Welcome to the Pathways to Prevention Podcast, where we explore transformative ideas, innovative approaches, and inspiring stories in substance misuse prevention and recovery. In this episode, Dave Closson sits down with Rocío Suárez Ordoñez, a psychologist, consultant, and global leader in women’s substance use disorder treatment and recovery. Rocio serves as the Chair of Membership and Innovation for the Global Women’s Network for Providers on Women’s Substance Use Disorder Treatment, a consultant with the University of North Carolina’s Women’s Health Research Center, and a Master Trainer for the WISE Curriculum.

Together, they explore:

  • The intricate connection between trauma and substance use disorders.
  • Insights into how trauma rewires the brain and its role in addiction recovery.
  • Challenges women face in treatment, including barriers to accessing care and the lack of gender-specific programs.
  • Rocio’s personal journey and transformative experiences that shaped her impactful work.
  • The power of hope, neuroplasticity, and evidence-based practices in fostering healing.

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Key Takeaways

  1. Trauma and Addiction are Interlinked: Understanding and addressing trauma is critical for effective addiction treatment, especially for women.
  2. Trauma Rewires the Brain: The brain’s survival mode and triggers significantly influence behavior and emotional responses, emphasizing the need for trauma-informed care.
  3. The Role of Gender-Specific Treatment: Programs tailored for women can create safer spaces, address unique challenges like childcare, and reduce treatment dropouts.
  4. Neuroplasticity Brings Hope: With consistent effort and support, individuals can rewire their brains and bodies for healthier responses and better outcomes.
  5. Self-Awareness as a Catalyst for Change: Journaling, meditation, and other reflective practices can uncover limiting beliefs and foster growth.

Resources Mentioned

About Our Guest
Rocío Suárez Ordoñez is a renowned expert in women’s health, trauma, and addiction treatment. From coordinating clinics to developing digital health solutions, her work spans neuroscience, global training, and innovation in care. Her leadership in the Global Women’s Network empowers providers worldwide to address gender-based needs in addiction treatment.

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Transcript

The Vision, a world where all people live free of the burden of drug use. This is the Drug Free America Foundation’s Pathway to Prevention podcast, where we are committed to developing strategies that prevent drug use and promote sustained recovery. Thank you for not only tuning in, but your continued support and efforts to help make this world a better place. We hope you enjoy this episode. Welcome to the Pathways to Prevention podcast, the podcast where we explore transformative ideas. Innovative approaches and inspiring stories in the world of substance misuse prevention and recovery. I’m your host, Dave Closson, and today’s conversation is one you won’t want to miss. I’m thrilled to be joined by Rocio Suarez Ordonez, a renowned psychologist and global leader in women’s substance use disorder treatment and recovery. She brings a wealth of knowledge as the Chair of Membership and Innovation for the Global Women’s Network for Providers on Women’s Substance Use Disorder Treatment, a consultant, and With the University of North Carolina’s Women’s Health Research Center and a Master Trainer for the WISE Curriculum. In this episode, we’re diving deep into the interconnected nature of trauma and substance use disorders. We’ll start to uncover and share some insights on how these conditions affect the brain and why, why we must break the stigma surrounding them and how global approaches and research are shaping the future of treatment and recovery. Speaking of research, I want to highlight a resource that complements today’s conversation perfectly. If you’re interested in how recovery capital can help individuals build their lives after incarceration, check out the powerful blog post linked in the show notes and available on the Drug Free America Foundation’s website. It provides a comprehensive look at the resources, both internal and external, that are critical for sustained recovery. And it offers practical insights for anyone supporting re entry and recovery efforts. So whether you’re a prevention professional, a healthcare provider, or someone passionate about creating pathways to recovery and working in prevention, this episode will inspire and equip you to make a difference. So let’s get started. Ah, welcome Rocio, welcome to the podcast. Hi Dave, I’m so, so happy to be here. So thank you very much for having me. Oh, it is a pleasure. It is a pleasure. You bring such energy and positivity to any room you enter, including These virtual spaces here. And before we really dive into the heart of this conversation, I always like to ask and invite our guests to, to share a little bit about themselves specifically. Where in this world are you located? All right. So let’s see. At this moment, I’m in the land of Messi and Asado. So I’m guessing everyone knows where am I. I’m in Argentina at the moment. So I’m not even in Asado, but I will soon. Uh, I’m a psychologist at UCS and I’m currently working in the Global Womens Network with an amazing team. Yes, indeed. I’ve met some of the folks on that team and y’all are doing some amazing things. And I know you have a fascinating background and I’m hoping you might share a little bit about your journey as a psychologist and What kind of drew you to focus on trauma and substance use disorders. Mm-Hmm? Well, Dave, uh, probably you’re gonna laugh, but when I was very young, let’s say 12 or 13, Do you remember those, uh, TV series like Criminal Minds, for example? Mm-Hmm. Well, I was such a fan because I was just, I watched them and I said, I want to know what’s in everyone’s