What Parents Need To Know About Substance Use and Trauma; What It Is And Isn’t, And Why We Can’t Ignore It, With Steve Sawyer

Hopestream for parenting kids through drug use and addiction
Hopestream for parenting kids through drug use and addiction
What Parents Need To Know About Substance Use and Trauma; What It Is And Isn't, And Why We Can't Ignore It, With Steve Sawyer

Just hearing the word “trauma” can cause a parent’s stomach to turn in knots and create feelings of guilt and regret. We believe we should be able to spare our kids from trauma and might push this aspect aside when seeking solutions or resources.

Steve Sawyer is an expert in trauma and adolescents and joined me for a deeply educational and enlightening conversation around trauma, and why as parents, we need to understand it better.

Steve helps by answering questions like, “if my kids were all raised in the same environment, why is only one using drugs?” Or, “if my child has experienced trauma, won’t sending them to wilderness therapy or treatment cause even more damage?” Or, “My child has had a wonderful, trauma-free life, I don’t think trauma is an issue.” 

In this episode, you’ll learn:

  • what trauma is, and isn’t
  • one of the most commonly missed causes of trauma in young people
  • why adolescents often turn to substances in the wake of untreated trauma
  • how trauma impacts a young person’s brain  differently than an adult
  • the 6 types of nervous system dysregulation
  • why trauma-informed doesn’t mean trauma-responsive
  • how trauma-informed care is changing in the field of wilderness therapy
  • new, more trauma-sensitive models for transporting kids to wilderness
  • the role of powerlessness and aloneness in young people
  • caregiver responsiveness and the impact it has relative to trauma
  • the difference between developmental trauma and PTSD
  • a simple project parents can do to assess the need for out of home therapy and transport


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Brenda Zane, Steve Sawyer
Welcome. If you are listening in realtime, it’s March 2022, and there is a lot going on in the world right now.
I just found out that the mask mandate in Washington state will be lifted on March 11th. Which is tomorrow. So that feels like a step in the right direction. For those of us who live in states, where we have been very restricted. Of course, there is the war happening with Russia and Ukraine. And that is surreal to say the least to be watching, play out.
So this episode about trauma feels really well-timed. And I say that because often as parents when we have a child who is struggling with substance use, we will hear the question from various people and therapists. What kind of trauma has your son or daughter experienced? And it doesn’t always necessarily compute because we think of things like pandemics and wars as trauma. Well, this is a subject that is vital to understanding what’s going on with our kids. And I got to have a really, really informative conversation about all things, trauma and substance use with Steve Sawyer. He is an expert in trauma and specifically in how trauma impacts adolescents and their relationship with substances. So I basically hit the bullseye with him. 
Steve is going to give you some of his background as we get into this. So I won’t repeat all of that here, but what I think is really important and why I wanted to have him join me for this episode is that he and his staff work with preteens and teens Every single day. So when he talks about this, he is talking from direct experience, not from a place of theory. This will be an important episode for you. If your son or daughter is struggling with substance use or with emotional or behavioral issues, they may be oppositional, defiant, depressed. They might have crippling anxiety. These are all relevant. And you’re going to want to hear about the true origins of trauma. What it actually is because it is not big, scary or stressful events in our kids’ lives. And that was definitely news to me a little bit about Steve. 
He is a licensed psychotherapist with over a decade of intervention with tough to reach clients and settings that range from residential community-based outpatient and wilderness therapy. He’s trained in several unique therapeutic models, including somatic trigger, release, traumatic memory, reprocessing, and heart math. And he’s also recognized internationally as a brainspotting trainer and consultant.
If that’s not enough, he has authored two books and co-founded with constants only wilderness therapy program, new visions, wilderness Steve’s largest project has been the development of new visions, trauma-informed care model in the wilderness setting. And that has really challenged and set the bar for the entire wilderness therapy industry in making healthier interventions with their clients. Be sure to check out the show notes for this episode, because there are a ton of resources that Steve shared with me. We didn’t have time to cover them live. Cause I wanted to squeeze every drop out of him that I could talking about his topic. So the show notes are at Brendazane.com/podcast.
And then look for this episode or scroll to episode 104 which is this one. Okay. Lace up your shoes or grab a mug of something and listen in because you are definitely going to want to hear every minute of this important episode with Steve Sawyer.
[00:05:26] brenda: Steve. It is so great to have you here today on hope stream and thrilled to have this conversation about trauma. It’s a topic that is all over the place and very confusing for parents. So thank you so much for joining me. You bet. I’m glad to be here in a parent’s side. I work with parents in our program every day.
[00:05:44] steve: I really enjoy being here. Work alongside parents in her journey. Yeah. We even had to delay this recording by a few minutes cause Steve was handling a parent call, which goes along with the job, right. When you’re running wilderness programs for, for young folks. Well, it is, I know there’s so many things that we could talk about, but I really wanted to narrow in on this topic of trauma for a couple of reasons.
