed you in a corner a little got? You say and wait a minute like there's always other ways of possibly can work right like we can back people in court. there's and shut them down and stop them from self reflecting on. What's going on with them, or we conversations where they can be curious, where they can run it governments of like I wanna, try this or that, but I'm willing to keep looking at it

passing whether not its working for me, one of the evidence based threat she's a we use something called motivational interviewing where you're really trying to help people have a conversation where they can look in, internally and activate their own internal motivations for change. You can have a gun station that turns out on, or you can have a conversation that shuts down I'd rather turn it on and not labeling people or telling them, there's only one way to do this, and if you're not doing this way, you're doing something scary and dangerous and harming people. Shutting the congress the shutdown has been harming people for decades in this country, like we have not been talking about it and people have been harmed as a result of that, so I'd rather keep the conversation open. I want to put a pen in motivational interviewing because it sounds very interesting, but after a lot of people right now, especially since we do see usage of substances go up during the pandemic? I think there are a lot of you right now are asking themselves. What is the relation by wanna, have with substances

I hear this a lot around alcohol. In my family we have pretty devastating alcoholism. just as there I don't drink, not because of that actually blue. Just because I have some of weird allergy, where, if I take a sip, I just feel awful and at last for twenty four hours. So a pretty strong We disincentive us is a lucky you in some ways year, while I totally absolutely, although I do miss it. I love the taste of wine and beer, And- and I love the social aspect of it, and I problems with substances not really without call, but anyway, that's neither here nor there. The point I'm trying to make is that I was talking, family member, the other day who was trying to figure out what their relationship to alcohol is. Gonna be, and you know could hear real struggle. You know there was a recognition that there was too much shrinking going on here too for and some real changes had been made of late, but also this person was having a story where they are.

The dinner with a bunch of people, and they had a wonderful bottle of wine and it was a bonding experience, and so I think that a lot of people feel this real tension between wanting to have the substance, often the hall in their lives, but also not wanting to have it ruin their lives, and I know you can't give one size fits all advice, but What are some general guidelines you can give to people who are confronting these questions? Also that ample makes me want to talk about multiple things, air, because that is such a good example of you talking to a loved one bright, their sharing their experience there, giving you the benefits of like what they love about it and some of the stuff that their struggling with. Had you conversation said well, you know Joe what your the same. I really think you have a very serious problem and you should stop you're. Probably an alcoholic- and you should stop how many might die, because, if you're drinking right that will send the conversation off the rails and bell and up the same? It's not that bad right. It's Israel

four pad and they'll probably start talking about some of the things that they liked about it more than those talk about the things that their concern about. So just how we talk, when somebody sharing information can pull them closer to examining it or set them back from looking anymore the other piece of bad weather, driving is something that we talk about us the costs and benefits. We do an exercise with people. Where is really look at the costs and benefits of the substance or your relationship with it. Like all the things you get out of it like what you like about it in terms of how it shows up in your relationships, do you think you're funnier when you ve gotta? the drinks. Are you able to have sex or comfortably when you ve got a couple drinks? Do you like say things in a conversation might otherwise be something that you would avoid. So you might here, those as like all those things that they should be able to do without the substance right, but the reality is the substance helps them do that, maybe it would do the stress. Maybe it helps them stay focused what

it is so there's all these benefits, then there's the cost, all the things that they don't like. Of course that's worth, paying attention to the value of looking at the benefits? Is that gives you a window into okay? Are there alternative pathways? Are there other ways that you can bond with your family? Does it actually have to be over a bottle of wine, or are there other things that can happen that make that bonding, feel as joyful and great as it did in that it's probably not the wine, but we're so condition to have expectancies of like a wine. He did so much better may probably not if you weren't so condition to think that way and like can you just work on identifying the things that you are getting from that, but learning different scope, in order to achieve those same effects. And then you have all sorts of ways hence the behaviour and become less dependent on it. Can people depended on the wine in the pathway or the substance being the pathway instead of feeling like I can take it or leave it. I want somebody be able to take it or leave it

trusting to hear you talk about other ways to get your needs met a man just kind of thinking. Back on my own life, I quit doing drugs in the mid two thousands and I computed it as devastating to my social life. You know, because I told myself I have a lot of fun being out late in with my friend. binding, and I couldn't we do that anymore. I told myself and ended up kind of withdrawing into work and in a healthier way into my marriage and woke up fifteen. Sixteen years later, realising that you know I still had those friends, but the relationships head, atrophied a little bed and have in this last year really made a big investment in seeing people and upping the cadence were socializing and I've, been, I still don't, do drugs or drink, and I realize it's really it's just the camaraderie that I watched. You know I mean it,