head. Why is this happening? what’s the consequence of this? So when I was 12 or 13, I was, uh, buying books from Amazon. From Robert Ressler. Robert Ressler is one of the most important criminologists of the FBI. So I studied everything and still today I have his books on my library. So I think it’s, it all started there. That’s the truth. And then I studied psychology. You know, in Argentina, the career is six years. So it’s like a little bit more than a bachelor. And then I went to North Carolina as a research fellow. With Dr. Hendree Jones, I was invited by her and, uh, then I, I came back to Argentina and I, uh, coordinated two clinics, one on trauma and one on substance use disorders. And then, and then a switch happened to me and it, this was a little bit traumatic. I was doing a research and, um, with fMRI and my mother was on the scan as a control and I found Her brain aneurysm. So that changed everything for me. uh, I left what I was doing and I co founded a company, a health tech company, just to make, data and appointments for medical issues available. So that’s what I did for five, five years. I was the CEO of that company. my own company. And then I stepped down. I started with international work, which I adore and I love. And now I went for the OAS TCAT and now I’m here in the Global Women’s Network. Thank you for, for sharing that very, very personal moment about your, your mother and I can’t even begin to imagine that experience was like for you and, and what you’ve, you’ve learned and how that shaped the, the work you do and who you are. So, so thank you for. For sharing that and what a powerful, powerful moment in, in, in anybody’s life. It was because, um, my mother is, I mean, she raised me and, You know, it was, it was very powerful to see, uh, that she was really in a risk of just, I, I lived, Dave, with, for two months with a bomb ticking in my head saying, she can die anytime. She can die anytime. Mm-Hmm mm-Hmm. I was lucky enough, Dave, to have, because where I worked. this amazing team of doctors and neurologists and I went to Buenos Aires and she had the surgery and everything went fine. But you know what I realized in that moment? That I was blessed, but 98 percent of people do not have that possibility. So that is why I changed and I said, okay, let’s do, let’s, let’s use technology. Let’s do, let’s use digital health. to help people to reach the best medical doctors in the world as soon as possible. So that is why I did what I did. Mm-Hmm.. And I, I’m gonna kind of speculate that, you know, that expanding your circle of being able to help more and more and more individuals. Maybe one of the things that led you to the, the international work, expanding your, your reach and impact, but I’m curious too. How did you come to work with the Global Women’s Network and the University of North Carolina? Mm-Hmm. Yeah. well, because one of the greatest persons I know, to be honest, it’s Hendree Jones. she came to Argentina when I was graduated. We met, this was 11 or 12 years ago. She came here, we met, we worked. And since then, we collaborate. Like, every day, in everything, we have the same ideas, the same goals. We worry about women around the world. And she invited me to North Carolina, back then, to the Research Fellow. And since then, we are working. So then, like, I think this was three years ago or two, we went to Chile to do a training together about the WISE curricula. And it was incredible. And then now we’re here in the Global Women Network because we know that we need to help women around the world. Dave, this is, this is a must. We need to do it. And off the cuff, can you give us a, a quick pitch and describe what is the, the Global Women’s Network? Sure. It’s a, it’s a platform. We launched it actually like in June this year, officially. And just a tip, we’re more than 2, 500 members. So yes, imagine the interest and the needs people have. So. It’s aimed for providers around the world that treat or want to treat women with substance use disorders. So what we do is we give practical tools. We gather in a platform once a month and we give practical tools to them. And one of the beautiful things is that we exchange experiences. So what happens sometimes is that first we give practical tools and then The last 20 or 30 minutes of our Practical Knowledge Program, that is of course free, they talk about their experiences. So what I love to see, Dave, it’s when, I don’t know, for example, a provider from Kenya says, I have the problem. And then someone from Indonesia says, you know, I had it too, but this, this, so you can do it as well. And you just create a powerful team. And that’s what we are, like a huge team that works helping women around the world. Oh, yes. And, uh, listeners, you know what I’m gonna say next is prevention is better together and y’all together is better. You’re learning and supporting each other. You’re, you’re a community. A community, uh, wonderful. And, and same question, just a quick picture overview about the wise curriculum. Uh huh. The WISE Curriculum has to do with the best evidence based practice to treat women. It could be in a residential or outpatient, but it gives you like the highlights and practical tools for you to implement actual evidence based treatment for women specifically. It’s a gender program. All right, listeners, I’ll drop links in the show notes so you can go check both of those out and learn more. But now I I’m, I’m ready to jump in to, to, um, a big hairy topic. I’ll call it. And one that’s very, very personal to me. As I’m still in the, the healing journey, talking about trauma and substance use disorder. And I know I’ve shared on some of the other episodes that I, I, of course, am in sustained recovery and also working through combat related PTSD and trauma. And so I’m, I’m really intrigued to, to Learn more and more about these from your experience and your wisdom. And I remember you said you had two clinics, you had