There's a Lesson in Here Somewhere
There’s a Lesson in Here Somewhere is a podcast hosted by Jamie Serino and Carlos Arcila that features exceptional people that have compelling stories to tell. Whether it’s a unique perspective, an act of kindness, an inspirational achievement, a hardship overcome, or bearing witness to a captivating event, these are stories that must be heard, and from which we can draw important lessons.
There's a Lesson in Here Somewhere
How Substance Use Treatment Has Shifted from Stale Stigmas to Compassionate Care
What does the landscape of addiction and substance use treatment look like today? What are the hidden truths behind society's fluctuating responses to drug epidemics? Join me as I speak with Lisa Ellis Gavin, a highly experienced clinical mental health and substance use clinician, who provides an insider’s perspective on the current state and future directions of the field. Lisa discusses her extensive career, detailing the journey from harsh, abstinence-only models and Wars on Drugs to compassionate, person-centered approaches that consider the mental, emotional, physical, and social well-being of individuals. This episode emphasizes the necessity of kindness, understanding, and compassionate support for those navigating recovery, making it an essential listen for anyone interested in addiction, substance use counseling, and mental health.
Lisa also discusses the dangers of fentanyl and its role in today’s drug landscape, alongside a deep dive into how drug use alters brain structures, leading to addiction. This discussion unravels the complex nature of addiction and highlights the evolving landscape of drug epidemics, ensuring a comprehensive understanding of these critical issues.
Curious about the pathways to recovery and effective communication strategies for substance use awareness? We cover everything from the benefits of CBD for medical conditions to recognizing problematic usage of substances. Lisa offers invaluable advice for parents on maintaining non-judgmental, supportive dialogues with their children about substance use. Additionally, explore the diverse and individualized paths to recovery, including therapies such as CBT (Cognitive Behavioral Therapy), Motivational Interviewing, EMDR (Eye Movement Desensitization and Reprocessing), Harm Reduction approaches, and self-help options.
Resources:
988: National Suicide Hotline
211: NJ Resource Website/Number for Housing, Utilities, Mental Health, SUD, Legal
1.844.ReachNJ: NJ Substance Use Treatment Support
SAMHSA.gov for National Treatment Locator
Lisa Ellis Gavin's website: collaborativetherapyservicesllc.com
Montclair State University Department of Counseling: montclair.edu/counseling
You're listening to. There's a Lesson in here, Somewhere, a podcast featuring compelling conversations with exceptional people. Whether it's an inspirational achievement, a hardship overcome or simply a unique perspective, these are stories we can all learn from. Here are your hosts, Jamie Serino and Carlos Arcila.
Jamie Serino:Hello and welcome to. There's a Lesson in here Somewhere. I'm Jamie Serino and we're here today with Lisa Ellis Gavin, a clinical mental health and substance use clinician in New Jersey and a clinical specialist in the Department of Counseling at Montclair State University. Lisa welcome.
Lisa Ellis Gavin:Hey, jamie, thanks for having me.
Jamie Serino:Yeah, thanks for joining us. So could you provide a little bit of a bigger introduction for yourself and go into your background and all the amazing things that you've done?
Lisa Ellis Gavin:Sure, so my name is Lisa Gavin, or Lisa Ellis Gavin. Um, I am a licensed professional counselor and a licensed clinical alcohol, uh and drug counselor in the state of New Jersey. Um, and I also am an improved clinical supervisor. Um, I currently work at Montclair State University as a clinical specialist, overseeing four of our counseling certificate programs. I also am the owner of a small virtual private practice in the state of New Jersey where I work with adults who are struggling with anxiety or trauma or that are in early recovery. So that's a little bit about what I do now.
Lisa Ellis Gavin:Background is I graduated from the same program I currently work in. I have a master's in counseling, specifically in addiction counseling. A lot of my background has been in the substance use realm, so I've worked in various levels of care, from typical detox, or what was formerly known as detox, to an inpatient short-term residential program to intensive outpatient programs, primarily in the urban environment, specifically Patterson, new Jersey. I primarily work with or worked with folks that were struggling with both substance use and mental health disorders so what we refer to as co-occurring disorders, or legally mandated or involved clients, mandated or involved clients. So a lot of my background is in that and more recently I've been getting into eye movement desensitization and reprocessing to help folks heal from traumatic events in their lives. So that's.
Jamie Serino:Yeah, I definitely would love to talk a little bit about EMDR, but to rewind a little bit, just for people listening or watching. You know, when we talk about counseling, that means like therapy, basically right. So the world kind of calls it therapy therapist, but really it's counseling, right. So if you want to talk a little bit about that, that would be interesting. But also I think it would be good to talk about how the sort of terminology has shifted away from addiction and that person is an addict to other types of phrases that are now used. I wonder if you can maybe start there.
Lisa Ellis Gavin:Yeah. So I guess, just even when we think of the evolution of the field right back in years and years and way before my time, the historic treatment of a quote unquote addict was an addict helps an addict and that's the only way that they can get better. Or a complete abstinence model Can't use drugs. Or a complete abstinence model can't use drugs. We need to break you down to build you up. Very kind of tough love, if you will. And the language being used is you're always an addict, right?
Lisa Ellis Gavin:And kind of labeling folks and keeping them in that box. So thankfully, the field has evolved and we're learning more and doing more research and understanding, but really approaching clients and people who are struggling with substance use through a more holistic wellness model lens but also thinking about the language that we're using with folks. So since the history of counseling, or specifically substance use counseling, we've seen it evolve to have more credentialing, more research, a national organization letters being licensed in it and really starting to move towards how do we help folks be successful in their ideal life. And kind of taking where we're not saying you just need to stop using drugs and that's the solution, but looking at the person as a whole, so thinking do they have what's going on mentally, emotionally, physically, socially within their family? Thinking about their education, background and their substance use currently, and seeing how do we address all of these at once. And also thinking about a person as a person, so they're not just a quote-unquote addict but they're a person who is struggling right now with the substance use concern.
