We discuss why addiction treatment in the early stages requires a narrow focus and sophisticated direction, and the approaches residential inpatient programs should envelop in order to properly carve a clear path towards a successful recovery. 

Topics:

It’s tempting to see a huge cluster of problems and feel like we need to tackle all these things and to make our 45-day residential program be able to treat this huge bundle of issues, and really that’s almost a mindless approach to care in this meta way. And being able to boil it down to taking a more bite-sized methodical, mindful approach to treatment planning through a residential program really allows for this stabilization to occur, and to address some specific things in a clear way. But really being able to build a system for clients, a path for clients, to know that they can walk. Regardless of the disruption that comes up. They will know how to walk through disruption and self-soothe on the other side of that. 

[Music]
all right
welcome back to another exciting episode
of finding peaks
i’m joined here again as we’ve been
doing
uh with friend and colleague jason
friesma chief clinical officer for peaks
recovery
and uh clinton nicholson chief operating
officer for peaks recovery centers so
so grateful to have you guys continuing
to follow us to join us
for this uh uh new episode and hopefully
the episodes are building up and
becoming meaningful for you and your
loved ones and
uh helping you expand on conversations
uh in your own household and so forth
and you know educating and giving
insights into the recovery journey
and you know really what it takes to get
somebody well at the end of the day
and peaks is working on a mission
or a project that sort of narrows the
focus of addiction treatment through the
lens of
stabilization but before we begin
defining terms like stabilization and
what it means
we wanted to sort of narrow in and focus
on what residential treatment is like
the tension we experience as a staff
within it and how we move towards you
know engaging individuals
within um early concepts of recovery
uh when you survey the vast arena of
addiction treatment spaces you’ll find
on all of our websites that we’re
talking about things
you know where we work to resolve trauma
or we work to resolve addiction or we
um use dbt or you know
buddhist mindfulness you know based
practices to engage individuals in
recovery
and though we speak broadly about these
things within website infrastructure
there’s a much more sophisticated and
narrow approach that we kind of want to
tune in and focus on today so
um you know with that it’as my experience
at you know peaks that especially when
individuals are
leaving that the detox episode sort of
like this grandiose experience of
they are everywhere but at our treatment
center they’re out in
a future opportunity or they could be
doing this they could be doing that
but it seems to take them out of the
present and remove the focus away from
internal recovery and sort of starts to
externalize the process and
i think one of the ways that we go about
treating that is kind of through this
lens of mindfulness and kind of just
wanted to open up the discussion to
um you two as the trained clinical staff
who’s constantly engaged with this
about what do we mean by a
mindfulness-based approach to care and
why is it so important
in that early part of a recovery
journey and i
i i always start with jason you always
do you’re the friend and colleague
though i’m just the ceo
i think the viewers are really depending
on you to kick this off
absolutely yeah to go with tradition
yeah so the question was what is
mindfulness or
how do we approach that i i why is it
such a why is it such an important
tool in early recovery when we think
about engaging them and getting them
focused
on their internal selves in the early
part of the process especially within
residential programming
i would argue i guess the reason it’s so
important
i think it’s kind of a cornerstone i
would say a
tool to for clients to put on their tool
belt to help them
walk through the myriad of problems that
they
begin to face in early recovery
um i kind of think about mindfulness and
think about its antonym of mindlessness
like just kind of not being able
to think about what is happening in the
here and now
and being able to helping helping
clients
figure out how to settle in and
acknowledge where they are
is a key component to the recovery
process
because oftentimes people coming out of
a detox setting
are either really miserable and thinking
about how to end their
misery usually through returning to to
substance misuse
or um they’re on what a.a calls the pink
cloud which is just feeling
like i have four days sober thank you
peaks
and i’m ready to go i’m just i know i’m
never gonna use again and so
that is certainly an issue and and
oftentimes
um you mentioned trauma kind of in your
intro and lead in there
and um
trauma is a pretty it’s a stuck emotion
if you will
and and it is difficult to resolve and
it requires an element
of learning how to be mindful learning
how to deal with one’s trauma from the
present
because trauma tends to be kind of stuck
in the past
and so teaching and learning
