“So much of what we do perpetuates problems, not by intent, but by a lack of understanding.” -Dr. Mike Barnes
The main focus of the recovery process is often given to the addict in the family and there’s nothing wrong with that. It is out of genuine love that they go to great lengths to make sure the needs of their loved one are well provided for. But for family recovery to be realized in its entirety, they must look into the often undermined effects of addiction: trauma. Family members don’t realize that they are traumatized until they start prioritizing their own needs. Hence today’s episode homes in on how to help family members realize that they are traumatized and help them recover from it. Our guest, Dr. Mike Barnes also talks about the biology of how we cope with problems and the epigenetics of addiction and trauma. This understanding will greatly help in the treatment and recovery process that families may choose along their journey. He also differentiates between problem and crisis and how our stories create an impact on the decisions we make. Dr. Barnes also gives some suggestions in making the paradigm shift in family recovery even more effective. It only takes one or two members to spark the change. The question now lies on who’s going to take that privilege.
Highlights:
- 03:47 Serving Families With Addiction
- 10:47 Living in Recovery Together
- 18:32 Coping Begins With Family Goals and Values
- 23:48 Helping Families To Understand That They Are Traumatized
- 31:53 The Epigenetics of Addiction and Trauma
- 38:13 Understanding The Biology of How We Cope To And Solve Problems
- 44:50 3 Rules of an Alcoholic Family And How to Challenge Them
- 54:55 A Shift In Recovery Processes Needed
Recovery needs more than the patient to get better. Join @TFRSolution and @Dr_MikeBarnes as they discuss what families often do not realize: “addiction in families is about trauma.”#familyrecoverysolutions #addiction #epigenetics #chronicIllness… Share on X
Resources:
Book
- The Alcoholic Family by Peter Steinglass
- It Didn’t Start With You: How Inherited Family Trauma Shapes Who We Are And How To End The Cycle by Mark Wolynn
- “It Will Never Happen To Me!” Children of Alcoholics: As Youngsters- Adolescents- Adults by Claudia Black
Quotes:
03:47 “Addiction in families is about trauma.” -Dr. Mike Barnes
06:07 “While our impulse is to be here to support our love one, we have to also begin to look at what family healing looks like.” -Dr. Mike Barnes
20:26 “The longer the family system stays in fight or flight the more they get away from values and goals and move into survival.” -Dr. Mike Barnes
35:31 “A family’s perception of the problem played much more of a fact in how they deal with it than the reality of the problem.” -Dr. Mike Barnes
01:00:07 “So much of what we do perpetuates problems, not by intent, but by a lack of understanding.” -Dr. Mike Barnes
About Dr. Mike
Michael Barnes, Ph.D. MAC LPC is the current Chief Clinical Officer at Foundry Treatment Center based in Steamboat Springs, Colorado. His expertise is around Marriage and Family Therapy, Trauma Counselling, Addiction Counselling, and Clinical Supervision. He has over three decades of experience in a variety of settings in both program administration and frontline treatment. Dr. Mike also serves as a speaker, author, and thought leader to help family members of addicted individuals who are required to live through traumatic situations.
Connect with Foundry Treatment Center:
Got ideas? Perhaps a future podcast? Email Jeff at sjeffjones@me.com
Transcriptions:
Jeff Jones: All right, so welcome, everyone, this is Jeff Jones on the podcast Families Navigating Addiction & Recovery. And today, I am here with Dr. Mike Barnes, and I have been looking forward to this conversation for some time, and I have known Mike for, I don’t know, seven, eight years, something like that. And I first saw him speak at a conference about trauma and have seen him speak numerous times, and now he’s going around the country with a very specific message around trauma and specifically with families. So, Mike, thank you very much for taking time out of your schedule to be here today.
Dr. Mike Barnes: Absolutely. It’s always nice to be with you. And I appreciate the opportunity to share some of these ideas.
Jeff Jones: Yeah. Thank you.
Dr. Mike Barnes: Sure.
Jeff Jones: So do you want to start by just saying a little bit more about who you are, so people listening really have a good sense of you?
Dr. Mike Barnes: Sure. I’m the Chief Clinical Officer @ Foundry Treatment Center in Steamboat Springs, Colorado. And we’re a small private treatment center that’s mostly at this point, residential and PHP, partial hospital, but really looking to expand into a more recovery oriented view with IPS and things like that. Before that I was at CeDAR, Center for Dependence, Addiction and Rehabilitation at the University of Colorado Health. And before that, I was a professor at the University of Colorado in Denver in the counseling program, and I’ve been in the field for 35 years. And actually, I’m a family therapist. I have a PhD in Marriage and Family Therapy, and have been really fascinated with family trauma. Having had a child who was hit by a car while I was in my doctoral program, that really changed the focus of my real academic focus. I went to get my degree so that I could actually do better with addiction and families, and realize that addiction and families is about trauma. And as you know, I spent the last couple years really building trauma integrated addiction treatment and quickly realized that the family programming that we have currently do is not very trauma integrated for families. And so really began to shift my focus back to my original focus, which was, how do we better serve families struggling with addiction from a trauma integrated standpoint?
“Addiction in families is about trauma.” -Dr. Mike Barnes Share on XJeff Jones: Yeah. Yeah. Thank you. And can you, I’m asking you questions that I think listeners might be interested in. But can you say a little bit why that would be important.
