Addiction Medicine Made Easy | Fighting back against addiction
Addiction is killing us. Over 100,000 Americans died of drug overdose in the last year, and over 100,000 Americans died from alcohol use in the last year. We need to include addiction medicine as a part of everyone's practice! We take topics in addiction medicine and break them down into digestible nuggets and clinical pearls that you can use at the bedside. We are trying to create an army of health care providers all over the world who want to fight back against addiction - and we hope you will join us.*This podcast was previously the Addiction in Emergency Medicine and Acute Care podcast*
Addiction Medicine Made Easy | Fighting back against addiction
What I Learned When I Talked About Addiction with a Licensed Therapist
I'm thrilled to welcome Amity Cooper to the Addiction Medicine Made Easy Podcast! Amity is a mental health professional specializing in equine therapy, to share her unique perspective on the pivotal role of mental health in achieving and maintaining sobriety. Together, we explore the intersection of mental health and addiction recovery, delving into therapies that support individuals on their journey to a fulfilling sober life. Amity's insights provide insight at how equine therapy and holistic approaches can transform the recovery process, offering hope and healing to those in need.
Our discussion then turns to the concept of personal transformation during recovery, focusing on the importance of establishing a guiding "North Star." We highlight strategies like polyvagal therapy and self-awareness practices as essential tools for managing co-occurring mental health and addiction disorders. Finally, we delve into the therapeutic benefits of equine therapy, where horses act as co-partners in therapy, promoting mindfulness and emotional expression. Discover how this innovative approach can empower individuals to redefine their futures, fostering emotional healing and self-awareness in the process.
At the beginning of the episode we look at how early cannabis use can impact academic performance. We discuss the findings of a compelling study published in JAMA Pediatrics. We'll explore how adolescent cannabis use is linked to lower grades and increased dropout rates, setting the stage for a deeper understanding of the long-term effects of substance use. This episode promises to equip listeners with crucial insights into how these early choices can alter life's trajectory, emphasizing the importance of informed decision-making for young people.
Amity's website: https://amitycooper.com/
To reach Dr. Grover: ammadeeasy@fastmail.com
Hello, my friends. Welcome to the Addiction Medicine Made Easy podcast, where we take topics in addiction medicine and break them down into digestible nuggets and clinical pearls that you can use at the bedside. Dr Casey Grover here as your host once again.
Speaker 2:All right. Thanks for joining me today on the Addiction Medicine Made Easy podcast. If this is your first episode, my name is Casey Grover and I am an addiction medicine doctor working on the Central Coast of California. If you are a regular, great to have you back Before we get going. I would like to give a quick thank you to the Montage Health Foundation for their support of this podcast and, once again, just like last episode, I am so pleased to announce that I am partnering with Central Coast Overdose Prevention, which is a nonprofit that operates on the Central Coast of California with a focus on reducing overdoses. By educating the community and improving access to treatment for addiction, I'd like to grow my audience. We have so much work to do to get the word out about addiction, so please help me spread the word about this podcast. We need both healthcare providers and people in general to learn more about addiction so we can improve the care of patients with addiction. So please share this podcast with a colleague and consider giving me a five-star review on whatever podcatcher you are using.
Speaker 2:Now, before we get into today's episode, I want to share some recent literature that I found. I found an article on cannabis in youth and how it affects academic achievement. It's entitled Cannabis Use During Adolescence and Young Adulthood and Academic Achievement. It was published in JAMA Pediatrics in 2024 with Olson Chan as the lead author. We'll do a quick review of this article.
