Hello, my name is Conan Milner and this is Words of Wellness, a show where we talk about health from mind body to spirit.

Today I’d like to focus on addiction.

Addiction is typically characterized by individuals who develop a strong and seemingly uncontrollable dependence for alcohol or some other drug of choice. Substance abuse has been a scourge for decades. Yet despite many attempts to address the problem, it only seems to be growing worse. opioid addictions, for example, have steadily risen since 1999. With all the attention given to the opioid epidemic, an even sharper spike in related deaths over the last few years reveal we are further than ever from the solution.

It’s true for other addictions as well. According to a recent study published in the Journal of the American Medical Association, alcohol related deaths have risen over 25 percent from 2019 to 2020.

The easy availability of more powerful and potent substances has certainly contributed to the addiction landscape. But it’s more than just drugs, because the definition of addiction itself has expanded in recent years. Once a term that applied only to substance abuse and dependency, addiction has come to characterize any behavior that we obsessively pursue, to the detriment of everything else. Think porn addiction, food addiction, or a gambling addiction. Some say even your cell phone and television or social media use can become an addiction when it becomes a compulsive and all too consuming habit.

Many fall prey to addictive behavior because it often serves as a reliable avenue of escape from past pain or trauma. Or it may make one feel like a better version of oneself. Simply put, we feel bad. So we seek an experience that makes us feel good. But we would probably never have any reason to reflect on this process if it didn’t charge such a heavy toll on the rest of our lives. Addictions can ruin careers, reputations, wellbeing, financial stability, and so much more.

Of course, our addictions don’t exist in isolation, and they don’t just impact us. Friends, families and co-workers can also suffer as a result of our addictive escapes, which are notorious for destroying relationships. They can erode trust, put other’s lives and safety at risk, and force the people around us to pick up the slack for our lack of responsibility.

Typically, this problem festers until we seek treatment, kick the habit and make amends. Friends and family are often made to pull away until this seemingly pivotal process takes place. But an organization known as the Center for Motivation and Change (CMC) advocates for another way. They stress that friends and families can play an enormous role in the healing process, even if the addict they care for never seeks treatment.

The doctors and therapists behind this organization just released a new book called “Beyond Addiction, a guide for families.” It discusses strategies for recovery, and exposes that a lot of the conventional wisdom surrounding addiction recovery and treatment can often do more harm than good.

Today I’ll be talking to Dr. Ken Carpenter, PhD. Carpenter is the director of training at the CMC Foundation for Change, as well as a licensed clinical psychologist and research scientist with over 20 years of experience using evidence-based motivational and cognitive behavioral strategies.

Hello, Dr. Carpenter, thanks for talking with me today. I wonder if you can start by talking to me about CMC. What is it? And what is your mission?

Dr. Ken Carpenter: Thank you for having me, Conan. I appreciate the opportunity to talk about our work.

CMC is a multi-dimensional organization. Our mission of the not-for-profit arm is really to bring evidence-based ideas, concepts, and tools into the world so that they’re accessible to families who are looking to support their loved ones who may be struggling with substance use or other behavioral issues, I think this is something that’s been lacking over the years.

Conan Milner: The Beyond Addiction book is my first introduction to you guys. What really drew me to it was the fact that it challenged a lot of the status quo that I understood. I’m familiar with this paradigm of tough love and interventions that are aimed at getting someone into rehab. I’ve seen people orchestrate this in real life. And I’ve also watched the same kind of dynamic play out numerous times on television, and movies. I just assumed this is how it works, but the book made me realize that this very common strategy that we’re all so familiar with, is often really not that helpful.

Dr. Ken Carpenter: Yeah, it’s amazing how I think historically the idea of what helps increase motivation that’s more likely to help invite people to start the hard process of making change has gotten a foothold. It’s all from one side or one perspective, and I think its unduly weighted to pain and punishment that change happens. It says that if people don’t want it, or they’re not moving readily [toward it, then we have to take the] tough love approach to promote change.

But what [we have started to find] is that people change for numerous reasons. But it’s in the context of relationships and interpersonal interactions that we start to promote thoughts about making change. We might find that, hey, this isn’t working for me. I’m experiencing negative outcomes. But in the context of supportive relationships, it tends to promote longer term change patterns, then some more of the confrontational approach that historically have been out there.

Conan Milner: Why do you think we have embraced the confrontational approach? Why do you think we’ve held on to it for so long if the track record has not been as successful?

