The Journey with Mark Astor

Ep. 12 Big T vs. Little T Trauma, ADHD & Addiction Explained with Renee Calhoun

• Mark Astor

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Not all trauma looks the way people expect it to and that misunderstanding may be holding more people back than they realize. What if the experiences you’ve brushed off as “not that bad” are actually shaping your behavior, relationships, and mental health in ways you’ve never considered? In this episode, Mark Astor sits down with Renee Calhoun to unpack the difference between “Big T” and “Little T” trauma and why both can have a lasting impact.

As the conversation unfolds, Renee connects trauma to ADHD, addiction, family dynamics, and even physical symptoms many people overlook. From generational patterns to the role of dopamine, medication, and emotional processing, this episode challenges common assumptions about mental health and recovery. You’ll walk away with a deeper understanding of how trauma shows up, why it’s often misunderstood, and how recognizing it can completely change the way you approach healing for yourself or someone you love.


Contact Mark Astor:

Website: https://mentalhealthaddictionlawfirm.com/

Phone number: 561-517-9405

Email: mark@astorsimovitchlaw.com

LinkedIn: https://www.linkedin.com/in/markastor

TikTok: Mark G. Astor (@astorsimovitchlaw) | TikTok

SPEAKER_00

There's two different kinds of traumas. We call them big T's and little T's. A big T would be something that I experienced, like that assault, or a car accident, or some sort of life-altering event that you can absolutely pinpoint and say, this happened to me on this date. Little traumas are more what we see in therapy and what you may see in the addiction world of lots of little relational things of people not consistently not showing up for them or consistently not getting their needs met. And that pattern of little T's adds up. So I'll have lots of clients who say, no, I don't have any trauma. I wasn't sexually assaulted, or my family was great. But then when you start digging into it a little bit, they can find patterns where maybe a relationship wasn't so great, or again, just people not seeing them for who they are and what they need.

SPEAKER_01

It's the journey with drug and alcohol attorney Mark G. Aster. Welcome to the journey with Mark Astor. I'm your host, Mark Astor. I spent a lot of years sitting across the table from people during some of the most challenging moments of their lives as an attorney, an advocate, and as someone who understands that the road isn't always straight. What I've learned is that success, recovery, and growth rarely look the way we expect them to. There are detours, hard conversations, and moments that change everything. On this podcast, I talk with people who are willing to be honest about their journey, what worked, what didn't, and what they wish they knew sooner. So today I'm joined by Renee Calhoun. Renee is a licensed marriage and family therapist. She special specializes in addiction and recovery, ADHD, anxiety, and breaking the generational cycles of family patterns, couples and family relationships, parenting stress, and the mental load. She's also very involved in the human trafficking universe, which is a very important, which is very important work. And I know that that is near and dear to you. And we have a bunch of things to talk about, but I know because we've spoken before you came on that that some of the things that you specialize in are is trauma, the genetic component with regards to behavioral health issues, which I've actually ironically just put some content out about. The whole idea of normalizing the idea that somehow the chaos is normal and it's okay. And also the family systems, because in my world, the legal world, we're speaking to families, and the one thing that's consistent is that is it's the family system that's really suffering, and it's frankly being slowly destroyed. So I I appreciate you taking time to be with us on the podcast and welcome.

SPEAKER_00

Thank you. Thank you so much for having me. I'm excited to be here.

SPEAKER_01

Did I do a half-decent job of introducing you?

SPEAKER_00

We did it justice.

SPEAKER_01

I want to make sure. Renee, tell us a little bit about yourself. Where are you based? What you focus on, how long you've been doing it.

SPEAKER_00

Sure. I'm a licensed marriage and family therapist, like you said. I have been licensed since 2011. I am licensed in Pennsylvania and New York. I'm located in the suburbs of Philadelphia. I started my journey in this world at age 16, working in a youth detention center in the suburbs of Philadelphia. From there, I got my undergrad in criminal justice and then moved forward with my master's degree in clinical counseling psychology, specifically marriage and family therapy, which, as you mentioned, really digs into the systems, family systems specifically. So I've been in that world since 2008.

SPEAKER_01

How did you go from if you study criminal justice? Normally somebody either goes into law enforcement or they go to law school. So how did how do you go say from criminal justice into your more obviously the clinical world, the therapeutic world?