substance use disorder clinic then trauma. And I think that’s often common in, in the field, across the globe. They’re, they’re often treated differently. Why do you think that is? There’s, there’s a gap there. And what are your thoughts on that? I’m so intrigued by it. So So that, that is, that is interesting, Dave, and thank you. I worked in a neuroscience organization, so I treated trauma and substance use disorders. And treating substance use disorders, you need to treat trauma. But the, the key here is that, speaking of women, between 75 percent and 98%, and I will say this is personal, 100 percent of women who are in treatment from substance use disorders, report. But not everyone has trauma, like, experiencing trauma, has a substance use disorder problem. So they need to be treated in the same moment if, of course, they correlate, because they usually do, especially in women, but you can have trauma without, you know, having a substance use disorder. Mm do you see a gap though, in, in folks wanting to treat substance use disorder and not addressing, treating, speaking to uncovering, working with trauma. We do. I say we do because we, uh, recently conducted a research survey. And we, uh, surveyed 800, uh, providers around the world across 82 countries. And while they said, they reported that they really think and they consider that trauma actually affects the development and the outcome of substance use disorder treatment, less than, 70 percent actually screen or assess for trauma in those settings. looking back on these results we see a huge gap between people and providers that actually acknowledge that trauma is important, but. They’re not treating, they’re not assessing, they’re not screening. And I think that it’s the time for us to change the narrative regarding and surrounding trauma. And if you, if we think about it, what was the thing that actually changed everything for substance use disorder treatments? It was when neurobiology and neuroscience appeared and said, Hey, wait, we have the data. This is actually a disorder of the brain, actually, using drugs change your brain. So that opened the door for two things. First, evidence based treatment programs, which much better results. But second, people started treating people and thinking about people with an addiction disorder differently. It was no longer a moral problem. It was no longer a willed problem. It was a problem. It was a disorder of the brain. And, you know this, Dave. What happened was that science has already proven that trauma actually rewires the brain. So, why don’t we work on this? Because maybe we can make it happen. Maybe if we actually talk about how trauma rewires the brain and changes the brain, we can start thinking about it differently. Anyway, an include trauma. In every treatment for substance use disorders because the correlation is just too big. I call them they are twins Okay, And even just as I reflect on my own addiction and my own trauma, yes, they are just so intertwined and not aligned, but tangled up, just tangled like a big knot, but you said something that I’d love to kind of dig into more. Out of curiosity, what are some of those, those significant ways that trauma rewires the brain? see the the the world in a specific world, right? We we have perceptions of who we are and what the world is and this is due to the connections We have in our brain how our neurons are Just connected each other because everything we learned, this is neuroplasticity, right? And it changed it. Maybe I’m in Argentina and then I move and then this, this, um, connections change, but when they change, my perception of the world changes. So one of the most important things that in the rewiring, and I know you know this because you have been very open about this. It’s, let me ask you a question, Dave, have you ever been in a situation so extreme that you just said to yourself, I don’t know, I can’t think, I can’t just, I just can’t, I can’t think, I’m just going to react. And then when the situation just passed, you said to yourself, why should, why, why didn’t I do that? Why, why, why didn’t I act differently? Do this resonate, resonates with you? Yes. On multiple levels, multiple levels. one being some of the high stress situations, uh, my, my military training, my law enforcement training, just, uh, Went into action, like, like it was supposed to, and then after the fact, when I replay the situation in slow mo, I actually noticed what I did and like, oh yeah, that’s why I did that, without having that pause and intentionality, but then in non combat situations as well, when I get overextended or stressed, the high pressure, yes, I’m rambling because it resonated so much and took me so many different places all at once. Heh I know. And it’s, again, it’s a, this is maybe a too personal question, but, I know you talk about this very openly. and when this happens, sometimes we don’t, we don’t think properly. We cannot think properly afterwards. We feel shame because what we did, we think. It was not enough in, for example, war settings, we can feel very, very guilty because our action has the consequences that we didn’t want them to happen, right? So that inability, because I’m going to explain what is inability, to think in that moment has consequences, but afterwards we can, if we don’t understand them, we can feel very, very guilty and can definitely. build trauma over it. Does this resonate with you? Yes. Yes. So actually in my, my therapy, we, we focused on one specific sort of traumatic event from my, my combat. And as I, I wrote the narrative of that event a couple different times, we then were able to articulate how one thing happened. But then the, the events that followed kind of reinforced that, that negative thinking almost kinda like, lock it in. So thank you for sharing that. So I want to, I want to tell why this happens because this, this usually what we know can take away the, the shame, the guilt, and, and can