"Levels of Care" with Pat McDonough LSW

Patrick McDonough is a Licensed Social Worker working as a therapist at Integrative Counseling Services. In addition to being an LSW, Patrick is a Certified Advanced Addictions Counselor (CAADC), holds a Certificate of Competency in Problem Gambling (CCPG), and is EMDR trained. Patrick has experience working in clinical and business development in the residential treatment in the field of substance use disorder. Patrick primarily works with adults presenting with trauma, addiction, depression and anxiety. He received his BA in Psychology from Penn State University and his Master’s in Social Work from Marywood University. Patrick is passionate about utilizing a person centered approach and creating a safe space for individuals to work through whatever barriers they have to achieving contentment. 

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 Discussions on addiction and recovery. We interview clinicians/researchers, legislators, and individuals that include a variety of means to recovery. Joe Van Wie is a father, husband, filmmaker, and reformed media consultant in recovery. 

Transcript

Joe Van Wie  0:08  
Hello and thanks for listening to all better. I'm your host, Joe van wie. Today is episode 20. And I wanted to give a shout out to Trisha right, Trisha thanks for being a patriot. Today's guest is Patrick McDonough. Patrick is a licensed social worker, working as a therapist at integrative counseling services. In addition to being an L SW. Patrick is a certified advanced addictions counselor. He holds a certificate of competency and Problem Gambling is also em Dr. Trained. Patrick has experience working in clinical and business development in the residential treatment. In the field of substance use disorder. Patrick primarily works with adults presenting with trauma, addiction, depression and anxiety. He received his Bachelors of Arts in Psychology from Penn State University, and his master's in social work from Marywood University. Patrick is passionate about utilizing a person centered approach and creating a safe space for individuals to work through whatever barriers they have in achieving contentment. And I also talked about the circumstances that produced his own long term recovery today. I hope you enjoy and let's meet Pat.

Pat, I would like to welcome you for the second time in studio, but the first time people will be hearing you that was a that was heartbreaking. technical error here and a corrupt SD card. Our first interview was lost.

Pat McDonough  2:09  
It was it was heartbreaking. You know, and in a way it makes sense to me. It felt it felt good. It felt organic, the most natural anything it felt to me in some time and you know, only to have it be wasted.

Joe Van Wie  2:28  
Well, it's at Rhodes studio right now, wondering how my file got corrupted. There's very high level people at Rhodes.

Pat McDonough  2:39  
So Road Studio, if you're listening, yeah, we'll leave that footage.

Joe Van Wie  2:43  
It's unscramble it. It took three months to to pin you down to there was a lot of transitions in your life, you started a new gig, you were engaged. And I was trying to get in here for some time. We've been friends. And you've been a helping hand to me and my return to recovery. And I wanted to talk to you about all the changes in your life that are still changing. And sit down for an hour. I finally get it. We have an organic conversation. And it's scrambled.

Pat McDonough  3:18  
But you know, it was it was a beautiful hour and six minutes, I think is what it came out to. Yeah, we it was it was good conversation, deep conversation. And I'm so grateful for it no matter what.

Joe Van Wie  3:34  
Well, now that you're back again, and I am to let's reestablish for anyone who hasn't met you be who is Pat McDonough. And how did you end up in recovery yourself?

Pat McDonough  3:50  
So, Pat McDonough and grew up in green urge Catholic school boy and great family, great friends. And I wound up in recovery for good in 2011 After some failed or half assed, however you'd want to word it attempts starting in 2008, another in 2010, and sober now since June 28 2011, after a series of misfortunate events, but ultimately, events that I believe were necessary to convince me what I needed to be convinced to be willing to embrace recovery.

Joe Van Wie  4:45  
And how old were you in 2011 2323? So from the age of 20 to 23 2008 2011 the entire process of people around you on your we're now well in it action could be about harm, you seriously took three years to get stabilized to give up and accept some form of recovery.

Pat McDonough  5:11  
Yeah. With any with any significant length of time. Yeah. So oh eight, was straight out of college to Clearbrook. And that basically didn't last at all, learned a lot of valuable lessons that I still carry with me from that experience to this day. 10 2010 February was a little bit more serious. There were two DUIs within a four month span just before that. And at that point, I really believed I was done. I believed I was going to be sober for the rest of my life, which I learned later on was my first mistake. Yeah. Having that level of confidence. I think it's okay to be confident. But I think, you know, with that confidence I had at that point, I lacked awareness. Yeah. And it got hard six months in, and I wasn't willing to be sober anymore.

Joe Van Wie  6:15  
So for six months, that confidence, would you say, that was coming from your intellect? And this this decision that you think you had will you can exert?

Pat McDonough  6:26  
Yeah, it was. Yeah, I'd say you can base it pretty much purely on intellect at that point.

Joe Van Wie  6:32  
Yeah. Here it is. Here. He said that that's not enough.

Pat McDonough  6:37  
Yeah, yeah, absolutely. Yeah, I thought I thought I was convinced that I couldn't pull it off. The other thing is, I thought that I would instantly be happy. I thought, because I made the decision in a moment that I wanted to be solver, that I was just going to be solver, and that life was going to be easy. And that's where I made my biggest mistake, because life was not easy. And if if I gave the details, a lot of people would probably say, well, that that sounds kind of easy, actually, compared to a lot of other recovery paths. But it wasn't because in my mind, I was still struggling greatly. And I didn't know how and I just, I didn't see I didn't see a way out other than chemical use again.

