Today, I welcome Heather Tidwell, a licensed clinical social worker, licensed addiction specialist, and trauma-informed care certified practitioner who has been in the mental health field for 12 years. Learn more about Heather and her team at B&G Counseling Services in North and South Carolina.
Heather and I discuss ways current systems are failing families impacted by the disease of addiction and how her work with clients is focused explicitly on meeting them where they are. We discuss the challenges for families when someone returns home from treatment and how navigating this transition can be improved.
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See full transcript below.
00:01
You’re listening to the Embrace Family Recovery Podcast, a place for real conversations with people who love someone with the disease of addiction. Now here is your host, Margaret Swift Thompson.
Intro 00:26
Welcome back. On today’s podcast episode, we are going to spend time with Heather Tidwell, a fellow colleague working in the field of addiction who shares a passion for family recovery. Listen as we discuss how the current systems are failing families, and why this happens, Heather discusses the vital role of meeting families where they are at. And together, we discuss realities of life within a family when a loved one with a disease of addiction returns home from a treatment center. This part of the journey can be very hard to navigate for our family members. But it doesn’t need to be this way. Please meet Heather Tidwell!
01:14
The Embrace Family Recovery Podcast.
Margaret 01:31
Let’s get started. Miss Heather, so glad you’re with me. I am excited to have you on the podcast as a colleague in the field, working with people with the disease of addiction. I would love you to introduce yourself to us in the way you want to. Who’s your qualifier if you want to share that or what got you interested in working in the field of addiction? And welcome!
Heather Tidwell 01:54
Well, first of all, thank you so much for having me, I consider it such a blessing just to have this this opportunity to speak with you and your listeners. An addiction is something I’ve always really been interested in since I can remember probably since middle school. It was something that I was exposed to myself, in my family, in my community, in my school. And it was something though, that I didn’t really understand what I was seeing. And it was something that wasn’t necessarily talked about. And it was almost whispered about, you know, like behind closed doors and things were kind of kept very tight. And it was very taboo to talk to others. Others about it. When I got to college, I was even more just kind of like interested and invested to immerse myself as a individual that could potentially be an agent of change, and kind of change, like the culture around addiction for both individuals, families and for systems. I went to a very small high school; it was a public school in North Jersey. And I graduated with 68 people, four of which had passed away since then, of overdoses,
Margaret 03:09
I’m sorry.
03:11
Heather:
Thank you. And it was something to that just my community as a whole didn’t really know how to breathe, how to deal with it, how to acknowledge it, and it kind of perpetuated in my community as a problem, pretty consistently. And we lost more young adults in that same community grade through grade.
So, one thing I did in my bachelor’s and master’s is I specialized in the social work field with acute specialization with addiction. I got my bachelor’s and master’s from San Diego State University go Aztecs. And I don’t know as some of you may know, St. San Diego because of the closeness to a variety of military bases, we have a pretty large population of homeless veterans that are suffering from some type of like mental concern, as well as a co-occurring addiction use. So, something I got really into was working with veterans who were suffering from addiction. I then kind of transpired and I started working with adolescents suffering from addiction. And then of course, whenever you’re working with an adolescent or really with anybody in addiction, you’re working with families. So this is something, I’m a licensed certified addiction specialist. I believe in continuously immersing myself in what is out there and what is new as far as what are evidence-based interventions to help not just only the people in active addiction, but their families as well.
Margaret 04:42
So Heather, that’s an amazing background of training, and passion, and academics. And not everyone, not a lot of people are drawn to this part of mental illness and addiction. specialty? And do you think it was coming from a small school and having those four pass that kind of propelled you to want to go further? Was it when you got to school? Just more interest in learning about it? You know, what was it for you that made you say, you know what, this is my sweet spot. This is where I’m going.