it's not just a camaraderie of me. Actually, I'm not. I don't want to degrade the value of drugs in that way, because I actually do think substances can be additive in the right circumstances, but mostly what I wanted was the dopamine and oxytocin from hanging out other people, you have been able to laugh share story, share experiences, that's what you are enjoying, but we are really condition to think and alcohol in particular to think that it is like you said, added I mean the alcohol industry and the marketing like sports events, just everything has alcohol wedding slick. Everything we goes was to be better with a few drinks, and we start to expect that when, if we take it out and actually work on those relationships and have those experiences sober. You do over time realize alcohol, nothing to do with it. In fact, it was probably making things worse cause. I was saying and doing things that I regret so I do wanna fact check myself because I says There was an entirely true. I do not drink just because, as I said before, it makes me sick and I dont do drugs with one asterisk.

His once in a very long while I might do a substance, but it's quite rare. So I just want to be fully honest with everybody here which brings me to a question. I I wrote down that I had for you, which you may not want to answer, which is where you are there substances you use yeah social drinker and lately have tried with in the cannabis field. Now that legal and massachusetts and reno hadn't trying to channel Since I was a teenager I felt like I need, We stand what was happening and again it and running my own experimental like it's actually not really that great. For me, it makes me I don't feel so great a veto in speaking of behaviors sense of I struggled with eating issues as a kid you know so, like my return of early twenties, it was billy. Eating disorder was kind of the way I was struck with my emotions and expressing myself and when I stopped doing that alcohol popped up suddenly I was binge eating and then all of a sudden I was binge drinking. You know started to work on those issues was in therapy and resolved some of the

underlying things that were driving that and I dont ever feel like been jean on alcohol, like it's just, not a thing that I would ever consider doing now it had she looked at me when I was nineteen years old. I was completely out of control and doing really scary and risky things, but they were being and by things that are happening to me at tat period of my life, and I did the work to deal with my oceans in a different way and adjust. Is this not a thing had ceased, not even something? I would want to do at this point. So I think there's a lot of people when you go back and assess them at different stages and in their life. They really it's like they had a serious substance, use problem of some sort and it just resolved on it's own. They did some other work. They never went to formal treatment. They never went to a a that. Never did anything.

pacific around the alcohol or substance use, and it just changed because they dealt with some of the underlying things, and I think that's so much of what your audience is focused on in terms of self compassion, mindfulness meditation. All of the strategies are ways to deal with our emotions and our thoughts in a different way and people use substances to manage their emotions and manage their thoughts, so those are perfectly exam some alternatives that review practice and develop aegis made felix substances are just not something you want to do any more. Just two weeks: you're, not saying a or intensive rehab are bad here, saying that there are other ways to go about an huge, a huge proposal of self help meetings and I have a rehab. So I am not against three had been. Is just the black and white way that people talk about it? That's you know when they hear a family member talking about a substance use or somebody saying. Oh, my husband, struggling our partner struggling they'll, be like you need to do in intervention. Maybe they need you gotta rehab. Maybe they need to go to meetings. Studies

been done that, like seventy percent of people who meet criteria for substance use problem some point naturally recover. They never seek treatment if they just get better and some of the things that they do to get better or all the things that we ve been talking about, which, as they find alternative strategies, you ve said it, but you just decided to It's a work for me anymore. I just it's ruining my life, I don't like it so I'm going to stop. I might. shift into something else and have more work to do, but I'm just not engage in this behaviour anymore and then they develop other interest other hobbes and their life is different. Coming up carry wilkins talks about. Why there's so much shame around substance! Use meditation can help and what actually motivate people to change.

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it's that many substances you know we've had Michael pollen on the show to talk about psychedelics and also things like caffeine, but from alcohol to cannabis. Many of these substances have beautiful applications, So it makes these conversations around substance, abuse or substances disorder complicated, because I dont actually fall on the side of vilified. The substance and I am grateful that you're not falling on that side, because agenda just shut the conversation down and to be able to have these conversations, knowing that you're gonna get a bunch of inflammatory emails assain what a terrible person you are that we have this conversation, that those are the people that I see they're just panicked there. There scarce user scary conversations we like to control things, we don't like uncertainty and when you say, like people, actually have the choice to make around their substances and to establish at what is healthy for them or not. Let's actually create room for them to talk about that and think about that, instead of saying

there is only one way to do this. It just scarce people who a better in that pathway. You know of the twelve steppin abstinence only they just get scared, because bad things happen to them along that way, and so I Try to understand its, it's ok, you're scared. I get it and I want to be able to have conversation with this person over here who is trying to have some sort of relationship with substances and their willing to talk about it. I want them talk about it, I want them to be able to explore, and I want them to be able to talk about with working and not working and be curious about it. And, if I just say it's terrible that you're thinking that or terrible that you're considering that they're just gonna stay inside of themselves and try to get out they're gonna. Do it anyway. I'd rather be while the net process and potentially try to help them speed up that learning process, because I'm creating a space where they can talk about it and be curious about it, and I have actually limitless compassion for people who are scared them and who prove it.

