Episode 60
Repairing Families at Peaks Recovery

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Description

How do you heal the family within addiction treatment? In this episode, we connect with Pema White, MSE, CAS, LPC, one of our primary therapists about recovery and how she is continuously building our family program to provide the best support for the surrounded family members of the individuals in our care.

Talking Points

1. Pema reflects on when she first started at Peaks Recovery
   
2. How Pema begins the journey of family recovery
   
3. The educational aspects of Peaks Recovery’s Family Program
   
4. The Family Workshop Peaks is developing
   

Quotes

“You can’t just teach a skill, you cant just present something and say good luck. There has to be some integration of it. And that’s where the magic happens. This is where our clients are at most risk for relapse, this is why we have IOP because there needs to be that extra support. But there is also relapse for families. So for families that are learning these skills as well…so the workshops are about the practical aspect, putting it into action, families have had some experience now.”

– Pema White, MSE, CAS, LPC, Primary Therapist

Episode Transcripts

Episode 60 Transcripts

hello and welcome to another episode of finding peeks i’m jason friesma chief clinical officer at peaks recovery joining me today i have a very special guest pema white um primary therapist moving into a in a a family role with peeks actually she’s been in a family role for quite a while uh running our family education support group on monday evenings and then recently uh pema has uh agreed to take on uh providing family workshops for our clients in person now that uh covet is over but uh before we talk uh about that i did just wanna kind of introduce you in a different way i know you’ve been on the show before but you haven’t been on here with me so i get to to kind of talk about you for a second

i remember pema getting your resume because you have such a unique name and uh actually pema shodren is a favorite author of mine and so uh immediately your name stood out um for that reason because those are the only two pemas that i’ve ever known and um immediately i was i appreciated your calm and your and your just your spirit immediately and and and you brought to our clinical team um uh a great presence and then with that um a great deal of uh background in working with families and working with families in pretty significant crisis uh through a variety of modalities like we were talking about before the show and i think um and somewhere i i can’t remember it was probably about a year ago i think alan cook and i started the family meeting but once ellen had to move on to hawaii poor guy but you were willing to step into that role and really take that family program and begin to elevate it and and and so i wanted to thank you for that but also uh that is pretty naturally now folded into um doing some family workshops in person uh so with all that being said um as you came on to peaks and and it’s been a little while so i’m asking you to kind of reflect back a little bit but what did you begin to notice about families and what families needed um as their as their loved one was coming into the peaks program um i think the the first thing that i noticed was that they very much needed to be heard um that you know i i don’t think i realized and understood what component they they played i was moving out of like the family as a unit the family as a relationship like the family as my sole focus and so i had to be very attentive to everybody and then moving into individual um you know it was almost like oh this is i got this i went from you know sometimes five people in a room to one person in a room um you know and it was so new and overwhelming and i think it was just really easy to focus on the individual and say oh we just have a client here um and we just need to get our client to this place and then you know someone else will take over i guess in some magical way um and then immediately started working with the families and realizing that my background um just really doesn’t allow me to forget that there’s a family that there’s a system um a wife a daughter a you know a mom you know a dad uncles even um and so you know and sometimes just brothers it’s really cool when you know a brother shows up and he’s like i’m not gonna let this one go um and uh and so um yeah like i think initially it was it was definitely like i they had a lot of pain um that it was really wasn’t so much about the client it was about their pain it was their relief that they were there and a need to be heard and a need to be acknowledged for the pain they were carrying the trauma of addiction the trauma of mental illness on a family and um you know and that in turn looks very different you know in some families it looks like a lot of blame and a lot of shame and a lot of criticism um and i you know often try to redirect from that of like this is just what we’re focusing on this actually comes from a place of hurt and fear um and then some families would just you know want to give information like can you do you got an hour because i have all the information you need to know so that you can you know see my person um and so you know and again still fear and hurt i think they all came from that place and and and then i can imagine um that it’s really difficult to meet someone new and have to like lay out all of the family history to this new clinician who has likely 15 minutes to to listen to you before they move on to the next um thing i think i think that’s a huge challenge and and you know to put it pretty succinctly i’ve certainly you know there’s a phrase going around for a while and i don’t even know who coined it but that addiction is a family disease and i would i would say mental health is a family uh disease as well and you know you and i have a very similar background we’ve worked for the same company prior to peaks different time frame but um we had plenty of opportunity at least i did and i’m sure you did as well of seeing you know a person an identified patient if you will taken out of a family taking a treatment do their work and then plugged back into an unchanged family that isn’t a great system for sustainable change for anyone in that process and so

