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00:00What role does trauma have in not being able to shake substance abuse?
00:15Trauma is very important. You can't recover until you give trauma a name.
00:23And when you name it, then you can deal with it.
00:27And if you never deal with it, it never goes away.
00:30You can ignore it, you can be in denial, you can run from it, you can run but you cannot hide.
00:35Wherever you are, there it is.
00:38And if you're medicating to cover up the trauma, then how do you recover?
00:43So one of the things trauma does is it goes beyond the system's ability to cope.
00:49And when you have exhausted all of your coping skills, sometimes alcohol and drugs
00:54it feels like a viable option, especially as the presenters before us were talking about
00:58being fearful of talking to your doctors about what you're experiencing.
01:02Some people don't recognize what trauma is.
01:05And so that's sometimes where the role trauma plays is first you have to name it,
01:11then you can actually treat it.
01:13But a lot of times we don't know it's trauma that we're treating with the alcohol and drugs.
01:17So there is this concern about you should just be able to shake it loose.
01:22But there is a mental illness.
01:25Can you talk about the connection between mental illness and substance abuse?
01:30Yeah, like Dr. James was saying earlier, are you medicating?
01:35And lots of people do use illegal substances to medicate or prescribe, you know, off-label prescriptions to medicate
01:45because it's really, really difficult to deal with a mental illness.
01:49And the drugs, what clients have told me, work.
01:53It numbs it?
01:54It work.
01:55It numbs it.
01:56It takes the voices where you don't notice the voices or the voices make more sense
02:00because you know you're high.
02:02So obviously when a person's high, they expect certain things.
02:06But the reality is the person really just wants help.
02:10And that's for them an easy help.
02:13It's escaping.
02:15Whichever way, whichever means necessary.
02:17And that's the slippery slope.
02:19I can use this alcohol temporarily to numb my pain.
02:25My pain doesn't go away.
02:27So I habitually go to something that was supposed to be temporary.
02:32And now I have a problem.
02:34So part of it is, yeah, none of us want to feel pain.
02:39None of us.
02:41Even psychic or physical.
02:43And if you use the substance, the substance takes it away temporarily.
02:46But it's not a fix.
02:48It's not a chronic fix for it.
02:50That's why we need specialized treatment.
02:53I have a question for the audience.
02:55It's so loud.
02:56Like, we have chosen a different time.
02:58But we're going to push through this.
03:00When you all think about substance abuse, is it something that you malign?
03:06That you think is like that?
03:07When you find out your cousins on drugs, you think badly about the person of your cousin.
03:11As an answer, you have an answer for them.
03:13Do you feel like they should get over that?
03:16Yeah, it's one of those things.
03:18How can we begin to look at substance abuse a little bit more cautiously, more carefully,
03:25more lovingly, more gracefully than we do?
03:28I think as a community, first of all, we need to recognize it is a problem that needs to be solved,
03:39not a problem that needs to be ignored.
03:42Because we can kick the can down the road, but that doesn't improve that person's quality of life.
03:50And so, as family members, I think we have an obligation, not just family members, community support,
03:57we have an obligation to look at a person as needing healing.
04:03And what would we do when anybody else needs healing?
04:06We would give them a sense of grace, understanding, tolerance, and patience,
04:12and end that and get them to treatment.
04:15And then maybe there is a release of healing.
04:18We talked about the rat pack.
04:21I'm going to go right to that.
04:22Can you talk about that?
04:23So one of the things, there's a study called the Rat Park study that was done on rats.
04:30Rats are social animals, much like humans.
04:33And they divided the rats into two cohorts.
04:36One cohort had access to drugs and nothing else.
04:39And the other cohort had access to socialization, community, a sense of belonging, and they had access to drugs.
04:49The rats who were isolated all died.
04:52They just used drugs to their death.
04:54The rats who had that sense of community, while some did choose to indulge in drugs,
04:59some did not, but none of them died.
05:03And that study, we can use that in humans.
05:06The connection is so important.
05:08And anybody who has ever loved somebody who used drugs,
05:12when they pull away from you, you notice how they spiral and get worse.
05:17Sometimes that connection is the thing that keeps them going.
05:20You know, knowing they come into your barbecue, they may try to get clean.
05:24And we all know how hard that is, but they will try to come for you.
05:29But when we no longer invite them to the family events, and they no longer have a reason, they spiral and get worse.
05:37And so this is one of the things, so this particular topic, and I shared this with them.
