Jim Bush CEO of a Trauma Center Part 2

Episode 12 February 24, 2022 00:34:52
Jim Bush CEO of a Trauma Center Part 2
Rachel on Recovery
Jim Bush CEO of a Trauma Center Part 2

Feb 24 2022 | 00:34:52

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Rachel Stone

Show Notes

Jim Bush LCSW Chief Executive Officer of Columbus Behavioral Center for Children and Adolescents with 25 years of experience. Jim covers the ACE Score and generational trauma.

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Episode Transcript

WEBVTT 1 00:00:00.360 --> 00:00:04.080 We have Jim Bush joining us again and he's coming back to tell the rest 2 00:00:04.120 --> 00:00:06.719 of a story. He's going to give a little bit of Intro for those 3 00:00:06.719 --> 00:00:11.279 who missed last week's episode and then we're going to go back into answering questions. 4 00:00:11.400 --> 00:00:15.759 Thanks. Yeah, Hi, my name is Jim Bush. I'm a 5 00:00:15.880 --> 00:00:25.839 licensed marriage and family counselor and have been treating folks with trauma and overseeing their 6 00:00:25.920 --> 00:00:33.280 care for about the last thirty three years and now men management and oversea programs 7 00:00:33.359 --> 00:00:43.200 that serve those folks. Fair enough. Tell me about your experience training with 8 00:00:43.280 --> 00:00:48.640 the ace score and tell us a little bit about the a score. Yeah, 9 00:00:48.719 --> 00:00:56.280 so Dr Philidian, Dr and got together. Gosh, now it spent 10 00:00:56.320 --> 00:00:59.520 a minute since is I think it was around one thousand nine hundred and seventy 11 00:00:59.560 --> 00:01:04.159 five that they started the a study, and it stands for adverse childhood experiences, 12 00:01:04.200 --> 00:01:14.439 and they were looking to find correlations between obesity and some kind of some 13 00:01:14.560 --> 00:01:23.239 correlation between trauma or abuse and obesity. And so they identified ten categories of 14 00:01:23.280 --> 00:01:32.959 abuse and they so as like, you know, the apparent being in jail 15 00:01:33.040 --> 00:01:37.560 or in the hospital, being slapped or hit or, on a regular basis, 16 00:01:37.560 --> 00:01:42.599 witnessing violence. So they kind of and they kind of define it, 17 00:01:42.640 --> 00:01:47.879 and so every person would have a score from zero to ten. You know, 18 00:01:47.920 --> 00:01:52.159 I think about like, I don't know, I can't remember now, 19 00:01:52.239 --> 00:01:55.000 spent a minute. Maybe fifteen percent have one. I mean if you have 20 00:01:55.040 --> 00:02:00.719 divorced parents, that's a one. So half the probably half two kids, 21 00:02:00.920 --> 00:02:07.000 would get that as a one. But where we saw is hundreds of correlations, 22 00:02:07.240 --> 00:02:12.879 especially if you got over for and so it's not the frequency of events. 23 00:02:13.080 --> 00:02:16.080 So if you had one, if you had one thing happened every day 24 00:02:16.080 --> 00:02:19.759 for a hundred days, but it was the same thing, that would just 25 00:02:19.800 --> 00:02:23.080 count as one. So it's categories of abuse and Dr and I would talk 26 00:02:23.120 --> 00:02:31.039 about doses of abuse and so is be like how much trauma did you get? 27 00:02:31.039 --> 00:02:36.400 And the and so the the complexity, the more different kinds. So 28 00:02:36.479 --> 00:02:40.639 if you had four or more, the likelihood, like, of doing of 29 00:02:40.639 --> 00:02:47.159 shooting up drugs, is like forty eight hundred percent. We're more than if 30 00:02:47.199 --> 00:02:52.400 you had a zero or a one on the score. So what we saw 31 00:02:52.560 --> 00:02:57.759 was zero, two, four was would incrementally, whether would be, you 32 00:02:57.800 --> 00:03:07.800 know, drinking or promiscuity or smoking or pregnancy, teenage pregnancy. We would 33 00:03:07.800 --> 00:03:10.599 see increases the more you had, the more likely it happened, but then 34 00:03:10.680 --> 00:03:15.520 some very physical outcome. So more likely to get pregnant, more likely to 35 00:03:15.560 --> 00:03:22.000 miscarriage, more likely to smoke early on, more likely to get CEOPD, 36 00:03:22.639 --> 00:03:25.599 more likely to get lung cancer and then more likely to die from lung cancer 37 00:03:25.680 --> 00:03:30.919 with somebody with a lower a score. So we started to see the more 38 00:03:30.919 --> 00:03:36.199 categories of abuse that people had, the more they would have a almost a 39 00:03:36.240 --> 00:03:42.439 compromised immune system, where we saw that people were dying twenty to twenty five 40 00:03:42.520 --> 00:03:46.439 years earlier than the general population if you had a score of for or high. 41 00:03:46.000 --> 00:03:49.960 And so really it's the the thought is a couple things. One, 42 00:03:50.039 --> 00:03:54.240 the amygdal in the brain doesn't feel safe and, as always hyper vigilant and 43 00:03:54.280 --> 00:04:00.960 always hyper alert to something bad happening, and then all these if you're smoking, 44 00:04:01.080 --> 00:04:05.479 doing substances, drinking, all these things the bodies having to attend to 45 00:04:05.560 --> 00:04:12.080 on top of the hyper vigilance. So we think it just ages people the 46 00:04:12.159 --> 00:04:15.720 more traumas that they've had. And now you know the one clear thing. 