SPEAKER_00

Yeah. At the ripe age of 16, I worked in the youth detention center, which now there's laws that would permit that or would not permit that, I'm sorry. And I was very curious about why I was coming from a single parent household driving, well, taking the bus, the public transportation system from the inner city of Philadelphia to the county, which I thought were like the quote unquote rich kids at the time in my 16-year-old brain. And I really like criminal justice because of that experience. So then I went to undergrad for that. And when I turned 21, I was all excited. I had been working at the detention center for so many years, and I'm like, okay, I'm ready, I'm here to work with the kids one-on-one. And they said at the time, which was heartbreaking and such a blow to my ego, you've never worked anywhere else, you don't have any experience, go somewhere else and come back. And so there was a mental health facility across the street from my college. And so I went over there and they said, Wow, look at all this experience. Ironically, and so I worked in a residential program. I was there for about two or three months, and then I was assaulted by one of the residents who was 15 at the time. And I pressed charges on her because at the time she was only involved in the mental health system, and she had attacked me and I had suffered a concussion. And then after I physically healed, I went back to work and immediately had a trauma response with one of the other patients. And so they sent me to therapy. And when I met with a therapist, I liked her approach in the sense that she was the only one not telling me what to do in reference to this situation, where everyone in my life had their own opinions and were expressing their own opinions, not allowing me to come up with my future and what I wanted to do. That was my first experience in therapy. And then when I graduated, I didn't know what to do with my time or my life. All I had known is being a student. And so I quickly, after the summer was over, was like, what am I gonna do? So I looked online and I found LaSalle University's marriage and family therapy program and systems work, and that spoke directly to my heart and all the questions I had growing up about what made me different than these other folks who were incarcerated. And so that's how I fell in love with family systems.

SPEAKER_01

So you mentioned the word trauma, and I know that's an important part of your universe these days, and it's something we see a lot of when we speak to families, and we're dealing with uh typically an adult child with a long history of behavioral health issues. There's normally at the root of things is some type of trauma. So tell me what you mean by that. Because you said you had a trauma response, and I don't if you want to, we can get into that, but I didn't want to pry into what happened with you. But tell me what you mean by trauma response.

SPEAKER_00

There's two different kinds of trauma. We call them big T's and little T's. A big T would be something that I experienced like that assault or a car accident or some sort of life-altering event that you can absolutely pinpoint and say, This happened to me on this date. Little traumas are more what we see in therapy and what you may see in the addiction world of lots of little relational things of people not consistently not showing up for them or consistently not getting their needs met. And that pattern of little T's adds up. So I'll have lots of clients who say, No, I I don't have any traumas. I wasn't sexually assaulted, or my family was great. But then when you start digging into it a little bit, they can find patterns where maybe a relationship wasn't so great, or again, just people not seeing them for who they are and what they need.

SPEAKER_01

So it sounds like there's the big T that does a lot of damage in one go, and then there's the little T's where we have repeated traumas that cause damage over time. So tell me about how does the body deal with that? Why is that, and why is that digging into the whole trauma issue that important? Because it sounds like it really is.

SPEAKER_00

It's so important, and these big T's and little T's can happen to us, but there's also been a lot of studies about generational trauma, which I'm fascinated with and the genetic component of it, where as a woman, when I was birthed, I carried all of the eggs inside of my body that would ever become children. And so any trauma that my mother experienced from conception until birth, and then for me, any from birth until my children were birthed, those eggs and those that DNA was all affected by trauma that is mind-boggling. And the kind of the joke in the therapy world is it's all it's mom's fault. And so we see a lot of parents who don't want to engage in therapy because they're worried they're gonna get blamed. But truly, we can now blame it on grandma. And then they recently did a study with male sperm. We always thought it was the egg that carried the DNA, but they exposed male rats to the cherry blossom scent, and then they gave them some sort of negative stimulus. I think it was some sort of like electrical shock. And then they took that sperm and impregnated a female rat and took the male rat away, and the baby never met their father. And when the baby was exposed to the cherry blossom scent, they also had a trauma reaction. So what we're finding is that genetically we're carrying trauma from at least mom and dad in our DNA, and it does affect the cells. A great book that goes into this, a little dry, but it's a textbook in the therapy world is The Body Keeps the Score. And it talks about how our DNA changes from trauma and how without doing the somatic work of releasing that stored emotion, you're just carrying it around. So we see lots of clients with chronic pain, fibromyalgia, where truly it's trauma and they're not talking about it or it's not being addressed because in the world that we live in, the physical body and the mental health world are not aligned and they're not combined when truly they they work together.

SPEAKER_01

Can I take a few minutes to dig into that a little bit with you?

SPEAKER_00

It's it's a lot.