beginning to wrap around families what what strategies have you used uh in peak so you mentioned family sessions yeah how do we how do you incorporate those into into how you work with clients um well i um i first i gather information you know so i’m listening to families and i’m working with the client um and a lot of times they want that to happen immediately but we generally put that on hold um just because it takes a minute um for clients to sort of you know disconnect and they’ve arrived in a state that they likely need to disconnect um and so you know usually within the first few weeks we’ve gathered enough information to get an idea about um what the at least from the client’s point of view what their struggle is and and maybe from the family’s point of view what they feel like the struggle is um and so then we can come together and say okay we all agree right on this one thing maybe a few things um or if we don’t agree then let’s let’s start that process right like let’s get some goals um because in in residential care there’s at best like three family sessions like that’s in the best case scenario we probably you’re doing three sessions um sometimes a little more sometimes a little less and um and so i you know have to i feel like i always have to strategize of like we have this much time and then we lose them like they’re gone yeah um and we just cross our fingers and um and so that that first session is about you know identifying progress i want to build some hope for the family that seems to be like one of the most necessary processes of walking into that family station and saying hey i want you to talk to your progress i want to talk about you know what you’ve learned here so far and what you’re working on and you know what you plan on addressing while you’re still here so the family gets this idea of like okay my my person is safe and my person is addressing some of these things that you know they are here for um hopefully these underlying issues so we’re not just talking about you know i need to stop doing what i’m doing um it’s i need to look at these things that keep me from you know walking into a healthy life and um and then we um hopefully have some um time to talk about um the family’s struggles just to kind of hash out some of like the whatever they’re carrying as resentments or concerns or fears to be addressed because it’s not it’s not a great system that if you walk out of treatment and feel very hopeful and feel very healed in a lot of ways to step into um you know what i call darts i think uh i tell people all the time like they have some reasonable darts you know it’s fair that they feel this way it’s fair that they have these resentments and um you know and it may not be so about you but they’re probably going to come at you because it feels very raw for the family and you know and i’m and i try to help our clients you know my clients see that they’ve had this runway so to speak that they have had this time and treatment and this surrounding of support but their families generally haven’t um and so they are often you know a couple steps ahead um and they expect their families to just sort of magically arrive there with them and that’s not what happens it’s not even you know reasonable to think that they’re going to be there um usually the families are put on pause and then you know they see their their people way ahead but they they’re still holding these darts they’re still holding these resentments and um so i want to try to at least get one session in to be able to talk about that and why that needs to be resolved or have a process of resolved and then hopefully by that you know kind of third session we’re talking about relapse prevention and so i’m given some information on what relapse looks like um you know affirming that everybody relapses they don’t all look like this kind of end result of relapse but that they’re going to experience anger or triggers in some kind of way and they’re going to feel activated and that’s when the family can do something and so hoping to get a client to talk about like what they need from their family um in those moments how it’s been different than you know we used to do this now let’s do this so we’re talking to like kind of family patterns and um and then once we look at that family pattern and how the the client themselves can shift that either by communicating or um you know taking some time whatever that looks like um then it’s you know kind of the family’s opportunity to say this is what we need um and so hopefully we’re now having this conversation that is um moving forward you know building this skill of i’m feeling a kind of way and i need something from this and how can we come to an agreement now and in the future um when you are in you know at risk where we don’t all fall back into our old patterns well i think you bring up you bring up such a good point too that in a residential setting of you know 30 to 45 days we don’t have a tremendous amount of time uh or hours to really navigate systems that have been in place for often times decades and even if it hasn’t been decades like it’s difficult to unwind some of that which which kind of led to us kind of starting this family support meeting on on monday evenings and we also have one on thursday evenings as well um

what has surprised you about that meeting let me start there that so many people are coming yeah like i think i i knew that people needed support and um and i think that i just it was surprising that um without that before we had that in place um sometimes it was hard to connect with families sometimes they didn’t have time sometimes they you know we’re just feeling so much um you’re feeling so overwhelmed that you know it’s really it’s a good surprise it’s a really pleasant surprise to see so many people coming and returning yeah um yeah and then what do you

