• Visit Britt’s website and connect on Instagram and LinkedIn.

Joe Sanok 00:00:00  We all know how tough it can be to collect supervision hours. That's why my friend and fellow therapist, Rachel, created motivo making clinical supervision easy and accessible with over 1200 vetted supervisors nationwide. I know you'll be able to find a supervisor that's right for you. Get started today at Motivo health. That's my health. This is the practice of the Practice podcast with Joe Santos, session number 1215. I'm Joe Santos, your host. And welcome to the practice of the Practice podcast. If you have been following this podcast, oh my gosh, such amazing topics, amazing people. I mean, I have been giving Josh our, our guy who finds guests just so many. So much credit for this. He has done such great work. We talked about the future of trust. We talked about the future of dying. We talked about the future of listening with Greg McEwen. So Greg McEwen wrote the book essentialism, which was one of the very first business books I read. And I usually don't look at my schedule more than like the morning of, and I saw Greg on my calendar and I was like, wait, like the Greg McEwen? and I'm like, oh my gosh.

Joe Sanok 00:01:26  And then it's like, we we covered the future of learning the Stanford Accelerator of Learning. Isabel, how we talk about the future of peak performance in the last episode with Kobe Bryant's personal, performance coach, Todd Herman. So this has been just a bunch of just pillars. I mean, honestly, like, as I show up to each of these, interviews, I'm sort of like, how the heck did I get here? I know I've been at this since 2012, and it was the first podcast for counselors in private practice. But, you know, there's still those ups and downs when you're like, you know, is this going to be successful or is this going to be successful? Is this going to work? And we've had things that have not worked, that we've fallen flat on our face. We've had so many times that, to have just like really killer guests, it's just been really affirming for our team to be like, dang, we are doing really good work. And, you know, today is exactly like that.

Joe Sanok 00:02:21  We have another amazing guest. We have Brett Frank, who is an LSG. He's a licensed neuro psychotherapist and author whose work has been featured in The New York Times, Forbes, Esquire, and New York Magazine. And her newest book that just came out like, You Can go Get It Today, Align Your Mind, is now available. She received her B.A. from Duke and her master's from University of Kansas, where she later became an award winning adjunct professor. Welcome back to the practice of the Practice Podcast, Rick.

Britt Frank 00:02:51  Hi. It's so good to be speaking with you again.

Joe Sanok 00:02:54  Yeah, I am so excited to have you back and to be talking about your new book and talking about the future of addictions and addictions work. There's so many ways that we could, take this, this episode. But first, I just want to say welcome. Glad you're here.

Britt Frank 00:03:08  Yay! Let's get into addictions.

Joe Sanok 00:03:11  Yes, let's do it.

Britt Frank 00:03:12  Let's do it.

Joe Sanok 00:03:14  Well, let's start with what do we need to undo before we dig into what we're building.

Joe Sanok 00:03:19  So like, what are maybe things that we were taught in grad school or that we see in pop media that you would say, we've got to undo this because the research and the clinical work just doesn't support this mindset anymore.

Britt Frank 00:03:32  It's such a mess out there. And it's important to me to preface that when I'm speaking about addictions, I'm coming at this as a licensed mental health practitioner. I've worked inpatient drug rehab. I've been a primary therapist, an outpatient therapist. I'm in private practice, but I'm also a recovering drug addict. And so I was addicted to amphetamines. Crystal meth was a particularly sticky one to shake opiates, pills, people, behaviors, all of the things. So when I speak about this, it's really from both sides of the couch. With that said, the thing that we need to undo is this idea that originated in the 50s is that addiction is a moral or character problem or a disease. Now, I'm not saying it's not problematic, but the addiction as a disease model.

Britt Frank 00:04:17  I'd love to see the field's trend in a new direction.

Joe Sanok 00:04:21  Yeah, I want to dig into what that looks like. but are there any other things that you would say? we have to undo before we get into what what we're building and what we see the future of it being.

