Episode 44
The Benefits and Hardships of Gender Specific Care

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Description

Today we discuss the reasons why we continue to implement gender specific care and the benefits and hardships we face while doing so.

Talking Points

1. A discussion on societal norms in our culture and how they affect care in our industry.
   
2. Going into the effective reasons why we continue to implement gender specific care despite the obstacles we currently face. 
   
3. The current hardships and obstacles with gender specific care in our culture.
   
4. The detrimental reasons why we don’t use non-gender specific care.
   

Quotes

““Trauma is typically experienced through a gendered lens. I think that a lot of the traumas we see are actually gender specific or gender impacted.”

– Clinton Nicholson, MA, LPC, LAC, Chief Operating Officer

Episode Transcripts

Episode 44 Transcripts

[Music]

hello everybody

welcome to

another special episode of finding peeks

i am brandon burns chief executive

officer of peaks recovery centers chief

clinical officer

guru

clinical officiant

part-time uber

driver clint nicholson chief operating

officer

part-time lyft driver

we actually share yeah we share a car

yeah

they fight all the time about it

he steals his uber sticker he steals his

lip sticker

here we are here we are you’re a coke

guy i’m a pepsi guy i mean yeah yeah

it’s all about the bumper sticker yeah

kidding and jokes aside folks of course

we’re just trying to liven it up a

little bit here be a little bit more uh

intentional about drawing you in to talk

about some serious topics that we want

to speak to the world about

here at finding

peaks

as an episode as me as the host i’m just

going to continue to talk more about it

that i am invested in this concept of

disrupting an industry through our

company culture and our vision and with

that hopeful that uh the folks on the

other side of these cameras and the

social medias uh and so forth the ones

emailing us fervently at finding peaks

at peaksrecovery.com

do it

thoughts ideas questions bring it

forward

hopefully to give you information for

which

if you are pursuing treatment services

whether it’s substance use disorder or

mental health primary uh in that regard

that at the end of the day the

information that we’re giving you

empowers you to seek treatment uh to

find the programs that appropriate for

you and your loved one and to identify

where

treatment centers may fall short and

actually delivering those services to

your loved ones so today we are going to

talk about

kind of societal norms and culture and

how that influences substance use

disorder

and mental health

uh for those out there who are like why

is he using substance use disorder and

not the word addiction is because our

prior episode

we really sort of went after that word

and got a little passionate about it and

i don’t want to use the word for fear

that

he will he will give me a good punch in

the face so trying to move away from it

it’s familiar

it’s a figurative punch in the face

figurative punches totally he can’t do

that it’s an hr issue you are my boss um

so cultural norms our experience is it’s

something that we see with an addiction

treatment it does influence behaviors it

does cause

trauma

for individuals within society i was

talking um

a pretty uh famous

marketing uh

platform in our industry without using

their name i was recently talking about

for example how uh during election

season right after election season

addiction treatment experience or

addiction treatment centers and mental

health centers experience an increase in

call volume related to the results of

elections in that regard so

something about elections is stirring

the pot of

substance use disorder and mental health

in that regard it’s interesting i don’t

have much more to expand or gain

insights into that but that is curious

there is something about

the world we live in

the society we live in that causes

people to experience

um suffering in those processes to the

degree that they’ll reach out to centers

like ours

to address what’s going on uh maybe the

hangover post-election maybe just the

anxiety about who just took power and

what that means for the individual

but really to open this up i’m going to

take a general direction towards you

know the benefits in disrupting an

industry

or taking a look at what it means to

disrupt an industry whether you know

co-ed facilities or gender specific care

is going to be really important

especially given the fact that when we

talk about male versus you know female

that we’re not really culturally

nurturing

um

these binary terms alone that it is much

greater than just those terms by

themselves but from our lens within

treatment you know it’s kind of at a

high level what are we seeing on the

therapist side giving your guys’s

talents in being therapist

that

you know whether it’s trauma or drive

something that’s driving

the substance use disorder or disrupting

them from an anxious depressive state

what are we seeing kind of through the

lens of our

patients

that

you are seeing where culture is actually

playing an influence on how they feel

about who they are

i feel like there’s so much to unpack in

what you just said truthfully

um and i i appreciate you mentioning

that obviously gender specific care is

automatically binary uh

and we and we can do things variable

things uh

to try to bridge that gap but but it’s a

binary decision i just want to

acknowledge that and

however that being said

you know having spent a lot of time on

both of our campuses our men’s campus

and our women’s campus

the the culture that whether or not it’s

from well it’s certainly from society

but the culture of both of our campuses

are very different i um

you guys have probably visited both our

campuses i assume yeah done the tour