Dr. Ken Carpenter: I think it’s just numerous factors. They are the narratives that are out there when families are caught off guard, or they’re thrown into this situation. They’re looking for any advice and, and a compass for how they can go about doing this, and culturally, these are the narratives that have grabbed the microphone.

I’m not saying they don’t come from some experience, but it has lost its nuance. And I think it seems to offer an easy answer for families that have to draw the line. And sometimes emotionally it might feel more palatable if I am sitting in a world of frustration, upset, scariness, and anxiety. It may be emotionally appealing for me to hear that I can draw that line or act in that way. In the short run, that may make sense. But again, if we come back to it, what helps promote change in the bigger picture? It’s usually not from that perspective. It’s more from the perspective of how can I collaborate? How can I send invitations to you as a person who’s struggling in a way that can open some possibilities here?

Conan Milner: It gives you a temporary sense of empowerment, but it kind of falls apart in practice. Well, you know, I bring this up because one of the things that was impressed upon me in reading the book was that there are numerous avenues that people can choose, and it’s not a one-size-fits-all type of situation. People are better off gravitating toward the method that helps them best.

Another thing that I found interesting was that most people end up getting better and give up their addiction, and there’s no therapy at all involved. They just decide one day. I’m done with this. That was surprising to me because I was under the impression that it’s got to be this long, hard road of pushing this way to finally overcome this.

So what motivates people to change? Because if it’s not a punishment thing, and if we gravitate toward our own way of coming into ourselves? How do we find that?

Dr. Ken Carpenter: Right. There are a couple of great points you made there. One is that one-size -does-not-fit- all. That is such an important point. And there is a hopefulness in that.

I think back to that earlier question that you raised, which is when people are looking for guidance, people are going to offer advice. Often, that advice is coming from a place where we want to be helpful, but it’s delivered in a way which says, this is what you have to do. This is the way that’s going to make things different, and it’s offered as if this is the only option you have. And if that’s not fitting, there can be a feeling of despair and hopelessness because often families will not know where to go after that. We’ve tried the thing we’ve been told, and it doesn’t work, so there’s no hope here.

But the evidence says people find change in all different ways. And it’s not often through treatment. As a treatment professional, that was eye opening to me that only about two out of 10 people who are struggling with a substance use disorder or a behavioral issue are actually going to recover with the treatment professional in that period of time. It suggests that change happens often outside of clinical interventions. And it happens in the context of family relationships and interpersonal relationships. And it raises an issue you said which is, well, what motivates people to want to make a change if they’re going to find it over time? And I think that is a historical framework that has always brought together the idea that people are only going to be motivated when they’re at rock bottom.

Conan Milner: Yes. Rock bottom. You’ve got to hit rock bottom to change. I hear this over and over again.

Dr. Ken Carpenter: There are natural consequences to any of our actions. And not only can they be reinforcing, but they can have negative consequences. So that is true. But where that became problematic is the message that there is nothing you can do until that loved one hits rock bottom. So you basically have to step away, and let that process unfold. And when they get low enough, they’ll look to make change. So [people have an understanding that] if you do anything to help them you’re going to get in the way of that process. You’ll somehow be protecting them from that pain, which is ultimately the only thing they need to be motivated. So you better be careful to not do anything that’s going to stop that. And that’s where terms like codependency and enabling started to come through.

But maybe the bottom doesn’t have to be as low. Maybe family members can help raise the bottom so to speak, so they can be on the sidelines and when a person is more likely to be contemplating change. They’ll be there so that can raise the bottom a person has to hit.

But there are studies from the late 90s which show there are things you can do in terms of your own self care and your own emotional support with how you interact with your loved one in ways that can help invite people to consider change. They really focus on just working with family members, regardless if their loved one wanted help or not. And the outcomes of those studies were that when family members were learning this communication, self care, and behavioral strategies, about 70 percent of those who were receiving this kind of help from their loved ones actually picked up the phone and wound up calling for help, relative to these other kind of comparison conditions of interventions, or just straight up Al Anon. The philosophy behind that was that motivational barriers weren’t really the absence of pain, but the absence of hope.

If we can use empowering relationships as ways of bringing hopefulness to change then people who may be less likely to think about changing, or taking the risk, can start to be motivated to make change. It was a little bit of a paradigm shift on how these empowering relationships really helps promote that.