leave their own lives or had their lives saved through absent in some really? I think that is we keep saying it. It's just a huge avenue for so many people, but I guess what I'm trying to on top of it is the. I think there are many many many very healthy people who are using substances in healthy ways, and that's actually a thing I don't think gets talked about that much now very gets talked about, because there's so much shaman stigma right about being able even say that out loud because there's all this fear and all this judgment about substances and relationships with substances. One of the things that's happening, thankfully, in the treatment field- is something called harm, reduction and more and more states for governments and treatment programmes are acknowledging. We actually have to meet people, whether at we have to work with me. while at varying levels of motivation to change behaviors, and maybe they really want to change their relationship with opiates, but they want to keep cannabis in their life

ten years ago, five years ago, if you said that to a treatment provider, they would say sorry come back when you're ready to be absent from everything. You can't do anything for you now people are saying of. Let's talk about that, let's try to help you figure. Well. Let's really help you get the tools you need to not use opiates and let's help you figure out what your relationship with cannabis is going to be. That's a really healthy important conversation to have, and I think that's what you're saying, which is like you- have all sorts of relationships or substances and were too embarrassed to talk about it We're going to get shamed we're going to get shamed by people who are going to say you're a bad person for suggesting that and bad things are gonna happen, they're happening way. Let's just have a conversation about it. Yes, that is what I'm saying, but on the isle of a further than harm reduction. I'm saying there is the argument that people in the jazz and hip hop and rock communities have been using cannabis for creative purposes for a long time, and that's great so, yes, you can have a dysfunctional relationship with this substance, but you can also have a really fun

shall relationship that is way more positive than even harm reduction for short, There may be all sorts of ways that they were used and helpful ways around creativity and in their work and whether or not their relation ships suffered at all or whether or not their health suffered at all either. So that's waiting these just nuanced conversations that is for each person, assessing maybe it works for He presented my life and I'm willing to take the twenty four, and where I know its not great from my relations that's just so important to me in this other area. I'm gonna keep doing it. Does that, matters to me- ok to live your life, and I think if we can shift the conversation to having more compassion and understanding and curiosity for person as they make their decision. Then you know we ve just got a bigger platform to about what people struggle with and be able to be. Like a case, it's not working in this twenty percent, a sack about the twenty percent make that better. You know, maybe you can have, it's in your life and less work on your relationship, so that is better and not being heard by your substance use, but if there

feeling like. I can't talk about it because I'm gonna be told they have to give it all up. What are we doing? It's just not helpful. for in therapy relationships and is not helpful in just friend relationship send family relationships guy. I agree what you're saying- and I think we need this middle ground, because on the one hand we ve got you know, the tyre multi billion dollar industry, thou call a beverage industry, sort of selling a glorified version, and then we have the absence unity, telling us that you're playing with fire, which actually is and not entirely untrue if you're having relation but these substances, and so what we want to have is a nuanced to use your word. caution about the pros and cons of all of this- and this is going to be very tough- to do and highly individualised. And yet, if we don't have the conversation, we're stuck with the poles gap payment. So

And the shame I mean our main point is: why is there so much shame you ve set at multiple times in this interview, like there's a lot of people using substances in a lot of different ways, and it's not all bad, but we all hesitates, talkin because there is so much shame and so much stigma and people just geared up to feel like. If I talk about this openly, somebody's gonna tell me, I'm done something bad somebody's gonna tell me. I should change somebody's gonna. Tell me that I'm out and so I asked and not talk about it or in gonna- pretend like everything's fine, even though part of it might not be. I might actually be a kind of worried about parts of it, but I'm for sure not gonna disclose that, because just the way, people too, about it is so judgmental and it'd be great if we could bring were compassion and curiosity to the whole exchange, rather than judgment men just going back that fear minutes. That's where the judge it's coming from absolutely again. We both have compassion for their fear, so