Lisa Ellis Gavin:So, really starting to shift our language into a more person centered or strength based approach, as opposed to the historic um put you down, make you feel less than language that we, we used to use.
Jamie Serino:Yeah, and so, as you were talking, I was remembering a scene from Mad Men and not to make light of this. But this guy, he gets too drunk and misses a meeting and falls asleep on the couch in his office. And so they decide, all right, we need to send him, you know, to some sort of program. And these two guys sit down with him to talk to him about that and they're like we're going to let you go and you know you're going to go to this program, then you're going to come back and he's like, okay, and then they go to him. All right, scene takes place in the 50s or 60s. So that just popped into my mind.
Jamie Serino:But what are some of the things do you think? And there are many, you know. But what comes to mind? The causes for the change, the changes that have happened, these positive changes toward? How can we help this person get through this? Or how can we help them understand better why they have a substance use issue and how can we help them get through it? You've talked a lot about the biology behind it and we seem to have a better understanding of that. You talked about a strength-based approach, person-centered approach. What comes to mind when you think about well, we are here today now and it's different from decades ago. What are some of the things that you think brought us here?
Lisa Ellis Gavin:Yeah, so I think there's more acceptance and that it's not a hidden secret.
Lisa Ellis Gavin:So I think, right you bring up Mad Men that was based in like the 1950s, 1960s and thinking even just as mental health in general it's always been this hush hush type of shame or scarlet letter, if you will, and that folks would just kind of wish it away, or if we don't talk about it, then it doesn't exist. Just kind of wish it away, or if we don't talk about it, then it doesn't exist. And, however, there has been a pretty noticeable shift, and we've seen it since the 90s, in terms of just the opiate epidemic, right. So that's kind of been the thing to push substance use and substance use disorders and substance use treatment really um, evolving more quickly and becoming more um, um, trying to think of the word but, uh, becoming more acceptable or seeking it's affecting more people. It can't be this like, oh, there's all of these people dying but we're not talking about it, right?
Lisa Ellis Gavin:So with the opiate epidemic, while unfortunately we've lost so many people, and especially young folks, it did shed light on the fact that, hey, something's going on that's really affecting our youth, affecting our communities or society as a whole. And what can we do to help or fix that? And I think social media, the ability to speak on this, more platforms of this, also the funding from just not even small funding sources, but national funding sources to get more credentialed clinicians be it social workers, counselors, psychologists having more training in substance use counseling and having more accessibility for people to seek help, for people to seek help. Um, I think really we started seeing this evolution because of opiates affecting such a massive amount of folks.
Lisa Ellis Gavin:Yeah, it still does to this day and we're seeing that. That, that um, that it it you. It came from opioids and heroin to now we're seeing a lot of the overdose deaths being due to fentanyl.
Jamie Serino:Yeah, yeah, well. So, going back a little bit, I think the narrative there you're talking about because I think part of the narrative of the opioid epidemic is one of, like, the person almost being victimized by it, that, oh, I only had back pain and I tried to take this drug and then I got addicted to it. It wasn't my fault, right? And that's different from the way people perceived people during, let's say, the crack epidemic, right? Crack epidemic was those people criminals. They're doing it to themselves. You know they sort of we shouldn't help them, right? So I wonder if you could talk a little bit about that. Like you know, there's a big difference between what happened in the 80s and then what happened in the 90s and, of course, the different populations. There are people of color, socioeconomic status, and then you know white people, you know maybe middle class. There's a lot there. It opens up a huge can of worms, I'm sure, but it's part of it.
Lisa Ellis Gavin:Yeah, I mean. So you think about the war on drugs being kickstarted in the 80s and the famous.
Lisa Ellis Gavin:You know there was a bag of crack cocaine found outside of the White House and the Just Say no campaign and all this stuff, and it really was based in a systematic racism and, you know, again, kind of pitting people and things away from each other. So it was how do we, um you, continue to oppress certain people in certain groups and, um and uh, keep uh our jails or our courts or our probation, um, you know, uh working. So how do we continue this law and order or this law and punishment model? Yeah, and you know, back in 2013, 2010 ish, is when we started hearing more about the opiate epidemic and needing to do something to address this, and that's when we really started seeing more white folks being affected by the opiates, and so then it became this up in arms of white children are dying. So now we need to do something.
Lisa Ellis Gavin:So, there's a very stark difference in terms of how um we societally, um, and even through the government or through means, have addressed these epidemics. The 80s that you know the war on drugs would didn't solve the problem right. Like it's like just say no or if we can arrest and um throw people away or put them in jails, that will solve the problem. And it's still happening put them in jails.
Jamie Serino:That will solve the problem and it's still happening, right, right. Going back to fentanyl, could you talk a little bit more about that and about you know it's sort of how it came onto the scene and the dangers there and you know what you're seeing now?
Lisa Ellis Gavin:with that and so and maybe some advice or warnings. Yes, so fentanyl has been around for quite some time. Um, historically, it's been used uh as uh within the medical field for um treating uh pain, specifically thinking about terminal ill clients, um people who are dealing with um like severe cancer, you know, terminal cancer et cetera.