Britt Frank 00:04:32  Oh, yeah. Well, me just saying, what if addiction isn't a disease is going to create a lot of commentary. and so I also think we need to undo the role of the clinician in the treatment of addiction. Because I was trained to be the layer of the law, the speaker of the truth. You know, when you're an inpatient drug addiction therapist, your job is not just to provide clinical care, but it's also to be traffic cop and disciplinarian and schoolmarm and everything else. And this power differential that we see in the field of I'm the therapist, I'm right, I know best. You're the addict. You're wrong. You're morally depraved, and you need to do it my way. That's an undoing.

Britt Frank 00:05:14  I also think that the model that's most commonly prescribed for addiction, which is a 12 step model, needs to. And again, I'm not anti 12 step. Those rooms saved my life. But to say there's a one size fits all approach and that every addict must identify as an addict for now, forever. I think there's an undoing. Let's undo all of it. The whole model of it's a personal character flaw and that the therapist is always right. I'm a big advocate of. Maybe it's time for some new strategies since the problem is getting worse.

Joe Sanok 00:05:43  It also seems to really perpetuate, like that old model perpetuate like an industrialist view of the world where that one size fits all, that we can have a machine, that we plug it in and a model T kicks out on the other side. Like literally just last night, I was at improv, every Tuesday night I go to improv, and there was this one guy there that he like. We don't usually allow observers, but he's a participant.

Joe Sanok 00:06:07  He's someone that does improv with us. But he just sat with like, the coaches watching, and he and I happened to just be walking out together. and he told me that, you know, a long term relationship had fallen apart and that, you know, things were, like, really rough for him. And I'm like, so, like, what are you what are you focusing on during this? And he said, you know, I'm just trying to stay sober. And I said, well, like, like, what does that mean to you? how long have you been sober? And he said, 54 days. And it was like, it was interesting because his point of view and he's a he's a, probably Gen Z, like either like a older Gen Z or younger millennial somewhere in there. his point of view was during this phase. Right now, I know that alcohol is not going to let me bounce back. I'm going to go into old coping mechanisms that he saw sobriety as a tool to use right then, but it wasn't a like.

Joe Sanok 00:06:58  I'm an addict. I need to always live this way. and I think that there is some nuance there, in regards to like certain phases of life too, that you need to kind of step into it. Now, what do you think of that? Like? Is that how you think through things or would you challenge what I just said?

Britt Frank 00:07:13  Well, if that works for him, I'm a big advocate of. Do you? even the counting days thing and what he said tracks for him. And I do think there are phases in the recovery healing process. And I'm not anti counting days for everybody, but for me it would. I mean, if I asked you how many days has it been since you learned how to drive. It's like, I don't know, driving is something I didn't know how to do and now I do and now I drive. But to count the days since I became a driver doesn't make any sense. It's just not part of, you know, not knowing how to drive just isn't part of my fabric anymore.

Britt Frank 00:07:46  And so for me, counting the days of sobriety was reinforcing the neural pathway in my head. That said, I am an addict and so I couldn't tell you how many days it's been since I've done drugs. Not doing drugs is just part of the fabric of how I do. Now, that said, early recovery counting days is useful, but everything that we commonly accept, from counting the days to the definition of sobriety being full abstinence from all mood altering chemicals, and if it's anything but full abstinence, you're either in denial, delusional, or relapsing. I think we need some nuance to describe. Not every person with an addiction is wired the same, and not every recovery path needs to look the same.

Joe Sanok 00:08:30  So let's talk about where it's headed. So if we're disrupting some of these old models, where are things headed? Where do you see the research and the practice headed.

Britt Frank 00:08:40  So I love that you do improv because you'll get what I'm about to say. And so if I were to look at the body of research, the history where we're going and boil it all down to what do I think addiction is.

Britt Frank 00:08:51  I mean, we know what it does. We know the devastation that it causes. We know the harm. We know the very, very real consequences. But I think of addiction, less of a disease and more. And this is a hot take. So I will back this up. I view addiction as a type of unconscious performance art addiction is performance art. Okay. Well what does that mean? It means that addiction is playing out a story that needs to be told. The symptoms of addiction are not healthy, but they are functional. And most people, when you start looking at their patterns, particularly with addictive patterns, those patterns are in fact telling a story. So what is performance art? Performance art is often and in your face sort of very oh my gosh, what are they doing type of thing that tells a story and asks us to look at old things in new ways? I don't think anyone sets out to be a performance artist addict, I think, but that that is sort of the framework that makes the most sense to me, because addiction doesn't need to be cured.