[00:06:09] brenda: I think one as a parent, Going through it myself, four or five years ago. I didn’t think my kid had any drama. I was like, this kid has led the golden life. Right? Like had everything he needed. I couldn’t see from my vantage point and my, I guess, educational point. That he would have had any trauma. And it was very confusing because people would talk about it.
And I thought, oh, that’s for other kids like kids that have been hungry or abused or things like that. So I’m really glad to be talking about this. Cause I think there’s a lot of parents in those shoes thinking my kid is not having any trauma. They are the luckiest kids in the world. They grew up in this amazing house.
They had all these resources. But I think what we’re finding. And obviously what you’re an expert in is that understanding of what is trauma for our kids, especially, and then how to, I guess, not manage it, but identify it. So before we do that, could you just give us a quick background who you are? I did introduce you, but I’d love to just get a little bit of.
Here the journey of how people end up where they are, because I’m sure you didn’t, you know, go into high school thinking I am going to be owner of a wilderness therapy programs. So maybe you can just give us a quick one-on-one on, on Steve Sawyer. Yeah. Well, it depends on how far you want me to go back on.
[00:07:34] steve: Yeah, I got into this line of work actually landed in my college times. I really was fascinated with the criminal justice system and the people that were inside of it. And early on, I met some people that convinced me to start mentoring youth. And when I was mentoring these youth, the struggles they were having, that I was interacting with all of it, it just amazed to me of how people, what people’s life journey was to bring him to that point of intervention and needing support.
That went into me starting as a line staff then going from entering into working at a residential treatment program for adolescent boys specifically in the unit that I ended up in. It was actually a post corrections boys. First. I was transitioned to some other units throughout time of working there.
I worked there for a number of years, but my entire career, early college years I was working with at-risk. Well, that culminated into me starting to do intensive in-home intervention all over in Southeast Wisconsin and was doing work with challenging situations and families. And as that progressed, I quickly moved into leadership of our clinic and later became a clinics director and we, I ran one of the largest outpatient mental health clinics in Wisconsin.
At that time we’re focused on trauma work, dual diagnosis work. Both of these coins have lenses of work before they were trendy to look at it through that lens. And I was raised by an incredible mentors. I’ve just been blessed with incredible mentors. The entire span of my career people took me under their wing and, you know, inside of that work, I started working with adolescent boys and girls that had.
Five plus outpatient therapist and I was getting some results and always, I got results with getting him outside. We would break the mold of sitting in the office, staring at each other and getting out and walking. And there was a Parkway not far from my office. We’d go and sit in the woods in that Parkway oftentimes and have a session.
You know, do experiential corner reflection, et cetera. And that was kinda my first dabbling in, in the concept of wilderness therapy. Back then, I didn’t even know that there was already programs already in existence in Utah and elsewhere. And I started taking my clients on clinical retreats up into the north woods of Wisconsin and the reputation built rapidly and people were asking for us to do it longer.
And I was using a lot of our cutting-edge research. From the Institute of HeartMath, I’m a faculty member, the Institute of HeartMath, which is really a stress research institution. And we know people were fascinated. I was capturing all these results on part rate variation, stress testing, and then working with our clients out in the woods on developing self-regulation.
And a lot of things we hear about now that wasn’t even really talked about back then in the late nineties very often anyways. And so that progressed to a me meeting the co-founder of new vision wilderness therapy, drew warn back. That’s been a wild ride ever since for 15 years now, we just celebrated 15 years for our Wisconsin program.
And since then we launched a chutes wilderness program in bend Oregon. The winters out here drew me over to this side of the country and I live in bend Oregon now. And then right before the pandemic hit, we launched a Georgia program. Firstlight wilderness. And so. That’s where we are today and how are we involved in, in training all of our clinical staff, but also we have a very heavy regimen of training clinical understanding to our line staff inside of our program.
And it’s part of being our trauma-responsive wilderness therapy model. And so this last year or two years ago, we got published with the APA, from our research results of 15 years from on heart rate variation testing. We now have a model that’s stood the standup time and pandemics and has research to support.
[00:11:12] brenda: Oh, that has to be fascinating to look at so many years of research, especially through the ups and downs of things that have happened in the world during that time. I can imagine that would be, that’s a whole nother episode that we could do, 
[00:11:25] steve: but yeah, especially now with the pandemic stress response, you know, is up in everyone and we’ve had a lot of ups and downs in 15 years. When you look at. The culture here, you know, lots of ups. 
[00:11:37] brenda: Yeah. Why, I guess when I think about the folks who are listening here and myself, you know, we all have kids who are really struggling with substance use and that might vary from, I think my kids just smoking weed every day. I say just, I say that like, that’s nothing.
