Courtney Messina, Director of Clinical Services for Greenhouse Inpatient & Outpatient Treatment Centers in Grand Prairie and Arlington, Texas, and a Licensed Professional Counselor Supervisor and Licensed Chemical Dependency Counselor, joins us to explore the invisible threads that bind the scourge of addiction to the turmoil of domestic violence. In this episode, we peel back the layers of these intertwined crises through the powerful narrative of "Amy," whose experience with substance dependency and an abusive relationship illuminates the harsh realities faced by victims of domestic violence. We navigate the often misunderstood concept of addiction as a complex brain disorder, dismantling the myth that it is a choice, and delve into how this malady exacerbates the already volatile nature of abusive relationships.
Ms. Messina, who has worked in the field of behavioral health since 2014, articulates the nuanced approach required to address the consequences of these co-occurring disorders. Our dialogue traverses from the statistical to the personal, examining the multifaceted forms of abuse and the vicious cycle it creates, often leading victims to seek solace in substances. This episode offers an insightful journey into the heart of these social issues and the transformative power of empathy and targeted support.
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Episode Transcript
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Speaker 1 (00:00):
Today we explore the intersection of addiction and
domestic violence with licensedprofessional counselor Courtney
Messina.
I'm Maria McMullen and this isGenesis, the podcast.
Courtney Messina is theDirector of Clinical Services
(00:37):
for Greenhouse Inpatient andOutpatient Treatment Centers in
Grand Prairie in Arlington,Texas, and a licensed
professional counselorsupervisor and licensed chemical
dependency counselor, workingin the behavioral health field
since 2014.
Ms Messina also works part-timefor Texas Christian University
in Fort Worth, providingcounseling services to student
(01:00):
athletes.
Her passion for working withindividuals who have
co-occurring disorders fuels hersense of purpose to serve those
who are fighting the battleagainst the disease of addiction
and likewise challenged withmanaging their mental health.
Her recent opinion piece in theDallas Morning News urged
readers to remember thataddiction is a disease and
(01:21):
domestic violence can be anunfortunate side effect.
Courtney, welcome to the show.
Speaker 2 (01:26):
Hi, good morning.
Speaker 1 (01:28):
Well, good afternoon.
So I first became acquaintedwith your work through an
opinion piece that you authoredfor the Dallas Morning News in
December 2023, discussing theintersection of addiction and
domestic violence.
Listeners can find this articleon the Dallas Morning News
website, dallasnewscom.
The article included a personalstory about a client you call
(01:51):
Amy.
What happened to Amy?
Speaker 2 (01:54):
So Amy had actually been to treatment here with us a
handful of times and I hadactually gotten the chance to
work with her myself for a shortstint since one of her
therapists was out sick.
So I got to know her storyfairly well and Amy was a client
(02:19):
that definitely had someextensive trauma and the trauma
had started all the way backinto her childhood and then
continued on, unfortunately,into her marriage which did
involve domestic violence.
She was here for treatment ahandful of times and this most
(02:43):
recent time when she'd made itback.
As I mentioned in my article,we did encounter one another in
the elevator one day and it'svery sad to say, but at that
time I did not even recognizeher.
Amy is a gorgeous woman and Iremember at the time thinking oh
(03:04):
my goodness, you know she looks.
She looks so thin, she looks sofrail.
She was utilizing a walker.
At that time she had a verylarge bruise on her face when
her husband had hit her.
Now, on the brighter side ofthings, when she was here for
treatment the recent time, shedid complete the program and she
(03:27):
finally was able to begin towork through some of her past
trauma which unfortunately hadled to her history of drug and
alcohol use.
And in addition to hercompleting the program, we were
very proud of her.
She finally made that bravechoice to ultimately remove
herself from the unhealthymarriage and start her, or begin
(03:52):
to start her life all over onher own.
Speaker 1 (03:54):
So just to clarify for listeners when you say
treatment, you're talking abouttreatment for chemical
dependency.
Speaker 2 (04:00):
Yes, Treatment for chemical dependency and severe
mental illness correct.
Speaker 1 (04:05):
And all of this happened for Amy and for others
at Greenhouse Inpatient andOutpatient Treatment Centers
right.
Speaker 2 (04:11):
Yes, ma'am that is correct.
Speaker 1 (04:13):
So addiction is a disease and according to the NIH
, the National Institute on DrugAbuse, and this is a quote it
is considered a brain disorderbecause it involves functional
changes to brain circuitsinvolved in reward, stress and
self-control.
Those changes may last a longtime after a person has stopped
(04:33):
taking drugs, and they go on tosay it is a lot like other
diseases, such as heart disease.
Both disrupt the normal,healthy functioning of an organ
in the body, both have seriousharmful effects and both are in
many cases preventable andtreatable.
But if left untreated they canlast a lifetime and may lead to
death.
(04:53):
So the NIH also identifiesanother critical factor the
initial decision to take drugsis typically voluntary, but with
continued use a person'sability to exert self-control
can become seriously impaired.
This impairment in self-controlis the hallmark of addiction.
Listeners can find thisinformation on the website
(05:14):
nidanihgov.
Courtney, what can you add tothese defining factors to help
us better understand the diseaseof addiction and its
complexities?
Speaker 2 (05:24):
Absolutely so.
First and foremost, a largepercentage of us addiction
professionals within theindustry do practice from the
perspective that addiction isnot a choice.
It is a disease that impactssomeone's ability to choose, and
a lot of the content that I'mabout to share with listeners
(05:48):
actually comes directly frompart of our weekend family
support curriculum that weutilize to educate our families
about the disease of addictionand many of the surrounding
factors.
And so addiction occurs in apart of the brain known as the
mid brain.
It can also be classified aswhat we know as the primal brain
(06:13):
, and so the primal brain cannotproduce thoughts that's the
easiest way to think of this andit really has one job, and that
one job is to keep us alive.
