Pulling The Thread with Elise Loehnen

Today, it’s just me. I thought I’d round out the year by trying something different, and offering five big things I’ve learned this year.THINGS I REFERENCE: Owning Our Wanting, Wants vs. Needs Transactional Relationships & Shadow Vows Undoing the Drama Triangle, Are You Victim, Villain, or Hero? Facts vs. Stories Transcend and Include Learn more about your ad choices. Visit podcastchoices.com/adchoicesSee omnystudio.com/listener for privacy information.

“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 ChangeThe Beyond Addiction Workbook for Family & FriendsCMC: Foundation for ChangeFurther 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?” Learn more about your ad choices. Visit podcastchoices.com/adchoicesSee omnystudio.com/listener for privacy information.

Screenwriter Akiva Goldsman discusses the healing power of storytelling in therapy. He reflects on how personal experiences of childhood sexual abuse influenced his work. The podcast explores themes of fantasy, reversal, and love in healing trauma, as well as the importance of self-compassion and forgiveness. It also delves into gender, sexuality, sleep deprivation, and the complexity of personal identities. Finally, the hosts discuss the impact of storytelling on healing and the moral clarity of Star Trek.

In this thought-provoking discussion, Maia Szalavitz, a contributing opinion writer for the New York Times and author, argues that addiction should be viewed as a learning disability rather than a moral failing. She emphasizes the importance of harm reduction strategies like needle exchanges and prescribed heroin, while also shedding light on the complexities of trauma and individual susceptibility. With her personal journey intertwined, Maia advocates for compassion and understanding in addressing addiction, pushing back against harmful stereotypes and misconceptions.

Renowned neuroscientist David Eagleman discusses the malleability of the brain and its ability to adapt to various inputs. He covers topics like synesthesia, perception in the blind and deaf, and the creation of imaginary worlds. They also touch on consciousness, brain damage, technology for vision, parenting in the digital age, accessibility of knowledge for children, and dreams. The conversation is highly engaging and thought-provoking.

Addiction psychiatrist, Carl Erik Fisher, challenges the addiction binary and discusses the history of addiction and the language used by addiction supply industries to individualize suffering. The podcast also explores the complexity of addiction, the importance of therapy and addressing personal pain, the limitations of traditional addiction treatment, the impact of sleep deprivation on women, the role of psychedelics in addiction treatment, and Carl's book 'The Urge' which offers creative solutions to addiction.

“I think what one of the things that's interesting to me is like when we think about what causes distress and a life that goes awry, there's so much attention to different causes, but the way that the story, or the diagnosis, or the treatment interacts with our identity, I think, is not thought about as much. Like, the way that the very intervention itself changes our sense of who we are feels like it gets neglected. There's this sense that, you know, the diagnosis is describing something that is always solid and real and less thought given to like, well, how does that diagnosis interact with a mind? And how does the mind change knowing that the mind has been characterized this way?”You might recognize Rachel Aviv’s name from The New Yorker, where she’s been a staff writer for a decade, covering subjects like medical ethics, psychiatry, criminal justice, and education. She’s been a finalist for the National Magazine Awards twice, and in 2022 she won one for profile writing. In 2022, she also published Strangers to Ourselves: Unsettled Minds and the Stories That Make Us, a recipient of the Whiting Creative Nonfiction Grant and named by The New York Times as one of the ten best books of the year. In It, Aviv tells the story of four people and the treatment they underwent—or not—for their mental illness. It’s a gorgeously told, layered exploration of all that we don’t know about the brain and the mind, and how various treatment modalities restructure our lives—including the stories we tell about who we are. Okay, let’s get to our conversation.MORE FROM RACHEL AVIV:Strangers to Ourselves: Unsettled Minds and the Stories That Make UsRead Rachel in The New YorkerFollow Rachel on X Learn more about your ad choices. Visit podcastchoices.com/adchoicesSee omnystudio.com/listener for privacy information.

Holly Whitaker, author of Quit Like a Woman, discusses the societal acceptance of alcohol and the lack of meaningful conversations surrounding alcohol use. The podcast explores addiction, challenges recovery culture, and emphasizes the importance of a holistic approach to recovery. The dangers of alcohol addiction and the need for alternative approaches are also discussed.

Psychiatrist Phil Stutz discusses Part X, a part of the human soul that inhibits progress and causes self-hate. He shares tools to counteract it and emphasizes the importance of taking action in personal development. They explore manifestations, the limitations of the third eye, and the instinct cycle. The power of tools and gratitude for personal growth is also discussed.

Starting next Monday, I’m doing another special series—this set is about addiction. You’ll hear from four distinct voices in the space, covering harm reduction, new paths to recovery, codependency, and the shape of addiction in our culture. This is just scratching the surface, but hopefully the beginning of conversations in our own lives, as addiction touches us all, in its myriad forms. While this set is focused on substance, we'll be back with more in this space—and if you want to get started, you’ll find links to two previous episodes on this theme. Dr. Gabor Maté, who spent much of his career working in the most addicted corner of North America, explains why trauma is central to understanding addiction, and Dr. Anna Lembke, explores the role of dopamine and the delicate balance between pleasure and pain. You can find those links in the show notes—and I’ll see you on Thursday for a regular episode of Pulling the Thread, and Monday for the beginning of this special episode.SHOW NOTES:ADDICTION: Anna Lembke, M.D., “Navigating an Addictive Culture”TRAUMA: Gabor Maté, M.D., “When Stress Becomes Illness” Learn more about your ad choices. Visit podcastchoices.com/adchoicesSee omnystudio.com/listener for privacy information.