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This is the second in a series of posts introducing the individuals who make up Driftwood Recovery’s community of caregivers.

Through these wide-ranging conversations, you’ll get a chance to meet most of the people on Driftwood’s team—from its executives to its care coordinators. You’ll learn about the programs they facilitate, and about the paths that brought them here.

In this post, Kuraĝo editor Matt Williamson talks with Consulting Psychologist Stevie Stanford.

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Matt Williamson: I’ve been told by a few people who have been your clients here that you have some amazing insights about trauma and attachment disorders. But since you’re the clinician at Driftwood who specializes in sex addiction and love addiction, maybe we should talk about that first.

Stevie Stanford: Ah, but the interesting thing is, is you can't really talk about sex addiction, love addiction, toxic relationships, without addressing attachment trauma.

MW: How do you define “attachment trauma,” then? It’s at the core of Driftwood’s treatment philosophy, but a lot of lay readers probably won't know what it means, or what an “attachment disorder” is.

SS: “Trauma” is not just shorthand for the pain from events like car accidents, sexual assaults or combat. It can refer to any negative experience that alters your trajectory, changing the way that you see the world.

Maybe your third grade teacher stood you up in front of the classroom to do a math problem, and you messed it up, and he shamed you. And from then on, you thought that you were terrible at math, you didn't like going to school, you tried to avoid seeing that teacher. You might have a problem with bald guys, because the guy who publicly shamed you was bald.

Oftentimes those smaller things have a big effect. And when you tell people about what you’re feeling, and you aren't validated, it becomes worse, because no one's there to nurture you and help you heal.

I once heard someone say that “attachment trauma” results whenever a primary caregiver is non-nurturing. That's a pretty drastic definition, and I don't know exactly how I feel about it. But I like to look at things on a continuum, and I would say that the continuum of attachment trauma begins with any non-nurturing behavior from a primary caregiver.

MW: But every parent on earth does things that are not nurturing. Are some of those traumas things that we just cope with, or deal with, during childhood, while others linger and become disruptive?

SS: Right, right. And surviving traumatic experiences can make us more resilient. But there are other traumas that we never quite wrap our minds around; we don't understand why they happened. To explain them, we tell ourselves: “I'm not worthy of love.” “I'm not deserving of compassion.” “I'm not good enough.” And as we move through the world, when bad things happen, we're like: “Oh, there's more evidence to put in the file.”

MW: Can you get more specific about the kinds of non-nurturing experiences that can change a person’s self-conception?

SS: A rupture during childhood can be perceived as abandonment, which is highly traumatic. If a parent has an affair and leaves abruptly—“see you later”—that’s a significant rupture of attachment, obviously.

But sometimes a rupture can happen because mom gets cancer and dies. A little kid may lack the cognitive ability to understand: it wasn't that mom wanted to leave. That child may develop some negative cognition that they carry into the world.

MW: So every child has one primary caregiver? Is abandonment by a parent less traumatic when that parent is not the primary caregiver?

SS: It would depend. Studies have shown that there needs to be some sort of attachment, attunement, with a primary caregiver. It doesn't have to be mom, it doesn't have to be dad; it might be grandma, grandpa.

I had a client whose parents were both drug addicts. He didn't have a close attachment with either one of them. But he had grandparents in his life who were phenomenal role models, who showed him how to love and how to connect. And so he was able to develop those skills himself.

MW: A person might say, “Well, such-and-such happened to me, and it was no big deal. Don't be so fragile." And maybe it wasn't a big deal for that person. For someone else, though, it was a life-shattering event.

What are some of the features that turn what is ostensibly the same experience into something that's deeply traumatic for one person, but forgettable, even meaningless, for another person?

SS: There are a number of identified factors that impact the effect that trauma has on people.

One of the first factors is age: the younger you are, the more impact it will have.

Another is preparation. If parents are going through a divorce, and are able to tiptoe into it and talk to the children about it, it may feel less like an earthquake.

And another factor is the degree of responsibility that the person feels for the trauma. If you think, for example, “the reason that I got raped at the college party was because I was wearing that short skirt,” the harmful effect of that even may be more significant.

Of course there are many other factors, but those are three that come to mind.

MW: Most people who go through severe trauma don't have access to any sort of therapy. What do those people end up doing?

SS: I would say, first, that everyone has experienced trauma to some degree, and everyone out there numbs. Whether the numbing strategy is binge-watching Netflix, or gorging on cookie dough, or injecting heroin, there's some way that we try to numb the pain from the experiences that we've been through.

When numbing comes from substances, alcohol or drugs, it's easy to get addicted. And it’s even reasonable to become addicted, because the drugs work—they numb the pain of those emotional wounds—until they stop working.

But there are also “process addictions”—when you're addicted to food, when you're addicted to sex, when you're addicted to love, when you're addicted to exercise.

