One of the great gifts of being out in the world talking about addiction and recovery is I get to meet so many fascinating and talented people working on these issues. This is one of my deepest motivations for writing and speaking about my own experience; to connect with other values-aligned writers and thinkers. One wonderful recent example is the fantastic writer Laura Cathcart Robbins, our guest on this latest episode of the Flourishing After Addiction podcast.

Laura is the author of Stash, My Life In Hiding, which hits a balance I love in addiction memoirs: simultaneously an insightful exploration of the phenomenon and a fun romp. We talk about her experience of addiction and of entering recovery, especially: “doctor shopping,” the use of prescription drugs (especially sedatives), divorce, and parenthood. The problems with treatment programs, rehab romances, boundaries and being honest with oneself. The process of writing about her addiction, journaling, inner work, her experience in publishing, reclaiming “Quit Lit,” the lack of representation in addiction memoirs, and her motivation to tell stories like her own. And, the way she makes sense of her recovery framework today.

Laura Cathcart Robbins is the best-selling author of the Atria/Simon & Schuster memoir, Stash, My Life In Hiding, and host of the popular podcast, The Only One In The Room. She has been active for many years as a speaker and school trustee and is credited for creating The Buckley School’s nationally recognized committee on Diversity, Equity, Inclusion, and Justice. Her recent articles on the subjects of race, recovery, and divorce have garnered her worldwide acclaim. She is a 2022 TEDx Speaker, and LA Moth StorySlam winner. Currently, she sits on the advisory boards of the San Diego Writer’s Festival and the Outliers HQ podcast Festival. Find out more about her on her website, or you can look for her on Facebook, on Instagram, on Tiktok, and follow her on X

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In this episode of Flourishing After Addiction, I had the honor of speaking with Bruce Alexander, a towering figure in the field of addiction theory. As regular Rat Park readers will know, I named this newsletter after Bruce’s iconic experiment in the 1970s, honoring not just that experiment, but also the decades of contributions he’s made since to the broader understanding of addiction as a deeply human phenomenon.

Now that Bruce is in his 80s, he’s said he won’t be doing much more writing and public speaking, so I’m especially grateful to have the chance to talk about the most important lessons of his work. We focus on his recent publication, "My Final Academic Article on Addiction," in which he distills his over fifty years of insights.

We discuss what Bruce identifies as the greatest threats addiction poses to modern society. We explore the theoretical stagnation in understanding addiction, the limitations of medicalizing addiction, and the subtle yet pervasive remnants of irrational thinking that hinder our approach to addressing mass addiction. Alexander argues against the notion that we can simply 'therapize' our way out of the problem, urging for a deeper examination of how society contributes to and can help resolve the crisis. Listen to the end for his take on what professionals and clinicians can do—and cannot do—to help us with the current crisis.

Bruce Alexander has explored many corners of the addiction field for almost half a century. Beginning in 1970, he has counselled people with heroin addiction, conducted psychopharmacological research (the “Rat Park” experiments); ran field research on cocaine use for the World Health Organization; critically analyzed theories of addiction by ancient philosophers and modern researchers; and served on the Boards of Directors of NGOs in Vancouver’s Downtown Eastside. He has published three books, Peaceful Measures: Canada’s Way Out of the War on Drugs (University of Toronto Press, 1990), The Globalization of Addiction: A Study in Poverty of the Spirit (Oxford University Press, 2008), and A History of Psychology in Western Civilization (Cambridge University Press, 2015, co-author Curt Shelton). Since retiring from the university as Professor Emeritus in 2005, Alexander has spoken frequently in Canada, Europe, and the United States. He posts many of his recent speeches on his website, www.brucekalexander.com. He was awarded the Sterling Prize for Controversy in 2007.

In this episode:
- Bruce’s "My Final Academic Article on Addiction"
- Naomi Klein, Doppelganger
- Conspirituality: How New Age Conspiracy Theories Became a Health Threat

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As a bonus for this special episode with the artist Erin Williams, author of What’s Wrong? Personal Histories of Chronic Pain and Bad Medicine, I got permission to post some of the illustrations from her new book, What’s Wrong? Personal Histories of Chronic Pain and Bad Medicine. Head over to my Substack page to see those. You won’t want to miss them.