you mentioned earlier mindfulness itself. Compassion is important tools that I talk about on the show. My guests and you use them to in your work. So if I in this situation, where I'm struggling with my use of substances, how would meditation and or self compassion help. So there helping with understanding, which is why we ve talked about so far. Which is just understanding. These behaviors makes sense. They work in some way. Let's understand what draws you to them, so he can be curious about that and think. Are there other ways you might be able to get? Those needs met right, there's the one. size doesn't fit all which is like. Maybe meetings are going to be helpful? To you may be a yoga class is gonna, be helpful to you. Maybe meditation is gonna, be helpful to you. Let's really opened the door if you're somebody wants to make change, and maybe Maybe treatment, maybe you're, never gonna crossed the door of a therapist's office. That's ok! one size does not fit? All ambivalence is normal, like really excepting like when you make any sort of behavior change, you're gonna be rustling within the balance and how you

wrestle with your own ambivalence and how the loved ones and the people in your life respond. Cheer ambivalence can really tipp it one way or the other, and that another thing people don't talk about so much and then pumping with software agnes and that's where the mindfulness and meditation of compassion for men, because if you're ruminating about past mistakes, if you're launching yourself into the future about how can you possibly live without the substance or here now we're going to be the same. If you don't have this in your life, if you're in the the future worried about things, you're really going to have a hard time with a present moment stuff that you have to face in order to make behavior changes, so we spent a lot of time trying to help people find mine from the strategies that just keep them in the present moment, because the present moment, when you're making significant life changes is hard facing a lot of unknown things right by a lot of stuff that you feel bad about ends if you're in the past your gun, have less energy to deal with what you're facing that particular day. So mindfulness strategies are really helpful and self compassion is, I think, key to helping people,

Stay on the learning process, because if you have a setback, if you like a cat, want to stop drinking or whatever it is, and you have a slip if you is we fall into. I wasn't taking seriously. Maybe I don't really need this. Maybe I am just screwed up alcoholic whatever it is that colonel critic assain to you you're going to have a hard time getting back on that path of wanting to change versus being able to say to yourself wow. This was really hard. I didn't actually know what I was doing. You know I thought I could go to the party or that event and be ok. I wasn't, it was way harder for me thy anticipated the cravings were worse if you can. Passionately be kind to yourself and that moment be like a really suffering. I miss my and this is hard you can then bring some kindness to it, which helps you stay in the willingness to keep learning. We like a can't make any more support. Maybe I need her slow, he's down, maybe to expect a little less of myself right now right, if we're just in the internal critic, chatter of I'm so screwed up

can't do this you're not gonna persist in all the things you have to learn and one of the things I The people on a time is like when you see somebody who's given up substances and you ve, given me enough examples today that I think is probably true for you too. You gave something up and then you had to learn all the southern new stuff right learn how to be social. You had to learn how to deal with them, Your feelings and that learning process takes a lot of time and takes trial and error antics practice anything self. Passion in the I have to learn, have new learning to do here and I'm not gonna be perfect at it. A monastery phenomena have setbacks and I'm gonna keep trying we kind of myself in that learning process, and that one of the things that we say to family members is, you can expect your love went to just give it up just because it's bad for

meant have made that decision and then be able to do it. They ve got to learn how to be sober or whatever it is. Our goal is, and that takes time- and that's where I think self compassion is key- can completely suda mindfulness would help you get out of the swirling stories in the fearful projections and self compassion would help you take it easy or on yourself get out of the inner critic and not be so up in shame that your paralyzed, you ve taught motivation. Quite a bit generally speaking, What motivates people to change? And Do we figure out what our motivation is, so one of the EU ways to think about it again, it's different for different people, but when you are looking at behavior change really wanted. Something has enough costs that it starts to, like you said it stopped working This is not working as well, I'm not getting as many benefits from it and having reasons there are important here that you, in the other, direction so we're custom

wrestling with the edge and the problem with substances they work fast right, so they may not be working for me in the long term way like my spouses, can be really mad at me tomorrow. But effectively. Right now is really fast. works really well for it. So my memory pathways are gonna, be like just do this, its quicker and it's easier because are always looking for the short circuit rain and the how I get a slow down. I've gotta try a new scale. I've gotta try to do this new thing, that's harder work, so we ve gotta, try to help. People have wrestle with ease moments when they feel ambivalent and be able to be like what you what's happening in my environment. That is concerned into me wanting to go back to an old behaviour, because it probably gonna have to shift something in my environment and what you said. Maybe your friends like, may be needed to distance yourself from some of those friends and the beginning of making changes, because if you'd have been hanging out with them, it is

