Addiction, Family Dynamics, and 40 Years in the Helping Professions

Hello and welcome to therapist voices at ReachLink. Uh Reachink is a digital mental health counseling platform. My name is Jessica and I oversee our network of providers. Today we are joined by someone I am again very excited about. Tim Logden um is a licensed mental health counselor in New York. And Tim, we have actually overlapped in previous worlds in the counseling field. Yeah. Um, so I was very excited to see your name when you joined Reach Link. So, thank you for being here. Um, we were going to talk a little bit about addiction today and how addiction is impacting families, loved ones. Do you mind telling us a little bit about how you got into into addiction work? Yeah, for sure. For sure. So, I've been in business for about 40 years in the helping professions. I got my start way back after college uh working for social services and I worked with kids and even back then even though the the focus was on children addiction was you know in many of the households that we saw.

We didn't know that always going up front but it would it would become clear that there was some kind of addiction going on. So I started out in social services, transitioned over to working at a mental health clinic and did that for about 10 years and then right over to the addiction field at little bit of a at that time there was a separation between mental health and addiction. They were seen as two separate things and they kind of are now still too. We have uh the the professional offices of mental health, we have the offices of addiction but they are now merging a little bit more together which is more appropriate because there's a lot of crossover. So I've been doing this for a very long time working with families and uh done some inpatient work uh as an administrator. I've done outpatient clinic work and then now I do mostly private practice where I help families that I get a lot of calls from say a a mom who has a son who has addiction issues.

That's probably the number one call I get. Sometimes it's a wife or her husband and uh but it can be any family member or friend. Wow. So you really you got into it. I now that does make sense how you started with with kids. Do you do any work with kids alone now? You do? I still do like addiction is my main thing that I do but I just regular anxiety, stress management, anger management, kids and adults. I also do couples therapy that doesn't involve addiction. So, it kind of pull across a gamut of a couple of different levels of the more traditional mental health, but also the addiction field as well. I want to ask you something that I feel like you are probably asked all the time or people who specialize in addiction are probably asked all the time. So, pardon the cliche, but talk if you could a little bit about I know in this world now with everything digital, with everything video.

I assume a lot of this has changed a lot with addiction, specifically within within families and maybe how how families can help someone who who is going through addiction. Can you tell us a little bit about about what you've experienced especially in this new era that we're in? That that's interesting because when you first start I didn't know you were gonna ask that question but I didn't either. It just came out. It it kind of took me back about gosh really about 20 years or so where I was at some kind of a training and it came up that all these kids that we're in Western New York here in Buffalo. I'm in Buffalo anyways. Um, but we had a training about these kids in University of Rochester, how they were all failing out. These were our best and brightest kids and like they did great in high school, but then they got to college and they failed.

And the reason was because they were um spending so much time on the internet and the the internet would become this addictive cycle for them and they would put off their work. They'd stay up all night. they wouldn't sleep. And and it prior to that I believe it or not, none of us had really thought of the internet as an addiction. This is going back a ways. You know, we knew drugs, we knew alcohol, we knew sex, and even then gambling wasn't as as prevalent uh in gnome. So nowadays though, I know that's not your question, but it took me back to No, please, please. This is perfect. Yeah, absolutely. It can it can pervade our life. You know, cell phones, there's a lot of good to social media. There's a lot of good to our cell phones obviously, but then there's that other side of it. But your question is more about how we do therapy kind of like this how we're doing the teleaalth and and that is um that's fantastic for me as a family counselor because again I'll usually get a call from someone who's concerned about somebody else, right?

So I I'll talk to that person. We might have sometimes the two of us in the room, but then I will talk about, well, let's bring in the aunt or let's bring in your brother. And at first people are like, what are you talking about? I don't want to do that. But a light bulb does turn on, especially for family members or friends where, hey, I I'm not alone here, but I feel like I'm alone. So, it's just me and my husband or it's me and my son or whoever it is. And and it's very common because When we talk about parenting, I always define parenting as you do the best you can with great intentions, but man, you make a lot of mistakes, you know, and you learn from your mistakes. Well, when you're trying to parent or you're in a relationship with someone who has addiction, that just gets just multiplied like just beyond belief where you just don't know what to do.

