What Actually Motivates Change? (Carrie Wilkens, PhD): ADDICTION

“Nobody wants to be somebody with a serious substance use problem. Nobody wants to be addicted to a substance. I mean, it doesn't feel good. Dependency doesn't feel good. And we end up in there anyway, right? So I think if we can bring compassion and understanding to, wow, it must really be working in a way that's really powerful for them to keep pursuing it. And then you've got the physical effects of substances, right? So then our bodies physically get dependent, you know, so it starts out as like, it's probably working for an emotional or something in our life and then we become physically dependent on it. And then it's a whole nother host of things in terms of how do you stop it? And people don't fully understand treatment in terms of there's medications available.”

So says Carrie Wilkens, PhD, a psychologist who is attempting to change the way we think about and address recovery and treatment—specifically by simply presenting evidence for what motivates change. AFter all, she is the co-president and CEO of CMC: Foundation for Change, a not-for-profit with the mission of improving the dissemination of evidence-based ideas and strategies to professionals and loved ones of persons struggling with substance use. 

As you’ll hear in this conversation—and throughout the entire series—we have not collectively been served by the mono-myth of addiction, that it’s only solved through harsh intervention and confrontation, that addicted people must hit rock-bottom, and that any involvement from concerned family and friends is inherently co-dependent or enabling.

As Dr. Wilkins explains, this simply isn’t true: In fact, evidence overwhelmingly suggests that harsh confrontation and intervention works AGAINST recovery, and that there is a very specific and meaningful role for family to play in what can often feel like a family illness.

The CMC:FFC team’s Invitation to Change approach is an accessible set of understandings and practices that empower families to remain engaged and be effective in helping their struggling loved one make positive changes. The approach has been widely used across the country and is utilized in trainings with laypeople and professionals. 

She is co-author of the award-winning book Beyond Addiction: How Science and Kindness Help People Change, a practical guide for families dealing with addiction and substance problems in a loved one based on principles of Community Reinforcement and Family Training (CRAFT), and co-author of The Beyond Addiction Workbook for Family and Friends: Evidence-Based Skills to Help a Loved-One Make Positive Change.

Dr. Wilkens is also the Co-Founder and Clinical Director of the Center for Motivation and Change, a group of clinicians serving all ages in NYC, Long Island, Washington, DC, San Diego, CA, and CMC:Berkshires, a private, inpatient/residential program for adults.

Dr. Wilkens has been a Project Director on a large federally-funded Substance Abuse and Mental Health Services Administration (SAMHSA) grant addressing the problems associated with binge drinking among college students. And she is a member of the Association for Behavioral and Cognitive Therapies and the American Association of Addiction Psychiatrists.

MORE FROM CARRIE WILKINS:

Beyond Addiction: How Science and Kindness Help People Change

The Beyond Addiction Workbook for Family & Friends

CMC: Foundation for Change

Further Listening on Pulling the Thread:

PART 1: Holly Whitaker, “Reimagining Recovery”

PART 2: Carl Erik Fisher, M.D., “Breaking the Addiction Binary”

PART 3: Maia Szalavitz, “When Abstinence-Only Approaches Fail”

ADDICTION: Anna Lembke, M.D., “Navigating an Addictive Culture”

TRAUMA: Gabor Maté, M.D., “When Stress Becomes Illness”

BINGE EATING DISORDER: Susan Burton, “Whose Pain Counts?”

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