What's it around, you everybody's doing it, and so it makes harder make that decision. So maybe you have to remove yourself for a period of time and step away from it. While you learn all these other ways and learn, that you don't need at ten march, that you can have it and manage your mood without it and then reintroduced those friends. So things are Environment should make us ambivalent because it pulls us back into old Behaviors in our emotions are thoughts. Can pull us back and told behaviors so being able to identify the things within yourself of like these are the things that to pull me to such behaviour that I dont want and then start to work on those things and that's again, a whole host of strategies that will help you with those emotions and thoughts and that's different for each person. So let's go motivational interviewing and how to talk to people. Gotta I've been forcing you to focus on no individual relationships. Substances, but a loving focus of your work is talking to loved ones at family members of people who are struggling and pretty acute ways? What is it,

of motivational interviewing. What is that, and how could we put it to work in our own lives as a journalist and if you're you're, probably better at this than you realized when we know how to make people defensive and we know how to get people to talk right so so in therapy. The motivational interviewing strategies are about trying to create environment and our relationship with somebody where they feel comfortable and safe to talk to you openly about how they really think and feel because you don't have an agenda so part of it's just really not having an agenda of like I don't have the right way here. My job with you is to try to actually create space for you to talk out loud to get some of yours and feelings out with another person and have me reflect, and it's a lot of its actually just reflecting what they ve already said back to them to strengthen, things that they ve set about themselves, because one of the things that happened therapy and in particular, in the dictionary my world where people were disclosed

things and then the therapist will say yes, but this is what you need to do in outward, but we have a very serious problem and these are the things you need to do to get out of it, which prevention? that conversation down versus saying he, then what is it? You said you concern about X, Y and excellency. What is it that you feel it might be helpful? What have you tried to? can you open it questions it? Get you to share what you ve tried, what you're thinking How did that work for you? So all the open and questions how what why versus question illicit, oh, yes and no response you or our agenda driven and so were teaching family members to have those conversations, because parents in particular will just get intellect tour mode right. You just want to tell your kid what to do and tell them to stop doing the scariest. Often do more of the practice in it adolescents versus been able to say hey? I notice your hanging out with your friends and I'm europe spoke in some pie and I'd love for you to tell me how that affects. You may know what makes you want to do that. Parents will think if I have that

in conversation, and I somehow condoning it right if I The conversation my kid about what they like about their substance use. Does that mean I'm condoning it and it does it. You can- said: I'm really uncomfortable with it, but I actually really want to understand it. I want to know what you get out of it, because, as a parent, that's going to give you a ton, information. If you can get your teenager to tell you about this aids is and whether struggling with and what they like about substances, it allows you to step away from that conversation and think: ok is using it social anxiety? What can I do to make their social interactions easier? Can I make it easier for them to get to lindsey group or a club. Or can I have people over at my house to make any you know just allows you to problem solved instead of just telling them, don't do this and having them go underground with the behaviour anyway. Do we want to keep the behaviour above ground wanna keep talking about it? you do a lot of myth, busting about the appropriate avenues and levers avail.

to those of us who might be dealing with people in our lives who, we believe, have problematical ship to substances. Some of the things you talk about include interventions being the right way. Tough love mandatory, rehab you know, people hit rock bottom. The notion, if you're in any way understanding your enabling is that list the exhaustive, and can you just sort of tick through why of these may not be the right routes, you can help me eliminates people saying they gotta hit rock bottom. That phrase just makes me crazy. It's cruel. It's not true and people are really dying because that's the belief in our family members get told all the time while there's nothing, you can do to help your loved ones. They just gonna hit rock bottom. In order to change end firstly, with the old provides that really is resulting in death, and we really need to stop saying that, because you can affect people's motivation at any stage and you

have a positive influence on it at any stage. It takes a fair amount of strategy and it takes some thoughtfulness and it takes you, the family, member, probably learning some new skills you might not have. So it's not an easy route to mean. If your panic stricken doing an intervention feels like a quicker fix, you know and that's a part of I also think what we're struggling with is everybody wants a quick fix. They want the problem to be gone fast when you have a level of a substitute, album it's scary and it's probably causing a lot of problems, so you just want that problem to go away as soon as possible. Re the idea of I'm going to have to slow down I'm going to have to learn some new ways to talk about the as gonna have to think about my environment a minute after think about my emotions. Feminine I don't really want to do that right. They want their loved ones, you get fix, so it is really changing that whole idea and family members also get told that their codependent, that's not in the diagnostic manual. There's no such thing as for dependency. It's a label. It gets hostile round which is equally problematic, us

telling somebody there an actor and alcoholic. You know if some eight if identifies as an alcoholic carnatic like if they're like yeah. This is and I'm a part of this community- and I relate to that concept- great mused, the word: it's fine, that's yours, But me telling you that's what you are very different. Act and we label people all the time and so the label, and it's a reason why people push away from help and it's a reason why people say I'm not that so big advocate of just eliminate those words. You don't need those words rusty self heightened by the tough love. I think it's just confusing ear parents get told that all the time and they have no idea what it means you know like for some people, gives them licence to be toughened lecture and yell and do all sorts of things that just make them feel There have any impact when they're just creating more friction in their relationship and it feels back to them and it feels back to their loved one. So the tough love thing I think it's just a confusing metaphor and telling apparently have to distance themselves from there

I've never met a parent who feel that they can do that without risking their heart out. They may really need to do. some strategies to set boundaries and set limits and possibly cut some things are their supporting and again think through that strategically. But we just say these phrases as if they mean something and they really dont twenty, unpack them coming up, carry talks about the strategies to use. If you ve got somebody in your life, you think's going down a dangerous path, what positive communication is and how to practise it and the problem with bringing a quick fix mentality. Very common these days, to something like substance use, disorder.