Speaker 2:It was a meta-analysis of 63 studies involving nearly 440,000 individuals to look at how cannabis use in adolescence or young adulthood affected academic achievement. The authors looked at the outcomes of school grades, school dropout, school absenteeism, grade retention, high school completion, university enrollment, post-secondary degree attainment and unemployment. So what did they find? Individuals who used cannabis during adolescence and young adulthood had, compared to individuals who didn't use cannabis during adolescence and young adulthood, lower grades. The odd to get B's or better was 0.6. A lower chance of finishing high school the odds ratio was 0.5. A lower chance of going to college the odds ratio was 0.7. A lower chance of going to college the odds ratio was 0.7. A lower chance of getting a degree after high school the odds ratio was 0.7. A higher chance of dropping out of school the odds ratio was 2.2. A higher chance of being absent from school the odds ratio was 2.3. And a higher chance of unemployment the odds ratio was 1.5. And the absolute effect size is, if you don't quite understand, odds ratios varied from 7 to 14%. So essentially, in young people who used cannabis, they got lower grades, they were less likely to finish high school, they were less likely to go to college, they were less likely to get a degree after high school, they were more likely to drop out of school, they were more likely to drop out of school, they were more likely to be absent from school and they were more likely to be unemployed. And again, the absolute effect size varies from about 7% to 14%. So you can say roughly it's about a 10% difference, not huge, but definitely adds up, given how common cannabis is used. Now this study looks at the association between cannabis and academic performance. There's definitely an association here, but we don't know fully the causes, which means that more research is needed. But I wanted to share this with all of you, as this is really compelling data to avoid cannabis in adolescence and young adulthood. And I go to a lot of schools You'll hear about it at the end of this episode today and I'm going to start including this information when I talk to students and teachers at schools.
Speaker 2:Okay, on to today's episode. Today's episode has had some interesting twists and turns that went into how it got made. Today's episode is an interview with Amity Cooper, who is a mental health professional with a particular interest in equine therapy. Amity's publicist reached out to me wanting to collaborate on an episode, and she suggested the topic, and I quote who do I become now how to build a life after rehab and I jumped at the opportunity to discuss this topic with Amity. So many of my patients do great in rehab, rehab, but relapse shortly after they leave. So I was all geared up to talk with her about this topic how to be successful after rehab and, as you'll hear, when we got into this episode, she clarified that her focus is really on mental health more than addiction. But since maintaining good mental health and treating mental illness is such a big part of helping someone with addiction get and stay sober, we ended up having a great conversation. I actually think she knows a lot more about addiction than she realizes, being a mental health professional. So much of what I do in clinic taking care of my patients is help them with their mental health, as their mental health is what drives their addiction.
Speaker 2:Now, as I mentioned in my last episode, these sorts of interviews are new for me. I'm trying a little bit of a different avenue. As you heard, my daughter thinks my podcast is horrendously boring, and I'm trying to make it a little more fun and interesting. Let me know what you think, drop me a line at ammadeeasy, at fastmailcom, or find me on LinkedIn, and with that let's start our interview with Amity Cooper. Well, hi there, it's so nice to get to connect with you. Why don't you start by telling us who you are and what you do?
Speaker 3:Sure Casey, thank you so much for having me. I am Amity Cooper and I am a trained mental health professional and life book coach and I dabble in all sorts of areas, but my clinical training and practice is in equine therapy, so I love working with horses and people outside in nature. And then I run a professional development company called Clinical Career Collective where I help other mental health professionals tech up and care wide in their practices by incorporating all this new technology. That's changing the landscape of how we deliver our services. But yeah, so, and I also run and operate a guest ranch out in Elizabeth, colorado.
Speaker 2:Wow, very cool. How did you get into the mental health space? What drew you there?
Speaker 3:Yeah, so after about oh, sorry about that After about 20 years in the business world. I was a product developer and marketer and anywhere from fashion accessories to my last business, which was chocolate making.
Speaker 3:I was a chocolate maker. It was really tasty. Until it ended in 2015, when I lost my factory and I had a moment of crisis. I was trying to figure out what I could do next, because I realized when I looked back over the span of my professional career, everything was so externally driven that I lost sight of who I was, separate from my businesses, and I know that a lot of people can relate to this feeling where they wake up one day and they're like who am I? What am I supposed to be doing? Who's been driving the bus really? And that set me on a new path and I went back to get a second master's degree in mental health counseling and that was about five, seven years ago and I've been doing this work ever since.
Speaker 2:Yeah, and you and I today we're going to talk about how to be successful after going through a residential treatment program. Okay, yeah, I have a number of folks I work with in recovery. In fact, last night was Halloween. We had folks over to our house. We went as the Spice Girls. My wife and daughter convinced us to go as the Spice Girls. I was Sporty Spice, oh my God. And one of the guys well, actually several of the guys with us last night were sober and one of the guys was like sorry, dude, I'm sober, spice. So that was really funny and witty and in the moment and he and I he's about 18 months sober.