help us understand why we act as we are, especially on traumatic experiences during traumatic experiences. So, Dave, our brain has one main function, one, and it’s, I need to keep you alive. I don’t care anything else. You just need to survive. So when we’re faced with a threat, there’s a part in the brain that is amygdala, just process the information and says, Hey, there’s a threat and something gets activated. That is the survival mode. You know this very well. Mm-Hmm.. Mm-Hmm. And when the survival mode,, starts working, what happens? All our energy or our blood flow goes to our muscles because we become much bigger and ready to what? To fight or flight. And then, in our brain, the blood goes to the parts of the brain that are in charge of you surviving. So, um, What part of the brain does not get enough That’s the, neocortex. That is the one that actually makes you what? Have abstract thinking and say, Okay, wait, let’s not react, let’s think, let’s look ahead, let’s look for the future. That part goes on vacation, goes offline. And then when the threat passes and we survived, we’re back again. And that is where we say, Oh, why didn’t I, you know, act differently? And the answer is you couldn’t, you actually couldn’t. So there’s no shame. There’s no guilt. You couldn’t, or you survived, or you acted differently. You choose and you survived. So you acted okay. So the problem with trauma is that you’re supposed to survive and you are supposed to put a stop to the threat. And But for example, Dave, when you are at war, a suit is, could you put a stop to the threat? You couldn’t. You were in constant, in constant trouble. Imagine in gender violence that we talked about yesterday during Orange Day. When you’re held down, you are captive in your house, you can’t get out. Can you fight or can you fly? You can’t. And the brain knows that. So what the brain does is, it just continues firing the survival mode. You never get out of the survival mode. So, you can actually, you, you actually get, as you said in your conference in ISEP this year, you said, I become numbing and I, I’m not interested in nothing. I cannot think. Does this resembles anything that happened to you, Dave? Yes. Yes and yes. Good. Good, because I think it’s very important for us to understand what happens. And the other part is the triggers. When we have trauma, when we have PTSD, our world becomes triggers all around the world, right? Everything is a trigger for us. Um, and I always say that the trauma lives in the brain, but it also lives in the body. Do you agree? Yes. I have a story reiterate stress that point home. Yes. Why, why would you say, um, that you agree that the, that the trauma lives in the body? Why would you say that? So I’ve been working with a trauma informed nervous system coach and one of the many experiences I noticed is we were working on the, taking the complete breath. So using your full lung, your lower mid and top lung. Um, and through learning about that. When we are very parasympathetic, that fight or flight dominant, we tend to be very shallow breath, so top lung, maybe mid lung, and we don’t use our deep, full, complete breath. And so as we were practicing me doing that, using my full breath, I first noticed that actually I was using my lower lung primarily, you know, that deep diaphragm breathing, which is good. Which we think is related to my training. That’s what I’m taught to do as a sniper. But when I tried to invite my breath up into my mid lung, it was like, there was a block, there was a block. It just would not go towards where my heart center is. And then as we, my coach continued to guide me and I was able to invite my breath up into my heart center. I felt this just flood of, of emotion, of energy, of. It was a transformative full body experience. And as I reflected on that, that’s where I hold my trauma. It’s locked up there. Cause that’s where my. I was, my moral injury kinda sits is my heart center. And through that experience, I felt such a calm energy as I, I started to tap into and invite my breath into my heart center where my trauma lives. Wow. Dave. actually if I answered your question. Yes. Thank you for sharing that. you’ve done such a tremendous work with you and your body and your brain. It’s incredible. So yeah, I just, I don’t have to say, but yes, congratulations. I think, uh, you are, the living example that you can do it. You can rewire your brain and your body. Not to live in survival mode anymore. So I think this is one of the messages, right? That we can do it, but we need to know. So, while you were saying this, I, I remembered there’s some, there’s a study made by Harvard scientists and they were, uh, like asking, like, why, why is this, is this people that, that are traumatized acting out this much, they are, they are very reactive. So they were really trying to help and understand. And what they did was asking those traumatized people to go to an fMRI machine because they wanted to understand. So first they were very surprised that they all say yes, because they were so overwhelmed, Dave, and I know, you know, that they just want to say, yes, just, just give me the answer. How can I get out of this? So, they went to fMRIs, the fMRIs are the ones that you can see the brain in real time, but with the plus that you give stimuli to the person in the scanner and you can actually see like a Christmas tree, that the lights and the parts of the brain that actually are active and respond to that stimu So what they did was, narrate the story of them, but first they sat with any with them and they said, okay, can you tell me the story so I can, so I can read it back to you while you are in the scan? And what happened first, and as you just said. You don’t remember the story. What story? I don’t have a story. I have flashbacks. I have Like certain smells I remember, certain sounds I remember. I don’t have a story. What story? So that’s first we know that we stored trauma in the brain