47 00:04:15.920 --> 00:04:20.800 If you could have a high a score and and have lots of resiliency of 48 00:04:20.800 --> 00:04:25.439 them, work through it and not have prevalence of things in your life. 49 00:04:25.639 --> 00:04:30.319 Right. But so just because you've had some bad things happen doesn't mean that 50 00:04:30.360 --> 00:04:33.879 you're directly going to have all these things. We just know there's a higher 51 00:04:33.959 --> 00:04:39.639 propensity for that. So it's really like, you know, a predisposition so 52 00:04:39.879 --> 00:04:44.560 and then and so there's lots of other things that also assess both, you 53 00:04:44.600 --> 00:04:47.759 know, childhood and Adult Trauma. But it gives you a script and understanding 54 00:04:47.920 --> 00:04:53.839 of whether you're going to be presisposed to this. And one of the parts 55 00:04:53.839 --> 00:04:58.560 of the study said somebody even as old as eighty five was still being affected 56 00:04:58.759 --> 00:05:01.879 by their by their a score of those first eighteen years. And so you're 57 00:05:01.879 --> 00:05:06.000 more likely to be on an antidepressent, more likely to try substances, you're 58 00:05:06.000 --> 00:05:11.240 more likely to try and kill yourself then. So the higher the score, 59 00:05:11.319 --> 00:05:15.279 the more all those things happen. So it's just kind of a warning sign 60 00:05:15.439 --> 00:05:19.959 one. It's like if you have been using substances and you find out that 61 00:05:20.000 --> 00:05:25.079 you're a scorers high. It's like that that would be predictable. And the 62 00:05:25.079 --> 00:05:28.560 other side of that, on the prevention side, with children. They have 63 00:05:28.600 --> 00:05:31.199 a high a score and they're not doing those things. How do you actively 64 00:05:31.319 --> 00:05:35.920 work to prevent that from happening. So if they find an outlet to talk 65 00:05:35.959 --> 00:05:41.519 about their trauma, then maybe they won't use the substances that helped none the 66 00:05:41.560 --> 00:05:46.759 pain. So it's very useful, but it's also not a program or an 67 00:05:46.800 --> 00:05:54.720 answer. It's mainly a identifier guideline for the most part. Absolutely, in 68 00:05:55.000 --> 00:05:59.800 US trauma and abuse happen after eighteen, of course, right, and some 69 00:06:00.079 --> 00:06:03.560 times it doesn't happen at all until then. And does that meaningful? Absolutely. 70 00:06:04.279 --> 00:06:09.279 One of the things somebody asked me was one of the questions is that 71 00:06:09.600 --> 00:06:14.160 you witnessed your mother being abused by, you know somebody, and that was 72 00:06:14.240 --> 00:06:16.199 an Ason. Somebody said, well, I had I don't know what to 73 00:06:16.240 --> 00:06:20.480 count this, but a father was being abused by the mother, and so 74 00:06:20.600 --> 00:06:24.839 I talked to you know, Dr Philippi and it said, do we count 75 00:06:24.879 --> 00:06:28.000 that? And he said well, you wouldn't count it for the study, 76 00:06:28.160 --> 00:06:32.240 but it would have the same consequential meaning. So, you know, I 77 00:06:32.240 --> 00:06:38.639 think they just can't stray from the original definitions. But the the you know, 78 00:06:38.720 --> 00:06:43.720 obviously if they're both your caregivers, seen one being injured by another's going 79 00:06:43.759 --> 00:06:46.240 to have probably the same effect. Maybe maybe a little different. At the 80 00:06:46.279 --> 00:06:49.480 mom as the primary caregiver, but you could have a stay at home dad 81 00:06:49.519 --> 00:06:55.160 being abused by the mom as the primary caregiver, you know. So just 82 00:06:55.199 --> 00:06:58.879 some interesting parts of the and that's a little bit more on the research side 83 00:06:58.920 --> 00:07:03.079 of that, but if you go to the CZC website and put in a 84 00:07:03.279 --> 00:07:10.759 study, you will find hundreds of correlation will studies that show links between this 85 00:07:10.839 --> 00:07:18.000 trauma and lots of physical ailments. What has been your experience with multigenerational trauma 86 00:07:18.040 --> 00:07:26.279 in Substance Abuse? Yeah, I mean I think that you see that extremely 87 00:07:26.360 --> 00:07:31.560 frequently, both right and that's a I guess my more mature goal than just 88 00:07:31.600 --> 00:07:38.000 helping people with trauma, would say the more impactful way of looking at it 89 00:07:38.040 --> 00:07:44.079 as can we stop this generational cycle right and I worked with an individual about 90 00:07:44.120 --> 00:07:49.040 twenty years ago who had been sexually abused by dad from two to seventeen. 91 00:07:49.040 --> 00:07:58.600 Came into my carrot seventeen and you know, I was extremely damaged and she 92 00:07:58.680 --> 00:08:03.160 started drinking at nine so she would avoid remembering Dad's, you know, perpetration 93 00:08:03.240 --> 00:08:07.879 to her when she when she was sleeping at night. So she was very 94 00:08:07.959 --> 00:08:11.560 damage but treatment in her teens. I mean she did have a she did 95 00:08:11.600 --> 00:08:16.160 have an incident whereth the police officer, where she punch him in the face 96 00:08:16.240 --> 00:08:20.319 and spent thirty days in jail. She's very bright and she was able to 97 00:08:20.399 --> 00:08:24.959 kind of process through that and she, you know, ended up going on 98 00:08:26.000 --> 00:08:33.039 to college, having a couple of kids, very highly functioning and she knows 99 00:08:33.320 --> 00:08:37.679 that the work she did. I mean both her parents like her. Her 100 00:08:37.679 --> 00:08:41.559 mom actually had borderline personalitis order. She did not live with her, she 101 00:08:41.600 --> 00:08:45.879 lived with her dad who then, you know, sexually abused her and of 102 00:08:45.879 --> 00:08:48.840 course denied at the grandma didn't believe her that the dad was abusing it, 103 00:08:50.080 --> 00:08:56.320 using her like that. And so we see, we see regularly those generational 104 00:08:56.639 --> 00:09:01.840 both and we know on the substance sue side there's a genetic factor that people 105 00:09:01.840 --> 00:09:05.519 are going to be more predisposed to addictions when they have the genetic part of 106 00:09:05.559 --> 00:09:09.879 addiction. But the trauma part and the abuse part is very, very similar 107 00:09:09.879 --> 00:09:16.879 too, because there's some kind of internal mechanism that's that to like if you're 108 00:09:16.960 --> 00:09:20.879 hurting me that and it's always been difficult for me