Notice that all of those are things that we generally want in our life. We want sex, we have to eat food, we like to be able to exercise.

When a person has an unhealthy relationship with alcohol and drugs, a therapist might recommend abstinence. But when the problem is a process addiction, it can be more complicated. A therapist can’t say “don’t do that again.”

MW: “Don't ever eat.”

SS: “Don't ever love again.” That's not going to make for a very fulfilling or enriching life. Something that we say here at Driftwood often is that we don't want people to survive in sobriety; we want them to thrive.

MW: How do you help someone figure out whether they've got a process addiction involving sex?

SS: It's tricky. There's an ongoing fight between people who believe that sex addiction is a thing, and sex therapists who believe that the idea of "sex addiction" is inherently stigmatizing.

I’m unusual in that I'm both a sex therapist and a sex addiction therapist. I’m interested in helping my clients find shame resiliency. On the other hand, when I meet a client who comes in and says, “I keep cheating on my wife. I'm seeing prostitutes. Because of this, I'm losing my money, losing my job”— this starts to track closely with the diagnostic criteria for addiction.

MW: What’s the difference between “sex addiction” and “love addiction?”

SS: My favorite way to differentiate the two is to talk about the end goals. So let's say we have—and this is going to be gender stereotyping, but I'm going to go there—let's say we have a 25-year-old male over here and a 25-year-old female over there. And they each have had ten one-night-stands in the last two weeks. What are their end goals? Oftentimes, the male is using love to get the sex. The female, meanwhile, may be having sex in order to get the love.

Looking at what the person’s attachment style is, and looking at some of the trauma they've experienced, helps give me an idea of what the person’s end goal is. When it comes to sex: when you're having orgasms, you're getting dopamine pings. It's hitting the same parts of your brain that drugs and alcohol hit. And so you can get addicted to that feeling.

MW: What is a love addict, then?

SS: A love addict is somebody who loses himself or herself in seeking relationships with others. So as soon as they meet someone, they feel an intense connection. I see love addiction happen a lot when people don't have a strong sense of self. And so they get into relationships and the relationships make them feel worthy, feel like they belong. Maybe you’re just a regular person moving through life, and then you fall in love with a punk rocker, and all of a sudden you're a punk rocker, too.

MW: If you're vulnerable to this sort of influence, and you happen to fall in love with the right punk rocker—less Darby Crash than Joe Strummer, say—could everything turn out fine?

SS: As long as there's still some sort of differentiation, as long as you are each able to remain separate. Otherwise, we fall into a thing called codependency.

Driftwood is an attachment-based program. The goal, however, isn't just for people to form "attachments and relationships." We want them to form meaningful attachments, healthy relationships.

It's Veterans Day, which means that people all over the US are posting and tweeting messages of gratitude to military service members.

If you support veterans, however, keep these facts in mind during the 364 days of the year that are not Veterans Day:

Fewer than half of returning veterans in need of mental health treatment receive any care. Around 40,000 veterans sleep on the streets on any given winter night. Veterans are at heightened risk of developing substance abuse disorders, which often co-occur with depression and post-traumatic stress disorder.

A new study reports that veterans "are at ground zero of the [opioid] epidemic, facing an overdose rate twice that of civilians." 44% of veterans return from combat service with chronic pain, which can contribute to heroin and fentanyl addiction.

Inadequate access to long-term mental health treatment for veterans is part of why the suicide rate for veterans is 50% higher than the civilian suicide rate.

Earlier today, Karie Fugett published a moving piece in Vox about her husband's suicide. "Shame and isolation," she writes, "killed Cleve as much as the fentanyl. If [you] want to help veterans . . . address the stigma surrounding addiction and invest in more policies and programs that not only help them with pain but secure their futures even if they do have addictions or are in recovery."

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Nobody, whether they've served in the military or not, deserves to be homeless, to be deprived of access to counseling, or to be excluded from society because of a substance abuse disorder. This stigmatization just seems more galling when it's directed at people who are in crisis specifically because they did the things we claim to honor.

Encourage those close to you to treat people struggling with addiction, economic insecurity, or mental illness with compassion and respect. They're not separate from us; they're our family members, our neighbors, and, in many cases, the people we honor on Veterans Day.

PBS Newshour ran a piece this weekend on a topic that isn't given enough attention: the inappropriate, but increasingly common, use of jails and prisons as "treatment centers."

Sam Weber tells the story of Robin Wallace, a Massachusetts woman who petitioned a court to "involuntarily commit" her opioid-dependent adult son, Sean. The judge did "commit" Sean, but not in the conventional sense; the state essentially incarcerated him, depriving him of access to methadone and keeping him in solitary confinement in an environment "supervised by corrections officers," leaving him "sicker than [he'd] ever been." A year later, faced with the prospect of returning to jail, Sean took his own life.

