Episode 92
Debriefing the 2023 Winter Symposium

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Description

In this episode, Jason Friesema brings Lauren Atencio and Samantha Archuleta back to revisit their experiences at the 2023 Winter Symposium and share insights into how the information can help disrupt our industry and pave the way for brighter client outcomes. Through sharing experiences and takeaways from speeches to debating how to best integrate the information into the industry, our team brings an educational conversation to the show.

Talking Points

1. Speaking on plant-based medicine
   
2. Looking into harm reduction
   
3. Models of care
   
4. Misdiagnosis
   
5. Misunderstanding codependency
   
6. The fentanyl crisis
   

Quotes

“There are more relapses with cancer, diabetes, all of these different things; those diseases are constantly relapsing, so why do we vilify addiction relapse so much? Why do we vilify mental health relapse so much? When this is an actual mental health disorder, when it’s an actual physical disease, we’re actually discounting the idea of relapse when, no, that’s part of the process. So tell me how you need to be able to approach your recovery to feel like you have some autonomy, and you can take it on your own. ”

– Lauren Atencio

Episode Transcripts

Episode -92- Transcripts

hello and welcome to another episode of Finding Peaks I’m Jason Frieza Chief clinical officer at Peaks recovery uh I’m very excited today to be joined by Samantha Archuleta IOP therapist at Peaks recovery and back again back again Lauren atencio Clinical Director of our men’s program and we are here to talk about um our experiences at the winter Symposium we just uh completed uh attending the winter Symposium here in Colorado Springs uh and it’s just kind of a conference where uh a fair amount of the focus is on Mental Health but most of it honestly is on addiction and we all had about three and a half days or so to attend as many sessions and have as many conversations as we could and so um we decided that today for finding Peaks we would just kind of talk through some of the things that we learned uh and some of the things that we experienced while we were participating so um first up uh the first event that we went to and the three of us were all there we uh we got to be a part of uh listening to a panel including our CEO and founder our CEO Brandon Burns talk about um uh the natural medicine um and um obviously we’ve had a lot of discussion on finding Peaks about the use of natural medicine and um and so I just kind of wanted to start off with you guys like what did you hear maybe knew from that discussion um on the panel were a couple of MD doctors a counselor and then um kind of a politician I guess if you will I like that title he did not like the title politician but it if it fits and he was a good politician all you know it’s very easy so um what did you guys pick up on I think the thing that stood out to me the most was um and I am going to butcher this probably but the contraindications between ssris and psilocybin um and how those who do take ssris they actually might not be able to engage in psilocybin therapy as effectively because some of those receptors are kind of blocking them and again I might be butchering this I don’t know all of the technical medical terms but it was just so interesting to me to really hear that you know the SSRI portion of it is actually taking away some of your ability to really engage with the psilocybin and not allow for you to really kind of engage in those processes I I thought that was really interesting yeah and I think I think hearing that from a couple of medical doctors actually and then the conversation I had with one of the panelists who’s also been on the show uh Kevin um really I what Struck it was what was striking for me is that um when we kind of pushed aside maybe some of the some of the excitement around it or maybe some of the Mystique around like taking uh psilocybin or something like that like this is you know pretty serious medicine yeah um and there are important considerations to have to include uh medication interactions and uh the other thing that Kevin was talking to me about too is like there it does open one up to potential Bad actors too and making sure that you have trustworthy people and and you know it’s likely most unofficial of good licensed people that operate underneath um a board of regulations and that sort of thing uh to operate with their license and so to me I think that was I think it was helpful because like I think we spend a lot of time talking about the hope of all of it and it is really exciting um and there’s limitations and I think uh to me it really was like this really needs to be taken very seriously too and it isn’t something then it’s just like you know like going to be like the 1960s or something so I’m Sam what did you hear I think one of the other kind of limitations that they spoke to that felt important was serotonin syndrome and the risk of even combining your SSRI with psilocybin or other of the natural medicines that are coming up and that a lot of doctors are saying you need to be off everything to be able to do that and that’s the scary thing for people on antidepressants to come off of those because for many people that saved their life and so to take that risk of coming off what saved your life is something that can enhance your life to such benefit is scary and at the risk of it not even working right we even talked about that right like talking to a client and they had been on ssris for a really long time and wanting to explore this process more but also just being really scared of like if I come off this am I going to be able to handle my emotions am I going to be able to regulate in a way that is appropriate for me because these medications