to kind of describe, 109 00:09:20.919 --> 00:09:24.279 but you can see it very frequently. If you're abusing me, I don't 110 00:09:24.279 --> 00:09:28.960 want to be myself. So, like you disassociate, so you leave your 111 00:09:28.000 --> 00:09:33.120 body. And sometimes the thing, the experience that people sometimes say they have 112 00:09:33.240 --> 00:09:39.919 as they projected onto the perpetrator, right, and this that you see these 113 00:09:41.120 --> 00:09:46.679 odd relationships sometimes with with people that like we see these studies where they've, 114 00:09:46.799 --> 00:09:50.919 you know, kidnapped somebody and they've been with them for a year and this 115 00:09:50.080 --> 00:09:58.240 odd like connection in the abuse. And so it's just it does replicate itself 116 00:09:58.320 --> 00:10:03.879 very often, very similarly to like when I was just in private practice. 117 00:10:03.960 --> 00:10:07.240 A lot of times. Have you know a dad bring in a kid you 118 00:10:07.279 --> 00:10:11.519 won't stop fighting at school. He's getting kicked out over and over and it's 119 00:10:11.639 --> 00:10:13.000 like, well, what do you do when you're mad at your kid? 120 00:10:13.000 --> 00:10:16.679 Well, I spank him. It's so like when so, when you get 121 00:10:16.720 --> 00:10:20.639 angry, you hit, and then when he gets angry and he hits, 122 00:10:20.639 --> 00:10:26.000 he's in trouble. And so sometimes trying to see that correlation that we're teaching 123 00:10:26.039 --> 00:10:30.240 them early and often how not to manage it, how not to handle then. 124 00:10:30.320 --> 00:10:33.559 So, but they generally are go very much hand in hand. But 125 00:10:33.799 --> 00:10:37.480 to be able to like this girl I was talking about, she knows I 126 00:10:37.519 --> 00:10:41.519 mean her girl her daughter's stremely bright, you know, on a roll, 127 00:10:41.600 --> 00:10:48.120 cheerleader, no abuse like now. Has she lived a perfect life? Now? 128 00:10:48.159 --> 00:10:52.159 She's struggled to maintain jobs. He's had a couple of marriages, she's 129 00:10:52.200 --> 00:10:56.799 been attracted to men that sometimes use her right, but at the same time 130 00:10:56.080 --> 00:11:00.919 she stopped the cycle of abuse and she knows it and that was that was 131 00:11:00.919 --> 00:11:03.480 more important to her than probably anything in her life was to have kids that 132 00:11:03.519 --> 00:11:09.039 didn't have the experience that she had. And so yeah, it's it's very 133 00:11:09.039 --> 00:11:11.919 difficult, though, because you also sometimes get ostracized by Oh, you think 134 00:11:11.919 --> 00:11:15.720 you're better than us, because you start setting limits. Well, if you're 135 00:11:15.720 --> 00:11:18.279 going to drink, if you're going to hit your kids, I don't want 136 00:11:18.279 --> 00:11:20.480 to be around Oh, you think you're better than us. Right, there's 137 00:11:20.759 --> 00:11:26.159 I mean it's a very sad things. Even educationally, I saw young man 138 00:11:26.159 --> 00:11:30.559 that we worked very hard to get through high school and his family wouldn't come 139 00:11:30.600 --> 00:11:33.919 to his graduation because, oh, you think you're better than us now, 140 00:11:33.960 --> 00:11:37.480 and so the only people he had his graduation where people from the group home 141 00:11:37.559 --> 00:11:41.080 that he lived in. And so sometimes just some you know, tragic things 142 00:11:41.159 --> 00:11:46.919 like that. But we've seen lots of frequency of this going on for generations 143 00:11:48.000 --> 00:11:52.120 and and so if you can get somebody the understanding of the power where they 144 00:11:52.120 --> 00:11:58.399 can stop that for generations in the future, that's pretty powerful. But it's 145 00:11:58.440 --> 00:12:01.879 also, you know, very difficult. Cool. Yeah, no, I 146 00:12:01.879 --> 00:12:07.000 can. I can relate that. Breaking Trauma Bonds and not allowing abuse in 147 00:12:07.039 --> 00:12:15.840 your life can be very isolating and lonely and at the same time, you 148 00:12:15.879 --> 00:12:20.159 know, life changing for others. Right, but there's a cost. There's 149 00:12:20.200 --> 00:12:30.559 certainly a cost to that. How would you like the mental health field to 150 00:12:30.639 --> 00:12:35.279 improve in the next couple of years? I mean, as much as I 151 00:12:35.320 --> 00:12:39.799 want to believe that we've reduced stigma, I think lots of people still don't 152 00:12:39.799 --> 00:12:46.279 get help because they don't want to be judged. That's where, in some 153 00:12:46.279 --> 00:12:50.000 ways, tell a health has open some doors where people can get care from 154 00:12:50.080 --> 00:12:54.759 there, you know, their couch or their own couch with their laptop or 155 00:12:54.799 --> 00:13:00.039 their phone. So I think trying to continue to reduce stigma. I think 156 00:13:00.039 --> 00:13:03.639 we continue to see. Think the more like Simone biles comes out and says, 157 00:13:03.639 --> 00:13:07.799 Hey, I had anxiety, people that we look up to, the 158 00:13:07.840 --> 00:13:11.399 more they own at the more they talk about the more. But we also 159 00:13:11.440 --> 00:13:13.360 get to it's okay, well, I'm I'm going to accept it for other 160 00:13:13.399 --> 00:13:18.080 people, but not my kid or not my spouse or not me. Right. 