One example of that was just in the context, not only of families, but of counselors. Bill Miller had done some early studies where he was finding that not all counselors had the same outcomes. So he got really curious about it. If all these counselors know the same thing, why are some counselors helping people change and others weren’t? And that started to really shed a light on the way counselors were talking with people, the way they were engaging people, and the way they were collaborating, and it’s the essence of those things, It gave rise to things called motivational interviewing, but it also started to present a compass to family members. If you’re going to interact, let’s think about how you can do it in a way that will help empower your loved one to start to consider change, and help support that long term journey to change. So there’s been a shift away from that idea that if you experience pain, that’s the motivator, and don’t do anything to get in the way of your loved one experiencing that, to, yes, there can be pain, but you don’t have to sit on the sidelines. How can you use your relationship to empower someone to consider making change with all that they’re experiencing?

Conan Milner: Very interesting. This makes me think about when friends and families do get involved, it’s often in a very confrontational way. They want to see change in their friend or loved one. But trying to change yourself is hard enough. Trying to change someone else’s behavior is impossible.

So how do you engage friends and family into this process? One of the things I learned from the book was that friends and family can learn skills that, even if an addict doesn’t come to treatment, can still improve the overall situation. So what kind of skills can friends and families learn to help facilitate the motivation for change?

Dr. Ken Carpenter: Sometimes the way we think about these concepts is like three buckets. There are three kinds of supportive avenues. One is understanding. What are the lenses we bring to try to understand the behavior of the loved one you’re trying to help. Those set of lenses not only will paint a picture and put a framework around it, but also open up avenues to think about it.

At its core, when we think of substance use we want to know what purpose it serves. This can seem irrational from a distance. But if we step beyond the behavior, the question that comes up is: What does your love one get out of the behavior? Often for families and friends, they’re never asked to consider that. And they find it very helpful, because it actually opens up a door of conversation. I may not necessarily agree with how you’re going about that. But I can understand why it’s important that this behavior has been part of what you do. And from there, if I can start to understand that, I can understand what things may need to come into play if you’re going to step away from that behavior. And it also helps me appreciate this idea of ambivalence, or the tug of war that can be associated with giving up a behavior that causes problems in other ways. It offers short term solutions.

So we start with that understanding. And then from there we also want to encourage this idea of self awareness in helping a loved one, interacting with a loved one. This comes with a history, and this is going to bring up emotions. It’s not always going to be easy, and there’s an emotional toll on you. We talk about the kind of person you want to be ultimately as a helper. You have that choice.

So how do you want to be seen in this relationship in the process of helping? One way we think about that is just in terms of values. You don’t have to leave your values at the door to help your loved one. You have a choice in how you want to be present in this relationship. Let’s just put that in the spotlight. Because that’s kind of your true north here. How do I want to be heard from my loved ones? As a parent, a spouse, or as a good friend? If we can put that on the table, then at least that’s an anchoring point for you. And both the understanding and the kind of awareness hold the communication strategies and the behavioral strategies we talk about, which is how can we think about communication skills in a way that open up conversations that can be helpful and have a chance of being more collaborative.

For those that know motivational interviewing, they’ll see a lot of that spirit and nuts and bolts in the strategies we’re offering families. There are ways we can structure conversations that can engage your loved one in change. The tone of interactions that might be more productive in the long run.

Sometimes I think so much of the narrative is about what we have to do to make the bad behaviors go away. So, take the metaphor of being a gardener. If I was to garden and I’m overly focused on the weeds, I may start to ignore the actual flowers I still want to grow and strengthen. So if my advice is to cut off watering the whole garden to get rid of the flowers or the weeds I don’t want, what I’ll inadvertently wind up doing is failing to nourish the flowers I do want to support and strengthen. So [instead take] a more balanced gardening approach: how can I reinforce the behaviors and parts of my loved one that I want to continue to strengthen and interact with? And how can I be strategic to not inadvertently support those behaviors I don’t. So it’s, it’s a more nuanced stance,

Let’s just be thoughtful about not responding in ways that inadvertently support the behaviors you don’t want to support. So we talk about natural consequences. We talk about stepping away, healthy limit setting, and the use of positive reinforcement for promoting and strengthening the behaviors you want.

The narrative you highlighted has somehow morphed into something that, if you do anything to reinforce attempts for your loved one to change, you’re an enabler, you’re doing something wrong, and you’re violating something. And yet we know from all the studies, it’s the behavior enhancing strategies that promote long term change. And that message has gotten lost over time.

Conan Milner: Hearing about this more nuanced approach was making me think that the conventional paradigm is very black and white. And you can end up driving someone away, or just ruining a relationship even more, in the process of doing what you’re told is supposed to be the best thing.

Dr. Ken Carpenter: Oh, absolutely. And, again, I think they grow out of experience. They grow out of perspectives that offer something.