Speaker 2:He and I have had so many conversations about 30 days is not enough. You go to a program, you don't have any life skills, it's a very artificial environment of rehab and you get out and you go back to your old habits. So let's start talking about and it can be mental health addiction. Obviously they intersect, but let's talk about what happens in a residential program and then thinking about being successful as you get ready to leave. In other words, what steps should people be taking on day one, as they enter a program, to be successful on day 30, 45, or 60 as they get ready to leave as they enter a program to be successful, on day 30, 45, or 60 as they get ready to leave.
Speaker 3:Well, yes, these are all great questions and topics, but, first and foremost, I am not an addictions counselor. That is not my training, so I'm turning to you and referring to you for that. But what I can definitely add value and talk about here is that whenever we experience moments of crisis and an existential point of transition, figuring out what our next steps are are really tricky, and making the decision or or going through a recovery program you're right and I agree with that Casey is like. This is. This is a, a filtered experience.
Speaker 3:You're getting in, you're getting a handle on your life's issues, what the challenges have been, and figuring out what those next steps are can be really foggy and unclear in that 30 to 90 days or whatever that you're in transition and it's really hard to peel back the layers of what's been directing your life, because the life that you've been living has been sort of the addiction has been in charge. You haven't been in the driver's seat of your life. So it's hard to sort of start picking apart and say what should you be doing in recovery or during that process, because you're just not clear yet. But as you start to crawl out of the hole and you start to see the light at the end of the tunnel and you suddenly become more aware and clearer and all that fog has lifted, become more aware and clearer, and all that fog has lifted. The environment in which you came out of is not suitable for the environment and the life that you're setting the course for in the future. Am I right? I mean, that's pretty pretty much. I mean you're at a whole different crossroads here than where you came in 30, 90 days before.
Speaker 3:So I can imagine and the way I sort of work with my clients about this is whatever old first principles you had, you have to totally redefine. You are rewriting not only each chapter in your life but your entire life's vision, and that means looking across and examining 12 major domains in your life. It comes from your health and fitness to your character. Who do you want to be? Who are you truly?
Speaker 3:When you take away that monster that's been driving the bus and I keep going back to that metaphor you think about the friendships. Those friendships that you had in an addictive state no longer serve purpose to you and unfortunately they probably won't be around, and so you have to redefine what friendship is, what family relationships are, what intimate relationships look like. You know it is a rocky road, but if you surround yourself with a community and you maybe, hopefully, you can take away one or two people that you've gone through recovery with and you create that home base with them, that is going to take you so much farther as you start taking those small baby steps towards a new life with clearer mind, clearer heart, clearer direction.
Speaker 2:Yeah, I mean I think we can maybe broaden the conversation to talk about entering a program and transitioning out of a program in general. I mean, people with mental health conditions can get admitted to a mental health unit and then transition to a supervised housing environment where they have mental health counselors that help them get to their daily appointments. But I think you made some really good points, which is that and I'm going to see if I can make it as simple as possible something has to change. Yeah, hands down, so yeah.
Speaker 2:So this is the conversation I've had with my colleague who was sober spice last night. Love the guy. So yeah, you know he, he, you know he and I are about the same age and you know, 18 months ago he was unhoused and using fentanyl and methamphetamine and and yeah, he made major changes. He's now living. He's cut ties excuse me, he's living by himself. He's cut ties with all of his old people he used to use with and he's very adamant that. You know, we really have to think about major changes when we want to emerge different after a program and I'm assuming it's the same way and there's not as much residential mental health I think more about like eating disorders or that sort of thing.
Speaker 3:I mean, I think it's the same, it's made up of the same constructs. Right, you were one way going in, and then you walk through a door and you're somebody different, but that somebody different is foreign to you. You don't know who that is because everything else has been dictating your life and so creating. We're almost engaging in a new component of life design building. You know it's like a design build process. First you come up, you have to create a new foundation, Then you have to come up. Well, actually, first you have to come up with a master plan of what that desire is going to.