161 00:13:18.159 --> 00:13:20.639 And so I think we got a lot still a long way to go 162 00:13:20.679 --> 00:13:24.960 with that. And then I think we have to just continue to find better 163 00:13:24.000 --> 00:13:30.480 and better ways that make a functional difference for people. Right. Like to 164 00:13:30.559 --> 00:13:35.919 me it's always about trying to help somebody manage their own lives. Like for 165 00:13:37.000 --> 00:13:41.000 a long time and mental health, people thought it was fine to see your 166 00:13:41.080 --> 00:13:45.360 therapist for ten, fifteen years, and I think the better model now is 167 00:13:45.399 --> 00:13:48.440 that we try and say, how do we help you, you know, 168 00:13:48.559 --> 00:13:52.440 instead of giving you a fish, teach you how to fish. That we 169 00:13:52.559 --> 00:13:58.279 don't really have, as clinicians, lots of special things. We just have 170 00:13:58.320 --> 00:14:03.679 processes and systems that can help you work so where you can go on and 171 00:14:03.759 --> 00:14:07.759 like manage your life better. I mean part of this there's not enough providers. 172 00:14:07.840 --> 00:14:09.279 So, like you want to get in, you want to be seen 173 00:14:09.360 --> 00:14:13.600 weekly, you maybe get in a month and then you can get in every 174 00:14:13.600 --> 00:14:18.320 two weeks at best, and it's really staggered. So like part of that 175 00:14:18.360 --> 00:14:22.559 I'd like to see more people going through the field, which also comes back 176 00:14:22.600 --> 00:14:26.200 down to pay like pace not good in our field. The work is very 177 00:14:26.200 --> 00:14:31.000 hard. I mean we are. We are really struggling in our field to 178 00:14:31.000 --> 00:14:35.000 get people, you know, in a residential setting there's there's lots of the 179 00:14:35.039 --> 00:14:39.960 trauma so bad. We see lots of, you know, violence, abuse 180 00:14:39.440 --> 00:14:46.960 self self, phone abuse like and then with the pandemic they've been they've not 181 00:14:46.039 --> 00:14:50.639 people have not been around them to know the stuff's going on. So I 182 00:14:50.639 --> 00:14:52.639 guess, like you know, trying to get more reduced stigma, get more 183 00:14:52.679 --> 00:14:58.039 availability and continue to try and be the best train that we can be. 184 00:14:58.159 --> 00:15:03.399 What can what else can we learn from people that have gone through it? 185 00:15:03.480 --> 00:15:09.000 And that's where the addition of peer supports has been useful. So people that 186 00:15:09.799 --> 00:15:13.720 came out on the other side, they work through some very difficult things, 187 00:15:13.759 --> 00:15:20.600 are now helping us, as certified peer recovery specialists, to help people engage 188 00:15:20.600 --> 00:15:22.080 in treatment. So, Hey, I was there too, and I know 189 00:15:22.159 --> 00:15:26.120 it's hard to trust, but this is helpful. So it's and we now 190 00:15:26.120 --> 00:15:31.919 pay people that had life experiences to share their life experiences with people, to 191 00:15:31.960 --> 00:15:35.720 tell them, hey, here's what a here's what an intake is. Are, 192 00:15:35.759 --> 00:15:39.039 I ask you, twelve pages of questions and they're not going to help 193 00:15:39.039 --> 00:15:41.200 you much to say. And then you'll get a signed a therapist, and 194 00:15:41.200 --> 00:15:45.320 that therapist is really important that you connect with them. Do you want a 195 00:15:45.399 --> 00:15:48.559 mail or a female? Is it meeting your needs? How would you know 196 00:15:48.600 --> 00:15:50.600 if I meet your needs? You know, how will you know if you 197 00:15:50.679 --> 00:15:56.360 are less depressed? And so like trying to define what you want out of 198 00:15:56.360 --> 00:16:00.840 it and take control over your own care, like you're the one investing in 199 00:16:00.879 --> 00:16:04.240 it. You know as a clinician, is not. I mean, we 200 00:16:04.279 --> 00:16:08.559 can point you that direction, but it's always best if if we're just helping 201 00:16:08.639 --> 00:16:12.519 you meet your goals. And so therapy, especially in substance, you so 202 00:16:12.559 --> 00:16:15.840 it used to be in your face, you're an attic during denial. That 203 00:16:15.919 --> 00:16:19.080 then really help people too much. Now we say hey, where do you 204 00:16:19.080 --> 00:16:22.240 want to go, and I'll help you, try and keep you on track 205 00:16:22.320 --> 00:16:27.600 to get there. So it's less confrontational. It's more what we call joining. 206 00:16:27.600 --> 00:16:32.919 So we were join in with our client and they're going to say hey, 207 00:16:32.960 --> 00:16:36.559 we're going to say are we getting there or not? And it's only 208 00:16:36.600 --> 00:16:41.159 you know, you as a client, you as the patient, should dictate 209 00:16:41.200 --> 00:16:45.039 whether it's working or not. It was not working. There's lots of things. 210 00:16:45.039 --> 00:16:49.039 So, like, let's say relaxation and meditation. There's dozens of different 211 00:16:49.080 --> 00:16:52.039 ways to do that. If one doesn't work for you, we can try 212 00:16:52.120 --> 00:16:56.679 different ones. So I you know, I really like it when clients say 213 00:16:56.720 --> 00:17:00.600 that's not working and as a therapist I want to somebody to say that's not 214 00:17:00.600 --> 00:17:03.399 working or I don't like that style. And so what I do at the 215 00:17:03.480 --> 00:17:06.160 end of session to say, was there anything that didn't go well today? 216 00:17:06.160 --> 00:17:08.880 Would you have liked another style? Do you want a female you know, 217 00:17:08.960 --> 00:17:11.960 especially when I work a lot with people that have trauma, like trying to 218 00:17:12.039 --> 00:17:15.559 be very clear about that, that we have plenty of work, we have 219 00:17:15.680 --> 00:17:18.240 plenty of people to see. We want it, we want well. You 220 00:17:18.279 --> 00:17:22.240 know, we'll get better outcomes if you're getting your needs met, if you're 221 00:17:22.240 --> 00:17:26.400 getting what you want out of therapy. If some doesn't work, like you 222 00:17:26.440 --> 00:17:29.640 know, when you talk to about your own little personal story, that wasn't 223 00:17:29.720 --> 00:17:32.839 very helpful. Okay, I'll make a note. I thought it might be 224 00:17:32.880 --> 00:17:34.839 helpful to see it. But, you know, like they were. You 225 00:17:34.880 --> 00:17:42.079 know, good therapists will really positively respond to critical feedback and then you're more 226 00:17:42.240 --> 00:17:47.279 likely to get what you want. What we generally see is that wouldn't really 227 00:17:47.319 --> 00:17:49.839 work, and then they don't come back and then we spend weeks calling them 228 00:17:51.200 --> 00:17:53.720 to schedule when they don't want to come back, and then they feel crappy 229 00:17:53.759 --> 00:17:56.880 that they're saying they don't want to come back and then everybody feels crappy. 