in senses especially like in little images and senses. So , they just tried to write the story and while we were in the, fMRI, they sent the story back to them and what they saw was that the amygdala was shining. And they were like saying like, how is this possible? If this person is on the scan, this person is safe, surrounded with scientists. How come that is that the brain is sending the signal that there’s a threat? And they were also, they were also connected to some measures, physiological measures. So they also, they were also seeing that the heart rate was going up, the blood flow was going up. And they were like, what is happening? What was happening? And they entered flight or flight modes. And they were on the scan. It was safe. So, this is why it’s so important to know this if we’re gonna treat trauma. Because, can you, and this is something you can answer to me, can you heal in an environment that you do not feel safe? No, everything starts with safety. You have to feel safe. And why? Because everything can relate. any any sound, any, any news you see on TV, any smell can trigger and take you right to what happened maybe 10, 12, 20 years ago. So we need to start, as you said, with safety and I see you and you are smiling at the moment and like nodding and I know you went through this. So I’m like honored to be able to be talking with this with you. Really. I, I will underline, highlight the, the example that you shared that the, the researchers at Harvard were seeing heart rate, blood pressure change. And everything. So I, and the intake for the trauma recovery program that I’m in during that intake, I had to just kind of a bullet point list of, Hey, this, this, this, this, just some of the things, some of my trauma events without retelling them. And I didn’t know it at the time, but afterwards I got a notification from my, my fitness tracker that I had completed a workout when I was standing here at my desk and my heart rate Went up to like 149, just from a bullet point list of the things that I experienced, not even reliving them. And that just made my eyes open up like, wow, okay, one, absolutely I agree. I saw it firsthand, the, the impacts of just trauma story can have on the body. But then also too, what kind of intrigued me. Was I didn’t know it at the time, I didn’t notice that my body was having that, that physiological response. I was just in a zone and the , amygdala was just doing its thing, right? Wow, thank you for, for saying that. I mean, it’s amazing. And what would be the difference if actually in that moment you knew, right? You were, I mean, maybe that information is like, okay, I need to, I need to heal this again or I need to, to keep working because I’m just, I’m on survival mode. So. If I’m in survival mode, probably I won’t be able to do a fantastic podcast, for example, or I will just suffer, right? So how important is this information?, would it have changed anything from you, Dave, if you knew this before? Just wondering. Yes. Yes. So that, that is something the, my nervous system coach, Uh, we’ve been working on building my awareness. So then I, my awareness of my setting, my surroundings to notice that I am safe. So I, you know, when, when I notice I’m, I’m starting to become overextended or, or have a response to any sort of adversity or stressor, I notice my surroundings. Hey, Dave, you are safe. Then I check in with my body and notice my body. And then I’m able to make a choice for what do I want to do? How do I want to respond? Do I just want to breathe? Do I want to leave? Do I want to pause? Do I need some water? But absolutely with the awareness, I am now equipped with different tools to, to be able to navigate those experiences. Dave, I’m just, I’m just listening to you and you are inspiring. Honestly, I mean You and your coach and your team are, are just doing such an amazing and transformative work that I’m just, I don’t know, I’m just, I’m touched by the, the work you’re doing. So, I don’t know, once again, congratulations. I, I, we barely know each other, but I am very proud of what you’re doing because I know it’s not easy and you’re doing it and you’re, I just got to be the best me possible. Cause I got a baby girl. I got a good daughter. I got to take care of. yeah, I was thinking about it. Yes, yes, I was thinking about it and you are, you. So, I, I, I said this offline, but I am the kind of person that likes to say thanks when they are good, in private and in public. And you’ve been through hell, according to what your experience was, because you were on PTSD. But now, being with you and sharing a moment with you, truly, it gives me peace. I told you the first time we met, it just, it gives me peace. And that talks about. Everything you’ve done, because you couldn’t give me this if you weren’t experiencing it. So, thank you, hmm. Felt like a nice warm hug. So thank you for that as well. And of course. I kind of, I feel like I kind of took off on us on a, uh, let’s talk about Dave sidetrack here. but I wonder, so I’ve shared some of the things that I’ve learned from my team as far as responding to navigating trauma and sort of what my team and I call everyday resilience. But what are some some other tips, suggestions, some wisdom that you might share with, with our listeners? So, when, when we understand, at least for me, when we understand how our, brain works, everything start having, making sense, right? So, What I experienced with, with, with people and with clients and , with patients, it depends where you’re in the world, you call them patients or clients, is that there’s like a stigma towards things, for example, as meditation or as breathing. They are just, Oh, well, I don’t know. I don’t have time. Meditation is like woohoo, right? Actually meditation, it’s one of the best ways to become self aware of what is happening And this is important. When we say that trauma rewires the brain, it means that you learned something. And what you