You Must Be Some Kind of Therapist

[00:00:00] Ryan: So there's something called kratom, which comes from, I think, Southeast Asia, and people would make it into a tea, and it's got some very mild opiate-like effects, but it kind of just relaxes you a little bit. But they've extracted stuff from that, a chemical that is called 70H, and it's [00:00:15] stronger than morphine, stronger than heroin, available at a lot of gas stations here in, in Texas.

[00:00:20] Ryan: This morning, I learned about a new one called MGM-15, which is supposedly two and a half times stronger than 70H. I've seen like good church-going people who would never [00:00:30] even buy marijuana if it was illegal say, "Oh, well, this is legal. I can get it at a gas station," and get hooked on stuff that's insanely powerful.

[00:00:36] Ryan: Like, I've heard the withdrawals are significantly tougher to come off of than heroin. I've heard guys at the rehab center where I work say they got on heroin to [00:00:45] wean themselves off of 70H. It's, it's just insane, and for whatever reason, there's this loophole to where it's legal in a lot of places.

[00:00:53] SKot: You must be some kind of therapist?

[00:00:59] Stephanie: Today on the [00:01:00] podcast, I'm welcoming back my friend Ryan Rogers. He's an addictions counselor in Texas, host of the podcast Reality Therapy, where he's also had me on as a guest, and author of The Woke Mind, as well as his newest book, The [00:01:15] Carpenter's Recovery, which is about, uh, 12-step addictions recovery through a Christian lens.

[00:01:21] Stephanie: Ryan and I have spoken a few times before. He's, uh, previously appeared on my podcast on episode 135, and I [00:01:30] borrowed my episode of Reality Therapy and posted that as episode 167 of this podcast as well. So Ryan, good to see you again. Thanks for joining me today.

[00:01:37] Ryan: Great to see you. Thank you so much for having me back on.

[00:01:41] Stephanie: I always enjoy chatting with you, and, uh, so I was [00:01:45] happy to have you on without knowing what we were going to talk about. But when we were just having our little behind-the-scenes chat, "Oh, what should we talk about today?" You told me about some new drugs I'd never heard of, which I guess as an addictions counselor, you have the unique privilege of knowing [00:02:00] about things like what's being called gas station heroin.

[00:02:03] Stephanie: So let's lead with that shocker.

[00:02:06] Ryan: Yeah, so I had never... It's called 7OH. So, um, I had never heard of this stuff prior to a little over a year ago. Uh, maybe a [00:02:15] year and a half ago, it didn't exist. Um, so there's something called kratom, which comes from, I think, Southeast Asia, and people would make it into a tea, and it's got some very mild opiate-like effects, but it kind of just relaxes you a little bit.

[00:02:28] Ryan: Um, but they've [00:02:30] extracted stuff, uh, from that, a chemical that is called 7OH, and it's, it's stronger than morphine, stronger than heroin, available at a lot of gas stations here i- in Texas. Uh, and this morning, I re- I, I learned about a new one called MGM-15, which [00:02:45] is supposedly two and a half times stronger than, uh, 7OH.

[00:02:49] Ryan: So they're, they're just, like, ridiculously powerful drugs. Uh, and what's, what's I think so disturbing about it is you have a lot of people-- I've seen, like, good church-going people who would never [00:03:00] even buy marijuana if it was illegal, um, say, "Oh, well, this is legal. I can get it at a gas station," and get hooked on stuff that's insanely powerful.

[00:03:08] Ryan: Like, I've heard the withdrawals are significantly tougher to come off of than heroin. I've heard guys at the, the rehab center [00:03:15] where I work say they got on heroin to wean themselves off of 7OH. Uh, it's, it's just insane. And, and for whatever reason, there's this loophole to where it's, it's legal in a lot of places.

[00:03:27] Stephanie: Wow, that's crazy. So I [00:03:30] really had never heard of this before. I'm still catching up, honestly, on things like, um, oh, what's it called? Ketamine. Ketamine, yeah. What people are doing with ketamine these days. Because like when I was [00:03:45] growing up, ketamine was this thing that people took to go into a so-called K hole, a dissociative state.

[00:03:50] Stephanie: Yeah, yeah. And it was like not, it was not a drug that respectable people did for respectable reasons. Yeah. Like a club drug. And like, yeah. And like, and it- Yeah ... and now, [00:04:00] like people are talking about ketamine like it's therapeutic. I'm still catching up on that. But meanwhile, I mean h- how are people even developing these new drugs?

[00:04:08] Stephanie: It's just crazy that this is happening in Texas of all places, not the most permissive environment.

[00:04:13] Ryan: Yeah. Yeah. [00:04:15] So not, not just, I mean this is, there's a number of them. So you go into these gas stations or these smoke shops, any kind of vape shop, uh, CBD shaman, like all these type of shops, um, a- and they're selling all this, uh, kratom [00:04:30] type products.

[00:04:30] Ryan: Uh, there's a lot of THC products. So, um, the, the way the, the federal law is, is worded, it's like THC nine, blah, blah, blah, blah, blah is like illegal. So what they did is they extracted something called THC eight and [00:04:45] THC 10, um, that are almost identical, uh, but they're not outlawed, so you can, you know, put these out in gummies or vapes or something like that.

[00:04:53] Ryan: And, and they're, you know, extremely potent forms of, of marijuana, and it's like, it's legal. [00:05:00] I, I've, I've heard, uh, you know, when it first came out, I heard people call it diet weed 'cause it wasn't as strong as the street weed. And then I've recently heard people say that they switched back to like street, like i- illegal weed because the stuff you can get at the gas station was too strong for [00:05:15] them.

[00:05:15] Ryan: Like, that's just, it's wild to me. They, they also have stuff called, uh, kava, which is similar to an alcohol type, uh, high. Um, and I'm recently starting to hear about stuff that mimics, uh, like psilocybin magic mushrooms and [00:05:30] LSD. Again, all this stuff legal at gas stations. I, I, I know people like that are, that are taking this stuff, and it, it's just wild.

[00:05:37] Ryan: Uh, there was a, a bill that went before Governor Abbott in Texas that was supposed to like ban all this stuff, and for whatever reason, Governor Abbott [00:05:45] vetoed it. So I don't understand like why this stuff is still legal, but it's causing a lot of problems, and I get, you know, the, the, the back end of that when people have to come to rehab.

[00:05:53] Ryan: I- that's where I'm seeing them

[00:05:55] Stephanie: Okay, let's talk about kava for a second, 'cause that's one that I know and, uh, [00:06:00] it tastes nasty.

[00:06:02] Ryan: Horrible.

[00:06:02] Stephanie: So it's really hard- It does not matter ... it's hard to overdo. I, I don't know any listeners, if you've ever tried kava, you know what we're talking about. It's, it's like not only bitter, [00:06:15] but it's, it's kind of numbing to your mouth.

[00:06:17] Stephanie: And the traditional way that it's made in Hawaiian and Polynesian culture is they would take the root and pound it into water or coconut water, and you drink the [00:06:30] water as a, a cool beverage. Um, it does... I think it's, it can cause liver toxicity if you heat it in large quantities. Um, but when I think of kava, I think of something that's very hard to overdo, you know?

[00:06:43] Stephanie: Yeah. 'Cause you could drink like [00:06:45] a pretty disgusting amount in terms of taste and just feel like slightly relaxed. Um, but are you saying... Because you're, you're also talking about these other substances like kratom, which I remember my friends doing in the, [00:07:00] in my 20s. I remember my like hippie friends were into kratom, and I was always a little like about this.

[00:07:05] Stephanie: Um, you're talking about, like, substances where people can extract things. Like, you know, marijuana people can extract extremely potent stuff. Are you saying that that's also [00:07:15] happening with kava?

[00:07:15] Ryan: Yeah. So similar to, like, kratom. Like kratom, the, the tea that people drink in, in Southeast Asia, very low potency, very low risk, very low addiction potential.

[00:07:26] Ryan: Um, kava, like in the Polynesian islands, [00:07:30] when they use it in, like, ceremonial, uh, stuff, again, very low addiction potential, very low, like, uh, abuse or very low risk. Um, they, they extract it and it turn into something like... So a good example would be the difference between, like, coca leaves. [00:07:45] Uh, like in Colombia, people chew coca leaves almost like a, a cup of coffee, but then you extract from that cocaine.

[00:07:51] Ryan: And cocaine is a very different animal than coca leaves. Like, the, the potency, uh, I think what's the, the saying? The, the, um, the amount makes it either [00:08:00] a medicine or a poison. You know? Um, and, and so with, with kava there's, there's a, a drink called Feel Free. I'm not trying to advertise this, but just, uh, so people are aware of it.

[00:08:10] Ryan: Um, there's a drink called Feel Free that's contains, uh, kratom and kava. And a lot [00:08:15] of gas stations, they have it right next to the 5-Hour Energys at, at the, uh, like, at the checkout. And so a lot of people, you know, it doesn't say, like, this is an addictive drug. It's not in the alcohol section or anything.