In 2016, Surgeon General Vivek Murthy released a report affirming the expert consensus that addiction is a "public health crisis," not a moral crisis. This article in The Atlantic, which discusses Murthy's report, describes many of the monetary and human costs of policymakers' stubborn insistence on treating sick people like criminals.

Once substance-dependent individuals are in the criminal justice system, they may never get out. (See, e.g., the much-publicized case of Meek Mill, whose teenage misdemeanor drug arrest kept him in and out of court for fifteen years. At one point, when Mill was in his early thirties, he was given a years-long prison sentence for "violations" like riding a dirt bike.)

In recent decades, policy solutions like dedicated drug courts have gained remarkably broad support as a humane way to treat substance dependency. In this 2017 Pacific Standard piece, however, Maia Szalavitz reports on the dangers this "half-crime" approach poses, particularly to young people and people with co-occurring mental disorders. A disturbing episode of This American Life explored the risks of giving judges near-total control over the lives of drug-dependent people.

Former drug-court judge Morris Hoffman, writing in The North Carolina Law Review, describes not only the danger and inefficiency of punitive approaches to addiction, but their Heller-esque absurdity:

"[Drug courts'] unstated central assumption is that modern treatment modalities are so effective that if a defendant fails them three or four times, it must be the defendant's 'fault,' and that particular defendant therefore must be one of those 'volunteer' addicts against whom the sword of the criminal law may morally swathe and not a truly 'diseased' addict. We compassionate judges can then sentence that defendant to prison, smug with the knowledge that our experts, by the simple device of offering treatment a certain arbitrary number of times, can separate the diseased from the criminal . . . But of course this whole approach is a charade . . . [If] addiction is really a disease, then the most diseased defendants are precisely the defendants most likely to fail many, and perhaps even all, treatment attempts. Drug courts thus may be performing a kind of reverse moral screening—those defendants who do not respond to treatment, and therefore may be the most diseased, go to prison, while those defendants who respond well and whose use of drugs truly may have been voluntary, escape prison."

Nevertheless, drug courts now exist in all fifty US states, and Canada is preparing to double down on its use of the criminal courts to deal with problems like fentanyl addiction.

As Sean Wallace's case illustrates, the use of police officers as drug interventionists, and corrections officers as drug counselors, is not merely unhelpful but dangerous, at once preventing individuals in crisis from getting the help they need and exacerbating their crises. Asking a prison to function as a licensed drug treatment center is, as Robin Wallace memorably puts it, "like trying to teach a snake to knit."

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Pedro Almodóvar's new Pain and Glory is rare in a number of ways.

It explores substance abuse and addiction without sensationalism or tragedy. In that sense, it's nearly the opposite of a movie like Trainspotting, which glamorizes heroin for an hour and then shifts into insincere-moral-panic mode for thirty minutes.

Pain and Glory makes distinctions between substance use, substance abuse, and substance addiction. It acknowledges the physical aspect of addiction without reducing its characters to addicted brains. As Stanton Peele notes in Psychology Today, Almodóvar's movie presents "work and purpose"—we could also say "attachment"—as essential in recovery.

As the title suggests, it's also a movie about chronic pain, and about the relationships between pain and addiction and between pain and attachment.

The movie's protagonist, Salvador Mallo—a legendary Spanish director whom we understand to be an avatar for Almodóvar—is, to use his own word, "paralyzed" by cluster headaches and back pain. This chronic pain has separated him from the creative work that was his primary reason for being. When we meet him at the beginning of the movie, he's fairly isolated. A gallery is interested in borrowing and displaying his art collection; he declines, referring to the paintings in his home as his only friends.

Salvador is not dependent on street drugs like cocaine or heroin, but we see him mashing up a daily cocktail of pharmaceuticals, which includes painkillers. These drugs allow him to better endure his solitude; they don't restore his freedom.

Early in the movie, the 30th anniversary of one of Salvador's 1980s classics prompts him to reach out to a former colleague, Alberto, with whom Salvador had a much-publicized falling-out.

Alberto is a high-functioning heroin addict: maintaining a successful acting career while struggling to manage his use of a drug he can't seem to quit. (When Alberto gets a new stage role that he values, he vows to stay sober while he learns and plays the part.)

We learn, later, that it was Alberto's heroin addiction—his inability or unwillingness to be sober and focused on set—that caused the professional rift between Alberto and Salvador. And heroin dependency, we will discover, is what destroyed Salvador's relationship with another man, Federico, who was the great love of Salvador's life.

Alberto and Salvador collaborate on a stage production entitled Addiction, which tells the story of Salvador's doomed relationship with Federico. As Salvador and Alberto rebuild their friendship and creative partnership, something else is happening: Salvador—perhaps feeling that he has nothing to lose—begins experimenting with, and then increasingly relying on, heroin.