05:41It was very personal for me to create this one, because my sister, 35 years, was an addict.
05:46We lost her recently.
05:47And it's very difficult for those of us who've been on that journey with a sibling or a parent, a loved one.
05:53After 35 years, you're just like, listen, I can't. I can't do it anymore.
05:58So can you guys give us some solutions for those of us who have family members that are struggling with substance abuse?
06:04How do we support them without putting ourselves at risk as well?
06:10And so the thing I always say is start with love.
06:13First of all, you are not the main character in this story, and a lot of times we center ourselves in this story.
06:19And so we say, I can't do this with you, versus really understanding what they are doing and on their journey.
06:25So I'm going to love you through it. Love does not mean free access to me.
06:30So I will have love you with boundaries, because that is love.
06:34But I'm not going to discard you. I'm going to understand you. I'm going to be there for you.
06:40I'm going to give you what you need.
06:45Also, this story is kind of personal to me also.
06:48We didn't talk about this at the beginning, but I'll share this now, that my father was an alcoholic.
06:53And when I was in college, until I went to college, we were always taught that something was wrong with him, that he was just weak, and it was just, he could just, he choose to do that.
07:07He went to rehab, and I went to rehab to see him.
07:12Against all of my better judgment, I went to rehab, and I asked him, I said, so what does this mean?
07:19You are now in rehab, what will happen when you get out?
07:23He says, I'm in here because I don't want to lose my family.
07:28And he walked out of rehab, went to AA, which is the thing that comes out of the part study, is that being away from the drugs is just not enough.
07:41It's the support and the community, once you're awake.
07:45That starts the recovery, but connection continues.
07:50So he went to rehab, knowing that he was not going to lose his family, we showed up to love and support him.
07:5750 years later, he's 91 and never had a drink again in our life.
08:04Now we drink, and we'll say, don't forget, you got that gene.
08:11Now watch what you're doing.
08:12And so we understand that, and keep it in context.
08:16Doctor, you made an excellent point about that gene, and being aware, and that's one of the things I strongly believe.
08:22When we know we have family members who have addiction, we should teach our children we have the addiction gene.
08:28Because it's genetic.
08:29And how to drink responsibly.
08:31Or if they're choosing to use marijuana when it becomes legal, if it's legal, how to indulge in whatever you're using responsibly.
08:39And also what are the signs that you may be having an addiction.
08:43So that you can, if you cut the gene on and find out that you have addiction, we can catch it early.
08:50And that this is a place you can come and talk to me, you know, about.
08:54This is a very important point.
08:56Because we live in New Orleans, where drinking is part of our culture.
09:01I know some people who like to say, I used to just stay up all night and drink and get up and go to work and there was no problem.
09:09And they wear it as a badge of honor.
09:12Let me say this to you.
09:14Yeah, it's a badge, Dr. James.
09:15Ain't no honor, ain't it?
09:16That's what it is.
09:17We're not going to take that from us.
09:18We do all of it.
09:19All right.
09:20That's a badge.
09:21But let me say this.
09:24If you've come to notice that your drinking, drug of choice, whatever it is, is interfering with your social relationships, your occupational status, that is a problem, people.
09:44That's a problem.
09:45Now we're talking about substance abuse and mental health.
09:49If we had time, we would talk about some of y'all other addictions too.
09:52Because y'all can be addicted to relationships, gambling, shopping, social media, all of these things that soothe you from previous and present trauma.
10:03So in some of my research, I found that it showed that for African Americans and Caucasian Americans, just for those two, that we both had the same predisposition to becoming addicted.
10:18But that African Americans did not fare as well after treatment.
10:23Is there any reason why after treatment, we may not fare as well?
10:29Because we think when the initial presentation of the addiction is over, the disease is gone.
10:38If I take an aspirin for my headache, my headache is gone.
10:42That is not the disease of addiction.
10:46The disease of addiction requires continuous attention to the condition.
10:54And so that is the support, that is the recognition, that is the avoidance of the places.
11:00In Alcoholics Anonymous, they say, change your spaces, change your places.
11:05Because you can't keep doing what you've been doing, inspect a different outcome.
11:11There's other reasons as well that we would be remiss if we didn't speak about as far as the conditions that the African American community lives in and what they go back to.
11:21So we can't pretend that when white people go to treatment, they don't go back to the same conditions.
11:26They don't go back to the conditions of poverty.
