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
Assault, Addiction, and Healing from Trauma
This is an episode on addiction and trauma, with the author Rikki West as a guest.
Rikki shares her powerful story of assault, addiction, and healing, and we discuss the deep connection between trauma and addiction. We had a fantastic conversation about personal struggles and the importance of community support, as well as finding the path to healing.
We discuss:
• Exploring the connection between trauma and addiction
• Rikki's journey from childhood through addiction to recovery
• Impact of familial addiction on personal development
• The role of community and support groups in healing
• Rikki's experience with therapy and emotional regulation
• Navigating relationships and intimacy after trauma
• The importance of sharing stories for healing and empowerment
To contact Dr. Grover: ammmadeeasy@fastmail.com
Welcome to the Addiction Medicine Made Easy Podcast. Hey there, I'm Dr Casey Grover, an addiction medicine doctor based on California's Central Coast. For 14 years I worked in the emergency department seeing countless patients struggling with addiction. Now I'm on the other side of the fight, helping people rebuild their lives when drugs and alcohol take control. Thanks for tuning in. Let's get started.
Speaker 1:Today we are going to be speaking about trauma, how addiction and trauma are closely connected, and surviving trauma. A brief warning this is a dark episode. We talk about sexual assault. I interview the author, ricky West, about her life story. She had a father with addiction, she is a survivor of sexual assault and she's overcome her own addiction to alcohol. We talk about her life and experiences and about her new book called the Empty Bowl. I also share some of my own mental health struggles during this episode. Unfortunately, ricky's internet connection was a little spotty during the interview, but overall it's a fantastic. Look at trauma, mental health and addiction. Here we go. Fantastic look at trauma, mental health and addiction. Here we go. All right, well, good morning. I am so excited to get to meet you and hear your story.
Speaker 2:Why don't you start by telling us who you are and what you do? Well, good morning, casey, and I'm really happy to be with you. I appreciate so much being able to talk about this and maybe help somebody else who's struggling with it. I've been an alcoholic since at least the age of 13. That's when I had my first drink. I come from a deeply alcoholic family and aunts and uncles all devastating alcoholism that caused us to lose opportunities and relationships and health and many, many things in life. When I had my first drink, it was a beer. I was at a party and I literally woke up several hours later in bed with strangers with a bottle of whiskey in my hand. I blacked out completely first time and I thought it was great. I met my boyfriend that night. For the next few years, alcohol enabled me to talk to people.
Speaker 2:I had profound shame from growing up in my family because my alcoholic father was cruel and insulting and mean to us when he was drunk. He was a comedic writer in an era when satire and insult was funny or thought to be funny, and he hurt us a lot and that was really quite traumatizing. But it made me deeply ashamed and I also. I was very loyal to my family and loved him very much. So I did not want to expose to the world our family secret. So I kept it to myself and treated my own drinking the same way. It was a secret, I tried to hide it and I knew I was ashamed of it. But it liberated me while I was high, before I got drunk Just the first three drinks maybe I was terrific.
Speaker 2:I was funny and interesting and clever and at ease. And then I was passed out or doing some inappropriate behavior, even having fights in bars. I'm 5'3", 110 pounds and I would get in fights with bars, with men who fortunately did not hit me back. Bless their hearts. When I was in my late 20s maybe it was mid-20s I was raped by the leader of a Buddhist organization that I was a member of. Well, the 1980s were a time of tremendous sexual liberation. The late 70s and 80s we had recently gotten the pill. Everybody had access to it and we were in a phase of free love, which turned out to mean men got to sleep with whoever they wanted and women had to pretend they liked it.
Speaker 1:Free love, at least that was for me. I understood.
Speaker 2:So I had a really rough time being sexual after the rape. This was a friend of mine. I had no intention, in fact I'm a lesbian and I was coming out at the time, so I wasn't very interested in men. I'm really sure I didn't flirt with him. But after we'd been out late drinking talking about something in our religious organization, he took me home and then he slammed the door open, grabbed me, knocked me down, held me down, raped me and left, leaving me going. What did I do wrong? How did I make that happen? What's wrong with me, me, me.
Speaker 1:Yes, I just want to pause there. I just finished a wonderful book called how to Quit Like a Woman by Holly Whitaker, and the last chapter is focused on empowering women to be okay with understanding that it's not their fault when this happens. I heard you say me, me, me. This was not a you problem. But my understanding is a lot of women internalize it Like what did I do wrong? That guy was being a horrible human being. It was not your fault. I just want to pause and acknowledge that that I'm really sorry that happened to you and I'm curious to hear what happened with the alcohol after that. And there's a lot of shame and guilt after something like this. But it was not your problem, but I understand how your brain worked at the time.