Dr. Mike Barnes: So I think the best answer to that is when I was at CeDAR, we did a survey of our families. And we talked to over 300 family members, and we asked them 15 questions, and they were everything from his addiction to disease, and just sort of trying to see where they were at in the process. And one of the questions was, do you believe that living with an actively using addicted individual is traumatizing? And the Likert scale, I’m trying to think the numbers, it was like 75% of the people said that they strongly believed that it was traumatizing. And another 20% said that they believed that it was. So it came out the 95% of all the family members that we talked to said: “You know, this has been really traumatizing to me.” So I’ve clicked, I’ve done a lot of research, my research is mostly qualitative, it’s not numbers, it’s more trying to understand where families are. And I have a lot of quotes from family members who have said, another example, I was doing a podcast or not podcast, a Webinar the other day, I got an email from a mom who said: “You know, my son’s been an addict for 25 years. And we’ve been in and out of treatment with this young man trying to help him and solve this problem. And you’re the first person who ever talked to us about the fact that maybe we’ve been traumatized.” And she said: “I was sitting listening to your presentation and I thought, I think he’s talking to me specifically.” And I wrote back to her and said: “I was speaking to you specifically.” And it’s really important that you begin to understand that while our impulse is to be here to support and love for, that we have to also begin to look at, so what is this family healing?
“While our impulse is to be here to support our love one, we have to also begin to look at what family healing looks like.” -Dr. Mike Barnes Share on X
Jeff Jones: Yeah, that reminds me of a question that I saw about his trauma. Oh, gosh, what was the question? It was like, is trauma something that we call a wound, a wound that we can heal? Or is it something that we just call normal? And that’s what our life is, and that’s what we cope with. And just from the thinking standpoint of it, it seems like it would be very different.
Dr. Mike Barnes: It’s interesting, I’ve been saved for a long time that I think if you look at the VA, and you look at my mentor government, Dr. Charles Figley and William Nash was the Chief Psychiatrist for the Marine Corps, wrote a book a few years ago called Combat Stress Injury, where they really were looking at Post Traumatic Stress Disorder is actually an injury to the limbic system of the brain. So let’s call it what it is, and it’s an injury. And in some cases, that injury can be cured. And in some cases, injuries going to result in chronic disease or chronic process. And so eventually, I think the term Post Traumatic Stress Disorder will go away, at least I hope it will. And it’ll become known as Post Traumatic Stress Injury, which really allows us a more broad view of what recovery looks like. So some people, I believe, are able to come out the other side of the trauma treatment process with very limited symptoms of trauma, and others come out with a fairly chronic struggle. And the thing that I think is really interesting also is we keep pretty good statistics. We do trauma symptom inventory on our clients, we have a really good idea of who has PTSD and who doesn’t. And about 30% of our clients on any given day have Post Traumatic Stress Disorder, but I think 60% of our clients are higher, have developmental trauma. So I talked a lot about I believe trauma happens on a continuum, and that the primary trauma, which is the Post Traumatic Stress Disorder, and then kind of coming out of the A study in the work of Courtois, and Ford, and Vendor Koch, really looking at what they initially called complex trauma, and then developmental trauma, that idea of the difference between what was done to you, PTSD, and event, or what happened to you as opposed to with developmental trauma is what wasn’t done for you. What did you not get that you needed to get to have a limbic system and an autonomic nervous system that it’s balanced and coherent and responsive as appropriate rather than always on Red Alert.
So my research stems actually from an incident where our son was hit by a car when he was five years old. And he’s 33 today and doing great. And he and I are actually doing a lot of work with, he’s a lawyer, and looking at trauma informed legal practice. If people don’t think of lawyers as being trauma involved, that’s all they do is work with trauma, least certain aspects of the legal profession. But he got hit by a car when he was five, and that was in 1991, and I had just started my doctoral program. So I was working with Dr. Figley, who was the top traumatologist in the world at the time, or one of the top, and then Patrick got hit, and I started looking at the research and there really wasn’t much, there’s a lot of research on Post Traumatic Stress Disorder, but very little on the impact on family systems. So dissertation was on the secondary trauma of parents of children who experienced a life threatening event and require a pediatric intensive care tree. So I’ve been really looking at, as I’ve worked more and more in the addiction world, I started saying: “It’s the exact same process, they’re just a lot older, they’re not pediatric. And it’s dealing with a chronic disease.” So I think for our families that come through our program, we talked to them a lot about their own trauma. They don’t always particularly want to hear it. They don’t always particularly make the connection initially.
Jeff Jones: Yeah. What have you found Mike to help families hear it, or start to understand, or start to be curious?
Dr. Mike Barnes: Well, I mean, that’s, I think, a pretty common question, and the idea of having a conversation with them about how they want this to end? What do they want it to look like after their loved one gets sober? And I hear families all the time say: “I just wish that I get sober so we can go back to normal.” And it’s like the normal ship has sailed, that in the years of living, so in chronic disease, we talked about the fact that from the time that symptoms start until first diagnosis, the family is in a state of crisis. And that they are constantly trying to solve critical incidents and events that they don’t quite understand. They don’t understand, they do the best they can to. And again, I’m a father of a kid that got hit by a car. I understand the idea that I did not have a playbook, how to handle that. So I handled it as best I could. But in hindsight, I began to realize that my own family history with addiction and my own family history of trauma played a huge part and how I handled it. And when I was able to make that connection, then I was able to say: “Hmm, maybe there’s a different way.” So it’s funny, I always relate to my students when I was a professor, and students will ask me these questions that stick with me. One of the questions that I was asked in the class was, how do you work with unmotivated clients? And I always start when I do presentations around the country, I always start with the story. Because I said to this student: “I don’t know, I’ve never worked with an unmotivated client.” In the course, the whole class starts laughing because that’s right. I said: “Most of my clients are pretty motivated to stay the same.” And that idea of, we’re pretty motivated to stay safe. And that idea that that was the thing that struck me as a parent was, how many understood the problem was I was trying to find a solution to really dictated the behaviors that I engaged in to try to fix it.