11:28They don't go back to the conditions of the neighborhood and the community traumas that we are all experiencing.
11:34So we get re-traumatized when we return to the community.
11:37And for white people, that's not the case.
11:40They don't have that trauma happening outside of their door.
11:44Most African American communities have more liquor stores than grocery stores.
11:50So access is going to be a factor too.
11:54So are there any resources for those of us who have family members and are really struggling, and we're in the hood, we don't have access to therapy.
12:03Are there any resources that we can share?
12:05We all have access to therapy.
12:06We do.
12:07We do.
12:08And that's one of the things that's a fallacy.
12:10Sometimes people will say I can't afford therapy.
12:12Medicaid covers therapy.
12:14So we all have access to therapy.
12:17Our insurances cover therapy.
12:19Finding a therapist, you're going to give me that face.
12:21Can you get a coat?
12:22No.
12:23But it's because therapy gets you something.
12:25There is therapy available.
12:27You, and when you're in the trenches, it's hard to do the legwork.
12:31But if we are not centering ourselves in your story, I can do the legwork for you.
12:36I don't have an addiction.
12:37I can call everybody on this list until somebody gives you an appointment.
12:41Or at least tells me what is the process to getting you an appointment.
12:46So therapy is widely accessible.
12:50There's, and I don't want to promote anyone, but there are mental health tech companies that exist where you can get therapy from the comfort of your home, on demand, any day of the week.
13:02Almost 24-7.
13:05Okay, before we even get to therapy, there are community resources.
13:10There are treatment centers run by the state.
13:13Yes.
13:14They're run by the city.
13:17There are treatment centers.
13:19Then there are AA groups.
13:22Just about every church will have an AA in a group.
13:26Those are helpful.
13:28Then we can get to therapy.
13:30And you're talking about, people are like, I can't afford therapy.
13:34People, if your life is important, you pay for what you need.
13:40And you've got to make your recovery a priority.
13:44We pay for everything else we need and want.
13:47But we don't want to pay for help.
13:49I'm not paying nobody to talk to me.
13:52But if that talking is the difference between your quality of life and a poor quality of life, you better talk about it.
13:59And so what are you talking about when you're talking about the price of therapy?
14:03Therapy is expensive.
14:04It's expensive.
14:05You can get therapy for $60 an hour, or you can get it for $200 an hour.
14:11Your insurance, if you've got insurance, your co-pay could be $25 an hour.
14:17Some of them have waived co-pays in recent times because of COVID.
14:21You can come to the office or you can do it virtually.
14:23Yes.
14:24You don't have to leave home.
14:26So before we open up to questions, I have one more area that I want to go into, which is about the shame.
14:33Right?
14:34This is a disease that has more shame than any other disease out there.
14:38So for those of us who have family members that are feeling guilt, they're feeling hurt, they're feeling pain, they're feeling shame for what they've caused to their families,
14:48how can we show them some love?
14:50How can we let them know that it's okay?
14:52They know they took the money, they took their cars, they took things from us, they hurt us.
14:57But how can we let them know that it's okay for them to come back in?
15:01There might be some alienation they're struggling with.
15:03I think there's two sides to the shame coin.
15:05Because as a family member, we often have shame that our sister or cousin or whoever is struggling with addiction.
15:13And so that is what leads to the alienation, is that shame.
15:18So first we have to, in ourselves, forgive ourselves for the feeling that we had when we found out you had an addiction.
15:26We have to open up our hearts for ourselves first.
15:30Because I can't really forgive you for doing that when I'm still embarrassed about what you've done.
15:37And I haven't, you know, and then we have to normalize this.
15:40Everybody in here raised their hands saying they knew somebody who had addiction.
15:45So if it's my cousin and your sister and her brother, we all have been there.
15:50So why are we having the shame and guilt?
15:52So we can normalize it first and then we can verbalize it.
15:56I can say to you, I see you feel ashamed.
16:00I can see you clearly and put language so maybe you don't have language.
16:05I know you're embarrassed, but you can still come over.
16:09I know, I know you took it and I'm not mad at you.
16:14Because I understand that was the addiction.
16:17Come.
16:18Yes.
16:19Yes.
16:20The thing I want to add to this conversation is that we got to call a thing a thing.
16:26We got to act like, we can't act like it didn't happen and be in denial and then say we love somebody and want the best for them.
16:36If we want the best for them, then we have to tough love them through that.
16:41And part of that is us fixing our stuff.