SPEAKER_01

It's a little bit relevant. So my mother, my dad's been gone nine years, and my mother's entire life revolved around him. She was a stay-at-home mum, and you know that, and she has been experiencing horrendous leg pain for about the last two years. So she went to see a million doctors, she had a million a bunch of shots, nothing really did anything. And she went to see an acupuncturist, somebody that we you know trust. And the first thing the acupuncturist said to her was, Wow, you're carrying a lot of grief. Because my mom lost, she lost her brother, her sister, and my father all in a very short period of time. And she said, You're carrying a lot of grief. That was the first thing she said to her. And so what you're saying is sometimes we have physical pain in our body, and it's not really a physical pain, it's uh an emotional pain because it's stored in the body.

SPEAKER_00

Yes, and a lot of those receptors are the same. The same receptor that opiates sit on is our pain receptor, which is the same, it's it's where people that's why people use substances, right? Because it's activating that same receptor, and so it feels better than sitting in physical pain and emotional pain.

SPEAKER_01

So, how do we go about releasing that pain? Obviously, and I hear what you're saying, and I agree with you, right? There's the there's the physical, then there's the mental health issue. And not one doctor has ever said to me, maybe there's a connection here between your pain, your physical pain, and your grief, right?

SPEAKER_00

Yeah, yeah. I think in a large systemic world, it would be lovely for physicians and therapists to understand that. Therapists also don't understand the connection between the physical world because we're not taught that, right? We're taught to talk about our feelings. And someone who practiced therapy for decades and who has a master's degree in counseling, no one actually ever taught me to sit in my own feelings and until my own therapist taught me that, right? And so doing somatic work, which can be done with a therapist who's trained in somatic work or can do body-based healing like yoga and acupuncture and some massage techniques and those kinds of things. But without truly understanding all of the systems and advocating for your own health, that's not going to happen like in the next few years. You have to find clinicians who are willing to dabble in other systems and learn about them and introduce you to other folks who want to understand and who are really curious about those things, or else you everything is in a silo.

SPEAKER_01

It's interesting. I've been reading quite a bit about just recently, one of the things that we see a lot of here when we're dealing with somebody who's got a history of especially of substance use, somewhere along the line, typically early in this person's life, somebody prescribed them a medication. And I think one of the things that I've been we've been seeing, and I was talking to somebody about this the other day, is uh you know, when you s suffer some type of loss, right? Rather than going through the grieving process or the emotional process, oh we'll take a pill. And so we never released whatever it was. I know when I got divorced 25 years ago, and I was only I only had a brief marriage, and honestly, I couldn't wait to get divorced because it was very clear it wasn't going to work for both for either one of us. But I'll tell you, three for the first three days after the actual divorce was signed, I couldn't get out of bed, and it took me a long time to get over that, and I was shocked because I was only married for about a year and I was like, thank goodness that's over. But from a trauma point of view, it knocked me on really on my backside. And I went to see a therapist and she explained to me that cycle of recovery. And once I understood what I was dealing with, she said you got it, you need to go through this or you'll never heal. But these days it's very quick, right? We go to see a therapist, oh, take a pill, take an antidepressant. And I'm wondering, is there a fine line between taking the medication to numb the feeling and not taking your medication and going through the feeling so that you can recover? Somebody joked from the other day, the reason that we cry is to release the pain. If you never cry and you don't release it, how do you ever heal?

SPEAKER_00

But I think people are scared because they don't know what's going to happen when they start feeling their feelings. Because in our culture, that's not something that's celebrated, whereas in other cultures it is. So they just they want the pill to stop feeling. And allowing you to live your life otherwise, going to work, going to school, doing all those things. But if you're not pairing the two of them together, then it may not work for you at all. Medication should not, there's a difference certainly between like genetic or biological issues that are causing you to have certain things like depression, ADHD, etc. But that's different than I'm upset because I'm grieving, the loss of something or someone. That's situational. And so therefore, medication should just be used to get you to do the work, not it's not the work.

SPEAKER_01

Okay. Can we digress for a sec? Can we talk about ADHD? I know on your website it talks about that's the work that you do. We see uh again, we see a lot of that in someone's history when they come to us because there's a behavioral health issue. Can you talk about that? Can you tell us what it even means? Because I don't know if people really know what it means, right? They see ADD, ADHD, and I don't even know. I'm not sure even I know exactly how I would define it. I'm not a clinician.