there’s obviously this educational component and so can you maybe just do an overview of what you talk about in there i know it’s you put on a six-week rotating uh curriculum i think that um you know so we we try to address things that we have seen have come up as themes um you know and and that’s oftentimes like uh you know i’ll make little notes along the way in the curriculum be like this needs to be changed or you know oh that was a good question let me add that in so i try to keep it you know kind of a living document and at least in the back of my mind sometimes in my notes to like remember to address these things that that come up but generally we talk about how to set boundaries in healthy ways you know how to really take care of yourself as a family support person i think that that’s a oftentimes surprising aspect of the family support group that you know when families show up i think they kind of have this expectation of i’m going to learn some magic about my person and what my person needs to do and then they find out that it’s actually about you and what you need to do um you know and and and then another surprising aspect is people are like oh okay yeah oh that makes sense and note to self um that my person’s recovery is about my recovery um and that the family recovery and you know and how to integrate some of those things and um we talk about you know i think just giving that education of like what relapse looks down looks like breaking down and you know in intense steps sometimes and what addiction and dependence looks like and and really breaking down you know depression and anxiety and how it’s this underlying um you know factor that drives you know these dysfunctional patterns and um and then i think a lot of it is really just support for each other i think i i see a lot of people really just sign when they hear other people and saying yeah same what she said what he said um and i’m not alone and this is common and you know and that i think it does two things at once helps them feel connected with people that they had no idea existed um and then two i think it kind of reduces some of the shame that a lot of family members feel because they know things have not been great and they might not have acted great and no one really wants to talk about it when we’re not acting great um but then when they hear it like oh this isn’t me not acting great this is a very typical response to trauma and addiction and and i just fell into a pattern that is natural and normal um for most people well i mean i was going to ask you about the communal aspect of it and you touched on it there i certainly find um you know we talk often about how addiction and even mental health are very lonely uh in uh diseases or uh when people are in active addiction or actively depressed or actively anxious it creates this isolation even even if there are people around or even if it seems like they aren’t necessarily isolating like it does create this great loneliness and great feeling of like um well i’m just by my i’m on my own and in this parallel process families feel much the same way often times due to shame and and um maybe not wanting to talk to people or not knowing who to talk to or or having friends or family who don’t understand what’s going on in the family and so they continue to shrink their world down and i was always amazed when i’ve when i’ve helped facilitate those uh meetings with the families is almost like you said a lot of people are saying yeah me too and i get it and same with me um it’s it’s always struck me how surprising that is for people that they aren’t alone yeah and and by definition that’s kind of shame right that if i think i’m the only person who feels this way i think i’m the only one that feels this desperately about my loved one or i think i’m the only one that um has been lied to over and over and i can’t give up on my person or i think i’m the only one that um has paid off a drug dealer or i’m the only one who’s gone to my kid’s house and pulled them out of bed but really or i’m the only one that kicked my kid out because they were using and that makes you know like yeah whatever that response is is there must be something wrong with me because i’m all alone here yeah and we know we know just from talking about shane that that is exactly what exacerbates it and then and the solution for it of course is just being able to talk about it and what i think are what our evening programming and it is just for families like that group our clients don’t attend it’s just it’s just a place for families to kind of come together get some education and also uh offer one another some support and it is a powerful space for sure and then so then we had this other realization well you did and and you came and talked to me about it and it is that um the families are engaging in this program our clients are engaging uh in our inpatient program and then uh we have an iop program in colorado springs and in denver and uh clients are transitioning to that and and the families are just kind of

uh left to go use community supports how about that and um and then you’ve designed uh kind of this uh kind of a workshop to help uh families integrate with one another again and i’m wondering if you can kind of give us a preview of what that’s gonna look like yeah i think um you know one realization that was happening over and over so it was a pattern um i you know i see things from a system so i don’t no one exists all alone we all exist in our system and um and so when i kept seeing over and over you know people were coming back they’re like can i keep coming um which is beautiful um it makes it bigger again you know i’m like oh they’re still coming and they’re repeating things you know and um and so which is beautiful but also i think it implied at least to me that they need more um they’re not ready to drop off they’re not ready to be let go and you know and that i think is very powerful when um family members can ask for help when anyone can ask for help in whatever way they do and so um to say like and then also this like fear so there was like people that were returning um because their people went into iop and then i would hear this fear we’d watch people um and listen to people coming through the program the first you know few weeks there was just my person is safe and they were feeling that and expressing that um but then as you know the discharge neared there was just this increase in fear you could hear it me too right connecting on that i think one time they even formed their own group afterwards because they want to support each other and um and so that it just seemed so clear that our families needed a um a step down as well um they needed not to be you know left to figure this out on their own and um and the practical aspects i know you know just from learning i worked in schools and i was a teacher and i knew that you couldn’t just you can’t just teach a skill you can’t just present something and say good luck like there has to be some some integration of it and you know and that i think is where the magic happens um because this is where our clients are most at risk for relapse that’s why we have iop is because there needs to be that extra support um but there’s also a relapse for families and um you know and so you know families who are learning this new skill of i’m having a feeling and i have a need and can we talk about it um is great in the safety of a family session um but then when you get in it and they’re back home for dinner and they don’t like what they made for dinner right um all of a sudden things go back to the default pattern and there isn’t anyone to coach him in those moments and so um to me like the workshops are about the the practical aspects putting it into action families hopefully have had some experience um if not through inpatient you know family sessions and online you know certainly the clients are in it and feeling it and getting supported and so it’s about putting those two um you know kind of concepts back together so the family comes the client comes and um and they’re able to talk about the real things that are happening um in the moment so you know we’re starting with same concepts it’s just sort of a you know higher level it feels like right like they’re now moving into this more practical aspect of it and so setting those boundaries in the moment talking about real things that are happening today um going back to talk about some of those you know resentments that families are still carrying and they don’t want to throw at their family member they they want to see them in recovery but they don’t know what to do with these sort of hard topics um you know examining the family patterns and and what that looks like and what what it might look like if we continue on this path and how to undo all of that

