The Finding My Psych Podcast - Sober Vegan Living

The Finding My Psych Podcast - Sober Vegan Living


Addiction & Precontemplation - Screening and Basic Approaches To Care

December 04, 2021

Denial just might have an organic origin.”


Knowing how to best support someone in precontemplation
Addiction and Precontemplation

You will remember the insightful conversation I had with Tamara Randall on her experience as an alcoholic who changed her life by choosing abstinence over a decade ago. This radical and decisive commitment is a reminder that decisive moments have the power to shift the trajectory of our life towards sustainable physical and emotional wellbeing.


However, not everyone is able to take, or even see, the first step that needs to be taken, even when change is required to save their life. It is difficult to know what to do when someone is stuck in precontemplation. While we often blame the individual using substances for their persistent denial of the impact their use has on their life, we also find ourselves trapped in their apparent lack of commitment to change.


In today’s episode I argue that there may be an organic reason for such persistence. I also review the physiological, psychological and social reason people continue to use substances despite the consequences. Finally, we round off the subject with a brief conversation on assessment, treatment options for care, and caregiver burnout.


Episode Outline

Welcome to Episode 60: Addiction and Precontemplation


  1. What We Do:
    • Behavioural Medicine and Health Psychology
    • Providing easily accessible content designed to help you design your own transformative experience.

  2. Today:
    • Revisiting addiction, with a focus on screening and approach with those stuck in precontemplation

  3. Services Review:
    • Finding My Psych offers both core and enhanced services focused on promoting physical, emotional, and spiritual wellness.
      • (Core) Foundations: Wellness Planning Workshop
      • (Core) Walking For Vitality: Powering Up
      • (Core) Running For Fitness: 5k Build-Up
      • (Enhanced) Alcohol Free Check-in


Pre-Contemplation and Stuck


  1. Defining the Pre-Contemplative Individual:
    • Expression of readiness.
    • Often mistaken as someone in, “Denial”
      • “Denial” is a conscious choice – It might be a matter or insight and/or organic changes in the brain that drives an inability to see consequences.
      • “Denial” insinuates stubbornness or a lack of commitment.


  2. Reasons People Do Not Change:

  3. Assessment:
    • Purpose – Concrete data to show the individual (building a case).
      • Physiological Measures (AST and ALT)
      • Psychological Measures/Checklists (DSM)
      • Screening Tools
        • CAGE Questions:
          • Have you ever felt you should cut down on your drinking?
          • Have people annoyed you by criticizing your drinking?
          • Have you ever felt bad or guilty about your drinking?
          • Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover (eye-opener)?




  4. Treatment Options
    • Abstinence vs Controlled Use
    • Concurrent Disorder Counselling
    • Harm Reduction

Support


  1. Supporting your pre-contemplative family member.
    • Balanced engagement and setting boundaries.

  2. Supporting yourself.
    • Caregiver burnout is real and critical to manage.


Full Episode Transcript (Edited)

0:10  


Hello, and welcome to the Finding My Psych podcast. This is your host, Jerod Killick. Thank you so much for joining us today. 


If this is the first time that you are checking out our show, we are all things Health Psychology and Behavioural Medicine. We provide you tools that you could use to navigate your own transformation journey, the radical change that you’re looking to make in your life from the field of Health Psychology, and specifically, the tools embedded within the field of Behavioural Medicine. And so we just try to make those tools salient to the general population, because we don’t believe that you need to go spend $180 an hour to see a therapist to get the things that we provide. 


So with that said, today, I’m going to do two things. In today’s episode, I want to spend a little bit of time very briefly talking about a new service that we are offering. And then the second thing I want to do today is address addiction. We’ve done a couple episodes on addiction where I have told you a little bit about my own family, in particular where addiction tends to lie. 


And so I think I want to just spend a little bit of time talking about how to support and love and manage the precontemplative people that are in your life. You may be in a relationship or it may be a parent or a brother or a sister. And I think the actual thing I’m trying to drill down and address today is to provide some understanding and conceptualization. How do you support that individual? And you also concurrently? How do you support yourself? 