05:19
Heather Tidwell: I think for me as I started to really get like some more psycho education, learning, just about addiction and mental health, and also like, what are some resources out there? And what are some resources that aren’t out there? I honestly kind of got angry at what had occurred in my community, and also what I saw kind of occurring around me from like the system point of view. And that, you know, addiction is so messy, it’s messy, it involves crisis. It’s not something that individuals usually like acknowledging or talking about. And it’s something that I found that when we do talk about it, and when we do acknowledge it, using assertive communication, healthy boundaries, acknowledging that the person in addiction is the expert on themselves, and not kind of giving them like a handbook that they have to do, if they want to get what we view as a version of better. I just found myself very drawn into the messiness of it, that’s something can still be messy. But that being said, we can approach it from a clinical perspective with a calm body, and a calm mind. And really begin to look at out of the boxes interventions to lead to positive outcomes in a field where it kind of has this overshadow where there’s not a lot of positive outcomes.
Margaret 06:46
So, I love that spin. And I don’t mean that disrespectfully. But I mean that in the most positive way, I love that your description of it is the messiness which boy, we know that’s true, it’s messy for the whole family, it’s messy for the person, it’s it is a messy illness. And it’s counterintuitive, when you love someone with addiction, because you can’t go after it like you would if you love someone with cancer, it’s a very different dynamic between the family members. And I think one of the things that we don’t do well is teach families and systems, healthy ways with communication, and boundaries. You know, treatment centers historically don’t do a lot for the family, they take the person out of the system, treat them and then put them back and neither know how to reintegrate after treatment. Is that your experience as well.
07:39
Heather Tidwell: 100%. And it’s really interesting after you and I kind of first talked about me being a guest on this podcast. Again, I love knowledge. And I also understand, yes, I’ve been in this field for 15 years, I don’t know all the things, and there’s so many various lenses to look through.
So, you know, of course, after we spoke initially, I go down that rabbit hole of looking at all these evidence-based articles of looking at testimonials and blogs, from family members who have been individual that’s an active, active addiction from looking at drug users. I even got into exploring a drug user union that they have in North Carolina. And regardless of what your lens is, it seems that everybody agrees is that the opposite of addiction is connection.
Margaret: For sure.
Heather Tidwell: And how important it’s to connect. And it’s like what you just said, so what happens, somebody’s in addiction, I take them out of their schools, take them out of their families, you know, I lock them up, I take them out of their communities. And then what happens is let’s say we go to like a treatment center. So, let’s say mom goes to like a treatment center, she comes back that family system is going to be dysregulated because prior to that that family system, they are homeostasis or their stability. They were used to like the rules of the addiction. Maybe we all knew around five o’clock mom’s gonna go upstairs, she’s gonna have a couple of bottles of like wine. So, we know that the adolescents you know, they’re they don’t really have like a lot of oversight. They’re able to kind of do whatever they want, maybe like they don’t have curfew. Well, now we come back the system, which is used to mom being dysregulated Well, the system is still dysregulated because they’re used to those norms, those values in that culture. So now here comes back sober mom. You know, maybe now I’ve speaking a little bit more assertively. It’s like my kiddos. I’m expecting them to go to bed to turn this off to listen to me. Well, what we’re going to find is, is that that system is going to push against mom. It’s dysregulated. This isn’t homeostasis. We’re not used to this, where again, we really should be talking about that discharge plan. The minute mom enters treatment, and there should be that connection to that family system. She’s going to go back to you know, most relapses happen 72 hours after being discharged from a treatment facility, we know how to be in there without all of this. But then we we get back and we don’t know how to get back to the system, to what our baseline is.
Margaret 10:12
Right. I think the other component that you absolutely see in person who’s sought services and is returning home, I use the word familiar, what was familiar, is automatically reinstated. And if someone comes back to do it different than your causes the reaction. I also think shame is a big pusher, you use the example of mom who went off to treatment and comes home, a mom is coming to consciousness and awareness for the first time in a long time of the impact of her mothering due to the disease hurting her and taking her away. And so often, I will coach people when I worked in the treatment centers to not go home and try to be supermom or super dad, because there’s no credibility and no trust Yeah. And so if you go back, jump in full force, there’s going to be even more of a resistance because your loved ones don’t have a sense of trust and credibility that you’re going to sustain recovery. So, take it slowly reintegrate slowly, but it’s tough.