All three of these men, then—the director suffering from chronic pain, the actor, and the director's absent ex—have important, but different, relationships with heroin.

Some critics have written that Salvador is creatively inspired by heroin. That's debatable, but the film, by the end, explicitly positions Salvador's heroin use as the alternative to healing, attachment, creation.

Pain and Glory's portrayal of recovery is optimistic: for one character in particular, maintaining sobriety is difficult and continuous, but enriching, work.

Even the description I've given ignores important dimensions of the movie, like Salvador's relationship with his dead-but-still-very-present mother. In his childhood, she was his fierce advocate, seeing and valuing what was unique about him. In adulthood, his sexuality made him unacceptable to her; he tells her in one flashback sequence: "I failed you simply by being as I am."

Salvador, then, is trying to reconnect with his community, and to become sober and productive, while coming to terms with chronic pain that may worsen with time, and while trying to make sense of his abandonment by the two most important figures in his life: the mother who didn't want a gay son, and the boyfriend who chose heroin over him.

For obvious reasons, Pain and Glory should interest anyone interested in addiction and recovery. Those themes aside, it's a beautifully constructed, affecting film. It's drawing a lot of comparisons to Fellini's 8 1/2, another great memoir of filmmaking, but it reminded me more strongly of Ingmar Bergman's best movies, like Winter Light and Wild Strawberries, in which reflective, intelligent people grope in the dark for meaning, and try to form lasting and valuable connections with other people who are as damaged, anxious, and confused as they are.

The performances are note-perfect—in particular the lead performance by Antonio Banderas, who has always done his best work with Almodóvar, a director Manohla Dargis rightly calls "a genre unto himself." Its excellent Alberto Iglesias score and its bright, colorful production design make Pain and Glory a movie worth seeing on the big screen, if you get a chance.

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This is the first in a series of posts exploring the various ways that addiction and recovery are represented in popular culture.

Today, Kuraĝo editor Matt Williamson discusses the Blake Edwards classic The Days of Wine and Roses with Lauren Walther, LCSW, LCDC, Director of Driftwood’s Courageous Family Program.

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In October 1958—25 years after the end of prohibition, and 23 years after the first Alcoholics Anonymous meeting—CBS aired a live performance of JP Miller’s teleplay The Days of Wine and Roses.

Directed by John Frankenheimer—who would go on to fame with movies like The Manchurian Candidate and Seconds—and featuring a cast led by heavyweights like Cliff Robertson and Piper Laurie, The Days of Wine and Roses was an early example of “event television.” (The Criterion Collection would include a recording of the telecast in its Golden Age of Television box set.)

Four years later, Days returned as a high-profile theatrical movie, with a Henry Mancini score, an Oscar-winning top-40 theme song, a bigger director (Blake Edwards) and a much bigger star (Jack Lemmon, who would get the second of his eight Oscar nominations for his performance here). Last year, this version was added to the National Film Registry of the Library of Congress. (Its fellow inductees included Jurassic Park, My Fair Lady, and another movie that we’ll probably get around to discussing on this blog, The Shining.)

On TV and in theaters, then, The Days of Wine and Roses was a major hit. More significantly for this blog, it was the last of what sociologist Robin Room has called the “alcoholism movies”: a 17-year run of post-war films, beginning with The Lost Weekend, that were centrally about substance abuse.

Unlike the temperance plays and slapstick comedies that had come before, these movies used the term “alcoholism” and even depicted Alcoholics Anonymous meetings. They signaled a generational shift in thinking about addiction. Often written and directed by AA members, they boosted the rise of 12-step programs and the adoption of a more humane way of speaking and thinking about alcohol dependency.

Although we’ll include a spoiler warning at this point, the plot is fairly simple:

Joe, a PR representative, meets and woos Kirsten, a secretary at his San Francisco firm. It’s a double seduction: he tries to win her affection, and also tries to convert her into a drinking buddy. (Kirsten is initially repulsed by the taste of alcohol, but likes chocolate, so Joe entices her with a chocolate liqueur.) Joe and Kirsten marry and have a child (though the daughter, unfortunately, feels more like a prop than a three-dimensional character). In short time, Joe and Kirsten have become compulsive drinkers: withdrawn from society, unable to hold steady work. They try, and fail, to get sober on their own. Joe finally, and successfully, turns to AA for help. Kirsten, however, does not give up drinking; the movie ends with her estrangement from her husband and daughter.

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Matt Williamson: What does The Days of Wine and Roses get right about addiction and recovery? What does it get wrong?

Lauren Walther: This was my first time seeing this movie and I was stunned by how much the movie gets right. Generally, I am dissatisfied with how movies dramatize the addiction and recovery process (which I'm sure we'll get to as we put out more of these), but this movie is pretty spot on!