So addiction is is rampant and it’s challenging – It’s so difficult. It’s this layer of patina on everything that we see around us, especially since COVID. You know, that we’re going on our second year now. That is shocking to think about.  I think we all somehow knew we were still going to be in this two years later. It’s evolved, it’s changed, we’ve evolved, we’ve changed. 


But we’ve also found ways of coping that are problematic, and one of them is substance use. In particular, what I’m really thinking about today is alcohol use. It’s the most challenging, the most evil for so many reasons. And so today, I just want to spend a little bit of time talking about the precontemplative individual in your life. I’ll explain what that means. 


But before I get there, let’s just talk about our services. And so every episode, I try to say something about the services that we offer. And we do offer two buckets of services. One is what I call our core services. The core services are our three cohort groups that we will run from here to eternity. It’s the curriculum that we’ve built. And we will continue to offer these services because they’re very popular. And we just love doing them. So these are cohort programs. There’s three of them. One is called foundations or a wellness planning workshop where we drill down into the changes model. We review the biopsychosocial and spiritual model for how we conceptualize the challenges that we have, and how to change, be more happy, and promote a fulfilling life. The other two are more focused on fitness because I do think fitness, physical well being, is core.


4:50  


Yeah, its kind of a core focus point. For us that happens to be the pathway to many positive things in our life. If we are physically healthy, and I don’t mean skinny, that’s not the point here, if we have a really well adjusted cardiovascular system where we know that we can get up and go for that long walk if we wanted to, we can.  It has an impact on our brain and our mood and our sense of well being – It is pretty profound. And so the two services there that we offer that are fitness focused, the first is called Walking For Vitality. And the other one is Running For Fitness, our 5k build up from not running at all. 


We have this other bucket of services that I call enhanced services. You could think of them as augmenting these are non cohort services. And so a cohort really just means you know that you would join a group of 10 people and for four weeks, you will meet with those 10 people in a Zoom meeting with me and we go through stuff.


6:01  


The enhanced services are all drop in style services. So kind of a weekly hour on a particular topic that we will run for many weeks to come. You can sign up for the week that fits for you, or you can come in every week. Whatever works for you. Great, we want to have you there! And so the one that we’re starting right now is called our Alcohol Free Check-In. 


At Finding My Psych we do not promote abstinence. I think abstinence is a great choice if that’s what you want. What we really promote is the big step before – That is you recognizing the impact that alcohol has on your life and you’re wanting to reduce your alcohol use, you’re wanting to get it under control. 


If you’re feeling like it’s out of control, you don’t want it to have such an important role in your life, it shouldn’t be one of those things that is always around and always the social lubricant to make you happy and comfortable in social settings. So we have one called the Alcohol Free Check-In and that will be starting next week, December 11. And we will run it every Saturday. I think I’ve booked up through April, the end of April. Maybe the first of April, I don’t know.   Go and have a look! 


But on the website, you’ll see a bookings button at the very top of the website at https://findingmypsych.com.  And you will see multiple dates that you can drop-in sign.  Sign-up for as many that you want to. I will drop you an email and give you a quick introduction and connect with you well ahead of time. All of these services are run over zoom and the cap for each Saturday from is 20 people.  Anything more than that is pretty challenging to moderate if everyone’s going to be participating in what we do there. For the core services that are cohort driven, it’s much smaller.  We bring that down to only 10 per cohort that move along over the course of weeks together.  It’s a closed, X number of weeks for each program. In other words, new people can’t drop in with our enhanced services.


So we know we don’t know week-to-week who’s going to be there. And so that’s kind of what makes it exciting. The check in is really not curriculum driven. We don’t have any major content that we’re going to talk about, it’s really just, “Hey, tell us why you’re wanting to reduce your drinking. How is that journey going? What supports do you need, you know, that we can all kind of think about and be creative together to help you along?” 


