Episode Transcript
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Hi, this is Rachel and recover. We've got a special guest with US
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named Jane Jim Bush, and he's
going to tell us a little bit about
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himself and then he's going to answer
some questions for us. Yeah, Hi,
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my name is Jim Bush. I'm
a licensed marriage and family counselor and
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have been treating folks with trauma and
overseeing their care for about the last thirty
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three years and now men management and
oversea programs that serve those folks. Okay,
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first question. What got you into
the mental health field? Well,
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my grandfather and my father physicians and, quite frankly, chemistry was not my
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best friend and so looked at alternatives. Was Interested in working with people and
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helping people and signed up for some
psychology classes and then just really enjoyed that
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work. Got My bachelor's degree at
Indiana University and then I went to California
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to get my master's degree out in
Berkeley, and while I was in school
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I got a job at a group
home. I knew I wanted to work
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with young people, but the group
home was really working with kids for about
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three months at a time and nearly
all of them had been removed by probation
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or department of Children Services and had
experienced a great deal of trauma and from
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that point just really loved working with
folks that had lots of trauma and trying
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to figure out the best ways to
serve those young people. Tell us when
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you saw the correlation between addiction and
trauma. I think that's a fascinating question
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because when you work with teenagers primarily, you're already, especially when I started
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my career in the late S,
you have a fair amount of substance shoes
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amongst young people already. So it
was normalized in terms of drugs and alcohol
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with people with with that lescence,
and so it took probably a little longer
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for me to kind of identify the
direct correlation. I think when it hit
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me it was kind of an Aha
moment that of course they would, because
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people that are experiencing trauma don't like
to reenact feel the pain of the trauma,
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and so the easiest way to address
it is to kind of numb the
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pain, not think about the flashbacks
the experience of both, well, all
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three, the physical, sexual and
then neglect issues, and so I think
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the same thing would hold true on
the adult side of substance shoes, that
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it it took maybe longer than it
should for people to really make that correlation
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that many of the folks that have
substance shoes sir a disorder, that they
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also had had trauma. And so
I would probably be in the early s
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where we really just started to see
things like the a study, the adverse
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childhood experience study, that began to
more directly make the link and then really
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try and look at ways that we
were missing the boat. Were we treating
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trauma when it was, you know, that was driven to substances or,
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you know, we're a lot of
times we were missing one or the other.
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So we're treating substance hues without knowing
the core issue of the trauma or
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retreating the trauma without seeing the predictability
of the substances. So it would probably
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be early s that we really started
to see a more direct correlation and a
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lot of people missed getting misdiagnosed.
Fair enough. What has been you experience
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with trauma in terms of treating trauma? Like, I guess that's a good
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place to start. Yeah, so, you know, I think I've done
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about twenty plus years of trainings on
trauma and the one thing we know is
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that two people can have an identical
experience and and have different interpretations of the
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trauma. The one example that I
would often give as you and I could
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be in a car and somebody run
a stop light and hit us both in
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the same accident. One of US
might only have heart palpitations when we go
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through that intersection in the future and
the other one might not leave their home
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or ride in a car based on
their experiences of the incident and of their
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past and those kinds of things.
So it's really hard to say you know
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what is a traumatic event. Obviously
some are more clear cut, but I
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think a lot of times there's you
have to kind of check in for an
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individual whether it was trauma. So
as I started doing these trainings and giving
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examples, I would say I didn't
really think of myself as some of that
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experience trauma. But when I was
a senior high school, our house burned
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down and I was we were I
was going to school when I noticed the
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fire and found that there was a
situation where my family was on a boat
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that another boat didn't see and it
hit us basically crack the boat that we
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were on and so those cut.
I think we probably all could say we
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had traumatic events. I would say
none of which kind of left big lingering
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effects, and the work that I
usually do are with people as more complex
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trauma, which would really be not
like a simple trauma, would be one
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incident that that led to, you
know, trying to get over it or
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passed it, like my house burning
down, whereas complex trauma could be you
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know, threats of physical violence and
physical violence for years, whether the violence
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occurred or not, still would be
traumatic. Or in an environment where in
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your neighborhood and your house and your
family people are actively hitting each other,
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slapping each other, abusing each other
using substances. So I think it was
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just really that I felt like we
could do better in treating trauma. Won't
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want. You know, I went
to school in the mid S in Berkeley.