that once i’ve done the tour um online i

did it to work yeah but i do think um

you know like at the

just in general like during groups that

are at our men’s campus we talk

clinically about

um

really helping men truthfully like it’s

an excavating process of like helping

men

gain insight into themselves and um

maybe even allowing themselves to

release some

difficult emotions that they haven’t

been able to release

and

the women’s house tends to be a lot

about containment where the women have a

lot more access it seems like

to be expressive and being open and are

a lot more in touch with their trauma

um

and it’s about kind of helping them

kind of make sense of it and then also

contain it um

and

combining these cultures in a primary

care setting

um i i think would be a lot like trying

to combine water and oil is that that’s

not a thing right you can’t do that very

well they don’t even do it just not well

yeah you can do it but they don’t they

don’t mix very well um

and i think uh i think that’s why

that’s the appeal i think of of a gender

specific program is that um

it’s just having that ability like it’s

just a different skill set if i’m just

gonna be totally honest with you and i

think

um and we see it too clinically like we

have clinicians that are drawn to work

more with the men and clinicians that

are drawn to work more with the women

because

um just of their their skill set and

approach uh

fits better in one side or the other and

not good or bad but just simply a fact

is what i notice

i think that you said something really

important um

like

i do think that there is uh the level of

care is actually important when you talk

about gender specific treatment um when

you’re doing the residential sort of

stabilization model

uh safety is is vital towards because

what we’re again trying to do is help

people access vulnerability and so in

order to establish safety uh i think

what i’ve recognized over the years and

i think what we see in our programming

is that gender specific programs

actually do foster a sense of safety

that

maybe a

co-ed program would actually create

barriers to

and so by providing these sort of

gender-specific

approaches we allow people to be able to

explore

in a way that is um

helps them actually kind of bypass

the uh

the shame and expectations and

um

that that the sort of like binary model

actually imposes on people um

now i think as you sort of progress

through your treatment

the integration of men and women

actually becomes really important and i

think it becomes uh really helpful and

really beneficial because in the end we

don’t live in these sort of like

vortexes you know we we live together um

with one another and so being able to

sort of uh kind of re-establish and help

people develop that sense of safety

within a coed environment is also really

important so

yeah in

into that point uh

and i think it’s worth mentioning to the

viewers that you know challenge me of

course go to the google

search engines whatever and you know and

ask google you know in relation to

addiction how

google the data and you’ll see that

women and men experience addiction for

example differently than one another

generally you’ll see that men are using

higher quantities of the drugs and

they’re using it more often where

women are generally using

less quantities and less often in that

regard but both experiencing

frustrations around that addiction and

of course that’s not going to be true

across the board

but when we think about you know

stabilization and vulnerability coming

into a setting if we’re

if our experiences are different

on one side of the equation coming into

another experience i think in ways that

makes us vulnerable to the people that

we’re around in a in a pretty

significant way but with those you know

touches of differences for people

entering treatment i think it’s

interesting from a residential

standpoint you know

that

it feels good and first and foremost to

break it up and move them apart but

that’s interesting to think of course

that well at some point there has to be

this integration um maybe interesting is

the wrong word because it is the world

we live in uh in that regard but the

world that we live in prior to coming to

p you know to a place like peaks uh is

scary and we’ve been mistreated in a

variety of different ways and we have

different experiences within that you

know maybe it’s trauma uh maybe it’s

mental health maybe it’s a female in the

way her dad treated her versus a male in

the way that his dad treated him and out

of those experiences it seems best to

create that separation so that that

vulnerability and the ability to bring

that forward

can thrive but also where where do we

where do you guys think we have blinders

on in this moment because we operate a

gender specific you know uh

culture of course and i think those

experiences for us are uh really

important but

um challenging you guys to think about

maybe in a gender specific setting maybe

it’s around the binary language of just

men and women where we’re not really

seeing that being fully efficacious

i mean i think

i’m not sure it’s a blinder like or

maybe it is like i’m aware of the

blinder that like

creating gender specific program it

serves

a significant portion of the population

but it doesn’t serve another part of the

population i think that’s very much true

um

and then i do think like another course

correction we’ve had i think just in the

last month or two is

we kind of had a lot of our residential

staff

matched the gender of the program they

were working in

and it

and it wasn’t the best idea necessarily

i think it it’s helpful to have

um well boundaried healthy people

of both genders interacting with our

clients and and we had kind of began to

isolate our programs into very specific

camps almost from a staff perspective

and um

and i’ve run plenty of uh programs in