Jeff Jones: Yeah. So how you were thinking about it framed, saw potential solutions.
Dr. Mike Barnes: There was a time when I realized that our son was the healthiest person in the house.
Jeff Jones: Wow.
Dr. Mike Barnes: And that we were still trying to make sure he was safe and that he was healthy. And then the process, we enabled him, we did things that were really in hindsight, things that we were doing so that we could feel as safe as possible.
Jeff Jones: Yeah.
Dr. Mike Barnes: And that in the long run, actually, if we had continued doing those would have created a pretty learned helpless process for him because we couldn’t have tolerated the fear of it getting worse.
Jeff Jones: And what you said right there, that is the exact position that families are in with a loved one at really any stage of addiction because all their focus is on them, are they doing better? Are they not? are they telling me the truth? What do I believe here? And are they going to be okay? And it’s like their nervous system may be activated until they walk in the door or something.
Dr. Mike Barnes: If you ask a family member, and I do this all the time, how long it takes them to identify when their loved one walks in the front door of the house, if they’re intoxicated, and the average answers to two seconds, that’s pretty hypervigilant, and you start being able to talk to them about that idea. And then I’ll often say to them, so let’s just say your loved one, because these are folks that their loved ones are in treatment already and we’re having that conversation about. So what’s it gonna look like after treatment? And I say: “If your loved ones been sober for two years, you haven’t seen them for a while.” How long do you think it’ll take for you to get to the thought of, Gee, I wonder if they’re intoxicated? And the average answer is two seconds. Yeah. Even after two years of recovery, and the idea that the thought of having to relive that, again, is so frightening, that it’s impacted that family. So think about that story about the point, my mind just went blank on that. My point is that all the new normal, like going back to normal, and the idea that the longer that family stays in crisis, the more they’re, kind of way of living, their organization, their rules, and roles, and routines, and the things that they do become more and more altered to a point of living with the addiction until we can figure out how to fix it. And so that’s the new normal, which is how to live with this person and get them the help that they need. And then when they get sober, we have to create a newer normal, like an even newer that says, how do we live in recovery together?
Jeff Jones: Right? Yeah. Yeah, I mean, one of the things that I’ve seen before is that sometimes families may or one person, not the whole family, but one person may understand and really get a concept but it really takes them quite a while to be able to practice it and be able to not revert back into old behavior kind of thing. So there seems to be some kind of ongoing practice, or connection, or revisiting, or reminding, or something like that, that it just takes time to make change. And I think for myself, like changes that I really want to make, still, it takes time to make changes, and these are changes that family members may not really want to make. It may take them a while just to really understand to connect the dots as to why that’s important. I mean, what I’ve seen sometimes is like the fifth time and treatment, or something like that, then a grandparent would say something in a group like, geez, maybe there is something to that family thing. I remember someone saying something about that, and at the time, I didn’t really listen to it, or I didn’t really get it. So they’re just starting to be curious, and it’s really unfortunate that it takes four or five times for their loved one to be in treatment before they start to become curious about this family system kind of impact and approach.
Dr. Mike Barnes: So it goes back to the idea of like Post Traumatic Stress Injury, and we spend so much time at Foundry. So this process of working with the addiction, and then the autonomic nervous system, the person experiences shame, and guilt, and doubt, and their nervous system activates. And then we pendulate out of that work into doing basic safety, work with trauma, bring down normal nervous system back down into alignment, teach them how to do that, build coping skills, and then get back to working on the addiction again, because we realized that it is an injury to the limbic system that clients need to learn autonomic nervous system regulation so that they can do this work. And in counseling, we talk about bottom, top down and bottom up processing, and all that other stuff that families don’t necessarily need to understand all of that. But we’re constantly moving between a process where talk therapy can be effective. And then to wear body based stuff needs to be done. And that’s where I came to very, not recently, but the idea that we do all this work for the client, but we don’t do any of this for the family. Iff indeed 95% of the families feel that they’re traumatized, why would we not think that their brains are going to take a little while, their limbic systems are going to take a little while to learn how to recalibrate.
So one of the things I found in my dissertation research was, the longer family stay in that sympathetic nervous system fight or flight response, that they begin to shift. So a guy by the name of Peter Steinglass wrote a really good book for therapists called the Alcoholic And The Family back in the late 80’s. And he talks about how our goals and our values are the central organizing fingers for all families that it guides us into how we want to raise our kids, it guides us to how we want to live our lives, and how we want to set our rules and communicate with each other. And what we found was that the longer the family system stays in fight or flight, the more they get away from values and goals and move into survival. So if we think about Maslow’s hierarchy, the first need is physiological need, and then the second need is safety need. And then if they’re not met, we’re never going to get to self esteem and self actualization, and being really value and goal driven, we’re just trying to stay alive. So what we found was the more families began to shift towards a survival focus, how are we going to keep going with this? The more they enable? The more hyper vigilant they become, the more they close the boundaries around the system and begin to organize around the addiction, organize around the traumatized person. That’s the case, then we should be doing a lot of the same things that we’re doing with clients, with the family members, so that they can begin to have conversations that are really different than this kind of symmetrical escalation that we see, these arguments that we see.