Joe Van Wie  7:35  
If we could pause right there, because I like to establish when anyone is telling their story, their personal story about that. Why is that? What is the prior condition that you can't see a life without what what we're calling? Some people would say drinking, indulging in drugs. It's basically a medication we found to the people I relate to. Yeah, prior prior scenario. What would you describe life without drugs? And recovery? What what what was your sober mind? What was the state of your sober mind

Pat McDonough  8:09  
deficient? Yeah, deficient, less than inferior? Uncomfortable. Just didn't feel like an even playing field. And I told the story of last time, I'll tell it again real quick. Because I think it sums it up. The easiest, but first time I ever got drunk, I'm ashamed to say I was wine coolers of when I was when I was a freshman in high school. And I literally did not I did not know why people drank alcohol until I had my first bus. Like I had always seen a lot of people drink. I had, I had had a few beers here and there, like seventh eighth grade, but nothing legitimate. And I remember the warmth, the confidence. The the energy, but at the same time, a calmness. Yeah. And I was just like, Holy fuck. Well, I did. I didn't realize I could ever feel this way. And at that point was one. In my mind. I had been deficient. All those years. Yeah, life wasn't fair. Yeah. I had an itch that I didn't know how to scratch. Yeah. And the journey began, and you

Joe Van Wie  9:38  
have siblings, and from all appearances and my understanding, you have a great family. Yeah. And you have great parents and great siblings and a community and, and a large, extended family that's just supportive and really wonderful people. So how could this happen? Like Like how does this happen? And I've heard that but you know, I never got an intellectual answer from the age of 16 to almost 39 Like what what does happen? It's just a love cosmic lottery that is this a gene that no one really could fully explain to me some primordial gene that makes us what addicts well I would evolution causes like to alcohol to drugs to release dopamine was that befuddling? Were you did you have to consider that in your head at all? Did that ever torment you trying to understand what what caused this?

Pat McDonough  10:36  
I actually never really got too wrapped up in that you should start. I was I was told from the age of about 16 by my father repeatedly that it was genetic. Yeah. Oh, yeah. And I kind of, you know, I knew I had it in my, in my family, my grandfather, my uncle. And I started, you know, every now and again, Googling things and reading different things. And you know, for me, there were that and that's, that's the scary and the dangerous thing about addiction is all all the all the right pieces could be there. And it can still happen. You know, like, I had that support, I had attention I had love, I had friends I had, you know, good education and never wanted for anything, but internally something was off and for whatever reason, you know, my my chemical makeup reacts to alcohol and drugs in a way that that becomes completely compulsive and unmanageable.

Joe Van Wie  11:58  
And Dr. Gabor Matta is profound work in the realm of hungry ghosts close encounters with addiction in chapter 18, titled trauma stress in the biology of addiction. It refers to the three dominant brain systems in addiction, the opioid attachment reward system, the dopamine based incentive motivation apparatus, and the self regulation areas of the pre frontal cortex. With describing these systems, he says there's three prior conditions to addiction that may not look like historically, what we would call trauma or abuse. He refers to the subtle process of attunement. He also refers to insecure detachment and attachment styles, and trauma. Now, the most subtle of these processes is attunement. Attunement is a subtle process it is deeply instinctive and easily subverted, when the parent is stressed, depressed or distracted. Any one of these conditions can mute the ability to build those reward systems and making it more likely for addiction.

Yeah, I, I relate profoundly to that. But you know, I had dysfunction around me as well. But that's to the degree that which, you know, what is it about that that doesn't make all of us alcoholics or addicts upon using something that euphoric, like does that heighten a regular person's not to dependency or use disorder disorder develop? I think, this year, maybe last year, reading a lot of Gabor Matta his work on Attachment, disorders, attunement, cortisol building up in a pregnancy, from stress. A narrative got completed in my head that was just out of intellectual curiosity. It's not something I think someone needs to understand or articulate to be sober because I was sober without knowing that. But it was starting to make sense of like, oh, wow, this addiction arises out of a culture, a stressful, anxious civilization, that mute your ability to soothe yourself with dopamine or your opioid system. This made sense to me like, Oh, this isn't and so the gene seems to be really irrelevant, unless it's activated by cortisol or or nature. Like it's strange. Like it's a real it's not fully understood to but it seems like we're getting closer.

Pat McDonough  14:45  
Definitely getting closer and regardless of my degrees and certifications, you know, I'm always willing to tell you when you know more about something than me and these these last these last few years In particular man, you have been just on a tear with figuring things out and getting educated on addiction in a in an ambitious way that I haven't seen anybody do in a long time if ever and credit to you

Joe Van Wie  15:17  
don't sis Geez Come on every week. That's freakish man you saw. You saw my relapse and we were always friendly or would if I saw you at a coffee shop, we would spend time together we had a lot of mutual friends. And I can only imagine through your eyes, I was sober 14 years, that relapse looking back at it. I've space of two and a half years now I was just telling you, it feels like I was hypnotized. Like, I'm waking up from it. Like a real. The word having an awakening is more profound to me now it's not supernatural, right? There's something cognitive or consciously happening to my mind. That just frightens me to look back at that, to think, Wow, if I don't take care of myself, I fall asleep. And then if I'm really in a deep sleep, it's safe to use drugs and drink for relief. It's I think I was just so frightened and humiliated and confused by what happened to me that I'm like, What am I not understanding? Now? There was like two tracks intellectual curiosity to fully on it. But I had to take a leap of faith or just trust somebody that maybe they understand how I could get better. Maybe I should trust this, because I don't really don't again, I feel totally lost man. And I think you've watched that happen.

Pat McDonough  16:46  
Yeah, and but what I've watched even even closer, has been your comeback in your recovery sense. And, you know, it's been incredible. And to that point, I think, I think, you know, that speaks to the fact that this internal thing that I mentioned earlier, this internal condition, be, you know, once once we get our first euphoric episode from drugs and alcohol. And we realize we recognize retreating that deficiency, that deficiency, it's still in me, somewhere. Yeah, me too. And, you know, what I do on a daily basis. And what I do over time, dictates how much that deficiency is going to control my behavior. Yeah. And if it goes unchecked for long enough and speaking for myself, if I don't have people in my life that understand that, that care that are willing to confront me if needed, in a loving way, then you know, that that happens to me. Yeah, just as easily. I want

Joe Van Wie  18:02  
to talk about that a little later on, of how that changed for all of us in the last two years of what is immediate care for people who have substance use disorder, being in a room full of people that you can relate to no have it with all different degrees of recovery. That changed monumentally. And that's, that's a huge change in the field that you're in now, especially, of how you give individual care. You worked in inpatient treatments, and all levels of care, you're now an outpatient? I want to start, why did you go into this field? And when did you decide that this was where you belong