230 00:17:57.039 --> 00:18:00.519 Right. So just that's the other thing is, how will we know when 231 00:18:00.599 --> 00:18:04.640 we're done? Generally people go to four or five sessions and then they're done. 232 00:18:04.720 --> 00:18:07.279 Well after that, then we chase them for three more and then we 233 00:18:07.319 --> 00:18:14.160 both feel like failures again. So letting people say I'm done is very important 234 00:18:14.200 --> 00:18:15.400 to me, like okay, I got what I needed, I'm done. 235 00:18:15.519 --> 00:18:18.920 I don't feel the need or no, I need to keep going or I'll 236 00:18:18.920 --> 00:18:22.319 come back, like we said. We see it as people have episodes of 237 00:18:22.319 --> 00:18:26.400 care. So it gets bad for a while when they adjusted that they don't 238 00:18:26.440 --> 00:18:30.000 need it as much and then maybe three months later they need a little recharge. 239 00:18:30.039 --> 00:18:33.200 But there's no like way it has to be. You don't have to 240 00:18:33.279 --> 00:18:37.359 be seen every week, you don't have to like fix it all, like 241 00:18:37.480 --> 00:18:40.160 all I want to fix is this. If this was better, I could 242 00:18:40.200 --> 00:18:45.559 function right, and so really encouraging people to to give that feedback and we 243 00:18:45.680 --> 00:18:51.759 know that the outcomes are better if the climission just ask those questions. That 244 00:18:51.799 --> 00:18:55.559 the did you get what you needed? What can I do better? We 245 00:18:55.680 --> 00:19:02.119 know just those asking those questions, people will have better outcomes. So it's 246 00:19:02.440 --> 00:19:07.000 important to guide your own care. Yeah, I think the whole you know, 247 00:19:07.160 --> 00:19:11.799 if you say something's not working, you know, I feel like I 248 00:19:11.799 --> 00:19:18.160 think some people are afraid to hurt their therapist feelings exactly, and know I'm 249 00:19:18.200 --> 00:19:22.680 guilty of that as well, but just hearing you say that makes me feel 250 00:19:22.759 --> 00:19:29.720 validated. Well, and you know what, what I learned one time was 251 00:19:29.720 --> 00:19:33.000 if you don't get critical feedback, you're not making it safe enough to to 252 00:19:33.039 --> 00:19:37.240 give critical feedback. And also, like there is that protection. You know, 253 00:19:37.359 --> 00:19:41.359 clients do kind of look up to you. But like, if we're 254 00:19:41.400 --> 00:19:44.839 not doing the best, if we're not making the most difference, we're not 255 00:19:45.079 --> 00:19:49.400 fulfilling our goals either. Right and so, and you don't have to say 256 00:19:49.559 --> 00:19:53.319 you know, you're an ass, that sucked right or whatever, but you 257 00:19:53.359 --> 00:19:56.720 can say like that I didn't really that didn't really work for me, and 258 00:19:56.839 --> 00:20:00.319 you're like Oh, okay, and and you know like I said, there's 259 00:20:00.359 --> 00:20:03.720 so many different ways to go about it. We're sometimes guessing. Okay, 260 00:20:03.759 --> 00:20:08.240 there's the probably ten or twelve relaxation models that I would go through and I'm 261 00:20:08.279 --> 00:20:11.720 like this seems to fit, but it may if someone said no, I 262 00:20:11.759 --> 00:20:15.440 don't really like that. That's I'm not going to do it against try something 263 00:20:15.480 --> 00:20:18.880 else until we find the right one. But I do think, I mean, 264 00:20:18.920 --> 00:20:22.519 I'm sure I've done it too, like not said something when I was 265 00:20:22.559 --> 00:20:26.640 like that's wasn't very useful, but it it is what a good therapist is 266 00:20:26.680 --> 00:20:30.200 going to do and what we're what we're in this field to do, is 267 00:20:30.240 --> 00:20:33.480 make a difference and if we're not making a difference, you know it's not 268 00:20:33.519 --> 00:20:37.640 helping anybody. So I would just encourage people to own their own care and 269 00:20:37.680 --> 00:20:41.839 if they doesn't, it's not working. Don't keep doing it. Okay, 270 00:20:42.519 --> 00:20:47.160 with that person, I mean keep doing it, but try and find some 271 00:20:47.279 --> 00:20:49.559 you have the right to find somebody that's a better match. And sometimes as 272 00:20:49.599 --> 00:20:56.359 personality, sometimes it's strategy. But, like you know, you should be 273 00:20:56.440 --> 00:21:02.039 respected with your course of treatment and support to in whatever you're wanting to do. 274 00:21:02.079 --> 00:21:04.400 Like our job is not to judge your path. Or job is to 275 00:21:04.440 --> 00:21:07.599 get you where you want to go. And and that's what's different in my 276 00:21:07.640 --> 00:21:12.279 career was we were a little bit more you know. Also, you know, 277 00:21:12.400 --> 00:21:15.680 Oh we're eight hundred twenty five and you have a job, and then 278 00:21:15.759 --> 00:21:19.200 you don't comment because you can't get off work and then we say, Oh, 279 00:21:19.240 --> 00:21:22.559 you're resistant, like Oh, no, I can't get off for you 280 00:21:22.599 --> 00:21:27.160 know, like we are. Field as has been a little self absorbed. 