“The longer the family system stays in fight or flight the more they get away from values and goals and move into survival.” -Dr. Mike Barnes Share on XJeff Jones: Right. And just from the standpoint of intervention, I mean, there’s certain kinds of intervention that aggravate that and re-traumatize the system. And I know that the goal is, if we can just get someone into treatment and they’re there for a while, they may see something of value and stay there, but the system gets retraumatized in that process, and it seems like there’s not a lot available to help the family with that. And on some level, the message the family has is it’s all about my loved one, Johnny or whatever. And oftentimes, interventions can reinforce that belief. And if someone’s in treatment, what? 90 days at best, then the treatment center has like 90 days to work with the family as well, but they’re really just getting paid to work with the individual.
Dr. Mike Barnes: Well think about it, so my bias is, I think we’ve become too medical and to psychiatric, quite honest. So we really believe that it’s a bio psycho social disorder. If I had a whiteboard, I would write a really big bio, and a really big psycho, and it’s little tiny words social. And I think it needs to be the other way around because it is a disease that does not exist. It exists in isolation but I think it is formed relationally in many cases. So we looked at genetics, and then epigenetics, and the impact of the environment, and transgenerational trauma. One of the things I say to families a lot is: “If you had a problem, would you want to know.” Which always stops them because they don’t get asked that question. And they have to stop and think, well, if he really wants something that impact is that something that I need to deal with, why I really want to know that?
Jeff Jones: Yeah, that’s a great question.
Dr. Mike Barnes: And the other question is, what if this is a lot more complicated than you can imagine, this isn’t simple. This is not a simple linear deal where this guy goes to treatment, they get sober and everyone goes back to normal. In my 35 years in the field, I’ve found that one of three things is going to happen when that person gets sober. If the whole family gets sober, meaning that the family, so physically in, I think it was 1989, this really fascinating paper on, what do resilient families look like? And resilient families, they don’t isolate or pick a problem person in the family. They’re very solution oriented. They look at the problem is for us to solve, not him to solve, they are very open to solution oriented thinking. They’re very open to keeping the boundaries open so that each person can get the support that they need individually, and then it may be different for different members of the family. So the idea of complexity is I think really important to realize that, A story I think may speak to this to some degree.
When I was at another treatment center, I had a father. I was walking through the admissions department and a father had just dropped off his 20 something year old son. And I was introduced to him and he said: “Can I talk to you for a second?” I said: “Sure.” And he said: “I just need you to know that my son is a liar.” And I said: “You know, that’s pretty consistent with the illness. That’s a big part of the defense mechanisms.” He says: “No, no, no, you don’t understand. My son is a liar. He will lie to your face, he will tell you things, and then that just isn’t true.” And I swap, again, we deal with this all the time, I will pass this on to the staff and will work on it, and so we had a period where the clients couldn’t call, make a call for a week so that they got acclimated into the program. And so a week later, I get a call from this father and he is just living it. He is up one side of me and down the other and all the stuff that we’re not doing. My son hasn’t talked to a psychiatrist. He hasn’t talked to a physician, and he’s only seen his counselor once. I put the pieces together pretty quickly . Okay, the kid finally got to make a phone call, and he basically did what he does, which is [inaudible]. And I said to the father: “How would you know any of that? Like, how would you know that anything that’s true? Isn’t this the same kid that you told me was like this liar?” And the guy stopped, and he hesitated, and I could tell he was starting to get emotional. And his comment was beautiful. He said: “I just need you to know that I love my son more than anything in the world. I have to make sure he’s getting what he needs.” And I said: “I appreciate that. I mean, I want you to understand, I get that.” But can we keep talking about your son for a minute and start talking about you?
Jeff Jones: Yeah. Wow.
Dr. Mike Barnes: What does that say? None of that’s true. You were right, he lied but you quickly went from being the educator of who your son is to being the enabler of who your son is. How do we make sure you get the help you need? And we got him into his own therapy, and that changed the dynamics of that family in a huge way. That’s the message that I would love families to hear. And that is, we don’t have any doubt how much you love your loved one. But we also don’t have any doubt how painful it is. how urgent it is to not have to live in that pain of time.
Jeff Jones: Right? Yeah, yeah. Wow. You know Mike, I remember you telling me that story years ago. And I just didn’t hear the last part, though, of his response, the father’s response there because initially I thought his response was going to be consistent with blame but he heard something that you said, he took a pause and he went right to how much he loved his son. What was most important was that you hear that, and you heard that.
Dr. Mike Barnes: I really think we have to understand that if family members are traumatized, they’re going to do the same things that clients do. And then I say on a regular basis, tell me again why we’re upset with this traumatized client for acting like a traumatized client because they do, their nervous systems are taking a while to recalibrate. They’re anxious, they’re upset, they get angry easily at times. Do the same thing.
Jeff Jones: Yeah, yeah, yeah. So right now I’m reading this book by Mark Wollum, It Didn’t Start With You: How Inherited Family Trauma Shapes Who We Are, and How To End The Cycle. Are you familiar with that book?
Dr. Mike Barnes: I tell people to read that book all the time, I think families should all read that. We have not really been able to get the message out just how much transgenerational trauma plays a role in everything we do. So whether it’s kind of the epigenetics of living with a family member with mental health issues. It’s funny how many families said to me: “Well, yeah, my dad was an alcoholic.” So think about the statement, but he got sober when I was 15.
Jeff Jones: So it doesn’t matter.