The progression of alcoholism from fun "it makes me feel good" party-time lubricant to devastating life-destroyer was exquisitely portrayed in the deterioration of their physical environment, social circle, personal value system, and physical form. Ugh, some parts were hard to watch.

Similarly, on the recovery side, the characters' reluctance to accepting that they have this illness—the blow to one's sense of identity and the social stigma associated with accepting the label of "alcoholic"—continue to this day. Additionally, the starts and stops of "drying out" and getting into recovery all felt very accurate.

I particularly loved the scene where Joe's button falls off on his way into the AA meeting: the self-consciousness people feel when they're connecting with people in a vulnerable and authentic way in early recovery was wonderfully captured in that moment. The way AA meetings and AA members are portrayed in movies generally makes me want to cringe. According to most movies, AA is a gathering of blowhards and sad saps who say contrived catchphrases to one as a form of support. The illustration of AA in this movie was closer to the actual experience—a gathering of normal people with alcohol problems sharing what they know about the disease and how to live differently. Maybe the actors were all just better than who they normally get in movies these days, but I appreciated a more accurate portrayal for once.

MW: It's got a lot of memorable imagese.g., an early shot of Joe holding a cocktail to one cheek and his phone to the other, as if he's literally propping himself up with booze. I also enjoyed all of the black-and-white Bay-Area cityscapes.

One interesting factoid about this movie: its director, Blake Edwards was, by his own later accounts, heavily dependent on alcohol and drugs at the time he made it. He got sober a few years after making this movie. And Jack Lemmon was, for decades, a "three-martini lunch" guy. He was arrested, once, for DWI. Later in life, he quit drinking and began to refer to his drinking problem as "alcoholism."

Some people in recovery talk about "the yets" –"I haven't been arrested yet," "I haven't gotten divorced yet"—as rationalizations for continued drinking. The ultimate "yet" might be "I haven't been put in a straitjacket yet." Most alcoholics, obviously, never end up in straitjackets, banging their heads against padded walls.

Do you think this movie exaggerates Joe's "rock bottom" moment in a way that reassures viewers that they aren't alcoholic?

For me, the moment when Joe trashes his father-in-law's greenhouse while looking for a hidden bottle is terrifying enough. It's clear, at this point, that Joe's addiction is destroying the things that matter most to him, causing him to harm the people he loves, making it impossible for him to keep his promises. When the movie intensified Joe's crisis by moving the action to a sanitarium, I was surprised.

LW: This is a great question because the movie allows us to view the progression of the disease of alcoholism. (Substance use disorders are considered progressive illnesses, meaning that they worsen without intervention or treatment.)

That rock-bottom moment at the asylum was the only moment where I was like "whoa, this is a bit much," but then I reminded myself that back in the day that's exactly what patient care looked like. Historically, they also didn't think of drug and alcohol issues as something that required medical treatment, so it was much more likely for the illness to progress into its later stages where folks are much more severely physically and mentally compromised. Approaches to treatment have been improved, so thankfully we catch substance use disorders in their earlier stages now. However, it is still accurate that folks experience multiple hospitalizations on their road to recovery.

So there may be some viewers who recognize themselves in the early stages of the progression like "yeah, I get into fights with my partner about my drinking," or "I scared my kid that one time," but they can differentiate themselves by saying, "I haven't lost multiple jobs," or "I'm not gnashing my teeth at the asylum." This is where I'd tell folks to look for the similarities rather than the differences. If a person is connecting with some of those early stage warning signs, it couldn't hurt to explore one's relationship with substances with a mental health professional.

MW: Do you have any ideas about why Joe is able to admit that he is an alcoholic, and seek help, while Kirsten is not?

LW: That is the question and I'll tell you up front there's no clear answer. There's a scene where Joe is asking his sponsor why he and Kirsten became alcoholics when other people drink the same, but don't become problem drinkers. The sponsor responds, "It's a lottery and you lost." That's not a satisfactory answer, so Joe presses: "Well, how?" The sponsor later says, "How many strawberries does it take to start an allergy? And which one gives you the hives?" Unfortunately, science hasn't gotten much further in answering the question why certain folks develop substance use disorders and why some folks' behavior looks problematic, but they're able to stop eventually.

The conundrum is similar for recovery. We do have data about risk factors and protective factors. For example, a person who has a family history of alcoholism, a history of trauma, early drug experimentation, and lack of parental supervision might be more likely to develop substance misuse issues. However, someone with this profile may not have any issues at all. Factors that influence a person's recovery include changes in someone's neural circuitry and brain structure (which we can't check, we just know that substance misuse causes brain changes), length of time in treatment and supportive relationships.

People's biologies and life experiences intertwine so uniquely, it would be impossible to tease out all the factors that contribute to the development of substance use issues or factors that support recovery. As folks get into recovery, I think it's valuable for individuals to construct a compassionate narrative about their understanding of their disease. As a clinician, I can make one up with some pretty educated guesses, but it's much more valuable and impactful for people to do that for themselves.