Erin Williams is the author and illustrator of ten books, including What's Wrong? Personal Histories of Chronic Pain and Bad Medicine, Commute: An Illustrated Memoir of Female Shame, How to Take Care and the Big Activity Book series (250k+ in print). Her writing and art have also been featured in publications including MoMA Magazine, Virginia Quarterly Review, and The Believer. She has over a decade of experience in healthcare, specifically data analysis and scientific research. She teaches illustration at Parsons School of Design and creative writing at Hunter College in New York City. You can find Erin on Instagram  and Twitter.

Dr. Ray Baker is a distinguished leader in the field of addiction medicine and a person in long-term recovery from addiction. This episode of Flourishing After Addiction particularly resonates with the theme of the longer-form writings I’m starting to post about frameworks for making sense of recovery, so I’m grateful to have the chance to talk with him.

A highlight of the conversation is Ray’s insight into the various processes of recovery, as he advocates for a holistic approach across different domains. He breaks down the framework of recovery capital: the internal and external resources that help people on their recovery journeys. We discuss how that model and others can serve as  organizing frameworks for change, helping people to plan their recovery journeys with autonomy and agency. My hope, by the way, is that this Substack newsletter can help with both of those elements: making sense of recovery, and itself serving as an ecosystem where people can learn and share with one another.

There’s a lot more here: Ray’s personal journey and the power of self-disclosure, including what one person shared with him that may have saved his life. His experiences in treatment, and the contrast between primitive and cruel forms of confrontational therapy, versus the principles of autonomy, agency, and compassion that he later came to value. Ray also entered recovery as a committed atheist and now identifies as agnostic, so we discuss secular recovery as one interesting recovery pathway. Ray also gives a balanced perspective on the uses of psychedelics and antidepressants in treatment. And, coming back to the theme of recovery frameworks, Ray shares his experience with exercise and physical health as a crucial aspect of his own recovery, and how that led him to a deeper consideration of physical health and wellbeing as a part of recovery processes.

Ray Baker, an addiction medicine physician and a person in long-term recovery from addiction, spent over three decades as a clinician and consultant after initially working as a family physician. He developed the University of British Columbia's Undergraduate Addiction Medicine program and authored guidelines for Canadian railway workers with substance use disorders. Recognized for enhancing methadone maintenance therapy standards, he received the Nyswander-Dole Award in 2003. Baker has served on the American Society of Addiction Medicine's board and contributed to addiction research and recovery frameworks in Canada. Since retiring from clinical practice in 2016, he has focused on community-based recovery, culminating in his book, "Recovery Coaching, Knowledge and Skills," published in 2022. That year, he was honored with a lifetime achievement award by the Canadian Society of Addiction Medicine.


In this episode:
- Brief assessment of recovery capital
- Barbara Fredrickson’s work on developing positive emotions
- Secular recovery: Life Ring,  The Secular Recovery group,  and a post about the secular recovery movement
- Recovery capital: a primer for addictions professionals (White and Cloud)

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In the latest episode of Flourishing After Addiction, I am thrilled to be exploring the intricate relationships between addiction, recovery, pain, and embodiment with Margo Steines, a writer and person in recovery with a deep understanding of these themes.

Margo Steines holds an MFA in nonfiction writing from the University of Arizona and serves as a faculty member in their acclaimed writing program. Her work, including her memoir-in-essays "Brutalities: A Love Story," offers a truly unique view into diverse experiences of addiction, including substance problems, self-harm, risky sex, eating disorder, and what is unquestionably the most captivating literary portrayal of exercise addiction I have ever read.

I was so happy to encounter Brutalities a short while ago. It’s a bold exploration of intensity, extremity, and physicality. It’s a cautionary tale of the thin line between discipline and compulsion. In the end, it’s an inspiring story of one person’s path toward a more balanced and healthy embodiment, including the impossible task of becoming a parent.