have kind of helped me me stay at this Baseline and so I it was it was a really interesting thing because there is this part of us right that like don’t want a dog on medications at all but if we can reach into this industry and really go full force with the psilocybin the MDMA the academy and all these different kind of modalities that are starting to roll out what could we be doing right we I think we kind of put ourselves in a little bit of a like box with medications at times and again not bagging medications but maybe there’s more that we can be doing that we aren’t exploring because we’re just so heavily Reliant as a society on medications yeah I think that’s a great point and the other thing that um I had a conversation later in the conference too with one of my old mentors from 15 or 20 years ago and she was like listen I’ve done mushrooms and there’s no way you can tell me that those things are going to be therapeutic and um I had the opportunity to kind of talked about like the set and setting and like making sure that like it’s directive and and intentional and all that and so to me even just that little conversation feels helpful too to be reminded like this this is an exciting time but it’s also like time to have some caution as well so I think I went to another um panel discussion about harm reduction and I think this kind of falls into that discussion as well right um something that the speaker said that really stuck out to me is the one of the biggest downfalls that this field does is we don’t ask the client how they want to recover we just tell them how they want to recover right like this is what you need to do and if you don’t do it you’re gonna relapse and um the thing that was really cool is like why are we there he said that there’s more relapses with cancer diabetes all these different things those diseases constantly are relapsing so why do we vilify addiction relapse so much why do we vilify mental health relapse so much when this is a actual mental health disorder when it’s actual physical disease we’re discounting the idea of relapse when no no that’s part of the process so tell me how you need to be able to approach your recovery in order to feel like you have some autonomy and you can kind of take it on your own well and I think talking about psilocybin with ssris we we’ve pigeonholed people especially they don’t get to benefit from psilocybin now because we’ve done ssris for so long we’ve pigeonholed people to this way that we thought for the time was great and over here is this other opportunity for healing that some people aren’t going to have access to and I think that’s a scary thing to think about in the same sense of we’re going to tell you the right answer for now and there’s these other answers that are coming out that might be better yeah well I think I think so this this leads me to talk about uh one of the other talks that that we also the three of us went to which was about kind of the models of care and that was toward the end of the conference um and uh the presenter um who is a physician from uh the meninger clinic in Houston talked about um all of the models of care and he started talking about the first one he talked about was the moral model of care which means looking at substance use as kind of a moral failing like you are falling short and you are not uh doing good enough and you need to maybe repent and try harder and what I appreciate about his discussion is first of all I mean that is um the AAA model is rooted in both that and also the medical model of care and we can get to that in a second but like what I appreciate about him talking about is he was using it in in reference to uh one of his clients who had benefited from that who wanted to kind of seek a faith-based recovery that would use kind of that moral um language uh as a motivator for healing and Recovery and you know certainly would I hear that moral model of care like it hits a chord in me um that is uh well uncomfortable I’ll just put it that way and it’s certainly not a way that I choose to operate um but that doesn’t mean that my way is always right and and he did talk about that bias so like we can fall into our models of care and how we think about recovery um and become pretty attached to it but but his point of the whole overall thing was that all of these models of care have Merit as long as they’re kind of fit in uh with the appropriate client I mean that was one of my takeaways from that right I think our chief operating officer Clinton he actually brought up like it requires agility yeah on our end to be able to say this is what the client’s asking for this is how we meet them and then we can bring our model other models and I can pull on you and you who have different model approaches to help me fully see this client and meet them where they want to be met whether that be medical model moral model whatever they come from and meet them around that yeah and I think um we did do a finding peaks with Kevin uh franchiati a while ago and this like makes me think of what he said is that he went through the normal process with treatment he did the whole treatment thing right and he finally went to his family and said this is what I need I need to go do this kind of um this is going to be my process into recovery and they listened right so like where I think as an industry when do we stop listening when do we start listening when do we open up to okay moral model might work for you abstinence all the way but you know you might need a different kind of model there might be that self-medication model you know I am self-medicating because my whole self feels so disregulated I don’t know what to do with it and so being able I think it just goes into so beautifully like every individual client is going to look different and if we as a whole Peaks whatever continue