That's my point is as a parent, nobody you don't go to any classes usually. You don't have to be certified. You just do the best you can do. And same thing happens with addiction and it gets very very difficult with that without knowing what to do. But anyways getting back to your question. So I will try to bring family members in and sometimes you can't get everybody in the office together which is nice but you just can't. People, you know, might be at different uh cities. They might have different um schedules and all that kind of thing. So, I'll do like the the Brady Bunch kind of thing where you have like an aunt and a an uncle and a cousin and and we all kind of get together, do a little genog of sorts. Yeah. Exactly. Exactly. So, it's really um opened up a lot of opportunities for us to be able to do tellaalth.

That's really interesting because I think I feel like when I asked that I was thinking in my head like oh gosh all the challenges but that is not at all I mean not not at all but some yeah sure but that's not what what you're speaking about and I think that's so such a good reminder that not everything is oh gosh we can't do this we can't do that But getting people in the same room, yeah, is is different now. And and it even transfers like so much more just everywhere. So, traditionally when I'm working with someone with addiction and they start to come around to uh what we call the the contemplative phase or even the taking action phase where okay, I'm ready. Maybe I do have an issue. I want to do something about it. It would be common to ask them to go to in-person Alcoholics Anonymous or Narcotics Anonymous.

That can, as you can imagine, that can be very scary. That can be very intimidating. Now, we can do this where, hey, you can log on and you can go to a meeting. You can even, you know, have your camera turned off where no one can see you if if you're embarrassed about it. And that can be a nice way to introduce somebody to, you know, what are these meetings? What goes on there? I really don't want to go in person, but at least I can do this and and it's a a safer way to do that or can feel safer. That is really interesting because I feel like I many years ago I joined a family member at an AA meeting and I remember thinking what about as they're going around the room I remember thinking what about people who are just not ready to be in person like this is me head to toe. You know, I know it sounds silly, but do you I guess I should probably read up on the research, but has has attendance in in self-help and step meetings, that kind of thing, has that significantly increased?

You know, I don't know the scientific answer to that, but from my experience, and I'm pretty blessed. I work with so many hundreds and hundreds of families. In my experience, there's much more um attendance that way. there's much more of a it's almost like a gateway. It's an introduction get into the meetings and and I'll again it's common for you know the person to not want to go and definitely not want to go in person. So going online does make it a little bit easier and I would assume and again on my experience it does show that that it does help and it increases that attendance there. And you know also we have things that just I don't know where you're at but last week we had this terrible weather where you just couldn't get around. You couldn't go anywhere. So, hey, I can't go to my meeting, but I can go online, you know, to a different meeting.

And and that's another thing, too. There's limitations obviously in person, whereas right now there's probably a meeting going on in California or Hawaii or somewhere that I could log into where maybe in person they're just not there. That's amazing. I mean, that is at least something good that has come out of where we are now. For sure. Do you when I was picture when you were saying the Brady Bunch thing and I was picturing you know all the squares, the first thing that came to my mind was and this might sound a little bit ignorant so forgive me but is there more of like an intervention feel when you're doing this? I don't know if that makes sense in on video. Is it more is there more of a feeling of you know all of a sudden everyone's here they all are saying all these things. Is that Yeah.

Yeah. That's a really good question Jessica. So let let me answer it in a couple different ways. I'm glad you knew what I was talking about because I wasn't even sure as it was coming out but it's just what came to me. Well hopefully I do. Hopefully I got the message. You'll hear my answer and we can tailor it if it's not where you want to go. Right. So, um, the interventions are a part of what I do. I try though to make those always the plan B. I I I try to put those as like the last resort. Um, but but it's it's interesting because, you know, yeah, that that feeling about everybody's here for me can be very intimidating. I mean, there's already, as you know, there's a lot of shame and there's guilt already attached. person already feels that the person might feel less than a piece of garbage.