All of our services and enhancements, just so that you know, do assume that you are working with a medical and or mental health professional. It is a prerequisite to be a part of any of our online groups. They are all free at this point. I hope it remains that way. But as you can imagine, all of this stuff does come at costs. Having zoom that can run more than 40 minutes and have multiple people in it costs so much per month, and our booking service costs so much per month. We’re managing that very well right now. 


And if in the future, this tends to build bigger, we might start charging a small fee just to cover some of the costs, but it is not profit driven. You will notice at least at this point, we do not run ads on our page. We do not accept sponsorships. This is really our heartfelt project to all of you. 


Alright, let’s dive into our content here. As always, there are show notes. And so if you go to the website, this is Episode 60, at findingmypsych.com.  In FMP Episode 60, you will see show notes in there. If I have time, I will transcribe the episode for you. Again, time providing because that takes quite a bit.


10:45  


You know, I’m a former academician, now healthcare administrator. But yeah, I like keeping the bar pretty high in terms of the content. So it is always good to be able to read along. And then if you have questions about our content, just drop us an email (podcast@findingmypsych.com or support@findingmypsych.com. 


So today, we’re going to be talking about the precontemplative individual and how we support them, how we support ourselves. What I thought I would do is give a fairly broad overview of how we define the precontemplative individual. What exactly does that even mean? And I want to talk about the best part of all of this, the second section, which will be reasons that people don’t change – You want that individual in your life to change so desperately, but they don’t. It’s important, I think, to remember the things we’ll talk about in this section, to help conceptualize what is it about that individual that makes them seem so stuck or stubborn and unable to make the change. In the third section, I want to talk a little bit about assessment and how we actually assess an individual from a clinical perspective. 


I also want to share some stories that I have seen with patients over the years or clients over the years, where there just seems to be a very big mismatch between the data you show them and the future steps that they take to make a change. In other words, the data doesn’t seem to help, interestingly enough.  And then I want to talk very briefly about treatment options. We’ve talked about treatment before, but I just want to brush over it really quickly so you have an overview about what treatment can actually look like. I do think that’s important, because we tend to think people, the media tends to promote, that people with substance use challenges should go to treatment, go to a residential treatment program, be there for three months, and somehow they’re gonna come out and be all better.  Actually, I don’t think that that’s the best first approach.  It’s is the best last approach. So we’ll talk about all of that.  And then just the last thing I’ll talk about is how you support yourself. 


Alright, guys, so let’s just dive into what it means to be precontemplative. So the expression precontemplative, comes from the field of Motivational Interviewing. And Motivational Interviewing is a really excellent.  It provides a real excellent core understanding with key language in how we approach addiction. 


Historically, it is the medical model that we emphasize the most.  Let me just be very clear, it is the medical model because we treat addiction as if there’s some kind of organic part of the brain that causes the addiction itself (ethology), like genetics, but also tied to that is the addictions model. And the addictions model, this would be AA and NA, it tried to align itself with the medical model.  The Big Blue Book has core language around the, “Disease Concept”.


So, precontemplative, or excuse me, Motivational Interviewing in itself, though, is not the antithesis, necessarily, of that historical thinking. Our understanding has really evolved. This came out in the 90s I believe – It was first drafted out in the late 80s. And I remember in grad school in the early 90s, for myself stumbling onto Motivational Interviewing, it was the most exciting time because all I ever heard about was AA and NA.


Motivational Interviewing was more about an understanding of how we categorize individuals in terms of where they’re at in their readiness for change. That is key language, “Readiness.” So someone could be precontemplative, which you could easily say, they’re not ready for change at all. 


The next stage is contemplative. And there’s other stages that go after that. But these are the two first ones.  In the precontemplative stage, they are definitely not ready for change. They won’t even hear the information most the time, or they walk away from it.  They may literally tell you, “I’m not ready.” Contemplative means they’re willing to sit down with you, and have that conversation. 


