Backstories

Welcome to the Summer 2019 edition of Family Matters – Families Matter, our new blog authored and curated by FSDP’s Guest Blogger–pioneering harm reduction therapist, educator, advocate and author Dee-Dee Stout.
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Backstories.  To me, it’s what makes us humans interesting and individual – and what I love the most about my jobs:  hearing people’s backstories.  It’s also the most important piece of information on which we base our opinions of others. As it’s been nearly a year since FSDP asked me to write a blog for them, I thought perhaps I would share a bit of my backstory with you all.  And since I’m unlikely to meet many of you (unfortunately) I can be brutally honest.   Learning more about people is also a big part of my job as a coach, counselor, and educator as it helps show their motivations for change and for not making changes.  First let’s define what a backstory is exactly.

According to dictionary.com[1], a backstory is “a history or background, especially one created for a fictional character in a motion picture or television program.”  That’s how I first became familiar with the word (while my son studied acting years ago).  It came up again when studying Motivational Interviewing (MI)[2] with Dr. William Miller and his colleagues at University of New Mexico Albuquerque in 2000.  This occurred during a conversation on the Spirit of MI which then was defined as “collaboration, evocation, and supporting autonomy.”  One of the biggest discussions both in and out of the classroom was on this idea.  One of the ideas we discussed was how knowing more about a person’s motivation for their actions helps us understand them better.  And that understanding is crucial to my work (and I’d argue to us all) in order to be accurately empathetic[3] and compassionate which are both necessary qualities in order to be helpful to others.

I attended a conference this week in San Francisco that was put on by the Drug Policy Alliance (DPA).  FSDP was one of the co-sponsors so it made sense that I would go as our local representative. I had no warning internally of how this conference would affect me, both personally and professionally but it has.  The conference was on “Coerced Treatment:  For Your Own Good” and was co-sponsored by some terrific organizations from around the country (more on that later).  There were several panels with amazing discussions on various kinds of coercion:  addiction treatment, mental health treatment, suicide prevention, and more. Panelists included experts in harm reduction, policy, and especially many with lived experience.   In fact, one of the biggest take-aways from this conference for me is the importance for those of us with lived experiences to share our stories to help make policy more effective and less harmful, to increase empathy and compassion by knowing a bit more of our backstories, and to be brave enough to speak your truth especially when so many are talking against your idea(s).  So, with that in mind and with the upcoming anniversary of these blogs, here goes a bit of my backstory.  First, in no particular order, let me name a few of the labels I’ve worn (all of which have been placed on me by others):

Genius, Schizophrenic-nymphomaniac, Incorrigible, Hopeless, Drug Addict, Alcoholic, Bad mother, Slut, Bitch, Favorite teacher, Lesbian, Insubordinate, Passionate, Mother-killer, Spoiled, Teacher’s pet, Smart ass, Talented, “Smarted person I’ve ever worked with who does some of the dumbest things” (a former boss’ assessment). Funny.
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When I was about 9 or 10, I made a decision to have friends at any cost.  I was tired of being the “smart one” without many friends.  This happened to be about the same time my siblings were born.  At 12, I discovered marijuana and alcohol (well I knew something about alcohol before then as members of my extended family drank but I had not tried it myself yet).  It was also around this time that my first sexual assault occurred (it wouldn’t be my last).  I don’t recall how it was that I started to see psychiatrists, but it was also around this time.  There was a psychologist I saw, Dr. Don Crowder.[4] After meeting with me for some months, he informed my family that I was acting like a pretty normal teenager (it was the early 70’s) and suggested we do some family therapy.  I recall my never seeing him again after that conversation with him (he remains the one professional I trusted for many many years afterwards).

After seeing a succession of other mental health professionals, I was taken down to Detroit to see a psychiatrist with Children’s Hospital, a Dr. Fishoff.  It was here, after one meeting, that I was given the label of schizophrenic-nymphomaniac.  My family was told that I was hopeless and should be committed to an institutional school for the mentally ill.  I discovered all this by complete accident, stumbling on a file with my name on it in my father’s file cabinet (it was also where the phonebook downstairs was kept plus I often helped my dad by doing some filing for him so the cabinet wasn’t locked or hidden).  Imagine my surprise when I discovered this file.  After reading it alone in my room, I was baffled at first and then terrified to read the letter from Dr. Fishoff. Also in the file was information on a residential school for the mentally ill in Ohio which my parents had decided I was to be sent.   I recall calling my boyfriend at the time, pretty freaked out, and then I have no further recollection until I was in court, suing my parents for legal emancipation.  I won.  I can’t tell you even how I knew about such a legal “divorce” nor who represented me.  I recall being given a legal document which I needed to show that I was now responsible for myself and essentially an adult.  I do remember finding an apartment to rent and having to show the document to the landlord to prove that I could enter into a contract.  I also recall being told I was now an adult “with all the responsibilities and none of the privileges” such as voting!