You know, I hear that or you know, um so when you have everybody else around, it's opening up this kind of thing. So, um it's an interesting question though because here's what you might not know. When I do get a call from a family member, they will they will have this understandable kind of plan in their head where here's my 21-year-old or whatever. He really needs help. He's going down a bad path. We've tried everything. Nothing works. So, can I bring him in and put him in your office in front of you? You know, and and I've done that kind of thing, especially in the inpatient programs and the outpatient clinics where, you know, you get a 9:00 and a 10:00 and an 11 o'clock. you get all those one after another. The problem with that, that's kind of an old model where the person's in front of me, it's one-on-one.

Okay. To your point, it's not as shameful, it's not intervention e, but the problem is is this thing called motivation, right? So, each person with addiction is at a whole different level of motivation. Some people are highly motivated. I myself, I call myself an alcoholic and an addict. I'm highly motivated to stay sober. I do what I need to stay sober, but not everybody is that motivated even though mom or uh the loved one is 100% motivated. So answering your question in a long way is my ideal situation is first to do just maybe a one-on-one. So it's either me and mom without the person or me and mom and dad without the person, okay? Or me and the wife or the husband. Then we expand out a little bit of family and we start bringing all those people into that Brady Bunch a lot of times without the person that has the addiction.

And the reason for that um and and you might have heard this the listeners might have heard this idea about is addiction a disease or is it a choice? You know there's been a debate about that and historically it's been looked at as a choice. You know just stop. All you got to do is just stop. You know you don't need to see a doctor. You don't need any medicine. just pull up your pants, your big boy pants, you know, and go on. Sounds lovely. If only I know, right? Um and and now we know that it is a disease, but it also has this element of choice as well. Okay. So, this this argument between these two kind of things without the person um in the room, we get an opportunity to talk about that and to talk about the lack. A lot of times it's a lack of motivation. the person will do anything to avoid rehab, anything to avoid AA meanings.

Leave me alone, get off my back. You know, I I got this under control that this kind of a denial. That's a very common early stage, if you will. But I say early that can last for decades, that early stage, right? So, when the when I have everybody in the room, a lot of times that person's not there. And what I do is I teach the family how much they unintentionally will be affecting their loved one. I I like to do this thing called a vcurve. So the vcurve means that any opportunity that I have to talk to my loved one. I am either helping them to get better or I'm helping them to get worse. And a lot of times we do the best we can and we help them to get worse if we don't even know we're doing that. That makes some sense. Yes. It really does. And what so what do you when you recognize that? Do what do you do?

Like what as as you as Tim, what do you do you bring that to their attention? I I can imagine feeling very defensive as the family member like, "Wait a second. No, I'm not doing that. I just love this person. I just want them to get better." Again, people are Everybody's so different. You know, we're all different and we're all the same. But a lot of people will do just what you were doing when I was talking is they start their heads are and I see you're getting these understanding this is enabling and people will be like I know I'm an enabler. You're right. I know I am and I know I don't know what to do about it. That's really more of the reaction I get is I recognize that I do my best and somehow I'm helping him get worse. But that's that says something about you though as the therapist because that's not easy as I I imagine as just a person.

It's not easy to say, "Oh my god, I know I'm an enabler." It's it's really not. It's then I guess then you get into all that, you know, all the family system, all that that other stuff. But does that typically do you find that it's well wellreceived? I guess you really are setting the stage and you've got that that rapport. Exactly. And and it's a it's a buildup process. It's an education really. I do a lot of teaching, a lot of education. People start to put the pieces together when they look back on everything that they've tried again. I hear this so often. You know, we've tried everything and nothing helps. We've gone to five rehabs and as soon as he gets out, he starts using again. The system doesn't work. You know, this doesn't work, which is understandable because a lot of it doesn't work, right? because of a lot of reasons.

So, as we start putting all those pieces together, family members do start to get this putting it together in their own minds based on what they've seen, based on what they've done, and what they've tried. Right. But everybody is different. And to your point, sometimes people don't want to hear that. And that word enabling has is can be really uh what's the word? Like offensive, you know, for some people. But I I I think that take the word out of it and instead if you can if you're able to do this to look back and realize what am I rewarding with my loved one without even knowing it. I call this unintentional rewarding but also unintentional messaging. It's a lot about communication. You know, I I had a call just before this when I got on, and I can't give away confidentiality, of course, but it was a situation where um one family member could clearly see how the other family members were helping the person get worse and it could create this conflict, right?