Pat McDonough  18:43  
in 2011, I was in treatment. It was my last time in treatment. At that point, I was I was broken, but I was motivated. And excuse me. A couple of people, I went to some meetings and a couple people came to me and said you got to you got to go back to treatment. I know you don't want to I know you're just there. But you got to go. And it was one of the best decisions if not the best decision I ever made in my life that I wouldn't have made on my own, that I was encouraged to make. And I was in a small group. I was given feedback. One of the counselors running the group came to me after asked me about my education level said to me that I had a great understanding of addiction, which was one of the only compliments I had gotten probably in years at that point, rightfully so I didn't deserve many compliments. It was one of the best compliments I ever got. I felt I felt pride. I felt some sense of achievement with that. And right there in that speaks to my condition and the deficiencies that I can live with but, you know, make make to a much greater scale in my head. That was one of the things that I recognized that I hadn't felt any sense of achievement really before. I hadn't felt like I had any, any level any semblance of mastery in anything or competence in anything. This felt natural to me. Yeah, it was, it was hearing, you know, people's stories, or just, you know, whatever individual barrier somebody had. I felt that I was able to empathize with it. Understand it, to some extent, yeah, you know, as much as a bystander can and give some feedback, and just between the bad experience and that conversation. It's something that stuck with me. And up until that point, I had no idea of what I wanted to do. For work for

Joe Van Wie  21:09  
what were you studying in school prior to? I don't think I even declare any I didn't

Pat McDonough  21:15  
declare anything now. Nothing was declared my life. Yeah, major did sleep. Yes.

Joe Van Wie  21:24  
Well, you know, what the defining thing you just said there is if you read any approach to social sciences, you know, psychology or, or clinical psychology, especially, an attribute you can't really train yourself in is deep listening, deep listening, that produces empathy. It's kind of a natural skill. I hate saying that about many things. But that is a natural skill. For for whatever reason, nature, especially nurture, that you have, and you you have that there's a lot of people in the field that don't try it, and they're wonderful people, but so much is missed in the delivery of treatment, or clinical treatment, because of their inability to listen deeply cheer to a person and, and let the client start to tell the story, not tell them some canned kind of piece of advice. And I've seen that and you you have this unbelievable ability to listen deeply. So you know, you have that that ability and need, it's a virtue. What How did you return to school, but early sobriety went right back to school to get credentials to start to pursue this.

Pat McDonough  22:45  
So I waited about a year before I went back to school. I was working two jobs that were, you know, such they were some form of stability for me and the perfect bridge back into, you know, ultimately what I wanted to do and came to do. But I went back to school, and I started off small I started six credits, I had about 50 credits when I went back. Yeah, I started off six, and another six, nine over a summer, then to full time, then I got a job that Clearbrook at the time. And then it was like, you want to be in this field and you want to grow in this field. You need a master's degree. Yeah, if you're going to be anything clinical.

Joe Van Wie  23:36  
So what did you finish undergrad with? Was a psych or psych

Pat McDonough  23:40  
psychology. Yeah, it was the first ever bachelor's degree in psychology from Penn State Scranton

Joe Van Wie  23:49  
really all that's awesome when they had 20

Pat McDonough  23:51  
Yeah 2015

Joe Van Wie  23:53  
I've been taking classes and onStop it was earn all one recovery does a grant that's right but recovery grant now people pursuing school and I always put information that offer Wow, okay, Psych and then you start at the best spaghetti house in the world for drug and alcohol treatment. It's Clearbrook the best you know, you have three to four decades of multiple people with four decades of experience that have saw saw the humanity coming in in the form of treatment, changes in the law changes in insurance what can be covered that it watching it culturally be declared yet this is a disorder of a serious need a fatal one. A lot of the guys that were your mentors experienced that and some were Mavericks of youth, your clinical director that was leading you then just okay. Yes, Mr. Can. I've been trying to get him on he keeps telling me next week and

Pat McDonough  24:57  
can't be trusted. Now I'm kidding. Oh, He's he's probably one person that genuinely is that busy.

Joe Van Wie  25:05  
Yeah. Could do. So you just finished school. What was your position there while you were starting your masters, we behavioral

Pat McDonough  25:14  
tech, primary counselor right away.

Joe Van Wie  25:16  
You didn't You didn't need never did a position as a tech.

Pat McDonough  25:22  
So I got a call from from a gentleman, Mr. Knowles. Yeah. And

Joe Van Wie  25:31  
he was just here, he.

Pat McDonough  25:35  
And he was someone that became a mentor since I came into recovery. And he was someone that I talked to about wanting to get in the field. And he was always really supportive and encouraging of that. And he, he called me and said that there was a position open to Clearbrook. And that I should call Dakota boy. So I said, What is it tech? And he said, primary counselor, and immediately my heart sank like, oh, shit, yeah. Can I can I do that? So it was one of those deals where I went in kind of, like, half wanting nothing more in the world than to be a primary counselor at Clearbrook where I went, where my recovery was born. And half. Oh, shit, terror, and I do this. Yeah, terror.

Joe Van Wie  26:26  
Boy, screw up what I want to do. Yeah, that's yeah, that's scary. Refugee care. I mean, do you care?

Pat McDonough  26:32  
Yeah. And I did, and I got it. And I had, I had Joe there and other colleagues there, that were really supportive and really, really good at what they did. And they had an environment cultivated there and an atmosphere that you know, to me was second to none, with with delivering truth. Compassion, and, you know, ultimately, recovery. And I don't know how I would word it's a loving way. Stern at times. So the word forthright

Joe Van Wie  27:18  
Yeah, the old guard was tough. Yeah, they had some grit. And it was needed for the time. And the culture. I mean, demographics change every decade of who's going to need treatment, so does culture it does straights to a degree deaf. And they saw a lot, and it was a good place to learn. Your craft your trade in your field, you have you been able to do this? Did you immediately pursue a master's while while you were there? Did that kind of just take form while you were working as a primary counselor,

Pat McDonough  27:53  
I was there probably six months. And I went, Yeah, I was there about six months or so. And I went in, and I went through the same program that Joe did. So I was able to talk to Joe about the program. And you know, he said to me, just do it. Yeah. So I went in, and I did it. The part time Saturday program. And, yeah, three years later,

Joe Van Wie  28:18  
that was Marywood. Yeah, you have a good program. Yeah. Master's in Social Work Out of my curiosity of recovery. And, you know, we we found our baseline of support, both not making an assumption here from 12 Step communities. Yeah. And that's peer to peer support. you're pursuing a master's? What, what were you? What? I don't know. What did you learn in graduate school? That puts you in a clinic like, that is a distinction from peer to peer help, like that? No one could understand. And in a clinical setting, recent research and things you needed to know was there discoveries there would you say?