Britt Frank 00:09:50  It needs to be listened to. And that's why I love the parts work framework. Because when we look at I am not an addict, I have parts of me that did very bad things and used very maladaptive coping skills in order to tell a pain story that needed to be witnessed and heard. And the solve is in the witnessing, not the abstinence in my take.

Joe Sanok 00:10:09  So. So how do you. So dig into that a little bit more. So you're saying it needs to be witnessed. so I'm thinking, you know, you you were addicted to some pretty heavy stuff. and, like, I'm thinking, like, okay, you can witness that, but then, like, how do you stop doing it? yeah. Without like, without, like, counting days or kind of the traditional sobriety model.

Britt Frank 00:10:34  Right. And I'm not saying that the behavior is what needs witnessing. It's what was underneath my addiction, what was driving it. That's the thing that needs witnessing. Because you can white knuckle your way through abstinence.

Britt Frank 00:10:45  You can't. Like I've tried all of the count the days do the this for me. And all those things are great. I've sat in 12 step rooms. I've worked the program with a sponsor, multiple varieties of the 12 steps. But until the story under the symptom is heard, those patterns are often going to either repeat or we're going to transfer the addiction to something else so someone can get sober from alcohol and still be a rage aholic. Someone could get sober from opiates and be a workaholic. We don't want to be hopping between compulsive behaviors. We want to know what is the function of this behavior. In other words, what is the story that created the need for this behavior at all? And when that story is brought to light, often the need to white knuckle your way through counting days and doing those things is no longer necessary. But that said, early sobriety is more about stop doing the thing and less about let's understand it. And that's where again, nuance is needed. Those first 90 days are really awful, but I focus less on let's stop doing the thing And more on what what's needed right now is to be comfortable with discomfort.

Britt Frank 00:11:53  And culturally, we're very uncomfortable with being uncomfortable. Everything is we have to watch our triggers, and we have to create all of these spaces where all feelings are welcome all the time. But distress tolerance, which is a, you know, a core DBT area dialectical behavior therapy. Distressed. I was never taught distress tolerance in grad school or how to help people feel miserable. Really, sports coaches and peak performance coaches probably should be involved in addiction recovery because if anyone knows how to deal with discomfort, it's those people.

Joe Sanok 00:12:26  I love that. Well, let's let's dig into some of that part's work. because I think for a lot of us, grad school was a while ago. and, you know, we each choose our own areas of specialty. And sometimes, you know, the only reminders of some of these topics is this podcast for people. So give us a quick masterclass on parts work and kind of what that looks like. And obviously just because you listen to this podcast doesn't mean you can jump into a new modality.

Joe Sanok 00:12:49  But like, like give us kind of some reminders there around parts work.

Britt Frank 00:12:54  Yeah. And parts work is a framework and I love it so much. Internal family systems is probably the most commonly identified modality that does parts work. But what parts work is, is the idea in general that our mind is not this monolith. Our mind, like our body, is made up of different parts. So just like I have an elbow that will need different tools and interventions than a spleen, the parts of me that are responsible for showing up and going to work are different than the parts of me who want to relax and be at home with my family, and everyone knows we use in our language, right? Part of me knows I should go to the gym, and this other part of me is binge watching episode 50 of Yellowstone. That's me. Anyone else? I'm a little behind, but why do we use this language and then not dig into what that means? Parts work and internal family systems uses it.

Britt Frank 00:13:46  Gestalt therapy uses it. Jungian active imagination uses it, but the language has been around since. If you look even in the freaking Bible, people are saying part of me is doing the thing I don't want to be doing. And this other part of me is not doing the thing I know I need to be doing what's going on. Part's work is the solve for that. It looks at our mind like the movie Inside Out is based on this framework. It's simplified, of course, but part's work to me was the missing link that clicked all of the other modalities I had ever learned into place. Why does cognitive therapy sometimes fail to work? Because some of our parts are not logical. Why does behavior modification sometimes fail to work? Because sometimes parts of us don't want to do that thing. And parts work is a beautifully compassionate way of looking at the human mind, as you know, adaptive and functional rather than the disease pathological model that most of us learned.