That is a lot, but everything from that to, you know, very serious addictions with fentanyl and, and all of those things. And so. I think as parents, we think about that, and then we hear this thing trauma, and we’re like, ah, I just want to get this kid off drugs. And so I’m wondering what is sort of so important about understanding trauma when we’re looking at it through the lens of a parent who is watching their child use these, these drugs every day, what is that connection that we need to really understand?
[00:12:30] steve: You know, being a person I’m a dual-diagnosis trained clinician. So just to clarify that I didn’t state that in kind of my developmental time, but I always had a dual track of looking at mental health, which included the trauma work and substance abuse and seeing how they interface with each other constantly.
And the research has been very conclusive that, you know, there’s a strong correlation between the. Inside of that experience, there is a particular cycle I’d like to talk about with families, et cetera, that actually was developed for attachment science and attachment theory. And it’s a really basic one.
There’s been variations of it many times, but it’s, it’s a pretty simple cycle, which is when we’re a baby and we’re born into the world. We have these needs that we need to get met. And inside of these needs that we need to meet. Whether it be, we need to be fed or we need sleep and rest, or we need you know, to even have our diaper change that need is communicated by our nervous system rising behind that need and it gets aggravated and as it aggravates more and more, you can hear a baby get fussy.
You can hear it, get kind of moody. Then it progresses to crying and that arousal. Cycle behind the nervous system is a way that we’ve been programmed as mammals to communicate when we’re stressed. And when we have a need that’s not being met. So this need not being met is met with the arousal. Arousal was communicated through crying or emotionality.
Both of those. As we progress in our development, it becomes more of an emotional expression. And then as it progresses from there, caregiver, responsiveness is a key variable here. If I cry and I want to be fed, but instead you put me in bed, that’s a misattunement. And so it’s aggravating it, aggravates the body even more.
So one of the key attributes of this entire cycle is how a caregiver responds to that arousal and it being accurately meant. So if you hear me cry hungry, and you give me food, I trust and I have a gratifying experience. So I go from. Being hungry to grab feeling a sense of gratification, which was brought to me by the caregiver.
So by somebody meetings, arousal needs and being responsive as a caregiver to our stress state, we experienced relational gratification and nervous system gratification. So the nervous system settles back down. I got my need met and the attribute of having good matches between what I’m aroused and communicating.
And what my caregiver responds with. It gives me gratification that happening over a span of time and being matched well, creates trust therapist and therapist, world. Talk about trust all the time and rapport, but it’s actually a nervous system experience to trust them. It means that you’re providing me something that fulfills a need inside of me, and I can feel it and I can experience it.
When we look at addiction issues, it’s like attachment to an unhealthy character. This is if I’m aroused and on edge or frustrated with my day or I’m angry, and my need is to get rid of that arousal and it might I’m agitated and I’m, dis-regulated an important word. We’ll talk about an often this podcast I’m dysregulated.
When you bring me as a caregiver, your response. It settles me down, but the older I get, the less reliant I am on another person doing that. And the more reliant I become on me, self-regulating my situation. And when people develop poor self-regulation skills or caregivers, haven’t had the best responsiveness we live in a stressed world.
So we, as parents are stretched to the edge all of the time, not just with kids, but work hours and demands to get our needs met for our family and safe. When there’s not attentiveness to that arousal, that’s from the caregiver in a good way, or we just give too much. And it’s just, we create an existence of gratification for our child all the time.
And now we go into the outside world and it’s just hard because my friends are hard on me or somebody makes fun of me at school. I don’t have the ability developed the ability to self-regulate well, so when we have that combination of either one of those two. And it’s culminated in a nervous system to a point a stress response.
It’s kind of now programmed in. That’s what we call dysregulation. Now, if I get high or I have my first drink, my nervous system experiences that completely differently for the first time, then somebody who doesn’t have that dysregulation living inside of them, it’s experienced completely differently from a person who has self-regulation capability versus somebody who has not.
The person who doesn’t have self-regulation capability. It’s like, wow, that’s the first time I’ve ever felt that come alone. And it becomes a solution to a problem. This arousal, this dysregulation of my nervous system. It’s a solution, not a problem at that moment. And the more aggravated, the more traumatized and the more stressed the nervous system is the bigger the solution is with that very first experience.
You talk to people that I work in addictions all the time. Let’s say, man, that first drink or that very first high of heroin was like a big, giant warm hug. Right. 
Or what we hear is it’s the first time I feel normal. 
Yes. Because right. It’s taking the nervous system from a place of dysregulation to not being dysregulated. And that is what normal supposed to be. And again, when you look at addictions work, why somebody doesn’t feeling normal is essential. In fact, you know, my friend Gabor Mate. And he has book coming out in September. I got the chapters chapter that I’m reading right now. It’s not available yet just to be clear, but he’s having me review it for a reason.
It’s called the myth of normal. And we live in a society where we’re constantly comparing ourselves to others. It’s part of our natural kind of human man of mammal response to look around us and say, Hey, are we as safe as those people do? We have our needs met, like those people where they’re sweet, do all this comparison and all these other variables that make us feel less than, or not.