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One of the things that I was
trained on was really to have clients
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re relive their trauma experience, so
basically tell you exactly what happened, how
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it happened and and how, you
know, in detailed steps and then kind
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of reinforced that well, now you're
safe, you don't have to be scared.
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Well, that really was an angle
that didn't seem to work when I
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started that after the training, it
seemed like every traumatized people it didn't seem
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to have positive functional outcomes. So
I guess part of what drove me was
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to find how do we do a
better job of helping people survive trauma thrive
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after trauma? And then just the
sheer experience of how many people in the
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General Society have you know that have
experienced trauma? And I think that's what
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a study also shows that you know, such a high number of people across
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all you know, socioeconomic areas has
really been affected by that. So when
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I would do my trauma trainings,
would be like, why do we need
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to know? Because it's pervasive,
right. And then really the thing that
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that clinicians want to know when I'm
doing the training is, you know,
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what do we do differently? How
do we help them get through this trauma?
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And it never the answer I never
came to was what I was originally
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trained on in terms of read living
steps of that trauma. Yeah, no,
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I can totally say that because,
I mean we leaving it over and
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overget does not help you get over
trauma, right, it's almost the opposite.
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That you're already readliving it. It's
like how do you one like center
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yourself around that? And really what
we spend a lot of time with now
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is triggers. Like if you know
your triggers, and I spend a lot
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of time with teachers principles schools trying
to help educate them on understanding triggers that
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they may be a trigger, whether
it's somebody that might have perpetrated on them
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or a parent or whatever. That
a lot of times it's helpful when somebody
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says a child says, Hey,
you remind me of so and so,
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an aunt, a teacher, coach, to really find out what does that
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mean to that kid? It could
be a very positive thing or a lot
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of times it's you remind me of
somebody that did harm and then their responsive
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to that. So why do you
always get sick or get kicked out of
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math class? Maybe you have a
math learning disability or maybe you are reminded
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of somebody who perpetrated on you,
or maybe both. Or maybe it's the
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time of day that you were,
you know, maybe after school at four
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o'clock. Now you're in school at
four o'clock. Maybe it's the time of
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day that triggers that kind of subconscious
sense of doom or something bad happening.
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So we really now look at,
you know, how do you predict it
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before it comes and then have a
plan when it comes on how to get
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through the situation so that you can, you know, keep functioning at your
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daily through your daily life? Yeah, and that's that can take a long
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time to masteringly. Absolutely, and
it depends on, you know, how
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long the the like the simple trauma, when there's a same single incident,
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that can some people don't go to
treatment at all, sometimes as a couple
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of months, whereas if you've been
traumatized for years and years or in that
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experience it, you know, you
may be triggered throughout your lifetime and just
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need to understand that was a trigger. I did this to care for myself
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and we really see things, as
you know, triggers, behaviors and consequences,
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and we do that for anger,
substance, shoes or trauma, and
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really, you know, it's really
trying to choose a behavior that doesn't hurt
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you and doesn't hurt anybody else,
and when you do that you should have
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a positive consequence, whereas if you
hurt yourself or somebody else. When you're
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being triggered, then you usually will
have a long term negative consequence. Yes,
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and those triggers are real and need
to be validated for sure, and
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most people do not know what they
are. Sometimes their smells, sometimes their
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sounds, sometimes you know what.
I had a great example of the Sandra
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Bloom as an individual who developed the
sanctuary model and she had come to my
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hospital and gave a talk on it
and she gave this perfect example about triggers
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that I shared often and she said. I was in with my client for
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her first session. She had lots
and lots of trauma. She was very
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triggered. Had A great session,
she really worked through a lot of things
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and when she left my door she
was feeling very calm and under control and
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so much better. However, as
she's walking past the front office, they
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flagg her down says, Oh,
you didn't bring your insurance card and if
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you don't bring it again then you
we're not going to be able to see
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you. So that kind of triggered
her anxiety of now we found the help,
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but I don't know, I can't
might not be able to get it.
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Then she walked outside the front of
the building and there was a men's
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group that was on break, that
was smoking cigarettes, while both men and
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cigarettes smell were triggers for her.
So she was heightened by this congregation of
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men, triggered again. And then
as she looked out to the parking lot,
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it was dark, there was no
security guard, and then she was
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once again triggered by the fear of
being in the dark and being attacked.