Lisa Ellis Gavin:Um, however, what we people started to realize is that it cause it's under the opioid umbrella that it produces a really good high. Right, People do drugs cause they like getting high. But so what they found is that a small piece of fentanyl or a small dose of fentanyl can produce a similar high to heroin. So it's cheap to make and manufacture fentanyl, comparative to heroin, and people can experience the effect that they were looking for. So, um, we're starting to see that heroin was being cut with fentanyl because it made that people were getting that high that they were seeking or searching for, and that we're going to try and get repeat customers right, Like, as a drug dealer, you want people to come get your supply and so if you're cutting with fentanyl, people are going oh, that's the good stuff.
Jamie Serino:Right, right.
Lisa Ellis Gavin:I'm not trying to like make that enticing for others, but this is kind of the thought process.
Lisa Ellis Gavin:Yeah, and so when people hear on the street, oh, this, this stamp or this specific dose, or I can't think of the word, but this specific batch, sorry, of heroin or this stamp is causing people to overdose, people are going to run towards it because that means that they're getting really high, they're getting that that euphoria that they're looking for and that they can handle it. And so what ends up happening is that people think that they can use fentanyl, that it you know the, that they know what they're doing, or they know how much they're supposed to use. But ultimately, fentanyl, a small amount, can trigger an overdose and overdose. The theory behind overdoses is is that it stops your central nervous system, so your brain receptors aren't receiving the message to breathe right or to to have your heart, to have your heart. So eventually it just becomes that you stop, um, uh, breathing and eventually that's how someone passes away from an overdose. Um and so, um, it takes a smaller amount of fentanyl to get that effect, comparative to heroin.
Lisa Ellis Gavin:And so it's cheaper to make. It produces this effect that people are seeking, and so people are going to continue to go towards that substance or want to use that substance, and we're experiencing that uptick. About 2016 is when we saw the highest rate, or really that's when the opiate epidemic was considered a public epidemic or was established as an epidemic or a national epidemic, and so the smaller amount of fentanyl is what produces the better high, which then ultimately can put people at risk of overdosing. The other thing is is that, because of how cheap it is to manufacture and cut into other drugs, it is now becoming seen in other drugs.
Lisa Ellis Gavin:So people have it cut in their Coke or mixed in their crack. Cocaine might be laced in cannabis. Street cannabis can be seen in pills of molly ketamine anything that's being sold on the street.
Jamie Serino:It might be being cut with fentanyl because it's cheap and it produces a high that people are looking for. So you, you touched a little bit on, like you know, some biological components there. You know of overdose. I wonder if you could talk a little bit about you know the biology of, you know substance abuse and you know sort of chasing a high, um getting addicted to something. Um, you know um dopamine activation. I wonder if you could talk a little bit about what's happening in the brain.
Lisa Ellis Gavin:Yeah, so substance use is so when we think about it, when you think of it, or we can theorize it as the disease of addiction, and so we have shown her. There is evidence that the brain actually changes certain brain patterns, brain structures start lighting up depending on the substance, and so you can see actual MRI or CAT scans of a brain before drugs, using drugs, after drugs. So there's an actual change in the brain. People don't actively go out and grow up and say I want to use drugs or I want to become addicted to drugs. Right, certain things, maybe through experimenting with friends, or maybe getting an injury, being prescribed a painkiller because they had their ACL torn or wisdom teeth removed or broke a bone, acl torn or wisdom teeth removed or broke a bone so then it becomes. This makes me feel good, this gets rid of my pain, and all of the things that were bothering me before don't exist when I'm under the influence, or there might be the I need to celebrate something. So why don't I go celebrate with this or that? Or I want to stay up all night. You think of even alcohol. Historically, if you're celebrating something, someone might say okay, I'll go buy champagne or I'll bring the wine. Oh, you're having a really bad day, I'll go get you a six pack, right?
Lisa Ellis Gavin:So substance use has been opiates, coke, weed, alcohol have all been used to either get rid of certain feelings or enhance certain feelings and ultimately what that does is it reinforces this effect that you're looking for.
Lisa Ellis Gavin:If you're saying I want to have a good time and you're using a substance and it produces more of that euphoria, that good time feeling. You have all these fun memories, right, you're going to go. Oh, this is going to do the same thing. So if I don't want to feel sad or mad or whatever, I can use this and it'll make me feel happy. Or if I'm feeling really down or anxious or just, you know, low and overwhelmed or stressed out by something, and I know taking a pill is going to alleviate that feeling and just let me feel relaxed or chilled out, that's going to reinforce that use where I'm going to seek maybe a Xanax or a pill of some sort to alleviate that feeling of anxiety. And so substance use ultimately can be considered kind of a learned behavior at times where it's worth learning. If I don't like these feelings, I can get rid of them really quickly through this substance so?
Jamie Serino:so then it in in the brain, then what? What's happening there? So you're talking about, you know, pushing a button, so to speak, um, a sort of of faster arrival at some sort of point that you're trying to reach, as opposed to, if I was to go do something else to release dopamine or whatever you know neurotransmitter, it might take longer, I might have to work more at it, and a substance is more like well, you know, I can just take that, drink that and and and have that effect.
Lisa Ellis Gavin:Yeah. So ultimately, if you're, you think about, um, for example, I'll just use, like Molly, mdma or ecstasy you'll hear people say you get flooded with serotonin, right. And so if you're feeling down and you don't want to feel that way, you want to flood your brain with positive good feeling neurotransmitters and brain chemicals. So you're going to say, ok, if someone's using Molly, they might say I'm going to use this because I know it'll flood me with serotonin and I'll have a great time and I'll feel happy and connected to people and everything is just brighter and livelier. And so they're going to learn that that is something that produces that effect and ultimately, their brain is learning that behavior as well. So, similar to any substance, our neurotransmitters are creating those pathways and in order for them to reach that same feeling, they might need the help of a substance, right, if that makes sense.