our

plenty of groups and individual sessions

in our women’s program and there is

there is some uh i think there is some

power to having like a a healthy well

boundaried um

compassionate person

providing some care in that women’s

program and then at the same time like

you know we have a lot of really

successful uh

staff members that are women working in

our men’s program that provide an

element of care and compassion and

concern

that um that has been really help

helpful i think

i don’t know what other blind spots do

you think we have i mean i i do think

that when we

you know anytime you sort of like

separate out um

into categories or groups you you are

reinforcing some of the stereotypes that

go along with those so they’re

in in a way that we um

having gender-specific programming does

further entrench some of those

uh kind of variables and i would say um

kind of

beliefs about self and experiences of

shame and victimization i think it kind

of can reinforce that sometimes rather

than

helping to break that up which is

i mean we live in

a diverse world you know like we are

like

gender is a spectrum you know everything

is a freaking spectrum really and to

when when we

reinforce that the world is black and

white we we miss all of the gray and in

the ends i mean the gray is where we

heal and so

i think that it’s uh

i believe pretty firmly in gender

specific programming to a point but i

think that it has its limits like there

is a ceiling that you hit at which point

uh it’s kind of run its course and now

it’s time to fully engage with the world

around you you know these these sort of

like um

i don’t know kind of like

self-manifested little worlds that we

try to live in and i think that and

maybe that’s hark that kind of goes back

to the election

era right like i think that we do we get

we kind of

find our own little cloister of our own

little beliefs and our own little circle

of people that feel and believe the same

thing that we do and when that gets

disrupted it is

extremely um imbalancing yeah but

um

in the end that’s what we’re trying to

learn how to do is to to balance and

stay still in chaos rather than try to

avoid or ignore it

yeah and and you know and and to catch

it really in terms of you know to bring

outside societal norms in you know

america has had many discussions about

it and about non-binary bathrooms in

that regard and that somebody who

identifies

as a female

for example with male genitalia wants to

use the female bathroom and there’s a

lot of tension about that within society

but at the same time we’ve had

individuals come in who are

male per their genitalia in that regard

transitioning into

womanhood and going through that

experience and we’ve

placed those individuals into our

women’s program at time and

out of that once it’s become aware

through the whispers of culture a parent

finds out or something and seems to be

you know dysregulated at some level in

the same way that culture is out there

you know so for me i you know went

around and i always found myself in the

marketing stance of like oh we’re gender

specific and that’s really great and

then people would say well what if they

are non-binary in that regard and what

are you guys doing about that

and how does that blur these norms of

you know gender specific care at the end

of the day and we’ve also done it the

other way women

or or individuals with female genitalia

identifying as male and making that

transition who went into our men’s

program as well too and

um and then tension occurs throughout

that as an experience but uh i think

those are you know the types of things

that are playing roles within this that

for which you know treatment centers

such as ours mental health treatment

centers and so forth integrated care all

have to be accounting for in real time

because these individuals uh across the

board in the spectrum are all suffering

in their own you know unique way uh in

that regard so

so having a gender-specific camp is you

know good to a degree but at the same

time uh really requires um an ability to

be

more relational and you know less

transactional from those those terms

absolutely yeah it’s complicated yeah

and you have to allow it to be

complicated i think if you try to keep

it simple

um

it’ll fail what do you guys think is the

biggest like concern men and women early

stages of recovery in the same room

group room together what do you think is

the the the sort of liability there for

which this industry might fear most you

know within those moments

i mean there’s the obvious

things of people struggling

people

who are maybe having some difficulty or

haven’t regulated their impulses in a

long time

providing them

an opportunity

um

to become distracted by either uh

trying to attract people of the opposite

sex but don’t get me wrong it happens um

even in gender specific programs so i’m

not

that right

that isn’t the only reason by any

stretch of the imagination but just

having sat in in i don’t know countless

men’s and women’s groups it is

men when they’re in groups with other

men they do share about their shame in a

different way or they share about their

stories are they sure about their

struggles in a different way than if

women are introduced to the room and

it’s the same with the women like i i do

think

um for a period of time i think that’s

just really important and i think even

you know even in the aftercare setting

um you know i don’t think it’s

necessarily a bad idea for people to

still attend um gender-specific either

groups or support groups or just have a

friend group that’s gender-specific

where they can talk about these things

without kind of some of that other

distraction but i mean it’s the same

reason why we you know in some ways we

don’t

uh

intentionally try to trigger people or

tempt them with things or or have

liquor bottles laying around like