11:20
Heather Tidwell: Well, and it’s also an what you just said, kind of triggered me to like think of something is that it’s great that mom may be getting, you know, again, traditional care, it used to be 90 days inpatient. Now with like insurance changes, it’s usually 30 days, so but still, Mom’s getting 30 days of intensive, like, it’s usually three groups a day, they’re doing a skills group, you know, maybe she’s meeting with a psychiatrist, but the family is still there. And most of the time, they’re not getting connected to services. So, they themselves can maybe learn or just be proactive, or have some of their own tools, because they’re also dealing with all of the reactions from addiction. And most likely, especially if there’s kiddos in like the home, we’ve most likely experienced some type of trauma. I mean, just being under the age of 18. And living in a home with an individual that is actively using is one of those adverse childhood experiences that we do know has adverse outcomes. But we don’t treat that.
12:29
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Margaret 12:32
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13:53
You’re listening to the Embrace Family Recovery Podcast. Can you relate to what you’re hearing? Never miss a show by hitting the subscribe button. Now back to the show.
Margaret 14:05
Well, I think Heather the other thing that this raise is one of the reasons I started Embrace Family Recovery because we do subserve and underserved the families. And so, they’re going into withdrawal when their loved ones and treatment. Partners, parents, children on some level but definitely partners and parents in that they don’t know how to navigate their family life without that person because they’re used to trying to fix, manage, control and when they’re gone and getting the help, they so desperately want which is wonderful and they’re very grateful that they’re getting help. They’re left with resentment, rawness, trauma, fear all the feelings that are masked by focusing on someone else and they’re no longer in their purview of control. And they can often spin out and struggle and how that manifests. I’m sure you’ve seen it too. You know they want to jump in and try and manage the treatment process. They want to be in touch with the clinicians all the time and make sure they know every time, or they have no contact whatsoever because they’re just done. Or they get irritated when they get calls. Because it’s like, it’s not my problem, it’s their problem, get them fixed, you know. And so that’s a lot of unresolved pain, grief, and hurt, that isn’t even touched. And then the person comes back shiny and polished from treatment and looking so much better, and want to jump in and do everything, right. Very noble, nothing wrong with it. But they’re met with a whole different level of resistance. Because the family doesn’t know what to do, or how to trust this new person walking in, or this changed person.
15:38
Heather Tidwell: And I also feel, you know, and again, like, when we’re talking about addiction, it’s its systems, its systems of care. And it’s also, you know, I think too on like us as clinicians and on those treatment centers, and on, you know, emergency rooms, like we’re, you know, where they’re seeing overdoses and things like that. And, you know, I’ve worked in three different emergency rooms, when we see an overdose like it’s treat them and street them, and then we’ll give them a bus pass, they’ll go get detox, and they’ll be right back next week.
But still, as providers, I see such an area of opportunity and growth, where we can partner, and pair with the family. And I know that you and I like when we first met, we talked about motivational interviewing skills, which is my jam, I’m obsessed with that. And I use that with every single individual I work with, specifically with individuals in addiction. As the goal is you meet that individual exactly where they’re at, you roll with their resistance, and you work on enhancing their intrinsic motivation for change. Well, what I did after our initial, you know, kind of talk is I looked more into motivational interviewing with families when the member is suffering from addiction. And they found that one, which I think is so great, because you know, resources everywhere, can be limited pending on like insurance, if you live in like a rural area. Is that motivational interviewing encompasses such basic tools, that family members can go online and educate themselves just about some of the skills and the model. And it can completely change the dialogue, to where they are presenting with less resistance. And they’re able to kind of talk about, like, maybe safety in the family, and what that looks like in regards to that individual. And it’s, it’s very powerful. And also, let’s say we do have somebody doing in Treatment, or partial hospitalization, or intensive outpatient treatment, is having that provider be able to, again, connect with the family, and have them working on their own kind of like stuff that they have going on simultaneously, while ideally doing at least like bi weekly family sessions, where it’s not saying you shouldn’t feel this way. It’s hell yeah, you’re allowed to be angry. That’s okay. Now, how do we work on the acceptance of that? And how do we respond to that versus not react? And how do we not just go all in or be all out? But how do we get to some semblance of a middle ground and acknowledge this is going to be uncomfortable? Not for everybody? This is going to be hard. And how do I meet that family there?