We have all these societal norms that are hard to meet and the tougher the, the child or adolescent is to meet them, whether they have learning differences or, you know, stressed experiences in childhood, the more aggravated my nervous system is. And the more unsafe it feels, the stronger that first drink is for my nervous system.
And yet they get to that feeling. And ultimately it’s a very gratifying experience. The more stressed a person is the more traumatized a person is the more unhealthy experiences, the more adverse childhood experiences, ACEs experiences that a person has, all of those set the stage for our, how that first drink or drug is experienced.
And it’s either going to be extremely gratifying or it’s just something that I experienced and it was. And in that is where the, the, the raw roots of addiction lives, because the more un-normal I am, the more gratifying it feels. And the more I trusted and in today’s world, there’s a lot, it’s hard to trust anything it’s stressful.
You know, a parent’s predictability sometimes is a variable, right? Because we have to be at work and do this project, or this. And, you know, can I trust parents responsiveness or emotional availability to me when I’m struggling? It’s simple things like this. When I work with addiction, sometimes it’s just, parents were in a stressful time and they weren’t as responsive.
So I was left feeling alone and inside of that, you know, I feel lonely. And then when I have that first drink, it feels way stronger in my nervous system than somebody who hasn’t got that going. 
[00:20:19] brenda: Yeah, thank you for explaining it that way, because I think that that helped me understand that when I hear the word trauma, it doesn’t have to be war or rape or some horrible thing that we think of.
I think often when we hear the word trauma. It can be one of these things that just isn’t working. Right? And then you’ve got all these different kinds of personalities of kids. And today, you know, I think social media sort of says, you need to look this way. You need to act this way. You need to be this way.
And for kids who aren’t that way, it can be really, really stressful. Because now they’re seeing, oh my gosh, everybody else was like that. And I’m not, I’m this quirky kid over here who just is themselves. And there’s nothing wrong with that, but they’re comparing themselves to something. I can’t wait to for this book, the myth of normal, that’s a brilliant title because it is like, what is normal for these kids?
So that really helped kind of peel back the onion on. Issue of trauma that parents
[00:21:20] steve: it’s a defined that trauma word a little more because it’s kind of being thrown around. It’s kinda like if you go back about 10 years, ADHD was thrown around and everybody can use ADHD and ADHD to define trauma. Very specifically, trauma is going through an experience and not being able to fully process that experience in that moment.
And that there’s an aftereffect of physiology after effect. That’s laugh lasting afterward, and it should proceed beyond six months of time per the PTSD kind of criteria, but it’s a lasting experience. So there’s acute stress experience, which means I get very stressed and I feel stressed for a certain amount of time afterward.
And there are a lot of people going in and out of acute stress day today. But the residual aftereffect of that stress, isn’t quite as dynamic as it is when it’s trauma. So trauma, again, this were being thrown around a lot past some very specific ingredients that we know through research kind of have the, the largest impact to differentiate acute stress experience that any one of us might go through at any given time based upon some big life change.
And the difference of that and having ongoing after effect for months afterward. And so in trauma to the keys elements that we know come through the research, especially in adolescents, a lot of this came out of the studies of the national childhood traumatic stress network. The research that they did found that adolescent.
We’re not meeting a lot of the criteria for PTSD post-traumatic stress disorder. When they really studied the attributes of what that person was going through. And those of us that were trauma therapist way back then would over and over be in this dilemma because a lot of adolescents and preteens didn’t meet the criteria for PTSD.
So. What happened in that process? The trauma center of Boston, we started with the forefront of this research, which was to look at what developmental trauma key attributes look like. And there are six forms of dysregulation that we see and dysregulation means a dysregulated nervous system. Our nervous system is, you know, aggravated basically on an ongoing basis.
And so when we look at individuals that have a lot of trauma in the first 10 to 12 years of their life, a lot of their attributes will not fit the criteria. And even the treatment that’s all been designed towards PTSD and a law of the strategies that have been employed treating PTSD. That is a diagnosis that was born out of research on combat veterans, really the most missed the mark on a lot of the research indicators.
And so inside of that, When we start to define trauma, and then we start to define it in adolescent or childhood terms, which is in a brain that’s developing, it’s creating new neural pathways, the way the brain responds ons to that, and kind of builds around those extreme stressors in childhood is different than an adult does if they go off and they fight in a war.
And so. A key element when we’re talking about trauma as is it is you’re right. It doesn’t have to be abuse or neglect. For example, when the most common missed ones in today’s challenging adolescent world is bullying. Bullying is a, can be a massive traumatic experience. It involves some of the most significant attributes of trauma experience being witnessed by others and judged by others.
