#28: Nancy Spitzer has been a Licensed Marriage and Family Therapist since 2012 specializing in trauma, addiction, co-occurring disorders and more. She was inspired to shift her career to therapy after losing her beloved brother, David, to a drug overdose. As a therapist, Nancy’s passion is to not only help her individual clients, but to help families understand how to navigate the painful path of addiction, while providing opportunities for much-needed resources and support. Nancy has spoken numerous times as a presenter for The National Association of Therapeutic Schools and Programs (NATSAP) on the topic of families struggling with addiction and trauma. Nancy is very proud of her family - she loves to spend time with her husband and two adopted pups, and they are excited (as we are too!) to add a little one this winter to their family!
#28: Nancy Spitzer has been a Licensed Marriage and Family Therapist since 2012 specializing in trauma, addiction, co-occurring disorders and more.
She was inspired to shift her career to therapy after losing her beloved brother, David, to a drug overdose. As a therapist, Nancy’s passion is to not only help her individual clients, but to help families understand how to navigate the painful path of addiction, while providing opportunities for much-needed resources and support.
Nancy has spoken numerous times as a presenter for The National Association of Therapeutic Schools and Programs (NATSAP) on the topic of families struggling with addiction and trauma.
Nancy is very proud of her family - she loves to spend time with her husband and two adopted pups, and they are excited (as we are too!) to add a little one this winter to their family!
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Ashley Loeb Blassingame:
Hello, beautiful people. Welcome to the Courage to Change, a recovery podcast. My name is Ashley Lowe [Blassingame 00:00:06] and I am your host. Today we have Nancy Spitzer as our guest. Nancy has been a licensed marriage and family therapist since 2012, specializing in trauma, addiction, co-occurring disorders and much more. She was inspired to shift her career to therapy after losing her brother David to a drug overdose.
Ashley Loeb Blassingame:
As a therapist, Nancy's passion is to not only help her individual clients, but to help families understand how to navigate the painful path of addiction while providing opportunities for much needed resources and support. Nancy has spoken numerous times as a presenter for the National Association of Therapeutic Schools and Programs on the topic of families struggling with addiction and trauma. Nancy is very proud of her family. She loves to spend time with her husband and two adopted pups, and they are excited, as we are, to add a little one this winter to their family. Friends, please enjoy Mrs. Nancy Spitzer, episode 28. Let's do this. Nancy, welcome to the program. Thank you so much for being here.
Nancy Spitzer:
Thank you for having me.
Ashley Loeb Blassingame:
So right now you are pregnant. How far along are you?
Nancy Spitzer:
I am going to be... Gosh, good question. So right now I'm 24 weeks. I'm working on 25. Tomorrow is 25 weeks.
Ashley Loeb Blassingame:
Awesome, awesome.
Nancy Spitzer:
Almost six months.
Ashley Loeb Blassingame:
Congratulations.
Nancy Spitzer:
Thank you.
Ashley Loeb Blassingame:
Well, hopefully this podcast won't stress out your baby too much.
Nancy Spitzer:
No, he'll just move around a lot. [inaudible 00:01:54] what he does.
Ashley Loeb Blassingame:
We have two guests today. So awesome. So you are a therapist.
Nancy Spitzer:
Mm-hmm (affirmative).
Ashley Loeb Blassingame:
When did you become a therapist?
Nancy Spitzer:
So I got my master's in 2012, and I've been licensed since 2014, so since then. And I've been working in the field since 2010, so I've been working in the field a long time, specifically in addiction.
Ashley Loeb Blassingame:
What made you want to come work with people who were struggling mentally and addiction and all of that?
Nancy Spitzer:
Sure. It's kind of a long answer, but I'll let you know. So I originally had gone to school for public relations and marketing, and at the end of the day I felt really unfulfilled. Get back about five or six years, I had lost my brother to substance abuse and went to Alateen and Al-Anon, got such amazing support. I also went through therapy at that time, and he had died from an overdose. And you know, like I said, I felt really unfulfilled. I was 21, 22 years old and I said to myself, what do I want to do with the rest of my life? Because not that there's anything wrong with marketing and public relations, I actually use it all the time in therapy in some ways, but I wanted to help families because I felt like my family was so lost and they didn't know what to do. And I think if they had some better education and some guidance, it would, maybe things wouldn't have ended differently, but they would have had more support.
Nancy Spitzer:
So that's really what led me. And then I started to get emails from Nova Southeastern. I had no idea that you could become a therapist. I always thought you had to be a doctor or you had, you know, all these career paths, I had no idea. So I went to the campus and explored it and they talked about working with families and systemic therapy, which is looking at the whole picture. And that spoke to my heart and that's what led me to work with people in substance abuse. And from day one, I did my interview and I said, you know, "My heart and soul is working with people in recovery." They tried to dissuade me in the interview. They said, they're like, "That's really hard. You're probably going to want to work with kids and couples." And I said no.
Nancy Spitzer:
And you know, the dean of the school and I always joke about it now, years later, because I've made my career out of it. But she said, you know, "You were very headstrong. That was always what you wanted to do." And I said, "Yeah, that is exactly what I wanted." And you know, I did my internship, I worked at the Hanley Center in Florida, and I had such a rewarding experience, but I really had to kind of carve my own pathway because not many marriage and family therapists work in substance abuse. So I'm kind of a loner sometimes. Lots of social workers, lots of mental health counselors, but not so much marriage and family therapists. I'm hoping that changes. I do try to go back to my university that I went to and talk often, and there's definitely more and more people interested in drinking and substance abuse.
Ashley Loeb Blassingame:
Yeah, definitely. Definitely. We're seeing a lot more marriage and family therapists who are working in substance abuse, so I think that's important. So you talked about your brother. Let's go back a little bit. Where did you grow up and kind of what was your family system? What did that look like?