Pat McDonough  29:01  
There wasn't there wasn't jaw dropping? Yes, discoveries. One thing I did learn was, how broad mental health is, yeah. How, how, how there's just so many treatment modalities. You know, learned about a little bit about policy and advocacy and ethics. Trauma, there was a pretty heavy trauma focus, which which I you know, I'm ashamed to say I really wasn't I wasn't educated on to the point that I should have been.

Joe Van Wie  29:47  
I don't think a lot of people were back then or or in the term itself trauma. CO occurring conditions with the average site was ADHD depression. In bipolar disorder, I don't remember hearing trauma until like, as a relevant term attached to addiction in all different forms till my late 30s. Like, why are they seeing a car accident? With someone, you know, was this violence? I didn't realize what's how broad the term was. Yeah, man.

Pat McDonough  30:21  
Yeah, yeah, absolutely. Well, and, and it makes sense, unfortunately. That it took so long for the addiction field to really embrace it. Because I think I hope I hope I'm not wrong here. I think it wasn't established as a diagnosis until 1982. Post Traumatic Stress Disorder. Yeah. And you know, that that took what it took.

Joe Van Wie  30:50  
And post PTSD would is, is it's trauma, it's a result of lasting trauma, memories causing an emotional upheaval as if the event is happening again.

Pat McDonough  31:03  
Yeah, yeah, you're you're the symptoms that you have in response to a traumatic event. Yeah. So amount and frequency in

Joe Van Wie  31:11  
PTSD is the last theme of the event. But then, I don't know how to speak to it intelligently, like, there is traumas that really aren't real or perceived that now you can't even articulate an event. It's just it's becoming a pattern of how you respond to your relationships. Your life, it starts to collapse.

Pat McDonough  31:35  
Yeah, yeah, absolutely. And, you know, with with trauma and adversity, and, you know, depending on the events that happen in our lives, you know, for me, it could be so I'll say it this way. I took a training that I've told you about an EMDR eye movement, desensitization reprocessing therapy. And part of that process was us going through EMDR. ourselves. So EMDR has been performed on me. Yeah. And, you know, here I am, as I described earlier, a, you know, grew up in a fine neighborhood and home and what my conception of trauma was, was combat. And, yeah, not, not when I took the training, but years ago, my conception was combat and major disasters and near death experience. I never, I never viewed it from the perspective of, you know, what is sometimes referred to as little T trauma,

Joe Van Wie  32:51  
little T, I'd never heard that. Yeah,

Pat McDonough  32:53  
big T, little T. And what I noticed in the training was a series of rejections in my life. And that rejection was a major theme for me. And we were doing what you call a float back technique. Where I, you know, had brought up a more recent negative feeling that I had based on an experience and my perception, and you know, floated back to an earlier time that I felt that way. And boom, this moment from first grade, pops into my head. Wow, when someone had made a comment to me about my weight. So I was a husky kid. And it was something that I struggled with, especially internally, you know, I didn't let people know that in first grade. Yeah, yeah, I'll probably up until eighth grade. You know, and then still, to some extent beyond that. And it just, it just hit me there. You know, it's, it's our, it's my emotional response to, you know, any, in any event that I perceive as rejection or failure or

Joe Van Wie  34:15  
right back to that same pathway. It's the same synapses firing at one, what's a one year old? Or a first grader? Maybe eight? Something like that? Yeah. I don't even know you don't know your sovereign person until you're eight so you're forming your personality can be built that's what that's why I started absorbing this idea of what trauma was beyond an event or tragedy like your yourself. This, this was probably a critical experience to form your personality, identify shame, kind of weave it in there, like a sweater. And one of the big threads is shape. Yeah. That's identified over and over. That is is the beginning of addiction. So when you do find drinking for me, I don't want to speak for you. But it's like getting the sense. There's a medication for something that's already pulsating in a brain with your personality, your self image, or identity. And it could start there and other traumas will build upon it, even if they're misperceived. Are they talking about my weight?

Pat McDonough  35:24  
Yeah, yeah. And any, any, any related incident? Yeah, you know, you're, you're on alert, based on previous experience. And

Joe Van Wie  35:34  
that's, that's wild, wild. In so when you did this therapy, it was in the training, it was this the first time you discovered went back to that experience in such detail was through the light there.

Pat McDonough  35:50  
It was the first time it was so specific to that particular circumstance. 12 Steps had similarities, but nothing like this, you know, I, I didn't, I didn't think that I could sit there in a forced situation. So mind you, like it's forced, and there's a little bit awkward. You know, it's not like I had chosen to go to therapy, and this was going on for for weeks, and it kind of built up to that point and training. Yeah. Is this training? Yes. This is training, you know, we break out. And, and so I didn't think I didn't think I'd get results like that when it when it felt so forced. Yeah. But once that happened, it didn't feel as forced. And I was able to go through the process. So yeah, it was it was the first time it was a unique experience. No doubt.

Joe Van Wie  36:50  
Now you sync go through the process. So you follow the training of the light. This comes into your head cognitively, form of a memory. Almost a revelation. This is a real memory. Yep. Did you articulate that to the facilitator? Is there a therapeutic end? I know it was a training, but like now, would that be?

Pat McDonough  37:13  
I did. Yeah. Yeah. You don't have to tell the whole story. Sure. Basically, try to sum it up in a statement or so like the image you're getting to the soil, say, you know, I remember when I was in first grade, and, you know, such and such said this.

Joe Van Wie  37:36  
And how did that feel to like, now you have the revelation, you've been sober, you're sound of mind and you're pretty sane guy and you practice a lot of things that were self care. Was there a hedge to tell someone did some of the shame come back because it's absolutely found the original sin here, this is where I got hit the first harm.