Speaker 2:Yes, it was not your problem, but I understand how your brain worked at the time. Yes, unfortunately, the way my brain worked was to prove that I wasn't raped, which was just too terrifying. I thought it's such a humiliating, degrading, vulgar thing to say it happened to me. It happened to me and that, of course, at the time, implied the Supreme Court at the time had passed a ruling saying if you did not fight to the extent of beyond your well-being, like fight until you were hurt, then you were complicit.
Speaker 2:Oh wow, and so it was rape if you didn't fight until you were and I didn't. So the whole social media told me it was rape if you didn't fight until you were and I didn't. So the whole social media told me it was my problem. And I reacted by having indiscriminate sex to prove that I was in charge and what I was choosing, which was not true. I was being driven by shame or remorse or something like that.
Speaker 1:I've had several of my female patients tell me that same story that they wanted to control it after they were violated, because at least they were in control of the situation. I recently saw one of my patients who was abducted at 13 and raped and she had sex with anyone and everyone afterwards because at least it was her decision. And I'm really interested in this conversation because so many of my female patients have been victimized and horribly treated and I'm really working on helping them heal. So I didn't mean to interrupt, but I just wanted to acknowledge that your reaction is something that several of my patients have told me about.
Speaker 2:That's really nice for me to hear, because I have not talked about this very much and I was a little reticent when I first got the invitation to join your podcast, thinking about talking about it. But here it is Now. To behave like that, I had to be drunk and then to recover from the shame of behaving like that, I had to be drunk and I was in trouble, from the shame of behaving like that. I had to be drunk and I was in trouble. This lasted until my early 30s when I tried to kill myself Pretty lame way, I turned on the gas in the stove, shut all the windows, stuck my head in the oven with a bottle of scotch and waited. I did pass out but I didn't die. But that scared me. I thought I'm really in the toilet. I got to do something.
Speaker 2:So I called my older sister and she had just gotten sober. So she knew what to tell me. She told me to go down to the county and talk to the county about potential recovery options. Aa wasn't in my mental sphere. So I got down to the county.
Speaker 2:About potential recovery options, aa wasn't in my mental sphere. So I got down to the county and they said go to AA and here's some gay meetings. Well, I thought I was completely closeted. I thought I looked normal, normal. Now it's 2025 and I'm saying gay is not normal. Oh well, I thought I'd look straight, I thought I was passing and you know, she had one, look at me and sent me to gay meetings. Now this was so helpful for me because I was in a room now with 20 or 30 gay people who told stories like mine that they had been institutionalized or they had been inappropriately sexual or they had been sexually violated or they had lost their job and their family or their health, and the first thing I thought is I do not want to be a member of this group. These are losers.
Speaker 2:Oh, wow I want to get away from them. I looked around the room and I saw all the slogans and steps and I said this is all about God. I can't do it. I don't have a God. A woman came up to me and said you never have to drink again and you never have to be lonely again. Just don't pick up the first drink and if you feel like it, give me a call first. That was it that changed my life. That woman, her name we called her Texas Patty and I called her and entered recovery and I lasted a year. Then I had a drink, then I started again and now it's been whatever. That is, 40 odd years since 83. Getting sober was really, really hard. I craved alcohol. I was addicted to cigarettes also at the time, so I smoked my hair off trying to escape from alcohol. There are a couple of points I'd like to make about what worked for me.
Speaker 1:Absolutely.
Speaker 2:One of them is that I no longer wanted to be like my father. I saw how it destroyed his life and his relationship with me. I saw what my alcoholism was doing and I thought I am not going to let this happen to me. I am not, I am going to beat it. So there was something in me Don't be like dad, break through. And at the same time I wanted to find the answer to help him, like if I can figure it out, if I can find the way out of this, I can help him get out of it. That never happened, but it motivated me. So I had motivation with someone I loved that. I really wanted to help, loved that I really wanted to help.
Speaker 2:Secondly, I don't know if everybody has this, but somewhere inside myself I believe that I wasn't born to suffer. I was born to be happy. Happiness is my birthright. I just have to find it. I just have to do something.
Speaker 2:So AA gave me a little path. He gave me a little 12 steps one, two, three, four. Just do them in order. And I did. And right away you had to reach out to God. As I said, I didn't have a God. Well, texas Patty said why don't you just borrow mine? Patty said why don't you just borrow mine? She was a Southern Baptist, which is not my cup of tea, and surprisingly she said I'll loan you Jesus for as long as you need him. And I borrowed Jesus and I talked to him every day. It just was remarkable. After about six months I gave Jesus back to Patty and I had formed my own sense of a higher power that I could rely on to help me, and I really needed that apparently external higher power. I asked for help, I asked for patience, I asked for just to get through the next hour without a drink, and I was helped every time. Do your patients use that part of the AA program at all?