Dr. Mike Barnes: Yeah. And it’s like, well, hold on a second, developmentally, what was going on when you were 2, 3, 4, 5? You know, this really formative developmental years where attachment gets formed. And research would tell us that 80% of my attachment is directly positively correlated with the attachment of my parents. So I’m an anxious attachment or a fundamental avoidant attachment. Then I probably learned that.
Jeff Jones: So in this book, one of the things I’ve been most fascinated about is some research by Dr. Rachel, and I can’t pronounce your last name, Y-E-H-U-D-A or something like that.
Dr. Mike Barnes: It’s Rachel Yehuda.
Jeff Jones: Yehuda, yeah. And in that she’s talking about, when the egg is in the mother, there’s three generations of DNA there. So what happened to the grandmother actually gets transferred to the DNA that just developing embryo, and then the whole conditions around the pregnant mom, and what stresses in her life, and now she’s dealing with it and it’s like, wow, the kind of a generational pathway is, I don’t know, it seems really, really important. And then whatever that is, families have a story about it.
Dr. Mike Barnes: Absolutely.
Jeff Jones: And that story, a lot of times reinforces whatever they think about themselves, or their loved ones, or other people in the family. And it’s like, I don’t know, this seems so important. So I really like watching your speaking and what your messages are, and going from one year to the next. I really have a lot of respect for what you’re trying to do, because in some ways, it’s like swimming upstream.
Dr. Mike Barnes: Yeah, it’s funny. We were talking beforehand, and I was talking about a presentation I did in 2013 at a conference where I’m really talking about trauma at a very biological level, and no one else was doing that. And I was pretty, actually concerned that it wouldn’t go over very well, because it was out of the box. And now we go to conferences and that’s what people were talking about, and I think it’s time to do the same thing with families. And what’s interesting too about that book, so there’s a whole other process of epigenetics where there are these methyl proteins that form on the DNA that actually impact how the DNA gets activated or not activated. There’s so much of looking at how mothers transmit trauma across generations, but men do too. And those methyl proteins are passed through the sperm of men as well. So it’s really important, like doing gene — and things like that. Really look at three generations of what was going on in my family three generations ago. And I grew up in Central Pennsylvania, and it was a route, you either worked in the railroad, the steel mill or the coma. And what bad thing could happen in any one of those three areas on a daily basis, accidents. And I did my internship at US Stealing Pittsburgh as a Employee Assistance Counselor, and I found a picture of eight horses lined up in front of the mill, front gate. And I said to the doctor that I was working with: “Wow, that must have been a really horrible day at the mill.” He looked at the picture and he says: “No, that was probably during Vietnam. We were running three shifts a day, full blast, probably eight people died in the mill, and several, multiple people died in the mail every day.” And so you think of a small town in the suburbs of Pittsburgh, mostly migrant, second generation people in a little time where three to five to eight people died in the mill, and they were fathers, grandfathers, sons, grandsons. So what’s the epigenetic kind of stressful trauma load that those families passed from one generation to the other?
Jeff Jones: Right.
Dr. Mike Barnes: And if you look at the three areas that have been studied, the most of the three groups that have been studied the most, in terms of this transgenerational trauma or Holocaust surviving families, Native American families, and African American families with slave histories, and that’s what you heard his work is all, almost all Holocaust survivors. So we need to let families know the importance of being able to look at what is my history? What is my family’s story about chronic illness? And can you say more from the standpoint of healing, the value of the story from a healing perspective are changing the story. So there’s an area family therapy called medical family therapy that really looks at the implications of stress and family system. This whole theory of family coping, family stress theories that look at how a family’s efforts to address or resolve issues, medical, as well as emotional, how does that either help the problem or hurt the problem? So one of the things that I learned in my dissertation research was that a family’s perception of the problem played much more of a fact in how they deal with it, then the reality of the tribe.
“A family's perception of the problem played much more of a fact in how they deal with it than the reality of the problem.” -Dr. Mike Barnes Share on X
Jeff Jones: Yeah, then whatever happens a lot of times, it’s secret from generation to generation.
Dr. Mike Barnes: Absolutely. So that idea of that person is coming into this crisis with a family story about mental health issues, and a family story about alcoholism. A family story about, I’ve done diagrams with people where they began to look at the number of people that died in their 30’s to 50’s, from heart disease, that they never really put the pieces together before. And the idea of my mother, this is not my story, so often people have committed someone, my mother died from that kind of cancer that when our daughter got that kind of cancer, we really believed that it was like a death. So it’s not a conscious process, it’s that perception. And as therapists, we’re really driven to give families resources. And then when they don’t take advantage of those resources, they get labeled at times as being unmotivated. So when I was at CeDAR, families used to ask me a lot, what do you think we should do? And I used to tell them, and then they sometimes determine a lot of times. So now when people ask me what they should do, I say: “If I tell you what you do.” And very rarely do they say, yes. Yeah, very rarely do they say, no. Well, it depends on what you tell me.
Jeff Jones: Right. If what you tell me reinforces my story, then maybe I’ll do that. But if I challenge my story, that’s a little much. I’m not sure I can take that on, or buy that, or something.
Dr. Mike Barnes: So that just reinforces that idea about our story about what we’re dealing with is far more important than, we can give them all the resources in the world. So think about problem solving, aren’t we as biological creatures programmed to solve problems based on how we understand them.