Jamie Serino:Yeah, yeah. So you're talking about, like underlying feelings, and so in your experience, do you find that most people that develop a substance use disorder do they have also depression or anxiety? Or we've also seen read about the correlation to trauma, experiences of trauma and things like that to trauma, experiences of trauma and things like that.
Lisa Ellis Gavin:Yeah, so I. What we do know through just research and data, is that people who have a substance use disorder are more likely to struggle with a mental health disorder as well. But as humans, I think, we all experience feelings of anxiety and sadness, uncomfortability, stress, and so it's not to say that it's a mental health disorder means that you're going to develop a substance use disorder or vice versa, but that people who use substances eventually don't like feeling sad or anxious.
Lisa Ellis Gavin:I don't think any of us do but it's also, how are we learning to manage those feelings Right? Um, someone who might have a supportive, healthy environment or, um, uh, you know different hobbies, different, um protective factors if they're feeling anxious, might be able to go okay, I know that drinking might make me feel good, but that ultimately isn't going to solve my problem. I want to reach out to a friend, or I want to draw or write or watch a movie, or go for a walk or do a mindfulness meditation, all of these things where maybe that is more natural for them to do. And for folks that might be really struggling with how to manage that distressing feeling, they're saying I need to get rid of this as quick as possible, because talking to someone right away is not going to get rid of this feeling.
Jamie Serino:So do you. It leads me to, um, you know, you hear about, uh, you know, kids today, or the younger generation, um, socializing less, or they're socializing online, um, and that might be different. Um, does that put them more at risk for developing, you know, a substance use disorder? Um, they are communicating with each other, but it's, you know, through their phone or it's through social media. They and this is just like what I'm hearing and reading through social media. They and this is just like what I'm hearing and reading they're getting together less and in your you know, practice in looking at younger people, are you seeing any impact of that type of behavior on you know, any detrimental impact there?
Lisa Ellis Gavin:So I think that we're seeing that and we really saw it during COVID, right Even, just as adults too and that feeling of isolation. So you know, alcohol use disorders increased during COVID. Liquor stores were considered essential, so they were able to stay open throughout the epidemic and you know, so people were like it's what? What do we do? Right, that isolation? Isolation can can breed substance use disorders or mental health disorders, right, like when we're alone, we can get lost in our thoughts. We can feel really disconnected. We're seeing all the things on social media, seeing people post what they want to post right, hearing all the scary news going on. So there is that sense of, yes, being connected on social media or to our screens too much can produce a feeling of loneliness and isolation.
Lisa Ellis Gavin:For some, it was really great for them and they did feel more connected socially because it was a way of staying connected to other people right well, um, I think, as humans, we just like being around people and each other, and so, um, we did see the uptick of of mental health distress, substance use disorders, when we were, for I guess, told to kind of stay away from each other, right Um?
Jamie Serino:so how about like availability, right Um? Now that we're seeing, you know, cannabis getting legalized um, are you seeing any sort of you know rise in people like abusing cannabis, or do you? There's a lot of good in in it being legalized and available Um? Are there any consequences that you think that we'll start to see?
Lisa Ellis Gavin:Um, that's a really good question. Um, so, I think that cannabis has a place in the world in terms of um thinking it through, a harm reduction lens um in terms of you know, if someone's struggling with an opiate use disorder, could cannabis help in terms of their recovery? And be more of what in terms of it alleviates undue, unneeded pressure or stress on the criminal justice system in terms of people getting arrested for a bag of weed Like 2024.
Lisa Ellis Gavin:Right, right or stress on the criminal justice system in terms of people getting arrested for a bag of weed like 2024, right, and that there's bigger fish to fry out there, in a sense. And what? Um? We're also seeing that the federal government is relooking at scheduling, uh, rescheduling, um, uh, thc. Uh, we're seeing that it can be beneficial for medical pain, for certain mental health disorders. So there is a lot of good in weed. I always go to and this is just also from my substance use lens is what's the purpose of the use behind it, right? So is it being used as a way to escape real life or is it a way to disconnect yourself or not manage or cope with certain feelings? Then maybe it's not being used in the most appropriate or healthy way then maybe it's not being used in the most appropriate or healthy way.
Lisa Ellis Gavin:So it's one thing if people are using it recreationally, because they're with friends, et cetera, but are you now becoming it's? I need it in order to manage or deal with X, y and Z, or deal with X, y and Z, and the intention behind it is so that I'm disconnected from reality. Then maybe there might be some cause for concern.
Jamie Serino:Yeah, my dog uses it.
Lisa Ellis Gavin:It didn't work with my dog it didn't and it did not work.
Jamie Serino:Well, we have to be careful with the THC with him, but the CBD helps him. He has arthritis. He's 13. He's a great dog and he has arthritis, like in his hips and you know, and it helps him. It really it's. It's worked wonders for him.
Lisa Ellis Gavin:Yeah, I mean it can be helpful for cancer patients who are dealing with nausea from chemo. It can be helpful for arthritis. It can be helpful for PTSD symptoms in terms of just difficulty falling asleep. It could be helpful for a mirage of things, but it's also. Am I using this for the intended purposes, or is this a way for me to disconnect from others? And I think really a lot of it stems from. What's the intention behind this and is it having a more negative impact in my life, or is it helpful?
Jamie Serino:Right, and so maybe there's some advice there if you could give it to like someone that maybe is seeing someone start to abuse a substance, especially a parent seeing their child and discovering that, or you seeing a friend or anyone really. And I think, going back to what we were talking about earlier, this isolation, and so sometimes it helps just check in on somebody you know, talk to them and see how they're doing and, you know, offer to go hang out or something. But how about a parent that is starting to see their child like, oh well, I kind of knew they were, you know, doing something, but now it's kind of looks like it's sliding, it's something bad. Do you have any advice for that parent?