Speaker 1:So it depends on the person. Some of my patients love AA and some of my patients really struggle with it At the highest level. We have three basic treatments for addiction individual counseling and therapy, group meetings and medication. And my rule with my patients is you got to do at least two out of the three. So if they like meetings, I encourage them to go.
Speaker 1:And when I tell people, if you go to a meeting and you don't like it, you need to find a different meeting, the analogy is if you go to a meeting and you don't like it, you need to find a different meeting. The analogy is if you go to a car dealership and they give you a Toyota Corolla and you don't like the Corolla, you don't give up on cars, you ask to see a different model. Same thing with meetings. Right, but what I can tell you is I want to pick out a few things of what you just said, which is, you found community and you found safety, and from what you were telling me, you didn't have those in the tumultuous drinking relationships, violence, part of your life, and I want to see what your thoughts are on this, because this is what I'm working on right now as a doctor and I'm going to use exaggeration to make a point you were not craving alcohol. You were craving relief from what you were feeling, and alcohol provided that relief to you. How does that resonate with you?
Speaker 2:Yes, I think that's good. I wanted relief from what I was feeling, what I was thinking. My milieu, the way I viewed myself in the world, just hurt and the relationship with my I'm going to say, kind of imaginary God. No, I mean no insult to any religious people, Just for me. I didn't have that, except I had to make it up and it worked for me.
Speaker 2:Many years later, I realized that what I had learned to do was access deep inner resources that I didn't know were there. Yes, so you mentioned that I was seeking safety. Well, yes, yes, and because I did not know how to cope with negative feelings, I couldn't take a rejection. I just I couldn't stand it when they you know I have to drink get my feelings hurt, get disrespected. Oh my God, you get disrespected 50 times a day by somebody. How can you, you know, let that affect you.
Speaker 2:But I had not developed the capacity to deal with negative feelings. And as my relationship with the universe and with myself deepened, I found within me reserves of courage, patience, acceptance. I also had an insistence that everything had to go my way, and if it didn't go my way, I'd be panicky, Like how can I be okay if everything's not going my way, but in life hardly anything goes your way. One or two things you can direct, but a lot of it doesn't go your way and you have to learn how to cope. So this was a huge part of my AA program and, as you said, I relied on community and the safe feeling that was developing as I learned to access these resources. And I want to say it doesn't matter how you access them. Use God, use an imaginary higher power, use an inner power, use the universe, divine mother, use anything outside your mind, because your mind is right now broken and it needs new thoughts is right now broken and it needs new thoughts.
Speaker 1:So you just unpacked the fundamental core of addiction medicine, which is to help someone learn to go from regulating themselves with substances to be able to self-regulate. I mean, that's fundamentally what I do. People seek relief with some substance, whether it's social anxiety, post-traumatic stress disorder, low self-worth. Whatever the substance is the solution to their problem and I have to help them find internal solutions, as you were saying right right?
Speaker 2:Yes, yes. So for many people this is spiritual. Yes, this book of mine, the Empty Bowl, is a story, from childhood to my 70s, of my spiritual search and hunger, which did result in a kind of awakening to reality. That's been extraordinarily beautiful and so forth, but I still don't believe in God, even though I've had this deep awakening. So I want people who don't believe in God to know that the resources are available to you. They are in you. You're part of the universe. The universe feeds you when you open up and ask. It will feed you courage. It will feed you clear thinking, which is difficult to do when you're befuddled with drugs and you're having a sense of panic and seeking relief.
Speaker 1:How did you address your trauma? So you mentioned starting well. You hinted at some sexual activity in your teenage years and then obviously there was a rape and so many of my patients are traumatized. In fact, this broke my heart. The other day. One of my patients just had an aggressive intimate encounter and poor thing, she's been traumatized so many times and she actually confided in me that after a man treats her badly around their romantic relationship, she'll ask him as a parting gift to buy her a bottle so at least she can cope. And that just broke my heart. I mean, I appreciate she was honest with me, but the trauma post-traumatic stress disorder from 14 years of working in an ER and I'm just now, at age 41, trying to figure out what to do with this. So I want to ask you tell me about the process of the trauma and how that's involved in your brain, because that's a major trigger for many people.
