In this episode of The Brain Warrior’s Way Podcast, Tana Amen is joined by Dr. Jennifer Farrell, a Psychiatrist and Addiction Medicine Specialist. We discuss how the moral vs. medical mindset affects the barriers of communication that tend to exist with one who suffers from addiction, as well as strategies for rebuilding that healthy connection.
Dr. Daniel Amen: Welcome to The Brain Warrior's Way Podcast. I'm Dr. Daniel Amen.
Tana Amen: And I'm Tana Amen. Here, we teach you how to win the fight for your brain to defeat anxiety, depression, memory loss, ADHD, and addictions.
Dr. Daniel Amen: The Brain Warrior's Way Podcast is brought to you by Amen Clinics where we've transformed lives for three decades using brain SPECT imaging to better target treatment and natural ways to heal the brain. For more information, visit amenclinics.com.
Tana Amen: The Brain Warrior's Way Podcast is also brought to you by BrainMD where we produce the highest quality nutraceutical products to support the health of your brain and body. For more information, visit brainmdhealth.com. Welcome to The Brain Warrior's Way Podcast. Welcome back. I'm so excited today to have Dr. Farrell with us. You are one of our addiction specialist.
Dr. Jennifer Farrell: Yes, I'm board certified in psychiatry, addiction psychiatry and addiction medicine.
Tana Amen: I love that. That is a big part of what we see here at Amen Clinics. This is really important not only because we have so many patients that come through, but this touches the lives of so many people. It certainly has touched my family. I mean, I had an uncle who is a heroin addict. I always say that the one gift he gave me was that he scared me so badly. I don't know if you've ever seen the show The Walking Dead?
Dr. Jennifer Farrell: Mm-mm.
Tana Amen: It's about zombies-
Dr. Jennifer Farrell: That's why I haven't seen it.
Tana Amen: Way before there was a Walking Dead show, when I was four, five, six, I didn't know what zombies were, but my uncle and his friends scared me because that's what they reminded me off. It scared me so badly that it always like scared me away from doing drugs, but addiction runs in my family. It's a scary thing.
Dr. Jennifer Farrell: It is.
Tana Amen: It's a really scary thing. For those of us who haven't been addicted to drugs, it's really hard to understand it, but we are heavily affected by it. I've seen so much of it here, but I don't by any means pretend to understand the dynamics. I'm so happy to have you here because I certainly struggle with my own issues, lots and lots of them, but not this one. I really want to understand it.
I think a lot of people who have family members who are struggling really want to understand it because I recently even had a situation with someone in our family who we had to really work through this process, and my husband being a psychiatrist did better with it. I'm going to be really honest, so I'm just going to be really vulnerable for a minute and go, "I didn't really get it and it's frustrating."
Dr. Jennifer Farrell: It is.
Tana Amen: I'm trying-
Dr. Jennifer Farrell: It's very difficult to understand because the average person doesn't have a medical mindset. We have a moral model. We look at what's right and what's wrong and injecting yourself with heroin. We look at that as bad. We don't have the medical understanding of why people make the decisions they make when they're using. How they become addicted? Why they just can't stop? Because we want to say logically, "Well, if you're using this substances and it's ruining your life, then you should stop."
Tana Amen: Or go get help at least.
Dr. Jennifer Farrell: Right, or go get help. I think that people who were suffering would agree with you logically, but there's something going on with them emotionally that's preventing that. I'm really glad we are here to have this conversation today. Just to really talk about how important it is to recognize and treat addictions because it's not like other areas of medicine. I had an ear infection, I went to the doctor, he looked in my ear. He said, "You need some antibiotics." I said, "Fine." It was done and no one was affected.
Tana Amen: No one judges you.
Dr. Jennifer Farrell: No one judge me. He actually did. It was kind of funny. He said, "What are you doing here?" I said, "I can't look in my own ear." He is like, "You know what you need to do." I did get judged just a little bit.
Tana Amen: I had thyroid cancer, so same thing. You get people feel sorry for you. They don't like to get mad at you.
Dr. Jennifer Farrell: Exactly. When you have someone who has a substance use disorder, you not only have to deal with the health issues it can go along with that, the liver problems, the heart problems, you name it. In addition to that, it affects the way that they parent. It affects the relationships with their siblings, with their co-workers, with their neighbors. It affects their careers, their ability to work or go to school. There's this ripple effect of one person's medical issue that can affect not only the community, but actually the economy when we look at the numbers of what alcoholism, for example, costs our country. Recognition of that and treatment then also has that ripple effect.
Tana Amen: Well, and if I can add one thing to that from a personal perspective, generational. It's generational.
Dr. Jennifer Farrell: Yes.
Tana Amen: I'm astounded at how it just seems to get passed along. I don't know why. Is it genetic or is it because ... I know some of these answers, but I want people to hear them and I know them logically. I don't understand totally. I'm trying to really understand it better because it affected my own family. I don't quite get all of the dynamics of why when you know that it affected you as a child, why are you passing it down and not getting help and allowing it to affect your children?