MW: A Driftwood alum recently mentioned to me that his parents used to beg him to stop “partying” so much. "Please, stop with the constant partying." His substance abuse was, at that time, solitary and isolating; he was surviving the day until he could get back to his apartment and be alone and drunk again. It wasn’t much of a party! In the beginning, though, his drinking had part of his rowdy college life, and my guess was that he had been a well-liked “character.”

The Days of Wine and Roses charts a similar trajectory. In the beginning, Joe is drinking with colleagues and clients and models on a yacht. On their first date, he and Kirsten are sipping Brandy Alexanders in a swanky bar. Later, the two are hiding together in a bedroom at her father’s house, drinking straight from the bottle. By the end, Kirsten has separated herself even from Joe, and is alone in a motel room.

LW: That's one of the most stunning features of the disease of addiction, in my opinion. We call it a "disease of isolation," and that plays out in a few different spheres. Unlike some other illnesses, the symptoms of addiction are behavioral as well as physical and psychological. On the surface, the behavioral component looks like a person turning into an unreliable selfish liar, which tends to deteriorate relationships, but underneath the surface something much more neurologically complicated is happening.

Even if people have loving, supportive people in their lives, like Kirsten has with Joe, the substance hijacks the brain into making a person think that the substance is needed for survival. That survival instinct is where the anti-social behaviors stem from—a person will do anything for the substance because on the brain-level it feels like life and death. The bottom line is it's hard to be in relationship with someone who considers substances their primary attachment. Simultaneously, a person gets sucked into their own personal shame vortex in their relationship with themselves. Unmet goals, poor self-care, social snafus, legal consequences, disappointed friends and families are just a few of the things that might contribute to some intense self-loathing. Sometimes a person "in their cups" doesn't even want to be around themselves anymore. So common sense says, "well, just stop drinking," but this disease doesn't operate on the common sense level. Breaking up with substances is much like breaking up with a toxic person, which is excruciating, especially if that person had become your whole world.

This is why we're big on getting people into community and into a lifestyle that fits their values because we want folks to heal those parts of the brain that have been hijacked. Healing happens by turning away from the relationship with substances and building relationships with actual people, which also helps us heal our relationships with ourselves.

This is the first in a series of posts introducing the individuals who make up Driftwood Recovery’s community of caregivers.

Through these informal and sometimes wide-ranging conversations, you’ll get a chance to meet most of the people on Driftwood’s team—from its executives to its care coordinators. You’ll learn about the programs they facilitate, and about how their work serves Driftwood’s overall treatment philosophy. You’ll learn about the various paths that brought them here. And you might also pick up a useful book or restaurant recommendation.

In this post, Kuraĝo editor Matt Williamson talks to Peter Fluor, who co-founded Driftwood Recovery in 2016 and is its president.

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Matt Williamson: So, you studied business at USC. And I know that you went on to work in real estate, and in oil and gas. I guess I'm interested to know, first, how you ended up making this seemingly radical career shift, becoming president of a residential treatment center in the Texas Hill Country.

Peter Fluor: It begins with my own experience in recovery. I became an active addict when I was in college, and I struggled with substance abuse for years after that.

A big part of the reason that I drank and used drugs is that I felt trapped in a certain trajectory in my life. The direction I was taking didn't feel true to me, but it seemed like the world was telling me I had to go in that direction. I don’t mean that any one person was pressuring me—it wasn’t just my parents, for instance. It was more a general sense that everyone around me, from my family to my peers—even my teachers—expected that I’d have a certain kind of professional life. But that life wasn’t what I had envisioned or hoped for myself.

At some point, as you mentioned, I was working as a financial analyst for an oil and gas company. And I was actually having a rough time. I felt some guilt about the fact that I was in that job, because I hated it, and other people would have killed to have it, and they could have done so much with the opportunity.

But then then I got into treatment, I got sober, and things started, inevitably, to change. I worked as a raft guide for a while! I got my real estate license. But ultimately, I still wasn't feeling fulfilled.

MW: I was just listening to a radio interview with the anthropologist David Graeber on this topic: the way a lack of meaning at work can erode our sense of well-being.

I talked recently with someone who had backed away from a career in medicine to work in experiential education: designing ziplines and ropes courses. When she first told people that she was making this career change, someone said: “so you’re going to teach kids to play kickball?” Obviously, that description was meant to diminish her work. But even if she really were “just teaching kids to play kickball”—that strikes me as a beautiful way to spend a working day. You’re doing something that’s fun, that makes people happier and healthier, and you get to see the result of your work every day.

PF: When I was working in real estate—where I definitely didn’t feel that I had found my calling—I was talking a lot about this kind of stuff with a friend of mine. This was someone who had helped get me into treatment. He was the owner of an adolescent program called Newport Academy.

