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Episode 19: B J Davis
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Dr. B J Davis (he/him) is the Executive Director of Sacramento Recovery House residential treatment programs and the owner of Davis Consulting. Additionally, Dr. Davis is an Adjunct Professor in the Forensic and Clinical Psychology Doctoral Program at Alliant International University, is a consultant to the Sacramento AIDS Housing Alliance, and is the past vice chair of the CAADAC Counselor Certification Board.
Dr. Davis is the author of the 2009 DVD What is Recovery?: A Quality-of-Life Perspective, and is considered an excellent motivational speaker and is an often sought out lecturer, presenter, and keynote speaker regarding addictions treatment, criminal justice reform, and addressing issues related to diversity.
Dr. Davis has significant experience testifying as an expert witness on substance abuse in criminal cases and is a strong advocate for challenging some of the long-held myths about what works in substance abuse and offender reentry programs. Dr. Davis has been committed to teaching students and clinical staff both the science and art of counseling for over 20 years. Recently, Dr. Davis has facilitated several workshops related to the psychology of the Black Lives Matter (BLM) movement and its impact on providing recovery related services for African-American clients.
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Transcript
Introduction to Podcast and Guest
00:00:09
Speaker
Welcome to Destination Change, a podcast where we talk recovery, treatment, and more. I'm your host, Angie Peter Sutton, with the National Behavioral Health Association Providers, and I use she-her pronouns. Our guest today is Dr. B.J. Davis.
Dr. B.J. Davis's Professional Background
00:00:22
Speaker
B.J. Davis, he-him, is the Executive Director of Sacramento Recovery House Residential Treatment Programs and the owner of Davis Consulting. Additionally, Dr. Davis is an adjunct professor in the Forensic and Clinical Psychology Doctoral Program at Alliant International University,
00:00:36
Speaker
is a consultant to the Sacramento AIDS Housing Alliance, and is the past vice chair of the KDAC Counselor Certification Board. Dr. Davis is the author of the 2009 DVD, What is Recovery? A Quality of Life Perspective, and is considered an excellent motivational speaker and has often sought out like lecture, presenter, and keynote speaker regarding addiction treatment, criminal justice reform, and addressing issues related to diversity. Dr. Davis has significantly experienced testifying as an expert witness on substance abuse in criminal cases and is a strong advocate for challenging some of the long held myths about what works in substance abuse and offender reentry programs.
00:01:12
Speaker
Dr. Davis has been committed to teaching students and clinical staff both the science and art of counseling for over 20 years.
Personal Substance Abuse Story
00:01:19
Speaker
Recently, Dr. Davis has facilitated several workshops related to the psychology of the Black Lives Matter movement and is it its impact on providing recovery related services for African-American clients. Welcome to Destination Change, Dr. Davis. Thank you. Appreciate the invitation.
00:01:36
Speaker
Now, um my first question is always pretty much the same for everybody because I know every story is different. You kind of talk about this in your TED talk, which we'll mention, we'll talk a little bit later, but how did you get into the recovery space, kind of your your basic, why that versus all the other job options that are out there?
From Prison to Education
00:01:55
Speaker
Yeah.
00:01:57
Speaker
Well, you know, like a lot of people that are, you know, that are substance abuse treatment providers or or in the field, you know, started from their own recovery story. For me, my, you know, I used substances, well, you know, I've been recreationally for years, but at some point in my use, using Copone, I,
00:02:27
Speaker
it got bad. I went from snorting cocaine kind of recreationally to eventually smoking cocaine. and And as a result of that and and behaviors related to that, I ended up going to prison twice. And the second time in prison, I had a kind of a transformation experience. my I actually talked about it at in a TED talk that I was invited to do in 2014. But anyway, as a result of kind of the awareness and and and and changes, you know, in my thinking as a result of my second stint at prison, you know, I decided that I wasn't going to go back to prison i again. And when I got out and while I was there, I was actually on a yard where they had treatment. And so I was thinking when I got out, I wasn't sure what I was going to do.
00:03:23
Speaker
But I knew I didn't want to go back to prison again, and I knew I wasn't going to know any way to do that was not to use. And so I ended up going back to school, which I think really was probably one of the biggest reasons that I got clean and stayed clean. School was pretty transformational for me. because that's believe ah very inspirational professors who actually communicated a belief in me. And and and so and and i I landed in the chemical dependency treatment program. I saw some counselors. I thought, well, you know, my background and felonies are going to keep me from from being able to do a lot of things. It wasn't quite as progressive back in 1998 as it is now. and so But one of the things I
00:04:07
Speaker
that I may be able to do is do substance abuse counseling. I had counselors and in in prison that were doing it, some better than others, but you know I kind of got the gist of it. and So
Developing Recovery Strategies
00:04:20
Speaker
before I got out of prison, I did some research on chemical dependency programs, certification programs.
00:04:27
Speaker
And there was one in in from Sacramento and there was one, a very well-spoke of one here at American River College. And so I just, when I got out of prison, I went right, I just went right into school, went into the chemical opinion certification program, really ah met some inspiring professors. And and that was the beginning of the new journey for me. I quickly became really very inspired by the program. Actually, the more I learned,
00:04:57
Speaker
about substance abuse in the certification program, the more my own, I became more aware of what motivated me to use in my own process, and what was going on with me, which really strengthened my own recovery. It made sense to me. And since I wasn't using cocaine anymore, I hadn't burned out all my brain cells. So I was actually I was a pretty quick learner. So I quickly you became really invested and bested committed and into substance abuse treatment. And part of it was because when I got out of prison, and I actually continued my own substance abuse treatment voluntarily when I got out because I had decided that I i wanted to stop and that I didn't want to go back to prison. And again, that was early in my recovery.