Nancy Spitzer:
Yeah, so I grew up in New Jersey in a beautiful suburban community, not like what's portrayed on TV many times when you associate New Jersey. It actually is a very nice place, at least where I grew up. I grew up about 30 minutes from New York City, so a lot of commuter people. Family, I came from kind of, not a split family, but my dad had been married prior, had two sons in that marriage. They were a lot older than me. We always kept a close relationship. He worked hard on that. And then myself and my mom. I was technically an only child if you want to put it that way. But my brothers were still in my life. So that's how we were raised [crosstalk 00:05:39]
Ashley Loeb Blassingame:
How much older?
Nancy Spitzer:
My brothers were... Now you're making me do math.
Ashley Loeb Blassingame:
Sorry, sorry.
Nancy Spitzer:
[inaudible 00:05:46].
Ashley Loeb Blassingame:
Pregnant therapist.
Nancy Spitzer:
Yeah, pregnant therapist. That's true, so I have an excuse, other than I'm bad at math. But about 17 and 19 years older than me. So big age gap.
Ashley Loeb Blassingame:
Yeah. And you got along with them. Did you feel like they were your full family, or was it like, oh, they're my half brothers.
Nancy Spitzer:
I don't like particularly saying that myself and saying half or step or whatever it may be. I mean my family just didn't address it like that, but my brothers were definitely, you know, a part of holidays and my dad would try to blend our families as best as possible with the age gap. Obviously, you know, having my dad being a little bit older and having a little girl, some of the attention went towards me and not to them and that was definitely, and my dad also worked a lot during their childhood and during my childhood he was more at home. So I think there were some splits there and differences in our, we did have different childhoods. We just, you know, my dad was busy in the film industry and often was gone and then when I came around he was home a lot. So definitely had a different childhood than them.
Ashley Loeb Blassingame:
Did you feel any of that from them?
Nancy Spitzer:
I did from my oldest brother, him and I still to this day we don't have the greatest relationship. He also had a strained relationship with my other brother too. I think there was definitely some, yeah, you know, why are you having another daughter? Why are you having another child, you know [crosstalk 00:07:13]
Ashley Loeb Blassingame:
Yeah, another family.
Nancy Spitzer:
Yeah, another family. It's hurtful. And as a young adult, because that's what he was becoming at that time, you know, who really wants to have a little sister in the picture too.
Ashley Loeb Blassingame:
Yeah, I'm sure it brought up a lot for him and it was out of his control, that's just kind of how he felt about the whole situation. That makes sense. So the younger brother was the one who struggled. What was your relationship like with him, and when did you kind of realize, how old were you when you realized what was going on with him or something was up?
Nancy Spitzer:
So ever since I was young, so his name is David, and David, my dad had told me many stories about David when, you know, just me growing up and him growing up and knowing him, we had a very close bond from a very early age. Every time he would come he would make me like roll on the floor, laughing, just hysterical, very warm, loving, loving person. But there would be times when he wouldn't be around for a while. And I remember asking my parents like, "Hey, where's David?" Even when I was little, and you know, my parents would be, "Oh, he's not doing great right now or he's working a lot." That was kind of their way of phrasing it. I knew something was wrong when I was younger and he would just disappear for times.
Nancy Spitzer:
He had gone to treatment when he was 15, and back then, you know, according to my parents and according to him as well, because he also told me the story, it was really humiliating. They had shaved his head. They did a lot of, you know, like punishment and consequential treatment with him. He ran away twice and the second time my dad had taken him home. My dad and mom had always talked about his story. Like he had rolling papers in his room and he said he liked to lick them. So like just very addict behavior very early on. So I was always kind of aware of it. My parents had me when they were older, so they always talked to me like I was an adult. They really didn't cushion things or sugarcoat it. Which, you know, I think now, you know, as I'm about to become a mom myself, it's sometimes hard to sugarcoat things that are just realities of life, that you have someone who's not well in the family.
Ashley Loeb Blassingame:
Yeah. Well, kids know. That's the thing about when I was doing interventions, it was interesting, I was trained in the arise model, the invitational intervention model, when I was doing interventions, we would talk about, you know, there'd be 10 year olds or you know, and they say, "Well we don't want them at the intervention." You know, and it would be their parent. And I would say, "Look, 10 year olds know that something's going on. They may not have the words for it, but they're experiencing all the pain and suffering, living in a home with an alcoholic. They're capable of absorbing that. It's important that they're also capable of absorbing the information that's talking about the recovery and what to do and what to happen." And I think that's kind of what you're talking about. It's like kids know something is up and it's important that we don't pretend that that's not real or tell them, or not acknowledge those feelings, and we acknowledge them by telling them what's going on.
Nancy Spitzer:
Yeah, I think my parents did a very good job of that. So when he'd come back, he was all in, you know, he was always very much, and he would come with gifts and I think, you know, looking back on that was such his love language and his way to express himself. Looking really back, I remember he had gotten me a Coach purse, and as silly as it seemed, but it was so important back then.
Ashley Loeb Blassingame:
Oh yeah.
Nancy Spitzer:
That was like the big deal.
Ashley Loeb Blassingame:
Oh yeah.
Nancy Spitzer:
And it wasn't just he wanted to fill you with materialistic things, but he just really cared and thought and like, you know, researched what I wanted at that time and how old I was. And that's the kind of person he was. He was extremely thoughtful, very creative. And I remember my dad telling me that he just always had low self esteem growing up, really had some... Like he would just never believe in himself and my dad would kind of tell me these stories so that I would take a different route, I believe. But he was like, "I always felt for your brother, because no matter how much I told him I loved him or how much I cared for him, the divorce played a role in his life. But not only that, he just never could see what we all saw." So I do remember my dad sharing that a lot with me and this was way before he had passed away. So, but around me, he was just a fantastic person and didn't ever treat me any differently and was never standoffish. But just overall very, very loving person.
Ashley Loeb Blassingame:
What did you think from your perspective growing up with this and seeing, oh, my older brother's doing these things, he's disappearing? At what point did you go, did it kind of resonate like, okay, drug addiction, right? Drug and alcohol, whatever, you know, and what did you think? What was the, I'm always curious, like what was the implicit thought around what a drug addict and alcoholic like... Wait, David? That doesn't fit. Did it fit with what you thought, and how did you, if not, then how did you reconcile?