SPEAKER_00

ADHD and ADD are now one and the same. I think the world views ADHD as a little boy jumping off of furniture, running around, and just like full of energy. And when that does not present itself, then they don't think that ADHD exists, though people will be called lazy or unmotivated. When in fact it's an issue with executive functioning. When I say, Hey Mark, did you brush your teeth this morning? You think of that as one task when in reality it's probably 10 tasks. You have to walk into the bathroom, you have to pick up your toothbrush, you have to put it under the sink, you have to put the toothpaste on. All of those things are a bunch of steps to do one task. So an ADHD person thinks about brushing their teeth as 10 tasks rather than just one. And it those 10 small steps can be completely overwhelming. The thing with ADHD is that it and executive functioning is one of the first things to go when your mental health is poor and when your physical health is poor, right? A lot of people don't take showers when they're depressed, or if you're sick, you're in bed all day. Maybe you don't get a shower. So the executive functioning piece is something to look at, but not the only thing. And we want to look at executive functioning over time, not again, not situational. I have plenty of women who are coming in saying, Oh, I've been on anxiety medication my entire life, and it's worked a little bit, but not a lot. It's probably because you have ADHD, and in women and in girls, that little boy jumping off of the furniture is what's happening in their brain. They're thinking about a million different things, and they can't finish an entire task. In my house, a realization I had is that when I'm not on my ADHD medication, I leave all of the cabinets open. So I might be emptying the dishwasher and I will leave the cups that go in another room, like like the school thermoses on the counter, and then I'll leave all the doors open. And it's like, it's just the last task, right? It's just the last part of that whole puzzle. And when I look into my kitchen, I see all the doors open, it's a good reminder for me to take that medication. One of the other things that you mentioned is you have so much crossover between ADHD and substance abuse, and one of the links to that is genetic, is a genetic component for sure. But think about two, it someone who has ADHD, a female or a male, who's constantly told to sit down and stay on task. And maybe their grades are slipping, but they're typically very high IQ as well with these folks, and they're often bored out of their mind in class. Because they need the stimulation, they need the stimulation, but they're not getting it because they're jumping off the walls and there are behavior problems. So they get sent down to guidance or to the principal or whatever, and they're told to like behavior manage. So that's one part. So those kids then grow up to be like, How do I fit in? How do I calm down? They may find drugs or alcohol, and then that works for them. Or the person, the female, I'm using very gender specific because this is how it typically presents, right? The female who's so socially anxious because in her mind she's thinking, What does that person think of me? What am I wearing? How's my hair? The alcohol kind of calms them down so they can go into these socially appropriate situations and not feel um so overwhelmed. But then that drinking eventually becomes a problem because now they need it to go out into social settings, and now they're drunk drinking too much and they've become an embarrassment and a work function or whatever. So that's one part. Then the genetic component that I was referencing is that there's a specific gene called MTHFR, and it talks about how folate and folic acid is in a ton of stuff. If you get enriched cereal, if you look on the back of the bread in your cabinet or your cereal boxes, it will say enrich with folic acid. That's something that can take someone who has MTHFR and just holds on their body holds onto it, they can't metabolize it out. So you're holding in a bunch of junk, a bunch of pollution, whether through air or the lotions we use and the shampoos and all that stuff and the food that you consume, and then your body's holding on to it, your brain can't get the nutrients it needs to function appropriately. So now, no matter how much broccoli you eat, if you don't have kind of that vehicle to take it to across the blood-brain barrier, you're never going to get it. And MTHFR is linked to anxiety, autism, ADHD, and addiction. And so it's no wonder that we see all these together.

SPEAKER_01

So basically, what we're doing is we're putting all these substances in food, and then we're medicating these people, and it sounds like a bit of a cycle here. Am I wrong about that?

SPEAKER_00

For sure. And you may or may not be medicating them appropriately without the appropriate gene testing either.

SPEAKER_01

Interestingly enough, just I think a couple of weeks ago, again, there was a lawsuit that's going on in California, and it has to do with addiction to social media. And I've got five nieces, and I know when we go out, they're all sitting there on the phone. And I'd be honest, I'm a little bit guilty of myself because there is something about it does stimulate, and I'm wondering if there's any connection between sort of the ADHD need to be stimulated and the fact that social media is well, it provides the stimulation. Is that why we're seeing so many people on their phones constantly on social media?

SPEAKER_00

Absolutely, because it provides a dopamine brush, right? So if I have ADHD, I'm already in a dopamine depletion, which means I need more stimulus to get me motivated, which is why a lot of these folks are called lazy. So the phone, let's just use the phone in general, takeaway social media. The phone and gambling are so similar, which are behavioral addictions, right? When I pull that lever on the slot machine, I don't know what's gonna happen, right? Same thing happens with my phone. When I pick it up, did I get a text? Did I get an Instagram alert? Did I get did someone tag me? What's going on? What's going on? So it's like a dopamine rush every time you get that alert. And so we're always chasing that high.