I was sharing some of my frustrations about work, my sense that it lacked purpose. And during those conversations, I was remembering that I had always been drawn to helping people. This goes back to my time at St. John's School, where the upper-school students do 36,000 combined service hours every year. It’s ingrained in you that giving back to the community isn’t something you do on the side; it’s supposed to be a central part of your life.

But it took me a long time to make the connection that you can help others full-time and also make a living. You can run a successful business that exists to help people.

At some point, my friend said: “just come work for me at Newport.” You used the phrase “radical shift.” And, yeah, it was a dramatic change. I took a 60% pay cut, and I was at ground level in a job without a lot of glamour, working with people in treatment. And I was the happiest I had been in my life.

MW: You were working directly with the kids?

PF: In a variety of roles, yeah. I was a recovery coach. I did some tutoring in Newport’s day school, and then I was in an operations role.

Almost immediately after I arrived at Newport, I knew: I want to start a program. Of course, I didn't really know how to do that. But I knew some fundamental things that would be really important.

The most important thing was to find the right people, and to create an environment where those people were valued, where they felt challenged, and where they could grow—and be held accountable, too. To me, that was the fundamental idea behind Driftwood: curating a staff, and a staff culture, that was second to none, in any treatment program. If there’s something that truly sets Driftwood apart, that's it.

MW: I talked to Jason Donoho [Driftwood’s Culinary Director] yesterday. And it was clear that when he was hired, he felt—to a degree that surprised him—that he had a free hand in designing the menu and the overall dining concept for the facility. He felt trusted to act with autonomy. And when I was talking to Connie Cole and Ryan Potter over in the Wellness Center, I got a similar impression: that both of them have a lot of freedom and a lot of responsibility—and that they respect and trust one another. If Ryan has a big idea—even a counterintuitive one—Connie wants him to give it a try, because she knows that he’s a brilliant guy, and also that he’s someone who’s going to act responsibly and compassionately.

PF: What you've observed is kind of the hope and the dream for me. Oftentimes, people in leadership roles want to dictate everything: to over-manage or micromanage. Our goal at Driftwood was to assemble the most capable people we could find, and then harness each person's strengths to create an environment where their best can come out.

Once you hire someone with the highest level of expertise, you have to cede some decisions to them, celebrate them when they need to be celebrated, and have the challenging conversations when those need to happen. We try and stay away from shaming any staff member—or resident, for that matter. We want to treat each other the same way that we want to treat our residents and alumni, and the same way we want residents and alumni to treat each other.

From my perspective, Driftwood’s success isn’t measured only by the experience that the resident has here. It's also about the experience that the staff member has. That's how you create the proper resident experience. Everyone at Driftwood is part of our community, however they arrive here.

MW: Could you talk about some of the ways Driftwood’s approach to treatment is unusual?

PF: I do want to say, in the spirit of what we were just discussing—giving people autonomy over their respective areas—that this is Brad Kennedy's area. Brad is a great resource for anything on this, and honestly can talk about it much more eloquently than I can.

But from a really high level: there are a lot of treatment programs that are a little bit . . . black or white. They take one specific approach. A treatment program might just be a 12-Step program, for instance. In that case, most of its programming revolves around 12-Step recovery. There are programs that are much more heavily clinically driven. And there are programs that are, you know, wilderness programs, experiential programs. The awesome thing about a lot of those programs is that they can do their particular things really well. The downside is that if they get somebody in their care who isn't responding to their particular treatment style, then that person is not going to benefit as greatly as they might somewhere else. In the worst-case scenario, you might have someone who’s trying to get sober, but is in an antagonistic relationship with the treatment program.

At Driftwood, we have a multifaceted approach to treatment. Our clinical team is established. I would say that it’s the best clinical team in the state of Texas, and one of the best in the country. So the clinical programming is really good. At the same time, we do a lot of experiential stuff. And we emphasize learning through action, rather than just learning through reading or listening.

We do try to foster a recovery lifestyle, and a big part of that, for us, is the 12 Steps. But most importantly, our program is about teaching people how to take concrete actions that will help them work a program of recovery.

All of these things that I’ve described, when you do all of them really well, simultaneously—create a unique, comprehensive treatment experience.

Just to be clear: we wholeheartedly believe in, and will always advocate for, 12-Step recovery. But if somebody is not vibing with that—if they're averse to it for some reason—there are a lot of other ways here to help them engage in treatment. And we may end up helping them work through some of those barriers that are preventing them from engaging in 12-Step recovery.

MW: Driftwood’s physical campus is pretty remarkable. I’m an Austin native, so maybe I’m not the most reliable source, but I think this part of the Hill Country is one of the most beautiful places on Earth. And the architecture here has a kind of serenity that matches the surroundings.