If that weren’t enough, we also talk about relationships, orthorexia, chronic illness, sex, sex work, and money. Margo walks us through her current recovery practices and the edges she’s navigating today. Finally, of course, we talk craft, including writing from and about pain.

Margo Steines holds an MFA in nonfiction writing from the University of Arizona, where she is faculty in the Writing Program. Her work was named Notable in Best American Essays and has appeared in The Sun, Slate, Brevity, Off Assignment, The New York Times (Modern Love), the anthology Letter to a Stranger, and elsewhere. She is the author of the memoir-in-essays Brutalities. Margo is a born-and-raised New Yorker, a journeyman ironworker, and serves as mom to a small person. She is also a private creative coach and writing class facilitator. She can be found at her website, Twitter, and Instagram.

In this episode:
-her book: Brutalities
-Margo’s “Write your story” class
-Margo’s other classes
-Leslie Jamison
-Marya Hornbacher
-Jerry Stahl

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Shame and self-stigma can be powerfully limiting and harmful, and they are especially common among people with addictions. We’ve discussed on prior episodes of the podcast that there may be valuable and wise forms of shame, but psychotherapy research has also shown that the wrong sort of relationship to shame can also inhibit growth and stand in the way of recovery. So for this episode of Flourishing After Addiction, we dive into the practical aspects of working with shame, guided by Jason Luoma, Ph.D., a psychologist and a leading figure in this field. 

Jason is a leading expert in the scientific study of shame, self-criticism, stigma, and the interpersonal functions of emotion in addiction. He has done crucial research on those topics in the context of Acceptance and Commitment Therapy (ACT) since 2002, and as a practicing clinician and leading trainer in the field, he is a true expert in strategies for dealing with shame.

Jason breaks down the complex process into tangible steps, including viewing the treatment of shame as a continuous learning process in which we work toward looking at shame, rather than living out of it, unconsciously. The answer is not removing shame, but becoming aware of it and working with it: using our pain as a signpost for meaning and purpose, and aligning with personal values to guide us through the challenges of shame.

This is also a great conversation for anyone who wants to hear about an inspiring model of social enterprise in mental health. As an entrepreneur and co-founder of the Portland Psychotherapy Clinic, Research, & Training Center, Jason also gives some insights into his pioneering and unique social enterprise, which dedicates its business revenue to fund scientific research and expand treatment for mental health.

Based in Portland, Oregon, Dr.Jason Luoma is a researcher, entrepreneur, clinical psychologist, and psychotherapy trainer. Since 2002, Dr.Luoma has been deeply involved in researching shame, self-criticism, stigma, and the interpersonal functions of emotion, especially in addiction, including the first randomized trial of an intervention focused on helping people with shame in addiction. Heco-founded the Portland Psychotherapy Clinic, Research, & Training Center, a unique model combining therapy and research funding. As an author of key books on Acceptance and Commitment Therapy (ACT) and a leader in the field, Dr. Luoma also contributes through a popular blog for therapists and has held significant roles in the Association for Contextual Behavioral Science.

In this episode:

-Jason’s articles and books
-Prior episode with Owen Flanagan
- Slow and steady wins the race: a randomized clinical trial of ACT targeting shame in substance use disorders.
-ACT Manual for Shame in Substance Use Disorder (which contains the “Feared Eulogy” exercise)
-An introduction to loving kindness meditation from Sharon Salzberg
-An investigation of stigma in individuals receiving treatment for substance abuse, Addictive Behaviors 32 (2007) 1331–1346.

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For this episode of Flourishing After Addiction, I wanted a guest who could offer some insights into the journey of seeking help for addiction and recovery. What is going wrong with our systems and services, and where can people actually find care? Brian Hurley is the ideal person to help us with these questions, with his extensive experience as a practicing addiction physician, President of the American Society of Addiction Medicine, and Medical Director for Substance Use Prevention, Treatment and Harm Reduction for Los Angeles County's Department of Public Health.

We talk about Brian’s background in the performing arts in Los Angeles, and how his personal experiences seeing the rise of methamphetamine in the mid-90s inspired him to dedicate his professional life to addiction medicine. We discuss his take on the state of addiction treatment today, and what it’s like for someone suffering with addiction to look for help and support.