To your point, which if I wanted to set a limit and say behaviors not aligned with my values, this is how I’m going to respond to it. But, like you said, it’s become very black and white, and dogmatic. And I think often it has put families in positions where they’re asked to choose between doing what’s going to be the helpful thing, versus doing what they feel is more consistent with their values. And that particular bind has been particularly hurtful, where a family member may feel like I either have to turn my back, because that’s what’s going to be helpful here, or I’m going to do something that’s going to make it worse. So I have to go against the way I want to be there for my loved one. But the evidence, you know, doesn’t support it.

You just highlighted what it winds up doing: it pushes people in the very opposite direction then what we’re hoping to do. We want to help and be there to help people think about making changes and moving in the direction of health and more valued living. But the confrontational black and white picture often has people defending the very behavior. They may actually, in the quiet space, have their own thoughts, and be struggling with knowing it’s not always working. So it can sometimes not be the most helpful blueprint that families get.

Conan Milner: One of the strategies you pointed out several minutes ago that really piqued my interest was in trying to find out what is the motivation behind why someone engages in an addiction. That was eye opening to me, because I think we just demonize it immediately. We don’t consider the deeper aspects of identifying what is motivating this behavior. This seems like a core understanding to solving whatever problem you have in front of you.

Dr. Ken Carpenter: Yeah, I wonder about that, too. When I think historically, what is it about the narrative that has made that particular question or that particular discussion often feel taboo? And it is fascinating. You know, even with all we hear, all the neurobiological, neurochemistry arguments, and dopamine, and we can think about that part of the medical and research world, in a lot of ways it’s trying to get at a similar question, which is: what makes this reinforcing? What makes substance use reinforcing? And to get the perspective of the person who’s actually engaged in it can be useful.

In some of our work we’ve done with families and communities, we’ve had people come back after the first day and say, “You know, we had a moment with my loved one. And I asked them a question I’ve always thought I was afraid to ask, which is: I’m just really curious. What do you get out of it?” And it’s opened up conversations that people come back crying that they’ve gotten an understanding from their loved one. “They appreciated the question. It’s just open up a different dynamic to the interactions that wasn’t there before.” And it can feel taboo, it’s like, “Well, if I asked my loved one that question, am I saying I’m condoning it? Or I’m agreeing with it? Or am I giving them permission? And you know, we want to say no, but we’re just trying to understand the behavior. Why? What is it about it that had you so invested in this that can at least you helped me understand it?” And that can just change things in a way that can open up doors down the line for a more collaborative approach to talking about this process of change.

Yeah, even in my life. I put on my clinical hat in the days where I would ask people that question. And at first, they’re suspicious of me, because that’s not what they’re used to talking about. They have answers to why it’s not working. People have that kind of rehearsed, this is why I shouldn’t be doing it. But that other question, which is: what do you get out of it? It can be it can be a game changer, sometimes in terms of the tone of conversations,

Conan Milner: No doubt. It sounds like the ultimate icebreaker. So that leads me to wonder, What does recovery mean? Because I think oftentimes people define it as abstinence, right? If you drop whatever your habit is, then you’re cured. But it makes me think that there is another goal that we should be aiming for.

Dr. Ken Carpenter: Yeah. I think there’s been right now and historically, such a push to define change and recovery differently. Not as the absence of something, but more about the presence of other things. And, I think at its core, one thing, and maybe this comes with some of the bias we have about change in so many areas of life, when we think about we have something that’s not healthy, something that’s, that’s not working, we can get to this model of changes by subtraction. Let me get rid of that thing. Let me get rid of that infection, or that bad tooth, or get rid of this medical condition.

But there’s a power in that which we change by bringing new things in, and learning new things on top of what we have already brought into our learning history. So it’s not like we can go in and somehow take pages of our learning history out. We’re changing by writing new pages on top of the pages that are there that can help family members shift their expectation, which is why does my loved one make changes, and then sometimes old behaviors come back? Well, that’s because all behaviors, they always have a say. They don’t disappear. It’s the strengthening of the new behaviors on top of the old behaviors that really helps foster that process of change and recovery.

In that sense, a lot of it, like you’re saying, is more than just the absence of substance use, or the disappearance or reduction of behavior, it’s more about, what are we bringing into our lives, sometimes you’ll hear about it in terms of recovery capital, that’s been the term that’s been used often when we think about recovery, what recovery capital of people bringing in terms of the values in their life, the behaviors that connect them to what they value, the quality of their relationships that they’re bringing into life, a sense of community, a sense of purpose, being able to connect with other aspects of their life that are just as important or more important in terms of the type of person they want to be.