[00:08:26] Ryan: It's right next to the 5-Hour Energy, so people think it's very innocuous. I've had a lot of [00:08:30] people come to rehab because of those Feel Frees. They didn't know what they were getting their hands on, and all of a sudden they're-- they think that, oh, maybe it'll help me study or help me relax at the end of a long day.

[00:08:40] Ryan: And all of a sudden they're, they're hooked on a, a, a, a pretty addictive drug.

[00:08:44] Stephanie: Wow. It's [00:08:45] really a brave new world. I mean, if you could separate the active ingredients in kava, which I think, uh, don't quote me on this- Kavalactones ... I think... Kavalactones, that's what I was gonna say. Yeah. Okay. So yeah, I mean, if you could isolate kavalactones, extract them in a way that's separate from the [00:09:00] taste, the bulk, the quantity.

[00:09:01] Stephanie: Like you're saying, I think the coca leaf to cocaine is, is a great analogy most people understand. Yeah, if you could do that, then there's no kind of upper limit necessarily on dosing because your taste buds are no longer a limiting [00:09:15] factor and, you know, the quantity of what you're ingesting is no longer a limiting factor, and that's just- shocking that people are coming into addiction treatment with these new addictions that those of us who don't work in addictions haven't even heard of.

[00:09:29] Stephanie: And I'm [00:09:30] curious how your field is keeping up with treatment because, uh, these are not necessarily, like, well-established, well-understood addictions. Are you using sort of the same approach as you would with anything, or do they have... Are, [00:09:45] are there different medical or psychiatric considerations that you have to bear in mind with these new substances?

[00:09:50] Ryan: Yeah, I mean, uh, when, when they're in, like, residential or inpatient settings, it's, it's very similar, uh, you know, there- there's some, some nuances, but [00:10:00] very similar, uh, for different drugs. Um, I'll say, like, traditionally you would treat alcohol a little bit differently than you treat, uh, street drugs because, you know, with street drugs, you know, part of it, part of it is you, you, you're looking [00:10:15] for some type of internal change.

[00:10:17] Ryan: Uh, but you're also like, "Hey, just stay away from certain areas." Like, you know certain areas that are just not good to be around, that are gonna trigger you, that are going to stir up some feelings of, you know, you're gonna see, see these drugs in front of you. Just stay away from those [00:10:30] areas. Alcohol, it's hard to do that 'cause alcohol is everywhere.

[00:10:32] Ryan: You can't go into a gas station or a restaurant without alcohol, so you have to kind of prepare them for that. Well, now, you know, a heroin addict can't go into a gas station without seeing something that's equivalent to their drug of choice. So that, that's a [00:10:45] really rough thing to try to prepare them for after discharge.

[00:10:48] Stephanie: That's so crazy. So- Before we started recording, we were talking about how heroin use itself is on the decline because it's been replaced with stronger things like fentanyl. Um, [00:11:00] but so let's say any kind of opiate addict, right, whether it be a fentanyl addict or someone who got addicted through, you know, starting with something like oxy, um, you know, a prescribed pill, um, you're saying that they're walking into a gas station and seeing [00:11:15] something equivalent to that.

[00:11:16] Stephanie: That's a really bold claim. What can you tell us about, like, the mechanism of action, the physiology of these drugs, what neurotransmitters they affect?

[00:11:25] Ryan: Yeah. So there was a study not too long ago on 7-OH. So the, the, the [00:11:30] two, the two big drug-- The one I've been seeing for probably a year and a half now or so has been 7-OH, and that's the kava extract.

[00:11:37] Ryan: I guess something was extracted from that called MGM-15, which is two and a half times stronger than 7-OH. But there was a study [00:11:45] on 7-OH maybe in the last year, uh, or so showing it was 13 times stronger than morphine, and morphine's about, uh, uh, half as strong as heroin potency-wise. So this is, like, significantly stronger, like gram for gram, [00:12:00] compared to heroin.

[00:12:01] Ryan: Um, uh, I, I mean, I've heard like, uh, horror stories, nightmares-type stories of people, like, withdrawing from the drugs. But it-- in terms of mechanism of action, it's hitting, like, the opioid system, so similar to what morphine, Oxycontin, heroin [00:12:15] are hitting. It's hitting the same pathways. Um, one thing that I, I, I've heard guys say consistently is when you first start, it's very cheap.

[00:12:23] Ryan: So you go into the gas station, you get-- A lot of them get capsules, and so they'll get one or five or however many, and think [00:12:30] this is, you know, relative to how high it gets me, this is a very good deal, and then all of a sudden they're-- the-- it gets incredibly expensive because they build a tolerance very fast.

[00:12:38] Ryan: So they're having to buy lots and lots of capsules, and it's costing a lot more money, and they're just like-- they're, they're kinda [00:12:45] sucked down the rabbit hole.

[00:12:46] Stephanie: So the withdrawal symptoms then for 7-OH and MGM-15 are similar to, uh, opiate withdrawal.

[00:12:58] Ryan: So, like, really bad fever, [00:13:00] uh, body aches, uh, digestive issues.

[00:13:03] Ryan: Um, they call it a kick, like, uh, kicking heroin because your legs are literally kicking 'cause you're restless and can't sit still. Um, so that's a lot of what you're experiencing.

[00:13:13] Stephanie: What patterns [00:13:15] or trends have you observed in who is particularly susceptible to falling into these types of addictions? I know you work with men specifically.

[00:13:24] Stephanie: Besides that- demographic, what, what have you observed? [00:13:30]

[00:13:30] Ryan: You know, it's, it's interesting. You, you can, you can build certain profiles around certain types of people. You have, like, a middle-aged white man comes into rehab, like, my bet is alcohol, right? If I have a [00:13:45] 25-year-old gay man comes in, my bet is crystal meth.

[00:13:48] Ryan: Um, so there's certain, like, types of profiles that I start to guess. Um, there's a certain type of guy, your more rebellious type of guy, has certain types of personality characteristics that's gonna get [00:14:00] into something like heroin. The trouble with 7OH is it's, it's attracting such a broad range of people.

[00:14:06] Ryan: I mean, you might have, like I said, good church kid, doesn't, doesn't curse, doesn't smoke pot, you know, all these things. And because it's legal [00:14:15] and easily acceptable, they stumble into it without having any clue as to what they're, what they're getting into, and before they realize it, they're addicted and way over their head.

[00:14:23] Ryan: So in terms of the profile, it's way more open because you see a broad range of people that are getting accidentally sucked [00:14:30] into this.

[00:14:30] Stephanie: I think this is a good segue into my little old lady story. So I don't know if I've actually shared this story on the podcast in any previous episode. I know I've, I've told a few people this.

[00:14:42] Stephanie: And, uh, Mom, if you're listening, you [00:14:45] can get mad at me for sharing this. I don't really care because I want other people to be warned, uh, that this could happen to anyone. So, um My mom grew up long before marijuana was [00:15:00] legal, uh, of course. She's quite elderly and is not used to living in a world where it is, what to speak of there being dispensaries on every corner because she's in a state where it's legal.

[00:15:13] Stephanie: And, [00:15:15] um, not only is it legal in her state, not only are there dispensaries on every other corner, but also, um, I've noticed in states where it's legal that the average quantity of any given [00:15:30] product has gone up. So specifically the trend that I've observed, um, not watching this too closely, but is that the standard gummy or edible, uh, used to be five milligrams and now it's 10.[00:15:45]

[00:15:45] Stephanie: And five milligrams of THC is already a lot, um, especially to someone with no tolerance, no previous use. Um, cannabis is actually a psychedelic in my opinion, and a lot of people will back me up on that. [00:16:00] Um, it's actually, it has a higher risk profile than another psychedelic psilocybin. Um, it has a higher risk of psychosis.

[00:16:10] Stephanie: Um, with cannabis you're looking at, um, also things like ca- [00:16:15] cannabis use hyperemesis disorder, which I'm sure you can probably say more about than-

[00:16:19] Ryan: Wait, what is

[00:16:20] Stephanie: that? Oh, you haven't seen this in your practice?

[00:16:22] Ryan: No. What?

[00:16:23] Stephanie: I'm not sure. Oh, man. Uh, so okay, I'll, I'll pause to ta- to talk about ca- cannabis hyperemesis.

[00:16:28] Stephanie: Yeah. So, um, [00:16:30] Ryan, have you met people who use cannabis so regularly, um, ostensibly they say that they're medi- they're self-medicating for anxiety- Yeah ... and/or nausea?

[00:16:40] Ryan: Mm-hmm. Yeah.

[00:16:41] Stephanie: But if they don't get high they throw up, right? [00:16:45] So, so vomiting as a withdrawal symptom.

[00:16:47] Ryan: Yeah.

[00:16:48] Stephanie: Yeah, so cannabis use hyperemesis disorder.

[00:16:50] Stephanie: So- I

[00:16:50] Ryan: didn't know the name for that

[00:16:52] Stephanie: Yeah, I saw it a few times back when I was in group practice when I was seeing a broad population, and usually there's a lot of denial that goes with it [00:17:00] because stoners are very attached to their narratives about how wonderful cannabis is and how it never causes any problems.