So, for example, it's the partof the brain that tells us to
whether it's breathe or drink oreat, or our heart to beat, etc.
(06:37):
And pain and pleasure alsooccur in the same part of the
brain, the primal brain, and sothis part of the brain will send
us messages, say, for instance,telling us to stop doing
something or hey, you're sick,etc.
And we actually once thoughtthat addiction occurred in
(07:01):
another part of our brain knownas the frontal cortex, but we
actually know now that it occursrather in the primal brain.
And so a little bit ofinformation about the frontal
cortex.
So the frontal cortex in ourbrain.
The easiest way to think aboutthis is that it's the part of
the brain that can think and itknows right from wrong.
(07:24):
It has a moral compass, if youwill, and it's the part of the
brain that can weigh theconsequences of decisions,
whereas the primal part of ourbrain cannot.
And so we used to think thataddiction was a choice that
somebody can actually choose tostop.
But now that we know it occursin the part of the brain that
(07:48):
cannot think, we know it's not achoice.
And the other piece to this isthat we can think of addiction
as a malfunction of our pleasuresensories.
So, due to the high levels thataddiction does produce, ie
using drugs and alcohol, otherbehaviors, for example eating,
(08:12):
can result in us feelingpleasure Maybe it's shopping,
physical intimacy, et cetera andso what happens is our brain
lumps our addiction into thesame category with other
essential life functions likebreathing.
I mentioned a few a few secondsago, and so one of the ways I
(08:32):
like to teach about this isthink about if you were to hold
your breath, your brain iseventually going to scream at
you, telling you to to breatheuntil you do.
And so you can think about thisfrom an addiction perspective.
If somebody who is addicted toalcohol or drugs say alcohol, if
that person stops drinking,that part of our brain, that
(08:53):
primal part of our brain, isgoing to scream at that person
to drink until they do.
And so it's really from theperspective that your brain
thinks that you're essentiallygoing to die and it's telling
you to drink in order to saveyou.
And so when clients or whenindividuals are struggling with
the disease of addiction, by anindividual going to treatment,
(09:15):
this allows that person's brainto actually heal Because, when
you think about it, they'restopping that exposure of the
brain to drugs, to alcohol.
And while that client is intreatment not having that
exposure of the brain to drugs,to alcohol, and while that
client is in treatment nothaving that exposure, it's
reducing essentially thelikelihood for that individual
to respond to what we callcraving or that drive for their
(09:37):
drug of choice, and then allowsus, as the therapeutic team or
the treatment team, to work withthat person to strengthen their
ability to use not their primalbrain, remember, it's the
frontal cortex.
Speaker 1 (09:49):
Right.
So do you find that clients whocome for treatment for
addiction have a history oftrauma as well?
What are the stats there?
Speaker 2 (10:00):
Yes, absolutely.
For our center here I would sayprobably about 70 to 75% of our
clientele come to treatment andhave some sort of trauma within
their backgrounds.
Now, that doesn't necessarilymean that all of them have a
formal diagnosis of PTSD, whichis stands for post traumatic
(10:22):
stress disorder, but because ofthe trauma that they've
experienced somewhere along theline in their past, a lot of the
times, unfortunately, their wayof coping with the traumatic
experiences is turning to drugsor alcohol.
Speaker 1 (10:36):
Okay.
You also noted some compellingfacts in the piece relating
addiction to domestic violence,and among them, alcohol or drug
use is involved in 60% ofdomestic violence situations,
and how alcohol myopia can fuelrage that leads to violence.
Let's talk about the factorsthat lead to abuse due to
addiction to drugs or alcohol.
(10:58):
What's happening here?
Speaker 2 (11:04):
to addiction to drugs or alcohol.
What's happening here?
So, when we think about drugand alcohol use, the use of
drugs and alcohol is going toimpair someone's judgment and
it's going to therefore lowertheir inhibitions.
And in addition to those things, drugs and alcohol also affect
someone's mood and theircognition, and so what I mean by
that is someone may engage inbehaviors that they would not
(11:26):
typically engage in when theyare sober or not under the
influence of alcohol and drugs.
So, for example, I'm sure manylisteners are familiar with the
saying well, maybe if you getsome liquid courage before you
do something, you'll be morelikely to do it right and so
that sort of somewhat clichesaying.
What that's really referring tois that piece behind drugs and
(11:50):
alcohol affecting our cognitionand lowering our inhibitions.
And so, because alcohol, forinstance, disrupts our normal
brain functioning, it could leadsomebody to be more likely to
engage in some sort of violentor aggressive behaviors.
And it just so happens that Irecently read an article of the
(12:11):
treatment center I work for isactually featured as part of
this website, but the website isknown as alcoholorg, and there
was an article that I read onthere recently by a Dr Jeffrey
on, and Dr Jeffrey on notes astatistical analysis that showed
that up to 86% of homicideoffenders, 60% of sexual
(12:35):
offenders and 57% of meninvolved in marital violence
were drinking at the time of theoffense.
So this is evidence for theconcept that when somebody is
under the influence of alcoholor drugs, it can lead to them
engaging in violent oraggressive behaviors.
Another thought behind thisconcept, too, is that, for
(12:57):
individuals who might already bemore prone to aggression or
violence, that drinking alcoholor being under the influence of
drugs may increase the risk ofthat individual engaging in some
sort of violent or aggressivebehavior.
And so, again, whether somebodyalready is more prone to be
aggressive or violent.
What we have to remember isthat the drugs or the alcohol A
(13:19):
it poisons the brain, but B itdoes lower our inhibitions, and
that's where a lot ofindividuals get into trouble.
Speaker 1 (13:25):
Yeah, that does make a lot of sense, and never can we
excuse domestic violence, abuseor violent behavior or sexual
violence because of addiction ordrug or alcohol use, and the
National Domestic ViolenceHotline explains that and this
is a quote from their websitedrugs and alcohol are not the
(13:48):
root issues of abuse.