So recovery is this multi dimensional perspective of bringing into one’s life meaningful connection, meaningful activities, meaningful behaviors. And I think when we think about it, in those terms, recovery becomes a much deeper construct for change than what’s typically been defined as just the reduction of behavior in a narrow sense. Because even if we reduce a behavior, if that’s all we have to show at the end of all that effort to change, I don’t know if that’s got the same level of depth and meaning, then this other way of looking at it, to what what enrichment is being brought in, which even speaks to the family and friends. Because at its core, we’re talking about connection and meaningful relationships. And that is part of recovery capital. In the process of change.

Conan Milner: It makes me think that this gives people something to gravitate towards: a greater field of awareness and choice. Whereas the previous world that they understood, was much smaller. And that’s what led them to the addiction in the first place. They’re able to visualize a greater world where there  are more choices, and there are other options, and that they don’t have to be stuck in this one way.

Dr. Ken Carpenter: Yeah, I love the way you said narrowness versus more breadth and wholeness. And I equate that with how people want to be seen. And the power that comes with being seen in a bigger way as more of a complete person.

So much, I think, of some of the narrative out there narrows the person down to just that one behavior. And if that’s all that is seen, there’s not much empowerment or hope there, because so much of what’s necessary for change to happen requires the complete person to be present and to be seen and to be built around to bring in that bigger meaning. So I think you’re right: the narrowness of language can undermine in a lot of ways that hopefulness and vision of what change can look like. It requires the whole person to be seen.

Conan Milner: In my introduction, I mentioned how addictions in general to me seem to be getting worse. Do you think this is true?

Dr. Ken Carpenter: Well, I agree with you. At the beginning you were citing the statistics and on a certain level the rates more recently have been going up. The rates of substance use disorders in certain domains have gone up. So I think there is a point that it is increasing, but I think it’s multifaceted. I can’t speak to one domain, but perhaps a constellation of societal factors: availability and accessibility factors. I think it’s all of these dimensions.

But there’s still a narrative where those behaviors make sense. So I think people experienced that the sense of connectedness in our society has gone down, which has made room for substance use to become more useful to people. And things that used to be protective against substance use, some of those safeguards in social communities have also been undermined, which has just created more space, I think, for substance use to get traction.

Conan Milner: Yes, a multifactorial reason. But one of the things you mentioned when we were talking about motivation was this idea of hope. I think that a lot of people are in a hopeless situation. They don’t see things getting better. They don’t see hope. coming into play. It was making me think that hope is an essential ingredient.

Dr. Ken Carpenter: Right. And perhaps it’s not the big megaphone hope. And that’s because there are other narratives that still command for various reasons, a bigger audience on the pockets of hope.

I think in the recovery community this is something we’re trying to help promote. The stigma shuts people down, shuts families down, shuts individuals down. So there’s less likely to be a message of hope, when any attempt to try to get guidance, or support is met. Still, with stigma, blaming, judgment, most often families and individuals just go underground. So there’s a sense of isolation and aloneness,

Hope radiates from the recovery stories that exist. Coming into contact with families that have been there and have stories of change, and empowered relationships. Stories of a family being able to stay connected even in these dark times of struggling. That’s where this recovery movement is picking up momentum. It’s the voice that needs to get out there more. And it’s a slow process. It’s really at the grassroots and is building, but it is slow. And, again, I think it’s the minority of families and loved ones that run into it, or it takes years before they actually find those pockets of hope that are out there.

Conan Milner: But it sounds like we all benefit from hearing these success stories.

Dr. Ken Carpenter: Oh, absolutely. Yes. When you see the real lives, the real stories… it’s hard to describe the impact when it’s the lived experience from families able to articulate the hope. It’s empowering regardless of your journey,

I think as a human being, knowing that the human condition in and of itself presents so many challenges. It’s not the narrative of perfection that is the most powerful. It’s the narrative of struggle and the narrative of being able to journey that human condition, and knowing you’re doing that not alone, but with other humans. And it does benefit all of us, because I think at its core, we all know what the challenges of being a human entail.

Conan Milner: For sure. We can all relate on that level. Well, what ultimately appealed to me in the Beyond Addiction book, was this approach of positive reinforcement and kindness. Because even if addiction isn’t a struggle we’re dealing with, we could all use these lessons for communicating better.