mindfulness is a key component to
learning how
the process of dealing with trauma even
before you
begin to actually try to deal with your
trauma and so it’s an early recovery
skill that i
that i think is critically important and
now i’ll kick it over to
the just the ceo of peaks
one of these days we’ll be friends so
yeah good luck
so mindfulness and early recovery um i
think that there
is an element of uh recovery
that often is kind of overlooked that’s
particularly in the residential level um
which is these sort of pragmatic skills
about um that help the uh
that actually help the brain to start to
restructure itself
and those are done through
mindfulness-based tactics right
um and they can be as simple as a
a very uh a rigid schedule right or a
predictable routine
or um engaging in um
integrating fitness and um and
meditation and
like very intentionally into the program
not as some sort of
uh like optional like experience that
people can have but actually it’s part
of the programming itself
because like jason was saying you know
in order to really do the work that you
need to do to
to be successful in recovery you have to
be present
you know you have to be here right now
and in this moment in order
i think so many of us even people who
aren’t in recovery live sort of outside
of this moment
and so they are really unable to kind of
nail down the things that they need to
to work through
because you’re always sort of working
around issues rather than actually
working
through those issues um
i think that uh yeah that’s
those are my thoughts i’m gonna stop
there okay yeah yeah
okay i wanted to add what you say well
you said too because i do think
you know from a clinician perspective or
even from a
uh maybe more of a marketing lens too
like it it’s tempting to kind of see a
huge
cluster of problems and feel like we
need to tackle
all of these things and to make our uh
residential program 30 or 45 day program
be able to treat this huge
uh bundle of issues basically this huge
thing
and really um that’s almost a mindless
approach to doing residential care in
this meta way
um and being able to boil it down to to
taking
more bite-sized uh methodical mindful
approach to treatment planning through a
residential program
um really allows for this stabilization
to occur
and to address some specific things in a
clear way but really to begin
to build um a system
for clients a path for clients to know
that they can walk
regardless of the disruption that comes
in whether it’s a trigger
or depression is coming back or my
anxiety is spiking or
my spouse won’t stop yelling at me i can
i know how to
walk through a disruption and and
self-suit on the other side of that
yeah exactly i mean you cannot really
walk the path of recovery
if you’re not grounded you know and so
grounding becomes
what the primary focus is it’s not just
immediately diving into the this bundle
of issues and trying to untangle them
it’s about
those first let’s just make sure you’re
here let’s just make sure you’re present
and let’s make sure that you
you know what your emotions are that you
know how to actually
uh navigate those emotions to a degree
that’s going to allow you to work
through these issues rather than just
kind of
throw it all out there and say go you
know
it doesn’t necessarily if you don’t know
how to ground yourself
then no matter how much work you do in
the residential program
in the 30 to 45 days as soon as you walk
off that campus
you’re you’ve you’re at risk yeah
because there’s no way to learn how to
to know how to walk
uh and live a sober life with presence
and intention
yeah so yeah and it seems to be the case
that there’s this
brute force i’m gonna do it right when
we think about the pink cloud
component of it but and i don’t know
where that’s come from where
that we have to embrace this soul sort
of autonomy then i gotta do it on my own
i just have to make a decision
a forceful decision not to use anymore
but the science of addiction is
quite clear that the physiological brain
state
that we or addiction is just that a
physiological brain state that is exist
and is depending on for how long you’ve
been using drugs and alcohol it is now
permanent right within the brain as a
craving state and so when we’re on the
pink cloud
we’re not triggered we’re not
associating you know
any potential future opportunities that
might disrupt the
present moment that we’re in but i think
it’s really important
to remind them how quickly they can be
disrupted
in any given process so you know within
residential models such as ours i think
it’s really important to go about that
kind of you know poke the bear a little
bit to to get them to see
that they aren’t so grounded and that
things aren’t on this you know pink
cloud and so
within you know the limited time frame
that we have whether through it’s a
whether it’s through a mindfulness lens
or so forth um
what are the unique ways we can have
families sort of engaged with what it
looks like in an addiction treatment
center for how we are sort of
um poking the bear getting them a little
elevated and re
bringing them back down to the ground
escalating the situation a little bit
again bringing them down because
we’re really not doing our job if we