to treat everybody the same then people aren’t going to get better yeah well suddenly um I think the it what feels like the most inclusive model is kind of what we are trying to embrace as an organization which is called the biopsych psychosocial um he called it spiritual we might call it experiential uh or existential sorry uh model of care thanks for it um care where we really do try to Encompass a fair amount of that like with mental health and with the body and then also with kind of that meaning and purpose component but like it does leave gaps it does um that that I think we need to be attuned to with our with our clients as well if they really need more of an AAA or or more moral model of uh care yeah well and I think even considering the medical model of some of our clients come in with disabilities and things like that and traditional outpatient inpatient isn’t actually formulated for minority populations in general and especially people with disabilities and so being able I think Peaks we do a pretty good job of being able to take what we’re working with existential all these other pieces and say okay let’s meet them here and I think that talk really encouraged me that we’re on the right track to do the right things for clients as the client wishes I think going into another I’m just jumping all over the place but another talk I went to which is incredible I wish I knew her name um but she presented on complex PTSD um and one thing that this brings up for me is diagnoses even right she kind of talked about how complex PTSD for those who don’t know actually really shows up a lot like borderline personality disorder and so a lot of people are misdiagnosed with borderline personality disorder when they have complex PTSD another thing she brought up which was just like crazy to me was that complex PTSD symptoms actually mirror a lot of the autism symptoms as well so then there’s this whole other discussion around diagnosis right if I have a client come in and I automatically say you have borderline personality disorder and I start treating that client for borderline personality disorder but they actually have complex PTSD I’m not treating them the way that they need to be treated so even diving deeper into like our diagnosis process how do we do that how long does it take us what labels are we putting on people and how do those labels affect affect their care right I think speaking to autism I have that background in autism that we speak about and having those overlap is actually scary because with autism there’s a very um typical and research way to treat that whereas complex PTSD there’s sonodus it we’re kind of figuring that out through the research now and the fear of misdiagnosing that and treating it appropriately um feels like it’s our responsibility to start to do the research and deep dive into that yeah I mean complex PTSD isn’t even in the DSM but it’s so huge within all of our clients and so how do we get more information on that when there’s not a lot of information on that how did how did she even Define complex like what makes PTSD complex a lot of it is attachment wounds so she it was really cool because she has said I’m not going to talk about trauma I’m going to talk about wounding because trauma is wounding so essentially with complex PTSD we had a lot of relational attachment wounds as children and therefore in our adult lives it’s harder to connect we might lash out more we might you know throw fits we have a hard time making eye contact we you know like all of these different things because essentially this attachment wound from childhood now has followed you into your adult self and you are just scared of the worlds everything is scary and you find your safe people but what happens when you lose those safe people um and so she really I mean she did a beautiful job at just kind of explaining how complex PTSD shows up within our clients and then also how do we treat those symptoms how do we actually just be there she that was one of her biggest things is like all my clients need is just somebody to talk to because they have so many attachment wounds in their lives that they don’t have somebody to talk to most of the time and so creating that safe space for our clients is so huge because complex PTSD is huge within Peaks I would say um yeah yeah and not just within people not just with the things everywhere well yeah yeah I think of like rupture and repair and therapy and if like we have a rupture with a client or within our staff we get to repair that and that’s part of healing those wounds and it feels scary in the moment and unsafe and insecure but when we can actually repair it it’s healing those like long-term wounds which helps us grow and be able to make better eye contacts lash out less have better connection
okay so then I’m going to Pivot back to the model of care just for a second because I I also went to a talk by Kevin McCully who was on with Brandon and I on this show um I don’t know a couple months ago I think and he um he had the video called pleasure unwoven which is uh pretty ubiquitous in the in substance use field and he he actually loves to kind of poke fun at himself for that video um and he went through kind of the bottle of care uh the medical model and how where the disease model came from for any diseases and The Germ Theory and all of that and gave all this great background um and one of the things he talked about which certainly kind of I found to be eye-opening was um kind of how little genetic predisposition plays into this that um he called it uh either like uh resilience genetic resilience so people that are less likely to become addicted or people that are a little more susceptible to it but he said it isn’t as common as you might think um and he even mentioned that um in in native people like we all think that