Lisa Ellis Gavin:Yeah, my first initial is like don't freak out, that that could be a great start in like a like a kind of way of right, if you walk into something and you uh have like big visceral emotions, they can be like absorbed, and then people start like it's it, it causes more chaos, right, and what we want to do is approach this in a way of like calm, understanding, and so I think a lot of times, as parents, we have to go in and have strong boundaries and rules and expectations, and that our feelings too can get involved in this, and so everything feels much bigger. So for parents, it's kind of approaching it in a non-judgmental, supportive, concerned way, as opposed to you doing wrong and I'm going to punish you way, right, and I think that goes with anything, also removing some of our emotion from it, because when we can have emotion it can become really overwhelming to manage or ask about.
Lisa Ellis Gavin:So I would say it's really just talking to your kid with just like a curiosity and a nonjudgmental like, not the like if you tell me I won't be upset, and then you're like seething on the inside but kind of like I just want to help, I want to understand you, or I'm coming from a place of loving concern.
Jamie Serino:Yeah, yeah it it. It definitely can be stressful and, like you're saying, is emotion tied up in there. And sometimes these stories are kind of sad, like oh, my child was this and that and they did this and that, and now they're doing that and I don't know how to get them to stop. And so I think the advice there, at first trying to come from a place of understanding and compassion and the shame and the guilt you know, doesn't work. And thinking of it also like would you be angry with them if they were depressed or they had, you know, anxiety or or let's say, like an eating disorder or something like that, like it doesn't mean that it's not scary, right?
Lisa Ellis Gavin:So we don't want to um devalue that or um seem like, oh, you shouldn't have any feeling and you need to go in as a robot. But it's also thinking about how, if we were a doctor, we wouldn't want a doctor having intense emotions during a major surgery on their patient. Right and I'm not saying that you that's the way we should approach our children, right? I think you can't separate yourself from your child in terms of your emotion. But it's almost like, how do you just say for the second, like, can I put my emotions on a shelf to just be with my child and accept whatever answer they're going to give me, or give them the space to have this open conversation without fear?
Jamie Serino:Yeah, and I think that you know the like having that approach where the child feels like they could communicate. I think you know obviously you're talking about this perfect situation, but that would be the goal there and I guess you know what what. One more question in this area like you know, we were all kids and we experimented with different things and, and you know, maybe we knew someone that developed, you know an issue, and we knew other people that didn't, and and you know what's, you know cause a parent would know, all right, my child probably is going to experiment with this or with that. You know, and, and what, what is a healthy amount? And I know there's no like real answer there, but you know, and any advice for, for a parent of like, well, when, when do I need to like step in here? How, how much rope do I give my child? How much is an okay amount of experimentation? Um, you know it's kind of a wishy-washy question there, but I wonder if you have anything.
Lisa Ellis Gavin:Yeah, I think that's really individualized to the parent and their comfortability. I think not that any parent wants their child using any type of substance, but I think it's how do you engage your kid in non-substance, using behaviors or connections, so you know?
Lisa Ellis Gavin:also, how are you modeling this? So kids also learn from our, their parents. So, if there's alcohol around all the time and you know, um, the parent is drinking at every meal, a child's going to see that as a normal, acceptable behavior. Um, if a parent is smoking weed in front of their kid, their child is going to say this is a normal, acceptable behavior. And so I think it's a matter of individual for the family what's appropriate for them, getting them involved in things that are non-substance related, staying connected, right. We also see that prevention interventions are really helpful in terms of, just, you know, being connected to extracurricular activities, extracurricular activities, having the education to make informed decisions Instead of saying, no, you can't do that, and that's the end of the conversation explaining and giving the education as to why.
Lisa Ellis Gavin:Yeah, um, for example and I know this isn't apparent to child, but I remember I had a friend who told me that he liked to drink and use Xanax at the same time and I was like, oh, that it actually like equals a hundred and that, um, you're that ultimately, two downers can make it can really depress your central nervous system to the point where, um, your heart rate becomes very slow or breathing becomes slow, and people there, it's just a dangerous combo. And I remember, uh, you know, I had this as like an off cuff kind of conversation with him and like a year later, when I saw him, he was like you know, after that conversation it really changed my perspective and so I stopped drinking and using Xanax. At the same time he was like so.
Lisa Ellis Gavin:I would choose one or the other and just even giving someone the ability to have the education to make an informed decision can be, really empowering, and I think even that comes with the prevention with kids.
Lisa Ellis Gavin:We don't want to pretend like things don't exist but we want to have them engaged in things that are non-substance related, have them connected to family, friends, loved ones. But also talk about it in the sense of thing. You know, you might see friends that are doing things and you know here's what that means and here's some education about these things. I'm not saying go out and do them, but if you decide you're going to try, maybe have a conversation with me or how can we talk about this or work through it to see, hey, is this a good decision for me?
Jamie Serino:Yeah, that's great. Shifting back to something you said earlier about EMDR, eye movement desensitization and reprocessing EMDR, eye movement, desensitization and reprocessing Could you talk a little bit more about that? And there would be some people, I think, watching or listening that don't know what that is and maybe you can, you know, describe it a little bit and then talk about its use in substance abuse and substance use disorder.
Lisa Ellis Gavin:Yeah, um. So EMDR eye movement desensitization and rate processing has um is a a um uh treatment modality, um that has been endorsed um by the WHO, um and the VA in treating post-traumatic stress disorder. The VA in treating post-traumatic stress disorder, um, so it's a modality in which um the clinician um uh has the client do eye movements, so kind of with fingers or a light bar, um, we could do it with sounds or tapping Um, and what it does is and I know I'm going to mess this up and so I like apologize to my trainers at the EMDR Institute but ultimately it allows our brain to have more of an adaptive opening of sorts. I'm like trying to make this in the most digestible way possible, but it allows your brain to kind of move the past that's been sitting in your present, to move that completely into the past.
