Ken Huey 0:00

Welcome to The Voice of Hope, where bold leaders and healers share how they're building hope, not just talking about it. I'm Dr. Ken Huey. Let's meet the change makers transforming lives from the therapy room to the boardroom. Today's guest is Dr. Daniel Hawkman, psychiatrist, psychotherapist, and founder of self-recovery.org, where he helps people uncover the root causes of addiction and self-destructive behavior through a more holistic and empowering approach to healing. Daniel, thanks very much for being with us.

Daniel Hochman 0:31

Thanks for having me on.

Ken Huey 0:33

Yeah. So what brought you to this point where you're dedicating your career to addiction and self-destructive behavior, emotional healing? Why?

Daniel Hochman 0:42

Yeah, it's funny to me because from the outside, people are curious why a psychiatrist does a lot of addiction work or does it the way I do. And from my perspective, it was just a very normal and natural unfolding. I'm applying things that I've got well trained in and went through psychiatry residency for. And so I just bring, to me, a very sensible approach to the addiction field. But from the outside, a lot of psychiatrists, doctors either hate dealing with it or deal with it in a very different or siloed kind of fashion. But yeah, people with addiction really should be getting just very good work looking at underlying issues. That shouldn't be a very different or novel approach.

Ken Huey 1:24

Yeah. Let's dig into that a little bit more. You've got a very specific philosophy. You talk about addiction as more than a substance issue, not to paint anybody else in a particular corner, but what do you do that's different? How do you approach it?

Daniel Hochman 1:37

Yeah, so I never get very distracted by the just the substance itself, the amount of use, the prolonged parts. So those are kind of what we call like war stories. And a lot of people get distracted when they're thinking about, well, I'm using IV drugs and it's gotten this much worse, or I've lost this much money, or I lost my family, or I almost died. And that's very different than someone that might have very light forms of addiction, whether that's a less lethal kind of form of use, or they haven't really lost anything in life yet. But that's a very big distraction. I mean, there's always in someone who's turning to some external vice, it could even be a behavior, by the way. So it can be stuff like porn would be very common. Anytime we're turning outside of us to a chemical alcohol, a behavior to regulate an internal experience, that's something we should be mindful of and try to work through and work on. So like I say, to me, that that shouldn't actually be very novel. But unfortunately, I see not just lay people, but even full-on treatment centers lose focus of that. And so it becomes rules-based, accountability-based, and there's a lot of discipline and things like that. And those can recreate a lot of unhealthy dynamics in that person's system that actually pulls them away from what matters.

Ken Huey 3:03

And what is at the root cause, do you think generally? There's lots of different things, of course, but what do you most commonly see?

Daniel Hochman 3:09

Yeah, well, so I know you do a great job of focusing on trauma work. There's trauma very much of the time in addiction, and that can be all kinds of trauma, but it can also be more subtle things, and that gets missed all the time. So a very subtle one might be something like boredom, just kind of flattening out in life, not really too excited or involved in anything, maybe connections getting a little weak or boring. So that'd be minor. And then you have a lot more commonly just things in the middle, not trauma, but also not as light as boredom. And that's something like bad marriage would be an example. And so a lot of people have regular kind of forms of depression, anxiety. But to also give listeners another dimension of this, it's not necessarily just, well, it's either trauma, boredom, some regular depression, anxiety. What converts it from a bad feeling to an addiction or something where we're turning in a habitual fashion to something that's destructive is that we have an intolerance for that state. So you can have someone, that's why someone who is sometimes bored has a very mild mental health issue, right? But they could still have an addiction. And that's because they don't have a tolerance for the state. Whereas you have some other people with heavy PTSD that don't have an addiction. And the way I frame that is that they have a high tolerance for that. So it might still be terrible. It may incapacitate them even functionally, but they don't necessarily have an intolerance to where they turn to the outside for that emotional regulation.

Ken Huey 4:48

Yeah. What do you do to start kind of cracking that to build up the tolerance for the negative that they're feeling?

Daniel Hochman 4:56

I like that question because it's I'll just back up for one second. The way I model out addiction is that it works like a current. So it starts with some underlying distress, which are the things that we were just talking about. Then the mind comes up with a way out of that, which is a craving. And then the addiction part of the current is when we partake in that. And so you don't actually have an outward addiction until you've gotten into that phase of the current. And then the current finishes with some kind of false pleasure, right? We don't go through all that unless we think it's going to provide some relief. It's either numbing or relief or escape. So where I usually start people is with grounding techniques and things that can help right now. So it's a lot easier to build skills very quickly than address years of childhood trauma, right? So usually we start in the kind of tangible here and now things where they start to kind of put some space between the craving and carrying out the addiction. And those can be all kinds of things. So those can be grounding techniques, it can be breathing skills, it can be distractions. So distracting things like apps and TV, music. So there's a huge list of things to do there. And so some of that work can get difficult for practicing deeper forms of mindfulness meditation. Some of it is very easy to do if it's an app on your phone to help you in those moments and everything in between, and knowing where you'll go or who you'll talk to. So developing out a strategy to create some space there is a good initial target.