Nancy Spitzer:
Yeah, I was a child of the late eighties early nineties, totally part of the DARE program. They really painted... I mean as horrible as that is but it's very true, you know, giving us those tee shirts [crosstalk 00:12:15]
Ashley Loeb Blassingame:
Oh, I remember.
Nancy Spitzer:
They really did paint a picture of, you know, drug addicts being horrible people. There really wasn't, you know, your brother or your dad or your mom. So looking back on it now, I just always worried about him. I think that was the fear. He was such a bright light when he would come around and he would be present in our lives. And I think for me, I was in music class one day and we played some song and I remember tearing up because I was worried about him. Why, I don't know. I think I was like in third grade or something like that. But I just remember being concerned and my parents kind of whispering in the other room about him, and those were the things that I picked on, the tension in the house. How are we going to fix him, what are we going to do? And at that point he was already an adult and you know, my dad kept feeling like he had to figure it out.
Nancy Spitzer:
So, and he had issues before. He had gotten, he was a bodybuilder, got really into bodybuilding, again all or nothing thinking. And he had gotten testicular cancer from using substances at that point too with bodybuilding. So things had happened. He had had serious consequences in his life from that. And just, you know, hearing about it kind of through, sometimes my parents would be very honest and open with me and then there were other things that they probably felt, you know, like a young child or a preteen doesn't need to know all the details. So you know, looking back on it, I just overall had just a worry for him.
Ashley Loeb Blassingame:
So you talk about this one moment where your brother tells you that he can handle his drugs, and how old are you? Can you tell us about that and how old were you when that happened?
Nancy Spitzer:
Yeah, so we, my parents had decided to move to Florida. Like I said, my pants are a little bit older. They wanted to not be in the cold New Jersey winters anymore. So we'd moved to Florida. He decided to come down. He did tile work. He was fantastic with that. And I was 16 at the time. We were sitting in the car and he had pointed to somebody who was homeless and he said, "See, they can't handle their drugs, but I can." And I remember just my stomach dropped and being in the car and feeling, even though I was younger than him, feeling so much older and wanting to like shake him and say like, what are, you know... Trust me, because of his experience, I've never been addicted to drugs. That's not been my path or my journey. But I remember at that moment feeling like we're losing him.
Nancy Spitzer:
And he was erratic during that whole trip. He couldn't sleep. He was up and down. He had told my dad he was addicted to the same thing Rush Limbaugh was, that guy from the radio. My dad was like, what? And really nobody had heard of, I mean at that point opiates were just coming. My dad hadn't heard about it, so, you know, and then eventually at some point, like millions of people, he switched to heroin. But yeah, he had started using opiates for pain and then it evolved from there and him already having addictive tendencies. So that was a really poignant moment. I remember that. And then shortly after that summer he had passed away.
Ashley Loeb Blassingame:
So what happened? Was he passed away while you guys were living in Florida? Was he there?
Nancy Spitzer:
No. So he went back up. My parents have given him a ton of furniture from our house and we didn't want it. And we had heard that he had sold it all. And my dad was kind of confused, even though my mom and my dad and I were saying, hey, something's up with David, like you really need to talk to him, during his trip to Florida. He had sold all the furniture and his mom, who's my dad's ex-wife, had called us and she had slightly mentioned that he had gotten arrested and that she had bailed him out. So it started to build like that. And then he kind of continued from there. My dad kept getting phone calls and he'd be on the phone a long time. Things would settle down. And then he would be on the phone again with his ex wife and talking about David. I'd always hear it, like in the background, worried about him.
Nancy Spitzer:
And then we had gotten, I remember, this is also another moment that I just remember so vividly in my mind, but we were sitting at my aunt's house in Florida. My dad was on the couch and he had gotten a phone call and he just started crying. And I knew at that moment that something was wrong and he just kind of, you know, did the air verbalization of David's gone. And from what we had heard, he was alone and he had gotten money from having a new job and spent it on heroin. And he had had a few weeks of sobriety according to everyone around him. And he had used. He was alone with his dog. The neighbor heard the dog crying, and that's how they found him. So, you know, I think he had a lifetime of hardships and sadness. And yeah, he really struggled in the end. And it happened fast. I mean, it really, I mean, obviously [crosstalk 00:17:09]
Ashley Loeb Blassingame:
What was the span of time?
Nancy Spitzer:
It was in I want to say November. Yeah. You know, it's interesting. He has a memorial online. I've never really looked at it. I haven't. Not because I don't want to or not because I don't want to come to terms with it. But I just, I haven't, and I didn't get to go to his funeral either. So it was from June to November and he had passed away. So it was really, really short, short time period that he had just spiraled so fast.
Nancy Spitzer:
And that's, I mean, very typical with heroin. It happens like that. And especially after a period of sobriety too. People around him said he was doing really well. He started working again, and then he probably used the same amount as he did before and his body couldn't take it anymore. So yeah. I mean I think about that, him being alone. He loved his dog. His dog was named Rush. It was after the band. And I was glad that he was at least with his dog, because that was important, you know. And he loved that dog. So yeah.
Ashley Loeb Blassingame:
Why weren't you able to go to the funeral?
Nancy Spitzer:
I was in school at the time and I just started a new high school and my parents were like, you know what... It wasn't really a decision. My dad just decided to go. Interestingly enough, my dad, when he came back, he told us that most of the people were there. David always had a knack for having these amazing girlfriends and they all showed up to his funeral, I think like nine of them over the years. And my dad, that was the one thing that we had kind of, you know, had that moment when he got back from the funeral and he just said, "Yeah, all his girlfriends were there," and he started naming off some names, and they all loved him.
Nancy Spitzer:
I mean, they all showed up for him and they said to my dad, because they each came up and kind of shared their condolences, they said, "You know, if it wasn't for the drugs, I would have married him. You know, if it wasn't for the things going on." So yeah. And he always had a knack for it. He never had anybody in his life... I mean, I always loved all his girlfriends. I always remembered that. They were always fun. Sweet. I mean he really attracted people in his life that were similar to him when he was doing well.