There’s a statement repeated several times in the book that says, what looks like an unwillingness to change is often just a defensive reaction. I think this applies to all kinds of interpersonal interactions and disagreements.  We could all probably get a lot further in our conversations with this mindset, rather than thinking how you have to compel someone to change.

Dr. Ken Carpenter: Yeah, I think there’s so many signals that show up in the context of discussions and interactions and sometimes we can see that defensiveness as being something about that other person’s level of motivation. I think that really motivational interviewing helped put that on the map. If we just assume that as human beings, we can be ambivalent about change.

We can have two sides or two voices around that. What happens, I think, is sometimes our narrative is you’re either motivated or you’re not. And if I don’t hear motivation from you, then I’m going to push harder, because that’s what I know to try to make you motivated.

The dilemma we get in there, I think, is that if I look at motivation not residing in you or residing in me but is really just a matter of our interaction. I can’t control your motivation. But what I have influence on how I’m interacting with you. So if I’m seeing signals that right now you’re giving me a red light, and I’m hearing a voice of “I’m not changing,” then at least it gives me a signal that I can try to shift gears or adjust how we’re having this conversation, so I don’t inadvertently keep pushing and have you dig your heels in deeper and deeper.

I have options. I can step back. I can ask what you mean by that. I can inquire or just reflect back to you what I’m hearing. “It sounds like this is really important. You don’t want to change. That’s what I’m hearing from you. Am I correct? Help explain more.” I have some flexibility to be able to maneuver differently that’s not going to back you into a corner while bringing this conversation into a kind of conflict. And as we practice we can get better just seeing those signals in the moment that give us a little bit of flexibility as a helper to maneuver a little differently.

Conan Milner: Perhaps we can end by talking about a hypothetical someone who has a friend or a loved one who’s struggling with addiction. This person doesn’t seem to have the motivation to change. Where can they start?

Dr. Ken Carpenter: All situations are different. There’s history there, and there can be numerous places to start.

If there are moments where conversations can happen, and they’re not about “I need you to change,” but where you’re in a situation where we have a conversation, one point of entry could be just that discussion of “Help me understand. What’s it like in your skin? What are you getting out of this? I’m not coming with an agenda here to demand anything, but I just want to better understand.”

Perhaps these conversations haven’t gone great in the past. I’m coming at it just trying to understand for families that maybe that communication isn’t there yet. There could be just thoughts about what possibly my loved one could be getting from this.

There’s also the idea of self awareness and self care. Sometimes people don’t feel that helps you at all. But consider how it’s affecting you as a helper. What’s the emotional toll it’s taking? What support do you have in these moments where there might not be communication going on? If we talk about the ideas of coming back to your values, giving you permission for how you want to be seen by your loved one, how you want to be present during this part of the journey, and show some self compassion? If your internal chatter is one of critiquing you, or judging you harshly about that, that’s a practice and a skill you can start with. It’s not always easy, but it is helping because it’s creating a context where you may be able to approach the situation differently if you’re able to care for yourself in those ways.

Another port of entry could be just thinking about communication strategies, and behavioral strategies. What can I change? How have these conversations gone? Are there things I can learn to maybe use in the next conversation I have with my loved one? Or how can I reinforce the things that they’re doing that I do notice that are going well, even though the substance use is continuing? Can I notice other aspects of what they’re doing?

Another port of entry is acknowledging those aspects of the person which may make some space for them to consider some of the things that aren’t going well. The message here is that there are numerous ways to enter. Understanding common self care or communication, that doesn’t back you as a helper into a corner, and that there are options there to think about your situation moving forward.

Conan Milner: Excellent. Well, thanks so much, Ken, for sharing your ideas and expertise with us on this very complex subject. Whenever I talk to someone who is faced with a situation where a friend or a loved one has an addiction, it appears from the outside to feel like a very powerless situation where you want someone to change, but they won’t and so you feel as if you’re left with no other options. But you’ve made me realize that there are so many options to consider, and that this is a much wider avenue [to facilitating change] than we’ve been led to believe.

Dr. Ken Carpenter: Yeah, Conan, thank you for highlighting that. So much of the narrative can be one of hopelessness. And that comes along with the isolation and stigma. I think that the hopeful message here is that recovery is found and families do find it. They find a way that they can bring their values and be allowed to be present the way they want to be. And there’s support for that. And there are evidence based ways that can be done,and you can tailor this to the way you want to be and there is support for that. So that message of hope is what we’d like to deliver, and that one size doesn’t fit all. There’s hope in that there are numerous ways to be helpful in these kinds of circumstances.