00:05:45
Speaker
And the thing about me is I'm a little bit cynical about this, so you'll understand this, Angie, because, you know, and sometimes I believe that I got better in spite of my treatment instead of as a result of it. You know, i I mean, I was in counseling, a lot of what they were telling me didn't make sense. I didn't agree with a lot of it, but but some of it did.
Evolving Substance Abuse Treatments
00:06:03
Speaker
But really what made sense was,
00:06:05
Speaker
learning about the neurobiology of substance abuse and the different strategies that can be used to help individuals become more aware of what motivated their behavior and and to develop skills necessary to to you know manage their urges and cravings and and and thinking patterns as well as to help them ah create reasons, find what I call compelling lies to not use and to be able to practice those things. So I started formulating my own kind of strategy for for my own recovery as well as for helping others. And and people told me I was good at it and um I enjoyed it. I kind of did very fulfilling. And so I just kind of enmeshed myself and and I've been doing it now over 25 years. I mean, and I've been clean over 25 years. so
00:07:05
Speaker
I actually never used again. So it worked. part you know you know i you know Becoming a substance abuse expert and provider actually helped support my own recovery as well as ah gave me the opportunity to pay my own recovery forward by helping others. So I've been doing that now for over 25 years. and
Impact of BLM on Services for African-Americans
00:07:32
Speaker
Congratulations on on the 25 years clean. I know that that is can be rough. What has changed over the past 25 years for you? i mean Obviously, things have in the world are are vastly different from 25 years ago, so what has changed in the terms of how you approach the business and how you approach recovery?
00:07:50
Speaker
well i think that Probably you know a couple of the biggest changes has been the introduction of more science to substance abuse treatment when I started 25 years ago. Substance abuse was words you know very much, it seems like,
00:08:11
Speaker
informed, if not monopolized, but ah you know a big part of substitute use and substitute treatment was kind of this 12-step philosophy and you know going to meetings and doing the steps and and you know getting a sponsor and and and things that I don't think that are necessarily bad, but that was really kind of fundamental to all treatment and the notion you know that you had to turn your life mill over to a higher God or higher power. and And that actually resonated with me. so But it was really, really prolific in substance abuse treatment back then. And and and and when i first end there seemed to be a resistance to looking at substance abuse differently and you know kind of rejecting some of the old fundamental approaches to that.
00:09:00
Speaker
and And so I had you know quite a few you know challenges in that area, even quite a few debates around that. But you know back when I started, there wasn't even you know there was even such a thing as evidence-based practices.
00:09:18
Speaker
And so that has changed ah pretty significantly, especially recently, which I appreciate. And as a professor, havevias you know um I try to do my part in that area. I'm very big on education and training.
00:09:35
Speaker
I even wrote my own kind of method um that I've done working on getting published and i did some it a workshop on it and there's some stuff coming out. and And I'm not going to pan campaign solicit that right now, but I do have it over the years, got a notion of kind of how we can be and do this work and be more effective. I think that that that in you know now there are competing self-help that I think have made treatment much better. I mean, now, you know, there's things like life ring and smart recovery and things like that that people can go to that, you know, have a different tone. They're not necessarily as religious based and they're a little bit more, I think, social and, you know, interactive. And so
Emerging Treatment Resources
00:10:23
Speaker
I think that's changed quite a bit. And then MAC services.
00:10:27
Speaker
newest really The newest thing is really adding medically assisted treatment to you know the menu of services that can people can get. you know Back when I started, the only medically assisted treatment well methanol which was which is an effective actually harm reduction treatment. I'll very much right support it and prescribe it, but there wasn't too much else. and so But now we have recently because of, especially with the opiate, you know, is that as the opiate crisis got to be ah more prevalent, um you know, and and you know, and and just between you and Angie, you know,
00:11:15
Speaker
When substance abuse was really seen as like, you know, you know a poor person's problem or lower SES or, you know, marginalized populations, there wasn't really that much of an emphasis on it, at least politically. and you know There was a lot of money being thrown at it. But then, you know, as the opiate epidemic started to grow and more mainstream people started being negatively affected by it. and You know, substance abuse is a equal opportunity disorder. They started to look at it a little bit more differently and there was no more research that being done. And so now, you know, not a long way. Methanol, we have buprenorphine and suboxone and naltroxone, better known as Vibratrol, are now
00:12:08
Speaker
you know, being added to a lot of the, what I call, you know, counseling programs, talk therapy programs, your typical, you know, group outpatient residential programs. And it's really making, it's increasing outcomes because it's making it um a lot easier for It's not easy at all, early recovery, but it's making early recovery, which I think is the most critical part of recovery, it's making it more tolerable for individuals that are you know trying to quit using opiates or alcohol
Cultural Sensitivity in Treatment Outcomes
00:12:46
Speaker
or even other substances. And it's much more acceptable. When I was starting, I remember when I first i sorry that got I got,
00:12:56
Speaker
I was asked to come back to Sacramento and work in ah an agency pretty live outfi agency. It was pretty large and I was going to be the clinical director, assistant clinical director, but I got promoted to clinical director quite quickly afterwards. and they were They had a co-occurring grant and they wanted me to help implement it. This is after I got my doctorate. After I got clean, I went to school and and and quickly advanced as far as degrees go. I went, I got out of prison, went to junior college, got two AAAs, certified chemical dependency, AA degree, professor there said, you know, you should, you have a voice, you should probably do more than this, but you're gonna need some credentials because you have a few felonies. So I applied and finished my BA degree that I had started in the 70s. And then went to grad school and got a master's of science
00:13:52
Speaker
a 60-unit master's of science and counseling in just three semesters. And so I think I still had kind of an addictive personality by a switch from cocaine to education. And then I got a fellowship that said, you know, we'll pay for part of your your doctoral degree if you want to pursue that. So I ended up going to a university and over the next four years got a doctorate. So I now have two masters, one in psychology and one in counseling science and then a doctorate in clinical psychology. So
00:14:31
Speaker
um They had brought me in to kind of overcome oversee that part of the there the program there at this at the end of the place. and i And again, you got to remember, I was one that, you know, i'm not a bit I'm not a proponent of the disease concept. I think substance abuse is motivated behavior like Dr. Mark Lewis and Dr. Jim Pullman. But they i the the director called me in and said, hey, you know, what do you think about people on methadone in our groups? And I was like,
00:15:01
Speaker
I think that's great. And she was like, what do you mean? I know they're getting help. That's what we do. So, so, you know, she goes, what do you want to do with them? I go help with them. And she said,
00:15:14
Speaker
Yeah, but what if they start nodding? That's what we talked to about there. We talked to them, talked to the person over the clinic to see if we can split the dose or reduce it, you know, when they come in. I mean, sure, they we don't want them nodding in group, but you know, they methanome, if they want to stay on methanome, but they don't want to smoke crack anymore, or they want to, you know, they want to use methanome, but they don't want to use methamphetamine anymore, or if they don't.