Ashley Loeb Blassingame:
Right, when he was doing well. It sounds like your family was a little bit distant from it, given that your mom didn't go to the funeral, and like what was the reaction after, if like the closeness was there, but then kind of the like, well, you should stay here or I'm just going to go by myself?
Nancy Spitzer:
Yeah. I mean there are things, you know, when you look back and you think, why did... I didn't fight to go to the funeral, you know, I didn't argue or plead or beg and I'm not, I don't particularly love funerals. I don't think anybody does.
Ashley Loeb Blassingame:
Oh, you don't?
Nancy Spitzer:
No, but I, you know, back then I just didn't really think about it. Everything happened so fast. It was like my dad was booking an air flight, he was gone, you know, that kind of thing. And my mom had spent, I mean she'd known David since he was very young, I mean I think three or four, four, four years old? He was young, he was a young boy and she played a huge role in his life. And then they had grown distant over the years because my mom would hold him accountable, whereas my dad wouldn't.
Ashley Loeb Blassingame:
Right, right.
Nancy Spitzer:
So I definitely think that played... You know, my mom would not tolerate. I remember hearing a story, he came over one time and he was demanding all these things and my mom had said, "No, we're not doing that." And you know, typical, I'm in relapse behavior, you're not going to feed into me, I'm going to turn away from you. So I think over the years they had gone distant. She didn't go to the funeral. I've never actually asked my mom why she hasn't to this day. But I think also our culture, at least in my, we're Jewish and sometimes, at least my understanding is sometimes that the body isn't really significant of death, if that makes sense too. Like we believe that people, like we've said our goodbyes to them. At least culturally, that's how I was raised. So I think that was that too.
Ashley Loeb Blassingame:
How did you get to Al-Anon and Alateen?
Nancy Spitzer:
So my mom had suggested, so I was really struggling with it and I remember moving to a completely different state, being in a new high school and my mom had said, why don't you try to go to a support group? I think at some point she had gone to a support group herself of some sort. I don't know if it was Al-Anon. So I had gone to Alateen and it was such a great experience and met a lot of teenagers there and really connected. And then when I went to college, one of my close friends was in recovery and said, you know, "I love Al-Anon myself. Why don't you start coming with me?"
Nancy Spitzer:
And because there was a lot of unresolved feelings about it too. There were times when I was angry that my family really hadn't done more or intervened more, which families sometimes just don't. I felt like they kept just pushing it under the rug, like it's going to get better. Things will turn around. He's done this before. He survived, that kind of mentality. So I talked about that a lot. But I think, you know, also for me, Al-Anon has taught me how to have stable relationships with people too. It's given me a foundation and that's what I talk about a lot in therapy, that it's not just about your experience with your loved one, it's also about how you react to relationships.
Nancy Spitzer:
And a lot of times I have noticed when I have trust issues or when I don't want to let people in. Even marrying my husband, my husband came from some similar backgrounds to and realizing, oh, that behavior is coming from there, you know? So it gave me a lot of insight into my life and really helped me and to be honest, I would tell everyone to go to Al-Anon at some point because it just really gives you that foundational piece, and also support. It's really good to hear other people share, you know? So for me that was really important at that time. And especially in college, getting other people and to hear their support. So yeah.
Ashley Loeb Blassingame:
What now as a licensed therapist and having had this background, when you look back on what happened and you kind of touched on it with like a lot of it was pushed under the rug, when you look back on that, what do you see now that you didn't see then or that you didn't see before you were trained in therapy and psychology?
Nancy Spitzer:
I don't know if this comes from such a theoretical perspective, but I don't think anyone's prepared to have addiction in their family. You know, again, about to be a mother, we have addiction on both sides of our family. I could go to years and years of school to be a therapist. Am I prepared if my son struggles with addiction? I don't know the decisions I'll make. I probably will make bad decisions just because of having emotions and feelings.
Nancy Spitzer:
But looking back on it, I think my parents the best they could. I think there were times when I didn't think they did. No one comes with this, a beautiful guidebook and says, okay, if your son is using heroin, what do you do next? You know, I mean there are books nowadays but it doesn't [inaudible 00:23:58]. So I think that's a big thing. Forgiveness is really huge. Families do hide things. They just, sometimes it's so uncomfortable to talk about the reality or the pink elephant in the room and we're a society at least as a whole, that everything should be happy. We really force this emphasis on happiness all the time when there's some serious issues in our family settings.
Nancy Spitzer:
I was watching an episode I think of This Is Us or something, I'd never seen the show, which is not great to start when you're pregnant because it's super emotionally, but they really beautifully show the dad having a problem with alcohol, and I was really impressed with that, because a lot of times shows will show other issues, but not alcoholism or drug addiction. I think they've done a really good job of that.
Nancy Spitzer:
And I'm hoping that becomes more and more because so many families, I mean, every time I tell people what I do for a living, they always say, "Oh, my uncle, oh, my cousin, oh, [inaudible 00:24:54]." It's not the quote unquote bum under the bridge. This is our family. I know so many individuals have struggled and suffered with it. So looking back now, I think that I have so much compassion for people who do survive and do you get the help that they need and are willing to get the help. I really try to honor that when I work with anybody. And yeah, I think that that's been something that's been really highlighted for me because not everyone makes that decision to change their life.
Peter Loeb:
Hi, I'm Peter Loeb, CEO and co-founder of Lion Rock Recovery. We're proud to sponsor the Courage to Change, and I hope you find that it's an inspiration. I was inspired to start Lion Rock after my sister lost her own struggle with drugs and alcohol back in 2010. Because we provide care online by live video, Lion Rock clients can get help from the privacy of home. We offer flexible schedules that fit our clients' busy lives. And of course we're licensed and accredited and we accept most private health insurance. You can find out more about us at lionrockrecovery.com, or call us for a free consultation, no commitment at (800) 258-6550. Thank you.