What I do remember all too well are my feelings of rejection, betrayal, hurt and disappointment.  I recall feeling that I couldn’t trust anyone except my friends and certainly not any of my family members.  I also remember being in so much pain that I would curl up into a fetal position, my legs pulled as close to my body as possible.  I wanted to become as small as I could so I could disappear.  My favorite fairy tale became “The Little Mermaid” as it was both Danish (my maternal grandfather’s parents emigrated from Denmark) and she dissolved into seafoam at the end.  That’s what I wanted too.  Seafoam sounded so elegant and gorgeous – and peaceful.  And so to get there, and to help with the endless pain I was in, I began to use more and more drugs.  I needed to be loved, held closer not pushed further away.  I wanted to shout “Can’t you see how much pain I’m in?”  and “Why am I not enough for you to love me?”

This is the event that has most shaped my life – for better or worse – and it appears to be the reason my family has never healed.  It’s only been spoken of once that I recall, too.  My folks (technically my dad and step mother.  My birth mother had died of pancreatic and other cancers in 1984 at the age of 44 when I was 28.  My dad remarried to a woman who was an executive VP with Dow Chemical which is why they were in SF at this time) came to stay with my ex-husband and our family as they had to leave the Fairmont Hotel in San Francisco where they were staying for business reasons due to the 1989 Loma Prieta earthquake[5].  While they were there, I asked my dad why, if I had schizophrenia, treatment with medication was never tried.  Since I had been studying psychology, I became aware that even in the 1970’s, medication was a pretty typical course of treatment – certainly before institutionalization.  I recall his saying that that time period was a particularly traumatic time for him and so he didn’t remember much so he couldn’t answer the question and didn’t want to talk more about it.  I remember thinking to myself at the time that, while I certainly understood it was traumatic, why didn’t he seem to think it was ALSO traumatic on me?  And that was it.  Case closed.  My drug use apparently was all anyone needed to explain why I was vilified and abandoned.  My mother told me often during those years that she wished I had never been born, that I’d ruined her life, and that she hated me for it.  We never got a real chance to speak again before she died though she did come to see my son and I in California on her way to Australia.  It was the first time she acknowledged my toddler son and spent time with us[6].  I’m grateful to that time.

After leaving Michigan for good at 17, I took the scenic route to CA.  A job in radio brought me from AZ to CA and out of a marriage to an abusive man (who only seemed to do so when he drank too much so I thought the abuse was my fault for many many years. Plus my father had been physically abuse at times when I was a teen so I was accustomed to it and the concept of all bad things being my fault).  After numerous sexual assaults in college (including an affair with my married psychology professor) and discovering cocaine (yes!!!), I was ready to head to CA:  even my medical specialist encouraged me to move to CA and get pregnant to solve gynecological problems I had suffered since about age 9 (the trauma I had endured at the hands of male MDs over the years is also another story).  Long story short, after 20 years of multiple drug use/misuse/addiction, I agreed to enter residential treatment at a local hospital and have been drug-free since.  My life is far from perfect and being drug-free doesn’t mean everything else is hunky-dory.  It’s merely one way to measure my success in one area of my life – abstinence.  I now think that it’s also the easiest, least accurate way to measure recovery, too.

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“Why do we use the worst-case scenarios as the basis for policy?”

This question was raised in one of the workshops.  It slapped me in the face hard when I realized the reality of those words.  We seem to ask for laws/edicts/regulations etc, mainly after worst-case scenarios occur as if they are the sign posts we needed to make big changes.  While this can be understandable, it can also lead to unintentional harm to others (the severe changes to how we now prescribe opiates for chronic pain patients is a good example of harmful policies implemented after thousands of deaths but not due to mainly prescription opiate use but rather due to tainted street opiates).   So what the heck do we do?  How do we make better policies and advocate for more sensible changes?

FSDP wants to influence policymakers to make better policies – after all, it’s in our name!  And we want our policy makers to use sensible, harm reduction strategies to shape those policies (think Portugal). Although this is a staggering task, we appear to be making some headway.  Included in the policies we’d like to see changed are things like offering numerous options for treatment and recovery for those using drugs problematically and their families; including family support as part of every treatment option; having all education/prevention/treatment be honest conversations about drug use – the good, the bad, the ugly – while demanding that scare tactics NEVER be used again…ever!  Another big portion of this conference, and of the work of FSDP, includes stopping our national & ever-increasing use of incarceration as a means to “treat” drug problems.  In many urban areas, jails are the largest providers of treatment to those with addictions and mental illness[7].  Drug and mental health courts may not be much better, depending on their concepts of both drug use/drug users and of the mentally ill, treatment, and especially medications for addiction treatment. Treatment facilities must have better oversight by the State/County/City and Federal governments.  And all providers of that often high-cost treatment services must be held to the same high standards that we now demand of hospitals and clinics treating other medical conditions[8].  We must demand that our policies be based in more than just “evidence-based treatments” and question the proof that agencies are properly using these methods as they often claim.  We must demand the use of objective outcome measures such as Scott Miller’s FIT and Barry Duncan’s PCOMS/Better Outcomes Now[9], both of which are based on measuring the client’s views of their lives and not the clinician’s view which is typical.  And we must demand that family members of problem drug users and drug users themselves be involved in policy setting at every level.  One new motto of this concept was said often at the conference: “If you don’t have a seat at the table, you’re probably on the menu.” Yes!