Speaker 2:One thing is after I was sober about a year, like solidly, the second time around I went to therapy and I was in therapy for six or seven years and I've checked in with that woman over the years. We were talking. Just last year I called to talk about something, but that therapy was really deep man, she was in my face and confronting me about my assumptions and thoughts and feelings. So, for example, asking someone out on a date was so intimidating to me. I was going to end up single for the rest of my life. And as a lesbian, you kind of have to do it yourself. You can't wait for the man because there isn't one. So let me tell you more story about when I was at work and I discovered that my male peer, who had less education but same job and same definition blah blah made about 20% more than me just because he was a man. And when I discovered this, I brought it up in therapy and she said well, what are you going to do about it? I said, well, I can't do anything about it because I'm powerless. I can't do anything about it.
Speaker 2:That's one feeling you have when you're addicted and you've been traumatized. Yes, yes, so true. You just feel like everything's arranged against you and there's no way that you could get supported out there. You and there's no way that you could get supported out there. So then she said that I should ask go to HR and ask for them to review it. Oh no, I can't do that. What if they don't think I'm good enough? And then I'm ashamed that I asked and embarrassed myself in front of them by thinking I was good enough to have the same pay as a man. This is the kind of self-esteem that I had, and she would tell me there's four basic feelings. I don't know if this is true, but she told me there are four basic feelings and I would always forget them. I could only think of three. Now I think they're fear, anger, happy and sad.
Speaker 1:Okay.
Speaker 2:And she would ask me what are you feeling? I had no idea. I could not tell if I was sad or angry or fearful, because I think when you're traumatized, when people have abused you, when you feel powerless in the world, everything inside is a tumult, a confusion, a noise. There's just red, hot noise and I need to kill it.
Speaker 1:With alcohol.
Speaker 2:Yeah, for me it was alcohol, and thank God I didn't find drugs, because I would definitely have succumbed. When I hear people talk about a drop of fentanyl, I want one, but I will never have one, so it's okay. So she dug into me that way to teach me how to sort out my feelings. What am I actually feeling? How to sort out my feelings? What am I actually feeling Now? As soon as you do that, as soon as you step back and look at yourself to isolate and figure out what feeling you have, you're not controlled by the feeling. You've now stepped back into a more rational part of your mind where you have more resources. When you're panicking, you can't think straight, you can't find any common sense, but that's stepping back. So my therapist taught me how to step back from the turmoil of emotions roiling inside of me and just put it into one of four categories, and then, when I'd say I'm sad, well, stay with that feeling. She made $100,000 off me by saying stay with that feeling.
Speaker 1:Sounds like it worked, though.
Speaker 2:Yeah, because when you stay with the feeling then you can cry. Yeah, I went through a couple of sessions where I had to beat the furniture with a soft baton that she provided me to open the access to my rage.
Speaker 1:Yes.
Speaker 2:At my father, at my mother, at the neglect my sister was molested by my father. This was all going on in my household. In therapy I realized my mother didn't help us. I was enraged. So a lot of my processing trauma had to do with sorting out feelings, identifying them and then developing the capacity to stay with them, listen to them, learn from them, but not be overwhelmed by them.
Speaker 1:So let me run an idea by you. Yeah so, and I will share a little bit about myself. I have my own demons, if you will. I struggled with self-harm and an eating disorder in my twenties, and so I'm now working with a therapist. My hospital, thank you, has offered free mental health counseling for doctors. If you didn't know, the suicide rate for doctors is higher than that of the general population. I did not know. So we're trying to work on the mental health of our medical professionals, and I went in having no idea what to expect from a therapist.
Speaker 1:But I have now learned that I have post-traumatic stress disorder from the years in the ER taking care of all these horrible abuse, stabbing, shootings. But I also have an underlying generalized anxiety disorder. And here's how I think about it in my mind. Imagine we have a blueberry muffin. It's a cinnamon blueberry muffin. I know that there's cinnamon, I know that there's muffin and I know that there's blueberries. And when I bite into it I can taste the warmth of the cinnamon, that fruity flavor of the blueberry and the sweetness and the texture of the muffin.
Speaker 1:I now know, having worked with a therapist, what my emotional ingredients are, and during the day I can stop and go. Whoa, whoa, whoa, that's my PTSD talking. Or when I get behind and click and I start to feel overwhelmed, I go stop, that's my anxiety. I will actually talk to my anxiety. No, no, no, it's not your turn. I need to take care of my patients and I wanted to ask does that resonate with you? Because that's what I'm working on with me and my therapist, and I explain that to a few of my patients just to feel I know what's actually wrong with me, helps me to understand what my brain is doing at any given time, and then the higher parts of my brain can then direct the emotional traffic and I can keep going with my day.