Ashley Loeb Blassingame:
It's interesting and you've probably dealt with this too, but with everybody talking about the opioid crisis now, it sounds like your brother and I were using kind of in the same, you know, using opiates in the same era. And you know, to me it's interesting to watch, like when I was using, and it sounds like when your brother was using opiates and heroin, I mean there were not young girls using heroin. There were not affluent people. There were not. It was an ugly, ugly place to be and most people did not know anyone who was using heroin. Whereas today it's mainstream. I mean, it's really mainstream, which is obviously frightening, but it's just interesting. You know, we have literally watched that progression from the pills and kind of the gateway opiates into what is now killing an incredible amount of people in America. And so for me, so with people now it's like in a crisis, right? Where for me it's been, this has been going on for decades.
Nancy Spitzer:
It's been a a crisis for a long time. It really has. Yeah, I agree.
Ashley Loeb Blassingame:
It's interesting to see.
Nancy Spitzer:
Well, when I started my internship, I was at the Hanley Center, which was predominantly a place for people with alcoholism. And I remember I had my first client, she'd come in and she kept talking about blues. I had no idea what blues were. So I had to google that. I really didn't, I mean [inaudible 00:27:43] as I am. But nowadays I know what blues are and all that good stuff. But yeah, so anyway [crosstalk 00:27:48]
Ashley Loeb Blassingame:
Oh wait, tell our audience.
Nancy Spitzer:
Oh. It's oxycodone. Different medication, but on the streets it was called blues. So she came in, she was a college student, great university she was going to, and she was actively using blues, as she kept referring to them. And this was in detox, so she probably couldn't even pronounce Oxycontin at the time. But yeah, she had said that. And you know, the center really didn't, they kept, you know, saying, "I don't know how to work with somebody who's on opioids. I don't know what to do." And I said, "You work with her like everybody else. She has the same struggles as everybody else. She's having a tantrum in the hallway. So is our alcoholic client, you know, it's the same."
Nancy Spitzer:
I mean obviously there's some differences, but my entire caseloads, once I started becoming a therapist, I would have, I would say 11 out of 12 clients were all opioid users and heroin addicts. And most of them had had chronic pain, some sort of accident, some sort of something like tooth related, and they had gotten addicted and couldn't afford opiates anymore and then went to heroin and it was across the board. You know, it's interesting, I moved to Utah almost three years ago, and they have billboards everywhere now really trying to address the opioid addiction, which is fascinating to me. We don't have that in South Florida, where it's also super prevalent because we had so many pain mills as they call it, pain medication centers that were distributing.
Nancy Spitzer:
But yeah, I'm hoping, you know, I think there's more and more attention to it now, but it's still, still people are confused. Like you talk to some people and they're like, oh, I didn't know that was an opioid, or I didn't know that was an addictive substance. I'm like, [crosstalk 00:29:26] do you not read? Things like that. Even quick scenario, I went, my husband had fallen off a ladder a few years ago and the doctor came in and was about to write him a humongous prescription for opioids. And I looked at the doctor and I said, "Have you even asked him if he has an addictive history or anything?" And he was like, "No." I said, "Did you ask him if he needs opioids?" "No." And I said to him, I said, "I think my husband probably could survive on Tylenol. Like he'll be okay." My husband was like giving the eye roll [crosstalk 00:29:57]
Ashley Loeb Blassingame:
Right, right. Like excuse me.
Nancy Spitzer:
Yeah, this is how people's addictions start though.
Ashley Loeb Blassingame:
Totally.
Nancy Spitzer:
And it was so casual and I said, "Look, that's like literally a death script for some people. They get that and they're gone."
Ashley Loeb Blassingame:
And that's it. I mean, that moment in time, and I know one of our episode two is with [Bane 00:30:21], oh Bane, and she tells her story, and the moment in time, she ends up, she's like crazy and she ends up in the emergency room for domestic violence. The doctor doesn't ask her anything about that, and he hands her a script for opioids. And that was it. Or sorry, for benzos, and that was it. It was done. It never stopped from there. And I just thought, wow, like that... Not that it wouldn't have gotten there or whatever, but that one moment in time. I've seen, I'm sure you've seen this too, but I had someone come in whose OBGYN was prescribing them benzos and opioids and I mean, [inaudible 00:31:00], I was like, wait, what?
Ashley Loeb Blassingame:
But there is a lack of understanding. And I think one of the things that it's like we've seen, how many times have we seen people come in, people talk to us, and they tell us this same story over and over. We can write it, we could write, we know they start saying, "I had a back problem," and we literally can write the rest. Or you know, "I had some trauma and then I had [inaudible 00:31:29], you know, I was abused and everything was fine and I got over it and then I had a back problem and then," or whatever. Like we can write that story. And I think if you are someone who hasn't seen that over and over again, you know, an OB or whatever it is, maybe it doesn't seem like, well, this patient or what, you know, like this person's responsible. But what people don't understand is like this is, it's not about the put togetherness of your patient. You know, there's so much more that goes into it. I mean, the story is right... For better, for worse, most of them are very stereotypical stories.
Nancy Spitzer:
They are, and that was my entire basic, you know, seven plus years of working in South Florida. I mean, every single assessment I ever did, the story was so similar and I mean, it really was, and it was heartbreaking because, you know, if I didn't work in this field and if I didn't have some awareness, who knows, I could have gone to the hospital with an injury or anxiety and gotten a prescription and been in the same exact seat. And I would tell that to my clients too sometimes. And there's a lot of underlying foundational factors too, you know, low self esteem, trauma, poor family history and things like that. But you know, in that situation your body physically gets dependent on something that you need in order to feel like you can exist. And people get fearful when they're going to go in withdrawal.
Ashley Loeb Blassingame:
Yeah, because it sucks. I'm just going to say that for the record. It's a real bummer. But what's interesting though and something that came up for me at the Hanley, you know, when you're talking about the Hanley Center, and I don't know if people, how many people know this, but you cannot, people don't die from opioid withdrawal, but they do die from alcohol withdrawal and from benzo withdrawal and the combination of those two.