00:15:35
Speaker
York, they want to reduce their drinking. Well, I'm here to help them. That's what we do. We help people with substance abuse issues. So, so I'm not sure what you want me to do with them, but that's what I plan on doing with them. And she goes, well, you know, I think that, you know, she was old school, drug is a drug is a drug is a drug, right? So methodadonee is a drug so know I think we should, we should go terminate her from treatment until they get off methanol. And I said, well, one, first of all, we're not MD, so that would be unethical for us to make that kind of medical decision. And number two, that goes against the oath we take. Why would we kick somebody out of treatment ah that's you know that's on methanol maintenance and trying to work on other things um that's acceptable until they you know until they you know until they don't need our
00:16:25
Speaker
our services. I mean, that doesn't make any sense. I go, um, so yeah. And in fact, I, I do a line in the stand. I say, Hey, look, if you start kicking people out of treatment, so let me know and I'll resign. And I need to go someplace else. I said, I absolutely believe in harm reduction. And so, you know, uh, you know, if they're having problems, Stan awaken group, or with their docile mounts, we can, we can work on that. That's what we do. But as far as getting high oh And so she decided she you wanted me to stay, so they changed the policy. do it Good, good. I'm a big proponent of of that myself. So let's talk a little bit more about ah diversity and your work with the Black Lives Matter movement and ah providing services for African-American clients. You yourself are a person of color, so I'm assuming that was a big chunk of why you wanted to help, but kind of talk a little bit more about
00:17:21
Speaker
What got you involved in that and how, how that differs from your other work?
Advice for Counselors
00:17:26
Speaker
Well, you know, when the, when, you know, the thing with George Floyd happened and, you know, and it was, you know, and then you just between me and you things like that have been happening. So that wasn't, that wasn't, you know, surprising to a lot of and African-Americans, especially people that come from rural era. I mean, you know,
00:17:49
Speaker
city areas and things like that, where you see a lot of high profile police. And um it's really not unusual for in the South, because no there's kind of a different attitude there. But you know this was, I believe, in Chicago. But anyway, the the thing about it, though, is that because it was so high profile, and then you had the Black Lives Matter started after that, and then there was this big, you know,
00:18:14
Speaker
contention. And then yeah and then a lot of things came to surface, you know, that boiled up a lot of, I think, you know, covert racism and discrimination, you know, a lot of people felt like it was just a protest. I mean, and there's been a lot of different protests, but because it was predominantly black protest, you got a lot of resistance. Now you got social media and people making comments. And so it affected in the black community, especially when they started to see the kind of
00:18:55
Speaker
vitriolic and even sometimes violent responses in rhetoric and and in behavior. um You know, black, and you know, the black population in general already has a a kind of evolved, learned, adaptive ah distress for majority, you know, majority culture systems and and and and images.
00:19:32
Speaker
And so, you know, black people drop out of ah treatment, ah you know, the only population the last time I checked that drops out of substance abuse and and and mental health treatment at a higher rate than African Americans.
00:19:47
Speaker
American Indians. And a lot of times that's just because they don't even participate in, in, you know, mainstream, what we could consider majority mainstream treatment, you know, they try to have them specialized, but that command has dropped out at really high rating. And that was before Black Lives Matter. And that was because they just don't feel respected or appreciated or there's empathy, understood, you know, a lot of times, you know,
00:20:15
Speaker
The thing that contributes to people using in general is just stress is being overwhelmed. They're coping mechanisms, healthy coping mechanisms are not adequate or not developed enough. And so they end up um using substances as a way to problem solve or manage those negative feelings and negative situations. It's very effective. If you're feeling bad, it can make you feel better. Anything that can make you feel better, you can become dependent on it.
00:20:52
Speaker
and so And so that was already the case. So, uh, and so, yeah you know, so the black population already had a problem with kind of mainstream, you know, provider systems of substance abuse treatment, provide even been a hope for provision. And then with black lives matter when that happened and made it worse. And then what happened was that because it became so prevalent, so out there, instead of being very,
00:21:23
Speaker
ah You know in the background kind of covered people had to start dealing with it And then, um and so then, you know, the majority of providers in the area were at work were, you know, white. I mean, just like, I mean, it's nothing wrong with that, but I mean, they were, they were, they were white and it were much more, they became much more aware of the disparities in their staff versus their clients.