But the other family, not obviously, we're not ever trying to do that on purpose. We're never trying to make anybody in a worse place, but we do that and sometimes it's hard to see that. It's a long answer. I don't know if I even answered your question. No, you did. You did. It's such I mean, what a web. Addiction is extremely complicated. And to be the the professional that is navigating all of that is, I can only imagine quite quite complex. You you were going to ask a question earlier and you said you know forgive me for this because the question I get a lot especially from people that are a little bit removed is they'll say how do you work with those people you know h how do you those people got to love got to love that people with addictions can be there's just so much variability but almost always really good people just like people without addictions that are really good people right so but I I that question always takes me back a step to say, you know, it's not so bad.

And it's actually very rewarding. Good. I hope that's talk about a moment to educate and and bring awareness to someone that might not know and when you see the person get better and then you see the family starting to be like it's just like this weight lifted off and there's this relief and there's this joy. Uh and it's just that's so rewarding just to see that. so rewarding. Something that keeps coming into my mind is that I know I know that you have a lot of experience in the EAP field. I do. How I sometimes feel like addiction, you know, is so um doesn't fit into the necessarily into the, you know, the short-term solution focused. How do you because it sounds like you have such great knowledge and experience with these intricate situations. Is it really hard to when you're dealing with EAP and you've got a limited number of sessions and you're assessing and referring, is it hard to go back to go back and forth between the two?

M you know it it it because so say say I get somebody like I just got a referral the other day with three they only get three visits with me that's all there is but usually you know a lot of EAPs will give five some of them nowadays will give 12 but e even in that scenario there's multiple follow-ups afterwards so a lot of the EAPs will give additional sessions whether that's another three or whatever uh most people are able to transition either over to insurance coverage for that fourth or fifth or 13th visit or whatever it is. Some people will pay cash out of pocket. That's that's actually a pretty big chunk with a lot of therapists uh because of insurance. Sometimes people don't even have insurance, you know, or their their deductibles can be just so high. But there's always an option. And I I will um the other part of this I guess is I'm not the only thing out there, right?

So there's when somebody's able to transition say to AA, they have that support there. Uh for the family members, we have things like Smart Recovery, we have Alanon, we have Narinan where you connect up with other people that are as supportive as a therapist is too and and sometimes that can be a really good match. So I I don't see it as like an end, but I just see like there's just all these branches and it just depends on which way is the best fit for the family to go, right? Do you do you see a lot of with your EAP cases, do you see a lot um do you see a lot of clients end up longterm that that transition to longer term? Yeah, I I do a lot addiction is a lifelong illness, right? And it's in some ways you could almost think of it as maybe one of the best ones would be like diabetes where you you are um I was going to say dependent such a bad word but that's what they say you know dependent on insulin you need to have that that insulin to continue or you might need to have some kind of ongoing therapy but but the the nice thing I think about this is that it doesn't just have to be insulin right so for people that are using opiates a lot of times we do transition over to an MAT, which is something like Suboxone or Vivitrol or some kind of a of a medication that helps that person return to normal functioning.

But there are some people with other drugs and even with opiates that can go and transition into some kind of a lifestyle change that really might involve things like exercising, um getting to the gym, um getting to uh the self-help meetings, obviously church for some people, right? Some people that's a really good thing. For some people, they they don't relate to that. But there's a there's all these other ways of managing the changes in our life that do, as you say, become this long term. But it doesn't just have to be counseling. You know, that being said, I have some people that will come and see me once a year, you know, or once every three months or or once a month, you know, just depending on what they need or not at all because they don't need that anymore. Right. Right. So, so many options.