Ashley Loeb Blassingame:
And so, you know, when we talk about like, oh, we don't know what to do with these people in terms of the opioids, but we know how to handle the alcohol, the truth is, I understand we have an opiod crisis, I'm not denying that, but the truth is that alcohol still kills more people than any other drug combined, and all the other drugs combined, still to this day, in the midst of the opioid crisis. Alcohol is still killing more people. And so, you know, in some ways I think it's kind of a vanity thing, like it's kind of like an easier thing to deal with, right? Like we're going to put this and then by default we'll deal with the stuff behind it if we deal with the opioid. But we've been handling some of the most deadly substances, such as alcohol, for many, many years. And this is just that, the new wave.
Nancy Spitzer:
Yeah. And I just want to say too, you, I mean, now they're a fantastic place. I mean, I think they just had to get used to anything. You know, it's always [crosstalk 00:34:15]
Ashley Loeb Blassingame:
Oh, for sure. For sure. [inaudible 00:34:16].
Nancy Spitzer:
[inaudible 00:34:16] on the market that, you know, I remember bath salts came out in South Florida too, and people said, "We don't know what to do with that either."
Ashley Loeb Blassingame:
I still don't know what to do with bath salts.
Nancy Spitzer:
Yeah. So it's an evolving process. And one of the things I'm always amazed about is that people used to get put in psychiatric wards when they were struggling with substance abuse. And that was not that long ago if we really think about in the grand scheme of things [crosstalk 00:34:37]
Ashley Loeb Blassingame:
Oh, that was what happened to me, and I remember being in these, it was 5150, right? They were like, we don't know what to do with you, we're going to stick you here and hope that you're okay until we figure it out, right? And that happened all the time with teenagers, you know, who had this going on, because you could do that. That was the main mechanism. And I remember just being in these psych wards and with people who were truly psychotic and thinking to myself like, no, no, no guys, I'm not crazy. I'm on drugs.
Ashley Loeb Blassingame:
Like you know, just trying to explain your way out of, and just sitting in groups of people that are seeing things and hearing things. And you're like, oh my god, how did I get here? And the solution in the psych ward is more medication, right? That's their tool. So, you know, they just really want to... So it wasn't that long ago that that was our, that was one of the very common main tools that we used to kind of figure out what to do with people.
Nancy Spitzer:
Yeah. And I'm hoping that changes more and more. But yeah, I talk to people about that all the time. Even the quote unquote 30 day model really came originally from the military and that's when people could take off time without getting in trouble with the military. So when clients say to me, you know, how much time does it take? And I say, to be honest with you, it takes a good full two years. It really does, of healing, and then it's a lifetime of work. So I'm hoping that that changes, and it really has. I mean even in my, you know, time period of working, so many things have changed in the eviction field. We're starting to know more and more and about trauma and how that plays a component and co-occurring disorders. So I've just been in awe of the changes, and we're really gravitating more towards understanding people and not just the substance they use.
Ashley Loeb Blassingame:
Right, right. Where's the pain? What are you using the painkillers for? When you work with families that have an opioid addict, I know a lot of people listening probably have, you know, son, daughter, sister, brother, maybe parent who has an opioid problem, where do you start when you are counseling the family? What do you start with? Someone says, "Hey, my 25 year old son has an opiod problem. I don't know what to do."
Nancy Spitzer:
I usually look at the family as a whole and talk to each one of them individually. But then on top of that, the hardest thing is I usually ask them, who takes care of them, because they've been taking care of somebody for so long, and trying to get them in the mode that they need to heal as well and this is going to be a twofold process. It isn't just our loved one who needs help. You need help as well and in getting the support. I think that's... If anything I can pass along to families, that would be the most important message. Whether or not you go to support groups or you go to therapy or you talk to a neighbor who is going through the same thing you are just to not feel so alone.
Nancy Spitzer:
There's a wonderful person named Katie Donovan who I've known for a few years and she helps families all over the country. But she, I mean honestly it's just moms talking to other moms and not feeling, because she felt like she was the only mom who had a daughter who was struggling and she started writing a blog and things like that. But it just, it unites people. It makes you feel like this isn't just my problem, it's a bigger problem than that. So starting there and then realizing, you know, obviously there's some hard work ahead and who's enabling and who's rescuing and who's doing that kind of stuff. But really getting them to a place where they can just start talking about it without just pointing fingers, because that's typical what families do.
Nancy Spitzer:
We want to blame. We want to find a scapegoat. We want to find somebody who's caused all this misery or something, the drug dealer. You know, and it's like, the drug dealer did it. Yeah. Well there's eight million other drug dealers out there in the world. So if we find them all, we'll let you know. But just talking about it, that's the first step. Start talking about it, getting the help and support you need, working on your own recovery, not just your loved one's recovery.
Ashley Loeb Blassingame:
So let's talk about that piece. As having worked in this industry and as a professional and as an interventionist, I'm very well aware of the importance of the family taking care of themselves, digging into their own work. However, if you were to tell me while one of my sons was struggling with an opiate addiction and I knew how deadly that was, that I needed to start taking care of myself, I might punch you in the face.
Nancy Spitzer:
Yeah.
Ashley Loeb Blassingame:
So you know, and so when you were talking about like all the training in the world, all of this, like if my son was struggling, I don't know what I would do, I totally relate to that. I have this, you know, picture in my head of telling people things sometimes. I had this woman who her daughter was homeless and we were trying to get her to come home so that we could get her to treatment. And it was like, it was this whole thing. And anyway, she was used to taking her daughter to get drugs and whatever.
Ashley Loeb Blassingame:
And so the thing I had her do was not answer the phone of her homeless daughter for two days. We mapped this whole thing out and I said, "She's going to come home, she's going to come." And I remember thinking to myself, she did come home, and I was like, I know my drug addicts, she's coming home. And I just remember thinking like, I'm telling her this and she's so brave and she's doing this and I have no idea if I'd be capable of not answering that call. And so when people come to you, like I have what I talk about, when people come to you and you talk to them about the self care piece and finding their own recovery and they're like, my kid is dying. What are you talking about? What do you tell them?