learned is that you have become somebody else. There’s a new you and there are new system of beliefs. So let’s take, for example, um, a gender violence problem that we are in November. Let’s talk about that. Um, because you know, the prevalence is one in three women. Gender violence in the lifetime, that’s a lot there. So for example, let’s take an example of a little girl that is 10, 12 years old, and all of her life, short life, was safe in her house. She was stacked in bed by her parents. She thought her parents were the most important things and the, her saviors, right? So their, her safe place was her house, her bed, and her parents. And those are systems of beliefs. So she acted on the world as that. She was afraid, she went to the parents. She wanted to feel safe, she was tired, she went to bed. Any problem sleeping? No, because she was safe. Those are the systems of beliefs. Suddenly, one night, she has an attempt of sexual assault by, for example, a parent, father, a family member, while she’s sleeping in her bed. What change is there? It changes everything. The bed that was a safe place is no longer safe. So if my bed, the safest place in the world, was safe, nothing will be safe again. If my parents that were supposed to take care of me allowed this, didn’t do anything or did this, anyone can hurt me. If they did this, just anyone can hurt me. Can I trust someone? No. It’s the, it’s uh, the darkness, dangerous, very, now it’s very dangerous, a day before it was, you know, great to sleep, now a ghost can appear. And then when that person grows, they, she will act on those beliefs, now, so it would translate into toxic relationships, for example, because I’m not enough. If, if I have no one to trust in the world, why am I going to trust you with my life, with my love, with my care? Will I be able to sleep at night? Probably not. I will need a light to sleep. Will I be comfortable alone in a bed? No, probably not. And when you have all those, um, patterns, they become patterns of behavior. They have results in real life. So you cannot grow, for example, in your work. You think you’re not enough. To, you know, have a university degree, to have a partner, to have a family, to have whatever you want. It doesn’t matter. But you just don’t feel enough because they have treated you as garbage, right? And you repeat those patterns. And if you’re not aware, and this is for me, the number one to get out of trauma and to recover and heal. You need to actually go inside and see, actually see, what are your beliefs in those parts of your life. If I believed because I learned, because I had experience that made me learn that, I just need to rewire. Because if not, if I see, if I feel, I know, because there are certainties we have. That the world is dangerous. I will act in consequence. I will never feel safe anywhere. And that will prevent me to do anything. So, step number one. Just, let’s practice awareness. And this is, this is hard. But it could be used in a journaling, for example. It’s great to do that. So. You just grab a page and you just put, okay, so what are the areas in my life, for example, that I feel stuck in, for example, I don’t know, my romantic life, and then you just see, okay, but what are my core beliefs on that? Do I actually believe? I, I mean, I can trust a partner? No. So, okay, so if I really don’t trust my partner, I could never actually make a relationship. a relationship. So these techniques, journaling, for example, meditation, that actually make you silent and just make you, you, you can see your patterns. Those are the ones that are going to make you, I mean, make you see what’s happening inside you and act accordingly and change. You rewire, you can rewire. So this is, I think this is the message there. As much as a traumatic experience rewired the brain, when you work on it, You can rewire it again and in a much better brain and a healthier brain. Yes. If, if you wanna change something, you first have to actually identify specifically what it is you want to change. And back to back to Dave, for me, I knew I just felt blah and just gray, and I didn’t have the vocabulary or the knowledge to be able to say, well, that’s. What I’m feeling is shame and, or disgust or guilt. I didn’t have that. And so it was hard for me to get specific and rewire my brain if I didn’t know what I had to unwire and what I had to rewire. And so I kind of had to learn there, and journaling and meditation. I had to, to break down and get over the woo woo factor for that. Um, and so like my, my quick take on it for listeners that might be kind of thinking, uh, I’m not going to meditate and journaling, uh, I’m not going to journal, whatever your, your, your paradigm or thoughts are related to. It’s, uh, the way meditation was when it finally clicked for me. This is explaining that there are multiple different types of meditation and you don’t have to follow a script or fit in a box. It’s about presence with yourself and thinking and keeping it. It’s okay to keep it simple and just being able to, to be alone with your thoughts and conversations with yourself and your mind. Absolutely. And just thinking what you’re saying, for those who are accept, like very s as you were, maybe you just think about a science you’re actually doing. What science has proven to work is, has the name of journaling, you wanna do something else. Okay. Then anything that works for you because. What journaling, for example, allows you to do is to rewire the brain. So, when you know that how you have your brain wired is no longer working for you, you know that there’s a word that is hope, that is neuroplasticity. neuroplasticity. is the ability that we all have, every, every person that is listening to us, you know you have neuroplasticity. It means you have the ability to change the connections in your brain. And the, the, the, the way science has proved that you can do it, It’s by becoming aware of the ones that are working at