Brian speaks about the fragmented nature of addiction care and how that affects us all. We talked a fair bit about the need to distinguish addiction from other kinds of substance use problems (considering, e.g., people who are on milder end of spectrum or who may not identify with idea of addiction), and the concrete effects of those considerations on our systems.

Brian highlights the disparities in treatment access based on insurance and location, and the urgent need for systemic changes. He emphasizes the importance of improving language and understanding around addiction, not only for professionals but also for the public. By discussing the nuances of substance use disorder and addiction, Brian paints a vivid picture of the diverse experiences of people facing these challenges.

Of course, we talk about the current overdose crisis and the urgent need for change. Brian gives some shocking statistics about the low percentage of people receiving specialized care and draws on examples from European models, particularly from Portugal, to illustrate successful strategies. He shares insights from his experiences on a recent trip to Europe, suggesting ways to modernize treatment in the U.S. and remedy the “treatment gap.”

Brian’s approach to addiction medicine is deeply rooted in evolving public policy perspectives. He advocates for a systemic view that requires transformation in leadership, administration, and policy. In this way, he also urges for a more comprehensive and empathetic approach that incorporates recovery.
 
Whether you are a clinician, person in recovery, or otherwise, you’ll find useful pointers for how to change, and how to participate in change.

Brian Hurley is an addiction physician, President of the American Society of Addiction Medicine, and Medical Director for Substance Use Prevention, Treatment and Harm Reduction for LA County's Department of Public Health. He works on projects that make services for people with addiction more accessible. He lives and works in Los Angeles with his husband and several dogs.

In this episode:

- The American Society of Addiction Medicine
- The treatment gap: only 6% of people with substance use disorders received treatment
- episode 12 with John Kelly
- episode 22 with John Strang

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Valerie Mason-John (Vimalasara) is a writer, Buddhist teacher, a person in recovery, and the founder of Eight Step Recovery. In this episode of Flourishing After Addiction, Vimalasara shares their transformative journey, beginning with childhood in an orphanage and evolving through various addictions, with a particular focus on their struggle with bulimia, to arrive at their current role as a spiritual teacher and author. Their story is a testament to the complexity of eating disorders and their commonalities with traditional addictions, with implications for all varieties of compulsive behavior.

Through probing the nature of compulsive eating, Vimalasara describes the essence of addiction from the Buddhist perspective. We discuss how to work with craving, chronic relapse, and the drive toward substitute addictions, redirecting oneself instead toward “sobriety of thoughts and feelings,” highlighting Vimalasara's journey toward finding balance and peace, rather than simply stopping the behavior.

This discussion is also a great exploration of various recovery methods and pathways, including especially the mutual help recovery community Vimalasara created, the Eight Step Recovery program. If you are curious to learn more about what actually happens in these types of alternative mutual help groups, this is a great introduction. This part of the conversation also highlights the value of a pluralistic, diverse approach to recovery, one that is necessarily in constant flux—for example, how Vimalasara is now in a relationship with a “big book thumper!”

Finally, we discuss Vimalasara’s perspective on how addiction intersects with timeless issues in mental health and wellness, from her first addiction—“to be in control of life”—to her biggest addiction: “to be loved and noticed.” They give us practical pointers for practice, working with difficult feelings, and concludes with a brief guided practice that can be helpful for a variety of habitual behaviors.

Valerie Mason-John (Vimalasara) is an award-winning author and editor of ten books, including Eight Step Recovery: Using The Buddha’s Teachings to Overcome Addiction, and Detox Your Heart: Meditations for Emotional Trauma. Their book I Am Still Your Negro: An Homage to James Baldwin was shortlisted for both the Dorothy Livesay and Gerald Lampert Awards. They are the co-founder of the mutual help group Eight Step Recovery, which holds meetings in the UK, USA, Canada, Mexico, India, Finland, and online. They are a senior teacher in the Triratna Buddhist community.

In this episode:
- Their book
- Eight Step Recovery
- The ethical precepts of Buddhism, stated positively.
- Kevin Griffin, friend of the pod. My interview with him here.

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