The shame that accompanies being. We don’t list that on our list of traumas. And, but yet it’s in our developmental timeframe where somebody is formulating their entire identity and it’s happens through peers. So things like bullying, parental divorce, which is over 50% now, more like 60% of households, parental divorce happens in like this.
These are these things like literally uproot the entire identity structure of a child. Inside of that, there’s a lot of pain that, that happens and it doesn’t show up or often get correlated as being traumatic. It’s like, oh, well he went through bullying. Okay. Or, oh, a divorce. Yeah. You know, 60% of families go through divorce, but it’s a massive of people in the nervous system, in a developmental timeframe where I don’t feel safe.
I feel vulnerable. I feel mumbled either to my peers or even to each of my parents that might even be alienating each other for. And so these coins is things have dramatic impact in a, in a nervous system structure around safety and understanding what the world around us represents either safe or unsafe.
And so people out traumatic experience develop a narrative of feeling unsafe in various scenarios. And you look at a kid who goes through bullying, whereas eight hours of their day spent it’s in school with other kids. I imagine the narrative that formulates after you’ve been Boyd, a number of times in front of people.
And now you’re sitting in school really terrified of that. That’s literally living in a traumatic situation. That’s starts to mirror living in a domestic violence household,
[00:26:52] brenda: so that makes a ton of sense. When you think about that. And I think that also goes, because another thing that I hear a lot, and I thought myself is, well, I have more than one kid and they all grew up in the same house and they all went through the same divorce. How come this one is over here? You know, smoking pot every day and the other ones were fine. Like that’s where I think we start to blame the kid for being not able to handle it or, or something. Do you see that? 
[00:27:22] steve: Absolutely. And that’s where we have to look at we’ll quantify individual factors were already in play that made that person more susceptible. So the more those alone experiences.
More powerless experiences. Somebody has previous to that big event has a huge factor in that. I mentioned this in my notes to you that two of the key elements we know that are a part of traumatization at one that has been very hyper-focused on until more recently is the spirits of powerlessness. My.
To control what’s happening in front of me. I can’t control it. So now I kind of fall victim to the situation I’m surviving the situation. And that gets all held inside of my nervous system because I can do anything with it. So it all gets trapped on the inside. You know, books like body keeps the score from Bessel van der Cole, who, you know, I’ve had conversations without, throughout the years.
Lots of conferences. And, you know, I had a lot of research conversations too. His book really outlines how this body just takes all that powerlessness and stores it inside the body. And the powerlessness has been very focused on throughout the PTSD kind of treatment focused of this event, a powerlessness.
And I said a specifically, any event, well, what happens when this kid’s in school and he’s being bullied every day for days on end, and now it’s a hundred or a thousand events because I’m growing up in a, in a volatile household, et cetera. This starts to differentiate the situation and the research found in that particular, those kinds of situations, when there was a lot of experiences of powerlessness and traumatization experience that the nervous system, the loudest factor, when you interview these individuals was the aloneness of the experience.
Caregivers responsiveness became one of the key identifiers or whether or not somebody showed traumatic symptomology long-term or. How responsive, where we, as a caregiver as appeared to take action to invoke safety, somethings we don’t have control over that. For example, you know, something, you know, what did we go in and advocate in a school or not?
Or did we feel like we could influence that? Or so caregiver responsiveness is the element of aloneness. I go through these experiences, they’re threatening to me, and then I’m going through my loan and I don’t have somebody to process it with, or I don’t feel anybody understands me or. Maybe we just brush it off.
It’s like, oh, he said something mean to you at school. Like, you know, just, just ignoring, but yet, you know, a whole classroom witnessed it. So I felt very embarrassed in front of the whole class. And now all the whole school was talking, calling me a nickname. So the more loneliness there is, and, and me and Gavin did a panel all across the country.
 We’ve done a bunch of them together now where we really talk and tear apart, powerlessness is absolutely can create traumatization. But the loudest point inside of the powerlessness of an experience in trauma is the aloneness inside of that moment. And that can happen before, during and after. So when we’re talking about a child to respond differently to a divorce, for example, what was the relational structure and connectedness before the divorce, during the divorce, and then after the divorce.
And Gabor and I were interviewing one of our students in the field and she’d done amazing work on a specific traumatic event. And she could talk about that event now, when she couldn’t talk about it before. But when he asked about how her parents responded, her head just dropped immediately and that alone, this part was still very alive there.
So. We had done a great job of working through the event, but the caregiver responsiveness, part of that was still an extreme wound for this young lady. And it had a whole narrative in and of itself. And so, so aloneness experiences are one of the loudest and biggest parts of treating childhood preteen, adolescent and young adult trauma that in a field where a lot of people focus on treating powerless.
[00:31:33] brenda: And I know you had said that in adolescents, it looks different than PTSD. And what, what may get quote unquote diagnosed as ADHD oppositional. So we may even be applying the wrong bandaid to the issue, I guess, 
[00:31:51] steve: Very commonly’ is that the wrong band-aid? Oppositionality. So when we look at these dysregulations, that, that are a part a, of the nervous system’s kind of stress response to being threatened throughout time.