Ken Huey 6:31

How about relationships? They either support or hinder recovery. And it seems to not be a lot of middle ground. It's one or the other. Talk us through that.

Daniel Hochman 6:42

Yeah, you could think of it kind of like an amplifier, right? Where it's going to tend to do one or the other. If a relationship's good, yes, that's very protective and healing, and we double down on it. Bad ones, yeah. If we start to make mistakes, they shame us, there's pressure, or they're just not available or there, and we feel like they've abandoned us. And so, yeah, it's a very strong thing. And what happens on a psychodynamic level, which is a lens I use, is that we're recreating a play sort of of our life all the time. And so, as one little example to understand that, if I'm feeling like I'm being victimized, so like the world has it out for me, and I tend to always get the shaft, right? We'll actually almost make our relationships go that way. And so the work is more deep, right, than just okay, this person's good for me or that person's bad. I mean, obviously, we need to think about that and take an inventory of our friends and family and see who's good for us. But first of all, that's often very hard to do when we're intertwined with people or even living with those people. But it goes deeper than that, right? Because we need to think about our role in it and not just blame others or say, you just don't have a place in my life anymore. We're often bringing our whole history into any daily interaction. And the more we can learn about what we're bringing to that, we have the chance to change relationships to a high degree. And the ones we can't, yes, obviously, we need to address or distance ourselves.

Ken Huey 8:22

Aaron Powell How do you think about shame in the cycle? What it does relative to addiction and recovery, and how do you resolve it?

Daniel Hochman 8:32

So I take a fairly eastern approach in this sense. So shame is usually just totally unnecessary. So the shame to me is that there's so much shame, if that makes sense. Because the eastern sort of part of this is like it's as is, right? So if I've screwed up and I've destructed my life or those around me, you can say I'm a screw up, and you can say I did this and this to you. And so if you call that shame, like fair enough, but it can just be as is. And so if I wasn't there for you because I was using or drinking too much, you can just say that, right? Just say that to me, and I'll also acknowledge that. And I should own that. But the extra shaming is where it gets more personal. So an example would be like thinking of a parent and child. Like you're allowed to say, Hey, child, like you, I've seen your math scores, they're not so hot. Like, what does that mean? So you're still allowed to address what's wrong. Ask them if they have a plan or if they noticed what went wrong. You can still name what's wrong, but shaming would be like, hey, you're calling them whatever you want, right? You're an idiot, you're a failure, you're not gonna amount to anything. Now you're making it personal, you're shaming them, and it doesn't add to anything. In fact, of course, takes away from the relationship, takes away their hope. They're gonna do all kinds of things to show you that, hey, you think I'm a piece of crap, I'll show you a piece of crap. So none of those help. So shaming is just a total waste of energy. We need to stick to the facts, which is you missed a lot more questions on your math test this month of what's happening. So same thing. Hey, you're drinking a lot more now, like what's going on. You're still allowed to name it.

Ken Huey 10:20

You emphasize self-mastery. What does that look like in everyday life?

Daniel Hochman 10:26

It can mean a lot of things, but generally speaking, for me, that means that our life is intentional and deliberate. So, for example, if I am intentional with my drinking, I know if I'm trying to drink at all or not, right? So it's so I might be intentional around sobriety, or I might say, actually, I'm gonna allow alcohol to have a place in my life, but here's how and when and where. So it's gonna be only at weddings, only this number of drinks, if I have the right people around me, and so on. So mastery to me is not necessarily that we're perfect, it's that we are living in a way that's in what we're deciding for ourselves intentionally is okay. And so an example that's kind of everyday for all of us is like how much dessert or sweets we want to have. So being in some mastery to me is not that I never have any sweet ever again the rest of my life, even though that's the quote unquote correct thing to do. But instead, I decide I'm okay with a certain level of relief in my day and to feel nice and to have some shortcut to that. And that's an intentional, deliberate thing. And so when I do that, it's still within some greater idea of control or mastery than I don't even know what I'm trying to do. This thing's in front of me. Maybe I'll have a lot of that cake, maybe I won't, and I don't necessarily have an idea of who I am with that.

Ken Huey 11:56

What's a really common misconception people have about recovery and mental health treatment?

