Incurable Hope with Lisa Gennosa

Announcer: Welcome to Addiction and the Family, “Episode 41: Building Incurable Hope with Lisa Gennosa.”

Casey Arrillaga: How has addiction affected your family?

Female Speaker: It robbed me of my father.

Female Speaker: Addiction's affected my family in absolutely every way.

Male Speaker: It has caused a lot of turmoil.

Female Speaker: It goes back to what I understand is at least three generations.

Female Speaker: It robbed my daughter of her mother. It robbed my mother of her daughter.

Female Speaker: Addiction has made our family quite challenging.

Male Speaker: Addiction has affected my family tremendously.

Male Speaker: It's affected my relationship with my sister where I wouldn't – I'd go for months without talking to her. It's a very difficult thing for everybody involved. It doesn't just affect the one individual. It's a disease that affects the whole family.

Male Speaker: Addiction is spread not only genetically through some of my relatives and I assume ancestors.

Female Speaker: It's generational.

Female Speaker: I think of him every day.

Casey Arrillaga: Welcome to Addiction and the Family. My name is Casey Arrillaga, and I'm a social worker and addiction counselor at both Windmill Wellness Ranch and InMindOut Emotional Wellness Centers in Texas. I’m the author of the books, Realistic Hope: The Family Survival Guide for Facing Alcoholism and Other Addictions, and Spirituality for People who Hate Spirituality.

Kira Arrillaga: I’m Kira Arrillaga, Addiction Counselor Intern and Recovery Coach at Windmill. Casey and I were in our addictions together for over ten years and have now been in recovery together for almost twice that long.

Casey Arrillaga: I've led hundreds of family workshops, but just as important is that Kira and I have lived the experience of being family to addiction as both children and adults.

Kira Arrillaga: Join us as we offer experience, strength, and realistic hope about how you and your family can find recovery together.

Casey Arrillaga: In this episode, we talk with Lisa Gennosa who wrote a wonderful book called Incurable Hope that combines a memoir of her journey through the trials of her son’s addiction with the wisdom and tools she has learned that can help anyone who loves someone that has an addiction or other mental health issues. Along the way, she looks at what changes can be made to move towards greater peace and recovery both as individuals and as a society. All this and more after a break to hear from one of our sponsors. [Commercial]

Casey Arrillaga: Welcome back. Without further ado, let’s jump into our interview with Lisa. If you would, go ahead and just introduce yourself to our audience. Let us know who you are and what are you doing on a show called Addiction and the Family?

Lisa Gennosa: Thank you, so much. It’s really a big honor to be here. I appreciate you having me on. I’m Lisa Gennosa. I’m a Physician Assistant. I’ve been practicing for a little over ten years. I live in a small, rural community where there is not a lot of access to specialists and such. Even though I’m family medicine, I take on a lot of substance abuse, and our substance use disorders, and mental health, a lot more than I ever thought that I would. I do very happily. I’m happy to do it every day. I have a son who has substance use disorder. He is doing really well today, throw that out there and break the suspense, we’ll say. He is doing really well today. We’ve been in the trenches for about 15 years. Our family has gone through our own horror show as many families do. I decided to write about it. I wrote because I needed this place to release all of that pain. Initially, my writing was just strictly about therapy. That’s all it was. I never intended to write a book. I really didn’t. Being in the practice that I am, I recognized that families were really trying to find resources, and trying to find answers, and trying to decode the language of addiction and what was happening to their family members. The more I wrote, the more I realized how it might be helpful or valuable to somebody else. It blossomed from there. It really snowballed. Here I am, today, with you, on a podcast talking about it. It’s a whole new experience, but I’m really glad it’s come around to this.

Casey Arrillaga: Me too, well, something I want to say is when I got your book, and I got a chance to read through it, it’s just a beautiful book. It’s heart wrenching –

Lisa Gennosa: Thank you.

Casey Arrillaga: – but it’s beautiful. It’s partly because you write beautifully, but also write in a very personal style just talking about here’s my experience. You also do a really good job of generalizing it, saying here’s my experience, and here’s how what I’ve learned along the way might benefit you. That’s such a big deal to be able to do that, to be able to put that experience out. I hear you on the idea of I just started writing this for me. I just needed to write, and then recognizing – and I think it probably helps being in the healthcare field. A lot of people need this information, but sometimes the best way to access it is through somebody’s personal story to be able to say, okay, I relate to that. This person understands what I’ve been through. I imagine you’ve probably had some experience hearing other people’s stories the same way.

Lisa Gennosa: Oh my gosh, absolutely. Being in this profession, you’re behind closed doors. It’s a private situation that people can reveal some of the hardest hardships that they experience. Yes, I’ve been receptive to that and wanted to share the experience along with them. I guess not wanting to, but being able to, I should say, being able to share that experience. It just provided a nonjudgmental safe place for myself and my patients to really dig a little bit deeper and understand things a little bit on a more personal level. When I wrote the book, I tried to have a very balanced way of looking at things. Even though what happened to my son, for example, was something horrible, I tried to understand it from that other person’s perspective, what happened in that case, for example. I do really try to understand the dynamics of everything that’s happening, not just from my viewpoint only.