i think one of the things i wanted to touch on as you were talking there is i um there is this process i think families go through or some families go through not all where the where their person comes to peaks and they begin to get better and communication within the family is improved um and there’s there’s a lot of excitement and there’s oftentimes relief on the part of the family and they kind of have some separation from their loved one and they’re like i’m sleeping at night i know my person is safe and and um is making progress and then um after some period of time that that wears off and and old patterns reestablish but i think also uh what i’ve what i’ve told some clients is like you you’ve created a kind of a reservoir of pain and hurt in your family and they probably haven’t you as well but like you’ve created a reservoir of pain and hurt and and it’s likely going to come out at some point and actually uh that would be a good thing if it came out um it would that’s the path kind of toward healing and and so often times uh you know i’ve seen it with clients toward the end of their treatment stay and their family members are finally like you know what actually really hurt us in these ways are we really we’re afraid or we’re really tired of this or we really can’t go back to this and and i’ve watched our clients come back and be like what has happened like things are getting worse and i’m actually this is actually the process of them getting better because they’re actually trusting you enough and it shows that they’re still invested and then i often quote the lumineers and i say that the opposite of love is indifference so their anger and their frustration and all that is actually just a form of their love um and certainly i think uh family members being willing to come and attend a workshop that’s an act of love too to say this is this relationship is worth healing um i did want to ask like do you can you share like maybe one practical thing you’re going to help families integrate with one another whether yeah i’ll let you uh um yeah well i mean i we made the first session boundaries for a reason uh so um you know i think it a lot of times it’s unspoken right like you just you go to someone’s house and you just assume that they were raised the same way that you were raised and um you know and so we’re not used to speaking to very specific boundaries and and it feels awkward and um you know and it’s unusual and you know and and it’s been introduced hopefully certainly to our clients because it’s something we talk about almost every week not every day um you know and it’s certainly something that happens in family programming um but then what does that look like do i have to write a list of rules and post it in the kitchen or um you know and that’s going to be different for each family so i think it’s just giving them a space to be able to talk about what their fears are what their concerns are because for me like if you have a fear then we need to set a boundary we need to address that by saying what’s your fear well i’m afraid he’s going to steal my car in the middle of night you know and go get high whatever you know um all right that’s the fear what’s the boundary there right like and can you respect that boundary for for now um you know your family member says that you can’t have access to their car because they’re afraid of that that has to be the boundary today and it doesn’t have to be the boundary forever boundaries are flexible they can be um but it’s just today’s boundary and you know and i think when it’s when it’s spoken and agreed upon and respected and understood of like this is why i have to set this um then it doesn’t turn into like over dinner going hey can i get the car no you can’t have the car right now we’re ugly now things are um you know um just and there’s no there’s nobody nowhere to go from there because we’ve already turned it into a place of anger so hopefully that’s what you know families will be bringing to the workshop is this um i mean they may not know that yet but you know they carry it in their pocket i know i do uh and so um i can tell you what my fears are in most situations and so i that’s what we’ll kind of talk through and work through and um you know the exciting part about you know building programs is that you know i get to hear from the clients i hope that every time we do the boundaries discussion it looks different i hope every time we work through you know this four-week curriculum it’s a it’s a whole different conversation because it’s a whole new set of fears it’s a whole new set of families that um are bringing their own you know needs and concerns and yeah yeah absolutely well pam i i i appreciate um as we kind of wrap up here i i appreciate your vision um for uh families uh coming through peaks and i appreciate uh your you championing championing them uh and the process and i really think this is a way uh we talk a lot about disrupting this industry and i think this is a way we get to do it to provide not only care and our peaks touch if you will to our clients but we also get to provide that to the family and help kind of you know help the families integrate what occurs in our program so i want to thank you for coming on the show today i want to wish everyone a happy have a safe independence day tomorrow please follow us on facebook instagram also on tiktok chris burns continues to churn out wacky videos that i think are mostly fun and anyway thank you all for viewing and feel free to email us any questions that you may have or comments and with that take care