Pat McDonough  38:01  
Yeah, I felt it, I felt the shame. I felt the rejection. I felt it in my body, which is another part of the process where you identify what you're feeling in your body. And, you know, my palms, My palms are even getting a little sweaty, just talking about it now.

Joe Van Wie  38:17  
Well, mine aren't because I'm thinking about it. And I know there's something about the light that makes the person I don't know what it is, but it makes them objective like you felt when you remembered it. Did you feel safe? Did it only feel weird when you had to now? Make the statement? That's what I guess I'm really curious that.

Pat McDonough  38:38  
Yeah, yeah. Making the statement. So there were and there were three other people there. So it was colleagues as it was, yeah, that was part of the embarrassment. But yeah, it was also humbling. It was also Yeah, it was gratifying in a way and then going through the actual processing part of it using bilateral stimulation, which for me at that point was tapping.

Joe Van Wie  39:11  
Tapping like physical touch. Yeah. Tapping tapping my shoulders. Yeah. bilaterally. Wow,

Pat McDonough  39:19  
I was able, you know, I was able to see another side to it and I was able to, to kind of not detach from it but but detach from the strong emotion of it, I guess you would say

Joe Van Wie  39:33  
yeah, your your objective it's it's non judgmental, almost in Zen quality. So Buddhist practice of

Pat McDonough  39:41  
to me it felt very It felt very much like like a good meditation in a way

Joe Van Wie  39:47  
would you use the word curiosity about yourself now objectively, like you can view yourself with a curiosity that dis distances from shame, like, like, like it's like curiosity. Why is this? Like, why? This is the circumstance of the memory? But what did it caused all of this to repeat like a personnel? That's what I experienced this last time around. And not from that therapy, but an objective curiosity about me being removed from the me like, What is a job fair? We, but yeah, why can't he get, like homeostasis with the being alive?

Pat McDonough  40:27  
without drugs or? Yeah, yeah. And it's a scary place to go. Yeah. And it's a lot of work. Yeah. And I don't, you know, I'm due for a deeper dive into, into myself, you know,

Joe Van Wie  40:44  
you say that, but listen to what we're doing. We're on two microphones. The reason you speak about this so clearly, because of the effort it does, because it helps people, you help a lot of people, and it's because you're honest. You're an honest guy.

Pat McDonough  41:00  
Yeah. Thank you. I appreciate that.

Joe Van Wie  41:02  
You're honest about your recovery. Every time I've heard you speak about it. People are helped by you because you're talking about what you just talked about. I mean, everything else kind of cliche. Sure, especially today. It's 2022.

Pat McDonough  41:19  
Hard not to be cliche. It is a, you know, cliches are

Unknown Speaker  41:22  
great ways to wrap up complex ideas for for sure.

Pat McDonough  41:26  
Amen. Yeah. Amen.

Joe Van Wie  41:28  
Yeah. That I my curiosity won't end yet on light therapy. It's really to just start from a basic zero psychology, just understanding the basic mechanics of what Freud or Jung started to is now, some dude figured out if you tap on top of your

Pat McDonough  41:52  
torso, white woman, Francine Shapiro, yeah,

Joe Van Wie  41:56  
you're tapping? Yes, Shapiro. She's all over lifespan. Studies. Like what what work like What a fascinating mind. I know it'll work. Let's get the light in here. Almost mimic REM. And in Tapi.

Pat McDonough  42:14  
Yeah. And she so orig. Obviously, the name eye movement could because she discovered it through eye movements when I believe she was in a park one day was going through, you know, a trauma of her own and was following birds. I think it was and recognize this change that occurred in her and then she went into studying it and carried it out into what it is today.

Joe Van Wie  42:46  
In 1987, Francine Shapiro was walking in the park when she realized that eye movements appeared to decrease the negative emotion associated with her own distressing memories. She assumed that eye movements had a desensitizing effect. And when she experimented with this, she found that others also had the same response to eye movements. It became apparent however, an eye movements by themselves did not create comprehensive therapeutic effects. And so Shapiro, added other treatment elements, including a cognitive component, and developed a standard procedure that she called Eye Movement Desensitization. EMD. Shapiro then conducted a case study and a controlled study to test the effectiveness of EMD. In the controlled study, she randomly assigned 22 individuals with traumatic memories to two conditions half received EMD and half received the same therapeutic procedure with imagery and detailed description replacing the eye movements. She reported that EMD resulted in significant decreases in ratings of subjective distress and significant increases in ratings of confidence and a positive belief. Participants in the EMD condition reported significantly larger changes than those in the imagery condition. Shapiro wrote a single session of the procedure was sufficient to desensitize subjects, traumatic memories, as well as dramatically altering their cognitive assessments. On four unfortunately, Shapiro has often been erroneously cited as claiming that EMDR can cure PTSD in one session. Shapiro never made the statement. What she actually wrote was that the EMD procedure serves to desensitize the anxiety not to eliminate all PTSD related symptomology and complications, nor did a prop provide coping strategy He's for the victims and reporting an average treatment time of five sessions to comprehensively treat PTSD. In 1989 was the first year that controlled studies investigating the treatment of PTSD were published. Besides Shapiro's Article Three other studies were published. The Brahm study compared the results of psychodynamic therapy, hypnosis, the therapy, and desensitization and provide an average of 16 sessions. It found clinically significant treatment effects for 60% of the civilian participants, with no differences between the conditions. The Cooper Klum study compared flooding, to standard care and veterans administration's hospitals. They reported moderate clinical effects after six to 14 sessions with a 30% patient dropout rate. The keen study compared flooding, to a waitlist control for veteran participants and reported moderate clinical effects. After 14 to 16 sessions. For more information, visit emdr.com. And it's history.

Pat McDonough  46:16  
But yeah, there's just there's incredible stories about it. And it's fascinating. And to go back to the grad school for a second, like, these are the types of things that I started to hear about in graduate school things that just yeah, they weren't referenced in, in treatment, no. years ago, some treatment centers they may have been, now everybody's talking about it, it's emerged, right? It's emerged. But like, you know, that's one of that's one of the biggest benefits of broadening your horizons, and, you know, reading and doing trainings and talking to people is, you start to learn, I mean, it's overwhelming the amount of I could modalities that there are, but they're difficult to master. And, you know, for me, there's still, there's still a lot of time education and practice that has to go into being able to master these.