Casey Arrillaga: Absolutely, and it sounds like we had similar motivations in writing our first books. When I wrote mine, it was like, okay, I have a lot of these same conversations. It’s not that I get tired of saying it, but then I think, well, somebody out there is not going to meet me personally. Somebody is not going to sit down in your office. They may not have that chance to just have that conversation with you one-on-one. In writing, we have an opportunity to put it out there in a wider way. You mentioned something really important there. It shows up very early in your book. In fact, I tagged it on Page 4. You go from a very personal, intimate, here’s my story, but you go on and you say, “It’s a disease of the human brain, but also of the human condition, and of our society.” You touch on those themes. Can you maybe talk about what brought you to that point of view, and what you might want to say to somebody.

Lisa Gennosa: Obviously, the brain part, what’s happening behind the curtain, I do talk a little bit about in the book and try to explain it so that when we’re dealing with it on that level, that we’re not approaching it from a place of anger and resentment towards the individual that has substance use disorder. We’re approaching it from an understanding, physiologically, what’s happening to some degree. I mean, that’s limited, obviously. My study is in biology. Even if you’re not studying that, there should be some limited understanding. On that part of it, I wanted to say we understand it because this is what’s happening. This is why it’s important to understand that. From society’s standpoint, I think it is a disease of society because commercially we sell a good, fun time with drugs and alcohol all the time, whether it’s in commercials, or movies, whether it’s alcohol, or even [08:27] substances, cocaine and opioids. Those are really glorified in a lot of ways in our television and movie sets. That’s important for us to realize that we’re perpetuating, essentially, the addiction disease by celebrating it, almost, by glorifying it. I guess the acceptance of that by society is what disturbs me a little bit, but also that we’re going to criticize that individual as well because it’s their moral failing, or they did something wrong. On one hand, we’re glorifying it. On the other hand, we’re saying you’re wrong for doing it. It’s these mixed messages, I think, in our culture that is just very confusing and very hard for the families that are dealing with this every day, going through the experience. I’m trying to help this person. Should I be treating them with tough love? I’m not a tough love advocate, right. They’re saying, should I be treating them with tough love because it’s their moral failing. Society’s saying this is okay. That’s not an accurate depiction. Ultimately, that’s why I was trying to say it is a problem of society as a whole. We really have failed by giving mixed messages, talking out of both sides of our mouth, I think.

Casey Arrillaga: Absolutely, and you’re singing to my social work heart over here. I’m a clinical social worker by trade.

Lisa Gennosa: I see.

Casey Arrillaga: When I come from that perspective, the first thing I’m trained is let’s see the individual for who they are. Let’s look and see what systems did they grow up with, family, culture, society, all these different levels. They all have an influence. Yet, at the same time, most addiction recovery programs are going to tell the person, you need to take responsibility for yourself and what you’ve done. Even there, I can say for me as a clinician, there’s a little bit of a tug of war because I teach addiction in the brain to families. I teach it to our clients. I tell them, you don’t need to know any of this stuff in order to recover, on either side. However, it may remove shame and blame. It may get you out of a mindset of whose fault is it? If we say, well, it’s society’s fault, it’s the media’s fault, it’s the individual’s fault, I think in any of those, we’re missing the mark. We don’t do that with diabetes most of the time. We don’t sit around and say, well, whose fault is this? Who do we blame? We need to treat those people with diabetes. We need to treat them with tough love, or we need to caudle them. None of those things really helps with the disease. Yet, when it comes broadly to mental health, not just addiction, I think people get very nervous because it’s the brain. It’s the control center. It affects the choices we make. We tend to judge people based on their choices. There’s a mixed message within that as well.

Lisa Gennosa: Yes, and to me it was important to be able to take away the anger and resentment. I would go to family meetings or even Al Anon, and so many of the parents would just be sitting there fuming, I’m so angry, and awful words coming out of their mouth about their loved one, whether it’s their spouse, or their parent, or their child. I wanted to say let’s look at a deeper understanding of what’s happening. Of course, that’s not my space and time to do that there. That’s why I did that in the book. There’s so much more behind the story. I really feel like there is an element of self-harm when using substances in my son’s case, specifically. Now, I don’t think that’s across the board, but I think in his case, was his use a form of self-harm?

Casey Arrillaga: That’s a deep question, and it speaks to the multitude of things that may feel like motivators for somebody. It also speaks to something that I know as a clinical social worker, which is a lot of the times a lot of the people out there, most of us, don’t actually know why we do a thing when we do it. We’re driven for emotional reasons that we may understand poorly, if at all. Then we make choices. We know this from brain research, then our frontal lobes, the rational mind, will then rationalize. That’s what rational things do really well. It will make up a reason why we did that thing that may or may not have anything to do with the actual reason that we did it. This becomes really, when we talk about who’s blaming the person with the addiction, probably nobody blames them more or worse than the person with the addiction themselves. How can I do this? I’m speaking also now that I’ve put on a different hat. I’m a guy in recovery, myself. From that perspective, I can say one of the best descriptors I ever heard was from a client in a family workshop who raised his hand and said, “This is like all-out war with yourself.” Yes, it is, absolutely nailed it. I said, “I’m going to be quoting you for years,” and I have been. It is different parts of the brain in a tug of war. The older, more entrenched part of our brain in the limbic system will tend to win when the fear gets great enough. Some of us grew up in a lot of fear. The addiction just becomes a way to relieve that fear. We’re not even sure what we’re relieving or why we’re doing it.