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by switching their home in car insurance to progressive, save nearly eight hundred dollars on average quota homing car bundled today progressive dekom, progressive casualty, insurance company in a fairly its national average twelvemonth savings of seven hundred ninety three dollars by new customer surveyed who save with progressive between June twenty twenty one and may twenty twenty two potential savings will vary. So what is the right side, at if you ve got somebody in your life, you think, is on a self destructive path here. What does work treatment whirls for two decades. There is a very effective strategy. Old craft which is community reinforcement, family training, the terror. acronym to what we have? It was designed for family members whose had a loved one with a significant, substance, use problem that was resistant to treatment and they did pots of studies with this, one of them as well researched approaches, and so they can.

the two assigning people to an intervention or to Al Anon. So they took families and put them in three pathways and said he learn craft You can go to an intervention or you can go on and the compared the outcomes. Family members who learned craft got their loved ones, treatment sixty to seventy percent of the time. It's high numbers right, when they got them into treatment, their loved ones. Substance use was down and the family members, mental health was up, there were lester or ass. They were less anxious and that he felt like their family was more cohesive. So those are great outcomes in terms of an intervention having a positive impact. when they compare that two interventions. What they found is like interventions get paid, the treatment about thirty percent of the time which is contrary to what interventionist will tell you they'll say I get hundred per cent of people into treatment, maybe at what cost, but in the studies,

actually around thirty percent and the problem with intervention scissors, enormous high drop out rate, so family members about two thirds of family members drop out of doing the intervention, because it's too painful and they're like I actually just don't want to do this to my loved one. It makes me feel bad. I don't want to do it and then the problem with interventions is people go into treatment and they're pissed they're mad as her loved ones to for doing that intervention, and then they come out and there's a fracture there with the family and the family is potentially the biggest resource when they leave treatment right. So that's not a great outcome and then the Elinor on strategy gets about ten percent of people into treatment, but Alan's not designed to get people into treatment. Elena, like a billy, nice self, help support group for family members, so craft is a set strategies that help families learn how to reinforce positive change like real

How do we support the things that are going help my loved one change, and how do I keep things positive so that my loved one wants to be close to me not just connected for me, like it's ok, to be connected where social preachers and one thing that can It was substance. Use is positive relationships. So if I'm distancing myself, there's no connection there and thus Essentially the lifesaving things thing craft gives family members permission to stay connected, but it gives them a set of strategies to do that. doubly so they're, not inadvertently. Supporting substance use its helping them taken. Actual consequences and let them play a role as a natural consequences are the things that are a direct outcome of your substance. Use No, so, if you're I'm getting out of bed in the morning, I'm not gonna get you out of bed, I'm not gonna help you get out of bed and so I'm going to. Actually, let you feel some of the consequences that are a result of your substance use because that's what's going to turn your motivation on cause you're going to be like? Oh wow, it's not working for me. I can't get up.

and I'm gonna lose my job versus. If my partners getting me up, I'm getting to work, but my partners mad at me right, then I think my partners, the press. I partners Adam all the time I'm not actually connecting the dots that I drank too much and I'm having a hard time getting up. So we hope family members, let natural concept just by a raw there's communication strategies that again lower defensive keep the conversations going, give the family members more information to work with, and then there's dose of care component, which is like you ve got to take care of yourself through this process because it. Incredibly stressful to care about somebody with a significant substance use problem. It's scary, its maddening, its confusing, and so you gotta take care of yourself. If you're gonna be a effective helper, you really do have a huge emphasis on to you the cliche here, putting your own oxygen mask on first day. I have to mean I have to do it and work that I do and you just see family members there so burned down, I'm working with a mom right now,

so desperately to connect with her son and she's, not sleeping she's so anxious that she's, not sleeping so every single time she tries to have a conversation with her son. She kind of either falls into tears or she gets really mad and loses her temper, so not going well, as you literally can't use the skills that we're trying to learn around the communication strategies. So I've got a backer up and we've got to really work on. How do I help you manage your stress so that you can sleep so that you can go into these conversations and actually be effective, so We gotta really try to help people. Take care of themselves, first so that you can stay regulated as you try to use the skulls and user communication tools, one of the phrases you you that I think, may sound a little flip at first, but is actually quite enlightened. Is your loved one isn't crazy? I don't mean that in a flip way at all, and even if you one does have severe mental health issues that might be contributing dino. If I worked with a family for a long time who really thought their kid was just