Jeff Jones: That’s the whole sympathetic nervous system stuff. That’s what people are trying to do. They’re focused on the problem, and I say people are trying to do it but it’s like biologically, we’re kind of set up for that, and it has saved our life. I mean, that’s probably why I’m alive because my ancestors were able to do that.
Dr. Mike Barnes: And it goes so deep if you read Porges is like the polyvagal stuff, the idea that when we’re really terrified, these bones, our ears begin to shift to only be able to hear the frequencies of certain sounds that would be consistent with predators. So people will often say, I was so scared that I could see someone’s mouth moving, but I couldn’t hear what they were saying, it’s because when we’re that afraid, our ears are programmed to only hear certain frequencies. And so we are biologically programmed to do what we believe is the right thing to do, so we try harder. Well, that first order change, where we use the same understanding and the same coping strategies that We have always used to solve a problem when it doesn’t work, we try to figure out how to alter it a little bit, because it’s the right solution based on how we understand it. So second order change, and from a systems perspective is where our understanding of the situation changes. And it really opens the door for us to use different resources, like new coping strategies.
So from a family stress perspective, the difference between a crisis and a problem is not the volume of the issue, whether we have a problem requires us to exert energy to fix a problem. A crisis is when we don’t have the skills to fix the problem, and it persists. So if we think about addiction, we typically don’t have the solution to just make that go away so we just keep trying the same things that we’ve always tried and we begin to cope with the Illness over the course of time. So from a chronic disease model, we go from symptoms starting to diagnosis as the crisis. And then the chronic phase or the coping phase is living with it. So if the person resolves it, from a chronic disease, particularly a chronic disease that by its nature has relapsing tendencies, which chronic disease literary will tell us the hardest for families, because they stay pretty hyper vigilant and alert to the fact that it could come back, and we don’t ever want to have that happen. So the family stress is even greater. So if the person goes to one treatment, and they get sober, it’s going to be less of a consistent process than to that person who’s been through three or four treatments, and your family gets more and more organized around the problem. So that means they have in many cases, more work to do from a system perspective.
Jeff Jones: Yeah, I mean, one of the things I’ve seen in working with families for like a year and a half or something like that before, during, and after their loved ones treatment is that the individual coming out of treatment for them to really practice what they learned in treatment and integrated. If they’re the only ones in their family who have made change, then the relationships are a little challenged and difficult, so I have wondered about if the whole family, if more than one person in a family can be engaged in a change process and they can have an overview understanding together what’s going on, that it’s like relationships well wouldn’t end with so many cut offs, or wounds, or etc. And I don’t know, do you think that’s even possible that more than one person in a family system can change?
Dr. Mike Barnes: Sure. So from a purely family therapy, I was trained back in the dark ages of strategic and structural family therapy, the idea that I really only felt that I needed, I only needed one or two people to be really willing to change in order to, over the course of time begin to change the way the system operates. I know that thinking and it’s interesting. I was doing a presentation recently where I was rolling out this sort of some new ideas that I had, how programming could look, and everyone kept saying: “Well, what if we all know that one person in the family is going to come and say he’s the problem, why are you trying to get us to change when we’re not the ones with the problem?” And I said: “I think that needs to be the first thing we talk about, not avoid that, we need to talk about that.” And the idea of what are the rest of the members of the family doing while that person’s saying, are they supporting that person? Or is everyone getting nervous now? So from a family therapy perspective, we talk about positive and negative feedback loops, and there’s all these therapeutic processes, and who’s the person with the power in the room?
Jeff Jones: Whose voice gets listened to? While other people speak and no one listens to them. And yeah, to understand that whole kind of play, that dynamic.
Dr. Mike Barnes: It’s funny when I was really a family therapist, and I was doing a lot of family therapy, and I wanted to know who the person with the power in the room was. I would ask the youngest kid a question so that I would see who they would look at to see if they have permission to answer–
Jeff Jones: Before they speak.
Dr. Mike Barnes: And it’s like, oh, okay, I have this figured out pretty fast. And to watch everyone else in the room how they react to this young kid being asked to talk about something that may or may not be allowed to be talked about. And I love Claudia Black’s work and she’s really, I think, so far ahead of everybody else. But back in the days of her early writing on children of alcoholics, the three rules of an alcoholic family, don’t talk about what’s really going on, don’t feel your feelings, and don’t trust anyone. Don’t take any risks.
Jeff Jones: Don’t trust me.
Dr. Mike Barnes: I say you create a situation where those three rules get challenged pretty quick. And then see who the people that are maintaining these patterns are. And maybe that one sibling says this is ridiculous, my brother’s been a problem in this family forever. And what he’s really trying to do is protect mom from having to deal with the pain of whatever. So that idea of what are we going to do if that happens, needs to be replaced with, well, of course that’s gonna. So how do we work with them? So I have these questions that I think are really important to ask. And I think they’re critical, but most of the time, we don’t ask them.
Jeff Jones: Do you want to go into those questions?
Dr. Mike Barnes: Yeah, I’m trying to find my slide.
Jeff Jones: I mean, while you’re finding that one of the things that I’m thinking of is how this relates to the generation that mom grew up in, mom’s parents, mom’s grandparents, and how difficult it is to compassionately hold up a mirror to the families so they can see these patterns, and it’s a challenge. I mean, I’ve found it a challenge.