Lisa Gennosa: I agree, and I remember it took me a long time to understand that the anger that was being spewed at me, right, in really dark times was really the internal hatred that he had for himself, the fear that he had, the self-loathing. For a long time, I took it so personally like this is an attack on me. Now I realize every bit of it was attack on himself. It just took me a long time to get there. I don’t want other parents to go through that because I know everybody takes it personally. You can’t help it to some degree, but so much of it in his case was because that’s how he felt inside.

Casey Arrillaga: Of course, in your journey as a parent, bringing it down now, again, more to the more personal, you talk a lot about denial in your book. This idea, I didn’t want to see it, I didn’t want to look at it, or denial to other people. I didn’t want to tell people how he was actually doing. To me, that maybe interfaces with that same thing, especially if we don’t understand what’s happening. Even if we have all the biological knowledge in the world, we can still take it personally. From that perspective, it’s hard to really see and/or talk about what’s happening. Do you mind talking a little bit about your own journey with that?

Lisa Gennosa: I denied for well over a decade almost. I mean, we probably were going through this for a solid 15 years, part of that not really understanding. The denial really became a protective mechanism. Unfortunately, that’s again why I emphasize that so much because if you can first avoid that denial, you can step in a lot sooner and make change, and help that change, start implementing practices that will create change for that person within your life that you love so much if you just first don’t denial. Denial was my sickness for a long time, I would say, because I just didn’t want to accept it. I wanted to avoid the reality. I grew up in, I guess, simplicity. There just wasn’t addiction in my home. We didn’t have a lot of drama. It wasn’t perfect, or super easy, or anything. There wasn’t anything that I had like this. This was something so out of the realm of what I had as far as my expectations were concerned. We all have these natural expectations in life. It’s why you get on the television and you see when there’s a natural disaster like a tornado, or a mass shooting, even. People, their first response is I never thought this would happen to me. I never imagined this would happen in my neighborhood. This is a really unified small town. We can’t believe this happened here. It’s because our expectations do not match the reality, the pain. We live in a world that’s predictable. When we get outside of that predictability, it feels very uncomfortable. I didn’t like that feeling at all. I didn’t like unpredictability. I didn’t understand it, so I just kept denying it. Even though he was getting deeper, and deeper, and deeper, I was pretending it was oh, it’s teenage antics. It’s experimentation. It’s all going to be okay. He’ll grow out of it. The more after you have hospitalizations, incarcerations, nine rehabs, there’s somewhere in there that I said, okay, I can’t deny this anymore. I’ve got to meet up with the reality of this and be present. I’m going to lose my son if I don’t.

Casey Arrillaga: That’s such a difficult moment. We talk a lot about the person with the addiction has to hit rock bottom. Then they’ll change. Yet many of us have seen ourselves or our loved ones bounce off the bottom. It’s like, that wasn’t bottom? Wait, that wasn’t bottom? You’re going to keep going after that? People will say, well, I hit rock bottom. I grabbed a pickaxe and a shovel, and I started digging. Sometimes we don’t recognize family members have to do the same thing a lot of times. You have to hit your own rock bottom where you say not just this is bad, but I’m not going to keep going the same way. If it’s the same way is denial, then I’m not going to keep going that way, whatever it is. You’re right, there is – and man, I wish I could rewind the time here and know what this was. Fifteen years ago, before I even was going back to school to be a counselor or studying any of this stuff, I heard a radio program. They just mentioned they had done this interesting set of experiments. They had found a chemical in the brain that encourages people to think that what happens to other people won’t happen to us. Like you said, we can watch it on TV and go, oh, those poor souls, or as they say in Texas, oh, bless your heart, which is a way of saying, I don’t know how you got yourself in this mess, but that’s not me. Yet when it does happen, what they found is they can actually dampen the chemical. People suddenly have a very realistic view. I mentioned this to one of my clients. I had just started working the addiction treatment field. This client said, “Whatever that is, can you get that for me?” I never think anything’s going to happen to me. You also mentioned adolescence. Yeah, it’s easy to look at our kids and say, well, this might be the normal thing. I did have one podcast guest that said the first time she drank, she was 14, she blacked out, and her dad, who had grown up in a family with a lot of alcohol problems, turned to her mom and said, “She’s an alcoholic.” The mom was like, “Oh, don’t be silly. I mean, she’s just 14.” He was like, “No, I’ve seen this one. I know this one. This is how it goes.” No one else in the family would believe him, including, yeah, including our guest, Theresa. If anyone wants to look up the podcast episode, it's a great interview. She talks about this. Her dad recognized it. She didn’t recognize it. Mom didn’t recognize it. Nobody recognized it because adolescence is a time where we’re going to have more of that media influence. We’re going to care a lot more about what people around us think. We’re supposed to take a lot more risk for a lot less reward. Also, another big piece that we add in is that anything that we’ve gone through emotionally as kids, that we may have seemed to sail through, is going to blossom anew in adolescence. We’re going to see it in a different way because in adolescence that’s around the stage of development where we get to recognize not just how one thing is different than another, but how something is different than the ideal or what it could have been. We look in the mirror, and we apply it to ourselves first. My life should have been different. I should be different. That could be really painful stuff. Somebody comes along and says, here, drink this, smoke that, snort that, it will feel better, and voila, it works. I don’t care how many DARE programs, drug education, whatever you offer somebody. When I was a kid, it was like, smoke pot, you’ll turn into a werewolf and run off the top of a building. You smoke pot the first time. You’re like, well, that didn’t happen. What else did they lie about? This stuff is not so bad, and I need some relief. Lo and behold, there’s relief offered. We’re at an age where even if someone says, hey, this could get really bad later, we’re like, yeah, I hear you but whatever. I need relief now. It’s difficult to recognize that’s happening with one teenager, whereas the next person over them is just partying hearty and they’re going to be fine. In a couple years, they’ll get to college, and they’ll ramp it up a little bit. They’ll get bad grades, and they’re like, whoa, I’m not doing this anymore. Then they cut it out. We don’t really know who’s going to keep going and who’s not. I’m going to say, for any family member, don’t look in the mirror and say, man, I should’ve recognized this when they were 14. That’s rare, and besides which, nobody would’ve believed you.