Abuse is about power andcontrol.
Achieving sobriety doesn'tnecessarily end the abuse.
Do you see thesecharacteristics of power and
control in your work and how doyou address them?
Speaker 2 (14:02):
So we absolutely do.
I want to first start off bysaying many of our clients
struggle with having andmaintaining healthy
relationships.
They are involved in unhealthyrelationships that unfortunately
consist of abuse, sometimescurrently, things that are going
on right now or at some pointin their past, and what I would
(14:26):
encourage listeners to bemindful of when it comes to
abuse A there's a cycle of abuse, unfortunately.
That's why so many individualsyou'll hear somebody say get
caught in this cycle, and partof the cycle of abuse is the
abusive partner being in controlof the other person.
I think a lot of the times whenwe think of abuse, we sometimes
(14:48):
immediately go to maybephysical violence, but we have
to remember that abuse, where itof course can constitute some
sort of physical violence,sometimes it can also include,
you know, maybe something likecontinuous intimidation or
threats of violence, or insultsor the abusive.
They will try to isolate theother individual that is
(15:09):
experiencing the violence or theintimidation, etc.
And so the way that we, asaddiction and mental health
(15:34):
professionals, address thisnature of the abusive partner
wanting this power and control.
So first, first off, we do a lotof group treatment here, or
group therapy, and so in thosegroup therapy sessions, our
clinicians are providing lotsand lots of psychoeducation on
certain topics related to this.
So, for instance, we have grouptherapy topics on healthy
(15:57):
relationships.
We teach our clients about theimportance of self-esteem and
knowing their self-worth.
We know that because a lot ofour clientele do come from a
history that involves trauma.
We do a lot of education hereat the facility about the
residual effects of trauma andhow to overcome what somebody
(16:18):
has experienced as a result ofthat trauma moving forward in
their lives.
We actually have groups herethat teach on particularly
domestic violence.
We actually teach this classonce a month here at the
facility.
In addition to the group therapypiece, in the one-on-one
individual sessions that ourclinicians have with clients who
this area applies to, ourclinicians will help our clients
(16:42):
essentially on how to get helpright or how to potentially get
out of their abusiverelationship, and this could
even be something along thelines of okay, how are you, how
are you going to get out, howare you going to escape your
abusive partner?
Essentially, and because so muchof the abuse is centered around
this control of the abusivepartner having the power over
(17:03):
the other person, we really tryto empower, obviously, the
victim and we try to help themfigure out how are they going to
regain control of their life,and we will process with them
and say and try to help themremember per se hey, you know,
what were you like prior tobeing in an abusive relationship
(17:24):
?
What were your life's goals?
Because it's sad to say, but alot of the times when somebody
does get stuck in this cycle ofabuse, it becomes their new norm
.
It's like that's what they know.
They don't know anythingoutside of what they are
experiencing.
Speaker 1 (17:39):
So you raise a lot of really good points and, to sum
it up somewhat, domesticviolence is a very complex
situation.
There's a lot going on andthere are many, many forms of
abuse.
They do not have to be physicalviolence.
There's sexual violence,coercive control, psychological
abuse, spiritual abuse,financial abuse, and the one I'm
(18:01):
really glad you brought up isisolation, you know, and loss of
identity.
Survivors of domestic violencetalk about these things very
often at Genesis, and so you'vetalked a lot about the whole
spectrum of abuse that anyonecould experience.
Now, on the other end of thespectrum of addiction and
(18:22):
domestic violence, I'm wonderinghow common it is for domestic
violence to lead to an addiction.
Speaker 2 (18:30):
Absolutely, and when we think about rather just
domestic violence in itself.
So domestic violence in itselfis obviously going to be
incredibly traumatic to thatperson who is experiencing it.
And, as you mentioned, Maria,unfortunately this trauma from
the domestic violence that theperson experiences it leads to
(18:52):
whether it's loss of self-esteem, loss of self-worth, loss of
their identity it leads to othervery uncomfortable and unwanted
feelings, For instance, feelingguilt over what happened,
feeling some sort of shame overwhat happened.
And what we find is that manyof our clients do not know how
(19:15):
to cope with these uncomfortableand unwanted feelings and what
ultimately happens is is thatthey turn to, whether it's drugs
or alcohol, to self-medicate oressentially numb themselves
from feeling these unwantedfeelings.
So the International Society forTraumatic Stress so they
(19:38):
actually did a study recentlyand found that one quarter to
three quarters of people whohave survived abusive or some
sort of violent traumaticexperience do end up reporting
problematic alcohol use.
They also report that women whowere exposed to a traumatic
(19:58):
life event show an increasedrisk for an alcohol use disorder
.
Along with the InternationalSociety of Traumatic Stress, the
American PsychologicalAssociation, they will tell us
that people who are seekingtreatment for post-traumatic
stress disorder are actually 14times more likely to also be
(20:18):
diagnosed with some type ofsubstance use disorder.
So we can easily see thatdomestic violence, which, like
we already know, is extremelytraumatic for somebody.
This can lead to, like Imentioned, self-medicating with
drugs or alcohol, but just thatperson being more likely to
actually be diagnosed with anactual substance use disorder.
Speaker 1 (20:41):
So is there a difference between addiction and
substance use disorder, or arethey the same thing?
Speaker 2 (20:47):
Same thing.
I would say addiction is kindof more of a overarching term,
if you will.
And then there can be manydifferent types of substance use
disorders, whether it's alcoholor methamphetamine, or opiates
or cocaine, et cetera.
Speaker 1 (21:03):
So when there are children in the home where
addiction and domestic violenceis present, how does that impact
their odds of also being abused?