Nancy Spitzer:
It's usually not the first thing that comes out of my mouth. Just FYI, that's not the first thing.
Ashley Loeb Blassingame:
Okay, okay, okay.
Nancy Spitzer:
But I totally agree with you. And you know I do, because I don't come from the addiction side, and I mean, I used to have a struggle with that when I first first started when clients used to kind of challenge me on that a little bit, but I can tell them, you know, I know what it's like to be your sister. I know what it's like to be in your family and to get that earth shattering phone call. But when I work with families, I try to get them united again because there's so much division, whether there's a husband and a wife and they're not on the same page. So I always tell them, look, you're going to do some hard work. There's going to be times where you want to curse at me and scream at me. You're more than welcome to do that, and I'm okay with that. I know that that's going to come, because all of a sudden I'm going to become your scapegoat. I'm going to become your bad person.
Ashley Loeb Blassingame:
Right.
Nancy Spitzer:
And I'm going to ask you to do things that are going to make you feel uncomfortable because you're used to doing things the way you've always done them. And now there's somebody new coming into the picture and looking at it from a different perspective. I usually ask them, what are you willing to do differently? Because you can't be the treatment center. You cannot be, you know the law. I mean you just can't. Eventually you will burn out yourself. You've managed to, okay, treatment center, so far your child's still living. But let other help you with that. And if I can...
Nancy Spitzer:
You know, I even have asked couples before who have, you know, a loved one or a child, I'll say, when's the last time you two went on a date? When's the last time you two hugged each other? Just felt love, and there wasn't this pressing of, you know, doom and gloom and death coming? And usually I've had a lot of families kind of break down and say, yeah, we... And that's where I lead into the self care topic. But the first thing is, okay, we have to create a safety plan because safety's really important. Getting your daughter, like you talked about, getting your daughter off the streets, getting her into treatment, and then there are going to be some boundaries that you're going to have to hold. It's going to be so uncomfortable because I'm cutting off your air supply.
Ashley Loeb Blassingame:
Totally.
Nancy Spitzer:
We're taking heroin out of your daughter and we're taking your heroin away. So be prepared for withdrawal symptoms. And I talk about that a lot because that's what families go through. Once you change those dynamics, they're so used to buying the drugs, rescuing, constantly on the go, doing something because they feel it's that perpetual need. If I'm doing something, then it means that everything's going to be okay. There's safety in the doing. So when we pull and take that away, that becomes really hard.
Ashley Loeb Blassingame:
Yeah, yeah. Really, really hard. And I love that, taking the air away because that's how I, you know, that's how I describe addiction, and what we do to the families as the addict, as the struggling one, is make them think they're insane and we make them turn on each other. And I had an experience last year where someone who was sober but then I believe had relapsed, but was telling me they hadn't relapsed, but there were all sorts of like really clear, you know, those really like, there's no way you would have done, you know, and but really convincing me, you know, telling me like, "No, this was just, you know, whatever." And I remember thinking like, am I crazy? Am I? Everything I know, having a history of this, having worked in this, I started to question my own sanity. Like I am, are these things, oh, maybe I'm overreacting, you know, whatever.
Ashley Loeb Blassingame:
And I started to believe what this person was telling me. And of course it turns out that they were using, and that was that, because that's exactly what it looks like. And I'd go, oh my gosh, I totally forgot how when you are in your disease and you are a, you know, you are, that is what's going on for you, and it's the only thing you can see, everyone around you feels insane. Everyone who loves you feels in insane. Like they don't know what's up. They don't know what's down. They don't trust themselves anymore. They can't [inaudible 00:44:15], you know, it's just, it hijacks everything in a family. And that is why it is, you know, and you talk about the family therapy, I cannot stress enough if someone has a loved one, the value of going to a session together, to have some cohesion and get everybody on the same page.
Nancy Spitzer:
Mm-hmm (affirmative). Yeah. And they also had that core issue of I'm a bad parent. That comes out so often. You know, I haven't, and I say this very, I really, in my career, I haven't worked with a lot of quote unquote bad parents. I work with parents that are loving, caring, connected, devoted to their children. And you can have a beautiful childhood, a well-rounded childhood, everything that you could possibly want. And you still have someone who struggles with drug and alcohol addiction. So you know, teaching that to parents too, that you didn't necessarily, yeah, there's been actions and things that have happened and we're going to work on that as a whole and collaborate together, but your intent was beautiful. Like you had a wonderful intent. I think parents go to that blame so much and that really prevents their progress too and asking for help.
Ashley Loeb Blassingame:
Yeah, right. Because, or they blame the other parent for what the scenario is and I know that I almost broke up, in my using, I almost broke up my parent's marriage, and the reason being that there was a decision, one parent wanted to send me to treatment and the other parent wasn't ready to send me to treatment. And in between the time that the first parent and the second parent was ready, a lot of really, really bad things happened and in order for that second parent to be ready to put me in treatment. And the resentment of the parent that was ready first and the blame and the, you know, all these different things, and it was interesting to me how many people, you're making life and death decisions and nobody knows what to do, but it's really easy to blame someone for getting it wrong or what looks like getting it wrong.
Nancy Spitzer:
Yeah. And again, nobody has a, you know, crystal globe or ball or anything that could predict any of those things. And it's hard. But yeah, that's the biggest thing. If I can get parents on the same page, or whoever's in their system, their family system to be on the same page. And it's hard. I mean, trust me, I've been cursed at, screamed at, yelled at, told everything in the book, I'm not doing that. That's fine. You know, I'm just here to help you. I mean, I don't... There's no gain I get from not giving you the advice I'd give my own family [inaudible 00:46:41].
Ashley Loeb Blassingame:
Right, right.
Nancy Spitzer:
But in their crisis zone, it's hard to make decisions. So yeah, with your parents and that's heartbreaking. But at the same time, glad they're still together, according to what you were saying.
Ashley Loeb Blassingame:
Yeah.