Lisa Gennosa: So true. I’m in medicine. My husband’s in medicine. He’s a family physician. We ate dinner at the table every night. My son played in sports and was in Boy Scouts, and we did all the things that were just everyday life. It was nothing really extraordinary going on, but there was this underlying brewing addiction starting at the age of 12 that went under our nose. We had no idea. You said something about getting to the point of that realization. There is a moment of grief not just for the individual with substance use disorder so their grief, their understanding, their rock bottom, but for the parents, or the spouse, or other loved ones, there is a reckoning of awareness when you realize that the life that you thought you were going to have is over. The life that you expected for your child is not going to be what it was or what it is, and you go through those stages of grief, absolutely, go through those stages of grief. I put that at the very beginning of the book because that is exactly what I went through. I went through that for years, and I fought that tooth and nail because I was just not willing to accept that this was going to be his life or my life. I was just not willing to accept it until one day acceptance happened. Now I’m incredibly grateful that we – as odd as that sounds, as weird as that is, I am so grateful our family has gone through this experience because we’ve grown. We’ve grown much tighter as a family. If there was a way to do that, we did. We’re so much more open to helping others. We’re more educated. These things would not have happened if we hadn’t gone through what we did. They never would’ve happened, and it opened our eyes and gave us the ability to help others. That is all I ever cared about was finding a way to help others. That’s why I’m in medicine, right? This just gave me and my son and my husband just an enormous opportunity to help as many people as we can. We had to go through that grief. We had to go through that – woo, that guilt, that denial. We had to go through all those stages to get here.

Casey Arrillaga: Yeah. For anyone out there that doesn’t know the stages of grief off the top of their head, the stage that is the gateway into acceptance is sadness, and in fact, in the original model, they would’ve said depression. You have to go through that sadness. You’re not going to get to the acceptance without going through the tears and the sense of loss. That’s, to me, emotional sadness is about. It’s a sense of loss. You’re right; it can just simply be the loss of I thought my life was going to look like this, not like what it does, that idea of comparing things to our ideal. As we move through that, we can find acceptance. One way to find acceptance is to find meaning in it or create meaning in it, and one of the number one ways that people can create meaning in their lives is being [23:41] to others, which is exactly what you’re describing. You found where is the gift in this, which I’m going to give long-term spoiler here? The book I’m writing for next year, I have a children’s book coming out in a few months to help kids understand what their parent might be going through...

Lisa Gennosa: Wonderful.

Casey Arrillaga: …and help caregivers understand how to talk to kids about it. Unfortunately, they tend to just lie to kids. The next one that I’m working on that the children’s book actually interrupted is about the gift of addiction and being able to see – that’ll be down the line [24:09].

Lisa Gennosa: Love to.

Casey Arrillaga: I’ll warn you ahead of time. I’m probably already going to want to interview you again if that time just comes up. Hey, we’ve made it all the way through Page 5 of your book.

Lisa Gennosa: Oh, gosh!

Casey Arrillaga: I’ve got so many notes here of things I want to talk to you about. We’re not going to hit them all. Some of them you talked about. On Page 46, you talk about this relapse was an awakening. I became a different version of myself because reality could no longer be avoided. While that is a painful moment, I also recognize that it can be a transformative growth moment. You also mention in there that, at that point, you lost your sense of spirituality.

Lisa Gennosa: I did.

Casey Arrillaga: It seemed like it was hard to reconcile that. You talk about your, again, anger and grief. If somebody said who said God doesn’t give you more than you can handle, I wanted to punch them in the face. What I’d like to ask you is, by the time you’re writing that, I can only assume you found your spirituality again, perhaps in a different way but in a way that works for you with the reality of what’s happening, rather than saying I can’t reconcile these. Would you mind talking a little bit about that?