Speaker 2:Yeah, that's a really, really excellent description of what I think happened for me in therapy. Nowadays I have anxiety every day, especially right now. The social and political situation in the country is profoundly disturbing to me and I wake up sad and anxious. And it's so subtle now it's just like on the back of my head and chest and it can take me hours actually to identify it. I'll be wandering around having coughs and going what's wrong with me today, and then I'll realize, oh, I'm having an anxiety attack.
Speaker 1:There you go.
Speaker 2:Wow, okay, okay, I know anxiety, I can sit with this.
Speaker 1:Do the alcohol desires ever come back when you feel that?
Speaker 2:No, not at those times. I want to drink when I'm with friends and they're drinking.
Speaker 1:Oh, makes sense.
Speaker 2:And especially when people get loosened up at parties and stuff and they start to laugh and say silly things and dance crazy there you go. So I try to cop a contact high often and get silly and act out a little. I love it, but that's when I want to drink mostly. You know social situations.
Speaker 1:And this is now 40 years of sobriety for you, though.
Speaker 2:Yeah, yeah, yeah. For the first eight, ten years I went to meetings three, four, five times a week. I had a sponsor. I worked the steps over and over again, was really careful about cleaning up any resentments. Let me speak to resentments. It changes the subject a little. May I go there? No, please.
Speaker 2:I think resentment is the number one killer for me. When I resent somebody which is easy to do I get insulted or I get mad because somebody has more of something I want than I do, I get jealous of them or something. Anyway, resentment, when I am angry at somebody and I feel a little hurt and a little dissed and I don't tell them, I don't process it. And it's not always appropriate to process it. Not everyone's close enough to want to have that conversation with you, but then I've got such a disturbance in my soul that I'm extremely uncomfortable. And of course what you want to do is act out and go hurt that person, get some revenge. But AA didn't allow me to do that because that would lead me to a drink. That level of emotional discord will lead me to a drink. So I learned during the steps to clear up any resentments before they festered. And if I couldn't clear it up with the person I had to clear it up in my soul and just get straight about what's really happening in reality.
Speaker 1:That goes back to your emotional resources. You had to learn them.
Speaker 2:Yes, you're right. You're right, I had to learn them. Yeah. So I think resentment is something we are not taught to process. In fact, what we observe around us in society is people taking revenge more.
Speaker 1:That's interesting. Yeah, so social media has discovered that rage is the most engaging emotion and you and I both know that social media is all about profit, right?
Speaker 1:The more time we spend on the platform, the more ads get sold, the more the companies make, and it's really ethically, I think, a really messy area that they're profiting from encouraging more rage. We are wired that negative emotions have a greater emotional weight in our brain than positive ones. It's estimated that it's about a four to five to one ratio, so you get four high fives and smiles. That's about the same emotional weight as one person dissing you, and so it's interesting. In my opinion, it's because we're not top of the food chain and we had to protect ourselves for many years. Fear and the fight or flight response take precedent over positive emotions, and so it's actually a very normal thing to have negative emotions easily spiral, and this goes back to the emotional toolbox that you talked about developing to change those weights or even just acknowledge the weight of something negative and to work on processing it, resentment being one of those.
Speaker 2:Yes, yes, and having these I want to say tools, but I don't know. I could quite identify which is a wrench and which is a hammer, but tools to identify what's going on with me and make a choice about my behavior. My father did not have that. If he had a choice about his behavior, he would have always been the nicest man in the world. My grandmother didn't have any money my mother's side so he bought her an apartment in Chicago so she'd have a place to live, just stuff like that. He was always rescuing animals, but he could not manage his own internal states.
Speaker 2:And so he used alcohol. Yep, yep, and I think this also requires a support community. For me it required a support community because I can't call my therapist every time I stub my toe or somebody steps on my toe. I had to get the detachment to stand back and look and name things and then find my own centered piece.
Speaker 1:But it's there, it's there inside everyone.
Speaker 2:That piece is in there. Nobody should ever think that they don't have it. You know what I mean.
Speaker 1:Well, and that's why some people really find spirituality and some sort of higher power, whether it be God or something else because you can pray 24-7. It's free, you can do it whenever you can do it in the bathroom, in the car, on a train doing handstands. That's one of the reasons, I think, that for some people, prayer is so helpful because, yes, you cannot always call your sponsor or your therapist, and if you can use prayer to self-regulate, fantastic. And I think that's why, for many people, the higher power thing works.
Speaker 2:Yes. Now, to a certain extent, I kind of hated God for creating the lives that we were suffering through. That was a bit of an obstacle. I had to put my health ahead of my opinions and that was challenging because I thought I was probably the smartest person in any room I was ever in. Not true, but I thought so, yeah. So I had to put my well-being first, and I think that's very hard for a lot of us because we don't have a lot of self-respect, so we don't know that our wellbeing is valuable and we don't know that inside ourselves are the resources that we need to be healthy. And the social thing I had oh, I had so many friends in AA and they're still my friends today. And when they told me, you never have to be lonely again, that's true, but also I don't think people realize how lonely we are. I have been reading a lot recently from some reporters in the New York Times about the epidemic of loneliness that we are currently going through. Yep, and it's like a petri dish for addiction.