Speaker 2 (21:12):
So, sadly, there is going to be a great likelihood
of there being some sort ofabuse in some sort of fashion
with the children living in thehousehold and again, it might
not be physical abuse, it couldbe emotional abuse, it could be
verbal abuse, maybe it's amatter of neglect, and that's
(21:34):
typically what we will see withour clients that admit to us for
treatment.
And, unfortunately, withdomestic violence being a factor
, we do see that CPS is involved, or we do have a number of
clients in our facility even atthis time where CPS is involved
in these cases due to thedomestic violence that has been
(21:56):
going on in the house.
Speaker 1 (21:57):
So, in other words, just you know, just a
hypothetical example dad'sabusive mom's in treatment for
addiction and the kids are infoster house.
So, in other words, just youknow, just a hypothetical
example dad's abusive mom's intreatment for addiction and the
kids are in foster care.
Speaker 2 (22:06):
Yes, or, for instance , maybe it could be the other
way around too.
Maybe the individual who is theabusive partner is in treatment
for substance use, and CPS isinvolved because either the
children are or have alreadybeen taken away from that
individual or because ofwhatever has transpired.
(22:27):
If that person does notsuccessfully complete a
treatment program, they are atrisk of losing their children.
Speaker 1 (22:33):
Yeah, it's devastating.
I mean, the intersection hereof addiction and domestic
violence has unbelievablerepercussions and consequences
for everybody involved.
Now this is a little off topic,but I know you work with
student athletes as well and I'mcurious how addiction is
(22:54):
impacting them and if there'sany connection in them coming
from families where addictionand domestic violence have
occurred, or possibly connectionthat leads, you know, between
addiction, domestic violence andthat might lead to dating
violence or intimate partnerviolence by these young athletes
.
Speaker 2 (23:13):
Yes, absolutely so.
I think you know, especiallynowadays with the NIL deals in
the world of college sports, Ithink a lot of folks kind of
tend to think and it is true tosome extent that student
athletes are kind of given mightbe the case, but I can
guarantee you from my experiencein working with them that
(23:41):
student athletes absolutely 100%experience challenges with
addiction.
They experience challenges withsevere mental illness and from
my experience working withstudent athletes from all over
the country or different partsof the country, a lot of them
when they come to therapy I endup learning about their past and
(24:02):
them coming from an abusivehousehold.
Maybe they themselves did notexperience the abuse, but maybe
the abuse or the domesticviolence was going on between
their parents or theirstep-parents.
I have worked with athleteswhere the situation with their
parents was unhealthy to thepoint where they have had to
(24:22):
move out of the house with momand dad and, say, move in with
an aunt or an uncle or move inwith their grandparents.
And so I think for me workingwith student athletes and them
experiencing many of the samestruggles as the folks that we
treat here at the facility, isthat it's a true reminder that
(24:44):
addiction, and whether it'saddiction or mental health
challenges that they certainlydo do not discriminate, whether
it's gender, race, age, etc.
Speaker 1 (24:53):
Yeah, absolutely.
We say the same thing atGenesis about domestic violence.
It does not discriminate.
It can happen to anyone,regardless of your status,
upward mobility, where you live,gender.
It's all possible that any ofus could experience some form of
(25:14):
domestic violence.
I'd love to direct people tosome resources where they can
get more information or a phonenumber where they can get help.
Can you give us someinformation?
Absolutely.
Speaker 2 (25:27):
So if there is an individual who is in need of
help due to substance use andaddiction, we do at the
Greenhouse, which is a facilityunder the American Addiction
Center's umbrella, we do have acall center and support center
number that anybody can call atany hour of the day, and so that
(25:47):
number for listeners would be615-375-3400.
And another entity I would liketo give we use the acronym,
it's called SAMHSA and it standsfor the Substance Abuse and
Mental Health ServicesAdministration.
So they do have a free,national and confidential 24-7
(26:11):
hotline which listeners canreach by dialing 1-800-662-4357.
And that is both in English andin Spanish.
And another option to reach outto SAMHSA would also be a text
message option as well, whichanybody who's listening can text
(26:31):
to 435-748.
Speaker 1 (26:35):
Yeah, those are really helpful, and I'd like to
also remind people of theSuicide and Crisis Lifeline,
which is 988.
And also the number to reachout for if you're experiencing
domestic violence.
The number for Genesis is214-946-HELP 214-946-4357.
And the National Hotline forDomestic Violence, 800-799-7233.
(27:01):
And you can call, chat or checkout their website at
thehotlineorg.
Genesis website isgenesisshelterorg.
Courtney Messina.
Thank you so much for bringingthis important topic to our
attention today.
Speaker 2 (27:15):
Thank you so so much for having me.
Speaker 3 (27:30):
Attention Spanish-speaking listeners.
Thank you so, so much forhaving me con el personal de
Génesis, en Español.
Speaker 1 (27:36):
If you or someone you know is in an abusive
relationship, you can get helpor give help at
genesisshelterorg or by callingor texting our 24-7 crisis
hotline team at 214-946-HELP214-946-4357.
Bilingual services at Genesisinclude text, phone call,
(27:58):
clinical counseling, legalservices, advocacy and more.
Call or text us for moreinformation.
Donations to support women andchildren escaping domestic
violence are always needed.
Learn more at genesisshelterorgslash donate.
Thanks for joining us.
I'm reminding you always thatending domestic violence begins
(28:18):
when we believe her.
Speaker 3 (28:20):
Genesis.
El podcast anuncia serviciosbilingĂĽes disponibles en Genesis
Women's Shelter, esupport.
Si usted o una conocida está enuna relación abusiva, puede
recibir ayuda o dar ayuda a orby calling or sending a text
message to our 24-hour crisisline at 214-946-4357.
(28:42):
Genesis Bilingual Servicesinclude text messages, calls,
counseling, legal services,counseling and more.