00:21:55
Speaker
um And they started being becoming more aware of their ah retention and attrition rates. and then they and And so they wanted to start having conversations about it, and they didn't know how. Because any time that you started talking to somebody about privilege, in many cases, white people get defensive, right? they you know They're like, you know, I didn't have slaves, and I didn't do that.
00:22:22
Speaker
i dont you know, I don't know why I should be held responsible for that. And, and it's really not bad, but, but, um, you know, i and, and so, so other providers reached out to me because by this time I was an executive and, you know, and I had, you know, I've i've done state presentations on cultural sensitivity and things like that. And, and, and and I was, I'm pretty good at,
00:22:53
Speaker
doing it in a way that that that doesn't make majority culture individuals overly defensive. ah you know I'm able to explain it in ways that makes it, I qualify it to begin with and say it's an uncomfortable conversation, but I do it in ways where you know they don't feel attacked and things like that. So so I was recruited to too you know help providers, executives talk to their staff,
00:23:22
Speaker
about providing services and how to deal with black clients and deal with retention and even talk to each other because you had staff fighting or you had, you know, white staff getting defensive and black staff minimizing and you kind of talk about George Floyd and saying this has happened, they go you know, and so you have those kind of problems and then it spills out into your provider.
00:23:42
Speaker
actually here where I've had, I actually had people from the county and say, what could you, you know, we want to have this conversation in our department. We're not sure how to have it. We want to do it right. We keep people in come and have it. And then I've done some, some, you know, even interdepartmental, almost like in service conversations about it. But, you know, I think that, you know, the biggest part is to, to not minimize it. I think that when, you know, if a, if a black person, discrimination is stressful, oppression is stressful. And so those things are legitimate contributors to
00:24:22
Speaker
Um, why people use it motivate people use, right? I mean, stressors are coming all kinds of places, right? I mean, it's not just not being able to pay the bills or you're going, you're having divorce or your children or, you know, having a difficult time or, you know, you're unemployed or just, you know, or the weather's bad. I mean, there's a lot of, there's a lot of life stressors period, right?
00:24:48
Speaker
And all of those contribute to making using, ah drinking and drugging attractive because they they are effective coping tools. I know people who say they aren't, you know, there they're being naive. They are quite effective. People don't use them because they don't work. People use them because they do work. Now they come to consequences.
00:25:07
Speaker
you know At some point, like that the costs outweigh the benefit, but they definitely work. So if ah you know if you're dealing with a black or brown client, and you know part of the conversation that comes up is, look, you know i feel yeah racism is an issue, or I feel discriminated against, or know it's been this oppression, or you know there's a system issue.
00:25:28
Speaker
You know, for a long time, people would just dismiss that, you know, they would dismiss it or they would, you know, in the old, old school way of doing treatment is very confrontational, right? And you got to break people out of denial and people had to be held responsible. You know, you've got to quit making excuses. And I remember that we used to put people in the chair in the middle of the room and talk about, you know, how awful they were and you own this stuff, you know, and stuff.
Recommended Books and Resources
00:25:52
Speaker
And when you do that with a client is telling you their honest feelings about what's you know, it's, been it's dismissive. And so, you know, if you don't respect where I'm coming from, if you're not hearing me, if you, you know, if, if you deny the reality of my situation, well, then you can't help me. So, you know, I'm going to go through the motions if I mandated the treatment and then, you know, and, and as soon as I can get out of here, I'm going to, and, you know, and probably,
00:26:22
Speaker
Since I don't trust you anyway, I'm not really going to pay much attention to what you're saying. building right i'm not going So maybe even information would be constructive, but you know if i'm if it's you know coming going in one ear and out the other ear, then You know, I'm just passing time, kind of like what happens when you go to prison, right? I mean, when you go to prison, all you're doing is passing time, you're not learning anything, right? There's, you know, there's very little education that's happening in prison, which is why people got out of prison and go back to doing the same thing before they went to prison, because they didn't, you know, they you just incubated whatever was the issue before they went in. And so ah the same thing happens in treatment. um And that's why I really got involved.
00:27:03
Speaker
I think I've been able to do some good work in helping that. I mean, at least here in this county, people seem to be really, within the communities, seem to be really concerned about cultural sensitivity and cultural humility.
00:27:19
Speaker
And it's not end all, be all. I it you know i don't make it more than it is. I try not to do that. But it does seem like you know that the the county has been invested in trying to make substance abuse treatment more readily available and also more welcoming to you know a diverse so diverse populations. so Well, i mean speaking of diverse populations, we have a wide range of ah people who are listeners, everyone from counselor to CEOs, and of course, all colors and genders and whatnot. So I always try and go back to resources, what kind of resources or advice you would you would use on a regular basis that they can maybe go out and look out for themselves if they want to learn more.
00:28:04
Speaker
Well, SAMHSA is always a really good resource. You know, I think that SAMHSA does a pretty good job of, um of ah you know, their tip books are really pretty good and and they update them quite a bit. And then, ah you know, and then ah the CDC is really good, especially as it relates to ah things like you know matt met you know ah you know, the medical side of ah of doing things, you know that you can go there and and get information about new interventions and stuff. I actually have, and this isn't a new resource, but you know, I'm a professor and so
00:28:44
Speaker
I do assign reading and I do teach. Again, I teach from a perspective, Angie, that's quite different than I think. Um, then probably the majority, you know, I, I think that the term disease is overly used and, and, you know, and I've gotten plenty of debates about that, but you know, there's some books that I recommend that I think people can learn a lot from my fundamental, my core.