SPEAKER_01

Yeah, it's a problem. And I've noticed it myself, and my wife will say, You're always on the phone. We put a lot of content out on social media, and that causes people to respond and post and all that stuff. And it can definitely be addictive, there's no doubt about it, right? You feel that little rush, right? Somebody posts something on one of your posts.

SPEAKER_00

If you know the five love languages, and if you don't, I highly recommend everyone to go to fivelove languages.com and take the quiz that says what their love language is. But if yours is words of affirmation and you're putting out this content and you get someone who says, Oh, Mark, I love your recent podcast. Now you A double dopamine rush, right?

SPEAKER_01

Or the opposite. I've been putting out talking a lot about just recently about the legalized marijuana and kratom, and people I've had people say, Oh, it's no big deal, you're a party pooper, blah blah blah blah blah. So you get that other response, and there was a time when I would take that personally. I'm like, all right, it's not personal. So I appreciate you shedding some light on that because it's a very interesting universe that I think is probably going to continue to evolve.

SPEAKER_00

Well, often with our love languages, too, if it is words of affirmation, when someone does make a negative comment, it hurts worse than if it if that wasn't your love language. Same thing with your phone. If your love language is quality time, and or if that's your wife's love language is quality time and she feels like you're always on your phone, it then harms that relationship because that's what she's craving and you're not able to give it to her in that moment. So the same way that we receive love is the same way that we're often punished, or it feels like punishment, I should say.

SPEAKER_01

Yeah. So the therapist I used to see when I was going through my divorce, I'd say, I'm having this feeling, and she still she'd say to me, You have to be careful about what meaning you put on that feeling. For instance, I she'd say, I'd say I had this feeling about my ex-wife, and she said, Okay, but that doesn't mean to say that you should call her up and tell her you want to fix your marriage. You are connecting the feeling with some type of response. And if so, sometimes we associate feelings with a certain response, right? Just because somebody posts negatively on one of my something I put out there doesn't mean to say they hate me. Right. Conversely, just because somebody posts something nice doesn't mean to say they want to be my best friend now or whatever.

SPEAKER_00

Yes. And if you have ADHD, you might also have something called rejection sensitivity dysphoria, which is often very comorbid with that, where they might misinterpret those cues as exactly what you just said. And so then they have large reactions to things that are happening in their social world, not because it's true, but because they had associated that thought or that fact, quote unquote fact, with how they felt.

SPEAKER_01

Very interesting stuff. Okay, I'm gonna switch gears with you for a second because I want to get through some of the things that we talked about before we came on. Talk about normalizing for me. I wrote that word down after I spoke to you. Tell me what you mean by that and how that fits into the work that you do.

SPEAKER_00

Yeah. So normalizing for me is that I have a lot of clients who feel like their story is very unique to them and that other people in the world have not experienced it, or they feel just very alone in their recovery process. Something that I really like to do is provide them with psychoeducation around family systems and dysfunctional families and some of the things that we've mentioned about genetics and trauma, and really normalize their experience for them. That yes, maybe their content is unique and it's unique to them, but in general, this story has been told unfortunately many times, and there's many people in the world that have experienced it, so they're not the only ones going through it. And I think that really helps my clients feel like they can breathe a sigh of relief that like they're not the only they're not forging this path. The path has been forged before them, and it they can do some things to make themselves feel better.

SPEAKER_01

Okay. Let me give you a little bit of a hypothesis and tell me if I'm on the right path here with the normalizing. So we speak to families from all over the country, and it's typically because somebody in their family, an adult child, has a long history of behavioral health issues, and there's treatment that hasn't worked, and they're in and out of treatment, they're probably med non-compliant. They may well even have been in and out of the criminal justice system or the mental health system, and they call us and say, Can you help us? And I've noticed there are two types of fears. The first fear is that what they'll work with us and whatever we try isn't going to work, and they'll be like, See, told you, doesn't work. The other fear that I've noticed is they're not afraid that it won't work, they're afraid that it will work. And now, a year from now, their loved one is over here and they're still here, and they don't know how to cope with that because their status quo has been for so long, basically to live is living in chaos. And for them, that is quote, normal, right? That's just how things have been for the last five years or ten years or sometimes longer. So, how do we address that? Because my understanding is that our subconscious mind equates change with danger, and right, and so we are hardwired to avoid anything that's different. It's why moving moving house is so stressful because it's new, it's change, and that doesn't feel comfortable. So maybe we could talk about that, the whole normalizing of it's just how it is. Because it doesn't have to be that way, and you know that because you work in the space.

SPEAKER_00

Yeah, I think you're talking about two different worlds, right? Like the first one who's who's saying this may not work, right? We want to ask them what's the plan if it doesn't work. Let's make a plan for if it does work, and let's make a plan for if it doesn't work. And we're not ever inviting relapse in, but we do need to make a plan for it, right?