Speaker 3:You know what those desires and goals are and for many, many people I would say the majority of people in life, you know, mediocrity is sort of the standard norm. We just kind of accept what the outside world tells us to be and spending the time to get to know ourselves and be curious about ourselves. It takes grit, it takes commitment to setting a new course and designing this life that you want to lead, and no one else can tell you how that's going to look. You can look to the outside world and say, okay, I like this. You can look to examples of people that you admire or that you can, sort of course, correct towards, but ultimately it's an inside job. It's not an outside job, and that comes with really doing that deep dive that I was mentioning before, of looking across your life in these multiple ways in which you interact with the world and with people around you, to really discover what looks best on your walls and how you want to live.
Speaker 2:What I'm almost hearing and I think about this with my patients is a lot of times I get into a clinic visit with them and they're just spinning. They're worried about I got the flu, they're worried about their rent and almost what I'm hearing from you is I need to level set with them what's your North Star? Yeah, and then as they spin, we can come back to that North Star. And as it pertains to transitioning out of a program, it sounds like the idea is on day one you set the North Star and then you work on setting all the steps in place to get there. Does that?
Speaker 3:I would question when and how you're able like when are you able to get through to the person underneath, when the addiction is under control, about to leave? I would say my recommendation is that most likely, your crew, your staff, is going to start working on a care plan for those individuals who are leaving. What do you see for yourself? Where are you going to land and what is that North Star? How do you start peeling back the layers to identify what that is, because they probably have never thought about it before.
Speaker 2:Yeah. So I want to unpack one thing you said, which was that when the addiction is under control and this is, I think, one of the things that's interesting about addiction medicine is and in healthcare we all know we love our silos, right, you have, you know, cardiology and then gastroenterology. What I find interesting is that sometimes behavioral health folks are nervous about seeing addiction patients because they're trying to parcel out what's what. And in addiction medicine I see them all mashed up together. We've got the anxiety, we've got the depression, we've got the alcohol, we've got the cannabis. It's all just smushed in there.
Speaker 2:And what's interesting is that your practice might be if someone has a history of addiction, they're going to come to you once they've gotten that out of control, to work on mental health. I see them in a different phase where it's all smushed together and I'm trying to pick apart what's what. And I think that's what makes addiction medicine very challenging. Is that a lot of times it's hard to know. You know, is this alcohol, withdrawal, anxiety, alcohol, you know, induced mood disorder? It can be really difficult to pick that apart. So let's unpack this. So let's imagine that you're seeing somebody with depression, trauma, ptsd, and they've got a history of addiction. Do you work with them on that history and, if so, how do you do that?
Speaker 3:Yeah, so of course you know anybody who walks through the door is going to be bringing a whole suitcase load of all of their issues that need to be unpacked and looked at and sorted.
Speaker 3:And so, yes, I mean day-to-day functioning is about addressing the front and center issues like the anxiety management, the depression management, all of those things and of course I will talk about that and I will work with that about bringing self-awareness to that experience and being able to tease apart and work and manage that ongoing dysregulation that most people are running in.
Speaker 3:I mean, I look at polyvagal therapy and treatment and just realizing and taking in a person's affect and presentation and how do I manage that? Okay, well, and doing some education around that, but that always, I mean we are not stagnant people. We experience the world on multiple levels and in multiple ways and we're always interacting with the environment and the field around us, right? So, yes, so in concert with managing our ups and downs of life and dealing with the anxiety and depression swings that we all have, I start to come in and I start to apply and introduce this concept of something bigger than just their internal perseverations. I see it as like I have to titrate between dealing with the everyday issues and then this future, forward solution, forward focused life that they want to lead.
Speaker 2:What does that sort of conversation sound like? What does that? How do you approach it?
Speaker 3:I would say I see that you, we know that we are always rattling with our demons and managing okay, this person has done something to you. What is your personal responsibility in that? How can we manage that? How would you like to address that? Practicing conversations with difficult people, because most of the time it's usually interactions with other people that we feel slighted with. I mean, isn't that true? And then what is within our control and what is out of our control, and can we deal with radical acceptance? So I sort of go back and forth between that and those conversations are rather fluid.