Call us or send us a text formore information, asesorĂa y más
.
Llámenos o mándenos un textpara más información.
(29:02):
Siempre se necesitan donacionespara apoyar a las mujeres o a
los niños escapando de laviolencia doméstica.
Aprende más a nuestra página deinternet en genesisshelterorg.
Barra inclinada donate.
Gracias por unirse con nosotros.
Recuerden que el terminar laviolencia doméstica empieza
cuando creemos a la vĂctima.
Thank you for joining us.
Remember that ending domesticviolence starts when we believe
(29:24):
in the victim.
Today we explore the intersection of addiction and
domestic violence with licensedprofessional counselor Courtney
Messina.
I'm Maria McMullen and this isGenesis, the podcast.
Courtney Messina is theDirector of Clinical Services
(00:37):
for Greenhouse Inpatient andOutpatient Treatment Centers in
Grand Prairie in Arlington,Texas, and a licensed
professional counselorsupervisor and licensed chemical
dependency counselor, workingin the behavioral health field
since 2014.
Ms Messina also works part-timefor Texas Christian University
in Fort Worth, providingcounseling services to student
(01:00):
athletes.
Her passion for working withindividuals who have
co-occurring disorders fuels hersense of purpose to serve those
who are fighting the battleagainst the disease of addiction
and likewise challenged withmanaging their mental health.
Her recent opinion piece in theDallas Morning News urged
readers to remember thataddiction is a disease and
(01:21):
domestic violence can be anunfortunate side effect.
Courtney, welcome to the show.
Speaker 2 (01:26):
Hi, good morning.
Speaker 1 (01:28):
Well, good afternoon.
So I first became acquaintedwith your work through an
opinion piece that you authoredfor the Dallas Morning News in
December 2023, discussing theintersection of addiction and
domestic violence.
Listeners can find this articleon the Dallas Morning News
website, dallasnewscom.
The article included a personalstory about a client you call
(01:51):
Amy.
What happened to Amy?
Speaker 2 (01:54):
So Amy had actually been to treatment here with us a
handful of times and I hadactually gotten the chance to
work with her myself for a shortstint since one of her
therapists was out sick.
So I got to know her storyfairly well and Amy was a client
(02:19):
that definitely had someextensive trauma and the trauma
had started all the way backinto her childhood and then
continued on, unfortunately,into her marriage which did
involve domestic violence.
She was here for treatment ahandful of times and this most
(02:43):
recent time when she'd made itback.
As I mentioned in my article,we did encounter one another in
the elevator one day and it'svery sad to say, but at that
time I did not even recognizeher.
Amy is a gorgeous woman and Iremember at the time thinking oh
(03:04):
my goodness, you know she looks.
She looks so thin, she looks sofrail.
She was utilizing a walker.
At that time she had a verylarge bruise on her face when
her husband had hit her.
Now, on the brighter side ofthings, when she was here for
treatment the recent time, shedid complete the program and she
(03:27):
finally was able to begin towork through some of her past
trauma which unfortunately hadled to her history of drug and
alcohol use.
And in addition to hercompleting the program, we were
very proud of her.
She finally made that bravechoice to ultimately remove
herself from the unhealthymarriage and start her, or begin
(03:52):
to start her life all over onher own.
Speaker 1 (03:54):
So just to clarify for listeners when you say
treatment, you're talking abouttreatment for chemical
dependency.
Speaker 2 (04:00):
Yes, Treatment for chemical dependency and severe
mental illness correct.
Speaker 1 (04:05):
And all of this happened for Amy and for others
at Greenhouse Inpatient andOutpatient Treatment Centers
right.
Speaker 2 (04:11):
Yes, ma'am that is correct.
Speaker 1 (04:13):
So addiction is a disease and according to the NIH
, the National Institute on DrugAbuse, and this is a quote it
is considered a brain disorderbecause it involves functional
changes to brain circuitsinvolved in reward, stress and
self-control.
Those changes may last a longtime after a person has stopped
(04:33):
taking drugs, and they go on tosay it is a lot like other
diseases, such as heart disease.
Both disrupt the normal,healthy functioning of an organ
in the body, both have seriousharmful effects and both are in
many cases preventable andtreatable.
But if left untreated they canlast a lifetime and may lead to
death.
(04:53):
So the NIH also identifiesanother critical factor the
initial decision to take drugsis typically voluntary, but with
continued use a person'sability to exert self-control
can become seriously impaired.
This impairment in self-controlis the hallmark of addiction.
Listeners can find thisinformation on the website
(05:14):
nidanihgov.
Courtney, what can you add tothese defining factors to help
us better understand the diseaseof addiction and its
complexities?
Speaker 2 (05:24):
Absolutely so.
First and foremost, a largepercentage of us addiction
professionals within theindustry do practice from the
perspective that addiction isnot a choice.
It is a disease that impactssomeone's ability to choose, and
a lot of the content that I'mabout to share with listeners
(05:48):
actually comes directly frompart of our weekend family
support curriculum that weutilize to educate our families
about the disease of addictionand many of the surrounding
factors.
And so addiction occurs in apart of the brain known as the
mid brain.
It can also be classified aswhat we know as the primal brain
(06:13):
, and so the primal brain cannotproduce thoughts that's the
easiest way to think of this andit really has one job, and that
one job is to keep us alive.
So, for example, it's the partof the brain that tells us to
whether it's breathe or drink oreat, or our heart to beat, etc.
(06:37):
And pain and pleasure alsooccur in the same part of the
brain, the primal brain, and sothis part of the brain will send
us messages, say, for instance,telling us to stop doing
something or hey, you're sick,etc.
And we actually once thoughtthat addiction occurred in
(07:01):
another part of our brain knownas the frontal cortex, but we
actually know now that it occursrather in the primal brain.
And so a little bit ofinformation about the frontal
cortex.