00:29:15
Speaker
approach is it's not a hundred percent. I mean, I use CBT and RBT and choice theory by, doctor um I mean, motivational interviewing and other evidence-based practices here and in California. you know You have to use either CBT or motivational interviewing or psychoid trauma-informed for remaster prevention. That's five because most of the treatment is paid for by drug Medi-Cal and actually the you know, drug Medi-Cal has said, you know, we want you using at least one of these five evidence-based practices um with your clients if we're going to subsidize typical scientists using these increased outcomes, which I don't have a problem with. So, you know, and, you know, they treat, you know, self-help as self-help. So, you know, so when I started, people were actually being assigned to go to 12 Step and get sponsors and treatment, and if they didn't do it, they'd get kicked out.
00:30:13
Speaker
Well, that doesn't happen anymore. Now, you know, self-help is where it should be, is self-help. And people should be, really, I don't see mandating people ah to a certain self-help is very effective. I think people should be able to choose a self-help that aligns with their own worldview, religious or non-religious views, and just in personality. So I, you know, I encourage people to go to the self-help that resonates with them the most, self-help to do health.
00:30:38
Speaker
But there you know there's there iss not one side that has a monopoly on on on what works. But books that I read that's core for me, the the core, core approach that I use is by, he's passed away now, but he's a He was actually he had it a psychologist and a psychologist, board certified. It was Dr. William Glasser. He wrote a book called ah Choice Theory, New Psychology of Personal Freedom. um i That's core to my approach. it's underneath it It has great concepts that can be used by ah counselors.
00:31:15
Speaker
um that clients really understand. There's a thing called the five basic needs, which is what motivates behavior, which actually helps clients identify why they're using. When you tell a client they got a disease and they're proud of this over, there's really not much room for intervention. I mean, you just have to wait for a miracle.
00:31:35
Speaker
and um you know and And my approach is to really respect that the the agency of individuals. I think that substance abuse is motivated behavior, just like a lot of other motivated behaviors. And that's good, because if we can if we can help clients understand what's motivating them to use, especially in the face of increasing consequences, um we can help them create strategies that to get their needs met.
00:32:00
Speaker
um in healthier ways, non-using ways that then they can choose versus choosing to use whenever they have a negative situation and they have a craving for urgency because, you know, I always said that the disease of substance abuse is actually memory because what's chronic about substance abuse is that you remember how good it felt when you used. But, you know, anybody, whatever you attribute your recovery to, every single person that's recovered today chooses not to use when they go That's truly what's happening. It's not magic. It's not luck. I don't think it's a miracle. I think it's increased awareness, education, skill development and practice. So, and choice theory gives you great tools. It talks about five basic needs for question quality world. It gives clients nuts and bolts things that they can understand about their own process, their own behavior.
00:32:55
Speaker
their own substantive
'Living Between the Fives' Concept
00:32:56
Speaker
using behavior. And it also gives them strategies for creating a ah they a recovery. it It makes recovery um i understandable, identifiable. It makes it something that they can work for. And it doesn't have to be this kind of, ah you know, you know, cloud like amorphous kind of mystical thing. It can just be creating a quality of life that makes staying clean and sober worthwhile. And I've had great success with it. Clients really respond to it very well. There's another book that I read that I thought was really good. It was it's it by Dr. Gene Heyman, research psychologist at Boston University, used to lecture at Harvard. And it's called um Addiction, a Disorder of Choice. um I think that's got great research in it. It makes sense if you read it.
00:33:47
Speaker
Another book I would recommend is called The Biology of Desire, Why Addiction is Not a Disease. If you're open to that, and that's why Dr. Mark Lewis, you might have heard him, Angie, neuroscientist, professor emeritus. And then the book I use in my course,
00:34:06
Speaker
is called rethinking substance abuse, what the science shows and what we should do about it. And that actually is edited. It actually has chapters written by different experts, but it's edited by William Miller. And I'm sure you heard of him for a little researcher and Kathleen Carroll. So those are books that I would recommend for people to read. I think that along with the normal resources available, but I think probably the gold standard for resources if you just want to learn about something, Sam's done.
00:34:41
Speaker
ah For those who are listening, all those books will be listed in the show notes so you can find them. um Should you you want to be interested in them? In terms of advice, what kind of advice would you give someone who wanted to do more in terms of either the choice theory or diversity or any of the topics we've been talking about? You mean as a provider? that Yeah. I think that what I would recommend is to have an open mind. I think that You know, one of the things that when I came into the field, 25 years ago, it was, you know, people were very, very, very, very close minded about things. If you were suggesting things other than what was traditional, it was really rejected. And, and and a lot of times you would get, you know, rectified and, you know, people would take it personal. It's not personal. We're all trying to do the same thing, right? Which is to help individuals struggling with substance abuse, substance abuse or chemical dependency or however you wanted to find it.