Joe Sanok 00:14:41  Yeah. As a therapist, I can tell you from experience that having the right EHR is an absolute lifeline.

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Britt Frank 00:16:01  So I can tell you how I do it.

Britt Frank 00:16:02  And as someone who's trained in internal family systems, I went through their three year training is, first of all, we view all symptoms as expressions of unmet needs creative ones, sometimes devastatingly dangerous ones, sometimes terrible ones. But if someone came into me with an addiction, it wouldn't be. How do we get you to stop using? It's all right. I want to know. The part of you who picks up the drug is doing a job. And often that job is protecting another part that's carrying a trauma. And so we need to know, okay, what are the roles of these parts? And internal family System talks about three primary roles managers firefighters and exiles. Simplified and in my work I, I, I took doctor Dick Schwartz's work and sort of reduced it all the way down. He was very generous in supporting the book, but it's like you got parts of you that try to prevent bad things from happening, parts of you that go bananas when the bad things happen so you don't have to feel bad, and parts of you hiding under the bed terrified of anything and everyone.

Joe Sanok 00:17:02  Yeah. And so when we look at each of those different parts, and the typical, how do those tend to manifest in the clients that you see.

Britt Frank 00:17:12  They tend to manifest a lot as symptoms. You know we talk about anxiety like it's this monster in our brains that are just waiting to pounce on us. And a lot of people, myself included, until I learned these frameworks are afraid of what's inside their mind. You know, I don't want to be a bad person. I don't want to be a person that thinks bad things, especially parents. If, you know, if I had a nickel for every parent who said, okay, part of me sometimes is not on board with this parenting thing, I love my kids. I would do anything for them I can't imagine life without them. But part of me sometimes wishes I had pre infant sleep. Part of me sometimes longs for being single. And if we don't give space for all parts to exist, those people are going to feel a lot of shame.

Britt Frank 00:17:55  So whenever I see someone really locked in shame, anxiety, impostor feelings, or really any type of feeling stuck in whatever form that takes, that's usually a sign that we have some parts that need our attention. And the beautiful thing is, once you start to get to, it's like doing family therapy in your head with all your different personalities. Once you start to get to know the cast of characters inside your head and you learn to work with them instead of fighting them. Life tends to go a lot smoother now. Does this solve for all the external things that we have to solve for, like systemic oppression and inequality? No, but this does solve for the how do I hate myself a little less? Because people that hate themselves a little less are going to be less inclined to act out addictively well.

Joe Sanok 00:18:42  So dig in a little bit into a line. Your mind. Your newest book. How does this intersect with the work we're talking about?

Britt Frank 00:18:49  Yes, and the word integration is often used, and it makes sense if we're talking after a psychedelic session, you know, we want to integrate that experience.

Britt Frank 00:18:58  But this idea that we can sort of integrate and push all aspects of our humanity into one bowl, it's just not a reasonable get. And so I love the concept of alignment. Alignment doesn't mean we get rid of parts. It means all of those parts like the tires on your car. When your wheels are aligned, your car runs smoothly. When your tires are misaligned, it's not a really great ride. So being aligned means all of your parts have are properly enrolls that they want to be in, and not these extreme roles like addiction that they were forced into to cope with some trauma or whatever. And I say force, that's a whole nother rabbit hole we can go down. But when you align your mind, you're not making choices that annihilate your wellbeing. You're not living out of connection with your values and your purpose and the things that are important to you. It's not my job as a therapist to tell you what your values should be, but parts work helps realign all of those aspects of you so you don't feel like you're split between the angel on one shoulder and the devil on the other.

Britt Frank 00:20:02  It's just not how it works.

Joe Sanok 00:20:05  Yeah. So walk us through us. Just some of what you cover in the book. like like what are different sections that, that align with this.