The the the field is so wide open. So much help is out there. Um, you know, we have the big push now with our the the the political uh establishment that we have is now pushing to change how addiction is looked at, which is probably a good thing. I'm not sure how they're going to do it, but we we My point is it's not the only game in town. You know, you don't have to just go to rehab. You don't have to just go to AA meetings. There's all kinds of things out there, especially if you know about that. A lot of times I'll tell families, I mean, almost everybody's heard of AA, right? But not a lot of people have heard of reformers unanimous or set free or celebrate recovery or smart recovery and those things you you you fit better into a certain area depending on who you are as a person. Not everybody fits in a right.

Does that make sense? Absolutely. That's something. And I don't think I even knew how many avenues there were. And I have I've thought to myself before you know what if this is not for someone? Yeah. What if what if the steps are not Yep. Because they're not Is that okay? Is that all right? It's very all right. You know, there's options there. And I think I was just kind of playing off that idea of long-term Yes. therapy, right? Doesn't have to be this kind of a thing. It can literally literally be finding your passion in life, finding something that helps to lift you up. There's the concept, we get too detailed, but there's the three circle concept, which I really love, where you have this, it's like a bullseye, this outside circle and then a smaller circle and then the little tiny one where in the little tiny one you'd put the drug or whatever we're trying to stay away from.

But in this outside thing, therapy can be anything that just helps me with self-care and to be a better uh version of myself. It doesn't really matter what that is. It can be a passion. It can be teaching. It can be re-educating yourself. But it's something that keeps me away from that inner circle, right? That um doesn't have to just be this kind of therapy like this. That that makes it all seem very very hopeful. Which actually full circle brings me when we were talking about, you know, what should we what should we chat about here? You mentioned I think at least twice you mentioned hope and in like my education and training it has always seemed to come back to hope and you know what do you have as if you don't have hope what what is there if that's not if that's not an option is hope a hu a big part of h of your work with your client like I told you to say that because we did it.

We didn't talk about that. But that's exactly right. I I think about that sometimes about how really a big part of my job is just showing people that there is hope out there and and my job as a therapist is going down which road is going to help this person to find the hope that is there. But really, you boy, you nailed it. You really are perceptive to pick up on hope is what I do. I'm an eternal optimist. when when I'm handed a problem, I will find a solution. And I especially um I think I do really well when people say we've done everything and nothing works. And and that's where I come in. And that was that was like the first the first thing that you said today that and that really resonated with me because I think so many that's what we hear, you know, when people are calling in for services.

I've tried everything. And I think for you to meet people there is it's in itself so reassuring that like you've heard this before. We've got things to we've got things to try. There are things. Yes. And I think that really is unique to to families or friends who have somebody that does have an addiction. It does feel hopeless. It can after you just try so many things. And again, nobody trains us how to do this. No one trains us how to be married to someone who has an addiction. So, we do the best we can. You know, it becomes a learning scenario where you ask your friends, you ask your priest, you ask your you ask your counselor, you you try to find help wherever you can. And once once you start feeling that hopelessness, that despair, um it can be tough. It can be tough. That's a hard place to get out of.

I think, you know, when I've felt hopeless in my life, that's when I've felt like, oh my gosh, what what is there? You know, what what's a reason to wake up? What's a reason to want this to improve if I don't have any hope that it can get better? And I just think that the way that you seem to frame things is very is very hopeful. Well, thank you. I appreciate that. And that's the feedback that I get. So I it's one of the things that keeps you going, you know, it's like why do I keep on doing this thing over and over and over again? That's one of the things that helps is when you get that feedback. I imagine that I mean you don't even have to tell me that that's the feedback that you get because just having this conversation, not a not a counseling session has made it very clear what you exude, what I imagine you exude.

If you're doing it here, then chances are you're probably doing it a million times more in your sessions that I'm with you. I'm here. I mean, I'm the one who's supposed to be interviewing and you're making me feel better. So, I think you really got something here. Jessica, you just made my my day. Thank you so much. It's a good way. It's very It's very early still. Do you do I don't mean to open up a whole a whole can. I would actually I plan on asking you if you'll do this again anyway. So I'll just say it for everyone now. I will be I will be asking for a followup a part two but I wanted to ask you if you do a lot of other other addiction work right when you started talking I was I w was brought back to my days of AOL right when all that started quite a number of years ago and and I was I mean I don't know if I was addicted to it but I sure as heck couldn't stop leaving the dinner table as a sneaking off into my room to to get on there.