Lisa Gennosa: Sure. It’s so true. I did. I gave up. How could the entity that is supposed to be getting you through these horrible times not be there at the most critical of all? I’m not a super religious person, but I’m a very spiritual person. I have always been, but I’ve always known since I was a little girl the story about footprints. There was somewhere along the way that it just popped up. I don’t know. It could’ve been on social media or something like that, and it was a moment of reckoning. You have these different things, the unexplained, the miracles, we’ll say, the people that came into your life, the phone calls that I got. It’s those things that really pulled me back into understanding what my spirituality meant, what it was that was holding me up ultimately, and what was going to ultimately get us through. Once I let go, once I accepted that, again, in that phase of acceptance, it was like I got washed of all the negativity and all the sadness and the hurt and said, all right, I’m going to lay this at your feet, and I am going to accept the outcome. That outcome might not be the one that I want. It might be the one that we all fear the most. There was that moment of acceptance. It’s terrifying to even say out loud, like to talk about, but with substance use, we all think about the possibility of death. It was when I said I understand that that is a possibility and that there’s a reason that I went through all of this, regardless, and that I came to understand and accept that I was going to be okay and my son was going to be okay and we were going to make it. I got to that point of understanding of my own spirituality again. That might sound a little unusual. I had to get to the point of accepting the possibility of my son’s death to understand my spiritual relationship. Does that even make sense?

Casey Arrillaga: It’s beautiful and it completely made sense. I will tell you, on a personal level, my daughter who is a young adult now did not struggle with addiction, and I’m very grateful for that. I sat her down at 10 years old and said this runs in our family. Both your parents have it. We’re in recovery. We haven’t talked to you a whole lot about it, but by the time I was 10, I was wading consciously into my addiction. I would not have put those words on it, but I had made those choices. This is going to be my life.

Lisa Gennosa: Wow!

Casey Arrillaga: I can trace stuff back to kindergarten and say there was the addictive thinking. I can trace stuff down to my very first memory, about 3 months old, and say there was my addictive thinking. The seeds were always there, but by 10 years old, this was the life for me. I sat my daughter down and said, hey, this runs in our family. Here's some things you can do that are protective factors. You don’t have to join a recovery program but have a spiritual life of some kind. Keep your mind open. Talk about your emotional problems. If you’re going through something, don’t go through it alone, all these kinds of things. I thought, up until about 13, it’s like, well, we’ll see what happens. What actually happened is she crashed emotionally and her mental health crashed, and she became suicidal for about a decade. I had a long time where I thought we may lose this kid, and initially, my thought is I need to save her. I’m a dad. This is my job. I’m supposed to protect, keep the family intact. Here’s what I’m going to do. By the time she was, I’m going to say, about 16, I had figured out that I can’t, and I ended up having a conversation with her in front of the school counselor. She went to a lot of different schools because of her issues and moving around, but in this case, I knew the drill. She was going to go to school. Within two weeks, I was going to get a call from somebody, if not a bunch of people, this case, a school counselor. “Did you know your daughter is suicidal? Did you know she’s talked about this stuff?” I said, “Yes, I know that.” “We need you to come down.” “Sure. I’m on my way” I sat with her in front of the counselor and said, “I can’t keep you alive. I would love to. If I could, I would.” I mean, I heard a little bit of emotion in your voice when you were talking about it. I can feel some emotion in me when I’m talking about it still to this day to say you’re going to have to decide if you’re going to live or not. I will love you either way. If you actually die, especially by your own hand, I’ll probably regret this conversation right here. I know it’s right. It’s the right thing to say, not because it’s going to influence your, or reverse psychology, or save you. It’s my truth. Probably took a month or two later when it suddenly hit me. Huh, I actually also need to tell her don’t try and stay alive for me. If you die, I will hate that. I will grieve you the rest of my life, but I don’t want you to stick around suffering because you think it’s what you need to do for me. You need to decide if you’re going to stay alive for yourself or not. I said your mom might be very upset at me for having this conversation, but again, it’s the truth. In that, I found that we were able to have a better relationship. The things I was doing and interacting with her were not colored by how do I say or do the right thing or not say or do the wrong thing that’s going to tip the balance here? I had to really recognize I don’t have that much power.

Lisa Gennosa: Yeah. Yeah. It’s relinquishing that power. I had to do that too, and I thought I could control his outcome. I know people feel that way, that somehow they can keep them alive. You read I would spend any amount of money, try any treatment, go to the ends of the earth, but I had to accept that I wasn’t in control of that and still not to this day. That’s why I’m in a much healthier place for myself and so is he.

Casey Arrillaga: I mean, that’s something I say humorously at family workshops now, but it comes up where so, well, I just need to do whatever it takes to keep him alive. I said, wow, you have the power of life and death. We need to talk after this workshop. You got to let me know the secret, except that we don’t. We don’t have the power of life and death. I think, partly thanks to medical advances, we take for granted – in our society especially, we’re in arguably the most affluent society on earth probably that’s ever existed, especially when it comes to medical capability and technology. We take for granted that our kids are going to make it, and therefore, if they don’t, it must be our fault. I think, for most of human history, not that we wouldn’t grieve the kids, but it was just understood. A lot of the kids are not going to make it. Thomas Jefferson, who had all the wealth and power of his day and was brilliant – I mean, a remarkably intelligent human being. All but two of his kids died by the time they became adult. I should say all the two of his legitimate, married to his wife kids. Ironically, the kids he had with his slave almost all made it to adulthood.

Lisa Gennosa: Wow!