And so today, we’re really focusing on the precontemplative because this is where many people stay stuck for many, many years. You’ll hear in addiction circles, that people have to hit their bottom before they get better – They have to hit rock bottom. And the challenge for me with that idea is that people will stay precontemplative until they hit rock bottom. And I don’t agree with that. I think the problem with that is, depending on the addiction, in particular, opiates, rock bottom typically means dead.


Alcohol is the most insidious lifelong challenge and is under reported big time. And so how we typically stumble upon it with individuals is they’re not necessarily coming to us as healthcare providers. But what they’re doing is they’re ending up in an emergency department with acute pancreatitis, or they’ve fallen and they’ve broken a hip, or have abrasions, or whatever, but they’re really really sick.  And that’s all secondary to alcohol use. 


With alcohol sometimes it seems like a lack of awareness – In addiction circles, it is often identified as denial. It’s pretty fascinating. And so I’m going to talk a little bit about that. Let’s just dive into this concept of denial and why I find it challenging. 


If you listen to last week’s podcast episode I talked about Freud and psychodynamics. But one of the words that I used in psychodynamics, was denial. And you’ll remember that denial is a conscious choice. And this is key. 


So you will hear in addiction circles, people will say, you know, they’re in denial about the impact of their alcohol use, again, that it’s a conscious choice. It insinuates that someone is, you know, stubborn, that they don’t know the impact of their use, and they don’t care. It also insinuates a lack of commitment to wellness and getting better. 


So I think where this is just really fascinating is in working with people that end up in care, what I start to notice is there seems to be something more going on there. That I wonder even though I haven’t seen the evidence yet, I wonder that something has happened in terms of executive functioning from alcohol, long term kind of baseline use of alcohol equals to some kind of executive functioning damage, which would be frontal lobe damage. I wonder that, and because I think if we use denial in its traditional form in circles, what we’re really saying is that person has no desire to change. 


Using that we’re really saying that that person doesn’t care about the impact on themselves and the impact on others, and that they’re making a conscious choice. What I’m starting to conceptualize and realize, you know, as the years go on for myself, in working with patients with alcohol use disorder, or seeing them in our system, it’s just not that simple. There seems to be something organic happening. 


I was going to share this a little bit later in the episode, but I’m going to just share it now. Because I think it makes the point. Many, many, many years ago, there was an individual that use to come into a clinic that I work in, and the individual had alcohol use disorder.  He was drinking lots, which means he’s drinking daily, not necessarily to the point of blackout. And I think that’s an important point to make. But what he was doing was drinking, you know, 12 to 14 drinks a day. That could be beers, it could be liquor, but that’s pretty much what he was doing. So I was working with him concurrently with a physician. I was working with him in terms of control drinking. The physician was working with him on the impacts of his drinking and other substances that he was using. 


This individual, it was very, very fascinating, because the physician that I worked with, would print out this individual’s labs.  We would show him is ALT and AST enzyme levels, two liver enzymes that are indicative of someone who is using a high amount short term and also a baseline amount over the long term, and therefore causing liver damage. And so the beauty of the liver, if you start treating it well, not drinking, it does repair itself. But there is certainly clear liver biomarkers that show the extent of use – His were 100 times over what they should be. 


And so, we thought we would just show that to him. We showed him the normal range, what it would look like with someone who’s not drinking so heavily. And then we showed him that his were extraordinary, extraordinarily high. And I remember sitting down with him having the conversation with the physician, and then later, it wasn’t that he was confused. It was just like he was staring at nothing on the page. It was almost like the numbers, even though they were so clear, didn’t mean anything. It didn’t have an impact on him. And he certainly wasn’t dyslexic to my knowledge. The numbers were simply there to contrast what was normal to where he sat. 