Margaret 18:23
And how do I acknowledge and respect that the bandwidth of family in early recovery when someone’s getting whatever level of care they’re getting, is pretty limited to growing because they’re still just catching their breath from whatever it led to them finally seeking care. And so, it’s like, I agree with you, I would love in a system approach our people working in this industry, around people with the illness and their families to start including families in their work? The dilemma that I have hearing in my head is what I’ve heard from many trainings I’ve done and being around people in the treatment world, our bandwidth with the chronicity of clients walking in the door, the level of intensity of the work we’re doing, mixed with managing our insurance, requirements of documentation. Families are more of a problem than a help. And so, I focused on the client. And I know you’re gonna react to that because I react
Heather Tidwell: Yeah. Oh, it’s true.
Margaret: I get it.
19:29
Heather Tidwell: It’s true how a lot of clinicians and I’m going to they hate working with families because it’s so difficult. You’re managing so many different dyads and roles triangulation you know, family rules, family culture, it’s something I personally love. I love working with families and you know, like more. I’m like, okay, let’s do this. You know, you guys have survived 20 plus years with this, and you all set and admitted, it sucks. It’s been miserable. Well, you made it through. Now, how do we kind of work together?
And also, like acknowledging I’ll work with like family members where they’re like, I’m not saying anything. I’m done. This is this person’s tenth time. I’m like, alright, well, what would be your thoughts of, maybe I just phone you went on speaker, and you don’t have to say a thing. But you listen, or maybe if they’re open, maybe I give you a little bit of like an email breakdown, meeting them where they’re out, invalidating that that frustration and not saying, well, you’re being a bad sister, you’re being a bad partner, because you need to support this person.
But I do agree with you. And that’s something too I do in my practice is I do my own education with my clinicians on working with families, how we don’t have to be scared. And how do we use our skill set from a systems view, because in my opinion, if you’re not looking at systems, and I mean, family systems, hospital systems, I mean, community systems, natural informal supports, I’m doing a disservice to the person in front of me, whether it’s one individual or a family unit.
Margaret 21:12
And I think it’s important because a lot of my listeners are families to say, like you, I disagree with families being the problem or a burden, I don’t like labeling anyone. And I think the reality is, is families are tenacious, and survivors, and have navigated stuff that people who’ve not been through this have no comprehension of the levels of stress they’ve lived with. And to be in front of a clinician is huge progress.
What I also can say is when I’ve watched families get help, whether their loved one is seeking treatment or not, the change within the system is dramatic. And the influence on that loved one, there setting boundaries, finding ways to navigate the relationship and a healthier way, separating the person from their disease, putting boundaries against the disease, it is amazing to watch how that can transform the system and also impact in a positive way the person who’s struggling with the illness of addiction.
22:11
It’s so powerful. And one thing rather than, than looking for triggers, let’s look for glimmers especially in you know, like a family system. And this idea. And I use this sometimes when I do trainings, it may not be the most PC thing, but I always say I’m a junkie for transformation, and for change. Like that is my addiction when I see it, so when I’m working with like a family, and maybe like they just shared something that is a huge win, or huge glimmer, but they don’t necessarily see it that way. I’m like, whoa, whoa, hold your phone. Hold the phone. Everybody stop.