Dr. Jennifer Farrell: There are genetics involved for sure and we know that addictions run in family. There's a lot of research on genes for alcohol use disorders and other things. I think part of the problem is not just the genetic vulnerability for addiction, but we also have to look at the environmental factors. Kids who are raised by alcoholic parents have issues that are unique compared to people who aren't raised in that kind of environment.
Not everyone who is raised in that environment will have a bad outcome, but there's a lot of chaos in homes where there are substance use. That can affect the way those kids and raised their kids and so you can see this effect. Again, there is something inherently different about the way many addicts respond to substances compared to people who don't have that genetic vulnerability. Somebody who doesn't have a propensity toward addiction, let's say, of pain medicines will have surgery. They'll take their prescribed pain medicines after surgery. They'll feel horrible. They'll feel nauseous. They'll feel sick.
Tana Amen: That's right. That's me. I hate it.
Dr. Jennifer Farrell: They'll feel sedated. They'll feel awful. Yes, I felt the same way after having my wisdom teeth taken out. I rather have the pain.
Tana Amen: Absolutely.
Dr. Jennifer Farrell: What I've heard time and time again from my patients who become addicted is from the first time they take it they have a completely different response.
Tana Amen: My uncle said that.
Dr. Jennifer Farrell: They feel euphoric. They have high energy. They're not getting sick and nauseous. It's completely different response. There is something about the way their body metabolizes it. Then we know that over time with repeated use when you keep hitting those receptors that there's this chemical messages going back to the cells and we're actually getting a change in the cellular DNA as the person is going either changing their own DNA with their substance use. It's more complex than even we really have a good understanding with, but there are so many factors that go into the vulnerabilities for addiction.
Tana Amen: Interesting. It's hard for families.
Dr. Jennifer Farrell: Yes.
Tana Amen: They probably don't always make it easier for people to get treatment. What can we do?
Dr. Jennifer Farrell: Well, understanding is I think the beginning and being open to having a dialogue. I think that probably one of the biggest barriers that I see with people getting treatment is just this big stigma around addictions. A lot of people have a judgmental viewpoint, a moralistic viewpoint of, "You should do this or you shouldn't do this." People feel very judged. Some people don't know how to talk to their family about them, about their concerns. They don't want them to be mad at them or it may disrupt some other kind of family dynamic.
I think that understanding what is a healthy use pattern versus what isn't and learning how to talk to that person can be very helpful. Creating an environment that is less judgmental like, "How dare you do this. You're ruining the family" instead of coming in, "Okay. There's this issue that's going on and we need some help and we want to come from a helping standpoint." How you talk to the person can actually contribute to whether or not they're willing to go in and deal with some of these issues.
Tana Amen: It can be really frustrating. I've actually recently dealt with this almost in family dynamics. From the family perspective, I think maybe reaching out and getting some help on how to do this could be helpful because I know in our case and we are fairly savvy. I'm fairly savvy just from ... Trust me, I don't claim to understand it or to know anything about it, but just having been primed on how to handle it. Having approached someone repeatedly with, "There's no judgment. We just want to be able to help" like all the right things to say, but then repeatedly having that problem with them not doing that. When they're constantly lying to you and telling, erodes the trust.
Dr. Jennifer Farrell: Yes.
Tana Amen: Then, when you asked them why, they feel bad, they genuinely feel bad and they don't really understand why they're lying to you about it. They're like, "But I'm afraid." We're like, "But I thought we just had this talk? We're not expecting you to do it perfectly." After a while, it starts to be exhausting.
Dr. Jennifer Farrell: It is.
Tana Amen: For the caretaker.
Dr. Jennifer Farrell: You can't be a successful addict unless you're successful liar.
Tana Amen: That's so interesting.
Dr. Jennifer Farrell: "No, I'm not using." "Is everything okay?" "Yes, everything is fine." People have to let lie to maintain their addiction.
Tana Amen: How exhausting.
Dr. Jennifer Farrell: It is. Well, it is exhausting and I have a lot of compassion for people who are going through this. This is how I ended up in this field. No one goes to kindergarten and says, "When I grow up, I wanted to deal with heroin addicts."
Tana Amen: Absolutely.
Dr. Jennifer Farrell: You find your gifts in life and you go into that, but people don't want to lie. People don't want to be addicted, but the addiction is so strong that it pulls them and locks them in. I do work with a lot of families. I coach a lot of families and then we use, when I can finally get someone in my office, a type of communication called motivational interviewing. That's really not sitting down and telling the person, "Everything in your life is going horribly. You have to change this." It's just looking at, "What are you using? What do you like about it? What do you not like about it? What's working in life? What isn't working?"
Tana Amen: They see it.
Dr. Jennifer Farrell: "What are your goals?" Then, helping them find their own internal motivation for a change. "Write down for me the three key things in your life that are important to you. Is your alcohol use getting in the way of these?"
Tana Amen: I like that.
Dr. Jennifer Farrell: "What would you think we should do about this?" And working-
Tana Amen: They figure out a process.
Dr. Jennifer Farrell: Yes.
Tana Amen: Rather being told.