281 00:21:27.240 --> 00:21:30.640 So it's like, are you doing evening hours? Are you so? Like 282 00:21:30.759 --> 00:21:37.119 we have to think about we true. You know, one time the organization 283 00:21:37.319 --> 00:21:42.880 used to say people don't fail, plans do and and really trying to say, 284 00:21:42.960 --> 00:21:47.839 you know, people aren't trying to to, you know, resist treatment, 285 00:21:48.039 --> 00:21:49.880 like sign up and then not do it, but if they got three 286 00:21:49.960 --> 00:21:53.440 jobs and maybe, you know, eight hundred five doesn't work right. And 287 00:21:53.519 --> 00:22:00.799 so trying to figure out how do we actually serve people instead of like judge 288 00:22:00.839 --> 00:22:04.400 them. I think the field sometimes gets to judge about our clients, even 289 00:22:04.440 --> 00:22:08.839 though we even, you know, all of us therapists have our problems to 290 00:22:10.160 --> 00:22:15.119 write. We want our therapists to stay till seven because we have patients till 291 00:22:15.200 --> 00:22:21.160 six. Right. So, but it's hard work and but it's very gratifying 292 00:22:21.400 --> 00:22:25.799 and especially for me with probably the most successful thing is when you're able to 293 00:22:25.799 --> 00:22:30.119 stop that generation of abuse. That's that makes my whole year if we and 294 00:22:30.160 --> 00:22:33.599 you find a case like that, because you just think about how many, 295 00:22:33.680 --> 00:22:37.960 dozens of people could be affected by one person's stance and they might have suffered 296 00:22:38.039 --> 00:22:41.599 to do that. And sometimes people don't have kids because I don't want to 297 00:22:41.599 --> 00:22:45.880 bring them to that and so they're going to stop it that way. But 298 00:22:45.880 --> 00:22:49.440 but I think it's it does. It takes a lot of courage and bravery 299 00:22:49.440 --> 00:22:53.839 and strength and it's hard. It's all it continues to be hard. But 300 00:22:55.079 --> 00:23:00.519 the power of not replicating harm and and you know, we as a system 301 00:23:00.519 --> 00:23:04.240 have to still keep saying, you know, are we punishing symptoms? I 302 00:23:04.359 --> 00:23:08.880 we never want to retraumatize somebody by punishing symptoms. And that's where I get 303 00:23:08.920 --> 00:23:15.799 worried about people with borderline if we judge them about their symptoms, were retraumatizing 304 00:23:15.839 --> 00:23:19.599 them and they don't want to be like that. But it's very it's easy 305 00:23:19.720 --> 00:23:25.680 to judge because the behavior, the symptoms are ugly right, they're very personal 306 00:23:25.720 --> 00:23:30.519 and very harmy, and so like trying to just deflect it and say, 307 00:23:30.559 --> 00:23:33.240 then set a limit. When you talk to me like that, I'm going 308 00:23:33.279 --> 00:23:37.359 to walk away because it hurts me too much. Right like versus, you 309 00:23:37.400 --> 00:23:41.039 know, losing your you know, losing it on them, which is the 310 00:23:41.079 --> 00:23:47.720 instinct, because they can say horrible things and very hurtful and they know it, 311 00:23:47.759 --> 00:23:52.680 but they're really responding to covering their pain. But then they create so 312 00:23:52.799 --> 00:23:56.599 much pain. It's just hard, vicious cycle, very much so, and 313 00:23:56.640 --> 00:24:02.920 they their lives generally always stay that way. They don't. It's hard to 314 00:24:02.960 --> 00:24:06.079 recover from me. You can get better, you can manage it, you 315 00:24:06.079 --> 00:24:08.720 can manage to it pause to a certain point, but that hole's going to 316 00:24:08.759 --> 00:24:14.480 be there and so either you can cope with it or you, you know, 317 00:24:15.400 --> 00:24:19.279 just have lots of failed relationships with people that you love. Can Be 318 00:24:19.400 --> 00:24:30.880 very painful. What advice would you give trauma victims? I think most of 319 00:24:30.920 --> 00:24:34.079 all probably to try and get help, try and that people can and do 320 00:24:34.160 --> 00:24:40.720 recover every day. That the power of stopping generational views, but also finding 321 00:24:40.799 --> 00:24:45.519 somebody that's knowledgeable and knows what they're doing and can actually help you and if 322 00:24:45.519 --> 00:24:49.759 they're not helping you, find someone else. That I think that's what it's 323 00:24:49.839 --> 00:24:53.799 really hard to go out alone, you know. And and yet, like 324 00:24:53.920 --> 00:25:00.319 my for thirty five years I've dealt with pretty much only trauma and and so 325 00:25:00.440 --> 00:25:03.720 like people know, you know, they don't they know how to help. 326 00:25:03.759 --> 00:25:06.720 They know how they it's not like they're going to lie. Oh my gosh, 327 00:25:06.799 --> 00:25:08.720 I can't believe that's the worst story I've ever heard. I mean it's 328 00:25:08.839 --> 00:25:15.680 it's also it's also hard on providers. You know that there's a secondary trauma 329 00:25:15.799 --> 00:25:19.079 that I said when to myself and I left graduate school. If I ever 330 00:25:19.200 --> 00:25:22.839 got used to hear in these stories, I'd need to get out. And 331 00:25:22.960 --> 00:25:26.960 I can say to this day, you know, every day I hear stories 332 00:25:26.000 --> 00:25:30.799 that I just it's a struggle with right, that a life experience of a 333 00:25:30.839 --> 00:25:34.960 young person was pursue tragic. And then I also am and continue to be 334 00:25:36.000 --> 00:25:40.480 inspired if they can go on through their day and fight to see another day. 335 00:25:40.559 --> 00:25:44.920 You know, my little things about my little life don't seem so bad. 336 00:25:44.960 --> 00:25:48.440 So I try and gain courage from them and I also try and tell 337 00:25:48.480 --> 00:25:52.920 them you know, your strength, your bravery helps me get be stronger because 338 00:25:53.480 --> 00:25:56.319 you know, like and and the girl that I told you about that was 339 00:25:56.359 --> 00:25:59.720 most by of that. I'm like, if you can deal with this, 340 00:25:59.839 --> 00:26:03.240 life is not on to be that