Jamie Serino:I think that's a I'm sorry to interrupt, but I think that's a really interesting way of looking at it. And to add to that, I feel like, so the desensitization part is that you know, if a person thinks about desensitizing themselves to something, if you keep thinking and thinking and thinking about something, you might end up desensitizing yourself to it or using a behavior to do that. And to me this it's it's an incredible uh treatment, because I feel like it just speeds up that process, a process that normally takes a very long time. This makes your brain do it much faster.
Jamie Serino:I've done EMDR and I know it works and I know that feeling of starting to go down the path of the thought and then not finding the path really is one way to describe it. And then the positive thought comes in and then, and then I move on. That's like one way to describe it. So it's it's like, you know, maybe I'm starting to go down that path, but it's it's just not a strong opening anymore, as as it was. And then the positive path, so the reprocessing, um, that path then is open and I go down that path and then I'm out and it's so fast, it's like I start to think it. And then I go, the positive thought, and I'm out like seconds you know.
Lisa Ellis Gavin:And so it's great that and I appreciate you sharing your experience, jamie, because it sounds as though EMDR was really helpful for you. And so there are clients that EMDR just works and clicks with and like there's some clients that are like boom, boom, boom and we're good. And that's not to say that emdr is for everyone. So it really depends on the clinician, the client, what they're working on, the openness to emdr expectations, right, um, and so there's uh, I I wouldn't say like everyone. I mean, obviously I'm a fan of it, so I'm like everyone should give it a try, yes, yeah, but also don't be frustrated if it isn't what you're expecting or unsuccessful, because sometimes EMDR just might not be the modality that works for you.
Jamie Serino:Yeah.
Lisa Ellis Gavin:And that's okay, and there's so many other thankfully so many other modalities out there that it's really about what works for you as an individual and what makes sense and what your needs are.
Jamie Serino:Yeah, I think that's an important point, because there is a whole like sort of evaluation process beforehand and point Uh, cause there is a whole like sort of evaluation process beforehand and, um, and and you know, so that helps to know, you know, could you be open to this type of therapy and stuff? And so that's a that's an important point. Um, when it works, it works, um, and then it might not work for everybody.
Lisa Ellis Gavin:Yeah, and it's not to say that there aren't things that are beneficial and helpful for folks and, um, I think it's also um, with a good clinician, it's and I would never a safety and supportive environment right, especially if we're dealing with some bigger traumas. But also, some folks just aren't interested in it or it might not be the best modality for them and they might be more body-based, and so that might be a different approach. Some people need more like black and white, like CBT, like let's map this out right Kind of. Some might need a blend of the sorts and have more of a dialectical behavioral therapy approach. So I think it really is dependent on the person and thankfully, therapy is not one size fits all and that that's the only way to go and that, um, the most important part of therapy is making sure that you have a clinician, a therapist, a counselor whatever you want to call them um, uh, be a safe, supportive person and one that you hold trust in or have a trusting relationship with.
Jamie Serino:Yeah, that's well said. You said, some people are body based, so what would that mean?
Lisa Ellis Gavin:So EMDR kind of takes into some of this in terms of like being aware of, like a body scan and where you're feeling your feelings. But if you were to do more somatic experience modality that really focuses on what's going on in your body in the present moment and kind of I guess that like more mindfulness, buddha Eastern flair of just really working through the body sensations and identifying where our feelings lie within our body and working through the body sensations and identifying where our feelings lie within our body and working through them. I don't know a ton about that modality and it's something that I don't have expertise or know too much about, but that's like the little bit I know.
Jamie Serino:Okay, it's interesting. So what are some of the things that you find to be most helpful? And realizing that everyone is going to be different. But what do you? Is there a certain type of therapy or a certain approach that you feel like works on most people, or is a general kind of umbrella?
Lisa Ellis Gavin:Um so I, I don't. I don't know if there's the right answer to that or like a definitive data supported answer.
Lisa Ellis Gavin:Um we're all human and individuals, so what works for you might not work for me, and what works for the person down the block might work for another person down the block, but not. So. We're all different and I think we all have different expectations and concerns that we want to address and what we feel comfortable in that why we seek therapy, what we're looking to get out of therapy right. There's people that might be I just need a place to vent. There's people that want to work on more deep seated, um, like internal self-awareness issues. There might be people that um are really open to, you know, really ripping back their um psyches, in a sense, and like doing a deep dive. So or there's people that are just doing it to say that they did it because that's required by probation Right.
Lisa Ellis Gavin:So everyone has a different reason for engaging in therapy, be it substance use or or mental health use or or mental health, um. What uh works best, I think is just and this is my, maybe personal opinion, so it's not facts, it's mine, uh, my thoughts is just treating people as humans, um, and that we are not just a label and I guess that goes back to an earlier question in terms of even just the word addict and the evolution of the field and um really thinking about and when we work with clients, thinking about them as a person and who they are, as themselves and as this individual, and accepting them as they are, um, and not defining them by their quote, unquote diagnosis or substance that they use or mental health concern, right. So I think the best maybe therapy is one in which you accept your client, or clients are accepted as who they are.
Jamie Serino:Okay. So there are some people that would just be like, okay, so let's say they have an alcohol use issue and they may not think to go see a counselor. They're just going to be like I'm going to stop and I'm going to go to AA, right. So I wonder if you could talk a little bit about, you know, group therapy, aa or NA, narcotics, anonymous, um cause those are all still thriving, and I wonder if you could talk a little bit about that as like a path and maybe a person does go see a counselor but also goes to AA or NA or something like that.