00:35:39
Speaker
helping them to get better. right And so you know one of the things I'm working on is a presentation called Doing What Works. And there's not a one size fits all. you mean I mean, different things work for different people. That's what motivational interviewing says. Motivational interviewing is actually not a counseling theory per se, as much as it is that if they as a style of interviewing. But you know it says, you know if the strategy you're using with a client is not working, don't blame the client. That's just an indication. you And that makes sense to me. And so I think that, you know, I would recommend that providers get out of your comfort zone. Look, you know, don't just research what you like, or don't just research things that agree with your opinion. You know, look at other ways. Look at, you know, critique some of the work that you, that you're looking at. Look for Google and look for peer review stuff, but Google things that are,
00:36:37
Speaker
that may come up that you hear that are working for other individuals or a different approach or a different strategy. I just really think that, you know, we can be a really, really narrow, close-minded approach to treatment. And and I think part of that is because a lot of providers are recovered individuals themselves. And so they're their theory of recovery is their own recovery. That becomes kind of their theory of recovery, right? And really your own recovery is, is really just a, is really anecdotal first of all, but, uh, but there's not saying that there might not be things in there that would be helpful, but your own recovery is really what worked for you, uh, or at least what you attributed for you, right? And it can be a reference,
00:37:28
Speaker
You know, I mean, I think that people who are seeking recovery tend to I trust individuals who are themselves recovered. I remember the first thing that people asked in groups when I was around a long time ago. I don't run groups first much anymore as an executive, but I'm writing grants and doing trainings, and I'm trying to actually reach more people the way that I'm approaching. I'm building a 52-bed compound pound right now for detox and residential, because there's money for it now, and so I'm adding that I'm working on that. But I remember clients would always say,
00:38:03
Speaker
You know, counselors get defensive if they want to recover themselves and, you know, and I'd help them work through that. So, but, you know, your own recovery can be a reference for, you know, you kind of have an empathy and understanding how difficult recovery can be and early recovery can be. But you really have to be more objective about it and assess the personality presenting problem, capacity, motivation, stage change, and resources available to the client that you're talking to and then create an intervention or a or or a treatment plan or a treatment strategy, again, however you wanted to find it, that is specific to that that client and their situation within the context of their lives. And if that's different than what you normally do,
00:38:52
Speaker
Um, if, you know, if they don't respond to, you know, like for instance, you know, you know, I've seen people refer people like if cell helps and they say, you know, go to their meets, get a sponsor clients is, you know, I don't want to do that. I don't, that doesn't work. And then they get mad at the client. Like, you know, you're in denial. You're not going to, you know, and versus saying, okay, well let's try something different. Let's, you know, let's try, you know, how about, you know, you, you've got to need help. So how about going over to a, you know, a smart green and check out, see how that works with you, right? But be open to different things. Also be, I wish we were a lot more open to harm reduction. I mean, if, you know, substance abuse treatment is, you know, again, you know, old school, traditional, you know, abstinence only is, you know, is, is it, and if you're not abstinent from everything, you know, back in old days, you couldn't even, I remember you couldn't even gargle with Listerine because of that alcohol in it.
00:39:50
Speaker
But if you're not absent, you know, everything, it won't work. And I just keep telling you, I, you know, I don't get that part, Angie, because, you know, I'm, I, I tell you why I teach at a doctoral level and I, I, I don't deal in the psych students if, you know, the doctoral students that are not in recovery, I don't think I'm sure they're probably drinking and maybe even dragging, but they're, you know, in, they're in a doctoral program. So I talked to them about this and if a client comes to you and you know, they're drinking, you know, a case of beer every Saturday and, and they want help. And and you can reduce that from a case to a half case or six pack. That's, that's good. That's progress. Right? I mean, you, you want to celebrate that, right? Versus somebody saying you're still in denial. You know, I know a lot of people, it's really funny cause I mean, and I know that people who are out there are going to resonate with this. I know they are.
00:40:45
Speaker
telling you right now if they tell it you, but I know, so I've been doing this such a long time, right? I know a lot of recovery wow and lot of them now are program managers and some of them are even, you know, running programs because I've been around 25 years. And so, you know, I've seen people, you know, move on where a lot of people started as, you know, interns counselors. and And so I know, I know a lot of the kind of the secrets, you know, where there's never, you know, everybody's kind of sharing each other. And I know a number of individuals that are recovered individuals.
00:41:15
Speaker
They'll tell you they haven't used meth in 20 years. They haven't used cocaine in 20 years. They haven't used heroin in 20 years. And have, you know, a glass of wine with dinner or beer with a ah yeah yeah a game. and and And they are undercover because they're scared that if anybody were to find out that they were still, you know, having to drink every now and then, they would just be thrown out of the club. They would not be considered in in recovery and somehow. And and that I just...
00:41:44
Speaker
that I shake my head at that I mean I why do we do that why they haven't used methamphetamine for 25 years and we are going to beat them up yeah because you know recovery is only this one thing and we we just gotta you know we gotta stop doing that we gotta you know we need to be you know we need to I think If I, you know, our advertisers would say that I was was using a term, wrong term, you can't use me or I, but I believe that, you know, that
00:42:20
Speaker
What really is empathetic, it's what's really adhering to our emocratic code, which is a do no harm, is to to actually meet people where they are, how they are.
Personal Motivation and Gratitude
00:42:32
Speaker
We hear a lot of people say that that's what they do, and it's really not. They meet people where the counselor is, and the client doesn't adhere to that. and not They it can be resentments themselves and yen and and be really confront confrontational or, you know,
00:42:49
Speaker
kick them out of treatment or something. but But if you meet a person where they are, how they are, then you know, they get, you know, science said that if they choose your own recovery goal, they're gonna put more effort into it and you're gonna have better outcomes. And so let's listen to our clients, let you know if they choose a different recovery goal than what ours is, what we, or even sometimes what we may think may be best. But you know, if you have a relationship with the client, that's respectful and they don't feel like they're gonna get beat up every time they come and talk to you and tell you the truth.
00:43:17
Speaker
then maybe they decide at some point, well, harm reduction won't work for me. I can't do moderation. You know, I need to just quit. Right. And then once they come to that conclusion, then they'll come back to you and you can help them work on that. Right. But, you know, I always, you know, tell the counselors that I've supervised, and the clients have their the right to choose the content and direction of their lives and the content and direction of their treatment, as long as they're not violating our you know our agency rules. They don't get to to change the rules of our program, you know disrespect my counselors, steal, break things, things like that. I mean, let me take all the rules, but they get to decide what they're
00:44:02
Speaker
And I'm fine with that. And my counselors who work for me, they understand that philosophy was darn new to them when I came along, but and but now they're big fans of it. So you know I think that that's that's natural really what I would would recommend for for um you know of new counselors if they really wanted to learn how to to do the work and be effective and get better.