Dr. Mike Barnes: It really is, as a family therapist, when you think about the things that people come to family therapists about, with kids acting out in infidelity, and addiction, and trauma, they generally come for something and then we work our way back to what’s really going on. One of my things is I think we have to help families to understand that, that the solutions probably have become one of the problems, because we tried to fix it the best way we knew how, and throughout our very best efforts, the problem hasn’t gone away, they’re still drinking, they’re still using. And this is not about blame, it’s not about shame. This is about a different blueprint for fixing the problem. Like the first question that I asked is, what’s it like for each family member to be asked at this point to engage in this process of self reflection and ownership of how you’ve been impacted by the addiction and trauma in your family, not identifying that your brother has caused you. So think of the concept in narrative therapy of externalizing the problem, this is something that has been, it hasn’t been a cakewalk for the addict, in the family, either. He’s or she’s had a pretty tough go. And while they do whatever they have to do, and their defense mechanisms become so strong, that it seems like it’s very volitional. It’s a chronic disease. If we can find a way to externalize that, this is probably in most families, there’s been addiction through multiple generations, or there’s been mental health issues, or it’s been trauma based, and someone died in that mining accident, or train accident, or something generations ago that has caused some of these family patterns to emerge. And again, it’s not blaming, it’s copping. So if I can shift the focus from, what’s it like for me to ask you to come in here to deal with your brother to what’s it like for me to ask you to look at yourself in the process of helping your family heal from something that has been long standing and really difficult?
And then the next one is, what one thing to happen before all of you are willing to become, willing to see yourselves, to see yourselves as necessary pieces of the family healing puzzle. A friend of mine, actually a guy that I went to school with by the name of Scott — to read a really good book on family system healing from trauma, and he calls them, these unresolved wounds. So if you look at all the family, the chronic family, chronic disease, work that’s done with families, it’s really about regeneration assessment, understanding what happened in those three generations to create a narrative within this family about how we’re going to heal from this problem. Looking at the one that I think is really fascinating, that we don’t think about very much is from a family life stage perspective of these two people coming together to form a family, to them, having their own parents died. In a word, this huge sandwich generation these days. We’re still raising kids into their 20’s, and we’re taking care of our parents into their 90’s. So what didn’t happen in this family that was supposed to happen in terms of launching our kids and us having relationships with our partners. Because now we’re worrying about helping people to not be in nursing homes, and all of those things. So the chronic disease, folks say, you have to really begin to look at what should have happened in this family that didn’t, as a result of the chronic disease, the idea of the couple of the parents, the couple dealing with the addiction of one of its members, what are the kids not getting in terms of launching? In terms of attachment? Because we’ve been dealing with this issue that has prevented us from taking care of these other things. So if we do good genogram and do this kind of work, we can get to a point where everyone begins to realize that I never really developed much autonomy. I never differentiate. Maybe I need to do that in order to be really sober. It doesn’t mean I’m banned in my family, but it does mean you’d have a different relationship with them.
Jeff Jones: Sure. One of them, I love that you mentioned the three family map, that genogram kind of thing. And one of the things I’ve seen many times and asking families about their grandparents, what were the challenges and strengths in that generation, and they look at me like, you know, there were no strengths at all. And just like, whoa, whoa, wait a minute, I beg to differ, and I’m just getting to know you, but you’re here, you’re breathing, so something happened. There were some strengths. There was some coping that got you here. And I think that can be so difficult for people to grok really, for them to shift their thinking, shift their story.
Dr. Mike Barnes: We tend to forget that there’s a whole movement in trauma work called post traumatic growth, that people actually get stronger from some of the challenges that they have. It’s really powerful when in the middle of a genogram, a father can say, I’ve spent my entire life trying to make sure that my own family struggle did not impact you kids and my family. And I’m beginning to realize that maybe my dad’s alcoholism actually, and the way he treated us actually did have an impact. And for everyone in the family to sit back and really look at that, and the looks on everyone’s faces when people begin to get really real about, I tried really hard that this didn’t impact it. But be quite honest, now that we’re talking about it, it really did impact me.
Jeff Jones: They realize, yeah.
Dr. Mike Barnes: And that powerful vulnerability that comes with that, to where everyone begins to realize we can all be [inaudible]. We can love each other, and support each other and be resilient, that’s pretty powerful. But we have to shift addiction treatment in some form or fashion. I mean, we were talking about before we went on the recording part that I found a paper that I wrote in 1991 that said, residential addiction treatment, is it time for a family systems paradigm shift?
Jeff Jones: Yeah.
Dr. Mike Barnes: I wasn’t kidding. I had been an addiction counselor for nine years prior to going back to school. And I really believe that the field needed to be more family therapy focused. And we’ve gone just the opposite way. We’ve gotten more individually focused. We’re more linear thinkers now than we were 30 years ago because everything’s medical.
Jeff Jones: Yeah. Well, and like you mentioned before, financial piece is a big part of that.
Dr. Mike Barnes: Yeah, absolutely.
Jeff Jones: And in some ways, I think, I mean, just from a very far away kind of perspective, what I’ve seen is that treatment centers are in a very difficult position in how they do business, and also provide the best care that they can. And I think not just in addiction, but in the whole psychology world, a lot of the family systems stuff has gone by the wayside, it seems, and that’s unfortunate. And I’m so appreciative of the work that you’re doing. And so I’m realizing our time here, I’m kind of wondering, can you talk a little bit about the direction you’re going, or what you see for the future?