At FSDP, we don’t claim to have all the answers because no one does.  In fact, I often advise people I speak to about treatment for mental illness and/or addiction that if a professional ever claims to have “the answer”, run!  While it feels good to talk about a single answer, we must remain both optimistic and realistic – meaning we know that there really isn’t any single answer to cancer, or tooth decay, or anything.  What we desperately need is to change the conversation to change the outcomes in treatment in our country.  And while we acknowledge that this means there must be a (small) place for coerced treatments, we want this option to be thoughtfully considered, on a case-by-case basis, and only used after every other option has been exhausted.  So what works?  It depends on the individual!  But one basic ingredient is needed for treatment to have any chance:  love and appreciation.  Jane Peller, a former mentor of mine, used to say, “You must find something to appreciate in every client you work with if you’re going to be successful working with them.”  And love?  When I asked my son why he didn’t become a ‘drug addict’ as genetically and environmentally the odds were stacked against him, he said, “because I always knew I was loved mom.”  That response still brings tears to my eyes (and to Stanton Peele to whom I shared this with years ago).

Too often here in the US (and other places too) we jump to fixing problems using these worst-case scenarios as dramatic examples (see how HORRIBLE things are EVERYWHERE because of ….insert single item) because it feels good and looks like we’re doing something (anything!) to solve some very serious problems.  However, we must resist that urge to implement more Band-Aid fixes.  Instead, we need leaders who are willing to be uncomfortable with not knowing the answers to all problems, leaders who are willing to admit there are no easy answers to be found, and leaders who are willing to try bold strategies such as the harm reduction concepts we advocate at FSDP along with our many incredible partners.  While love isn’t all we need to solve addictions, love is absolutely at the core of what we need.  As the developer of MI has said (when describing what MI is), “[MI is] love with a goal.  Love isn’t all MI is but without it, you’re not using MI!” And without love at its core, treatment can’t work either.  I believe this awareness is the first step (pun intended) forward to address our collective addiction issues in this country – which are many – and that means really seeing people just as they are, not as we’d like them to be; understanding & listening to the backstories of our loved ones and their families to see WHY we are a nation of problem drug users – and being willing to look right into the eyes of the wounded (that’s both the folks using drugs problematically & their families) about what they all need from US to make meaningful and desired changes.    And then?  We need to just listen, intently, and with love.

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Dee-Dee Stout, MA

*All photos courtesy of unsplash.com

You can learn more about Dee-Dee at www.deedeestoutconsulting.com & reach her for comments or questions at deedeestoutconsulting@gmail.com.

[1] Accessed 5.18.19.

[2] According to the website, www.motivationalinterviewing.org, Motivational Interviewing (MI) is defined as “a collaborative conversation style for strengthening a person’s own motivation and commitment for change.”

[3] https://positivepsychologyprogram.com/empathy/

[4] I was living in Midland, MI at the time.  Dr.  Don Crowder was a young psychologist who also attended our church with his family.  Now retired, I found him recently through LinkedIn (I’ve searched from time to time over the years) and was able to thank him for his kindnesses all those years ago.  He was lovely and responded to my note though I doubt he remembered me.

[5] The 6.9 Loma Prieta earthquake shook us for about 12 seconds, hitting the Bay Area at approximately 5pm on 10/17/1989, causing the collapse of part of the Bay Bridge, most of the Marina District, and even a section of the double-decker style Nimitz freeway in Oakland.  The quake occurred during the World Series which was being played in Candlestick Park and televised.  63 people are known to have been killed, thousands were injured, and it resulted in $5.6-6 billion dollars in property damage (equivalent to about $11.3-12.1 billion dollars today).

[6] My mother’s literal last words were to my son.  I’ve always seen her herculean effort to sit up and speak 2 words as her apology and acknowledgement of her love for him and for me.

[7] “In a recent television documentary, the Los Angeles County jail was identified as the largest provider of mental health care in the United States.” http://shq.lasdnews.net/pages/PageDetail.aspx?id=508. Accessed 5/28/19.

[8] While written in 2016, this article is one of many that discuss the problems caused by the lack of oversight in rehabs around the country: https://www.thedailybeast.com/why-drug-rehab-is-outdated-expensive-and-deadly

[9] More on these measurements can be found at www.scottdmiller.com & https://betteroutcomesnow.com respectively.

 

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