00:44:30
Speaker
Awesome. Well, I could talk to you for hours. Um, this is, we barely have even touched on your resume, but unfortunately we're running close on time. So was there something that you wanted to talk about that we haven't or something that you thought I was going to ask, but I haven't. Yeah. My publishers are going to get mad at me for giving this away. But one of the things that I think that really makes early recovery, early recovery is the most difficult part of recovery. And what makes it hard is I believe expectations, which is, so before individuals get really, you know, what we call chemically dependent, there are peak experiences. I call it, there's a hedonic set point. People know what that is, but it just means what, you know, your, your measure of what feels good. And so,
00:45:29
Speaker
you know, there are things that make you feel good that we would call 10, right? You know, uh, getting a good grade, yeah you know, your first kid, uh, you know, good food, um, you know, just things that make you feel good. And, and, and, you and, you know, if zero would be neutral and 10 would be yeah like, just great feeling great. Right. And so, and we got to get ah used to that. And at the same time on the other side,
00:45:59
Speaker
we have negative feelings, right? Bad days, bad grades, break up with, you know, with a partner, lose a job, whatever. But I mean, so, and those would be considered, you know, on your, your negative days or your negative experience, you know, can go from zero to what I call minus 10. So you have, and typically you kind of live between plus 10 and minus 10. You are lives, you know, most of the time it's, you know, it's in between, but you know, but there are, you know,
00:46:28
Speaker
you know, really peak good feelings and, and I guess you'd call peak negative feelings. Well, that gets changed when you start using because the dopamine that gets released when you feel good prior to using gets highly elevated once you start using. And so, so I, I use it as an example, this is just a scale, but you know, eating, uh, you know, eating, uh,
00:46:58
Speaker
a good food, your favorite food before you start using at some point in time. Let's just say that but that's 200 units of dopamine. But when you start smoking, snorting cocaine or smoking crack or shooting heroin or or things like that,
00:47:16
Speaker
that becomes your brain starts now a status creating 200 units of dopamine. It is being artificially elevated or chemically elevated. It's not artificial to 2000 units of dopamine. I mean, it's hugely different amount of euphoria. And that's why it's so attractive. That's why people keep using it. That's I mean, people use because it feels good. It works. It either makes you feel yeah I always say using does one or three things. It either makes you feel better.
00:47:44
Speaker
It makes you feel great, makes you feel better, or makes you feel less bad. But it makes you feel one of those three things. But at the same time, and what we talk about in treatment all the time, Angie, is the consequences of your use, right? So now, when you start using, the consequences of that use on the other side of that that lever now becomes jail, running out of money, depression,
00:48:11
Speaker
loss of children, you know, disruptive family, even health issues. But that's what, you know, in the, in the, in the rooms they call hitting your bottom, right? And so now that becomes your minus tens, right? So there's a big difference between breaking up with your girlfriend and going to prison. So now, so now, so now you have these plus tens that are highly elevated and you have these minus tens that are incredibly low. So,
00:48:41
Speaker
And now that's where you're at. That's where you're at. That's from ditch, from peak to ditch, from peak to ditch, from peak to bitch. And it depends on how, you know, your addiction, how severe it is. Now, when we have people stop the promise for recovery, right? Regardless of the approach is that if you stop using these minus tens will go away or they'll get better. And that's true.
00:49:08
Speaker
If you are not doing anything illegal, you're not going to go to prison. If you stop using, you can prove that and get your children back. If you're not spending you know all your last money on cocaine or heroin, you're not going to be running out of money. If you stop using and crashing, you're probably going to increase your your mood. You won't be as depressed. I mean, it that people's lives get better from from from you know, if you stop using the things, the consequences that go along with using, although they may have some residuals, but they typically get better. That's what recovery promise. The problem, and I think this is a problem that a lot of providers and counselors have and lay people is they don't realize that when you get rid of the minus tens, you also get rid of the plus tens. You can't get rid of the bottom without getting rid of the
00:50:05
Speaker
So yes, you get rid of all the negative reasons that people, that were the consequences of their use, but people weren't using for the consequences of their use. That wasn't the motivating reason for using. So you're not getting rid of anything that Ashley is going to that, that speaks to why they were using now. But when you get rid of the top,
00:50:29
Speaker
you're now getting rid of the thing that was reinforcing the use that was motivating people to use in the face of consequence. Now, here's what the reality is. So now if you stop using your minus 10s become minus fives. What used to be a minus 10 now in comparison to your real mind, you're you're using mine is a minus. fine Right? I mean, it's not as bad. You look at it like it's not bad. I've had worse days, right? I mean, I went to prison twice. So there's things that happened to me in my life that, you know, that frustrated me and stuff, but it's not like walking to York. I'm like, compared to that, I'm good. Right? So, but here's the thing that makes early recovery difficult is now though, when you go back down to 200 units of dopamine from 2000 units of
00:51:21
Speaker
that now is not a plus 10 anymore. So what used to be a plus 10 for you is a plus five. So now you're actually, you haven't to live kind of in a, almost a, what I call almost a, um, this finite level, right? Cause you're, you're, you're for your, your joy, your excitement, the things that you got used to don't compare and they are not going to compare to that.
00:51:48
Speaker
And, and that's when people get, you know, the expectation of recoveries that they're going to still have the same type of peak experiences they had when they were using and they're not. And I've had a lot of challenges. So I call that the fives. So one of the things that I teach my clients is I go, look, early recovery is hard.