Speaker 1:Yes, it is.
Speaker 2:And we don't have any more clubs or some people have their church but not everyone and in fact probably a majority of us don't have a church. We don't have our astronomy club or our radio club or places we go to get together with people. Even if we have a book club, it's on Zoom and this really makes it hard to stay sober. So the thing of having a community or a group you go to once a week, a place you know you can talk and be heard, really heard. You can tell the really truth and be really heard, not like with your spouse, who you have to keep some kind of facade up most of the time. Maybe you don't, but I do. It's so important.
Speaker 2:So now we've talked about inner resources, getting the independence to stand back and look at what you're feeling, being able to identify what you're feeling, having a community of some kind in which you can talk and tell the truth and be supported. It relieves your shame. Like I don't know if you have a community where you can talk about being a doctor with limitations, like, of course you have some, but there used to be professional AA groups just for doctors, just for lawyers, so they could protect their reputation and professionalism, and I just think having such places is so, so, so important.
Speaker 1:Yeah, I was hoping we could pivot to a difficult topic and if this is triggering or traumatizing, we can obviously stop. But I want to talk about deep personal relationships and intimacy and transitioning from intimacy with substances and intimacy after being raped to creating healthy, long-term relationships intimacy after being raped to creating healthy, long-term relationships. So there's two parts to this. Right, you told me that your first drink at 13 led to getting in bed with someone, so you initially came to intimacy with alcohol and then you were a victim of sexual assault. I'm going to try to empower you. You're a survivor of sexual assault. You have moved on. Yes, you're also a survivor of addiction, but at some point you had to learn how to be loved intimately, sober and with a head full of bad memories. Can you talk me through that process, Because this is something that I really am trying to again unpack with my patients. They're just so traumatized and they just want to be loved and accepted and it's really hard for them them yes, this was a very difficult thing to me.
Speaker 2:I didn't get married until I was in my 60s.
Speaker 1:Congratulations I saw you wear a ring yeah, yeah, that's, that's true.
Speaker 2:these little rings are actually made of some gemstones mixed with the ashes of our favorite dog. Oh, and we made them our wedding rings.
Speaker 1:Wow.
Speaker 2:But anyway, I had a very hard time with intimate relationships In sexual situations. I couldn't handle them at all for five, six, seven years after I got sober Say seven and then I just didn't enjoy. I just felt so exposed and so vulnerable.
Speaker 1:Yes.
Speaker 2:I could not enjoy being intimate. Just getting undressed made me feel so ashamed and my sexual feelings I thought were bad, just bad. Everybody has them, but I thought mine were bad, kind of disgusting, and I didn't know how to deal with that. It just took a long time. I had a number of relationships that didn't go anywhere and then I just stopped trying. I had friends with whom I could be intimate, but a part of myself, the core, the real me I still keep very close and I still feel that I'm not well understood and that I don't know anyone who listens to me deeply. Now, actually it's not true. My daughter and her father, two of my best friends. They really listen to me and my wife listens to a lot of me. But I always feel like I have deep, dark secrets that I'm hiding from the world, and in that package are scenes of the rape. I didn't realize I was raped until the Kavanaugh hearings. Was that in the 2000s? When was Brent Kavanaugh?
Speaker 1:appointed, it's within the last six years, I think.
Speaker 2:Oh yeah, you're right, it was around 2018. Oh my gosh, wow, I didn't realize, until that woman I've forgotten her name there was a woman who accused him of assault in her teen years. When I heard her talking, I went oh my God, that's what happened to me, except he actually perpetrated the rape, but I hadn't even realized. It's buried that deep as a secret even to myself.
Speaker 2:but so I now have a lot of friends with whom I feel very close and, I would say, intimate. And of course I feel very intimate with my wife, who knows my moods and many things. But there's a whole Ricky in a little capsule that I keep to myself and I'm not entirely happy about that, but it's something I had to learn to live with.
Speaker 1:What is the name of that capsule? Is it trauma? Is it shame? Is it fear? I call it shame.
Speaker 2:I call it shame. It seems the closest. If someone really knew the depths of me, they would reject me, and part of that is because I've been abused. Proves that I'm not good enough.