When we, we break them down. There’s quite a, when they develop the diagnosis, it’s a proposed diagnosis. Developmental trauma disorder is a proposed diagnosis right now. It’s been proposed to the APA, basically a waiting further research. And that’s not because there’s not research behind it. It took PTSD 15 years to be accepted into the diagnostic Daniels.
 15 years of research to be. In developmental trauma there’s there’s six dysregulation. So there’s aspect or emotional dysregulation, which starts to describe a lot of teens, except this is I have a pretty extreme kind of swing in it. You know, it’s, it’s a level of moodiness and reactivity that is now a notch up from kind of standard day-to-day team, a process of having a bad day.
It starts to go from day to day to month, a month, a year to. Somatic dysregulation. So the body’s dysregulated and this means like, maybe I need to move a lot. I, I feel the need to flight. I need to move around a lot. And, and, and I can’t sit still. We let’s see. Where does that start to fall into attentional dysregulation, which says it directly out.
I can’t focus my attention in a particular direction, which comes from my focus on the external environment. I’ve checked. Am I safe? Am I not say what’s over there? What’s that new movies and, you know, kind of joke and say ADHD per squirrel, squirrel, they look over there. What is that over there? It distracts them very quickly.
That’s the brain in a state of hypervigilance searching for the threat around it, behavioral dysregulation, which oftentimes is what comes to, you know, parents first allowed is to some kind of behavior happens at school or at home that they’re not expecting, or haven’t seen before. It has a pattern to it.
It gets very stuck. And so this is oftentimes what brings periods to this treatment place, self dysregulation. So my sense of self one day, I liked myself one day, eat myself one day. I’d like how I look the next day. I despise how I look. So my sense towards myself is dysregulated and unpredictable. And in the last one, relational dysregulation, which is parental to teenager.
Relationship, which throughout time has always been a struggle. Teens are individuating and developing their own identities. They’re supposed to be kind of working they’re away, their selves away from their parental identity and developing independence. But inside of it, there’s natural friction for teenagers, with parents.
And then there’s relational dysregulation. Meaning my relationship chip to you is very volatile versus I’m trying to kind of work my distance away from. But I now have reactivity to you that might even be misdirected or unpredictable in terms of how much re misdirected it is. So those are the key attributes of that diagnosis that differentiated from adult PTSD symptoms.
[00:34:52] brenda: That is really, really helpful that you just walked through those because I can see I could see my listeners going. Yep. Yeah. Yeah. Like so many of those. So if you’re seeing those as a parent, you’re, if you are the one who is nodding and going, ah, ha that’s my kid. And you’ve been thinking about treatment.
I know wilderness therapy can sound very scary and this isn’t necessarily, this isn’t an episode for, or against wilderness therapy, but I know that it is an option that a lot of parents look at as. Last resort, you know, they’ve, they’ve exhausted all of their local resources. They are concerned for the safety of their kid.
That was me, but I could not pull the trigger on wilderness therapy because I was so concerned about my already. I knew my, my kiddo had been traumatized in some way. I didn’t really know why. I thought, okay, I’m going to have him transported to another state away from his family. Like what parent would do that, right.
That was in, that was my mindset. So hearing this and knowing that the people that my son is going to be with have been trained and understand this because once you understand this, it makes so much more sense. What’s kind of going on in. I guess not just with wilderness therapy, but in treatment programs in general for adolescents, because this seems like it is just vital to understand, to be able to help them not just help them in a therapeutic setting, but, but get them they’re in a state of mind that they are ready to do some work.
[00:36:37] steve: Yeah. This is the biggest dilemma that parents face with. Higher-level. Wilderness therapy, particularly we, when we look at the continuum of care, we’re one of the highest intensity kind of closest supervision environment. So stating that clearly the ratio of staff to student tends to be higher in our wilderness therapy environment than almost any other environment out there.
So. Oftentimes the safety variable, a wilderness is misunderstood and not, yes, you’re out in the woods. However, the tightness of the ratio, staff to students is this high, but getting them there is a whole nother story. And there’s a huge point of discussion happening nationally right now about this.
And when it comes to the experience of getting an necessitating, a child, getting the treatment, how far do we let things go before? We have to make treatment happen is what parents have to ask themselves. What is my bottom line, where I will at this at this point, I will absolutely have no choice, but to go straight into treatment, whether it’s forced or not forced now in trauma-informed care, you know, one of the principles is to try to avoid anything by force, as much as possible.
However, if somebody’s trauma and or behavior is life-threatening on a day-to-day basis, whether that’s self-harming behavior or extreme addictive drug use behavior, what is the bottom line before you as a parent necessitate? This is outside of my capability of time, commitment and expertise to deal with.