00:52:08
Speaker
really hard and quite frankly, it sucks. You know, people tell you to be grateful and all these wonderful things. And I'm just going to tell you, look, if you have a compelling boy, you're motivated. I believe if you get clean and stay clean and work on it and work on your putting your life back together, quality of life and your relationships, your life can absolutely get better. Um, you can get your joy back and recovery can be worthwhile, but it's it, but it doesn't happen by magic. But in the short term, you really have to,
00:52:35
Speaker
to understand that you're really going to be living between the fives. Your bottoms are going to be as bad, but your tops are not going to be as peak. And if your expectations are not adjusted to that, you're going to have resentments. And then what we need to do is start working on those fives and building them back up again in a more healthier way. But what's really important in early recovery is learning to live between the fives.
00:53:00
Speaker
I wrote that, I taught that to the clients and you know what, and it's really interesting because you're going to find anywhere else. And I'm putting it in my new workbook, but I've done lots of groups and every single group, every single group, when I go, I teach living between the fives, they say, that's right. That,
00:53:22
Speaker
Dr. Davis, that is exactly how it feels right now. Things are as bad as they were, but I really do miss the peak experiences, things that, sex isn't as good. You know, things are not as fun. I don't have, you know, there's not as much excitement.
00:53:42
Speaker
The things that that I use that you that felt great. I go. Yeah, because anything you do on methamphetamine feels great. Anything you do under your own cocaine feels great. Anything you do. And in general, like I go and you're not naturally going to produce that kind of dopamine or serotonin or naphtha. You're not going to. I go, but your life can be, you you know, so you stop thinking of building your life this way, which is peaks and valleys.
00:54:08
Speaker
you start building your life this way, which which means with more more substance, more more you know more it's more about relationships, more about purpose, more about meaning, more about direction, more about accomplishment, right? more yeah When you start filling it up with those type of things, those fives become six years, those sixes become sevens, those sevens become eight, and you start to actually benefit from, you where you start to see the but reinforcement now becomes what you're able to do with your life, not chasing, not running away from the consequences, but being pulled forward by the reward of your recovered life. And i yeah I just think that that was something when you invited me to come on here, I go, you know, I'm going to share this. I think, you know, just the term, I think that I think people out there will understand it, they'll resonate with it, they can reach out to me about it. But it has been
00:55:05
Speaker
I can just tell you one of the most effective things. I've had ah clients come back to me two, three, four years later and they go, living between the fives helped me more than anything else because it helped me adjust my expectations. And you know what, Dr. D, now, you know, my, I don't even, my minus fives are now like minus ones and twos and my plus fives are now seven and eights. And so, you know, my recovery, but, but I was able to understand what I was going through.
00:55:34
Speaker
And so, instead of having resentment and being angry and things, I actually just accept that, hey, this is how it is, and I need to do is the focus on on increasing those you know those fives, getting getting getting that back getting getting my joy back, working on it. And so, I just want to share that with you, Angie, because I think that that That is a great idea, I love it. For those who want to learn more about you or get in touch with you, we'll have link links to your TED Talk and your LinkedIn and the other presentation that you gave me, but how else can can they find you? Oh, I'm that well i'm the the the Executive Director of SAC Recovery House Incorporated, so you can email me at dj at sacrecovery.org.
00:56:21
Speaker
and I will that's the easiest way I will I will get back to you or you can you can ah you can call either one of the I don't I don't have the actually number I've worked remotely so they can eat that disc called sac recovery house incorporated in Sacramento or gateway house in Sacramento Now, before we close out ah my my last final question, at the end of the day, when all is said and done, why do you do it? What what is your goal? You know, um I do it because I am grateful. I really do do it because I am grateful for my own recovery. I got a second chance.
00:57:09
Speaker
I had some people who didn't have to but saw something in me and communicated to me that they believed in me and supported me. And they really, I was in a dark place, Angie. I mean, before I got home, I think I came as close to giving up on life as you could. I mean, literally, when I was smoking crack and at the bottom, you know, I didn't think I'd ever quit. And I figured I'd just, I'd probably die someday or, you know, or even maybe just give up and jump off a bridge or something. I mean, it was pretty bad.
00:57:41
Speaker
Um, I had something pretty low, lost my family, you know, just, you know, separated from my child. You know, I'd been, you know, stolen from my mom. I just, all kinds of stuff that was really incongruent, I think, with my values. And I felt pretty bad, but you know, I got, you know, I got a second chance.
00:58:05
Speaker
and And I took it, I worked hard, but I had people that believed in me, and that communicated to me, that I then i that i had value and and they could see that. and they And they believed in me before I believed in myself. And I believe that that yeah that that i that i it's about redemption, I owed it.
00:58:32
Speaker
i mean I'm grateful for the second chance I got, and I want to give as many individuals out there that are open to it, that are motivated to it, that same opportunity. And that's really where I come from. And I've tried to do it on an individual and a group basis when I first started, and now I try to do it on a much broader basis. I actually try to I'm trying to create a generation as much as I can of clinicians that reflect my philosophy, that come from a strength-based place, an empathetic place, from a place of you know being respecting the agency in people, the value in people, and the willingness to to hang in there, be patient, and and provide the support that people need who have a mind to change and get better.
00:59:28
Speaker
the opportunity to do so. That's really, at the end of the day, that's what I'm trying to do, always. That is beautiful. You've been listening to Destination Change. Our guest today was Dr. B.J. Davis. Thank you for being here. Our theme song was Sun Nation by Kizza and used via a Creative Commons license by the Free Music Archive. Please consider rating and reviewing the podcast on Apple Podcasts so we can get more listeners. In the meantime, you can always see more about the podcast, including show notes and where else to listen. on our website, www.mbhap.org. If you have questions for the podcast, please email us at info at mbhap.org. Thanks for listening.