Speaker 1:It proves it Does that make any sense to you, a hundred percent. I'm thinking exactly of the patient who told me that after she's been mistreated she'll ask for a bottle of alcohol. I tell her at the end of our visits and sometimes she's in tears. And this is not her name, lindsay. I need you to know that I respect you as a human being and I'm sorry you're hurting. And I'm going to go down a little rabbit hole here and I'm going to see if this resonates with what I try to create as a doctor.
Speaker 1:We adopted a dog about a year ago. We went to the shelter and she was all defensive posture. She was hunkered down, tail between her legs, and we brought her into the meet and greet area and she was just so afraid, her legs. And we brought her into the meet and greet area and she was just so afraid and we almost didn't adopt her because we were worried about a dog with anxiety that would be destructive. And then one of the staff from the shelter came out that had obviously worked with this dog and she just lit up like a Christmas tree that dog's smile, the tail, and we went. She's petrified. So we took a chance on her. We brought her home and within even just a week or two, she is the most friendly, loving dog we have ever had. Her name is Pixie and her nickname is safe and loved, because she is safe and loved and it changed everything when she felt that.
Speaker 1:So back to my patient. I want my patients to feel safe and cared about, so I think of this particular patient and I need her to know that, no matter what she does, I respect her as her doctor and I care about her as a human being. I have to drug test my patients and they're all so worried like what's Dr Grover going to find? Is he going to cut me off? I tell them I don't judge you for your drug test If your drug test my patients and they're all so worried like what's dr grover going to find? Is he going to cut me off? I tell them I don't judge you for your drug test. If your drug test is abnormal, it means you need another appointment with me that's what I would say to you, ricky, if I were your doctor is that residual shame is okay.
Speaker 1:I still respect you and care about you as your doctor, no matter what you've been through and and for me, having had my dark times of self-harm and my eating disorder and now PTSD and I've gotten triggered a few times during this call and I'm working on managing I understand what they feel and I think the best way I can say what my work is as a doctor is it's not about the substance, it's understanding the why and what they've been through and what they've been through and what they're feeling. I love my patients. They are some of the nicest people on planet earth. This patient, as she was telling me about her horrible trauma, said to me through tears Dr Grover, I just want to acknowledge that you have PTSD too, and I hope you're okay today. Ptsd, too, and I hope you're okay today. Oh, wow. And so, coming back to you, it's okay that you have that there and if you get to a point where you can process it and accept it, it's part of who you are and I would argue it's part of what's made you successful today. It's almost like it has helped you learn and grow and evolve.
Speaker 1:My eating disorder was one of the worst things that ever happened to me, but I am a stronger man today because of it. And I actually saw a very, very close friend of mine who was horribly, horribly traumatized and I asked her yesterday do you think you are who you are today because of your trauma or despite of your trauma? And she's still trying to process that and I can tell you for me, I am a better doctor today because I your trauma or despite of your trauma, and she's still trying to process that. And I can tell you for me I am a better doctor today because I've had some demons in my life.
Speaker 2:Yes, I can completely agree with you. I know that life can be very difficult. I know that people can feel frightened. I know that people get ashamed. I can relate and understand to so many different human experiences that we keep secret and try not to share with other people. And I'm no longer afraid of myself. We didn't mention that earlier, but it's true.
Speaker 2:I used to be really afraid of myself because if some feeling came up it could overwhelm me and get me into trouble. I could start a fight in public. I'm embarrassed to say that's okay. I'm really happy to hear that you tell your patients that. I want to say that when I was in therapy, I completely fell in love with my therapist and I wanted her to take care of me, because being around her was one of the few times when I felt okay, because she was constantly validating me. And then I got dependent on it and then I would call her during the week thinking I was in an emergency and if she didn't call me back I'd freak out. So it's kind of a two-edged sword there of learning to accept support, accept love, but not take a hostage.
Speaker 1:Well, let's unpack this a little bit right. We talked about addiction at its core being regulating oneself with external substances to self-regulating. You were in your journey and you used your therapist to regulate as you were learning your own emotional tools. That's fairly normal.
Speaker 2:Yes, yes, yes, that's right, that's a good way of putting it, as I learned my own tools Because I did. Eventually, you know, obviously I quit therapy, yeah.
Speaker 1:Yeah, so tell me about your book. I am looking at your book called the empty bowl. I will be purchasing it after this interview.
Speaker 2:I'm excited to hear what's in your story thank you at the end of my life well, it's not the end of my life, I'm right here but in the last few years I 73, I'll be 74 in a couple months and in my late 60s we left California, where I had been since I was 12 or something, and moved to Santa Fe, New Mexico, to retire. And at that time I had lost everything. I'd lost my job in high tech. I'd been living on my savings for years. I used the last of it to help my daughter get through college. I had nothing, and I mean I had my Yamaha guitar. I didn't have a car. I had books. I didn't have a house. I lost my house. I was in a terrible state. I was married to Jill and Jill had some money, but I was kind of dependent on her and I was in an intense spiritual search for truth.