So the frontal cortex in ourbrain.
The easiest way to think aboutthis is that it's the part of
the brain that can think and itknows right from wrong.
(07:24):
It has a moral compass, if youwill, and it's the part of the
brain that can weigh theconsequences of decisions,
whereas the primal part of ourbrain cannot.
And so we used to think thataddiction was a choice that
somebody can actually choose tostop.
But now that we know it occursin the part of the brain that
(07:48):
cannot think, we know it's not achoice.
And the other piece to this isthat we can think of addiction
as a malfunction of our pleasuresensories.
So, due to the high levels thataddiction does produce, ie
using drugs and alcohol, otherbehaviors, for example eating,
(08:12):
can result in us feelingpleasure Maybe it's shopping,
physical intimacy, et cetera andso what happens is our brain
lumps our addiction into thesame category with other
essential life functions likebreathing.
I mentioned a few a few secondsago, and so one of the ways I
(08:32):
like to teach about this isthink about if you were to hold
your breath, your brain iseventually going to scream at
you, telling you to to breatheuntil you do.
And so you can think about thisfrom an addiction perspective.
If somebody who is addicted toalcohol or drugs say alcohol, if
that person stops drinking,that part of our brain, that
(08:53):
primal part of our brain, isgoing to scream at that person
to drink until they do.
And so it's really from theperspective that your brain
thinks that you're essentiallygoing to die and it's telling
you to drink in order to saveyou.
And so when clients or whenindividuals are struggling with
the disease of addiction, by anindividual going to treatment,
(09:15):
this allows that person's brainto actually heal Because, when
you think about it, they'restopping that exposure of the
brain to drugs, to alcohol.
And while that client is intreatment not having that
exposure of the brain to drugs,to alcohol, and while that
client is in treatment nothaving that exposure, it's
reducing essentially thelikelihood for that individual
to respond to what we callcraving or that drive for their
(09:37):
drug of choice, and then allowsus, as the therapeutic team or
the treatment team, to work withthat person to strengthen their
ability to use not their primalbrain, remember, it's the
frontal cortex.
Speaker 1 (09:49):
Right.
So do you find that clients whocome for treatment for
addiction have a history oftrauma as well?
What are the stats there?
Speaker 2 (10:00):
Yes, absolutely.
For our center here I would sayprobably about 70 to 75% of our
clientele come to treatment andhave some sort of trauma within
their backgrounds.
Now, that doesn't necessarilymean that all of them have a
formal diagnosis of PTSD, whichis stands for post traumatic
(10:22):
stress disorder, but because ofthe trauma that they've
experienced somewhere along theline in their past, a lot of the
times, unfortunately, their wayof coping with the traumatic
experiences is turning to drugsor alcohol.
Speaker 1 (10:36):
Okay.
You also noted some compellingfacts in the piece relating
addiction to domestic violence,and among them, alcohol or drug
use is involved in 60% ofdomestic violence situations,
and how alcohol myopia can fuelrage that leads to violence.
Let's talk about the factorsthat lead to abuse due to
addiction to drugs or alcohol.
(10:58):
What's happening here?
Speaker 2 (11:04):
to addiction to drugs or alcohol.
What's happening here?
So, when we think about drugand alcohol use, the use of
drugs and alcohol is going toimpair someone's judgment and
it's going to therefore lowertheir inhibitions.
And in addition to those things, drugs and alcohol also affect
someone's mood and theircognition, and so what I mean by
that is someone may engage inbehaviors that they would not
(11:26):
typically engage in when theyare sober or not under the
influence of alcohol and drugs.
So, for example, I'm sure manylisteners are familiar with the
saying well, maybe if you getsome liquid courage before you
do something, you'll be morelikely to do it right and so
that sort of somewhat clichesaying.
What that's really referring tois that piece behind drugs and
(11:50):
alcohol affecting our cognitionand lowering our inhibitions.
And so, because alcohol, forinstance, disrupts our normal
brain functioning, it could leadsomebody to be more likely to
engage in some sort of violentor aggressive behaviors.
And it just so happens that Irecently read an article of the
(12:11):
treatment center I work for isactually featured as part of
this website, but the website isknown as alcoholorg, and there
was an article that I read onthere recently by a Dr Jeffrey
on, and Dr Jeffrey on notes astatistical analysis that showed
that up to 86% of homicideoffenders, 60% of sexual
(12:35):
offenders and 57% of meninvolved in marital violence
were drinking at the time of theoffense.
So this is evidence for theconcept that when somebody is
under the influence of alcoholor drugs, it can lead to them
engaging in violent oraggressive behaviors.
Another thought behind thisconcept, too, is that, for
(12:57):
individuals who might already bemore prone to aggression or
violence, that drinking alcoholor being under the influence of
drugs may increase the risk ofthat individual engaging in some
sort of violent or aggressivebehavior.
And so, again, whether somebodyalready is more prone to be
aggressive or violent.
What we have to remember isthat the drugs or the alcohol A
(13:19):
it poisons the brain, but B itdoes lower our inhibitions, and
that's where a lot ofindividuals get into trouble.
Speaker 1 (13:25):
Yeah, that does make a lot of sense, and never can we
excuse domestic violence, abuseor violent behavior or sexual
violence because of addiction ordrug or alcohol use, and the
National Domestic ViolenceHotline explains that and this
is a quote from their websitedrugs and alcohol are not the
(13:48):
root issues of abuse.
Abuse is about power andcontrol.
Achieving sobriety doesn'tnecessarily end the abuse.
Do you see thesecharacteristics of power and
control in your work and how doyou address them?
Speaker 2 (14:02):
So we absolutely do.
I want to first start off bysaying many of our clients
struggle with having andmaintaining healthy
relationships.