the moment, the ones you do not want to work anymore, and which are the ones you want to work now, we want to build. And you can do that by journaling, by talking to a friend, by talking out loud, by saying mantras. But this is science. this is not woowoo. It is, right? Yes, and I was probably surprised because of my trauma and moral injury. I, I, that trust, that, that feeling safe to be vulnerable and trust others and share. I didn’t have that. And so that’s what journaling was at first, was a way for me to, to quote to somebody. And so I just Wrote what I was thinking and I didn’t follow a, a structure or a format. I just pulled out the journal and whatever was on my mind, I just wrote sometimes not in full sentences, not paragraph, not following a a story arc, just a brain dump. A heart dump of what was on my mind.’cause I didn’t feel safe talking to somebody else yet. Yes, it reminds me of, this is, this is personal for me as well, but you know, I feel very safe with you here. So, um, so I remember it was a moment in my life that I wanted, I was trying to solve something that was happening to me. I remember a friend said to me, you, why don’t you do this meditation? And I was very, you know, no, it was a no, no, this some, some, some years ago, no, no, no. And then I said, you know what? Let’s try it, let’s try it, and it was a very hard day, so hard, like, I could do like two minutes a day, three minutes a day, four minutes a day, and I just was consistent, and let’s say after, I don’t know, maybe a month or two, that I was doing the meditation, and I swear, it was like the matrix, I’m closing my eyes now because I remember, it was like the metrics. That I had everything unlocked and I saw everything, every pattern, everything I wanted to change and I say, yes, that’s it. I can see it now. And I had a very very physical reaction, um, that I realized I was on the right path. And I said, yes, it works. It actually works. But I went through my personal stigma. Right? And I said, no, science says it’s, it’s working. My friend is saying you should do it. And I’m doing it. I did a specific meditation, right? And I just, I did it. And it’s very important when we train people, when we use those things for us as well. And you say, yeah, you know what? This happened to me. I know this is hard. I know it’s going to cost, but I did it and it worked. So yeah, for those who are. Not, not knowing if you’re gonna do it. Yeah. Know that you can’t. Maybe it’s not for you, but the ones that actually wanna do it. Yeah. Go for it. that just sort of inspired a thought or a thought popped into my mind around one of the pieces of wisdom my, my father had passed down to me is that you need to live by example if you want to lead by example and kind of piggybacking or funneling from that is that we as behavioral health professionals need to be mindful of any of our biases or stigmas of seeing journaling as woo woo. And not, not offering that or having that on a menu for a client or patient or even to share with a peer or colleague as a possible tool Mm-Hmm.. Mm-Hmm.. Mm-Hmm..Yeah, I, I was thinking, I remembered I, had the privilege of, uh, train with Edna Foa. She’s the creator of the prolonged social therapy. She is, uh, one of the golden standards for PTSD and, You know, so when you, when you, when you are training that you can see and you, when you, when you do it, I remember my first patient with PTSD, with very severe PTSD, she was, she was like a professor, a university professor, and she had so many barriers and stigma on how to do things. Even her sexuality, I mean, she was even blocked on that. She could even have sexual intercourse with her husband because she had PTSD, very severe PTSD. So I think that when you open up to new possibilities, and we talked about how she can think about her sexuality, her self differently, and she had a huge resistance. Everything changed, but everything changed. I remember, Dave, that, um, I was about what, what was her relationship with her own body, right? And she was like, none, absolutely none. I have no relationship with my body. I don’t want anyone to touch me. I don’t want nothing. So I said, you know what? Why don’t you go to this place here that has like the most amazing creams with smells? Why don’t you go and buy this, anything you like, and then after your shower, you just put some cream on your, on your body, right? And she was like, no, no, no, I’m not going to do it. I’m not going to do it. But she was very committed to the treatment, so she did. And. After the treatment was over, she couldn’t even leave the house, Dave. After the treatment was over, she came to me with a, with a basket of, I don’t know, it was like 10 creams, and she said, You were right. Yes. Thank you, because I was very, very skeptical on doing this, but this changed my life, the relationship with myself, with my husband, with everyone. So, yeah, just, we need to get out of the box sometimes. And you just shared a topic that we could probably do a whole nother podcast episode about, but the, the concept or the, the conversation of self love and self compassion. And I’ve been looking into and learning about, , mindful self compassion. Neff, I believe is Dr. Neff. I believe she’s the author of that book., but learning to really love and accept and forgive yourself and loving all the imperfections and all the, all your whole self, as Brene Brown says, wholehearted living. could be a whole nother conversation. Whenever you want, I love talking with you. the wonderful, wonderful story and, and it speaks to some of the unique challenges women are facing, but what, what might be a couple other unique challenges that, that women are facing in, in addiction treatment and, and, or any other. of those beautiful and innovative, inspiring stories. Well, uh, regarding gender, one of the things we saw in this, uh, survey was that, 83, I’m sorry, percent of the treatment centers had or treated a mixed population, 