Speaker 2:As it turned out, I encountered the right people after I moved and opened a whole new door to understanding myself and reality and what I really am. But this process took my whole life. I became a Buddhist. There's some kind of spiritual power involved in that, Hard to define. But I studied yoga, the spiritual kind, with meditation and fasting and chanting and so forth. I did that for a number of years and I threw all these things out the window in order to look deeply within myself and tell myself the truth, my truth, what I found for myself. I studied science at UC Berkeley and I wanted an explanation of the universe to fit with my scientific understanding and not have something come in from the outside as a deus ex machina to solve the problem. And the book tells the story of the search through philosophy, through science, through spiritual pursuits, and then how the door opened for me in the last few years.
Speaker 1:I look forward to reading it. Thank you. As always happens when I do podcast episodes, the hour just flies by. It does. Yeah, we have covered all sorts of wonderful topics. Many of my patients listen to my podcast and I try to leave each episode with some sort of take-home point to ask you if you were ever judged by your healthcare providers for your history of addiction and if you have any thoughts on how we can have less stigma towards patients about addiction.
Speaker 2:I have never been wrongly treated by any medical professional.
Speaker 1:Oh, that's good news. Wow, that's. Wonderful.
Speaker 2:Yeah, just checking. Nope, even I had a psychiatrist for a while who gave me anazepam, so I got addicted to them right away. I mean, they're great, are you kidding? And you don't even have a hangover.
Speaker 1:It's like alcohol and a pill and you don't even have a hangover.
Speaker 2:It's like alcohol and a pill, yeah yeah. So so he was going to keep them to me, so I dropped him and went to somebody else and got off them. And I have a psychiatrist now who gives me Benzos and I have them in the closet and when the anxiety gets too much I'll take one. It's like really small and I take a half one and I have no addiction problem with it. So anyway, they've been really good to me. What I think might be one of the most powerful tools you have is telling the truth and being honest when you share your experience. It makes mine normal, it makes mine acceptable.
Speaker 1:My experiences.
Speaker 2:When you just shared with me that you have various things oh yes, traumatic stress syndrome and anxiety and stuff I felt it physically. I felt my self-protectiveness drop. You know what I mean.
Speaker 2:And then oh, yes, you and me were people struggling with people, things, not I'm broken. You're the fixed doctor and you're going to give me stuff to try and fix me because I can't fix myself myself. That's an easy position to get into. So doing it your way, I think, really can help open the door to people to begin to have faith in themselves.
Speaker 1:I am very honest with my patients about my PTSD and I've started to be honest with my colleagues as well. I was very ashamed initially and I'm supposed to be Mr Tough Doctor and I just I'm an empath and I'm working with a therapist in processing. I have to say, though, I am so impressed to whoever your healthcare providers are, that they didn't make you feel judged, Because I have so many patients that are so afraid of going to the doctor and I just try to create a welcoming space in my practice for them to be seen and feel safe. Again, safety what is my dog's nickname? Safe and loved. I need my patients to feel safe and that I care about them deeply and I do. I get really protective of them.
Speaker 1:One of my patients just got assaulted and I am on fire about it. I had to go lift weights and I just triggered again. I have to go lift weights and channel my anger and journal and talk to my therapist. But these are my people. They're almost my family. I care so deeply about them and they feel it and it's really cool and this is the type of medicine I always wanted to practice.
Speaker 2:Yes, that's fantastic. I'm really glad to hear that. I think you're a fine example for other professionals. I'm not sure everybody's an empath, but you chart a path that I think, is very healthy and helpful.
Speaker 1:Yeah Well, Ricky, this has been amazing. I can't wait to get this podcast out there.
Speaker 2:Thank you so much, Casey. I've really, really enjoyed it.
Speaker 1:Absolutely. Before we wrap up, a huge thank you to the Montage Health Foundation for backing my mission to create fun, engaging education on addiction, and a shout out to the nonprofit Central Coast Overdose Prevention for teaming up with me on this podcast. Our partnership helps me get the word out about how to treat addiction and prevent overdoses out about how to treat addiction and prevent overdoses To those healthcare providers out there treating patients with addiction. You're doing life-saving work and thank you for what you do For everyone else tuning in. Thank you for taking the time to learn about addiction. It's a fight we cannot win without awareness and action. There's still so much we can do to improve how addiction is treated. Together we can make it happen. Thanks for listening and remember treating addiction saves lives.