[00:17:07] Stephanie: Right?

[00:17:08] Ryan: Yeah.

[00:17:08] Stephanie: Like, it's all good, never bad. Yeah. Um, which, like, you know, m- most things in life are not all [00:17:15] good, n- never bad, right? Yeah. So, um, yeah, I mean, this typically is, is paired with certain, like, very, like, pro-cannabis narratives and a lot of denial. Um, you know, it's usually... The, the narrative that I've seen attached to this is like, [00:17:30] "No, the anxiety and the nausea are just always...

[00:17:33] Stephanie: That's my baseline, and the cannabis is what helps me." Um, but really it's, it's actually a withdrawal symptom, right? People say that cannabis is not addictive, but we're also looking at, you know, a product that has [00:17:45] been bred and hybridized over long periods of time to be extremely concentrated. Um, you know, there's a lot of chemicals involved, especially in extracting all these, like, products people are using now [00:18:00] that are highly, highly concentrated.

[00:18:02] Stephanie: Um, so, uh, yeah, that's cannabis use hyperemesis disorder. So there are withdrawal symptoms associated with, um, you know, stopping cannabis use in regular [00:18:15] users who are constantly high. So, um, what I was saying is that, uh, you know, the average gummy in a, uh, a state where it's legal and that where, uh, products are sold in dispensaries has gone up [00:18:30] over the years.

[00:18:30] Stephanie: It used to be five. Last time I checked it was 10. And as I was explaining, um, in a, a person who's never used before or is sensitive, five milligrams alone could cause psychotic symptoms. Um, and you know, I- so I [00:18:45] was sort of comparing that to the risk profile of something like psilocybin, which has actually a lower risk profile across all varieties of harm, including risk of triggering psychosis.

[00:18:55] Stephanie: So I s- And

[00:18:55] Ryan: addiction potential too.

[00:18:57] Stephanie: Yeah. Yeah, I mean, psilocybin is [00:19:00] actually... There's good research, uh, pointing to psilocybin's usefulness in treating addictions because of its effect on neuroplasticity. Um, so all of this is to say that once upon a time, I gave my mother a [00:19:15] THC-free product containing only CBN, a, a cana- cannabinoid that is shown to help with sleep, uh, and CBD, because my mom has chronic insomnia.

[00:19:27] Stephanie: So I had given her a product for her [00:19:30] insomnia, and then she Wanted more CBN and let her, I guess, stoner massage therapist advise her on [00:19:45] this. And he, like, took her into a dispensary near his massage office or something and did, like, muscle testing with this little old lady. I'm not completely against muscle testing, okay?[00:20:00]

[00:20:00] Stephanie: But, uh, he ends up giving my mom a 10 milligram THC gummy product, which also contains CBN. So CBN being the active ingredient that I had given her, right? Um, [00:20:15] and, and the only reason I find this out is because she had a medical issue, thankfully unrelated to that product, and I went and visited her in the hospital, and then she wanted some things from home so I went to her home [00:20:30] to get her, you know, a sweater, socks, books, whatever.

[00:20:34] Stephanie: And while I was there, I found this packaging. And I was like, "What the heck is this?" My mom's like 90 pounds soaking wet. She's in her 80s. [00:20:45] She's never done any drugs in her life. And I'm like, "What the hell is this?"

[00:20:54] Ryan: You know, the way I've seen some of these things marketed, uh, they're, they're like, you have to know what they're [00:21:00] talking about.

[00:21:00] Ryan: So there's-

[00:21:00] Stephanie: Yeah ...

[00:21:01] Ryan: like two different w- with C- uh, CBD or C- CBN, like these different types of things, they might say broad spectrum, which is just CBD, or full spectrum, which means it contains THC. So, like, it's kind of [00:21:15] deceptive labeling in some of the packaging where you, you might think, "Oh, I'm not doing like actual weed, I'm just doing CB- CBD," and don't really know what you're putting in your body.

[00:21:24] Stephanie: Well, you know, I think that's probably a good way of describing the concerns for some people who don't know what they're getting [00:21:30] into. You know, in, in the case of someone like my mom, you know, this is an elderly person who's not used to living in a world where these drugs are sold, period, right? She's used to like a...

[00:21:39] Stephanie: If a supplement is s- sold in a health food store, it's like a health supplement- Yeah ... right? Yeah. Like, so there, [00:21:45] you know, the... It was on the label 10 milligrams THC, it's just that she didn't know that THC- Yeah ... is the psychoactive stuff that gets you high that used to be- Yeah ... illegal not too long ago. So basically what I learned is that, like- [00:22:00] Those gummies knocked her out all right.

[00:22:01] Stephanie: She got a good night's sleep. Mm, yeah. But, but when she woke up to pee in the middle of the night, she was, like, feeling pretty woozy. And I was like, "Well, yeah, Mom, like, you were on a drug that can make people hallucinate, [00:22:15] and I'm really thankful that you did not fall and lose your balance, because you really could have."

[00:22:20] Stephanie: Like, she's at the age where she's falling and breaking things, you know? So, like, thankfully, there was no THC involved in any of her falls. [00:22:30] Um, and I took, I took the products away, or I just made her promise not to use them. Um, I did not take them. I do not use THC myself. Um, I got her more CBN, THC-free product, um, to help with her sleep.

[00:22:44] Stephanie: But it [00:22:45] was... I, I, I feel like I do have to share this story as, like, a public service announcement, not to humiliate my mom. I, I feel like I'm saying it with empathy, like she d- she does not know what it's like to grow up in a world where this, where you have to be on the lookout for this stuff. Um, but a- as a warning [00:23:00] to other people with, with your elders, with your, I don't know, people from different cultures, people who are not used to navigating this landscape or don't know how to read labels or don't know what these things are.

[00:23:10] Stephanie: Like, it's very easy for someone who [00:23:15] has no idea what they're doing, or imagine someone with a, with a, with an intellectual disability or, you know, like to end up getting really, really high unintentionally. And it sounds like what you're seeing isn't, you know, quite lining up with what [00:23:30] I'm seeing because you're in a state where THC itself isn't legal, but people are doing all these, like, workarounds on, like, creating molecules in labs that are really similar to illegal molecules, but these ones are legal, and they haven't been made [00:23:45] illegal yet.

[00:23:45] Stephanie: And so there's all these crazy workarounds, and the disturbing thing is, like, there are people who would not intentionally use illicit substances, right? H- people who are high in conscientiousness who just [00:24:00] think that they're, like, taking a relaxing herbal supplement or something, and then they're ending up experiencing tolerance, withdrawal.

[00:24:09] Stephanie: Like, can you tell us how far that goes for, for your patients?

[00:24:14] Ryan: [00:24:15] Tolerance and withdrawal for THC

[00:24:17] Stephanie: Oh, for this other stuff that you're talking about. Oh, for- 7-OH, MGM-15. You were talking about kratom and some kava extract stuff.

[00:24:25] Ryan: Yeah, I mean, uh, first of all, on the THC front, um, as, [00:24:30] as the weed products, the legal weed products have gotten so much stronger in the last few years, the amount of people...

[00:24:36] Ryan: And it's, like, probably 95% of the people I see are younger men, like, men, men under age 35 is, like, who I see this happening to. [00:24:45] Like, being hospitalized for psychosis, like, THC-induced psychosis, that's just, uh, you know, skyrocketed in the last few years. Um, it's, it's, uh, it, it's wild how, how much stronger it's gotten and how it's impacted [00:25:00] people.

[00:25:00] Ryan: Um, and in terms of, uh, like, the 7-OH, it's just, I mean, like, uh, it's, it's to the point where, like, people almost have to be in, like, hospitalized or in a detox or in some type of facility because people [00:25:15] just, like, psychologically can't... It's, the, the withdrawals are not gonna kill you. Like, opiate withdrawals don't, don't kill people, but they make them, like, hurt so much and so uncomfortable they think, "I, I just have to do something to make this stop," and the only thing that makes it stop is getting high.

[00:25:29] Stephanie: So [00:25:30] Traditionally with opiates, there were things like, um, methadone, Suboxone, these like... I forget, I forget, I get like a- agonist and antagonist mixed up. But these, these [00:25:45] chemicals that basically help people get sober. Um, do things like that work with these new drugs? Or are, are there other ways to help people detox?

[00:25:56] Ryan: It's not a silver bullet, but, um, I think someone who [00:26:00] goes through like... Personally, and this is just my opinion, some people really don't like this take, I think methadone is horrible. Um, the, the people that I've seen on methadone describe it as like living in hell. Um, 'cause they're, they're more hooked on it than they were hooked on [00:26:15] heroin.

[00:26:15] Ryan: Oh, yikes. The half-life is like 36 hours, and so the withdrawal can take like six weeks or more to, to like withdrawal from methadone. Like it's j- it's, it's a horrible process. Um, I'm much more pro [00:26:30] Suboxone or Subutex, like e- either one. Um, people I see on that, most of the time they're on it short-term, a week or two, something like that.