Do you do I know that was a silly example. Um well, not but that was just my own example. Do you do a lot of um a lot of gambling addiction? Do you do a lot of of other types of addiction or are you more No, it's it's it's open. So we we call you know the traditional substance abuse, alcohol and drugs um is the other side of that would be what we call process addictions. process, okay? Or behavioral addictions to use those two terms are synonymous, but they do include trying to rank those like in my head where probably sex, pornography are really up on the top in my experience and even in some of the literature will show there's just so much of that that goes on which is it's almost hard to separate that from like I feel like it's the same thing when you talk about internet addiction because a lot of that uh sexual acting out happens on the internet or starts on the internet.

Right? So, there's this whole line in my my head here about that being like kind of like the number one process addiction or behavioral addiction. Obviously, I shouldn't say obviously it's tends to be more male oriented in that not completely right. um may maybe really is a separate internet or um like uh not tellahalth but social media even phone addiction you know let's say and then gambling gambling is a really big problem in our country I particularly don't see a whole lot of patients that way but I know there's a lot of them out there and I think maybe the reason I don't is because there's a lot of good help out there right now if you you watch you watch the Super Bowl you watch anything you know the these commercials about whatever the betting apps are. Right at the bottom it says, you know, call this number.

So, it's really well advertised, but that is a a big process addiction as well. And then we have well, food addiction. I I I laugh about that because don't we all, you know, I think all of us really have had some experience with food and the addictive nature of food and there are a good um amount of people that seek therapy just for that reason. you know, I can't control my eating. I I was that the term there's like a the snacks at nighttime where, you know, they just go from one snack to another to another to another, that outofcontrol feeling. And we again long term, we have things like uh food addicts anonymous, overeaters anonymous that are on that same 12step model um that that can help with that. So, what did I miss there? Maybe money addiction. I have a I have a question to ask you.

Yeah. Is when we talk about um like meetings for for food for food stuff like an overeaters or a binge eating. Yeah. I went to a meeting once many years ago for binge eating. Awesome. And I I went to one meeting and I was I always wanted to go back. I wanted to see if there were other other options available, but I got very turned off because I went to this meeting. It became very clear to me that we weren't allowed to talk about to name foods. And all I wanted to do was tell everyone how nervous I was to come and how I had eaten a box of cupcakes in the car outside that very meeting. And I was kind of admonished a little bit that I I couldn't say cupcake. Wow. I know that came out of left field, but you're really doing a number on mine. It's more I'm reacting more to the advice and what I'm reacting to is like the really the differences in how meetings are run.

Okay. So you and I've had experiences like that too because again I'm an addict so I've been to like Overeaters Anonymous. I I like to check them all out you know and to see what I get help from anything you know. Um, but I had a similar thing happen at overeaters where it was clear to me after the first meeting that regardless of what you thought you were coming in here for, you can't have any sugar or flour. And and that wasn't like really what I was going there for and it was really very militant style. And that's what I'm reacting to is that you'll have like I don't think that's the norm. You know it most meetings tend to be very warm and welcoming and they give you the chance to empower yourself with if you want to talk about cupcakes that's do that but there are some of these time some of this is personalities right you just get the the wrong person in there who becomes leader and and um and then they go off maybe on some tangents and I I shouldn't even say that's always the case because there probably are some meetings that are pretty strict in what they do, right?

But but that's too bad, you know, because that does tend to turn us off when we're, you know, really put into a box, if you will. Absolutely. And, you know, I do I do remember now I left with so I left with a cucumber. I left because someone there had brought things from their gardens to like not have us eat cupcakes. So, I got home with this cucumber and I said, "Mom, I went to my meeting. I've got this cucumber. Like, do you want to make a salad? What do we do? I had cupcakes in the car, just so we all know. But now I've got a cucumber for us. God bless people. You know, I was about 16, but I'll never forget. Oh my goodness. Oh.