SPEAKER_01

And it happens, it can be part of the recovery process.

SPEAKER_00

Absolutely. But often when people talk about recovery, they talk about the person using, they don't talk about the entire family system. So that's where I come in, right? So if you think about one of those baby mobiles that hangs over the crib, maybe it's deer hanging or a little sunshines or whatever, right? It hangs over the crib. And if you think about putting a clothespin on there so slowly over time, that's the dysfunction, right? We put that clothespin on, maybe it's dysfunction, maybe it's substance abuse, whatever. The whole mobile shifts over time and everyone accommodates that new weight. When that person goes to treatment and they rip that clothesline off, the whole mobile is chaotic, right? It's all blah, blah, blah, blah. We don't know what to do, we don't know what to say. Um, if that whole system doesn't get treatment, then unintentionally they are going to want that person to use because they know what their job is. I know what to do if my husband's drinking, I know what to do if my son's using, I know what to do if my daughter's out all night. I don't know what to do when they're home and healthy. And so it's not, it's exactly what you said, right? The dys the dysfunction and the chaos is normal. Not that it's healthy or wanted. It's just we know what our job is. So al-non, naranon, absolutely for all of these people as well. If the child is of age and that feels okay for them, if not, then family therapy. So many rehabs have family programs where no one even participates.

SPEAKER_01

Yeah, and I tell families you need to do that, and the good facilities will do that. It is so important. I tell families you have to work. The way I look at it is it's as if the family has actually been traumatized too. They just don't know it.

SPEAKER_00

So there's dysfunctional roles in each family system, right? There's the ad. And I when I say dysfunction, because I see so many people coming also into treatment for ACOA issues, which is adult children of alcoholics or dysfunctional families. And if you look on their website, it's called the laundry list. And I go over that with my clients, and a lot of them are like, yes, they absolutely fit that mold. But in a family with addiction, there's the enabler, there's the addict, there's the hero. Nothing could possibly be wrong in our family. Like Johnny's star of the football team. The scapegoat, who, in my experience, the scapegoat as the child typically grows up to be the addict. You have the clown who is joking around and taking the heat off of things. You have the lost child who may be upstairs reading a book and doing whatever. I think I got them all. So you have the addict, the enabler, the hero, the scapegoat, the mascot, or the clown, and the lost child. And some can obviously every family doesn't have six people in it. Some can take on different roles.

SPEAKER_01

Okay. What about the family that calls and they'll call us every six months for years on end? And for whatever reason, they can't make the decision to save their loved one and uh just boil it down because we're dealing with somebody who can't make the decision to save themselves. So somebody else has to make a forum, and the families just can't make it. And sometimes when we check in with these families, we find out that somebody ended up dying. And it's tragic, and that's heartbreaking for us too, because we take the work personally, even though we probably should. How do you, from a clinical perspective, how do we how do you look how do we look at that? How do we understand that? Uh because sometimes my staff, especially when they're brand new in the office, will say, I don't understand it. There's a long history here. Why can't they why can't they not make this decision to save this person? And I know there's a very strong clinical component to that that I'm just learning to understand, but maybe you could help us with that because I'm sure there's going to be families here. And I think if they understood why they couldn't make the decision, maybe they would.

SPEAKER_00

Let me understand. So you're saying like your staff not understanding why their family can't make the decision to save the addict, or the addict not making the decision for themselves.

SPEAKER_01

Maybe there's a bit of both. We could talk about both because it's bring up a very good point, right? And I, from my perspective, the way I look at it as a non-clinician, I say it's as if their brain was hijacked. And I tell the families, I know it looks like you're a loved one and it sounds like you're a loved one, but they are not running the show right now. And either that person cannot make the decision to go to treatment or take their medications, or they go in and out. And I call it the honeymoon phase. They go for 10 days, two weeks. And during that period, they're just settling in. But then they start going to therapy sessions and the hard work begins.

SPEAKER_00

And that's and they're scared.

SPEAKER_01

And at that point, they say, I'm out of here. And that goes on. There's multiple treatment centers, and the family tells us treatment doesn't work. Or they say, in the past, I marchman acted somebody, which is our statute here in Florida for involuntary commitment. The march connect doesn't work. Well, first of all, what does that mean? It doesn't work, right? What does it mean? Treatment does work, but it's it's not a magic pill, right? It's not go to treatment for 30 days and everybody's hunky-dory and we will walk away and sing kumbaya. That's not the way recovery works, right? And so you've got the family member who goes in and out, and then you've got the family who can't either make the decision to force them to stay, right? Or can't make the decision at all to make them go for any period of time.