[00:26:38] Ryan: They have like a, a step-down withdrawal, and it's a smoother transition into sobriety. Usually those people [00:26:45] still need some kind of a facility to be in. Um, but that seems to be a lot more effective for people from, from what I've seen.

[00:26:51] Stephanie: So methadone sounds like hell, but Suboxone, does that... Is that offered to people who've gotten hooked [00:27:00] on 7-OH or MGM-15?

[00:27:02] Ryan: Yeah, I mean, I think almost any detox you would go to would offer you Suboxone for opiate withdrawal or opioid withdrawal. Hmm.

[00:27:10] Stephanie: Wow, so these things are considered opiates.

[00:27:13] Ryan: Uh, I think the... I mean, [00:27:15] technically op- opiate is like from the opium poppy. Opioid is like anything that's similar to that, that could be synthetic.

[00:27:22] Ryan: Uh, or, or, you know, anything that targets that system in the brain.

[00:27:26] Stephanie: So they fall under the same umbrella.

[00:27:28] Ryan: Under the same umbrella, yeah. [00:27:30]

[00:27:30] Stephanie: And these are extracted from kratom.

[00:27:33] Ryan: Yeah.

[00:27:34] Stephanie: What have you witnessed with kratom? 'Cause I, I mean, what I recall is that shortly before 2010 or so would be like when I first started hearing about kratom.[00:27:45]

[00:27:45] Stephanie: And people would talk about it as if It's natural, and there are different varieties, and some are more uppers and some are downers. That's not how they would call it, but like- Yeah ... they would say some give you energy and some help you relax. Um, I thought of [00:28:00] it as being quite similar to kava, but just something that I was never interested in trying because my relationship with kava dated back to living in Hawaii.

[00:28:08] Stephanie: And, you know, I, I appreciated the sort of the indigenous history of kava as a [00:28:15] tradition, um, and, you know, the traditional preparation method, so I had respect for that. Whereas kratom was, in my world, it was this kinda new thing and this unknown. And the way that a certain friend of mine would talk about it, I just, I like, I felt suspicious.[00:28:30]

[00:28:30] Ryan: Yeah.

[00:28:30] Stephanie: And then I just didn't really hear anything about kratom for a while, and every now and then, uh, you know, just driving down the road, you would pass some really sketchy looking shop that s- that said kratom. And whether it be a gas station or a head shop or, you know, [00:28:45] something like that, and you're just like, "Well, if this really sketchy looking place has a big sign saying kratom, then something tells me that maybe this is, like, not a good thing."

[00:28:55] Ryan: Yeah.

[00:28:55] Stephanie: And, and then I just didn't hear about it, and now you're telling me that there are these extracts. So where is kr- [00:29:00] what's the status of kratom these days?

[00:29:01] Ryan: So I don't think I've, uh, uh, said this, yeah, I think I might have said it last time, but I'm, I'm a recovering addict myself, and I got sober, uh, January 2nd, uh, 2017.

[00:29:12] Ryan: Um, so when I was using back in the [00:29:15] day, I used, uh, kava and kratom and things like that, and, like, as an addict who wants to get high, those things, like, weren't really, for me, weren't, weren't really worth messing with 'cause, like, they were too weak relative to the price. It just wasn't worth it for me. It's like, it was, [00:29:30] like, barely, you barely feel anything at all.

[00:29:32] Ryan: It's like, if I'm looking to get high, that's not what I'm looking for. Um, it's really only in the last few years that they've got the extracts that made it, like, so much more potent. Um, and, and, um, y- yeah, it, [00:29:45] it's a completely different ballgame than it, than it was before. Like, it's like that you were talking about the, the traditional Polynesian or Hawaiian, like, ceremony around kava where it's like, A, it's, it's a lot weaker, and B, it's, like, something kind of, uh, like, a [00:30:00] really special ritual part of that culture.

[00:30:02] Ryan: Um, this is, it's, it's just a drug to get high at this point. There's nothing, like, sacred or, or anything like that. It's, it's, it's, uh, you know, that's, that's all it's used for. And in terms of, like, kratom, like, I [00:30:15] still see some kratom stuff around. It's, it's hard to tell the difference between, um, different things.

[00:30:20] Ryan: Like, I, um- I mean, for, for example, like, uh, the, the Feel Free shots. You know, that's... It, it's ju- it's just so deceptive, I think is a, is a big [00:30:30] part of what, what bothers me a lot. Just, you know, y- like, nobody announced necessarily this stuff got this much stronger, and this much more addictive, and this much more dangerous.

[00:30:39] Ryan: It just kind of appeared, and it took so many people by surprise.

[00:30:43] Stephanie: Makes me wonder [00:30:45] who is behind making these products and getting them into gas stations of all places. 'Cause it feels like, you know, a gas station, it's a convenience store, attracts all walks of life, including, you know, people without a lot of money, people without a [00:31:00] lot of education, you know?

[00:31:02] Stephanie: And, um Like, how did they set up that supply chain?

[00:31:09] Ryan: I mean, so I think this was a bit of trial and error. Um, I remember [00:31:15] 2012, uh, I had just got on probation and I was living in a sober house. And so, you know, if you're people like me in that situation looking to get high, you gotta get creative for something that, you know, you can find that you can pass a drug test with.

[00:31:29] Ryan: And back [00:31:30] then it was spice or K2, which was supposed to be like knockoff marijuana, and then bath salts, which was supposed to be knockoff crystal meth. And that, those are the types of things I do. And they, they were, they were awful drugs. They were, they were a horrible high, but you could pass a drug [00:31:45] test and, you know, go to probation, everything, and skate by just fine.

[00:31:48] Ryan: Um, something happened. There was some kind of legislation. All that stuff got outlawed. You see, like, spice and, a- and bath salts disappear except for in, like, homeless areas. You see s- you still see [00:32:00] s- that kind of stuff. But, like, the rest of the population, you never see spice or bath salts anymore. And then, you know, I, I mean, there's, there's obviously, like, high demand for people who wanna feel good, who wanna change the way they feel.

[00:32:11] Ryan: And so people were experimenting with this type of stuff for years [00:32:15] before they s- found stuff that just clicked and, like, this is, th- you know, this is our cash cow. This is, this is our money maker, and they started pumping this stuff out.

[00:32:23] Stephanie: I remember hearing about spice around 2012 as well. It was awful.

[00:32:28] Stephanie: Yeah, I had a, um... [00:32:30] When I was in grad school, I had a job at a tea house, and my boss was going through a trial h- um, for having... He was caught selling drugs, and so he was, like, on probation or [00:32:45] something, having regular drug tests, and so he was using spice. That was his way of getting high because it did not show up on drug tests.

[00:32:51] Stephanie: I remember that. And again, just my spidey sense being like, "Eh,

[00:32:57] Ryan: something's not right here." Yeah. It was, I mean, I, I... That was, [00:33:00] like, the only time I f- I felt like I was, like, borderline psychosis doing spice and bath salts 'cause they're, they're extremely powerful drugs, but not, like, euphoric. Like, you know, make, make your head spin off in a weird direction.

[00:33:12] Stephanie: I once heard from a patient [00:33:15] something that was very confusing, um, that I never really figured out what it was, but it was a reference to some kind of Like fake, like okay, what, uh, what, what spice [00:33:30] is to marijuana, this is to magic mushrooms. Some sort of like

[00:33:35] Ryan: That's, I, I've been hearing that go, I don't know exactly what it is, but I've been hearing people talk about that.

[00:33:40] Ryan: There's, there's stuff in gas stations like fake mushrooms that are like a psychedelic or [00:33:45] trying to be like similar to LSD. Like I don't know what the chemical compound is, but I've heard i- in the last few months a lot of people talking about that.

[00:33:51] Stephanie: And you don't know what it is.

[00:33:53] Ryan: No, no.

[00:33:54] Stephanie: Okay. Listeners, this is your time to comment if you know what this stuff [00:34:00] is, where it's coming from, who's pushing it, what lab they're making this in.

[00:34:05] Stephanie: Like wh- what, like, um, please let us know in the comments what you know about this weird fake, fake psychedelic stuff. I don't know. [00:34:15]

[00:34:15] Ryan: I mean, we know the demand is there, and so if, if there's an incentive for anybody to, to come up with some new chemical compound, uh, that just can be a, a goldmine for them.

[00:34:25] Stephanie: Let's see. So, th- so those are all the modern drugs that, [00:34:30] that you're catching me up to speed on. Is there anything we missed? Did we talk about fentanyl? Um, not much.

[00:34:36] Ryan: Yeah, I mean, the only thing I'll say about fentanyl, you kinda mentioned it a second ago, but I've, I've almost entirely seen heroin disappear.

[00:34:42] Ryan: I don't remember somebody that I've [00:34:45] seen check into a rehab in the last year for heroin specifically. There's people who they were used to be heroin addicts, but everybody's either on fentanyl or 70H these days. Um, I think the reason, a lot of people actually [00:35:00] preferred the heroin high, but heroin got so expensive and fentanyl is dirt cheap.