Dr. Mike Barnes: I think the future of addiction treatment is going to be more and more line with recovery oriented systems, that idea that people need to stay in some form or fashion of treatment for a year. We say that all the time, but we don’t necessarily always adhere to that. I can tell you where I’m going and it’s really in the process of developing a family program, that from the time that the person hits the treatment program, that the family is involved in that process that we’re not. So often, we talked to families about we we’re going to give you support, and we’re going to educate you on what you’re doing, but we’re also going to ask you to give us lots of information about all the stuff that your loved one did, like kind of impact and cost to the family so that we can help them break through their denial, but that just divides the family and the client even more that just sets pillars. So that idea of can we do that work in a different format. That’s more family system for him to include families in a family therapy process that is in conjunction with in parallel to integrate into the addiction treatment process. I’ve already started to look at developing a program, I actually presented at the winners symposium, and I presented on it yesterday in Baltimore, to a group of what I thought that process needed to look like. So here’s the problem with that, and you said it beautifully, length of stay in residential programs or in some cases down to two weeks. We can get someone for 90 days, that’s a remarkable process. We can make a significant impact on the resources needed to do that kind of intensive family work or really costly resource perspective for treatment centers. And so we’re gonna have to figure that out. That’s the big struggle.
Jeff Jones: So I mean, one of the things I’ve been curious about, and I don’t know if this is possible, and I think in my own little way I’ve tried to do some of that, but to start to educate the family before their loved one even decides to change, or goes to a treatment center, or anything like that, but just to start to get the family a little bit curious. And if they can look at their situation through a new lens, which this podcast and all the podcasts that I’ve done, I think can be a wonderful opportunity. But for families to look at their situation differently, even if they do it just while they’re listening to this conversation or something.
Dr. Mike Barnes: Yeah, and I have to say to you, I think the work that you’ve been doing, I’ve always been pretty fascinated with, and I think that it’s really important, and it’s hard to get treatment centers work with, the work that I’m talking about need to be more like the work that you’re doing. Where it’s outside of the treatment center perspective, or working with the treatment center where you have to figure that out, and I think you’ve been a forward thinker in that way. And it’s not always easy to be that guy, the first one thinking about a lot of that. So I would love it if we could implement these kinds of programs into treatment programs, but I don’t know that there’s the resources to do that. So do we begin a process where we start working with insurance companies that pay for family services, separate and distinct from what they’re paying for the addiction treatment. I don’t have that one. Having a hard time believing that could work very well in the work that I do with insurance companies on a pretty regular basis. So I think it’s easy to build a theoretical model that I think will work. It’s another thing to be able to have it help the people that really needed to help right in that process. I’m sort of working backwards. It’s for working as a therapist, and as a family therapist, and as a family traumatologist. What should treatment look like? And then how do we make it happen?
Jeff Jones: Yeah. So is there something that you wanted to say, a message that you wanted to say that I haven’t touched on, or that you haven’t touched on before we bring this to a close.
Dr. Mike Barnes: So it’s interesting. I saw a blog post from someone who works with families, and the title of the blog post was, we need to quit shaming families. And I thought, wow, I wonder if my work is perceived by people as being shaming because it’s really getting people to move beyond the status quo to family healing, and I hope not, because that is never my intention. But the idea in family therapy we talked about more of the same always results in more of the same, or what are you communicating when you don’t think you’re communicating? So much of what we do perpetuates problems not by intent, but by a lack of understanding. And that’s really what I’m trying to get at is, if we’re going to be trauma integrated in our treatment, we better be trauma integrated in our treatment of families, too. And if we’re going to provide family services, I think they should be the right family services. So I don’t ever want to shame anyone, and I certainly, my work with families is critical to me. But it’s really always from that place of, if we just move beyond that kind of understanding that keeps us stuck in the same place. And that is a linear process, it’s his problem and not my problem. And I’ve said to many families, it sounds to me like your loved ones addiction has been a problem to you for a long time. To say, well, it’s not my problem, it’s his problem. And if he would get better than me, get better. That’s generally not consistent with how it works.
“So much of what we do perpetuates problems, not by intent, but by a lack of understanding.” -Dr. Mike Barnes Share on XJeff Jones: Yeah, yeah, yeah. Wow. Well, Mike, I really appreciate the conversation. And yeah, I would love to continue this conversation at another time.
Dr. Mike Barnes: Sure. Love it.
Jeff Jones: But before we end, is there information that you want to give people, a website who wants to learn more, they’re curious about some things that you’ve said and they want to learn more about you. How would they do that?
Dr. Mike Barnes: So my personal website is dr.mikebarnes.com. And it has other podcasts that I’ve done that talks a little bit about different aspects of family healing that people might find interesting as well. I’m doing a webinar series with Rocky Mountain Health Plan, a seven part series on different aspects of trauma, and family trauma, and all those things. So if people want to send me information, I can send them the links to all actually, the link to it is on my website. They go to my website, they’ll see the first, Trauma 101 is listed there. And then there’s a little link that you can click on to register for all the other ones that I’m going to do, and that’s every other month. So in March, I’ll do Trauma 102, which is really the neuroscience and how memory is impacted by trauma. And then I’ll move into medical stuff, and then into family stuff. So that would be a good place for them to start.
Jeff Jones: Okay, yeah. And thanks for doing that. I did see the recording of the Trauma 101, and actually, I listened to it twice.
Dr. Mike Barnes: Great. It’s funny, I had way too much material. And I got halfway through it and realized, man, I’m out of time, so I just like racing through a lot of it so I have to apologize. Trauma 102, I was not very good time manager for the first one.
Jeff Jones: Well, thank you very much for this conversation. I appreciate it.
Dr. Mike Barnes: Okay, Jeff, thanks. I appreciate just having the opportunity to talk about this.
Jeff Jones: Great, thank you.