Casey Arrillaga: Talk about not having the power, and of course, it affected him and you can see. It didn’t stop him dead in his tracks. He went on to help found and lead this nation and double its size, and his personal book collection became the beginning of The Library of Congress. I mean, he had a lot going for him. This all happened after most of his kids died. People just understood sometimes this happens and it's beyond our control. I think that we’ve gained maybe more than an illusion of control as we’ve gotten better with medicine and parenting and just the assumption that the kids are all supposed to make it, and if they don’t, we must’ve done something wrong. It’s simply not true.

Lisa Gennosa: So true. Oh, my gosh, you talked about the blame in there, the blame that you hold on to, and I did all these things wrong for so long. That is something that I really hope people will work through a lot earlier in their loved one’s addiction, that they are not to blame. Letting go of that blame frees you up and enables you to again do the work on yourself and the work for them and with them. There are so many reasons. There are so many things, but it’s not something that you did specifically. Now, I guess I can’t say that. I don’t know people’s specific situations, and I’m sure there’s some family dynamics out there that created negative situations. In most cases, it’s just not the parent or the spouse that is to blame for the substance use disorder. It’s just not the case.

Casey Arrillaga: There’s way too much that goes into it, and I’ll take a moment, put a shameless plug. Episode 5 of this podcast was actually just a recording of me giving an hour-long lecture to families about addiction and the brain, just so people could wrap their heads around we could let go of shame and blame. It’s not somebody’s fault. You’re right; I used to do a family workshop where we would have sometimes up to 60 people in the room, all of our clients from the treatment center and all the family members who showed up that weekend. You could hear the family member said, well, if only we hadn’t gotten divorced, or maybe if I had been more strict. Then so-and-so, well, maybe I’d been less strict, or maybe if I’d been more consistent. Maybe if I’d been less consistent. I would just run an experiment just for fun in the room. I’d say, okay, everybody raise your hand if your parents got divorced. About half the hands would go up. Okay, raise your hand if they stayed together. The other half of the hands – raise your hand if they were strict. Okay, raise your hand if they weren’t strict. Raise your hand if it was chaotic. Hands would shoot up for all of them. In a room full of people, like you said – I know you’re using the medical terms, substance use disorder. It’s the same thing I put on my documentation. I use the word addiction because it’s just shorthand. I will tell you; I’ve moved away from calling people addicts because it doesn’t have to be our identity. There’s a lot more to us. In any case, just looking at that and saying there’s no ideal set of circumstances. People come out of chaos and abuse and active addiction in front of them. They don’t have a substance use disorder. They don’t become addicted.

Lisa Gennosa: Exactly.

Casey Arrillaga: Other people sail smoothly through life, at least from the outside, and they do. I remember working at a treatment center and one of the nurses, she said, “Yeah, everybody else in my family is addicted, but I didn’t become addicted. I knew better.” I’m like, “Everybody in your family knew better.” The thing that is so hard sometimes to wrap our heads around because it’s scary is that some people sometimes just got luckier, the combination of genetics, how you interpreted a certain life event. Even if you had a twin and you were standing next to them, one can become addicted and the other one doesn’t. It’s not one has better moral character. Sometimes it’s just one gene variation or something that happened 10 years earlier that helped you reinterpret this event that just happened, and something just wiggles a little bit one way or the other.

Lisa Gennosa: Absolutely.

Casey Arrillaga: I had a family member say that, actually, once at a workshop. He got to the end of it, and he said, “I am so glad I did this because I partied really hard, just like my stepson who’s here,” he said, “and I’ve always just thought, oh, I have better moral character.” He says, “Now I just recognize I pulled an ace out of the deck and he pulled the two. That’s the difference, just luck.

Lisa Gennosa: Yeah, it’s so true. That is so painfully true. It’s important to recognize that at some point and release yourself of that blame because it’s so unhealthy. We don’t do it but we should.

Casey Arrillaga: Tell you what. We’re going to take just a moment to hear from another one of our sponsors, and then we’ll be back with the rest of our interview with Lisa Gennosa. [Commercial] Welcome back. Let’s have the rest of our interview with Lisa Gennosa, author of Incurable Hope. This leads into the opportunity for self-examination, and you talk about that in your book, particularly talking about people who work in the helping professions such as you and me, people in law enforcement, professionals that work around addiction. You say it’s tough to do the consistent self-examination needed in these professions but it is critical. Could you talk about that a little bit? I think that draws from what we’re talking about so far.