And in bringing up to him a couple weeks later, it just seemed to be like this cognitive miss. And it really put me in this place of thinking, you know, I’m starting to think that there’s something organic that drives denial. He you could not deny the numbers that were in front of him. He just stayed away from talking about it. He stayed away from acknowledging that he noticed it was an issue, that the numbers were so different. That’s very, very interesting. The most kind person you’ve ever met, nothing about him presented as angry or stubborn or unwilling. So I’m just making this point that the precontemplative person, it is about readiness. And the people that we tend to see that are the most ill are those that are in the precontemplative stage. 


There are many reasons I think that people are in that. It could be someone that’s completely stubborn and just doesn’t give a fuck, but I just don’t like to err on thinking that way. I think there’s something organic that’s going on here. 


So what are the reasons, then moving on to the second point, that people do not change? And so,I’m going to do three categories – These are very broad strokes, I do think this is where, if I could give you an assignment after this, this is where you should be spending your time. But there are definitely reasons people don’t change. I think that there are psychological reasons, certainly, there are physiological reasons. And then there are social reasons. 


The physiological reasons that people don’t change is just this is just simply that the impact of using hasn’t gotten to them to such a degree physically, that they that they want to make the change. And so I think that one’s very, very straightforward. 


With the physiological addiction itself, the person is certainly probably keeping the hardcore physiological symptoms at bay by continuing to use and they just don’t know a pathway forward out of that. Because if they stopped drinking, for instance, blood pressure can go up, and all kinds of things like that. And so, there certainly are physiological reasons that people choose not to make a move and not to make a change. 


The second one, though, is a psychological reasons and psychological reasons, we have to start from the beginning in that, for many folks, the ethology, or the thing that lead to problematic drinking, is a underlying anxiety and depression and/or depression that the individual is living with. 


And so, alcohol does a really good job. It’s amazing. And it’s got a very quick half life. It reduces anxiety and gives you a bit of an elevated mood when you’re using it. Some of that’s adrenaline and very complex, hormonally. No doubt. 


There are psychological reasons because it works. Alcohol works to make you feel better. Just like people that are addicted to benzodiazepines, it works. It ameliorates their anxiety elevates their mood while they’re taking it. And so the psychological reasons are so clear. And to deny that alcohol is effective, is ridiculous. 


The problem with alcohol is that it comes with horrible side effects. And such as assaulting your pancreas, and depending on the chronicity of use, cause brain damage, a  disorder called Korsakoff’s, which is a form of cognitive disorder resulting in a type of dementia. And so yeah, taking that tool, that coping tool away from somebody, maladaptive or not, is actually potentially harmful, because you haven’t replaced it with anything else that’s effective. 


So there are clear psychological reasons people don’t want to change and the other one, I’m going to say, the social reason, is the has the most impact.  It’s not as simple as saying that individual has a broad social circle supporting their addiction.  To me, it’s a little bit deeper than that. To me, it is that the individual cannot imagine what their life would be like without it, not just because the social pieces and the confidence that it gives them, but also how it makes them feel better.  It’s their go-to.  It’s their friend. And it’s hard to imagine when you’re deep and thicken to that, not having that and then what your life can actually look like – People will also have much higher expectations on you than they do when you’re embedded in use. It’s those expectations around you like performing well at work or in your marriage or whatever else. 


So okay, I honestly for me today, this is the best part of the conversation – These are the reasons that people don’t change. There are physiological reasons, psychological reasons, and there are definitely core social reason. You just don’t know what your life would be like without it and it’s a lot easier to avoid the unknown, I think. 


All right, moving along here, guys…Assessment, I’m just gonna rip through this assessment section.  Assessment serves the purpose of providing concrete data to show the individual and to build a case around their addiction. So I’m going show you all sides of the coin here. 


We talked about precontemplation and what that actually looks like.  It’s someone who just doesn’t want to make a move. But one of the ways that you try to help that individual is you start to provide them information on addiction, to try to find some kind of hook. And, you know, one of the other ways, of course you do is support them where they’re at, and you approach them without judgment. But you can also at the same time throw in little bits of information to about the impacts of their addiction, for instance, to see how they respond.