Jamie Serino:But there are people that I've known from the past that that's how they just dealt with it. This, going back, you know, I think today more people might think to go to a counselor, you know, and as time moves on, I think more and more people think to go to see a counselor. But I think in the past it might just be like I think more and more people think to go to see a counselor, but I think in the past it might just be like I'm going to take care of this problem. I know I can go to AA or whatever. So within all that you know sort of context. I wonder if you could talk a little bit about that path.
Lisa Ellis Gavin:So AA and NA are Alcoholics Anonymous, narcotics Anonymous, any of the anonymous groups. 12-step based recovery are helpful and great for clients, right, there are certain people that flourish and find success in their recovery in those rooms, and those rooms have served a great purpose for a lot of people, and some they are completely turned off and it's not for them, and so I guess it kind of goes back to just what I was saying earlier in the sense of, like, everyone is their own individual person and so what works for you doesn't work for me. And you know, similar to people's recovery, what works with someone's recovery might work great for another, but not someone else's. And AA and NA are wonderful areas and environments and resources for people who have felt alone and isolated by their struggles. You hear it as it is a fellowship, fellowship, and that is very much what it is at its core, right, and it's a place for people to come and have something in common Right, and have support and an environment in which they are not judged for the things that they often carry as shame or guilt. Yeah, and so some people thrive in that.
Lisa Ellis Gavin:Um, aa or 12 step recovery is not the only modality or the only place to find that.
Lisa Ellis Gavin:Um, you know, there's um so many other support, mutual self-help support groups out there um in terms of just different views or understanding connections. And so, while AA and NA are probably the most that you're going to find out in the world that have the most amount of meetings worldwide, you can go on a cruise and find a meeting. You can go to any continent and find a meeting. I think the fact of the accessibility in terms of virtual meetings has allowed for more accessibility for non-12-step-based meetings to happen. You have online forums, facebook groups, different websites, apps now that really allow for more connection and support for a substance-free life if that's what someone's using running or harm reduction life or looking for different um connections. But I think the biggest part and the biggest um benefit of all of this and it goes kind of back to that, that um notion that I mentioned earlier of the isolation this is about connection. Like the opposite of dark is light, the opposite of isolation is connection, and that's really where we find a lot of that support and resource for folks.
Jamie Serino:Yeah, yeah, and I guess you know a positive of social media, or a positive of, you know, being able to go online, is you can find those groups of people and can connect with them and know, like you're saying, know that they're out there and know, like you're saying, know that they're out there, yeah, so a person doesn't feel alone. Yes, and I'm amazed you know at how many of these groups there are and how often they meet, mm-hmm, and you know, in one respect I think, oh, wow, there are many more people out there with these issues than we all probably imagine that. And then, oh, it's great that there are these support, you know systems out there for people like that, and you know you brought up a substance free life, I think. I think, if those were your words and that brings me to like how difficult it is is because you know we live in a society that's pretty much everywhere you turn there's maybe an advertisement or just a liquor store, or now you know you walk down the street in New York City and you're just constantly smelling cannabis and so we're surrounded, and so it takes a lot of strength for a person to live in our society and not use right, and if that's what they need to do, because you know, I've heard, you know some stories.
Jamie Serino:This one gentleman was saying he hadn't drank in 20 years. He retired. He thought he could have a drink at his retirement. He had a drink and it led to a three or four week binge. He couldn't stop himself from drinking and health issues and everything. And you think how powerful that is. That one drink did that and I think that's helpful for people to understand how difficult it is, if a person does have an issue, um, to make the right decisions and to live in our society where you're constantly tempted and constantly constantly being triggered, um. So I wonder if you could talk a little bit about that and any you know advice you have for people any either you know dealing with that or to help people understand more like that a person may be going through something that you know um, who, uh, okay, um, so I think, um, uh, one of the strongest things and most courageous things people can do is say I need help.
Lisa Ellis Gavin:So seeking help is probably. I always tell clients like the, the really showing their strength and courage to to identify what your goals are so I can tell you in terms of what, like you know, textbook and data and DSM and ICD and all those like fun clinical stuff suggests, but like that's not real life all the time. Um, you, and again, individual, you are a person, you are your own being, and what works for you might not work for me and similar in someone's recovery, and so defining that for what it is and what works for them, and so that really takes away this like a black and white of what recovery should be and really puts it into you get to create that for yourself. Um, for some folks it's medicated assisted recovery or medications to treat opiate use disorders or medications to treat alcohol use disorders or being on, you know, mental health medication of sorts to help with anxiety or depression. To help with anxiety or depression.
Lisa Ellis Gavin:Um, it could be, I'm going to continue to use, but I'm not going to use um uh substances that I haven't used uh, the fentanyl testing for or that I'm not going to use, without having, um, someone with me. And so right, everyone's recovery and what that means to them is their own personal choice. Obviously, our ultimate goal is for, and we hope, that someone can live a substance-free life, in terms of what that means, and that they're not continuing to use drugs that put them at risk. But it's all at their discretion or their decision, and so again, giving them agency and autonomy to make that choice and supporting them without judgment.
Lisa Ellis Gavin:So I think that really goes to someone's recovery journey and how they get there and what it means for them. And then I know there was a second part of your question and I can't remember.
Jamie Serino:It's kind of a rambling observation that led to a question. Yeah, I mean I think that was very helpful. Yeah, I mean I think that was very helpful and it just was. You know, like I said, I have this wonder about amazement at how difficult it is for a person and living in our society, where you're just constantly tempted and surrounded by all these things that know, all these things that you know, drink, this take that you know, and so it just it's very difficult.