When is it I’m to hand them off inside of that? The fear. That is often because people have an identify what their bottom line is yet. What has to happen first before I, I there’s no choice involved. And then, okay, what level are we at? Where it’s like, okay, I could or could not go this direction, but very seldom do parents call us when there isn’t something really serious going on, they’ve already done the outpatient therapy.
They’ve often tried out intensive outpatient programs, still no progress. And it’s like, you know what? Like we, we don’t got much left to treat. And when we’re inside of that scenario, and we’re going to talk about leaving the behavior, especially when you’re talking about addiction, leaving my addiction behind and going into a program, not a lot of individuals are going to choose to take that leap on their own.
Correct. And so this is where a pair of boundaries and limits come in, where we have to enforce safety for our child. It’s about enforcing safety, not firming our child by not enforcing safety and protection is security for our child. We actually help the addiction. The self-harm, the traumatic abreaction and a dysregulation get works.
And this is where so many professionals go off track to outpatient therapist of what don’t send them away from your home. You’re harming the attachment or the connection. But when most of the connection is based in abreaction from trauma or reaction from drug use and protecting my drug use, or most of the reaction in the relationship is coming just from a historical conflict, good healthy therapy can’t happen on that foundation.
We have to get everybody stabilized the step in therapy. And so inside of that, that’s where our whole place me becomes a necessity. Inside of that. Could there be some impact or even some residual? Yes. But when you look at the, the view from a 30,000 foot view of where the person was headed and nurtured Eric Bree.
So what I love to do at parents do is do a timeline and its layout all the events. If we look in five years ahead with doing exactly what you’re doing right now, where does that line go? And that’s the part where parents are. And even the clients that are advocating against transport now are so focused on that moment of transport.
But now looking at what that timeline would have looked like in five years from now, or three years from now, or in some of these cases. And in most cases coming to wilderness one year from now, where are we going to be at for less? Yes. Are we talking 5, 6, 10 hospital stays right before and, and people will do that over and over again in therapists will even enable that.
When one of those times could be fatal. And, and so inside of that, I, I often, you know, it may or may not be LT metaphor, but I have had family members with cancer in my family where we know that when we use chemotherapy or radiation, it harms themselves like, you know, that people are going to be sick. You know that it’s going to have some tissue losses, for example, hair.
We all expect that when it comes to cancer treat. But what is it doing? It’s trying to save that person’s life from something that’s growing inside of him. And so when we look at trauma specifically, and then the trauma correlation with addiction, there is definitely something growing inside of that person.
This dysregulation is getting worse. The addiction or the use of substances is getting worse by the time most people call us, if it’s not getting worse than it stayed in the exact same. And it’s not life-threatening or if it’s not progressing in that three-year old. Doesn’t look like it’s going to get worse or it’s not going to lead to them.
Be not who they are fully capable of being, you know, then maybe not maybe transport, isn’t it. Right. The right choice. And I’m all again, our program used to not in the beginning, not take transport. So there was two elements. It was that seeing that trajectory is three years or one year even offers a lot of the people that were calling us and then knowing we had to get them into treatment.
And it was, it was a life-saving situation. And then the other attribute is the conflict that would happen between the period of child relationship when they wouldn’t use a transport, which, which is like, it would be, I mean, I literally was sitting at a table once, were a kid threw a cup of hot coffee in his mom’s lap because she didn’t want to do the transport.
And now we have that to deal with in treatment, you know, at the front door of treatment, we already have two years of struggles. Anger and stuff like that, but nothing at this level, like at this moment it was the worst air she had ever seen from him. And so we have to think safety also and inside of relational safety for the parent and the child, I love some of the new kind of trauma informed models that are coming out for for transport, which often includes the parents to a certain point as much as they possibly can that the kid and the parent can both handle well and stay in a state of regulation.
And then when dysregulation is met on either side, it’s like, okay, time to separate and move forward with the treatment process and trying to have it not being aloneness experience a great person. Heather pays out of Georgia as a transport group that really focuses on parental engagement in it.
And so their model has been fantastic, you know, but there are situations where the dysregulation so high by the time we come to this level of care that on both sides, Like, it’s absolutely essential. It’s saving and it’s essential so that there’s no points of further repairs necessary and treatment because the relationship gets at its highest kind of acuity of dysregulation before change happens in the treatment process.
[00:43:56] brenda: Right. Right. That was a great analogy with the cancer. I really liked that. And you know, and I’m the mom of a kid who now. Seven years later, it says, mom, if you hadn’t transported me, I would’ve died. Like you saved my life. And at the time when we had them transported, you know, we were the worst parents in the world and I’m going to Sue you, you can’t do this, you know, the whole, the whole nine yards.
So I, I like how you say, we’re only thinking about that moment and we’re not thinking of the, the trajectory that I might not have my son here to give me. Wisdom. If I hadn’t made that very difficult choice. So thank you for that. Talking us through that there’s like a million other questions I have, but what is something that you wish all parents knew or understood about teens, pre-teens adolescent and trauma. 