there’s no value in that creating that

safety is just to me about removing a

lot of

um

a lot of temptations maybe for people to

that

so they can just really dial in and

focus on themselves and and

having done this in both settings i can

just tell you the the

depth and the quality and the safety

um in in the group setting certainly is

just different when it’s gender specific

it’s it’s

for sure for a period of time to your

point well and i think i mean

to your point jason like whether you

like it or not um

trauma is typically experienced through

a gender a gendered lens you know i

think that

a lot of

um of the traumas that we see that we

address are actually gender specific or

gender impacted i guess maybe would be a

more appropriate way of saying it so

when you are

bringing people especially who are sort

of like early in this process who are

just starting to access these feelings

who are processing shame who are

experiencing vulnerability who are still

working on establishing a sense of felt

and internal safety bringing those two

worlds together can be um cataclysmic to

a certain degree so it just has to be

done very mindfully

and um they are

there are

certain ways to approach it and um

i think that there are also ways in

which you can talk about it directly you

know to to not try to avoid it actually

but to really engage in it and and speak

to the fact that you know um

the way that men and women i think

experience uh being a victim in our

culture is really different

and um i think that there’s a lot of

really interesting dialogue to be had

around that

um so that would be like just an example

of one way that you can kind of open

that door but in the end you’ve got um

you know

when you when you’re bringing these

traumas together you always have to be

really careful

yeah it in

this is just the the kind of i’m going

to go out on a limb here and trying to

describe something that

is just coming to mind as we have this

uh conversation but uh you know in

consumerism for example in america like

there there are there’s specialization

of services there is you know peaks

recovery is an addiction treatment

center to resolve you know in it you

know mental health issues and uh

substance use disorder and then there’s

the the doctor to help you know manage

pain and then there is the restaurant

that specializes in serving food that

you can’t necessarily cook yourself or

whatever the case might be

what i’m getting at here is that

oftentimes we experience things that we

need as an internal frustration hungry

externalize it go to a restaurant i’m

got an addiction externalize it i go to

this place can’t sleep externalize it

get on these meds

as an experience at the end of the day

and so for me

in the seven and a half years or so now

that i’ve been doing this and just you

know witnessing this within addiction

treatment cultures and uh integrated

care as well too is this immediate

externalization to create that internal

wellness and the individuals that we

treat and serve are so disrupted

generally speaking when you take the one

externalization feature drugs and

alcohol away from them or the

environments which it was more

comfortable to be depressed in or

anxious in or those sorts of things now

they’re in these new environments and

we’ve talked about it before it becomes

about the pillows and the couches and

you guys tvs are only 70 inches and it

should be 85 and you know

couching the silliness aside from it it

feels like in a in a in a co-ed facility

we start wanting to feel internally well

and

because culturally speaking of course

we’re

largely a heterosexual population

there’s a significant potential for

conflict there in the externalization of

i don’t feel well in here they’ve just

taken this i mean i can’t think of a

greater dopamine kick on the other side

of losing all that dopamine kick from

drugs and alcohol that sex as an

opportunity provides now it doesn’t

as you guys are pointing out discourage

externalization and gender specific

cultures because

people can be sexual in multiple ways

than just being heterosexual in that

regard i think the world has taught us

that

in a big way as we have more and more of

these conversations and bring it to

light but

it seems to be that conflict that is

most uh

as an experienced dire within thinking

about whether to cross that bridge into

a coed facility

and if we’re not disrupting that then it

leaves this major external

externalization and distraction in front

of us and if i’m motivated by that i’m

not going to talk about how you know my

dad smacked me around maybe culture has

taught me to be strong and big and now i

see wounded you know female on the other

side as a male heterosexual and i think

oh i’m just going to be tough man and

i’m going to save and now i’m being you

know maybe codependent all these sort of

features out of it and i think that’s

the rub

that um

to the core of this that we’re not

thinking about in terms of business

models but it’s a cheaper business model

in our industry to invite the model in

to have them all on one site and yeah

they’re housed together here and here

but we’re running groups in the middle

here and then we have two or four you

know staff members at night time trying

to keep all the kids apart and in

between but the reality is with

intentionality and once that external

external hook takes place it’s nearly

impossible to do productive work um

am i wrong am i no i don’t think you’re

wrong at all and i do think

i think people

i mean you’re mentioning substance use

like when when people are struggling

with substance use

issues

they

uh

yeah

um

but i will say it is it’s challenge like

they’re used to feeling an uncomfortable

feeling and i have to do something about

it and that something provides immediate

relief from it

and so

when somebody is four days sober that