Joe Van Wie  47:20  
And they all have merit to the individuals that would need them that some work on some and some don't. And they get to a point where you'll find your stable, long term path to recovery. Exactly. I always wanted things to be binary. And it's maybe it's a taste of the region we grew up into. It's the bravado of wanting to be masculine, it's yes or no, I want to do it the fundamental way. And you lose sight of what the answer is, is to stay open. Be humble, and not be a false expert. You only have a man only has so much time and a woman to actually be an expert at something. It kind of pivx wanted me to I wanted to pivot with a couple of questions, because that'd be he said you didn't have a handful levels of care. Clearbrook Brookdale Brookdale. You wore that was a huge population was a different demo. A little bit thing. Clearbrook for sure. Had 30% Medicaid 70% They had a really nice recipe for cultural and community success. They're the the patients and residents.

Pat McDonough  48:36  
Yeah. Clearbrook when I was there, we were probably about 40%. Medicaid actually 60 Private. Yeah.

Joe Van Wie  48:42  
And then Brookdale seems, you know, it's it's exclusive. It's serving a wealthier demographic of for the most part, luxuries. Hmm. And without judgment that needs to be served. You You did a stint there. And now you've transitioned four out of a desire to do longer work, long term recovery work and outpatient. And you've been doing that for a couple of months now. Was that? That's one other aspect that's kind of really different. Was that a big change for you?

Pat McDonough  49:27  
Yes, and no. I had a lot of experience in the drug and alcohol space, particularly the inpatient space, and in between Clearbrook and Brookdale was my stint as a marketer in business development for treatment. Which gave me a lot of insight and a lot of experience and got to meet a lot of great people and learn a little bit more about the business side of it. So Oh, after that I went, Yeah, I went back and as a clinician to Brookdale we did we did serve a different demographic than I was used to. And even even from 2018 to 2021. I felt like I felt like I felt like populations not not not just population change, but people changed. Yeah. And culture changed. culture changed. And

Joe Van Wie  50:34  
always will. Yes, as far as I could tell from what I'm reading about, yes.

Pat McDonough  50:41  
And it's, you know, the thing, the things that you did in treatment 10 years ago, even five years ago, you know, the way the way that you carried out an intervention, it just can't be done that way anymore with with certain people. And when we talk about individualized care like that, that's a real thing. Yeah, at least it should be a real thing. And, for me, it was, it was it was not the right fit for me, ultimately, because it was hard. I like to be organic, you know, I like to build rapport, and not in any kind of a controlled or coerced course to fashion. Totally organically. And I just found that difficult to do, within, you know, three to four weeks. So being in the outpatient setting, and working with still addiction, and I love, I love working in substance use disorders. But also, you know, more in depression, depression, anxiety, and trauma and, you know, relationship difficulties. And, you know, which is not as much my speed necessarily as addiction is. But nonetheless, you know, things that I'm really interested in and take a lot of pride and working with people on. It's just a better fit for me, and it's a better fit the setting, you know, the,

Joe Van Wie  52:31  
that's nice. Yeah, it's a nice change. And it also, I think, gives insights, if someone doesn't understand the field of clinical how complex levels of care different forms of care are, not only just with drug and alcohol, now you're transitioning to some of your patients could be non alcoholic, have no history of substance use disorder. And we were, we were talking about it earlier, that's, that's a change to give therapeutic treatment to someone whose baseline doesn't be you need to stop drinking and using drugs. And that's, she's such a clear line to start a therapeutic relationship. Being an alcoholic, and that's all my therapy has been around and at drug addict. That was the goal. The main goal was tangible. If you're sobered the therapy's working.

Pat McDonough  53:27  
Yeah. Yeah, exactly. Exactly. And it was so it was so easy for me in the residential setting to get caught up in you know, hope they get through detox without much of an issue. hope hope that my client is going to be able to sleep stages. Hope that you know, we can do some family sessions and some individual sessions, you know, hope that they take away a good experience from this. And hopefully they'll go on to aftercare Yeah. or long term care and being completely honest, it was easy for me to get caught up in like that picture. Yeah. And those details rather than what's this person going through right now? And I don't know if I don't know if anyone sitting across from me ever perceived it that way. Because I think I did a pretty decent job despite what I'm saying now at having them not perceive it that way. Because I I do I do care and you know, always did always will always give it my all but it was easy for me to perceive it that way like that. That's what I was doing. And I didn't like that feeling. Yeah.

Joe Van Wie  54:51  
I while you were talking, just discussing that I was just it just popped in my head I listen to right 30 hours of Alan Watts, recording TV. Are you familiar with Alan Watts?

Pat McDonough  55:04  
I've heard the name I don't know much about him.

Joe Van Wie  55:07  
philosopher, writer, great author, spirituality, New Age, very proficient Hindu, then Christian history. You he's a Briton, your kind of guy. Yeah. snarky really funny, perfect 60s movement. You know, I was listening to a seminar, about 30 minutes, when I find it, I'll send it to you. And he's talking about therapy. And psychology is the new priesthood. So this is probably a seminar from the 60s 68. And he goes, what is it that you're going to see a psychiatrist, psychologist, therapist for you want to change of consciousness, and there's got to be an alliance and allegiance there for a report. This is the new priesthood, you know, so it's, it's it's priesthood without religion. Like we're using method, but in the end, what a what is the result for depression, anxiety for myself, I want, I wanted it to go away. But what the consideration is, you have to have a new consciousness, like that's a fundamental change on how you view and believe that this world material world exists, and your role in it. That's a revolution you need. If you're going to have a sustaining order, outside of maybe some medication assistance, non medication assistance, you need a change of consciousness. Yeah. And what is that? And the tools that are being used now that you've been trained in the light therapy, to the years of listening, addiction. Does that does that feel you still need to create some kind of alliance as a therapeutic or your partner? Is that your like, what modality do you use in this outpatient?

Pat McDonough  57:06  
Yeah, I'm a partner, I'm, I'm big on person centered.

Joe Van Wie  57:12  
What would you describe? What is that person centered?