Nancy Spitzer:
And that they got through that because it rips families apart. It really does.
Ashley Loeb Blassingame:
Yeah. Yeah. Really does. Before we kind of wrap, I want you to talk about the relevance or instance of trauma as it relates to addiction, alcoholism, and how often you see that playing a big role.
Nancy Spitzer:
So again, I do assessments, I probably do four to five assessments a week, you know, throughout my time as a therapist, and I would say I don't have many clients who don't have some form of trauma of some sort. And whether it's childhood trauma, adult trauma, or trauma when they're using, because as we all know there's a [crosstalk 00:47:41] of that.
Ashley Loeb Blassingame:
Oh yeah.
Nancy Spitzer:
And I think that many clients, you know, maybe they don't perceive it as trauma initially too, just because it's just part of the [crosstalk 00:47:52], right?
Ashley Loeb Blassingame:
Right.
Nancy Spitzer:
Like when they're talking about their life story with me and I'm writing all these things down and then I repeat it to them, they're like, "Oh yeah, that happened. And that was... But I got through that. And then that happened. Oh yeah, but I got through that." Because people who struggle with addiction, they're resilient people. They really are. They've had to be resilient to survive. So until they start talking about and realizing, and not that we want to label somebody as a trauma client, but at the same time, once we start realizing that was really painful in my life and I haven't wanted to deal with those emotions.
Nancy Spitzer:
I had a really good mentor and he was old timer in recovery. Old timer is somebody who's in AA for, you know, they're older and old timer. Anyway, he was just amazing. But he said in a group once, and I'll never forget this, he said, "This is a chronic thought disorder." And I love that because it truly is. I mean, no matter what drug or what substance you put in your body, it's the thoughts and the thoughts are connected to our trauma, our core beliefs, and who we are and the belief system we've created, whether it's true or not. And then if we can start to shift that to be more vulnerable, then we can really open up some pathways.
Nancy Spitzer:
So I see it pretty much every day working as a therapist, some sort of trauma, whether you know, childhood, adulthood, or during. So I think the more and more we realize that it's not just the substance... Like clients always want to tell me this is the substance they use. Thank you for that information. Might want to know more about you [crosstalk 00:49:21] I can get to work with you, because that's just the surface. That's the vehicle you use to get where you wanted to to not be present in your life. Now we have to figure out how to get you present in your life.
Ashley Loeb Blassingame:
Right. What was the reason. You have been working at Lion Rock doing telehealth for a little bit now. What was your experience with telehealth before that and what has it been like to treat clients over video conference?
Nancy Spitzer:
Sure. So for close to two years, I worked with adolescents in Utah, which is really common here. And I worked again in substance abuse and mental health and we did telehealth with their families because they didn't live locally. So I really loved it then. It was a great tool. And then when I got presented with the opportunity to work at Lion Rock, I just really embraced it. I didn't know if I would at first because there is that distance, but my client... One of the things I love about Lion Rock is that my clients bond with each other. It's absolutely incredible, and they all care about each other and they're all asking each other questions. You know, how did this happen, or how are you doing? And they are so connected. It's a beautiful thing.
Nancy Spitzer:
I actually did a presentation on telehealth the other day for my daytime job, and they were asking questions around that. And I just said, obviously if only they could be a fly on the wall, if HIPPA wasn't involved, but I said, these clients, they have so many different backgrounds, they come from all different places, all different ages, and they just care about each other. And that's the beautiful part of not only Lion Rock but recovery, because they become invested in their lives. They become invested in other people's lives. They become, as I call it, other centered instead of self centered. And that's when I see that shift. So when I notice that so-and-so is all of a sudden asking about another client and they're worried about that person, I'm like, oh, you're getting better because you care about other people.
Nancy Spitzer:
That gives me chills during group because I just, how much they care and how excited. Like I had one client who missed group the other day and she's like, "I missed you guys. I really missed being here." And I was like, "We missed you too." I think that connection, you know, again, connection is the biggest thing in recovery and they get really connected to their peers and the people in their group and they want to hear how they're evolving and growing and they want to see each other grow. So that to me is Lion Rock in a nutshell and what works about the program.
Ashley Loeb Blassingame:
Yeah. Yeah. It's cool to see because you know, you don't know at first like how is this going to work? How's this going to play out? People have met up and people get, you know, really, really connected to each other. And my best friends are all from a treatment center I was in for a year in Arizona. You know, I am very, very close to them and you know, I think you just have a bond that's like no other with those people.
Nancy Spitzer:
Yeah. So that for me it's... And then again, one on one, when I do individual sessions for Lion Rock too, and telehealth, I love seeing the clients grow, the assignments they do, and just seeing them really flourish. It just gives me a lot of hope. And I do think this is where the industry is going. You know, I never thought... I remember there was a ride on Epcot where they had like a video presentation, and I remember seeing that when I was little and I'm like, oh, that's kind of what I do now. That was like in the wave of the future. I think that ride's no longer there, that's how outdated it is now. But yeah, it's just amazing. And I also get to meet some amazing people that I would never get to work with sitting in my, you know, office in Utah and I get to meet all these incredible people all over the country. So it's really awesome.
Ashley Loeb Blassingame:
Awesome. Well, we're blessed to have you, and thank you so much for coming on the podcast and sharing your story, and it's just awesome. We're so grateful that you have your story, your background, and that you're able to help other families now.
Nancy Spitzer:
Thank you so much for having me. It's been a pleasure.
Ashley Loeb Blassingame:
The Courage to Change, a recovery podcast, would like to thank our sponsor, Lion Rock Recovery, for their support. Lion Rock Recovery provides online substance abuse counseling, where you can get help from the privacy of your own home. For more information, visit www.lionrockrecovery.com/podcast. Subscribe and join our podcast community to hear amazing stories of courage and transformation. We are so grateful to our listeners and hope that you will engage with us. Please email us comments, questions, anything you want to share with us, how this podcast has affected you. Our email address is podcast@lionrockrecovery.com. We want to hear from you.