Dr. Jennifer Farrell: I will guide them through a treatment plan. I will come up with the treatment plan. I can have the best treatment plan on the planet, but if it doesn't feel like that person's treatment plan, she is not going to do it. Helping that person find her own internal motivation.
Tana Amen: [crosstalk 00:11:46]?
Dr. Jennifer Farrell: Yeah. Why don't we [crosstalk 00:11:49].
Tana Amen: That makes sense. That actually makes sense. I just think if there is something we can tell family members to give them hope, I think that's a really important thing because it's hard. It's hard being the family member. It's not just hard being the addict.
Dr. Jennifer Farrell: It is.
Tana Amen: It's hard being the family member.
Dr. Jennifer Farrell: That's what we're talking about it has a ripple effect and it affects everyone around that person. When that person gets better, that ripple effect will spread also. I always tell people if you can't get your family member in to come see me, come see me, let's sit and talk about the situation. Then, I'll say, "We'll offer them a phone conversation with me." I'll just say, "This is who I am. This is my background. This is what I do. If there's ever a time you'd like to talk to me about it, let's talk about your health. If you don't want to talk about drinking or not drinking, we don't have to do that, but your family is concerned about your heart, so let's come in and talk about that or let's look at your liver." Once they see that there's actually a physician who has a non-judgmental approach, then you can get treated.
Tana Amen: To the people who come out this from a judgment perspective, I know I got really angry at one point, really angry. People manage their anger in different ways. For me, I was praying and I was meditating. I'm like I was praying and meditating about this anger because I knew that it wasn't useful. It's not a useful way to manage not only my state, but my energy. I wasn't going to get anywhere with it. It wasn't going to help the person I was trying to work with and it wasn't going to help me. I was like, "What is something better that I can do with this?"
I was praying. I was meditating and it just left. The anger left and what I realized is that it wasn't that I was actually angry. Anger is a place I go to when I'm scared. I don't know if other people do that same thing. I wasn't actually mad because I grew up in chaos. I grew up in a lot of chaos with a lot of addiction and a lot of just craziness around. Anger is the place I go to when I'm scared. Anger is the place I go to for survival. The minute that I just felt really scared about the situation, it's like, "I'm going to fight."
I don't know if other people have that same issue, but when I could recognize it, the anger left me and I was able to have a really honest conversation and I don't right wrong or any different. It came up very differently than when I was angry and I was so sad. I just said, "Look, I'm worried. I'm just worried about you because this feels bigger than what I can do and it's above my pay grade. I don't know what else to do for you."
Dr. Jennifer Farrell: You can't do it for anyone. They have to do it themselves.
Tana Amen: Right, and I'm used to being able to jump in and fix things and I can't.
Dr. Jennifer Farrell: You can't protect them. You can't do it for them and it's very frustrating, especially when you're the type of person who is very nurturing and you're a caring type of person. You can't go in and fix it and it's really hard for parents or loved ones watching the person's life crumble apart. People do get angry because anger is a fear response. If I am afraid of something, I can either back into the corner or I can come out fighting because it makes me look stronger and see this sense of control.
Tana Amen: Feel stronger, it's empowering.
Dr. Jennifer Farrell: It gives us false sense of control. You're right, it's tapping into that compassion and being willing to let go and just think, "I can't do anything about this. I can't control it."
Tana Amen: "I'm sad."
Dr. Jennifer Farrell: "I'm sad."
Tana Amen: "I'm scared." It was just a very different conversation if I had walked in with my normal way or responding to things. That's really helpful. Is there anything else you like to let people know?
Dr. Jennifer Farrell: I think that I want to get back to that point on the stigma and how much of a barrier that is for people really coming in to get treatment. I helped start a clinic for pregnant women with substance use disorders. That's the biggest barrier is they're afraid if they go see the doctor, their children are going to get taken away. CPS will get called and all this, so they're afraid to go in. They can't stop using because this is a medical condition. There's a lot worse outcomes. If we as a society can reduce the stigma and encourage people to go in and get help, then that's when people can actually get better, it makes a huge difference in people's lives.
One of the biggest barriers to women getting treatment is child care. We also need in my field to talk about and address more what we can do to meet people's needs practically. As a family member with someone, let's say, who has children or other responsibilities coming in to help with those issues, so they can get treatment and removing some of these barriers I think can be very helpful as well.
Tana Amen: That's such a good point. Dr. Farrell works at Amen Clinics here in our Costa Mesa office. If you're struggling or you know someone who is struggling ... I think you're amazing. You do a great job. Our patients love her.
Dr. Jennifer Farrell: Come see me.
Tana Amen: She's very empathic and kind. I'm really glad we talked about this because it just touches so many people's lives. Thank you so much.
Dr. Jennifer Farrell: Thanks for having me. Absolutely.
Dr. Daniel Amen: Thank you for listening to The Brain Warrior's Way Podcast. Go to iTunes and leave a review and you'll automatically be entered into a drawing to get a free signed copy of The Brain Warrior's Way and The Brain Warrior's Way cookbook we give away every month.