Speaker 3:I don't work in a set treatment plan like this is what we're going to tackle. I have a Jungian analytic background, so I tend to go with the flow of the person in front of me, whatever they bring into the room. That's how I approach it, and then I try to deal with the moment that's happening between us. And then I also sort of project and leave a golden thread or throw it out the door and see if they can follow it in, imagining what a life would be like when this particular issue is under control and managed. What would they like to see? How would they like to envision the situation and the future being so, I hope that's helpful.
Speaker 2:It's almost like motivational interviewing. Yes, yeah, yeah, yeah. So it's interesting as I'm listening to you here. You know essentially how I approach addiction is exactly the way you approach your work. It's just we have the issue of cravings, withdrawal and dependence. It's like what you do, just with a little kind of an extra bit on it. But yeah, I spend so much time with my patients trying to figure out where they are, where they want to go, and then how do we make that link in between. But you said something that I really liked was when people slight us. The first five minutes of almost all of my appointments is a vent. All of my patients come in. They've got to get something off their chest. I was never trained how to do this. How do I receive the vent and make it therapeutic?
Speaker 3:Oh my gosh, what a great question. Well, for me, I receive it like they're practicing on me. Oh, okay, they're practicing on me. I use it as a tool to say, well, how did that person piss you off today? Use me as the example. How would you let it fly? I allow that anger and all that emotion to land on me and I work with it and I practice and I engage in that conversation so I allow them to let it out and feel what it's like the pushback or the response in a way that they can process. So it's more gestalt-y sort of work that I do in that. So it's fun, I think it's fun.
Speaker 2:Well, I mean it's, it's, yeah. I mean I think of one patient in particular. I always have to book extra time for his appointments because he's very talkative. Love the guy. He's trying so hard, he's doing really well but, yeah, the first five minutes he's just got to get stuff off his chest.
Speaker 2:I think how I approach it is I try to take the nugget out of the conversation that allows me to remind him that he's human. And the phrase I use so much in my practice and I'll pick on you is this is not an amity problem, this is a human problem that you have. And I try to reflect to them that a lot of what they're feeling is normal, and then to see how we can learn about how you regulate yourself in that conversation. Did that go well? Did it not go well and can we learn from it? And my perspective on relapse and the stakes are so high right now because of fentanyl, but a relapse is an opportunity to learn. Just as much as that guy pissed me off and I yelled at him and I shouldn't have is an opportunity to learn. I'm curious what you think about that.
Speaker 3:Right, right, no, absolutely.
Speaker 3:And I would sort of attach onto that and add to the fact that when we get aggravated and when we're suddenly thrown into a sympathetic response, we go and we become very impulsive, we become agitated.
Speaker 3:I mean, it varies, everybody has different reactions, but in general, learning to control the impulsive reaction you know the knee jerk, the punch, the, whatever it may be, the slurring, and just being able to breathe through that and into the moment and being able to pause is so essential to managing and regulating the emotion. And we're all going to have those flare-ups, we're all going to be like, okay, to your point, we're all having a human experience, right, this is life school that we're living and it's also helping our clients and our patients at better interpersonal communication skills. You know, like, what is the proper way and how do you respond. Those skills are never taught to us and most likely you know they need to practice. They need to practice those and I see that as my role, as being an ally and a witness to their life, and practicing on me and with me in that inner change is essential to making it out in the rest of the world.
Speaker 2:I think you sold yourself short at the beginning of this podcast. You have plenty of expertise in addiction. You have all the things that we're talking about is everything my patients need learning how to emotionally regulate, learning how to understand their emotions. I mean, gosh, these things are every part of every one of my visits and for me it's hard.