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And so what I always say is
two things. One, we can't,
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you know, prevent all triggers,
but as organizations we can be mindful of
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those things being very common triggers.
I mean, you know, most hospitals
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don't have don't allow you to smoke
within so many feed or whatever already,
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but try. And so after that
we were I mean we had in building
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that had both trauma victims and substance
use, where there was a lot of
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smoking, a lot of men,
and so organizations, when you become trauma
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informed, you really I mean we
were going to spend twentyzero dollars to put
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lights and and and in the parking
lots and get and get security guards because
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we wanted to be a trauma informed
organization. So once again it's like you
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can be triggered easily and quickly.
And then the key is how do you
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bround yourself? What do you do
in internally to stabilize yourself? And then
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what you know, especially as a
as a provider to people that that experience
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a lot of trauma, we want
to be mindful of a safe environment.
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And so, you know, most
grants these days and most funding funders will
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require that you're a trauma informed organization, and these are examples of being trauma
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in form so trying to be mindful
of how to keep somebody in that sense
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of feeling. So that's excellent that
they're making that requirement. Absolutely and it's
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really been my passion throughout my career. And, like you originally had asked,
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you know, why did I get
drawn to that? I don't I
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don't have any like friends or family. It was an experience that I had
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never experienced, but it really felt
like they were people that needed good care,
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were fully functioning and if they could, you know, learn how to
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manage this, that they could really
have a better life. And my goal
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was always like how do we give
people that we serve a better tomorrow?
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Whatever? That is right, and
so to me it's just you know,
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I grew up in a strong faith
based family that really, you know,
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pushed out the to be helpful to
others, and that happened to be my
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course of what fit for me.
My grandma, every time I saw her,
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she lived to be a hundred and
one, but every time I saw
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her she would say, I'm praying
for those boys you work with. And
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I never worked just with boys,
but somehow in her mind she thought that.
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So every night I go to bed
praying for those boys that you work
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with that had had abuse, you
know, and so it's just something that
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I have always had a passion for
and and feel blessed an honor to continue
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to be able to do that work. What has been your experience with bpd?
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So borderline personality disorder, is it
goes hand in hand with abuse.
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And so back in the the group
Home in Berkeley, you know, that's
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where I first got exposed to it, at a time where I was learning
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about it in school and there was
never forget this case. It was a
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eleven year old and a twelve year
old brother and sister that have been locked
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in a closet for over a year
and they had been fed dog food under
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the door and so they had defecated
and lived that entire time in there and
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they were severely abused in damage and
they both exhibited signs of borderline personality disorder.
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And so it's really generally characterized by
early age trauma, often times with
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primary caregiver, and so the parts
that should be attaching to a primary care
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giver or person in their lives tend
to not, you know, kind of
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stick together and complete themselves. And
so people with bpds do, you generally
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spend their entire life struggling in relationships. What they crave and want the most
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is what they're all most fearful of. The book I hate you, don't
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leave me characterizes it very well and
simply, and so it's it's usually characterized
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by early age trauma and then it
manifests itself generally throughout a lifetime because it's
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it's the key ingredient of the relationships
with other people. And so generally almost
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all the people will say they feel
this giant hole inside. They think that
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what would fix it would be a
close relationship, a bond, and yet
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when they get even close to being
personable, connecting with somebody, they get
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very fearful. They have what's called
real or abandoned I mean real or imagined
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abandonment experiences. So even if,
let's say, you roll your eyes or
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you blink or something like that,
someone might take that as you're rejecting me,
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you didn't accept me the way I
was. So it's this is this,
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you know, roller coaster ride of
trying to get, get close,
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but if you get at all a
semblance of that, so you just have
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a normal day, then they generally
turn around very quickly. If you got
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too close and they shred you to
pieces, they push you away very hard
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and very clearly, and so they
generally tend to have very difficult times with
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their primary relationships. And so it's
not that people can't get married and don't,
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but they generally have very volatile,
very challenging relationships. And so you
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know, based on that, the
therapy is a is a therapeutic relationship,
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right, and so it's really important
that people with borderline personality find somebody,
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a clinician that is well trained in
that, because the symptoms are very difficult
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to manage. They will project those
feelings onto the therapist and so a lot
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of people have adverse feelings because of
this projection of feelings, but it's really
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like it's it's probably one of the
most challenging disorders to experience. So you
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can't get close to anybody. People
tend to go on buying sprees or sex
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sprees or all these different things.