Pat McDonough  57:16  
Person Centered therapy? The individual basically, basically drives it, you know, I'm there to provide education, Insight modalities, you know, maybe

Joe Van Wie  57:30  
you give homework or I do yeah,

Pat McDonough  57:33  
yeah, I do. We're not going to talk much about that.

Joe Van Wie  57:36  
Oh, that's the secret sauce. Yeah. Well, I very interested in that last question, kind of and this role of your professional life because I want you to come back. Are we almost out of time? Like who cares

Oh, I have a Patreon now too, so I put over time soon there Chris refis was my first Patreon it's this site I had to start like I street this Chris reef is from Greenwich, who line out reef is he jumped on so I sent them a private video link of me and Timmy kelp and having the brainstorm that will become all better. Just on a zoom call one day. Can I do a recovery podcast? Will Tim had it scripted out as almost a variety show of badness?

Unknown Speaker  58:36  
Like I could come out and some sequins jacket. Hello everyone.

Pat McDonough  58:40  
Yeah, save the Ellen law says the footage I need. So

Joe Van Wie  58:45  
in the future, there's so many dynamic ways to practice what you care, therapy, study and understanding of psychology the mind the disorders that we both relate to. Have you ever been interested in you know, see, have a long and healthy life research or teaching? Do you ever see that in the future? Like would like I feel like people who went on to graduate studies for psychology they get this little like, you know, bite that stings them that they want to be involved in research at some point in their career.

Pat McDonough  59:28  
Yeah, it's funny you say that research and teaching. Initially, if you were to ask me, I probably would have said they'd be the two last things Yeah, that I would want to do in the field. But that changes over time. Yeah, you know, changes when? When when I have more experiences, right so i i could find I find myself daydreaming particularly about teaching. Yeah, I find myself daydreaming something I was about it. Where? I do think at some point, I would love to teach. Yeah. I don't know about full time. Research for me a little bit different. You know, all the all the details involved. And, you know, statistics and just think when I spoke earlier about

Unknown Speaker  1:00:25  
you get interns to do Sure. Yeah.

Pat McDonough  1:00:27  
Yeah, exactly. Research just it. It doesn't. It feels it feels foreign to me. Yeah. And being in a being in a position of actually conducting, but then again, I haven't really experienced it at that level. So would that be the case? If I had an opportunity? I don't know. And one of one of my teachers that Mary would encourage me strongly to go out and get a doctorate in social work.

Joe Van Wie  1:00:59  
Yeah. Do they offer that at Marian? What is social work? They don't they offer Psy D. PhDs? Id

Pat McDonough  1:01:05  
they do? Yeah. But I haven't I haven't pursued it, you know, my, my goal at the time and continues to be, you know, LCSW, because there's still there's still a lot that you can do with that. And I'm a few months away from your, what is attaining that

Joe Van Wie  1:01:26  
licensing for therapy to be licensed therapists.

Pat McDonough  1:01:28  
Yeah. So I'm a licensed social worker, I am a licensed therapist, Licensed Clinical is just more experienced in supervision and taking an additional exam. Yeah. But yeah, I wouldn't count anything out. You know. And bottom line is, like you said before, we're always changing. Yeah. And therefore the research is going to have to change and we're going to have to continue to do more. And we have to do more. And we have to be more aggressive. In keeping up with

Joe Van Wie  1:02:04  
our society. Intelligent. Yeah, intelligent. And I think most intelligence starts from the basis the simple base of listening. You, it's tighter, you can take off from what is you're just listening to what is, yeah, and then you'll, you'll see the needs that needs to be met. And I've always saw you do this, in Joe Kane. And in the way you've treated me, I might be a hopeless drunk, and I have I am, and a drug addict, but I'm not a moron. And I know people, I want it to be treated with dignity and respect. And alcoholics. Even at their lowest point, they could have lost their home. Their family are very sensitive people there, there is a window of of not massaging an ego, but letting someone have a soft landing to help them save their own life. You guys always did that. Just because someone's a drunk doesn't mean you know, they should be happy with crumbs, you could treat them with dignity, respect, intelligence. Day one a treatment. Always. Yeah, yeah. Yeah, I always I was waiting to, for someone always humiliate me when I would get the motivation to go to treatment. Me and I wasn't ready. But every one of those counted to get me there, like there would be a missing Jenga piece. If, if I didn't do them, they're not failures. And I think that's another thing. Stigma needs to combat the multiple times people may go to treatment, before their revelation of their understanding of what inner resources could overcome their trauma, detachment and recognize that their addiction could be in a state of recovery.

Pat McDonough  1:04:03  
I couldn't agree more. And you know, that that, to me is one of the complexities of addiction. However abstract it can be, and how, you know, you mentioned earlier cliches what was the line above cliches? Do you remember,

Joe Van Wie  1:04:23  
they're the easiest way for culture to express a complex idea?

Pat McDonough  1:04:26  
Yeah. So you know, one being like, you know, you'll stop when the pain gets great enough. Right.

Joe Van Wie  1:04:31  
Well, let me write that down.

Pat McDonough  1:04:34  
Yeah, it's like what does that mean? And how it's how much pain what's paying for this person versus that person? And, you know, like, we we can't, we can't put a finite and definitive answer to when someone is going to be willing to, to change and when someone is going to be You know, willing to explore that change of consciousness. And you know that that's one of the more difficult and frustrating things about substance use disorder and mental health disorders. And I think, you know, the response to that often is, and that was frustration and punitive measures and challenging challenge. Oh, and yeah,

Joe Van Wie  1:05:29  
it was like a sergeant, drill sergeant mentality to therapy. Right.

Pat McDonough  1:05:33  
Exactly, exactly. And now we're, we're coming to the place where we do recognize more. We have to treat people with dignity, respect, and ultimately love no matter what,

Joe Van Wie  1:05:47  
yeah. I could do a whole episode cliches because it's amazing. I mean, just want to say, the model of the first cliche one day at a time.