83 percent. But when we ask how many of them had actually a gender based program, you know what was the result? Three out of 10. So there’s like 70 percent that are treating women without a gender, uh, program, right? And having a gender program has to do with acknowledging the Unique things women have and are, right? So one of the things that to come to our mind is that we are, we take care of people. We take care of our kids. If we have, if not for our parents or sisters or anyone, right? So one of the huge barriers to enter treatment, it’s when treatments do not allow So I will go to a treatment if I cannot take my, my, my kids, for example, who, who, what, what should I do now? Who should I leave them with? So those are special things that need to be treated and that’s huge, right? So treatments start opening up and just having a gender curricula. It means that it will, they will address many of the things women need and kids. It’s one of them being pregnant is one of them being having a trauma of gender violence, you know, then you need to have, for example, a safe place as we talk free of, triggers, because we know that if we’re in a mixed treatment, but we have, for example, mixed psychology in groups. Probably a woman that experienced gender violence is not going to open up. And we know that when they are very traumatized and it’s not only women or it’s just a gender program, they usually leave. And this is because what we just talked about, Dave. They have too many triggers. They do not feel safe. So they are in survival mode, and in survival mode, it’s very difficult for you to, to actually do a successful treatment. This is, this is where I may be at risk putting my foot in my mouth as a man, but I, I also too kind of see when, when as a provider you say I have a, a gender, gender focused treatment program for a women’s treatment program or curriculum that. Just that alone communicates to the women that we see you. We hear you, and we’re here to support you.’cause human natures, we all want to be heard, seen and supported by having those specific programs is just one way to communicate that to, to maybe help create that, that safety, that sense of safety. Yes. I mean, you, I couldn’t have said better. Of course, we see you, that is because they, uh, when we are going through trauma, we feel that nobody get us, right? We feel that nobody knows how we are feeling. And when we have someone that just says, Hey, I’m here for you, I, I know what you’ve been through. I know that I can help you. I started to help you. I have it. I have an evidence based treatment to help you. It just changed the narrative completely, Mm-Hmm..Yes. Just that alone can be oh, so powerful in, in helping more, more women, more individuals seek access treatment and support, but then also changing the narrative across the globe. So I’m, I’m curious as we start to kind of bring this conversation, unfortunately, to an end for today. Got, I’ll say two more questions for you and that first being what what is one thing that you wish more people understood about trauma and addiction?, that if you have a trauma, and you are going through substance use disorders. You probably need to address the trauma because it’s very linked, they’re not two different things and I’ve seen way too many cases where we ask these people about the trauma or try to open up about it and they just say, wow, I, I’ve never thought these things could be related. Right? As, as if they were two completely different things, unlinkable things. And they are. Right. Right. But the most important thing is, I would say, you can heal from it. You have perfect neuroplastic brain that if you teach him correctly and your body, your brain and your body will respond because they want you to be okay. You just need to put the work and I know it’s, it’s not easy to be honest. It’s, it’s very difficult and you know it very well. But. And this is one of the first things I talk to, for example, my patients or my clients with PTSD when we are doing prolonged exposure therapy. The first thing is, this is going to be hard. The truth is that. So are you ready for the challenge? Are you ready? This, this is what, what’s going to happen. To be very clear on that. This is what is going to happen. I’m going to be with you all along, but this is what I’m going to happen. Are you ready for it? And when they are, and they do, they change the brain, they change the body. Okay. Okay. So they change their emotions, and so what changes is their perception of the world and themselves. And when you do that, Dave, everything everything changes everything. You mentioned hope. That’s almost like, you know, my next question, because I’m curious, as you look ahead, what gives you hope in the work addressing trauma and substance use disorders globally? moments like this, Dave, because you were, kind enough and curious enough to invite me to this place, to this beautiful podcast and talk about it. The webinars we’re doing and the interest people, providers, policy makers are having still is not enough probably, but we’re there. Just being here talking about this in an international podcast, this gives me hope, Dave, so I appreciate you, I appreciate you, the work you’re doing, the wisdom you have shared, and the, the safe space you have, you have helped nurture in this conversation. So I can feel safe and share as well. Oh, I have goosebumps. Thank you very much. what a, an inspiring and insightful conversation and can’t thank you enough. And I look forward to our next conversation because there’ll be many more to come. Thank you very, very much. It was a delight, it was a pleasure. Thank you and I am so, so proud of you, really. Thank you, Dave. That concludes this episode. Thanks for tuning in. Be sure to hit the subscribe button and share this episode with a friend before you leave. And we look forward to seeing you on social media because prevention is better together. Together we are stronger.