It's try and fill that emptiness. And
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so you know, as much as
it's difficult in the field to work with
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people that have borderline personality disorder,
it's something that's, you know, far
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more difficult to have yourself, and
so you live your life striving for something
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you'll never get, which is close, safe relationship, so so that sometimes
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it's real abandonment, somebody leaves you
because you went off on them too many
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times. And sometimes it's imagine.
But if you ever, if you have
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a relationship with somebody with borderline personality, if you're having a good day and
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feeling close and that was really nice, you should be anxious about the other
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side. Like it's better to pull
back because if you get too close you'll
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be pushed back one way or another, generally by negative comments, things that
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are reactive. So in some ways
they're extremely self centered. Every response is
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based on their own needs, and
yet they're also very externally based. Where
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if they think you're going to leave
them or hurt them, they're going to
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hurt you first. So it's a
very volatile experience and very challenging. But
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we have some, you know,
well established evidence face practices that will help
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people manage those those, you know, the regulate their move that's really where
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they have. The problem is this
dysregulation. It's all over the place.
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What's the best treatment for those with
borderline personality? So probably the you know,
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the most effective one. It would
be a dialectical behavior therapy by marshal
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in a hand. She that was
she came out with that about twenty,
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five, thirty years ago, and
it's really it really helps people look at
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these explosions or these incidents and kind
of track backwards. Where was the trigger?
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Where was the point that I could
have done something differently? So,
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you know, it might be that
you go back and say, Oh,
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well, you rolled your eyes,
so I knew that meant you rejected me
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and that's why I started calling new
names. Right. So it's kind of
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it's kind of a look backwards at
this mood regulation and then say, Oh,
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when this happens, if I'm around
somebody that I know triggers me,
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then how am I going to handle
it when it feels like they're rejecting me,
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because that experience of rejection is going
to lead to maybe an explosion and
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outburst or even self harmy like that. That's another strategy in some ways that
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you hurt me so bad, now
I'm going to end my life and I'm
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going to cut or I'm going to
hurt myself to make you feel bad like
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about that, that you rejected me. Does that make sense? Most definitely.
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What's the best advice for family members
and those with borderline personality like to
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support borderlines? Yeah, that's a
really good question because general, so you
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know lots of people with borderline they're
there extraneous, they're superficial friends, the
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people that they know, cowork sometimes
are never affected by that, like they're
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really good to them, but anything
that's primary and important to them. So
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you talking about family and friends,
they're going to get that roller coaster.
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They're going to get that more than
anybody else. The more primary, the
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more you're going to get the negative
pieces of that because they want something more
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out of it. Like if it's
a you know, Co worker, they're
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just trying to you know, not
stick out at work or whatever. And
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so I mean really a couple things. Is One, trying to understand what
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it looks like like reading. I
hate you, don't leave me. Understanding
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this dynamic of closeness is both good
and bad. Realizing that it's symptoms of
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trauma. And then part of it
is is regulating your amount of time,
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you know, in like investing in
that process. Right. So, like
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people, no one's going to no
matter how much you love or care about
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that person, you can't just go
in and fix it. It's not like
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that. So people that. So, in some ways, setting appropriate limits,
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like if you say hey, call
me if you having a bad day,
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you might get called every day,
right. And so then set limits
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to say hey, when you have
those let's try A, B and C,
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count to ten, read your book
and then go listen to your music
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whatever. Try to have a strategy
to help them deal with that real or
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imagined rejection or abandonment and trying to
be patient. But you know, when
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people come into care, the family
and friends, usually the spouse is really
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tired and ready to be done right. And so it's almost a self fulfilling
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prophecy. If I tries, you
enough, you're going to leave me,
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which I knew, which the whole
time I knew you were going to leave
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me anyways. Right. So then
the the imagined abandonment becomes real. And
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so you know, like I worked
with somebody who you know, used to
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she got in therapy at fifteen very
severely borderlin symptoms, and you know,
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she was married for five or six
years and she would just straight out say,
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well, why did you engage with
me? You knew that was just
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my borderline rage. But when should
so like this perception of you. Understand,
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why are you doing that? Well, they take that. They're extremely
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good at knowing what people's buttons are, what they what means the most of
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them, and in those moments of
rejection they push on whatever will hurt you
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the most. So they're experts at
hurting people right and it's it's to them
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like trying to even the score,
trying to protect themselves, but it's very
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damaging in relationship. So, you
know, trying to do that kind of
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whatever fair fighting thing, like let's
agree not to, you know, call
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my mom names or say horrible things
about whatever. You know, like if
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you think you're very honest, and
that's the one trait that you value the
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most. Then they would say all
you do is lie, and they will
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come up with things and they almost
could convince you that you did lie.