I entered against the family and all these kind of things, and it turns out he was actually hearing voices and he was self medicating. The voices and the father for years thought he was just disrespecting the family's culture and the kid just was terrified to tell anybody that he was hearing voices. So you know even if there are a mental health issues that those are worth understanding and being curious about? You gave us a nice overview, let's, as the nurse said, double click. On some of these, one of the things you talk about is positive communication. What does that entail so. Those are the open, ended questions soon get conversations going. It's a really subtle like when you say things in a negative way. If you say to somebody, I don't want you to drink tonight versus I'd love it You came home sober tonight. Those are just a little have step switch

of telling somebody what you dont want versus what you do want that really can shift the tenor in a conversation in relationships are helping. People frame thing is in a positive way versus the negative way there is also the strategy's around making requests in a tub asked permission before you make a request, be lik maiden, like I have an idea like to run it by you. Are you open to hearing about it? if you say no for a right now being able to believe. Ok I'll come back tomorrow. I'll try going to morrow. Whenever you know so, it's kind of knocking on the door asking permission and then seen whatever it is, it you have to say and then, following up with a wrap up us, so that we get that right and wrong came back using a lot of reflection and validation, bird sing that gets really sideways and families with so it's his promises. Everything just become so negative. It becomes all about the problems ray and everything that other person is doing wrong. So we spent a lot I'm trying to help people start to validate more and validated.

shouldn't and being able to notice when the person is due. It's something positive that you want to sprinkle some fairy dust on that like feel like I see that I see you made a really positive change here. You might be doing all these other things that are really concerning, but I see this little sprite of brain that I want to for some water on, so that it grows more and that's especially true for people who have kids with attention on issues you know just becomes all the things that are not doing versus that miss if they get it right and being able to really be like the eu really struggling at your awesome on that? One thing: so: let's pay attention to that too. So I believe we are grabbing. There is reinforcement, yes, so community and can be a reinforcement, weakened compliments we can notice. We give affection, there's all sorts of free communication strategies that act as reinforcement but reinforce. My can also be hey you just me that you're a struggling with stress, you're using substances because you're having a hard time with stress, can I you with a membership may now. Can I help you download the temperature.

Happier up ends actors mindfulness, because it might be really helpful. so those are reinforcing alternative I have and really kind of helping the person gain access to those things or you don't have a car. You need me to take care of you Why you gotta treatments or can I pay for treatment? So those are reinforcing the behaviors that you want to see more of an then limits around so the behaviors that you want to discourage? So I might not give you money, may not give a cash for durant, because I know you're going to spend it on substances, so not going to do that. But I'll support you in these other things, so helping a family be very strategic in what they're going to support and what they're not going to support. So reinforcement can be through behaviors spending time with somebody in that they enjoy it can be through communications that can be through financial means ways that we support her transport things. What about consequences? The models based on really letting natural consequences play a role. So that's again

Those behaviors at our direct outcome of the persons substance, use choices employees. A lot is. I worked with a woman whose husband would drink a lot and took a pass out in his living. A chair And you'd get him up. Im upstairs and she'd be furious in the morning, and one of the things that she was trying to do was prevent his teenage kids from seeing him in the chair with the beer bottles all around him, because she was embarrassed for him, but he'd get up, go to work, be mad, and so he thought she was the nightmare. They were fighting and he's like your on me all the time you're out of me all the time, and he didn't remember, passing out so she said I meant to just leave him in his chair and the kids came down in the morning. They'd find him and he started to get embarrassed. He started to feel I don't want my adolescent, kids, seeing me sitting here in the chair, passed out, so came a consequence that she didn't want to live with you now and when she was getting him up, she was being the consequence in some ways. Her anger was the consequences. It just didn't change anything it made. The relationship were so things like that

but in other some natural consequences that you can't allow a manoeuvre, loved ones, drinking and driving. That's something you the inner fear with right? You would want to block that from happening by me. You're gonna, let them walk home from the train or maybe your partner needs to lose their job, because you calling cancelling, but maybe that isn't something your family can tolerate need that money, so each family member has to make pretty tough decisions around which natural consequences they're gonna let play out. But it's usually a lot that the families kind of shaving the rough edges offer. You know, because we. Ultimately, dont want our loved ones to suffer, and so we block things you now and if we get out of the way and let the world to be the teacher start to realize I got this is and actually working. Is it never rare for me to allow one of the consequences to be that I'm pissed at you, fur ex wire Z. Of course it not about not being passed, two buddies again up. She was extra past because she had taken him upstairs. She got him in bed should clean up the mess you saw. Her anger was way