Lisa Gennosa: Yes. What happened to my son was by a mental health deputy. That mental health deputy took my son from a hospital bed. He was suicidal. He was supposed to take him to a mental health facility, and instead, in an open gown or he was completely exposed, he took him to a jail and, ultimately, within about 12 hours, put him in solitary confinement. The self-examination there was, okay, what happened to the crisis intervention? What happened to de-escalation, and what happened to the empathy or compassion from the officer that night? This wasn’t a simple case. This guy had come in. He didn’t know. None of us knew the underlying trauma at that point, but he was asking officers to shoot him because he could not handle what he was holding inside of him. It was too much. Where did the officer go get misdirected and say, oh, this is just another drunk tonight that I have to deal with. I don’t want to have to deal with him. It’s the middle of the night. I’m driving him to jail. I don’t know what else to do with this guy. When everybody in the hospital – the emergency room physician, the psychologist, the social worker, everybody said this guy has to go to mental health facility tonight, no exceptions. That’s not where he went and ended up in solitary confinement. The self-examination of that officer was really important to me. I said what happened here? Was he burned out with his job? Was it compassion fatigue? Is he just completely apathetic, desensitized? What happened to that individual? I know this is not a systemic problem in law enforcement or medicine, but I worked in the emergency room myself. I saw it in there too. There is a lot of apathy going on, and it’s very disheartening and very concerning to me because that is where we need the intervention. Right there, between these professionals who are in the job to take care of individuals, that’s where the intervention needs to be. Get them where they need to go. Help them in that moment with the education that we can get from crisis intervention, the de-escalation. I really felt like this individual needed to have the self-assessment as to what he did in that moment that provided really bad outcomes and say maybe I could approach these situations a little bit healthier, little bit better, little bit more managed, and even more educated. That is where I started going into – myself, I actually went in and volunteered for speaking engagements and did that for a couple of years, training for mental health for police officers, EMS professionals, medical professionals. I would go in and train them more thoroughly than they get in standard care on mental health and substance use disorder, crisis intervention, de-escalation. Those were my talks over and over and over again. I felt like, if I could just help even one of them see how they could handle that situation differently, then the outcomes will be better. We got to get through people one at a time. It was fascinating because I’d have hardcore narcotics agents come up to me afterwards with tears in their eyes and saying I really need to take a second look at myself and what I’ve been doing out there, and that couldn’t have been more rewarding than anything I’ve done so far. I mean, it was just incredible. I said, if that’s how you feel, then I’m really glad you were here today and that you could hear this perspective. I’ve gone into work with incarcerated individuals as well teaching them the same and recognizing and learning from their perspective what they’ve been through, and that’s been eye opening as well. It’s been probably the most rewarding thing that I’ve done to date is work on the heroin recovery program within the jail. That also has really helped me to explain to others what that looks like. I’m actually working on a compilation of their stories right now as well.

Casey Arrillaga: You’re at it now. You’re an author.

Lisa Gennosa: It’s just coming naturally now. Although, again, you couldn’t have bet me a billion dollars to say this is where I was going to end up. I’m a biology nerd. I hated writing when I was younger, and here I am. I just think their stories are incredible, and I’d really like to share them.

Casey Arrillaga: Again, I’m going to say it’s really – it just hits a lot of social work notes in there and you getting out there on an individual level but also like a – what’d we say, a meso-level on onto a macro level of how do we actually help people’s perspective in there? Unfortunately, especially in a crisis situation, a lot of it comes down to how my trauma response interacts with someone else’s trauma response, and we don’t know for sure what that is.

Lisa Gennosa: Absolutely.

Casey Arrillaga: I would love to say, hey, you know what? Everybody who works directly with mental health should probably make sure they get some mental health help too. There should be free therapy out there. Sometimes there probably even is, but then, again, not everybody’s going to look at that and go, oh, yeah, I should sign up for that because it’s difficult to look at ourselves at the end of the day. Whether you’re in recovery from addiction, or you’re working with people who should be in recovery from addiction or another mental health issue, at the end of the day, it is easier in the short term for a lot of people to look and say, oh, that’s them. That’s not me.

Lisa Gennosa: Right. In that culture too, it’s very hard to reach out for help, even today. We really have come a long way in accepting mental health and understanding it. I take care of police officers. I take care of medical professionals, and there’s still that stigma. They don’t want anybody else to know that they might be feeling something related to their job. There’s a great quote that I use all the time. They say, “The expectation that we can be immersed in suffering and lost daily and not be affected by it is as unrealistic as walking through water without getting wet.” I use that quote for my talks all the time because it is absolutely spot on accurate. You can’t be exposed, whether it’s in the emergency department or on the street, over and over with trauma and that loss and that suffering that we see and not sort through it, not deal with it. You can’t just look away and pretend it didn’t happen because you’re going to see it again the next day and the next day and the next day. That builds and builds and becomes very traumatic in your own right. You have to sort through those things. I wish there was something right now, and it’s something that I would love to see changed in law enforcement and even in medicine where there is a designated amount of time where you are pulled from very difficult duties on the street or whatever, and you’re made to do something else for a while, something that’s very positive, something that’s giving back, and something that you’re being built up for as opposed to chronic trauma that you see on a daily basis. There isn’t anything like that right now.

Casey Arrillaga: I can share that kind of proposal, though, that idea of, yeah, doing a rotation. In the military, if you’re in combat, you’re supposed to rotate out for a while, rotate back in. if you’re down there in the middle of it, it can feel like you are in the trenches of warfare, so that idea of having a rotation out is a beautiful idea. One more thing I want to touch on, Chapter 24 of your book. You have this beautiful chapter. It’s called “Lessons Learned,” but it’s a bunch of practical advice on finding yourself, finding peace. You don’t have to say all the things, but can you just talk about what that chapter means for you?