PF: A wonderful lady named Robin Garrison designed this place. She transitioned it from the ranch houses that used to be here to the property that we're on today. Robin modeled it after a spiritual center she had visited in South America. The idea was that it would be a bed-and-breakfast, a wedding venue, a retreat, and so on.

But she was more in love with the process of building the place than in going on to run it as a hotel. So when it was put to her that this might be the perfect site for a residential treatment facility, she loved the idea. It’s almost as if, without knowing it, she had built this place for us. I don't want to put words in Robin's mouth, but I think it’s safe to say she feels that way.

We love this location. But I want to add that I don't think treatment should ever be compared to a spa-like experience.

Going through recovery, no matter where you do it, is one of the hardest things you will ever do. And probably the most freeing thing you'll ever do.

So when I talk about the property, I always say it's the cherry on top. It's an added bonus that we get to do this work in such a beautiful setting. But the meat and potatoes—the heart and soul of the program—is the staff, the community, the culture. The work that’s done here, the programming, is the important piece.

Vice's 2016 documentary Fentanyl: The Drug Deadlier than Heroin is full of disturbing scenes, but one moment early in the movie is especially memorable.

In this scene, a young man has come into a publicly funded treatment center asking for help with his addiction. His desire to get sober seems genuine and urgent. A staffer explains to him, however, that before he can begin the program, he must stay sober for at least five days: he has to find the "willpower" to go through withdrawal while he's alone, broke, and possibly homeless.

After he pleads his case and loses—"five days" is a strict requirement—he seems to check out of the conversation, to give up on the idea of entering treatment, at least for now. (In the next scene, a different person tells the filmmakers that he would "rather die than go through the pain of the withdrawals of these pills.")

"But it's only five days," you can imagine somebody complaining. "How hard could it be to not take pills for five days?"

***

I asked Driftwood's Medical Director, Dr. Rey Ximenes, to explain why a person addicted to a drug like fentanyl often won't just do the prudent thing and lay off for a while.

"I have a favorite analogy, actually. So there’s this cup of coffee on the table here. Let's imagine that I told you to take a sip of that coffee, and you didn’t want to. If you felt strongly about it, you’d refuse."

"Now—what if I took a .45 out and pointed it at your head and said: 'drink the coffee?' What are you going to do?"

"That's what the addict is experiencing during acute withdrawal. 'If I don't drink that, if I don't snort that, if I don't shoot that, I'm going to die.' The person might know that they don’t really need the substance. But they feel that they do. And that's the trap."

I asked Dr. Ximenes how easy it might be to kick fentanyl alone, while squatting in an empty house or sleeping under a bridge in cold temperatures.

"It would be like five days of re-enacting The Deer Hunter. Click. Click. Click. Five days of that? No. That's where supervised detox becomes crucial."

Dr. Ximenes takes exception to the idea that opioids like fentanyl hijack the brain's "pleasure center." "The first thing people need to know is that these drugs take over the survival center. I don't call it the pleasure center. It's the survival center."

***

The question "why don't you just quit" implies, subtly, that drug dependency is fun—that people addicted to fentanyl or OxyContin are indulging. If they wanted to get sober, they'd find the willpower to deal with a week or two of "dysphoria, insomnia, pupillary dilation, piloerection, yawning, muscle aches, lacrimation, rhinorrhea, nausea, fever, sweating," and life-threatening "vomiting and diarrhea."—and then independently solve all of the problems that had made them susceptible to addiction.

But the world we glimpse in that Vice documentary—of young people wandering around in the autumn cold begging strangers for spare change, living in tents and under bridges, obsessively looking for the next pill—doesn't seem like such a fun place to be. It's easy to see why the glassy-eyed young man at the treatment facility in Calgary wants to free himself from his addiction. It can be harder to see why he doesn't "just do it."

Welcome to Kuraĝo, a new blog covering addiction, trauma, recovery, wellness, and the search for meaning.

While Kuraĝo is (obviously) hosted by Driftwood Recovery—and will feature conversations with Driftwood’s clinicians, dieticians, physical therapists, and canine client support specialists—it’s not necessarily a blog about Driftwood. This blog is for everyone, and we want it to include a wide variety of perspectives.

Alongside explainers on “Dialectical Behavioral Therapy” and “opiate hyperalgesia,” you’ll find movie recommendations, recipes for non-alcoholic cocktails, meditations, and links to whatever else we found interesting during a given week.

Whether you’re taking your first awkward steps toward sobriety, trying to learn more about the challenges that a friend or family member in residential treatment is facing, or just looking for strategies for weathering the daily stresses of life, we hope you’ll find something of value here.

For all of the above plus occasional cat memes, follow us on Twitter.

If you're interested in contributing to the blog—or you know about something we should be discussing here—drop us a line at: kurago (at) driftwoodrecovery.com.

We're glad you found us.