aren’t creating or exposing that tension
that actually
uh exists in their lives so as i
generally do ask a question followed by
a
a statement a statement another in that
regard the question is
how do we how do we break through that
pink cloud and do it in a way that
allows them to reground on the other
side without totally disrupting
their progress well you know
interestingly the pink clouded
itself i mean first of all labeling it
being able to say hey this is a
predictable part
of a recovery journey and i’m not trying
to be the bearer of bad news but it
doesn’t
last it doesn’t last yeah um and i
always
a i align with people like i fully
believe that’s your intention
like it that statement feels very true
inside of you that you will never use it
again and i want to acknowledge that um
but you also you know and then i just
describe either you know
and i can intend to lift my car with my
full intention
and i won’t be able to you know just
just saying
that that there’s translating that
intention into a how
i think is the key part um acknowledging
that that
will take work or a process and and
and if that doesn’t work i’ll i i have
another metaphor i’ll use is
you know you can say you’re gonna save
ten thousand dollars
or you’re gonna say i’m gonna do what it
takes to save ten thousand dollars and
i’ll
i’ll go with i’ll do what it takes to
save ten thousand dollars like
acknowledge that there’s a process and
it’s gonna take some work and some
planning
and um and you may run into some
difficulties along the way that
that usually helps people kind of begin
to round a corner to say okay
i and then i say ride it too by the way
i’m glad you have that in that intention
let’s
use that as momentum to kind of walk
through this
let’s get as far as you can while you’re
feeling like you’re never going to use
again
uh because that is kind of some fertile
ground to get some momentum
um to build some of the tools that we
had talked about when they’re when maybe
some of those other
baggage or whatever is with them isn’t
weighing them down at that moment we can
use that as
momentum in a path
what are your thoughts i have actually
been called the
pink cloud popper because i have a
pretty dry
first of all sense of humor and my
approach to treatment is rather
disruptive so
i and i like jason said i enjoy singing
seeing the pink cloud because there’s a
moment there to agitate
because there’s a moment there to bring
a dose of reality and recognizing that
hey
so the reason why you feel like this
this experience is coming from
this is the first time you’ve been sober
for multiple days and feel good
physically and i don’t know how long and
you
pair that with a safe environment full
of people who are completely dedicated
to your well-being
you are completely safe there are no
there’s no
trigger as far as the sort of external
world is concerned and so
that immediately forms a bubble and
the reality is that in about two weeks
you’re gonna try to leave
treatment because you’re gonna be so
frustrated and it’s gonna
that you’re actually gonna wanna get the
heck out of here and
there’s this disbelief obviously i think
with
when people hear that but the reality is
that it’s
uh treatment goes in cycles you know it
really does like there are times when
you feel really grounded in the process
and there are times when you feel like
this is so heavy i want to get the heck
out of here and that’s what it should
feel like
like that’s what the that sort of
tension
brings about because you need to be able
to navigate both of those parts you need
to be
able to navigate when you feel good and
then you need to be able to navigate
when you’re ready to run
and um i mean even as something as basic
as our curriculum is designed like that
it’s designed to
to really sort of like escalate somebody
and then ground them and then escalate
them with the topics of the day and then
ground them again
um so you go through this process and
i think that it’s again i totally agree
with jason that it is fertile ground
it’s fertile territory and also it’s not
real and it’s
going to go away pretty fast so yeah
yeah and
sorry sorry dad burst your bubble so to
speak so yeah
that’s not gonna last you got more to
say jump in well i i just was gonna
one of one of clinton’s famous quotes is
uh yeah that’s not a thing
like he it’s like his line yeah that’s
not a thing
yeah yeah so whatever this whole like
i’m never gonna use again yeah i mean
that that’s a moment of like yeah that’s
not a thing like you you would use
within minutes if you left here right
now
right like you feel really good in this
moment which is great
also it’s not gonna last because you’re
an addict
because like you said brandon like there
is physiologically
that person is still in the craving
state like they have
not worked through the neurological
processes necessary
in order to even begin to have the
skills
uh to manage triggers and cope with
these sort of um
external uh agitators that
as soon as they walk out of treatment
they’re gonna experience right right
and uh the verbiage that’s coming up for
me i think we talked about a pre-episode
here but uh distress
tolerance is really the name of the game
and it and it’s