[00:35:04] Ryan: So you can get really high for a very small amount of money with fentanyl, or you can get it legally from a gas station with 70H, and because of that, just even though some people preferred it, [00:35:15] heroin's just i- almost disappearing.

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[00:35:56] Stephanie: Well, let's switch gears to recovery [00:36:00] now because- Yeah ... this is, so you, like you said, um, have recovered long ago now from a history of addiction. Now you treat addicts and, um, you know, I'm glad that we're actually talking about what you do the rest of the week because, [00:36:15] you know, we're, we're both podcast hosts, and I think, you know, those listening can, like, keep, it- it's easy to fall into the trap of, like, seeing a podcast host as primarily a podcaster, but most of us, podcasting is, like, secondary or [00:36:30] tertiary, right?

[00:36:30] Stephanie: There's a handful of people actually, like, making podcasting their full-time gig, and they mostly have huge audiences and daily broadcasts, and that's not us, right? You and I, this is like a side hobby. Um- Yeah ... so what you do the rest of the week, I mean, I know you spend a lot of time on reality [00:36:45] therapy talking about the capture of the field, talking about clinical, um, not, not just clinical issues, but the intersection of psychology and culture just like I do.

[00:36:52] Stephanie: I think our podcasts are kind of like sister podcasts. Yeah. Actually, we're both... By the way, I'm now officially, I've joined you in being one of, uh, [00:37:00] CTA's media affiliates. Um.

[00:37:01] Ryan: I

[00:37:01] Stephanie: love

[00:37:02] Ryan: it. I love it. Yeah.

[00:37:04] Stephanie: Which Michael Oland told, told me, like, it doesn't necessarily, like, mean you have to do anything different.

[00:37:08] Stephanie: You know, it just means, like, you're part of the team. You're re- kind of representing- Yeah ... you know, I think those of us, like, [00:37:15] with that stamp of CTA media affiliate, it means we're out here representing that there is, you know, just like if you see one cockroach in your kitchen, there's 1,000 behind the walls.

[00:37:25] Stephanie: Well, if you see a Ryan or a Stephanie out there, there's 1,000 other therapists who [00:37:30] aren't putting their name and face out there, but who share our concerns.

[00:37:34] Ryan: I'm sure you can back me up on this, but I've had so many people message me or DM or, or comment on stuff like, "Hey, I would never speak out." They might be an anonymous account or [00:37:45] something.

[00:37:45] Ryan: "I would never say this, but, like, I agree with you. Like, I'm, I'm a therapist and, like, this, this has totally ruined our field, and, like, I agree with you." So there's a lot of people who agree with kind of the stuff we're talking about, but because of how vicious some of the [00:38:00] ideologues in our field can be, they, they don't wanna, like, announce it publicly.

[00:38:03] Stephanie: Yeah, for sure. And, and you know, we need those people. Like, they, you know, not everyone can, uh, afford to take the risks we've taken, and I don't just mean that financially, right? Like [00:38:15] m- mentally, emotionally, not everyone's cut out for being a public figure, and it's really hard to square publicity and therapy.

[00:38:22] Stephanie: Those two things do not, like, mix very well, honestly. Um, so we need good therapists out there, and we need that [00:38:30] kind of underground network of people who are mostly just sticking to their work and, you know, not, uh, putting themselves out there because once you do express a certain view in public, the internet's forever, right?

[00:38:42] Stephanie: You can't put the toothpaste back in the tube. [00:38:45] And, um- So we need those people, and we, yeah, we are kind of like the public face of, uh, those who share our concerns. Um, you know, that being said, like I was saying, right, this podcasting stuff we do is only, [00:39:00] you know, for me it's just one day a week, um, if that, that I'm doing this.

[00:39:04] Stephanie: Um, the rest of the time I'm talking to parents of ROGD youth. And so for you, when you're not podcasting, you are doing addiction recovery counseling, and you just released this book. Do you wanna show [00:39:15] us your book and tell us about it?

[00:39:16] Ryan: Yes. Um, this one. Uh, it's A Carpenter's Recovery. It is a, a Christian guide to addiction recovery, so it goes through the 12 steps from, uh, the lens of biblical principles.

[00:39:29] Ryan: [00:39:30] Um, the reason that I wrote it, uh, it's, we- we use it in the addiction recovery ministry at my church. Um, but the reason that I wrote it is, uh, I, I love AA. I'm super pro-AA and 12 steps and things like that. But in a lot of AA meetings, [00:39:45] uh, you're, you're, they encourage you to get a higher power. And in a lot of discussions in a lot of places, you can talk about Buddhism or new age stuff, uh, but saying the word Jesus, like, uh, people will shut down your shares or tell you to be quiet.

[00:39:58] Ryan: It's like a, a really [00:40:00] odd paradox, uh, there. And having a place where, okay, if Jesus is your higher power, like, this is, this is where you can come and, and talk about that openly. Um, and I think it's, it's freeing for a lot of people, and I think it's also healing for a lot of people who say, [00:40:15] um, "Okay, I have a higher power.

[00:40:16] Ryan: What is that higher power like? Who is it? Like, what, what does this higher power want from me?" Like, it's, I think, I love the 12 steps that gives you, like, specific actionable steps to take on the road to sobriety, and I think the Bible gives me a much clearer picture of [00:40:30] who that higher power is that I'm praying to.

[00:40:32] Stephanie: I'm surprised that you see the 12-step world as being so hostile to Christians, even in Texas.

[00:40:39] Ryan: It, it, it's interesting because, like, if you look at the AA literature, a lot of it came explicitly [00:40:45] from Christianity. The first four years, Bill Wilson and Dr. Bob are the founders. The first four years that they were doing this, it was part of the Oxford Group, which is, like, explicitly Christian.

[00:40:55] Ryan: And, um, after that it kind of, it became like choose your own higher power, [00:41:00] essentially, a god of your own understanding. And kind of over the last 80 or so years, um, a, a lot of different things have been kind of incorporated into it. And, like, I think it's good to, you know, for example, have, like, a kind of a [00:41:15] Eastern mindfulness.

[00:41:16] Ryan: You know, I think that's useful in practicing meditation. I think there's a lot of good research on meditation. So there's some things that have been useful to incorporate. I think probably living in a predominantly Christian nation, a lot of people are, um, like hypervigilant of making [00:41:30] sure, like, uh... I, I...

[00:41:32] Ryan: There's a lot of church hurt, things like that, and people are, like, on edge looking for, like, you better not bring XYZ into this, and XYZ is, like, anything, like, overtly Christian. There's, like, certain [00:41:45] themes, kinda like in grad school, like anything that's, like, might even vaguely be conservative, like, we have to banish it.

[00:41:51] Ryan: It's got kinda similar to that with AA. They want it to be, like, an open place, and I think they sometimes view Christianity as, like, the unopened or the, the, [00:42:00] the closed-off religion. And because of that, they kinda justify keeping it at arm's length.

[00:42:04] Stephanie: That's kinda sad. Like, I, I, I get it. I get the religious trauma angle.

[00:42:11] Stephanie: But at the same time, I'm gonna play devil's advocate for a [00:42:15] second because you can have that with Buddhism too, you know? Like Uh, I, I, I was a California hippie for a lot of my life. I've met some real a-hole Buddhists. [00:42:30] I've met people who hide behind that veneer. So, you know, to exclude one of the most popular religions of all time just because some people [00:42:45] have said certain things in the name of it, I mean, I can understand that being appropriate in certain places, and it would make sense with something as big as AA to have different groups.

[00:42:57] Stephanie: Like a, you know, like there could be a [00:43:00] Buddhist group or there could be a, a group for specifically people who want a certain approach to talking about a higher power. But it would also seem like there's enough Christians in America that, that [00:43:15] there could be some Christian AA groups as well. I'm sure there are, right?

[00:43:19] Stephanie: Like some-

[00:43:20] Ryan: Celebrate Recovery is a big one. Um, I'll say just like numbers-wise, I mean, America's what? 60-something percent Christian. Um, and [00:43:30] like in Austin, Texas here, there's hundreds of AA meetings, uh, not to mention Cocaine Anonymous, Narcotics Anonymous, all the others, uh, every, every week. Um, as far as Celebrate Recovery, there's like maybe 10 per week through the whole greater Austin [00:43:45] area.

[00:43:45] Ryan: And so I think there's just like a, there's a lot more demand for a Christian recovery than there is supply.

[00:43:51] Stephanie: So what are some of the principles that you offer in your book then?

[00:43:55] Ryan: A big thing that, uh, I try to hammer home is, [00:44:00] um, I think there's certain people who, uh, like Jesus and don't like a lot of the people who follow Jesus, which is understandable.

[00:44:09] Ryan: I think, you know, basic Christian theology would tell you that Christians are imperfect. Um, and I think [00:44:15] there's a lot of people who come out of, uh, religious faith that is very judgmental or rigid or kind of similar to what we would see from like the Pharisees in the Bible, who are very big on following the rules and not a lot of heart.