Unknown Speaker  1:06:04  
Now think of how complex this idea is

Pat McDonough  1:06:06  
someone someone just challenged me on that a few weeks ago. I didn't say it to them, thankfully, but they brought it up and I was laughing. It's a

Joe Van Wie  1:06:13  
monk's game. Now, you don't have to be a tactician in math to understand you're talking about at least the timeframe of the life of our star. That's, that's a day that that encapsulates our day, 24 hours. And that there's some profound, Misty, you know, truth in this. That is a spiritual axiom, the moment one day at a time, but in practicality, if you okay, one day at a time is a pretty reckless way to live. That's how I lived when i i used cocaine every day. I will get through today figure out the rest of my life tomorrow.

Pat McDonough  1:06:50  
Yeah. Yeah. Yeah, that can be spun a lot of ways. So

Joe Van Wie  1:06:55  
what seemingly would be noise to a guy like me or you, I've been around 12 Step talk, since I'm 16, would sound just like okay, noise, Oh, what did I not say one day at a time, the right way that it became profound to me. So this represents like, an ancient spiritual idea of what is your life, if you can't experience the moment, there is no life, you only only can be what you are now. And there's a liberating truth in that that could go in either scale. You don't have to be your past. Your anxious future is not even guaranteed. So why even worry about it and take the worry all the way? What what are you in the midst of not existing in that? I couldn't hear that. And one day at a time anymore. That wasn't going to be revealed to me, I had to read. Yeah, I had to listen to more people. Because maybe, you know, some people would be like, you're so smart. You're a dummy, kind of you'd hear Sure. nonsensical. But maybe there's truth to that, because I had to find out the most complex way. May mean for someone else, I had to bury myself at other. You know, I had I had to be, like, uncontrollably curious as my life dependent. And I found it. Okay, that represents one day at the time for those people. I wasn't getting it from those few words.

Pat McDonough  1:08:23  
Right, right. And in response to any, any challenge or desire for elaboration or more, you know, you get things like, you're so smart, you're a dummy, and smart for your own good. And keep it simple, stupid. Thank you, when when, when in reality, you know, tying it into treating someone with dignity. And, you know, there's 30 Other ways to say something else to you or to me, that could be helpful.

Joe Van Wie  1:08:55  
Yeah. And for some people I know who are really wonderful people, it would require them to train themselves more I know, they can help one person by saying that, but if you're going to be in this field, are you going to help 30 different people, but that same canned statement? No, you better you better train more to meet people where they're at.

Pat McDonough  1:09:13  
Exactly. Yeah, exactly. And that's, that's the reality and it's work. You know, it's more work. More patience.

Joe Van Wie  1:09:22  
It's more understanding, listening to people. Yep, compassion, and it's hard. And it's not a skill. Here's where the skill begins. Can I can I go deeper and challenging myself? That could end up looking like a meditation practice that could be maybe taking more schooling, that it wasn't a burden. Maybe there is stuff that is emerging? I'm not completely aware of that can be helpful to how I approach people. I hope I don't lose that curiosity. Because I've decided I've the same way you did. In 2011, I think this is where I belong. That's where I think I can make the most out of the rest of my life.

Pat McDonough  1:10:03  
No doubt. No doubt. I couldn't agree more.

Joe Van Wie  1:10:06  
I want to come back and I'm gonna leave a teaser. Pat's gonna come back because he has a lot to talk about a rich history of Pat's grandfather. Bernie is a pioneer. And I mean that and he's a pioneer in AAA, especially to our region. A pillar and that will entice people, I'm not going to let Pat talk about it anymore, because he's gonna have to come back and talk about Bernie.

Pat McDonough  1:10:32  
Yeah, who wouldn't? Who wouldn't be back for that teaser?

Joe Van Wie  1:10:35  
Would you come back and so we could start on the topic of Bernie and see where it goes.

Pat McDonough  1:10:39  
Of course. Yeah, you know, I'm a few blocks away. Yeah.

Joe Van Wie  1:10:43  
And I stopped for dinner. Pat was here for corned beef and cabbage. My other guests are gonna be filled with MB. Not all of them made dinner.

Pat McDonough  1:10:52  
Well, I'm special guy.

Joe Van Wie  1:10:55  
Long live the Irish.

Pat McDonough  1:10:56  
Amen. And dinner was excellent. By the way. Chris, really grateful.

Joe Van Wie  1:11:02  
Another shout out to Chris refis. Chris, we're glad you're supporting this podcast in this discussion. You are our sole producer at this point.

Pat McDonough  1:11:11  
Fun fact. You know that Chris? Rufus is the brother of my aunt Stephanie. Oh, Rita. Yes. Oh my god. That's Oh my god. This my whole life.

Joe Van Wie  1:11:21  
I didn't even put that Chris, you have a personal guests here. This is this is exclusive content for one patriot.

Pat McDonough  1:11:29  
Probably the first lunatic I was exposed to from a young age. He was my man I come to find out you were probably 10 times more of a lunatic at 12 years

Joe Van Wie  1:11:39  
old. We were scrambling to find some liquor for plan excursion for the weekend. And we would steal from my great aunt Marge best who is March Calvin. And she had Cream Sherry And Lord Calvert under her sink. We mix that in a Snapple bottle. Well, she hid them now. She knew we were just dipping into that her supply. So we left her house we went over to Chris's mom, and we're scouring because we were going to we had a weekend. I forget what we're gonna do. But we found a bottle it was a glowing orb. It looked like it was from the Vatican. I've never seen it because I'm Irish. Nobody in my family drank those Chambord and I sat behind Park Gardens and drink sham board with Chris Rivas for two hours until the vomiting ensued, and we thought we had the best night of our lives.

Pat McDonough  1:12:33  
Sounds awesome.

Joe Van Wie  1:12:36  
All right, man. Thanks for coming back. I'll see you next time.

Pat McDonough  1:12:41  
IHL thanks so much.

Joe Van Wie  1:12:50  
I'd like to thank you for listening to another episode of all better. You can find us on all better.fm or listen to us on Apple podcasts. Spotify, Google podcasts, Stitcher, I Heart Radio, and Alexa. Special thanks to our producer John Edwards, an engineering company 570. Drone. Please like or subscribe to us on YouTube, Facebook, Instagram or Twitter. And if you're not on social media, you're awesome. Looking forward to seeing you again. And remember, just because you're sober doesn't mean you're right.

Transcribed by https://otter.ai