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Like they're very they gender generally are
very good at this line of thinking and
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understanding what drives people. But then
when they're hurt, they go to hurt
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you and so that. So I
guess the biggest thing is try and get
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them help with somebody that understands borderline
personality and and manage the boundaries very tightly.
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They generally tend to have no boundary. So they'll they'll come into close
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and like talk to a child about
their own sex life or to want to
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do drugs with a fourteen year old. Or they might be the opposite,
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where they're just, you know,
being sexually active in front of their kid,
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like they just don't have a sense
of where they stopped and where other
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people begin. And so set limits. You know, don't like engage for
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hours trying to fix it while they're
crying because they're going to kill themselves if
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you hang up. Like that's the
kind of drama. And yet the Seri
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the serious side of it is many
people to suffer enough that they take their
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own lives, and yet they might
have been perennially suicidal for ten or fifteen
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years. So you have to take
it seriously at the same time, like
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it's hard not to just feel like
it's another incident. No, it's it
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can be very difficult, especially,
I mean dealing with suicide day and a
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day out can be very difficult for
family members and friends and people get burned
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out a hundred percent. Yeah,
and and yet it's not like I mean
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it's not like they're making it up. They are feeling very lots of pain
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and generally learned that that's what will
get the most reaction and they're trying to
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soothe their pain right. And so
it's most important to help somebody with the
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borderline personality find something that sues that
pain or eases that pain. But there's
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generally not a lot that works because
this it's this very early age trauma that
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can ever get fixed. It's just
always am I mean I don't know if
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there's been much research done on Emdr
neurofeedback or any of that for borderlines.
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And and if I know an I
depressents can be help just manage things right
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and they generally had tend to have
a lot of anxiety as well. But
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Yeah, a MDR has a lot
of, you know, positive outcomes related
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to trauma. I thought what what
fits well for people with borderline is that
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it's not kind of emotionally delving very
deeply into that experience. It's more about
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kind of retraining the brain to have
a positive pathway that that doesn't you know,
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it's at a more subconscious level.
So that's kind of effective. There's
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trauma focused cognitive behavioral therapy. That
has some some good efficacy. The thing
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with the DBT is it was designed
for adults. Is Pretty and so,
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like you know, an individual that
doesn't have a lot of insight, they
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may struggle with it, or kids, and so it was probably about ten
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years ago began to be adapted to
kids because it's really a little too complex
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the full model. So it's good
that they've done that and so there's a
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trainings on that now. But But
yeah, You MDR, trauma focused CBT
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and and dbt or probably the primary. But like you don't want to just
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go to somebody a generalist that hasn't
worked with borderline personality before and somebody that's
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a therapist. If you say you
know you have that and you say you
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know I have borderline personality. Would
you be able to help me? They
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should refer you to somebody that has
it. Otherwise you're just gonna probably not
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make things worse but make things more
complicated because you might be feeding the wrong
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things, not realizing, you know, the boundaries that are being crossed and
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try and kind of nurture somebody to
wellness and that will never work. Well,
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that's it. Thank you for being
on my show and thanks for being
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patient with all, mostly on my
end, let's say. But yeah,
349
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I'm glad we were able to do
this. This was this was great and
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I appreciate the opportunity to share my
thoughts, and certainly they're mostly just my
351
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thoughts, right len, and my
life experiences and they're not everybody's, but
352
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I'm pretty passionate about them for me, and so I appreciate the opportunity to
353
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share it. Thanks again, Jim, for being on our show. He's
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coming back next week to finish talking
about trauma and he will be on the
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a score and we are very appreciative
of his time. And make sure you
356
00:30:57.140 --> 00:31:03.819
tune in on your favorite podcast platform
and always follow us on your favorite social
357
00:31:03.819 --> 00:31:08.450
media platform and always tune in on
Thursdays. Thanks for listening.