[00:44:28] Ryan: Um, and I don't think that's who [00:44:30] Jesus was. Um, so, uh, things like the prodigal son, like God is anxious for you to come home, and you don't have to clean yourself up before you come home. Like He wants you, He loves you. He doesn't love you because you've done anything special, He loves you just 'cause you're His kid Um, there's, [00:44:45] there's two lines from my church that are a big part of this, this book and this recovery ministry.

[00:44:51] Ryan: One is, "God loves you exactly as you are, but he loves you way too much to leave you where you are." Um, God doesn't want you to get sober because [00:45:00] you need to follow his rules or else he's gonna be mad at you. It's because he, he designed you, and he, he, he knows who you are, and he wants a better life for you.

[00:45:08] Ryan: Um, and the other line is, "It's not about not sinning, it's about not settling." Um, I think sometimes you have this [00:45:15] idea that God has these, like, arbitrary lines in the sand that he's drawn, and if you cross them, he's gonna smack you or something like that. And really the idea is, like, he, he's inviting you to a better life with him, not, not shaming you 'cause you mess up and you're imperfect.

[00:45:28] Stephanie: What are some of the ways that you have [00:45:30] seen the Christian faith help people in their recovery?

[00:45:32] Ryan: To me, a lot of it comes down to the example that Jesus set. Um- So how to be a leader. You know, Jesus as a leader got down on his hands and knees and washed the feet of his disciples. You know, like taking [00:45:45] that principle of, like, servant leadership into everything that you, you do.

[00:45:49] Ryan: Or, uh, valuing, uh, helping others. Um, you know, Jesus said, "Whatever you do to the least of these, you've done it to me." And I think you have to have that mentality. Like, if you're, [00:46:00] uh... Like i- one of the principles of the 12-step is you help other people. Once, once you get through the struggle, you help other people get through that struggle as well.

[00:46:07] Ryan: And if you're dealing with somebody who's in the middle of detox or... You know, I mean, a lot of these people can be grumpy and unpleasant to work with, and you have to have this [00:46:15] mentality of, like, you know, "This is who I'm here to help. This is, you know, the way I connect with God, is by helping people who are not always super pleasant or not always super lovable."

[00:46:24] Ryan: And I think that's what Jesus did, that's the example he set, and, like, knowing that is kind of [00:46:30] inspiring, I feel like.

[00:46:31] Stephanie: And for your patients, do some, uh, seek you out specifically because they're looking for a faith-based approach?

[00:46:39] Ryan: Yeah. So I lead the, uh, Christian therapy at, uh, the rehab where I work, [00:46:45] um, and a lot of guys are super interested in that.

[00:46:48] Ryan: Um, and that's, you know, really, really exciting to a lot of them. Um, again, I think there's... AA is an incredibly, or just 12-step fellowships generally, are incredibly powerful, um, in [00:47:00] that they explain alcoholism and addiction very well in a way that makes sense to people. A lot of people when they first read the AA literature, it's like, you know, a light bulb moment.

[00:47:09] Ryan: "Ah, I never understood myself or why I did these things that seem insane, and now I get it." Um, and they also give you [00:47:15] very clear, actionable steps of how to, the road to take to get sober. But I think a lot of people think, you know, like, "I, I, I don't have to wonder what my higher power is. It's not something vague.

[00:47:26] Ryan: You know, it's not just kind of the universe or, or whatever. [00:47:30] Like, I, I know Jesus is my higher power, and I need a place to be able to, like, talk about that and say that." So I think a lot of them are, are grateful for that.

[00:47:36] Stephanie: Are you a therapist in need of continuing education that's not over-the-top woke?

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[00:48:10] Stephanie: Again, use code SOMETHERAPIST at [00:48:15] lisamustard.com/podcourses. I'll include that link and coupon in the show notes for your convenience. All right, now back to the show. So Ryan, you started Reality Therapy a year and a half ago, and, uh, certain times you were going really [00:48:30] strong, like multiple episodes a week, which I, I could never keep up with.

[00:48:33] Stephanie: I always just tried to commit to that once-a-week pace. Um, and you've, you've met so many people now. We have a lot of overlapping guests. Like I mentioned, we're sort of sister podcasts in a way- Yeah. Yeah ... part of the same network. Um, [00:48:45] what, what have you learned about the state of the field in this year and a half of doing Reality Therapy?

[00:48:51] Ryan: I mean, I think one of the things that's been such a pleasure and such a privilege is being able to connect with so many amazing people, like yourself, [00:49:00] um, but also people all over the world. I, on Reality Therapy, I've had people from US, Canada, Australia, New Zealand, uh, the UK, Finland, um, Jaco's from South Africa.

[00:49:14] Ryan: Like, just [00:49:15] a, a lot of people from all over the place and, and what's so fascinating is so many of them are, are saying similar things about the corruption of the field of, of therapy and psychology, and how, uh, woke ideology and indoctrination is hitting [00:49:30] CUs and grad programs and, uh, professional organizations.

[00:49:34] Ryan: Just to see, I mean, it gets repetitive sometimes, but I think that drumbeat is somewhat necessary. Like, hey, you know, this is... You know, it, it's not just Stephanie and [00:49:45] Ryan saying like, "Hey, therapy is woke and we don't like that because we're bigots." You know, like, there's, there's people... I've had everyone from conservatives and libertarians to progressives, socialists, all kinds of people on my podcast saying like, "Hey, something is [00:50:00] seriously wrong here, and we need to take that seriously."

[00:50:02] Ryan: And I think the fact that there's such a diverse range of people, um, men and women, different, uh, racial groups, uh, gay and straight, like all, you know, detransitioners, all kinds of people saying like, "What is [00:50:15] going on here is seriously troubing, troubling, and we need to take it seriously."

[00:50:18] Stephanie: Where do you think we're going?

[00:50:21] Stephanie: And, and maybe this is the same question or maybe this is a different question, but what do you think therapy or- [00:50:30] counseling in the 21st century needs to accomplish

[00:50:37] Ryan: A question I've asked a lot of my guests is, have we passed peak woke? And I think in society generally, we've definitely, like woke ideology, [00:50:45] social justice, critical social justice, I think it's been discredited thoroughly.

[00:50:49] Ryan: A lot of people are taking their pronouns out of their email sign-offs. Like, people are just not doing that anymore. Like, I think generally speaking, it's kind of fallen out of favor. However, there's pockets, [00:51:00] uh, like academia is a big one, um, and just the therapy profession. Therapy is, is incredibly woke, and, uh, it, it will probably be a very long time before that stronghold falls.

[00:51:12] Ryan: Um, it's, it's one of those [00:51:15] things where, um, in grad school, in, in a lot of CEUs or, like, the professional organizations, you can't say, "Hey, gender-affirming care is actually really harmful, uh, to minors, and, and, and we shouldn't be recommending [00:51:30] that." Um, or like, "Hey, maybe critical race theory for five-year-olds is not...

[00:51:35] Ryan: shouldn't be best practices," or whatever. You know, that's just, it's, it's not, it's taboo to talk about these things that seem common sense to you and I. Um, [00:51:45] and I think what's going to eventually, uh, fix the field of therapy i- is the market. Um, a- and by that I mean, um, you know, intersectionality has limited applicability for dealing with someone with anxiety or [00:52:00] depression or bipolar disorder.

[00:52:01] Ryan: You know what I mean? Like, that's wonderful that you can dissect, you know, which is a, a more potent level of oppression, uh, being, uh, gay or being Hispanic, or just like, you know, calculating the [00:52:15] intersectionality scores. Like, that, that works... That's wonderful in academia when you don't actually have to solve any problems.

[00:52:20] Ryan: But when someone's sitting across from you and it's like, "Hey, I'm going through a divorce," or, "I, I have an addiction issue," or whatever, like, [00:52:30] all the cute things, the social justice things that you learned in grad school, like, that's really not gonna help you. You actually have to have some therapy skills, and I think it'll probably start with cash payers first, of people saying like, "Okay, who out there is doing therapy that works?

[00:52:43] Ryan: That's who I wanna go see." [00:52:45] And I think insurance companies are gonna, uh, uh, like, take the, take the lead after that. Like, "Hey, you know, we're, we're going to pay for things that are evidence-based." That'll probably be a, a buzz phrase which obviously gets abused, but I think people are gonna start to [00:53:00] see that and You know, even if you are super social justice oriented, when it's your own life, you know, I might think somebody else needs to, needs all these woke interventions, but if I'm dealing with my own suicidal depression or whatever it [00:53:15] is, um, I, I actually want something that works.

[00:53:17] Ryan: I, I wanna get better. Like somebody else, that's, that's fine. Give them the intersectional blah, blah, blah. But for me, like give me something that works 'cause I'm suffering right now.

[00:53:26] Stephanie: I think, um, the ideological rigidity [00:53:30] is Creating friction to discovering what the modern problems are that most need our attention.