there’s a genetic predisposition to it and he said that genetically there isn’t there there’s no predisposition to it which led him to talk about how he believes and he talked about on this podcast too but one of the biggest factors in um substance use recovery is actually just safe housing and and meaning and purpose and like that is certainly what um can be lacking at times for that uh particular culture uh for a variety of reasons and um and that’s what kind of propagates the alcohol use problem um for that culture and it isn’t doesn’t have anything necessarily to do with genetic predisposition I found that to be um really pretty interesting that is cool and something I’m going to keep talking about the complex PTSD stuff but something she kind of relating to this though is like well some of our clients will come in and be like I don’t really have a lot of trauma my my growing up was really good and then she’d be like okay well what was going on with your mom when she was pregnant with you so even looking at the in utero stuff that happens the in uterus stress and how if my mom loses her husband or something while she’s pregnant that’s going to take an effect on me even in the womb and I know that gets all like no I well he actually talked about this is the epigenetics right where it isn’t your DNA but like it’s these I’m gonna hit a picture and it’s way too it’s way over my head but yeah how like it isn’t like generational trauma and generational addiction and all that sort of thing it might not be like in our actual genes but it might just be kind of implanted in the genes and he he actually used the example of um hunger like people uh that were in concentration camps in World War II wasn’t their kids but their grandkids um had issues with diabetes and that sort of thing and they believe it’s the link to the epigenetics of people um coming out of uh concentration camps that’s crazy that is crazy well I think epgin X paired with then if mom lost her husband and now her attachment to men looks different baby’s attachment to men is going to look different and I think taking into account both of those factors we’re kind of doubling down on these things that are going to impact our attachment and our complex PTSD and then the way that we treat it another thing too is that we’ve we’ve actually been talking about this a lot too is like how do we talk about this stuff with our clients right like I think Lisa Smith one of our um she does amazing family work with reclaimed recovery really kind of talk to us all about verbiage in this big way right like okay so we have people struggling how do we put words to that show all right because if you have a woman who just had a baby and she had just lost her husband and you ask her okay what’s the plan she doesn’t know what the plan is she has a baby to take care of and a husband to grieve and so how do we even start to change like yeah this must be hard and so let’s sit together and make a plan even going into codependence right if we’re telling everybody they’re codependent you’re always telling people they’re wrong we are codependent beings we need each other to survive so when people say that codependent is a bad thing it kind of makes my screen skin crawl a little bit because we absolutely are codependent can it be harmful at times yes but then what do we call it then right we just call it like maybe uh an attachment issue instead of just putting these labels on it I mean that’s a great segue to a session at Savannah that I went to um by Dr Robert Weiss who unfortunately was sick so he had a he appeared by video which one but it was actually a great uh presentation and um it was called the myth of codependency and he actually challenges us to begin to use the word pro-dependency and really kind of relabeling like never using the word enabling just like Lisa talked about um and just really um it’s just the support because he he talked about kind of um the beginning of the term codependency actually comes from AA and the AAA big book tend to be written toward men uh who were alcoholics and then the women were the enablers and so it has kind of uh there’s an undertone to the word codependency that it is directed toward women and certainly a lot of the first books on codependency were kind of written in that direction as well so it has those underturned undertones and he talked he laid out this example of like you know like if my partner of 15 years got a cancer diagnosis and I quit my job and or I got an extra job sorry to pay all the bills and I took care of him and I took the kids to school and I did all the things while he was recovering or healing or battling cancer sick with cancer everyone would praise me right like it would be I would be put on a pedestal but when I do the exact same behaviors for somebody struggling with addiction even and mental health people call me an enabler and um and I thought that was a great every point to begin to challenge some of that that language of codependency that is meant to be kind of pejorative in a way or at least has become that I think codependency and enabling are the two words that are gaining traction with the negative connotation towards attachment and perpetuating this attachment isn’t always healthy and it’s dangerous and unsafe when in reality it’s exactly what many people need to heal is healthy safe attachment and if we can shift our language even at Peaks that we’ve discussed like shifting our language around those two words specifically to help us heal through attachment not be fearful of and cautious of well even looking about what enabling means like I think if you’re telling your mom a mom to a 20 year old not to enable her child anymore that’s all she’s done enabling is what we do we change our children’s diapers we you know we we enable them to live their lives or whatever that