Speaker 2:I trained in emergency medicine first, so I don't have a background in psychiatry and a lot of what I've learned about addiction has just been sitting down with people and talking them through what they're feeling and it's like my patients fall into buckets. I have like the can't sleep uses alcohol bucket and the untreated ADHD so I use meth bucket, and then the horribly traumatized person that uses anything they can to feel better bucket. But it all comes down to when I ask them why do you use the substance? What does it do for you? So often it's they just don't know how to regulate their emotions and mental state. And I try to get all of my patients to see a therapist, and availability where I live is pretty minimal, but yeah, it's just. It's like addiction medicine and mental health are two peas in a therapist. Availability where I live is pretty minimal, but yeah, it's like addiction medicine and mental health are two peas in a pod, so I think you do have quite a bit of expertise.
Speaker 3:Oh, thank you so much for saying that. I really appreciate it. That means a lot to me and it is well. I think we all have something right. We all are struggling with some sort of challenge. And if we have the coping skills available to us, if we don't have the resources, if we cannot resource ourselves, if we don't have efficacy, if we feel like we don't have agency to defend ourselves, what else are we going to do? We're always looking for coping. It just depends on your choice of therapy, right? I mean, that's the way I approach it.
Speaker 3:But again, it's key if we're talking about because ultimately, this conversation is like what do we do and how do we live a life of recovery? What does that look like and how do we come through it? On the other side, I mean, we've put all of this time we've fallen down really hard. I mean most of life, I see and I'm sort of rambling here but most of life, I see is split into two ways. You either have a call or you have a fall, and maybe it's what you do and how you get up or how you move forward is really the key here. We constantly are living in the past and all we have is today and the possibility of tomorrow. I think it's a gift to be able to not that you've gone through the suffering in this way. I think it's a horrible, what a journey to travel, but if you can get through that, the recovery process is a huge opportunity to a life that you never dreamed of and you can write it yourself.
Speaker 3:I think it's really a powerful place to be, and maybe I'm not saying as eloquently as I would like to believe, but this feeling of opportunity out of great trauma and crisis is available to all of us. If we look at it like that, it's a different shift in the mindset.
Speaker 2:Yeah, we really try to avoid stigmatizing language in my practice.
Speaker 2:So I prefer to use the term a person with addiction rather than the term addict, but I was at an event last year and a woman said my name is and this is not her name for privacy reasons my name is Stephanie and I'm an addict and I cringed and then she goes and I'm so proud of that because the person that I emerged as after my addiction is stronger than anyone I could have believed I could have been. My addiction made me grow and I'm a better person today, which I thought was really cool.
Speaker 3:Yeah, I love that sentiment. And who am I to judge on how they identify with that Right yeah. Sentiment? And who am I to judge on how they identify with that right, right, yeah. Who am I? I'm just again bearing witness to that, and how lovely that. That is a motivator that has redefined her whole paradigm to your point.
Speaker 2:she went from a a fall to now she has a call. Love it. Yeah. So I want to ask you, because your expertise is in equine therapy. I don't know anything about it, except that it involves horses, so please fill me in that sort of backs and supports and validates ancient histories of the human-animal connection and bond.
Speaker 3:And I think maybe equine therapy is sort of like on trend right now. Everybody's talking about you know, oh, I had this amazing equine experience or whatever, so I can relate to that. But I came into the horse world at the same time that I was going through my clinical training. There was this random day with horses, come spend a day with horses. And I was like yes, please. And I walked into the arena and there were three horses at liberty. That means there's no tack, there's nothing on them, there's no lead line on them. So we're just alone in this arena, together, and being so up close and personal and intimate, like smelling and sharing breath, with this thousand pound animal times three, was so magnificent and so magical. I literally left that round pen and just started crying. It was so visceral, it was such a somatic awakening that I was like this is what I want to do with the rest of my career and my life.
Speaker 3:Horses are powerful, sentient, intuitive beings that amazingly so want to partner up with you and when you are working with them, I consider them a co-partner with me. They are my partner in clinical practice and out in the field, and it has been shown across demographics and across issues from young to old anxiety, depression, ptsd that people have dramatic changes in the presence of these animals. It brings awareness to what's going on within us and outside of us and they mirror our experiences and our behavior. So all they want to do is hang out with us, and when we're busy perseverating in our own thoughts and our own anxieties and talking about ourselves, they can't be bothered with us. They'll go to the opposite side of the arena. But if you are staying present and you're able to express yourself and open up to the possibility within you and your emotions, they're up, right next to you, they're, they're, they're around you and you're. You're experiencing elevated levels of oxytocin. There's mirror neurons that are activated. It is an incredible healing experience.