They are involved in unhealthyrelationships that unfortunately
consist of abuse, sometimescurrently, things that are going
on right now or at some pointin their past, and what I would
(14:26):
encourage listeners to bemindful of when it comes to
abuse A there's a cycle of abuse, unfortunately.
That's why so many individualsyou'll hear somebody say get
caught in this cycle, and partof the cycle of abuse is the
abusive partner being in controlof the other person.
I think a lot of the times whenwe think of abuse, we sometimes
(14:48):
immediately go to maybephysical violence, but we have
to remember that abuse, where itof course can constitute some
sort of physical violence,sometimes it can also include,
you know, maybe something likecontinuous intimidation or
threats of violence, or insultsor the abusive.
They will try to isolate theother individual that is
(15:09):
experiencing the violence or theintimidation, etc.
And so the way that we, asaddiction and mental health
(15:34):
professionals, address thisnature of the abusive partner
wanting this power and control.
So first, first off, we do a lotof group treatment here, or
group therapy, and so in thosegroup therapy sessions, our
clinicians are providing lotsand lots of psychoeducation on
certain topics related to this.
So, for instance, we have grouptherapy topics on healthy
(15:57):
relationships.
We teach our clients about theimportance of self-esteem and
knowing their self-worth.
We know that because a lot ofour clientele do come from a
history that involves trauma.
We do a lot of education hereat the facility about the
residual effects of trauma andhow to overcome what somebody
(16:18):
has experienced as a result ofthat trauma moving forward in
their lives.
We actually have groups herethat teach on particularly
domestic violence.
We actually teach this classonce a month here at the
facility.
In addition to the group therapypiece, in the one-on-one
individual sessions that ourclinicians have with clients who
this area applies to, ourclinicians will help our clients
(16:42):
essentially on how to get helpright or how to potentially get
out of their abusiverelationship, and this could
even be something along thelines of okay, how are you, how
are you going to get out, howare you going to escape your
abusive partner?
Essentially, and because so muchof the abuse is centered around
this control of the abusivepartner having the power over
(17:03):
the other person, we really tryto empower, obviously, the
victim and we try to help themfigure out how are they going to
regain control of their life,and we will process with them
and say and try to help themremember per se hey, you know,
what were you like prior tobeing in an abusive relationship
(17:24):
?
What were your life's goals?
Because it's sad to say, but alot of the times when somebody
does get stuck in this cycle ofabuse, it becomes their new norm
.
It's like that's what they know.
They don't know anythingoutside of what they are
experiencing.
Speaker 1 (17:39):
So you raise a lot of really good points and, to sum
it up somewhat, domesticviolence is a very complex
situation.
There's a lot going on andthere are many, many forms of
abuse.
They do not have to be physicalviolence.
There's sexual violence,coercive control, psychological
abuse, spiritual abuse,financial abuse, and the one I'm
(18:01):
really glad you brought up isisolation, you know, and loss of
identity.
Survivors of domestic violencetalk about these things very
often at Genesis, and so you'vetalked a lot about the whole
spectrum of abuse that anyonecould experience.
Now, on the other end of thespectrum of addiction and
(18:22):
domestic violence, I'm wonderinghow common it is for domestic
violence to lead to an addiction.
Speaker 2 (18:30):
Absolutely, and when we think about rather just
domestic violence in itself.
So domestic violence in itselfis obviously going to be
incredibly traumatic to thatperson who is experiencing it.
And, as you mentioned, Maria,unfortunately this trauma from
the domestic violence that theperson experiences it leads to
(18:52):
whether it's loss of self-esteem, loss of self-worth, loss of
their identity it leads to othervery uncomfortable and unwanted
feelings, For instance, feelingguilt over what happened,
feeling some sort of shame overwhat happened.
And what we find is that manyof our clients do not know how
(19:15):
to cope with these uncomfortableand unwanted feelings and what
ultimately happens is is thatthey turn to, whether it's drugs
or alcohol, to self-medicate oressentially numb themselves
from feeling these unwantedfeelings.
So the International Society forTraumatic Stress so they
(19:38):
actually did a study recentlyand found that one quarter to
three quarters of people whohave survived abusive or some
sort of violent traumaticexperience do end up reporting
problematic alcohol use.
They also report that women whowere exposed to a traumatic
(19:58):
life event show an increasedrisk for an alcohol use disorder
.
Along with the InternationalSociety of Traumatic Stress, the
American PsychologicalAssociation, they will tell us
that people who are seekingtreatment for post-traumatic
stress disorder are actually 14times more likely to also be
(20:18):
diagnosed with some type ofsubstance use disorder.
So we can easily see thatdomestic violence, which, like
we already know, is extremelytraumatic for somebody.
This can lead to, like Imentioned, self-medicating with
drugs or alcohol, but just thatperson being more likely to
actually be diagnosed with anactual substance use disorder.
Speaker 1 (20:41):
So is there a difference between addiction and
substance use disorder, or arethey the same thing?
Speaker 2 (20:47):
Same thing.
I would say addiction is kindof more of a overarching term,
if you will.
And then there can be manydifferent types of substance use
disorders, whether it's alcoholor methamphetamine, or opiates
or cocaine, et cetera.
Speaker 1 (21:03):
So when there are children in the home where
addiction and domestic violenceis present, how does that impact
their odds of also being abused?
Speaker 2 (21:12):
So, sadly, there is going to be a great likelihood
of there being some sort ofabuse in some sort of fashion
with the children living in thehousehold and again, it might
not be physical abuse, it couldbe emotional abuse, it could be
verbal abuse, maybe it's amatter of neglect, and that's
(21:34):
typically what we will see withour clients that admit to us for
treatment.
And, unfortunately, withdomestic violence being a factor
, we do see that CPS is involved, or we do have a number of
clients in our facility even atthis time where CPS is involved
in these cases due to thedomestic violence that has been
(21:56):
going on in the house.