looks like and so if I’m sitting with a mom and I’m like don’t let him back in your house but then this mom is also sitting over here scared to death because fentanyl deaths are through the roof right right now that’s not good direction right I think we need to meet that person where they’re at like tell me what you’re feeling but I’m not going to tell you what to do because you’re going to do what you need to do but I do want to help you move through these emotions in any way I can and I think um I think you bring up such a great point and um as a parent like when when you have a baby right the baby’s fully dependent on you and then you know slowly but surely their little circle of existence begins to remove itself you know like they slowly become they get little aspects of Independence when they go to preschool and kindergarten and elementary school and go to a sleepover and like they be and have their own friends that you don’t know the parents and like slowly but surely but but then when it’s interrupted like there’s almost like a development of relationships if you will that there can be rupture in those developments where it gets kind of stuck in a place where I’m I’m caring for something that maybe should be a little bit more independent but um our words have power it turns out too and and these things um I don’t know they matter and so I did appreciate a lot of that the that new terminology well and I think teaching about boundaries gets the word enable can be removed we can say hey what boundaries do you need for you and to keep you safe and to keep you to be able to be attached to your child in a healthy way versus how do we get you to stop enabling your kid right and I think Lisa covered that so beautifully in her presentation of what does family recovery look like what does the family disease look like right family recovery is communication family recovery is saying hey I’m going to set this boundary with you and I’m going to explain to you why I’m setting this boundary to you I’m not just going to say don’t come to my home I’m going to say you know I have a lot of hurt I am still healing in my own recovery process being able to just puts words to what you’re feeling because I think we as a whole we get stuck in the content of things you did this you did this you did this and underneath it’s just all fear let’s talk about the fear because let’s stop talking about the enabling let’s talk about you’re scared and that’s okay to be scared your child is struggling and you just want to help them well speaking to the fentanyl crisis like your child could die yeah your child could not be back yeah to say like don’t do anything for them that doesn’t feel fair to ask a parent or ask someone that loves you and cares about you just to just like say no we but what does feel fair is what’s good for you what’s healthy for you to grow through that yeah Jason and I attended um so really uplifting it was really interesting and the woman presenting was was really great but it was fentanyl deaths in children and in El Paso County the rates have just like skyrocketed for fentanyl deaths in children we’re talking 15 months to 17 years old we’re not even talking the whole rest of the people that are here right and so this is a real thing that we have to talk about but we have to talk about it the right way because people are hurting and struggling and we just we need to help them not push them away yeah that was going to be the last one I talked about too is it was it was a session uh it was a medical examiner here in El Paso County came and presented literally um eight cases of children who have died in El Paso County over the last 16 months from fentanyl overdoses and she was a great presenter is very thorough and I’m sitting there like why am I here why am I listening to this but I learned some things about Fentanyl and then it it felt really important um to say this crisis is real and it isn’t out there these are these were children some I mean all the way down to 15 months old that died from fentanyl overdose um because of careless actions of course of adults around them and um that’s real and it’s it’s a real uh crisis and and to your point I think there were I think 138 deaths of the unhoused in Colorado Springs too and most of those were also from uh fentanyl overdose and um you know it just it just really hit me that this you know this disease if you will is really hitting the marginalized people or people who can’t protect themselves as well and it was a powerful uh reminder um of what we do too is that we really work pretty diligently to save lives um and I don’t really want to end this session it’s a toenail um you know all in all I think uh it is always fun to go and get around um people in the fields um I know uh we at Peaks we really are working diligently to disrupt the industry um but it’s so important to like it isn’t Peaks against the world either it’s we have to we get to hopefully lead a charge to disrupt the industry and and we can’t do it all on our own like there are so many people um that are suffering and and I think the more we kind of share ideas and have these conversations I mean we we all during talks we’re texting about how we can even keep course correcting our curriculum to make sure that it’s up to date and and doesn’t contain inflammatory language or um is kind of incorporating uh the latest research and that sort of thing which is um a fun and diligent process so um with that I I thank you both uh for joining me today um for those watching if you haven’t uh followed us yet on the social medias the Instagram and Facebook and that sort of thing please do um check out our Tick Tock account as well it’s always fun um and then you can scroll uh later and then um and then also find us on uh the iTunes Store as well so that’s it have a good one thank you