Speaker 2:So I'm assuming it gets used for addiction, and I know that's not quite your expertise, but let's talk about trauma, since so many of my patients have been traumatized. In fact, dr Gabor Mate, the famous addiction physician, has argued that all patients with addiction have been traumatized. I have a patient I'm thinking of horribly traumatized. I give her to you depression, ptsd, alcohol use. What does equine therapy look like for her?
Speaker 3:For me.
Speaker 3:So my particular practice or orientation is gestalt, you know so a lot of it is very loose and it is usually an introduction.
Speaker 3:So, first and foremost, many, many people who come to me or come to this work have been semi-curious about horses but maybe have not had exposure and the majority have not had exposure to horses. Horses, but maybe have not had exposure and the majority have not had exposure to horses and they are taking in everything that's around them. So they're looking out to the field, the physical field and the internal you know, emotional field, right, and it's foreign to them, no-transcript and seeing what, observing the horse behavior and getting an education. It's psychoeducational. But then it sort of begins this dialogue, this nonverbal dialogue between themselves, the horse and the environment, and understanding and noticing and speaking about all the sensations that they might be having and how to bring awareness to that and how to learn how to deal with all of those changes.
Speaker 3:Back to our whole question and discussion earlier a few minutes ago, just about the dysregulation that they might be experiencing and how the horse in that moment can bring them to regulation. And that is a foreign feeling. They don't know what that is like and knowing that maybe that there is this bridge that they can walk across with the horse to learn how to regulate themselves without something, without a tool, without some sort of assistance. They start to become more aware of their bodily sensations and tuning into those to bring them back to homeostasis effectively.
Speaker 2:So, if I'm making sure I understand this, it's almost that the horse provides them kind of a center point to which they come back to when they feel dysregulated. Yes, cool, wow, I got to find. If there's equine therapy near me, where are you based? I'm in the central coast of California.
Speaker 3:Oh well, there's lots of stuff out there.
Speaker 2:We have lots of horses here, yeah, so regrettably we've got to wrap up. Because I'm off to a middle school to teach about drug and alcohol use. I've now made sure that at every school I go to, someone gives me a dose of naloxone, just to show that it's not scary. So I got naloxone about an hour ago and I'm going to get naloxone in about 45 minutes. It's a little bitter If I get Narcan on an empty stomach. I get a little bit nauseated sometimes. But yeah, so you're obviously a mental health champion and a mental health warrior. When you look back on your patients, leave us with kind of a take-home point that you know now that you didn't know at the beginning of your practice. That just reflects what you've learned about mental health as you've taken care of patients.
Speaker 3:I need to pause and think about that for a moment. I need to pause and think about that for a moment. I I've learned humility. I have learned how to be still and curious the horses, in a lot of ways, have taught me how to do that so that I am more capable of being present and open and available to my process and that it is much bigger than me, and I just stay humble to it because I just respect everybody who is trying to make themselves better. It's just a powerful place to be Well said.
Speaker 2:I've learned the same in addiction medicine. I've been doing this for about two years and the best thing I do is I can sit and I can listen. Yeah, it's huge Well said. Well, I have to say I am totally going to go down the Equine Therapy rabbit hole and educate myself. I am so excited to go down the Equine Therapy rabbit hole and educate myself. I am so excited to refer some of my patients for this. Thank you so much for joining me today and helping my patients to learn more about mental health, and I love the idea of setting a North Star and I'm going to start using that in my patients. I see one of my patients at rehab later this afternoon. I'm going to talk about that with him.
Speaker 3:Fabulous.
Speaker 2:I'm going to talk about that with him. Fabulous, I'm so glad that we had this discussion. This was really fun for me Right on. Thanks so much. All right, that is the end of this episode. I really enjoyed discussing mental health with Amity and how mental health factors into the treatment of addiction. I also have to say that I liked learning about equine therapy. Thank you for listening and thank you for what you do, and don't forget treating addiction saves lives. Thank you.