SPEAKER_00

I hear a lot of times treatment doesn't work, or clients can't be mandated into treatment and it's going to work. It absolutely does work, but the therapy needs to be individualized for each person showing up. And a lot of times some programs can't do that because of whatever curriculum they use or their standard of care or whatever. And some therapists don't know how to meet them where they are. Some people just need three hots and a cut, and they just need to eat. But instead, we try to throw, let's talk about, let's talk about your traumas. Let's not do that. You don't know me. I'm not a safe person. Yeah, this is a trauma treatment center, but like that doesn't mean that the client's ready. And so sometimes folks are like, let's day three, and today is the group about trauma, and so that's what we have to do. Instead of saying, Hey John, hey Judy, what do you need today? But it's because so many of them, unfortunately, are like managed care dictates what treatment looks like, and so they have to check the boxes, not meet the person where they are, which is different. I think the other thing that you're talking about is something called internal family systems, where you think about that baby mobile, right? All of those parts, we have different parts in our brain, and a lot of people know the Disney movie Inside Out, where Reddy's a teenager and she has these different emotions that come up to the control panel. And in internal family systems, we talk about each of those emotions, like each of those emotions are called parts, and one part might have a million different emotions, right? So I'm I have a part of me who wants my family member to get recovered, like to be in recovery and to get treatment, but then another part of me is scared because I don't know what to do. And so these parts are constantly in battle with one another, and if you're not recognizing them, you're either telling them to shut up and go away, which is when they pop up as a leg pain, perhaps during a grief episode, or show up as tense shoulders or you know, anxiety or whatever. So getting to know those different parts and integrating them is the goal of that kind of work to and allowing your true self to run the control panel, not these other parts. And when someone's actively using the part that's going to be loudest is the part that needs to stay well, physically well. And I think a lot of times family members don't understand that people are no longer using to get high, they're using to stay well. And when I say both physically going through withdrawal and then emotionally, because again, we're not taught that feelings are okay, and we're not taught how to sit in them. And so most people are really just scared because they don't know what's going to happen when they start to feel them, and they think it's just gonna be like a big explosion. When in reality, if you have the right support system, it doesn't have to be a big explosion, it can be a slow leak until you know you can manage them.

SPEAKER_01

Okay.

SPEAKER_00

That's I don't know if I answered that because that was a big question. The other thing I did want to hit on is that your staff members, when there are overdoses, especially in the work that you do, they are probably little tees. And maybe some of them are big T's based on how much work that they did with them.

SPEAKER_01

So that should absolutely be there's so interesting that you say that, Renee. We had a staff member that worked for, she worked in intake and she was with us for about almost a year, and she was speaking to families on a daily basis, and one day she turned around and said to us, I can't do this work. And I said, What's the problem? She said, Every time I talk to a family, it triggers me. And there was something in her own past that obviously we hadn't learned through the interview process. It's not something I would typically ask somebody about. You've tell me about your own trauma issue, right?

SPEAKER_00

Yeah, I don't I that's probably not legal. I don't know.

SPEAKER_01

Probably not legal, but the point was that she was having a conversation, she's having conversations with families who've been through all kinds of horrible things, and it sounds like she had been through something like that herself, and it was triggering her, and she couldn't ask the really tough questions. And I said to her, I don't think this is the right place for you. I said, Why would you want to work in a place that's going to trigger you and make you unhappy? I said, I'm not looking to make you unhappy. I don't want to trigger you. And I said, I don't think you're it's not only not good for you, but it's not good for the families that are calling in because you can't ask them the questions that really need to be asked so we can get to the root of the problem. We parted ways and I said, Look, uh, sounds like we've got to let you go. I said, if you want a recommendation, I'd be happy to help you. I'm not firing because I don't like you or firing because you're not good at your job. I'm letting you go because honestly, I don't think this is a good place for you to be working.

unknown

Right.

SPEAKER_01

If you can't put yourself through this every day, that's insanity.

SPEAKER_00

And it's not that she couldn't do her job. Well, it's not that she maybe at her job, but she like couldn't do it.

SPEAKER_01

For almost a year, she compartmentalized, right? She'd say, Okay, here's my trauma, I'm gonna put it aside. But eventually it just broke her down. It just wore her down every day and she couldn't take it anymore. So I completely understand where you're coming for, and I appreciate that. Before with the time that we have left, I want to talk to you about the your involvement in the whole human trafficking thing, because I know that we've that has been very much talked about in the news recently. So tell me about that, what you're the work that you're doing, why it's important, how we can deal with this, because I know it's a serious problem.