Oh, my goodness, like, did we just realize what y’all just sit complex as a system? This is, guys, we’ve been on now for 10 minutes. I’m hearing respect. You know, I’m hearing understanding and we’re making eye contact. And we’re also everybody’s here, Dad, this is the first time I heard you say anything this whole session. Like it’s, it’s looking for those glimmers when I mean, even culturally, like we’re so prone to look at, like the negative, and you know, do this. But you know, I’m like, okay, yeah, it’s great. We, you know, maybe we’re aware of what our triggers are. What about like the daily glimmers? And what do those look like? And do we celebrate those? Just kind of like how we harp on the relapses? Do I celebrate like these glimmers?
Margaret 23:35
And I think that’s a great word. And I agree with you. And I think both are equally valuable. And I do 100% agree. And I think it’s due to the fear that we focus on the worst-case scenario, what can happen, then how do I plan? How do I prevent? How do I control and all of that, and so putting out the glimmers and really highlighting them as a beautiful way to do it. I love that Heather. And I think that’s so important for families to know, that’s a simple change they can make for themselves without a therapist or a professional or coach, they can start looking for the glimmers in their family system.
24:06
Heather Tidwell: Right now, I do outpatient work. So the like, primarily, I’m working, you know, with that one individual, but often, you know, again, with addiction, I’m always working with the family system, you know, so whether like that individuals open to, you know, parent partner joining is I always try to give, you know, I’ll say yes, I am this individuals, clinician, you know, there are HIPAA guidelines, but I always share you know, would you be open or even interested if maybe I sent you some like just resources, you know, if you wanted just to kind of educate yourself on like ways or even tools that you can do, you know, I’ll always offer therapy as well, but I want them to have more informal resources that they have control over. I always recommend families look into acceptance. Steven Hayes is the founder of that. He’s written over 40 books about it. He’s published usually every three weeks, he’s on several podcasts, his concept of like acceptance can be used in regards to addiction, and it is so powerful, and it can be very freeing just to, you know, I always think like the families, when they have somebody in active, like addiction in their family, it’s almost like they’re holding on to the 25 pound weight. And it’s like, they’re just, you know, and we never know when that weights gonna drop. But we feel like we have to just Oh, but acceptance is a way to kind of like put that weight down, maybe breathe for a little bit, understand it a little bit more and be able to hold it. Not saying that we’re getting rid of it, but we hold it in a different way. So, I always talk to them about acceptance of motivational interviewing skills. And so much of this stuff is free on podcast on Insight Timer.
Margaret 25:50
Sure. So, you give them a lot of resources. One of the things I should be transparent on how we met, I reached out within our professional community in the area to find someone who talked about harm reduction because of the Recovery Month, and I really want to talk about Narcan and access to that. And in North Carolina, they’ve made some serious progress about having it be accessible in vending machine, and free and no, no asking you just go get it. And I think that’s tremendous. And I hope that will become a nationwide change that happens because people need to know more about it.
And you shared a lot of amazing things when we spoke Heather about the types of harm reduction and work you do, which may not be exactly what I’ve been conditioned and trained to do in my work from the Minnesota Model and the abstinence-based model. But I think it’s important to recognize there are many ways for people to get well. I have no right to tell anyone the path they need to take. I will be clear about my bias. I know what saved my hinny what has saved my life and I will share from my perspective. But at the end of the day, every human being deserves and requires, in my opinion, the autonomy to find their own path. So that makes me excited when I know there are professionals out there that offer different things.
Outro: A lot of passion in this discussion, which is exciting to know there are others out there in the field of addiction with such passion as Heather Tidwell shows. Come back next week while we continue this conversation, and we discussed the importance of understanding harm reduction in addiction and recovery.
I want to thank my guest for their courage and vulnerability and sharing parts of their story.
Please find resources on my website.
This is Margaret Swift Thompson.
Until next time, please take care of you!