bad, because they are nothing worth and 341 00:26:03.240 --> 00:26:07.119 and she's like that's right. In fact, she she posted something today on 342 00:26:07.680 --> 00:26:12.400 facebook about about, you know, someone believed in me once and now I 343 00:26:12.480 --> 00:26:19.079 made changes in my you know, community and like that's powerful stuff and you 344 00:26:19.079 --> 00:26:22.559 don't, you rarely get, you know, much of that knowledge. When 345 00:26:22.599 --> 00:26:26.200 they're better, they leave and you don't hear from them. But at the 346 00:26:26.240 --> 00:26:30.359 same time you just have to know, you just have to be committed to 347 00:26:30.720 --> 00:26:36.200 not being judgmental, not taking it personally and doing your best. I always 348 00:26:36.200 --> 00:26:40.279 tell people, especially in residential when if we give them our best every day, 349 00:26:40.359 --> 00:26:42.319 they're still going to struggle in a big way. This is not an 350 00:26:42.319 --> 00:26:47.759 easy course. So we can't show up halfway to work like we got to 351 00:26:47.759 --> 00:26:52.160 give them everything we got, every resource we got, whether it's for housing 352 00:26:52.240 --> 00:26:56.640 or relationships or getting off drugs or finding a new way, and that you 353 00:26:56.640 --> 00:27:00.640 don't hurt yourself, whatever it is. But no, even at our best, 354 00:27:00.640 --> 00:27:03.319 life is going to be tough. So it's a big commitment, but 355 00:27:03.359 --> 00:27:07.079 it's also a life filled with no one. You did the right thing. 356 00:27:07.160 --> 00:27:11.240 You put your head on your pillow at nights and I did my best to 357 00:27:11.240 --> 00:27:15.160 help right and and sometimes a lot of times you feel like you're not making 358 00:27:15.200 --> 00:27:21.359 the difference, but I think we are. What are some innovative treatments out 359 00:27:21.400 --> 00:27:26.400 there that you're a fan of in the mental health of field? I mean, 360 00:27:26.440 --> 00:27:30.559 I think we've probably covered them, like in the EMDR, the efficacy 361 00:27:30.720 --> 00:27:37.759 there, you know, the DBT, trauma focus, CBT, the better 362 00:27:37.839 --> 00:27:42.119 outcomes. Now is a model that that talks about those questions, that gages 363 00:27:42.240 --> 00:27:47.559 those things, that helps you really it helps you see if you're on the 364 00:27:47.599 --> 00:27:52.400 trajectory of getting better like you should or that you've stoled. It also helps 365 00:27:52.480 --> 00:27:56.000 predict whether people are probably going to drop out of there, because if you 366 00:27:56.039 --> 00:27:59.839 don't get enough back, you're going to drop out. So that's a model 367 00:27:59.960 --> 00:28:07.720 that that works. You know, there's we've seen a lot of efficacy with 368 00:28:07.039 --> 00:28:12.319 very severely depressed people where they still use the electric shock therapy in a very 369 00:28:12.359 --> 00:28:18.720 different way they used to do. Few episodes, very strong and powerful and 370 00:28:18.720 --> 00:28:22.880 and lots of damage to the memory. What we still what we see to 371 00:28:22.920 --> 00:28:29.079 this day is, you know, maybe several sessions with low doses. We 372 00:28:29.119 --> 00:28:34.319 see less of the damage to the memory piece and sometimes people go from perennially 373 00:28:34.440 --> 00:28:41.599 suicidal and almost hallucinating to functioning. The weird thing is, you know one 374 00:28:41.640 --> 00:28:45.480 you don't want to do unless there's no other alternative because it's risky. Until 375 00:28:45.559 --> 00:28:48.400 we still don't really know why it works. You know, there's a lot 376 00:28:48.400 --> 00:28:52.799 in psychiatry and psychology, that and the brain that we just don't know why 377 00:28:52.839 --> 00:28:57.440 it works. And say with medications there's usually something that works. We don't 378 00:28:57.480 --> 00:29:02.519 really know why a lot of times or takes a lot of different combinations or 379 00:29:02.519 --> 00:29:07.000 different trials. I wish we could get better and I guess there is some 380 00:29:07.000 --> 00:29:11.880 some technology. The genome therapy. We're on certain diagnosis. They figured out 381 00:29:11.960 --> 00:29:17.559 like they can read your genomic pattern and say you will respond better to this 382 00:29:17.640 --> 00:29:22.519 classification than that, and so they they jump to past ones that they're pretty 383 00:29:22.519 --> 00:29:26.079 sure won't work. So if we could get better at that that applied to 384 00:29:26.119 --> 00:29:30.839 more diagnostic things. I mean, I think the frustrating thing you're super depressed 385 00:29:30.920 --> 00:29:33.680 or suicidal. Here's some Mani depressants. It'll start working in a month as 386 00:29:33.720 --> 00:29:38.039 a very long time for somebody who's severely depressed. Right and and like a 387 00:29:38.079 --> 00:29:42.440 psychiatrist said, it doesn't like magically start working on the thirty day. It's, 388 00:29:42.519 --> 00:29:45.400 you know, one percent a day or two percent a day, like 389 00:29:45.480 --> 00:29:49.240 it's but that's just too slow. Like how do we help people feel better 390 00:29:49.359 --> 00:29:53.279 quicker? And so getting the right medications as part of it, getting the 391 00:29:53.359 --> 00:29:59.279 right therapy, getting the right there, because and being able to tell doctors 392 00:29:59.279 --> 00:30:03.000 and therapists when it's not working so we can try something different. But having 393 00:30:03.079 --> 00:30:07.400 people wait in pain, I think, is is we can do better. 394 00:30:07.799 --> 00:30:12.920 What do you do for self care? HMM, it's a good question. 