16:44The non-addicted have to deal with their traumas, their shames, their failings that they are sometimes projecting onto the other person.
16:55And because that person's addiction is so provocative, then that's the problem.
17:02No, that's the residual and symptom of the problem.
17:07You know, people don't just become addicted.
17:10Broken families create a situation that then they become addicted.
17:15So we got to fix all of it.
17:17Yeah.
17:18Yeah.
17:19A hundred percent.
17:20All right.
17:21Are there any questions from the audience?
17:22Any questions you guys have for these amazing social work people?
17:26I mean, I'm just happy to have a psychologist and a social worker.
17:29It's amazing.
17:30Yes.
17:31Yes.
17:32I heard you all mention trauma.
17:33So can you all just talk a little bit about how trauma is such a big factor impacting substance abuse in our communities?
17:51Let's talk about what trauma is.
17:53We could be here all day because this is something I like to talk about.
17:58Because we would like to think that trauma is some big thing that happens to people.
18:05Sex abuse, physical abuse, emotional abuse, alienation, abandonment.
18:12Those are the big things.
18:14But there are little things that happen every day.
18:18The accumulation of slights, misunderstandings, what I would like to call them empathic failures.
18:27And Dr. James, what the hell is an empathic failure?
18:31The empathic failure is when someone that's caring for you does not meet your emotional need when that need needs to be met.
18:43Didn't mean they didn't meet it.
18:45But they don't mean it.
18:46They don't mean it at the time when it needs to be met.
18:49You create a story about that which sets the stage for a trauma or a story that then you then use as your coping throughout the rest of your life, unchecked.
18:59And you're like, well, I've just always been this way.
19:02You've been this way because of earlier emotional trauma.
19:06And we don't call it trauma.
19:08We just normalize it and say, I am just the way that I am.
19:13You did an excellent job explaining trauma.
19:18The thing I always talk about is trauma is on a spectrum.
19:21And I know as clinicians, you know, when we diagnose trauma, most people are always thinking post-traumatic stress disorder.
19:28And if they don't have that, then they don't accept the fact that they have trauma.
19:32So like you mentioned, the micro traumas, the small insults, it's over time that have accumulated.
19:39That causes an issue.
19:41And there's so many.
19:42And then as black people, we get the microaggressions and the racial traumas often and, you know, it happens multiple times a day.
19:51So much so that we become numb to it.
19:53But at the end of the day, you come home and you need a glass of wine because you have to put up with that all day at work.
20:00All day at work.
20:01And then that glass of wine turns into a bottle.
20:04And now we're on that slippery slope, right?
20:08Well, I just invite everyone here who has a family member who is struggling with this.
20:14If we can find some compassion and some understanding in our hearts.
20:18I know for me, we've talked about this.
20:21I will never forget that moment when my sister had done something that really, really, really pushed me over the edge.
20:27And I said, I am so disappointed in you.
20:30And I thought that was going to make her like be like, and she said, I am too.
20:35And I was like, oh, my God, I didn't realize that she was trapped.
20:40That if she could have, she would have.
20:43But there was something that happened very early on that I found out about later on that she couldn't get past.
20:50She couldn't get past.
20:51So I invite all of us to really think about, okay, instead of just saying, she's on that stuff, he's on that stuff.
21:00Maybe there's something they really are working through.
21:02They've never really been able to figure out.
21:05They've never been able to find the treatment.
21:08And the closing comments for me.
21:11This is something I always say to my patients all the time.
21:15We need to stop saying, what's wrong with you?
21:20We need to ask the question, what happened to you?
21:25And once we start the conversation, we learn things about people we would never know.
21:31And to your point, with my clients, yes, what happened to you?
21:36But as a family member, I know what happened to you.
21:39I was there sometime.
21:41Or I've been on this journey with you.
21:43So I don't even have to ask what happened to you.
21:45I have to recognize the impact of what happened to you.
21:48Because to me, I thought maybe it wasn't enough.
21:51You know, it wasn't that big, but obviously it was.
21:54And I need to stop minimizing your experience.
22:00If they want to find out, connect with you guys as professionals in the industry,
22:04how can they find out about you?
22:07I'm at Instagram, DapperDoc.08.
22:10And email, if you're writing emails, arja60 and yahoo.com.
22:15And I'm at TherapyGYS on Instagram and TherapyGYS at gmail.com.
22:26Thank you very much.
22:27Thank you very much.
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