[00:53:42] Stephanie: AI psychosis is on the rise, and few [00:53:45] of us are prepared. I mean, there's very little research on it 'cause it's so brand new. I did just listen recently to an episode of the Psychology and Psychiatry podcast with David Puder, Puder, something like that, where he interviewed... Do you [00:54:00] know that one? It's a good one.

[00:54:01] Stephanie: It sounds familiar. He, he, um, yeah, you can get CE credits from listening to his podcast. Hmm. It's a pretty good system, and a lot of his guests are pretty solid. Um, and I listened to an episode he had with an expert on AI psychosis recently. Um, but there's [00:54:15] that. You know, my h- the horn that I'm always sounding is like, why doesn't the field of marriage and family therapy c- care more about blended families?

[00:54:23] Stephanie: Blended families are, like, a third of America. I'm in one. You know? Like, that... There's, there's a lot to talk about [00:54:30] there. Um, and you know, I think a lot of the space that has traditionally been filled by therapy is going to be filled increasingly by a combination of AI [00:54:45] and, uh, people with niche expertise.

[00:54:48] Stephanie: And so what I mean by that is most of the people who come to me for ROGD parent coaching would not care if I lost my license over this issue. Uh, you know, it's [00:55:00] like a-- It's to my credit that I have faced down threats to my license over this issue and succeeded, but if I had lost my license over this issue, it would be just as much to my credit.

[00:55:11] Stephanie: They're concerned with the expertise that I demonstrate [00:55:15] through speaking competently about this issue and through the, my recommendations coming from other clients and people who have done my course. That's what earns my trust in their eyes, and they wanna come and talk to someone who understands this particular issue.

[00:55:26] Stephanie: And when I think about myself on the other side of things, like I mentioned, as [00:55:30] a stepmom, um, you know, there's a stepmom podcast that I listen to, and she's not a therapist, but she really, really understands stepmoms because her podcast is about being a stepmom. She's a stepmom. She has a whole coaching practice specifically [00:55:45] for stepmoms.

[00:55:45] Stephanie: She has a course for stepmoms. And I am actually probably more likely, as a therapist myself, I'm more likely to hire her when I'm running into issues in my own blended family than I am to go to a therapist. And so I [00:56:00] think in the age of social media, podcasting, everyone can have their own YouTube or TikTok or whatever, it's seems like the people who can confidently demonstrate their expertise in a given niche Are going to be sought out for their expertise in [00:56:15] that niche.

[00:56:15] Stephanie: And, uh, I think that makes it harder for your average therapist who doesn't wanna have a public profile. Like, like we were saying earlier, like, I respect therapists who don't wanna have a public profile. I think people deserve a private life. A lot of people are not cut out for this kind of work. [00:56:30] This kind of work can als- honestly be contraindicated for having a good therapy practice where you don't necessarily reveal too much of your values to the world.

[00:56:40] Stephanie: Um, but at the same time, I think that's the main source of competition. Like, as [00:56:45] therapy becomes more and more watered down, um, less and less reliable, more and more ideologically afflicted, you know, like, there's so much trust being lost in the therapy profession, and people still need [00:57:00] help. Where's that gonna go?

[00:57:01] Stephanie: I imagine it goes to people, regardless of their professional credentials, licensure, uh, graduate degrees. Regardless of that, the people who can speak competently to a particular [00:57:15] type of issue are going to be sought out for their expertise on that issue. And it's a different frame than therapy, right?

[00:57:21] Stephanie: Like, in the coaching framework, I'm directive Um, I engage in occasional [00:57:30] self-disclosure. Um, there's just different boundaries around it, but I feel like giving myself permission to have those different boundaries in my coaching practice allows me to almost be more free in some ways than, um, than in [00:57:45] the therapy model.

[00:57:46] Stephanie: And I, and I wish I had fai- like, I still wanna believe in therapy, but it's just like there's so, like, few good ones out there and it's so hard to find them.

[00:57:57] Ryan: I love being active and directive in [00:58:00] therapy. I love self-disclosure. Like, where I work, that works very well. Um, I mean, I remember in grad school, like people with this hyper person-centered, you know, like very opposite of anti- or opposite of, uh, like active and [00:58:15] directive.

[00:58:15] Ryan: Just like sit there and go, "Mm, mm-hmm, mm-hmm." You know? Like my question is like, why are they paying you? You know? Like if you're not like actively engaged, giving advice, things like that, like that's considered, considered taboo for a lot of people. But my question is [00:58:30] like, if you're not doing some of that stuff, like, like what value are you providing to somebody?

[00:58:35] Ryan: They're taking an hour out of their day. They're paying however much money. I don't know. It j- it doesn't make sense to me.

[00:58:40] Stephanie: Honestly, one of my favorite populations is men who [00:58:45] are really tough nuts to crack. Um, like I have a lot of dads usually dragged in by their wives, um, who are, you know, either the like semi-autistic engineering type that's like, "What's the point of all this abstract bullshit?"

[00:58:58] Stephanie: Like those guys [00:59:00] or, you know, the guys who are just like, you know, really thick-skulled and need someone to be very blunt with them. I do really well with those men. Um, and I'm not saying that's the [00:59:15] only side of me that ever comes out, but like, it's... I feel like in order to meet them where they need to be met, I, I have to be more confrontational than the average therapist.

[00:59:29] Stephanie: And I do think that's part of [00:59:30] the difference between the marriage and family therapy training background versus LPC, LCSW, PsyD, any of these other things. You know, marriage and family therapy specifically, uh, you have to be willing to interrupt people. You have to be willing [00:59:45] to tolerate heated conflict and know when to let it play out and just hold the anxiety that everyone's feeling, when to jump in, when to call people out on their BS.

[00:59:55] Stephanie: You, you have to be so much more, so much less conflict averse, I [01:00:00] think, in order to do marriage and family therapy than to do other types of individual therapy, especially the kind where you're just, you know, sitting back and all of that. And if I do sit back- Um, I'm letting conflict play out to see what [01:00:15] happens, right?

[01:00:15] Stephanie: If I, let's say I'm doing coaching with a mom and dad who are having a heated argument over the best approach with their kid. Yes, I might sit back for 10 minutes and let them argue. Um, but then I'm gonna jump in and I'm gonna say... Or, or [01:00:30] even 30 minutes, but then I'm gonna say, "Okay, would you like to know what I just witnessed?

[01:00:35] Stephanie: And because I'm seeing where the communication's breaking down here. I'm seeing where you're missing each other, where you're failing at communication." I'm gonna give them that really direct and honest feedback.

[01:00:43] Ryan: I, I feel like that's the s- the same [01:00:45] way for working in addiction. Like, I had so many grad school professors talking about, like, your, your main job is to affirm and validate the client.

[01:00:52] Ryan: Like, don't disagree with them and all, you know. And I'm like, if a client says, like, "I'm, I'm going to relapse 'cause I have a belief system that [01:01:00] heroin is nutritious for you," um, I'm not gonna say, "Live your truth, king." You know what I mean? Like, you, you, you ha- that's part of the job. You have to be confrontational and push back to some degree.

[01:01:11] Ryan: Like, you're dealing with clients who are... It's almost like on a schizophrenia [01:01:15] level, like, delusion. Like, you are not connected to the real world if you think, you know, an alcoholic with liver damage drinking vodka is, is, is a good idea. Like, that's a, that's a serious delusion that needs to be challenged.

[01:01:28] Stephanie: And it's infantilizing to [01:01:30] patients to assume that that's what they need or want or can tolerate from us. I mean, part of the reason I enjoy having those types of relationships with, like I say, the, you know, the men who are tough nuts to crack. I have one guy, I basically have to call him a bozo for him to hear me, and he loves it.

[01:01:44] Stephanie: He [01:01:45] just laughs. He's like, "Bring it on." Like, I, I have to be that- Yeah ... direct and almost mean to get his attention. You know, sometimes that's how it works to have a relationship. And the thing is, there's so much more warmth and trust in a relationship. You know, if I can call [01:02:00] you a bozo and know that that's gonna bring a smile to your face and make you listen to me, then that means there's a certain level of trust and rapport established between us, right?

[01:02:11] Stephanie: Mm. Yeah. Like, like, there's a closeness there. The [01:02:15] other thing about delivering people honest feedback, which I do all the time, I give a lot of honest feedback, I give a lot of warnings, right? I, I tell people, "Here is where I see this pattern leading if you do not change it," um, i- is that you're showing [01:02:30] people that you view them as capable of hearing that, right?

[01:02:34] Stephanie: And I think if, if a therapist, especially one who's instructing other therapists, is saying essentially all people can handle is agreement, then [01:02:45] you're really underestimating your clients and infantilizing them. And I think that says a lot about you, right? To not respect people's intelligence, to not, uh, believe that there's some part of them, a, a, a higher [01:03:00] self in them that wants to be recognized, right?

[01:03:04] Stephanie: Like-

[01:03:05] Ryan: Yeah, I mean, I, I think it's almost like a, like a hyper-capitalistic, like, customer's always right mentality.