395 00:30:14.599 --> 00:30:18.720 One of the things I can the trauma work that I do. We we 396 00:30:18.759 --> 00:30:22.359 do require everybody that we work with the have a selfcare plan. We don't 397 00:30:22.400 --> 00:30:25.599 dictate what it is, we don't enforce that. It happens. But you 398 00:30:25.640 --> 00:30:30.319 know, I have a hour drive to work and an hour drive home and 399 00:30:30.359 --> 00:30:34.039 that's where I spend a lot of my time. You know, dstressing. 400 00:30:34.119 --> 00:30:40.880 I've been I've been listening to a lot of jazz and in some classical music. 401 00:30:41.319 --> 00:30:45.119 Bach has some upbeat stuff. What I like about those two models of 402 00:30:45.200 --> 00:30:49.160 music is there's no words to detract me, so I have to like be 403 00:30:49.240 --> 00:30:53.359 more genuinely like what does this music make me feel, which takes me off 404 00:30:53.440 --> 00:30:57.279 of, you know, the the abuse that I heard earlier or whatever. 405 00:30:57.359 --> 00:31:03.519 I like to play Golf, I love sports. We've got three big dogs 406 00:31:03.519 --> 00:31:07.920 that keep us very busy working on the house. I got a couple kayaks 407 00:31:08.000 --> 00:31:11.960 that I like to use. So, you know, the more physical the 408 00:31:12.000 --> 00:31:18.440 better, because it's very, you know, very much mindstress. Like I 409 00:31:18.440 --> 00:31:22.440 could come home so tired and have set at a desk do enough, like 410 00:31:22.599 --> 00:31:26.759 quote, nothing all day, right, but it is very important because otherwise, 411 00:31:26.920 --> 00:31:29.680 you know, we won't survive. And I learned in the first six 412 00:31:29.680 --> 00:31:33.079 months in the field and the group home in California. It's like you either 413 00:31:33.160 --> 00:31:36.039 leave it at work or you won't survive. Like, you know, your 414 00:31:36.039 --> 00:31:37.559 first inting, I want to take this get home. They're so sweet and 415 00:31:37.839 --> 00:31:41.920 you didn't see the rage and you also are twenty two year old. I 416 00:31:41.920 --> 00:31:45.759 can't do anything about it, right. And so you really have to do 417 00:31:45.079 --> 00:31:49.640 compartmentalized work, but you also have to, you know, find ways to 418 00:31:49.759 --> 00:31:53.519 know that you're doing everything you can to help the people that you serve. 419 00:31:53.680 --> 00:31:59.200 You're, I judging them, you're supporting them and you're finding the best ways 420 00:31:59.240 --> 00:32:01.400 you can and you're trying to encourage that with people that you work with. 421 00:32:01.720 --> 00:32:07.279 One last questions off the books. How is this all impacted your faith? 422 00:32:07.599 --> 00:32:14.640 M You know, my faith has been a really strong part of where I 423 00:32:14.680 --> 00:32:20.599 started with all this and it really is something that still drives what I do. 424 00:32:20.720 --> 00:32:24.920 Like I've always wanted to do mission work. My parents, my dad 425 00:32:24.960 --> 00:32:30.319 and my mom, went to Haiti eleven years in a row and did medical 426 00:32:30.319 --> 00:32:34.599 mission work where they pulled teeth and you know, my dad was a doctor, 427 00:32:34.599 --> 00:32:37.559 my mom's physical therapist. They went with about ten or twelve people. 428 00:32:37.640 --> 00:32:42.720 But it's like I don't have the time to take a week off or do 429 00:32:42.799 --> 00:32:45.160 that, but so I try and do my mission is every day, like 430 00:32:45.240 --> 00:32:49.119 I pray on the way to work, I pray on the way home to 431 00:32:49.200 --> 00:32:53.039 try and be the most effective with the people that I'm working with and, 432 00:32:53.200 --> 00:32:57.440 to be quite frankly, what I've been doing every day in the last couple 433 00:32:57.480 --> 00:33:00.839 weeks is just being grateful, finding you and multiple things to be grateful for 434 00:33:01.000 --> 00:33:06.680 in the midst of all these bad things happened to so many people, both 435 00:33:06.720 --> 00:33:09.160 in the you know, in the world the pandemic that you know, there's 436 00:33:09.240 --> 00:33:15.000 so much negative trying to stay away from the news and I feel like I 437 00:33:15.039 --> 00:33:21.880 need data, you know, around the pandemic, because we have recently had 438 00:33:21.440 --> 00:33:25.720 to put a stop on admissions because we had to we had in January we 439 00:33:25.759 --> 00:33:30.480 add a seventy three staff. We had thirty seven COVID outbricks, and so 440 00:33:30.759 --> 00:33:36.759 trying to stay open was important, but at the same time, you know, 441 00:33:36.920 --> 00:33:42.039 trying to not see all the pad because it's just you brain just gets 442 00:33:42.039 --> 00:33:45.119 worn out on this isn't a safe place, if you knows what it feels 443 00:33:45.160 --> 00:33:50.960 like over time. So, but but I feel like it's strengthens my faith 444 00:33:51.039 --> 00:33:55.440 in terms of my job, my responsibility to be there for somebody else. 445 00:33:55.519 --> 00:34:00.480 Okay, well, that's it. Thank you for being on my show and 446 00:34:01.759 --> 00:34:08.039 thanks for being patient with all the technology issues we've had, mostly on my 447 00:34:08.239 --> 00:34:13.000 end, I will say. But yeah, well, I'm glad we were 448 00:34:13.039 --> 00:34:16.239 able to do this. This was this was great and I appreciate the opportunity 449 00:34:16.239 --> 00:34:22.119 to share my thoughts, and certainly they're mostly just my thoughts right learn and 450 00:34:22.159 --> 00:34:28.679 my life experiences and they're not everybody's, but I'm pretty passionate about them for 451 00:34:28.760 --> 00:34:34.000 me, and so I appreciate the opportunity to share it all right thanks guys 452 00:34:34.039 --> 00:34:38.159 for listening. We'll be tuned in next Thursday and you can always follow us 453 00:34:38.280 --> 00:34:46.599 on social media and I'll on the website at Rachel on Recoverycom. Thanks for 454 00:34:46.639 --> listening.

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