Speaker 1 (21:57):
So, in other words, just you know, just a
hypothetical example dad'sabusive mom's in treatment for
addiction and the kids are infoster house.
So, in other words, just youknow, just a hypothetical
example dad's abusive mom's intreatment for addiction and the
kids are in foster care.
Speaker 2 (22:06):
Yes, or, for instance , maybe it could be the other
way around too.
Maybe the individual who is theabusive partner is in treatment
for substance use, and CPS isinvolved because either the
children are or have alreadybeen taken away from that
individual or because ofwhatever has transpired.
(22:27):
If that person does notsuccessfully complete a
treatment program, they are atrisk of losing their children.
Speaker 1 (22:33):
Yeah, it's devastating.
I mean, the intersection hereof addiction and domestic
violence has unbelievablerepercussions and consequences
for everybody involved.
Now this is a little off topic,but I know you work with
student athletes as well and I'mcurious how addiction is
(22:54):
impacting them and if there'sany connection in them coming
from families where addictionand domestic violence have
occurred, or possibly connectionthat leads, you know, between
addiction, domestic violence andthat might lead to dating
violence or intimate partnerviolence by these young athletes
.
Speaker 2 (23:13):
Yes, absolutely so.
I think you know, especiallynowadays with the NIL deals in
the world of college sports, Ithink a lot of folks kind of
tend to think and it is true tosome extent that student
athletes are kind of given mightbe the case, but I can
guarantee you from my experiencein working with them that
(23:41):
student athletes absolutely 100%experience challenges with
addiction.
They experience challenges withsevere mental illness and from
my experience working withstudent athletes from all over
the country or different partsof the country, a lot of them
when they come to therapy I endup learning about their past and
(24:02):
them coming from an abusivehousehold.
Maybe they themselves did notexperience the abuse, but maybe
the abuse or the domesticviolence was going on between
their parents or theirstep-parents.
I have worked with athleteswhere the situation with their
parents was unhealthy to thepoint where they have had to
(24:22):
move out of the house with momand dad and, say, move in with
an aunt or an uncle or move inwith their grandparents.
And so I think for me workingwith student athletes and them
experiencing many of the samestruggles as the folks that we
treat here at the facility, isthat it's a true reminder that
(24:44):
addiction, and whether it'saddiction or mental health
challenges that they certainlydo do not discriminate, whether
it's gender, race, age, etc.
Speaker 1 (24:53):
Yeah, absolutely.
We say the same thing atGenesis about domestic violence.
It does not discriminate.
It can happen to anyone,regardless of your status,
upward mobility, where you live,gender.
It's all possible that any ofus could experience some form of
(25:14):
domestic violence.
I'd love to direct people tosome resources where they can
get more information or a phonenumber where they can get help.
Can you give us someinformation?
Absolutely.
Speaker 2 (25:27):
So if there is an individual who is in need of
help due to substance use andaddiction, we do at the
Greenhouse, which is a facilityunder the American Addiction
Center's umbrella, we do have acall center and support center
number that anybody can call atany hour of the day, and so that
(25:47):
number for listeners would be615-375-3400.
And another entity I would liketo give we use the acronym,
it's called SAMHSA and it standsfor the Substance Abuse and
Mental Health ServicesAdministration.
So they do have a free,national and confidential 24-7
(26:11):
hotline which listeners canreach by dialing 1-800-662-4357.
And that is both in English andin Spanish.
And another option to reach outto SAMHSA would also be a text
message option as well, whichanybody who's listening can text
(26:31):
to 435-748.
Speaker 1 (26:35):
Yeah, those are really helpful, and I'd like to
also remind people of theSuicide and Crisis Lifeline,
which is 988.
And also the number to reachout for if you're experiencing
domestic violence.
The number for Genesis is214-946-HELP 214-946-4357.
And the National Hotline forDomestic Violence, 800-799-7233.
(27:01):
And you can call, chat or checkout their website at
thehotlineorg.
Genesis website isgenesisshelterorg.
Courtney Messina.
Thank you so much for bringingthis important topic to our
attention today.
Speaker 2 (27:15):
Thank you so so much for having me.
Speaker 3 (27:30):
Attention Spanish-speaking listeners.
Thank you so, so much forhaving me con el personal de
Génesis, en Español.
Speaker 1 (27:36):
If you or someone you know is in an abusive
relationship, you can get helpor give help at
genesisshelterorg or by callingor texting our 24-7 crisis
hotline team at 214-946-HELP214-946-4357.
Bilingual services at Genesisinclude text, phone call,
(27:58):
clinical counseling, legalservices, advocacy and more.
Call or text us for moreinformation.
Donations to support women andchildren escaping domestic
violence are always needed.
Learn more at genesisshelterorgslash donate.
Thanks for joining us.
I'm reminding you always thatending domestic violence begins
(28:18):
when we believe her.
Speaker 3 (28:20):
Genesis.
El podcast anuncia serviciosbilingĂĽes disponibles en Genesis
Women's Shelter, esupport.
Si usted o una conocida está enuna relación abusiva, puede
recibir ayuda o dar ayuda a orby calling or sending a text
message to our 24-hour crisisline at 214-946-4357.
(28:42):
Genesis Bilingual Servicesinclude text messages, calls,
counseling, legal services,counseling and more.
Call us or send us a text formore information, asesorĂa y más
.
Llámenos o mándenos un textpara más información.
(29:02):
Siempre se necesitan donacionespara apoyar a las mujeres o a
los niños escapando de laviolencia doméstica.
Aprende más a nuestra página deinternet en genesisshelterorg.
Barra inclinada donate.
Gracias por unirse con nosotros.
Recuerden que el terminar laviolencia doméstica empieza
cuando creemos a la vĂctima.
Thank you for joining us.
Remember that ending domesticviolence starts when we believe
(29:24):
in the victim.
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