[00:44:54] steve: Well, I think I spent some time, I guess, on that question earlier, which is differentiating and working on our definition of trauma, that more nervous system based perspective that, that adolescent and young adults symptomology looks different than adults who experienced trauma.
So don’t expect it to look the same or have a therapist expect it to look the same if they do, then that’s probably a warning sign that they’re not calibrated to something. The other part of it is that there is a point in both attachment relationships and in trial relationships where relational hewing cannot occur, unless we get some stabilization on both sides.
And if we’re trying to build a new relationship house, we can’t be doing it on a broken up shattered foundation. And the foundation of every relationship resides in the individual self of each of those individuals involved. And so we have to have some basic stability and foundational stability underneath to which build a relational.
If there’s so much instability that, you know, sessions are being refused therapy’s not occurring. There’s close to in blocks or misses in being able to have therapeutic contact with each other. It’s time to start considering what’s the foundation of the house we’re building on here. It’s 2:00 AM. Is it too unstable to create productive relational healing process?
And if that’s the case, we have to start looking. To some other sources to get some individual stability. And in wilderness, we do do good family interventions. It’s not all focused on family work, but there’s a lot of good family interventions that happen that also start to repair that relationship too.
So both of those are a part of the process inside of wilderness therapy. And I personally believe that wilderness therapy is one of the best environment. To be able to work with adolescent relationships at the helm and work with peer relationships and adult caregiver, relationships on all the variables that translate back to home.
And so it’s a tight container. There’s a lot of supervision. Stuff’s still can happen, but it’s very, it’s much more tightly supervised in most therapeutic environments other than a hospital. And so inside of that, if you want to get some therapeutic progress and you’ve been in and out of the hospital and those kinds of things, this is a far different approach.
 And it’s tightly supervised and your kid can get help and get stability. So you can work on getting your kid back. Ultimately that’s what parents want. They want that kid that they raised back and we have to do something to get that. Yeah, the foundation is a good analogy. I like that. Just in thinking about what are we trying to build on top of, so that’s very helpful.
[00:47:42] brenda: Well, I know I need to let you go. If I could ask you one last question. What do you love most about what you do?
[00:47:50] steve: Well, for me, you know, I, I do a lot of training and I love training clinicians and staff, but for me, it always goes back to the kids and young adults who work with, I love getting out in the field.
And doing interviews with students, I’m going out tomorrow to visit with a student and looking at what they’re getting and what they’re not getting in their therapeutic journey. Okay. I like to, of, you know, come in under cover and just be, if there a wilderness therapist and not a founder and not a chief clinical director or anything like that, I, I like to walk in and just be this therapist and get, you know, play Colombo a little bit.
And I still love to go out there and find out where our students are at what they’re getting, what they’re not getting and, and work on the perfect treatment equation, you know, and every single one of our students needs an individualized. Upon their experience in life with stress, especially when it comes to.
And anxiety issues too. We have to individually calibrate. So a lot of our model has been built around that. So when I get to go out there and kind of hear how it’s working and how are our model and equations working for them or not either way, I just love that contact with them and seeing them blossom and grow in their journey.
And even when they struggle, I still love that conversation because, you know, I see that that 30,000 foot view of where they probably were at where they’re at right now and hopefully where they’re headed. So that’s my favorite part. I would, I would love that too. I think the getting out there is so special and it has to just be a full circle thing for you because you’re talking about it at a clinical level, but then you actually get to go and hang out outside with the kids and talking with them kids, I should say the young, the young.
Yes. I had to keep getting mad the other day for calling him a kid I had there. I, you know, I’m getting older as the years go by here and I gotta remember he’s a young man. So the God I got. And when you say that to an adolescent, sometimes they’ll correct. You really fast. Yeah, exactly. 
[00:49:45] brenda: Well, so if you’re listening, Steve gave me a ton of resources that I’m listing in the show notes. So we don’t have time to go through them here, but just know that you can go to the show notes. Brenda’s zane.com/podcast, and you will get all of those books, podcasts, links to resources. Thank you, Steve. I appreciate it so much. It’s going to be incredibly helpful for parents and enjoy your time in the field.
[00:50:07] steve: You bet. Thank you. Thanks Brenda. Thanks for having me on the show. I appreciate it. 
[00:50:11] Brenda  
Thank you so much for listening. If you’d like to go to the show notes, you can always find those at At Brendazane.com/podcast, each episode is listed there with a full transcript, all of the resources that we mentioned, as well as a place to leave comments if you’d like to do that. You might also want to download a free ebook I wrote called Hindsight: Three things I wish I knew when my son was addicted to drugs. It’s full of the information I wish I would have known when my son was struggling with his addiction. You can grab that at Brendazane.com/hindsight. Thanks again for listening and I will meet you right back here next week.


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