impulse doesn’t go away like i’m feeling

uncomfortable i need to do something

about it

call the craving right

um

but okay now i don’t have access to my

what i would prefer to do so i’m going

to access a variety of other things and

sex is a really powerful one to your

point

you know eating issues like we’re not

going to set up like a gambling parlor

in a rehab either because that would be

appealing too like if i could go get

lost

in the gambling way provide the rush and

all of that but

but i do think like that’s part of this

early process and stabilization is

saying okay you have these feelings that

feel intense and overwhelming but can

you recognize that

they don’t last forever in fact they

don’t last very long at all if you kind

of let them what lasts a long time is

ruminating about them and telling

yourself i have to do something about

this rather than just like

letting it come through and being

mindful about it um

so providing gender-specific care to me

takes away one very dramatic thing that

people can

do often times or would be drawn to do

and there’s an intensity too that like

okay

people are sharing things that maybe

they haven’t talked to anybody about and

and it’s being well received it gets

really easy to conflate

um empathy with love right like if

people are understanding what you’re

saying it’s easy to feel like oh my god

this is the most important person in my

life that i met

yesterday right right so i don’t know

that’s where i see it yeah

yeah i mean

i agree i think

that

really

i guess for me treatment

and recovery is

the process of sort of reconnecting to

self

and you’re talking about externalization

right um

we there’s there’s still that tendency

early on to to believe that you’re

that your answers and your connections

lie outside of you and i think that you

can create environments like a co-ed

program especially at that like early

residential stabilization period

in which you start to reinforce that or

at least i don’t know it’s almost like

you’re kind of setting people up you’re

tempting fate really at that point and

when in reality what

you really need to be doing is getting

people to go inside go inwards right

and anything that you can do early on in

the process of treatment whether it’s

for

substance dependence or mental health

is help people reconnect to themselves

because they people come in completely

detached you know they i’ve most people

come in can just completely lost and i

mean that’s why

identity and purpose is one of our our

primary program weeks you know that’s

one of our intensives because people

have completely lost that sense of self

so

um and i think that anything that we can

do as a program anything that we can do

as therapists

to

help people

remain

focused on what’s going on inside as

opposed to outside

the better

the job that we’re doing essentially

that makes sense

to me yeah to me hopefully the viewers

uh in this regard and i think we’ll just

we’ll take it out from there this is a

uh

this is a topic that is uh interesting

and it’s uh it’s got tones of

combativeness in it uh the way that

culture probably experiences addiction

and what it is and how addiction

treatment centers substance use disorder

centers integrated care mental health

should be

behaving in this world

but there are internal conflicts within

our industry and the services that we

provide each and every day and these are

things that whether co-ed or gender

specific facility that we have to be

thinking about in real time and how are

we going to disrupt that and you know in

our experience i think i would prefer to

be generous if it feels like you we do

away with a lot by separating that out

from the very beginning but if we’re not

thinking thoughtfully about these things

and the business model is just to push

them all in one room and think like

here’s the group therapy go but yeah

they sleep in separate places that’s

just not being thoughtful about how this

works

at the end of the day because

individuals who are receiving our

services are hollow within and looking

for

largely anything to fill that space in

that void within

and sometimes these

simple you know primitive features of

our existence are the things that they

will quickly move to fill those in and

it’s just something to be mindful of so

over the next few weeks uh jason

friesman i and clinton as well too will

be joined by dr ashley johnson uh our

president chief medical officer at peaks

recovery and we’re going to be talking

about major dis major depressive

disorder

in a variety of different ways how it

connects with or

more innovative care how that connects

with treatment

the limitations of medication management

in that regard the complexity of what

takes place within treatment episodes

around this um

so uh for my next hosting position i’ll

be joined by clinton and dr aj as we

call her at the office and jason will

have another person and dr aj i suppose

to talk about uh what they’re looking at

so stay tuned for that

i think we’re going to learn a ton about

that

and you know especially around the whole

notion there are slogans around there

that say keep recovery simple and with

major depressive disorder it is just not

simple it is quite complex and really

difficult to navigate in real time so

stay tuned for that in the meantime the

tick tocks the facebook back to tick

tock follow chris burns

you know screaming at it whatever he’s

passionate about recovery it’s energized

he brings a lot of people into it they

do squatting and all kinds of

interesting things that have me just

reeling for more so check it out uh

facebook finding peeks at

peaksrecovery.com

questions inside thoughts ideas concerns

whatever it is give it to us we want to

bring future episodes to you that are of

value to you

the consumer of these types of services

uh in that regard so until next time

signing off

[Music]

you