bigger. You know, then, when she just gonna, let him sit with and let him pick up them ass. She stole angry with him, understandably, but it was, it was less intense, theirs intensity and he was able to see his own behavior because she was picking it up for him. This is it about like just be nice all the time and behind all the time read your feet. The matter, but it's how you express them is often when you express them. You know if you're getting it, argument with your loved ones when their higher, when their crashing that's We're going to go well and you're going to probably get wounded in that process. You know just in terms of that conversation going sideways. So can we help you time that conversation where you tell the person that you really really actually with them and time when you are regulated and can say what you want to say and said at a time where you can handle it will actually helping you, have more control over the situation, because you're thinking about what you need and not just resigned the entire. Whatever crisis is in front of you really being thoughtful about yourself and

the support you need as a loved one may now going back We were talking about the beginning of the shame. People don't want to talk about. You know what I'm really worried about my partner's substance use or my kids substance use. There has actually been studies done about how families are judged by other family we now, if their substance, use problem, so people don't want to talk and they need to be able to talk about it. They can get support and brainstorm, and you know if you're super mad or super distraught be able to go talk to somebody that cares about you and can help you regulate and figure out what you want to do one of the bottom line points that you make. This goes for family members or loved ones of people who may be struggling with substances. Animal for people who are struggling with their own struggles with substances? One of the key points you make that I want to get you hold forth on now is change is often slow. I think it's incredible

slow and requires a lot of new learning and we are a quick fix society right and retaining its getting worse. Our phones in get anything you order. On your phone in two seconds, so why a change really quickly and its hard work. It's hard work to learn to regulate your emotions in a different way. It's hard work to change a relationships might have to change entirely Gypsy might have to have some people that you're, like a can actually have you life anymore and now I'm lonely and I have to establish new relationships, but takes a a time and a lot of trial and error, and so it is quite complex and hard and you had substances in their way your brain and body or being affected, and you have cravings and your brain saying this makes perfect sense, go back and have that cigarette like you'll feel better. If you have had cigarette right you're, just having done taller a lot of discomfort to one of the strategies that we use a lot is acceptance and commit

the therapy, which is about figuring out how to relate to pain and discomfort in a different way and be able to know, actually, I'm probably going to have to lean into this pain and discomfort in order to, she's. My end goal here. I chant avoid feeling uncomfortable and subsidies is kind of by its nature avoidance, we're using a substance to avoid something. It changes, if feel also, if we're gonna take the substance out, we ve got to figure out how to lean into that just go for to end figure how to cope with a tolerate it move through it change it whatever it is before. I let you go here. Can you please plug everything plug your books, plug your rehab, anything that we should know that sure The thing I would like to plug most is our foundation agency m foundation for change, because we really started that because we want family members to have access to these evidence based ideas to help and to also be able to connect with each other. So beyond addiction, there were for family and friends? That's the invitation to change approach, the funding

the website is full of all sorts of free videos and free materials, and you can join facebook groups to just talked other family members who are using this approach to try to help in a lot of this family members. Are people who have been through so much swift The family members who are trainers and the invitation to change approach in a lot of them have kids who over overdosed and they went through the treatment system and they went through these horrible experiences and they just want to get back to other family members and help them now. I suffer in the same way did they did because they got all that really not great advice in terms of letting their kids hit rock bottom and their kid ended up dying. So there's just a huge community of people who are trying to get the word out that there's other ways to approach helping a loved one. So that foundation, I think, is the most important place to go. Look in the beyond addiction book and then rewrote beyond addiction, Science and kindness help. People change wrote that about six years ago and that all about craft really talks about how to use craft and how to think about

behavior change in general, and how to get your lot when its treatment. How to understand the treatment landscape, which is a pretty messy and gave there's lots of different ways to go about treatment, treatment options, and I think we we can help consumers become more educated about that landscape. Then everything get get better gary. Thank you very much really appreciated. Thank you. Thanks again, carry wilkins, like I said, hit me up on twitter acts instagram tik tok. Wherever with your feedback, you can also find me over on the ten percent your website, ten percent that come thanks to everybody who worked so hard on this show. Ten percent happier is produced by Embryos are justine davy lawrence, myth and terror, Anderson DJ cash Where's our senior producer, Marisa, snyder men, is our senior editor and can be regular. Is our executive producer scoring and me by all travailing audio and nick thorburn from the awesome band islands wrote our theme,

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