[01:03:11] Stephanie: Yeah. Yeah.

[01:03:11] Ryan: But, like, the customer is coming to you because something is not [01:03:15] right. Like, you can't just pretend everything's okay. Like, it, like, they wouldn't be coming to you otherwise.

[01:03:20] Stephanie: Mm-hmm.

[01:03:21] Stephanie: Well, I mean, when I think back on times in my young life when I was lost [01:03:30] and not making good decisions, and someone helped me, not necessarily a therapist, but just someone said something I needed to hear, you know, it was the people who could recognize that I was [01:03:45] not living my best life, the people who could recognize that I was not fulfilling my potential, that there was more in store for me, right?

[01:03:50] Stephanie: That I was living a life that did not reflect my integrity, my intellect, my capacity, you know? And to treat me as someone who [01:04:00] deserved to know that, someone who, who had an instinct to grow higher, that was what helped me grow the most. Whereas people who saw me being stupid [01:04:15] and assumed that that's all I had to give, you know, those are the ones I'd be most ashamed to cross paths with because that's all they thought I was, you know?

[01:04:24] Stephanie: And, you know, hopefully I've demonstrated that I'm more than my worst decisions. But I think about this stuff a [01:04:30] lot because my parent coaching work, I am helping people make decisions that influence the lives of young people, and I think we have to honor the potential of these young people by recognizing that they're not there yet, right?

[01:04:42] Stephanie: The, the n- [01:04:45] The awful character that they're demonstrating at age 17 is not indicative of the character quality of the person they are capable of becoming. And if you treat a 17-year-old who acts like a total narcissist because they're 17, um, as if [01:05:00] that's who they are and that's all they're ever gonna become, then you're really doing them a massive disservice.

[01:05:05] Ryan: Yeah, it, it is such a disservice and, and gosh, it, it has the potential to trap someone in, in a life that's far [01:05:15] below what they're capable of and what they should be living. Um, it's, it's really sad.

[01:05:20] Stephanie: I think we all wanna be seen, right? But it's the narcissistic part of us that wants to be told you're perfect just the way you are.

[01:05:26] Stephanie: It's like we know we're not perfect just the way we are. We [01:05:30] know, I mean, at, at best we are lovable the way we are. We are worthy of grace, right? Uh, but we're not perfect.

[01:05:40] Ryan: I had a, I had a 12-step sponsor one time. I had relapsed and I was [01:05:45] coming back, trying to get help, and he goes, "Give me a hug." And I hugged him, and he goes, "Now turn around and let me kick your ass."

[01:05:52] Ryan: That's a very, like, tough love type of perspective, but I think from that world, like, accountability is part of love, and if [01:06:00] you, like, remove accountability or any type of, like, I'm never gonna disagree with you, there's no confrontation, like, I think that love is very superficial and very surface level.

[01:06:08] Ryan: Like, it, it doesn't have any depth to it. If somebody is like, like regardless of w- how it looks, addiction, [01:06:15] self-harm, whatever, like if someone's engaging in those behaviors and you're not confronting them, that's not real love.

[01:06:20] Stephanie: You know, one of the sort of vital signs that I'm monitoring for when I'm getting to know a new family in my parent coaching work is I wanna, [01:06:30] I wanna notice how quickly and easily do I develop a genuine fondness for the child that we're discussing?

[01:06:40] Stephanie: 'Cause I don't ever meet the kid. I work with the parents. Sometimes I'll work with aunts, uncles, [01:06:45] grandparents, other people in their lives. Um, but what we're doing is my clients are helping me form a comprehensive mental map of the child in question, the family system, everyone's personalities, relationships, communication styles.

[01:06:58] Stephanie: It's takes many [01:07:00] hours together to form that map in my mind. And along the way, I want to notice that I feel genuine care for this person I've n- never met who we're spending all this time talking about. And I wanna see how [01:07:15] quickly and easily I can get a picture of who they are as a person, and that itself is kind of a vital sign to me.

[01:07:22] Stephanie: Like, another vital sign I'm looking for is how quickly does a kid bounce back? So for example, if I'm dealing with parents, let's say of a 15-year-old who thinks she's a boy, [01:07:30] and they just h- you know, had a really, like, hard conversation, but within an hour she came back for snuggles or ice cream or whatever.

[01:07:41] Stephanie: Like, I'm like, "Okay, that's a really good vital sign." Right? That tells me, like, there's [01:07:45] resilience, there's re- like, rapid recovery. You can have difficult conversations. She's not gonna, like, go silent on you for two weeks straight, right? So similarly, right, I'm looking for how, how do I feel? So my countertransference, um, [01:08:00] and, and that's one of the things I'm monitoring.

[01:08:03] Stephanie: Can I, can I see the potential in this child? Do I respect their soul, right? Do I... I mean, of course I always respect people, right? I respect that this is an individual who we're here [01:08:15] to, you know, try to help from a distance and all of that. But it's how, how easily can the parents convey that to me? 'Cause it's a real, like, danger sign if the parents [01:08:30] themselves are losing that vision of who their child really is as a person.

[01:08:36] Stephanie: You know, the, the person they're gonna become as an adult is not the person they were as a child, but there are some common threads. [01:08:45] And what I'll remind pa- parents of this when they say, "I just want my little girl back," or they say something like that, I'm like, "You can't get them to go back in the womb."

[01:08:53] Stephanie: And if your vision of success To them feels like giving up autonomy or going [01:09:00] backwards in time, that's not gonna work, right? You have to be able to have in mind a vision of who they're becoming, who they're capable of becoming, that leaves room for the possibility that, of the parts, all the parts that aren't yours to determine, but that s- you [01:09:15] know, has some of those good threads from who they've always been.

[01:09:19] Stephanie: What are those, like, aspects of their character that have always been there that are going to show up in one form in- or another in adulthood? But also all this potential, right? Like, do you have [01:09:30] regard and love, um, and can you keep the hope for that person that they're growing into? 'Cause as long as we can have a shared vision, it doesn't have to be prescriptive, it doesn't have to say, you know, "They're gonna become a doctor, and they're gonna do all these th-" No.

[01:09:44] Stephanie: It's like, but [01:09:45] can we see the unfolding? Because if we can keep that vision in our mind, then we can treat the unfolding young person as a work in progress, and we can gauge our actions accordingly to support that future version of that [01:10:00] person emerging.

[01:10:01] Ryan: I, I love that. I think, you know, I, uh, even though they're very different areas with you with the gender thing and me with addiction, I think there's a lot of overlap there because a lot of these people can't go back to who I was in [01:10:15] high school before drugs entered my life, you know?

[01:10:17] Ryan: It's like-

[01:10:17] Stephanie: Right ...

[01:10:18] Ryan: that's, this has already happened. These years of, of abuse have already happened. Like, we gotta kind of take some of this person that's, that's come through that and, like, add some- something new on [01:10:30] top of it, right? Like, you can't just, like, become that old person again. Like, you're, you're forging a new human being in a sense.

[01:10:36] Ryan: There's still part of you, uh, that's, that's lived that old life, but there's, like, this, this new element as well. I, I really like how you phrased that. [01:10:45]

[01:10:46] Stephanie: Well, Ryan, it's good to talk shop with you. Uh, were, were there any, like, lingering threads we left behind that you wanted to put a final spin on?

[01:10:54] Ryan: I don't think so.

[01:10:55] Ryan: I think we had a fantastic conversation. I always love talking to you, Stephanie.

[01:10:59] Stephanie: Cool. I [01:11:00] enjoyed it as well. And, uh, so I guess we should talk about where can people find you.

[01:11:06] Ryan: So I'm on X, uh, @ryanmcrodgers, um, and then Ryan Rodgers on YouTube. Those are the two main places that I post. Um, [01:11:15] yeah, you can find, uh, either of these two books on Amazon.

[01:11:19] Stephanie: And for those who are just listening and not watching, Ryan's gesturing to the books behind him, his books The Woke Mind and The Carpenter's Recovery. Yes. And we'll include those links in the show notes. [01:11:30] All right, Ryan, thanks so much. It's been a pleasure.

[01:11:33] Ryan: Same here.

[01:11:35] Stephanie: Thank you for listening to You Must Be Some Kind of Therapist.

[01:11:39] Stephanie: If you enjoyed this episode, kindly take a moment to rate, review, share, or comment [01:11:45] on it using your platform of choice. And of course, please remember, podcasts are not therapy and I'm not your therapist. Special thanks to Joey Pecoraro for this awesome theme song, Half Awake, and to Pods by Nick [01:12:00] for production.

[01:12:01] Stephanie: For help navigating the impact of the gender craze on your family, be sure to check out my program for parents, ROGD Repair. Any resource you heard mentioned on this show, plus how to [01:12:15] get in touch with me, can all be found in the notes and links below. Rain or shine, I hope you will step outside to breathe the air today.

[01:12:25] Stephanie: In the words of Max Ehrmann, "With all its sham, drudgery, and broken [01:12:30] dreams, it is still a beautiful [01:12:45] [01:13:00] world."