Daniel Hochman 12:01

They often just put too much vocabulary and concepts into it. So they may say, I'm trying to be sober, or they have an idea, like a vague idea of being in recovery, but not really define what they really want in all of that. So rather than the same way when we lose weight and people get fixated on the language and the numbers around that. So I've lost this many pounds, or I want to have this particular look, and then they attach a bunch of unhealthy things to that. We instead would want that person to just have a good, healthy lifestyle day in and day out. And you just you see where that takes you. Now it will happen to take you to a healthier weight or greater fitness, greater mobility, but we don't focus on these surface level kinds of things with rules. And so, same thing in recovery, we would want to focus on the things that really matter, right? That we have good people in our life, like you had brought up, that we're doing and applying ourselves in ways that we enjoy or we feel any kind of purpose around. We want to behave well with people. So we want to treat people kindly, we want to be a respectable person in the community. So we can go on about all these nice things, right? Those are the deeper things, the better targets. It will just so happen that when you do those, you create a life of meaning, and all those things become very important and you have accountabilities all over the place, and you will do really well with regards to an addiction. But when we focus on, well, I've got to control and not have that many drinks or not at all, or whatever the drug is, the journey becomes difficult, it becomes a chore, and it loses target of what's gonna actually carry us through those hard times anyway.

Ken Huey 13:52

Yeah. There's some sort of a line between healthy coping and emotional avoidance. Can you describe that?

Daniel Hochman 14:01

Yeah, I'd say this goes back to some of that mastery. Is I want to know, I'll just put my chocolate example in it. I want to know if I eat chocolate, that's within the bounds of what I would consider a healthy and good choice, versus just kind of justifying reasons after the fact where I've got something in front of me, and then I lose myself in a bad way. And I've lost my rules, I've lost my discipline, I forget what I'm trying to do with myself. So, so to me, that's an important thing is knowing that it's part of something we have already decided for ourselves is important and meaningful. And so if it doesn't violate that, there's room for either mistakes, we can have certain things we even intentionally allow that aren't technically good for us. We can watch some crap TV, right? But it's when we let ourselves do those things and they were not part of any deliberate idea of what we want to do with ourselves, that that's when I'm starting to go wrong.

Ken Huey 15:04

You you really you said it at the beginning, but uh, you do have a very eastern philosophy. Where does that come from? Where'd that land?

Daniel Hochman 15:11

I would say just in my own pursuit of trying to find what really works in life. So for myself, for my patients, just observing the world, I have not found that even though, for example, I practice psychodynamic psychotherapy at my core, which is just a that's one particular modality as like a deeper form of therapy, there's a lot of therapy modalities, but a lot of them don't provide the fullest answers. And so I found myself just getting more and more into philosophy because to provide answers for why we suffer, how we suffer, and the ways through suffering, we kind of have to turn to ancient wisdom and tenets and truths. And Eastern philosophy has a lot of that. In the West, we have largely adapted and adopted Eastern philosophy. So we have now like acts like acceptance and commitment therapy, which is going to be really helpful, and some other things, and those are entirely born out of that. And we've had John Kabotzin bring mindfulness meditation over here, and we've studied it now with MRIs and stuff. So we have a lot of wisdom that's already been passed down through the millennia. And so I like to be a student of stuff that's been around a long time.

Ken Huey 16:29

In your Eastern philosophical mindset, I hear little reverberations of what I would think was stoicism. Has that been something you studied too? Yes, it is.

Daniel Hochman 16:40

And I'd say I mostly like stoicism, but I see people sometimes take it too far as what we would consider like overly stoic. So if you have that as like your only tool, it can make you feel like you've got to be able to kind of rise up and charge through everything and do it in this sort of like overly courageous, brave manner. But sometimes that doesn't leave room for navigating, contorting, or like in therapy, we'd call like processing trauma feelings. And so if we don't process those, we can have patterns keep re-emerging over and over. So there's complimentary pieces, I would say, to stoicism.

Ken Huey 17:24

All right. You work with folks that get pretty stuck sometimes. I feel like they've tried everything. What gives you hope in those moments?

Daniel Hochman 17:32

I have so much hope because I've never encountered a case that there isn't a way through. There always is. And it's only a matter of how sort of ill they are with thinking is this gonna take a few sessions or is this gonna take years? But there's always a way through. And it's usually not based on the factors people think. It's not like how much I've been drinking, it's more like how stuck are my ideologies. And so if you're stuck on an ideology that I'm born with this disease and the genes, and great, we'll keep trying on all these cute, mushy things, but like none of it's gonna work. Don't you know my dad and my dad's dad? And or you don't know what I've been through. I was I was in Afghanistan, you have no idea what it was like. And so when people have these ideologies that keep them stuck, it takes a long time. Doesn't matter how much you're using or anything, if you are open and a student to how we suffer as people, and you find a good guide in that, everyone can change dramatically. And it's usually a lot faster than people realize as well.

Ken Huey 18:41

Dr. Daniel Hawkman, I gotta say, if I'm looking for a psychiatrist, I want to talk with you. There's a very soothing method of navigating a path through that I just really want to say thank you for. It's this has really been enjoyable. I appreciate it. Yeah, thanks a lot for having me. I enjoy it too. Thanks for joining us on The Voice of Hope. If you were inspired, share the light. And remember, hope's not just a feeling, it's a force. We'll see you next time.