at least my non-clinical experience you
know in surveying the patient
demographic that comes through
our program that it seems like they’re
they’re quick to take the things that
cause
stress in their lives and tear them down
it might be you know it might be a
marriage it might be the place they live
it might be the place they work
in a lot of instances it’s almost
everything it feels like that
is causing you know distress in their
lives um in that regard and i guess
you know sort of as we kind of go down
the the end of this episode here
um how how is it i mean it
i i don’t get to be in the group
settings i don’t get to be in the
individual sessions
but how are we allowing that how are we
giving them that space
to really hone in on say it’s a marital
issue that they wish to tear down
um how are we bringing them into that
because they’re escalating within it and
kind of what is the process i suppose
look like for
increasing that distress tolerance and
that sort of wave that you’re bringing
them through
like what buttons it up you know and uh
yeah i’m the unbuttoner yeah
you know to me and i’m going to let
clinton really take that question
directly but you know the alternative is
distress avoidance right like
just try to shrink your life so small
uh if if you get your substances shrink
your life so small
to be as limiting in distress as
possible
um and so you know
really clint and i when we sat and began
planning out
some of the curriculum um we really
i really thought through a lot of the
unbuttoning like creating the distress
and and beginning to excavate some of
the things that people are avoiding or
want to avoid or
getting to some of the causal issues
leading to the substance use
um and then really relied on clinton and
his
kind of expertise in bent to say okay
and this is how i can see buttoning that
up so i’m gonna
i’m gonna let him kind of take that
the how question for that how well uh
like i said earlier i think recovery is
actually really quite pragmatic
it’s about um being able to so easy
yeah it’s super easy like you just got
to do it yeah i don’t know what to do
[Laughter]
uh i think that there is a practical
quality to it though it’s not
magical like it’s actually work you know
so
in my experience the way to ground
people is through work like you actually
have to do
some work you have to live what you have
to experience
life in recovery which is very basic
it’s very normal
it doesn’t feel exciting it doesn’t
actually feel um
there’s no thrill about it you know it’s
act and
so that’s one way is to actually really
start engaging people in just this sort
of
basic life of recovery and and really
reinforcing that
um you know a day in the life of
recovery is just
a day doing laundry you know it’s a day
mowing the lawn
it’s a day going to the grocery store
you know
and being able to sort of reiterate that
and
allow them to experience that in a way
that is actually fulfilling
the other hand the other way to do that
is somatically actually getting into the
body
and really grounding people either
through yoga or
through other various exercises through
actually going on hikes you know there’s
a there’s a way to sort of ground the
mind
through the body that uh we also lean
into pretty heavily
um because the reality is like you’re
i mean i don’t know if i personally
believe in
resolution to trauma i don’t know if i
actually believe that that’s a thing
but i do believe that you can re you can
work around your trauma you can
recognize that it’s there
see how it’s impacting you in your
day-to-day life and then change that
impact you know um very easily and very
pragmatically of course
yeah we can flag that for another
episode by the way because that may be a
another episode for sure
super easy guys yeah well and and
bringing this uh
um to its uh natural end here i i all of
this resonates with me i sit in front of
clients
you know a lot of times and they say
stuff about how this is boring
and i think this industry has done
a major misstep from those attitudes of
boring because recovery is boring
just living sometimes you’re going to
find yourself an absolute boredom it’s
just a part of life
and when you get to our websites we say
we do all these things because we’re
trying to sort of do a dance at the end
of the day but the dance is too big
and it should be narrowed and it should
be focused and so
over the course of coming episodes
certainly we want to continue to bring
forward that
narrow focus and how it can be helpful
to individuals engaged in early recovery
processes and then expand from there
where we can start doing a greater dance
beyond the walls of a residential
addiction treatment facility so
speaking of boredom if you’re bored
today this afternoon check us out on
spotify the itunes store
um wow find us somewhere go to our
website uh
our program is not boring by the way
like that’s not a thing let’s just throw
that out there that it’s very exciting
full of thrills and wow yeah it’s pretty
and uh email us questions comments ideas
concerns at
finding peaks at peaksrecovery.com
send us your comments in social media
and so forth we’d love to build upon
questions and ideas that you guys have
thank you so much again for joining us
until next time