Lisa Gennosa: The work on yourself part, even in my practice, I’m a huge advocate for self-care. Self-care is just critical. There’s actually a podcast I was listening to that was the young guys, and it was unrelated to this completely. One of the guys actually said something like it’s when you take care of yourself that you are being the most selfless person that you can be. Most people feel and my patients will tell me all the time, if I take care of my – that’s selfish. I can’t. I have to take care of all these other people and all these other things. It’s selfish for me to take out time for myself. I explain to them, if you do not take out time for yourself – I didn’t either in the beginning, but if you don’t do it, you’re ultimately being selfish because you’re not giving them 100% of yourself. You are minimizing what capabilities you have for them. You’re coming at them at 50% instead of 100% when you could be all of yourself and helping them in the most productive way. Taking care of yourself with self-care, what does that look like for you? I told people it’s different for every human on the planet. Going for a walk, or talking with a friend on the phone, or painting, or meditating, whatever that is for you, whatever that looks like, afford yourself that every single day. If you do, you will become stronger and healthier, and that will translate into your loved one’s recovery. I don’t know how it does. It’s magic. I don’t know but it does. The more you take care of yourself, somehow it translates into the more they want to take care of themselves. Over time, you see that. It’s hard to believe but it does happen. Letting go was another strong point in my own recovery. I’d say I was addicted to my son’s addiction, so I had to recover from my own addiction. Letting go was just that moment of reckoning, that recognition of we’re either going to go under together – he’s going to pull me under, and I’m not going to be able to breathe anymore. We’re going under the water quick, or I had to let go and free myself and free him ultimately. Guess what happened? When I let go and stopped trying to hold on to all of the control and everything that was happening, he started to get better, and I got a lot better. The stronger I got, the more I communicated, the more I helped other people, the more I worked on myself, I got better. He got better. It was wonderful. It took so long for me to get there, and I don’t want people to go through 10, 15, 20 years, 30 years or more and not do that. I want them to start now so that they can start to see those changes in themselves and their loved one. The connection part of it, there’s just nothing that compares with human connection and nothing compares with your socialization, I say. When I tell my patients the best way to get through their own mental health is eating better and having a really good sleeping pattern – we call it sleep hygiene and exercising all the time and drinking lots of water and getting plenty of sunshine. One of those critical things is socialization. When you are going through this, you automatically want to hide, and you want to isolate, just like someone with addiction because you are addicted too. By letting go of that, by calling someone or going out to lunch with someone, accepting that you can go to a dinner party and that’s okay – for years, I stopped doing anything. I didn’t go anywhere. I didn’t talk to anyone. How can I explain 15 years of education and our pain in a short conversation with somebody? I can’t. It’s a waste of time. I’m not going to do it. I realize now that was so foolish of me. I should’ve done it a million times and tried to talk to everybody so that there’s less stigma. There’s better understanding. It promotes many things. It promotes legislative change. It promotes health insurance changes, if we all start to understand it a little bit more. The more of us that close off and don’t communicate and don’t connect, the message doesn’t get out, doesn’t go anywhere, and we stay quiet. That’s why your podcast is incredible. You’re talking about it, and we’re having the conversation. I think it just took a really long time to get here. We’re here and we’re finally here.

Casey Arrillaga: Absolutely. Today’s society, overall, I think we’re actually doing pretty well with this. If I think back to the roots of Alcoholics Anonymous in 1935, it’s been less than 100 years since there’s been anything like a viable solution that anyone could believe in, and nobody believed in it at first. Even the people doing it were shocked that it worked, so it’s really just been a small handful of decades that there’s been a solution that anyone could recognize and that there could be hope. I love that because the title of your book is Incurable Hope, and that hope is so important. Sometimes that’s what makes all the difference for somebody. It’s just thinking maybe it’s possible to be okay, and that’s such a theme in your book, the journey I went through to get to be okay. Thank you so much for putting that out there and for telling your story and all the advocacy and the work. God bless you for all the wonderful things you are doing to help people’s lives be better and born out of your own pain. Lisa, where can people find your book?

Lisa Gennosa: You can find it on Amazon or – and wherever books are sold, so that would be Barnes & Noble, Books-A-Million, all those. You can go to my website, www.lisagennosa.com. That’s with two Ns, and you can also find me on Facebook and Instagram. I am out there, trying to get my word out there, the book out there to help others, and that’s really the only goal. I just want to help as many people as I can, and I’m available. You can reach out to me on email as well. I can be reached at admin@lisagennosa.com.

Casey Arrillaga: Beautiful. Thank you so much for coming on the show. I would love to have you back sometime.

Lisa Gennosa: Thank you.

Casey Arrillaga: Just keep doing that great work.

Lisa Gennosa: I appreciate it so much. Thank you so much.

Casey Arrillaga: That’s our interview with Lisa Gennosa, author of Incurable Hope. Available everywhere that books are sold. Thanks for being with us through another episode of Addiction and the Family. As they say in many recovery meetings, take what you liked and leave the rest. Go out and explore the possibilities for recovery in your life and give your loved ones the space and dignity to make their own choices. If you like this podcast, please subscribe. It means a lot to us. If you know anyone else who could use what we have to offer, please tell them about Addiction and the Family. If you have comments about this podcast, have a question you’d like answered on the show, or want to contribute your voice, or just want to say hi, you can write to us at addictionandthefamily@gmail.com. We’re also happy to be your friend on Facebook, and we can be found tweeting on Twitter.

Kira Arrillaga: Addiction and the Family is produced, written, and engineered by Kira and Casey Arrillaga, with music by Casey.