SPEAKER_00

Yeah, absolutely. Thanks for bringing that up. A lot of people, again, with the ADHD and the little boy jumping off of the furniture, when people think of human trafficking, they think of people moving in like box trucks.

SPEAKER_01

Exactly.

SPEAKER_00

That's not what trafficking is at all. And it can be for sure, right? But the definition that I like is people exchanging something for sex, drugs, money, or a place to stay. And when you put it in that context, so many of our clients involved in substances have exchanged sex for blood for sex for drugs, money, or a place to stay. And initially it might just be I'm going with this person and I sleep with them and they provide me drugs, and later it can become something much more involved or with a much more bigger system behind it. But our children, like you were talking about with social media, right? They make innocent posts like, I got this bad grade on my test. And someone then comes in and starts talking to them and meeting them where they are, and these traffickers or pimps are really good at figuring out these vulnerabilities. And we think about Maslow's hierarchy of needs and a place to say we talked about before, love and belonging, learning their person's love language, right? They're really good at skilled at that, and they meet that person where they are and they meet that need. And so, oh, your parents are mad at you because you got a grade, like they shouldn't be. Don't they know that teacher's awful? Blah blah blah blah blah. So it's like a long grooming process, and it can be with anyone. It doesn't just have to be what you come what comes to mind when you think of a trafficker. Traffickers can also be women and family members.

SPEAKER_01

So you've hit the nail on the proverbial head, right? Because we do think about people being shoved in a box truck and somehow snuck across the borders or whatever. Yeah, that's what we think about, right? Oh, and so that's an interesting, it's an interesting dynamic. How how do we s stop some of that? Because obviously it's causing tremendous trauma.

SPEAKER_00

Yeah, for sure. So I'm involved with a with an agency called Worthwhile. It's a nonprofit located in Pennsylvania, but we serve some things nationwide. Our mission is to meet those where they're at who've been affected by human trafficking. And there's different different states have different prevention programs, like in Florida and in, I think in only two other states, human trafficking is part of the health and wellness curriculum and it's mandated. Other states, we don't have it at all. I'm trying currently to get into a large city in our area and nothing but red tape to get this curriculum approved. And we're talking about healthy relationships and how do you stay safe online so that what do you do when you don't have your Maslow needs met? And who do you go to who are not then going to turn around and exploit you? So that's one way, is certainly prevention. And you can check out Worthwhile's programs online. For me personally, as a therapist, I want to talk to other other clinicians who are in this world because you are directly involved with the vulnerable populations, kids on the spectrum, ADHD, anxiety, it's not just kids too, it's adults, right? Adults with substance abuse issues. How are we pro okay? If you go home and you relapse, what is your plan? How are you going to have money to buy drugs? How are you, again, we're not inviting this in. We don't want to promote it, but we want to plan. If you do decide to have sex with someone for drugs, money, or a place to stay, how are you gonna stay? How are you gonna stay safe? Who can you talk about this to? But I've had I've worked with some clinicians who are males and they're like, I'm not gonna talk about sex life with one of my female clients. It's like what then you're not doing your job. Kind of what you said. If this is going to trigger you in some way, then you're not doing your job. You are hired to help them, not to shy away from the hard conversations because they're weird or feel some kind of way. So that's one way that you can get involved in trafficking, and then also talking to your kids about who are their five safe adults to go to, who and have them say that as you get older, as they get older. I'm sorry. Because it's not always parents, and sometimes it's a coach, sometimes it's a teacher who are exploiting these kids. So who do who can they go to and who are also parent-approved?

SPEAKER_01

Yeah, you're doing some amazing stuff. I'm very grateful for you. Okay, before we go, can you uh tell folks how do they find you? How do they get information about the work you do? How could they potentially work with you?

SPEAKER_00

Sure. So in Pennsylvania or New York, I'm currently accepting new clients. They can go on Renee Calhoun LMFT, like licensed marriage and family therapist.com. For more information about human trafficking and the work that we do at Worthwhile, you can go on to worthwhile.org.

SPEAKER_01

I love that. And for folks that are watching, thank you for tuning in. If you want more information about the work that we do, mental health addiction lawfirm.com. That's mental healthaddictionlaw firm.com. Or just Google Mark Astor. I think we have about eight hundred and twenty five videos on YouTube, which we put out on a daily basis, because I think it's important for people to get the information they need. And they shouldn't have to call a lawyer to get it. So Renee, thank you for being here with us. You're doing amazing work, and thank you for what you do.

SPEAKER_00

Thank you for what you guys do.

SPEAKER_01

So, with that said, we'll see you in the next episode.