The other part of this coin, is that, I think that for some people, at least, they just don’t even have the ability to see what you show them. So just keep that in mind. But that shouldn’t guide you. I think that you really should approach it from an assessment perspective, to be able to provide some concrete data to the individual, not putting it in their face, but certainly to able to build a case. 


If the person is teetering towards contemplation, this part is much, much easier. So anything we can do to find little hooks, with individuals, that might start to get them thinking, as you align with them as you support them in a very supportive, non judgmental fashion.  I think this is the way to go. So there are physiological measures.  I just told you in the previous example was ALT measures. There are certainly a psychological measures. And think of this as checklists. The Diagnostic and Statistical Manual of Mental Disorders, has a very clear checklist assessment on what is alcohol use disorder and what it actually means.  Does it impact your work? Does it impact your marriage? Those checklists are extremely helpful. And then, just to try to define for the individuals addiction, there are screening tools that can be helpful as well. 


I like the CAGE questionnaire.  I’ll again provide links to all of this for you. But CAGE is very commonly used.  There are four basic questions to ask the individual to get the individual engaged in conversation and thinking about readiness.  The first question is, “Have you ever felt you should cut down on your drinking?” The second question is, “Have people annoyed you by criticizing your drinking?” That’s a good question. “Have you felt bad or guilty about your drinking?” And then the last one is, “Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover? An eye opener or hair of the dog?”  


33:32


No doubt. That’s an interesting one. Because I know when I was younger, I definitely hit it pretty hard. And that was the one thing I never did. I saw others around me doing it on occasion, having that drink in the morning to help get rid of their hangover. It was the one thing I never did. Because to me, that really did mean alcoholism in my mind. For someone who uses regularly, yeah, I would say if you’re doing the your drink in the morning to get rid of your hangover regularly, then yeah, that’s an issue. So anyway, that’s the CAGE assessment.  The CAGE is a really great assessment. Again, there’s going to be a link on the website in the show notes for you to go dive deeper into that. 


The fourth thing I want to just cover really quickly is treatment options. And so, in terms of thinking about treatment, these are conceptualizations for how to approach care. And so the first one just to think about is abstinence versus controlled use. I’m a big believer in controlled use. I think abstinence is for a population of people, I have definitely worked with that population where they literally just can never have a drink.  There’s no such thing as controlled use in their world, that one sip equals a litre of vodka in the end within the day. And so I would say you just can’t go down that controlled use path. In other words, controlled use is not something to defend, you shouldn’t approach controlled use from the perspective that everybody should be able to have a drink once in a while. Control use is really about how much you drink in a period of time.


And so, again, control, drinking is just mapping where people are at and then slowly chipping away at the numbers and bringing them down over the course of a few weeks. Both control drinking and abstinence, if you’re new at it, do require you to work with a physician to make sure you’re okay. Alcohol withdrawal is something you can die from. And so depending on again, how chronic your use is, you are making a decision early on about absence or controlled use. And there you go. 


The other thing that we really promote here in terms of treatment, after you’ve made a decision like that, is to engage in concurrent disorders counselling. Concurrent disorder just means that you are seeing someone for both mental health challenges, and for substance use.  There are experts in the field of counselling that know both. 


So remember how earlier I talked about what the psychological reasons that people don’t change or end up misusing alcohol was anxiety and depression? Being able to work with someone that understands mental health and also addiction, who is a trained professional, is critical.


Try to find someone who does this work.  In the States, I think you call it dual diagnosis counselling. But we call up here in Canada, concurrent disorders counselling, because we’re weird.  I would say just the other thing to remember, that whether your absence focused or controlled use, during your course of counselling, work with your physician, etc. 