Lisa Ellis Gavin:Yeah, and I and now, like thinking about it too. I'm thinking about even some clients that are like I just don't want to have anxiety anymore. And it's like, well, you know, we all don't want to have anxiety, but we want to minimize that as much as possible or have the tools to deal with it. Should you experience it? And I know just thinking about some clients getting really frustrated in the fact that it's like I've come so far but I'm still experiencing it, or I still have moments of and it's like that's a reminder that you're human and it means that there's room for improvement.
Lisa Ellis Gavin:that's a reminder that you're human and it means that we there's room for improvement. But look at how far you have come.
Lisa Ellis Gavin:And even just thinking back to that story that you shared of that person who was sober for 20 years, decided during his retirement he could have a drink.
Lisa Ellis Gavin:For some folks, recovery is a daily practice. It's something that they need to make sure that they start their day every day with how am I staying sober today? And the classic line that you'll hear in rehab or rooms rehab, short-term in treatment is while you're doing push pushups in here, your addiction's doing pushups outside. You know, like it's just um, it's something that unfortunately can't just disappear from your life, never to be thought about again, but that's something that is to have moments of self check-in. And is this, um, a decision that I want to make or a decision that I don't? But also that if someone does decide, after 20 years, to have a drink, that doesn't mean that they're throwing away their whole life and all of that time that they might have had, or knowledge and recovery. It's something, maybe that's something that you shouldn't toy with. And how can we make sure that, if that thought pops up again, learning from this experience?
Jamie Serino:Yeah, yeah, and as you were talking there, I think it was making me think that it is a daily management of something, and I think that's what led, or leads, people to believe. Well, it's like an illness and so that's like the illness model, but we've kind of moved away from that, right.
Lisa Ellis Gavin:Well, I think if you wouldn't tell someone who has diabetes that they don't need to take their insulin or their medication or watch what they're eating or just and it might not be something that they have mind where it's if I don't take my medication for a certain amount of time, then I might be risking a flare-up or having, you know, my diabetes like unmanaged diabetes, and so we have to almost take that same kind of thought and notion with mental health, with substance use, and it's not that it's every day. That's like this forefront of I need, like checking off that I took my medication or did my daily whatever, but it is something in terms of just being aware and knowing that you have to navigate life in that with that as a thought. And I know for some people it's really frustrating because it's well, people, it's really frustrating because it's well you can't you just stop and it'd be done and over with and that's it Right.
Lisa Ellis Gavin:No, we wish but no Right and unfortunately, it's not that it's not that easy or that solution, and it's not just this flipping of, you know, a switch.
Jamie Serino:Right, yeah, it is that understanding and I think more and more people have it that oh well, I drank, or I drank, or I tried this, or I tried that and I didn't develop a problem. And we kind of talked through all the reasons why that type of thinking isn't accurate. So is there anything I didn't ask or anything that you want to add at this point?
Lisa Ellis Gavin:you know, the only thing I guess I would add is just, you know, be kind to one another.
Lisa Ellis Gavin:Yeah, know that, uh, there's a lot more going on underneath than that.
Lisa Ellis Gavin:Um, yeah, like I said before, the opposite of dark is light and, um, we do walk around with a lot of baggage or shame and guilt about certain things and that, just if someone is reaching out to you and saying you know I have a problem or I'm struggling with something, is to not have that initial visceral reaction of, but to how to be supportive. You know, if this is something that you think you would be good at, obviously it's like, think about maybe exploring a counseling or a degree or something, and so a shameless plug of Montclair state university department of counseling, no, yeah, but that the need for licensed clinicians is, is, very is is needed. I mean, we're seeing that in terms of just data. And if we are looking at the need for more credentialed clinicians to help clinicians to help, um, unfortunately, it is a field that it there's people that need the help and, um, our ultimate goal within our field is to put ourselves out of business. But, um, you know, I think, um, you know, just be kind.
Jamie Serino:Yeah, that, that. That definitely helps. That's a good approach and we know the suicide hotline is 888. Thank you, and are there any other sort of hotline type, numbers or websites that you would recommend?
Lisa Ellis Gavin:So in the state of New Jersey you can call 2-1-1, and that's kind of like a resource for, like housing just is the Substance Abuse Mental Health Service Administration. So that's S-A-M-H-S-A. They have a treatment locator to help you. Just type in your zip code and it'll bring up all the treatment options around you. And then I wish I could, and if it's substance use related in the state of New Jersey and I might get this wrong, but I think it's 1-844-REACH-NJ and that's to be connected to resources to help find a treatment locator should you need substance use treatment. Not to say that they wouldn't help with mental health as well, but it's substance use related, not to say that they wouldn't help with mental health as well but it's substance use related.
Jamie Serino:Yeah, okay, yeah, thank you, and then people can find you like Google you or like.
Lisa Ellis Gavin:Yeah, you can Google me. No, so you can find me on LinkedIn under just Lisa Ellis, my, my uh and uh, you can uh find me my some more information on my website, uh, collaborative therapy services LLCcom. That's a mouthful Um. Or also at Montclair state university website. You can look under the department of counseling. You can learn about all of our faculty members, um members and our department as a whole.
Jamie Serino:And yeah, those are some. I'll add some of that to the show notes. People, of course, can contact me, but there are a lot of different ways to reach you. Lisa, thank you so much for your time. All this wonderful information.
Lisa Ellis Gavin:It was a lot of fun. Yeah, it was Thank you yeah, thank you again Okay.
Jamie Serino:Thanks everyone for watching and listening. We'll see you next time. Thank you.