38:06


The real thing we’re trying to accomplish here is harm reduction. The harms of alcohol are profound. Harm reduction is not a treatment approach. It is a way of thinking about the impacts of addiction. And so people that for instance, are living in abstinence, still have a lot of harm reduction to do in their life of where alcohol impacted their relationships, impacted their work, impacted their health. Harm reduction is more of a public health perspective, reducing the harms of doing an activity. Just because you are absent doesn’t mean all the harms are suddenly gone. We tend to think of harms as only disease prevention.  In actuality, there’s a lot of social harm reduction that needs to happen, relationship harm reduction, etc. 


Okay, last little section here, guys.  I just want to spend a moment or two talking about how you can engage in support for yourself, and then how you can support the precontemplative family member in your life based on the information I just gave you. And I would say, this is just really, really difficult. It is the crux of what we’re talking about today. But in terms of supporting the precontemplative person in your life, find a way to engage with them in the most balanced way possible while having boundaries. 


What I mean by balanced engagement is, you know, if you nag on the person constantly to not drink alcohol, there’s going to be trouble. You won’t convince someone to reduce their alcohol by just screaming the same message over and over again, and pointing out their faults. Balanced engagement means that you do mention it on occasion. But it’s extremely strategic and targeted, if you can do that. I find personally myself that’s also difficult. So I’m not talking about my skill level at this. If you’re in a relationship with somebody, or it’s a parent or brother, sister, aunt, uncle, that you engage with regularly, it’s balanced engagement around the topic.  You don’t want to enable use by sitting around and drinking with that person heavily. But, you also don’t want to be the person that sits around constantly yelling at them. You want to set boundaries and you at some point in your journey, depending on what relationship we’re talking about here, if this is a marital relationship, you yourself need to decide when enough is enough.  You need to be able to communicate where that line is with the person you love. And you need to be willing to follow through on that boundary. 


Thus, it is good probably to ask yourself at what point would the marriage not be viable anymore? That’s it’s really good to know that. I think, depending on the use, living with someone that uses heavily and watching them kill themselves and watching it destroy your marriage and everything else, you don’t need to stay there. I know that’s really hardcore for me to say, but you don’t need to stay there. You staying in that marriage needs to be a want. The The question then is, “Where’s the line when you wouldn’t be able to do it anymore?” Is it that the person lost their job, that you now have to have two jobs to support them while they’re spending every penny they have on alcohol and your money? Where’s the line, when you say enough is enough? It is important to know that is, and it’s important to communicate that really, really clearly.


This also leads me to the second part, which is how do you support yourself?  This is if you’re in a parent or partner relationship where the other person is using substances. There is such thing as caregiver burnout – It is real, and it is critical that you manage it.


42:58  


So you see caregiver burnout when an adult child cares for their Alzheimer’s parent, right? That is caregiver burnout.  It also applies to providing emotional and physical care to someone who has an ongoing addiction that is destroying them. How do you get enough support for yourself?  There it is, right? How do you get enough support for yourself to where you’re able to provide support to the other person.  You are not an endless vessel of energy and support.  You have to find ways to recharge your own batteries and to get the care that you need? 


Consider AL-ANON.  But there’s also affected others counselling.  As an affected other, you are someone that’s in a relationship, or a caregiving relationship of some kind, with someone that’s living with addiction.


Okay, well, there it is guys – That was 45 minutes. I did not think it was going to last that long today. I am so grateful for you. I’m so grateful for the listenership and I am really in deepest gratitude for all of you who have left reviews on iTunes for our show. We love your feedback.  Drop us an email if you want.  


On our website, we’ve got a couple phone numbers there too. One is based in the States and one is based in Canada. You can send us a text message or leave us a voicemail. We can play that on the air in the next episode, if you like. Yeah, there’s lots of ways to connect with us. We’re on Facebook. We’re on Twitter. We even have a Reddit site. Yeah. So anyway, you guys peace and light to you and take good care. Stay warm as it gets cold.


So I’m not going to wish you Merry Christmas yet. And we’re also going to do a New Year’s episode just like we did last year.  Johnny and I so I look forward to that. You take care and chat with you next week. 


Cheers!


Transcribed by https://otter.ai