Britt Frank 00:20:14  Yes. And as this relates to what we're talking about especially for the future of addiction, you know, the first thing that I do when I work with someone who struggles with addiction is write a letter to your part who is addicted to stuff, and thank them for keeping you alive. Now, when it gets this gets dicey when it comes to partners. If you and I were a partnership, my job is not to cosign or excuse your parts behaviors. Your job is to take care of your more extreme parts. Otherwise, we get into codependency. But in treatment, when we can work with this idea of aligning with our parts rather than getting rid of them. You know, the rhetoric with the inner critic is banish the inner critic and tell the inner critic to shut up and be quiet. And it's a liar that actually sets us up to be at war with our own minds.

Britt Frank 00:21:03  And we know physiologically, if we're fighting with ourselves, we're going to release cortisol as if we were fighting a person outside ourselves. And so when we align our minds, then it's let's seek to understand and connect with and solve the problem externally. The problem is not these different parts of us. Doctor Dick Schwartz says there's no bad parts. Bad behaviors. Absolutely. Should there be consequences? Yes. But as far as our inner work goes, when you start to connect with your parts, you realize, well, one, you've never been alone and you've got lots of company all the time. And to you know, there's a solve for this. So my book really simplifies it and uses it. So I talk about things that most of us can connect with, the inner critic being one of them. The inner child, the parts of us that are playful and spontaneous. And as adults, we sort of learn to train that playfulness out of ourselves and then compulsive behaviors. Not everyone is a crystal meth addict like I was, but we all, especially if you have a smartphone, have problematic repetitive compulsive behaviors somewhere between your phone, online shopping, doomscrolling, whatever.

Britt Frank 00:22:14  Show me a person that doesn't struggle with some compulsive something. And I go into really how to simplify the frameworks so you can start doing it on yourself without having to have a clinical license or access to therapy.

Joe Sanok 00:22:27  what are some of those, kind of quick hit things that we can start working on? in addition to therapy, or outside of therapy that you talk about in the book.

Britt Frank 00:22:36  One of them is this idea that your mind is like a company full of people, but you can't fire anybody. You can reorg your system, but you can't get rid of anyone. And so the inner critic who's screaming at you all day, telling you how terrible you are. What if we replace the voice of the inner critic with the voice of an amazing, you know, peak performance coach? For every coach that you see throwing chairs and breaking hockey sticks, you can go to YouTube and watch coach meltdowns. It's interesting. But then there are coaches that know how to get the best out of their players, and that doesn't mean coddling or enabling.

Britt Frank 00:23:11  A good coach is going to strike a balance between toughness and seeing your strengths and building you up, and not just tearing you down. And in the book, I go into practical exercises how to transform the inner critic into an inner coach.

Joe Sanok 00:23:26  And how do we do that?

Britt Frank 00:23:29  Just, you know, change your mind, Joe. That's all you got to do. Now, there's a lot of it is based in repeat rational emotive behaviour therapy, which is we have to take inventory. What are the voices in your head saying to you? If we want all the voices in your head to get along, we have to start by putting pen to paper. What does your inner critic like? What's its core fear? What's its core desire? And what's its core need? Because there's a big difference between what I want, what I need, and what I fear. And so when we can start teasing that out and separating it, then it starts to make sense. When I started to understand why I was doing the things I was doing, and even more so than why, but just what these characters in my head were all about.

Britt Frank 00:24:11  It was a lot easier to not feel afraid of them when we're afraid of our own physiology. It's really hard to solve a problem when you're in fight, flight, or freeze. So some of the book goes into practical nervous system poly vagal type downregulation or upregulation things. And then it's a lot of inventorying. It's all right. Let's sit down and actually just listen to what's going on in your head. How often do we listen to the conversations in our head? Not often. And it's fascinating when you can turn your inner monologue. I'm anxious. I'm terrible. No one will like me into an inner dialogue. Hello. Part of Brit who feels inadequate and terrible and wants to go ingest all of the chemicals. What if we sat down and had a cup of coffee? One of my favourite techniques. I call it the coffee cup exercise. We actually sit down with two cups of coffee and dialogue with this part of yourself, as if you were talking to another person. It's my riff on empty chair therapy, but you can you can do it yourself.

Britt Frank 00:25:08  And it's it's a little scary and it's unnerving, but it's fascinating when you start dialoguing with your. I talk to myself in the car, like Alanis Morissette style. You know that ironic video where she's sitting in every seat, you know, like look over at the passenger seat? Imagine your 16 year old self is there. What do they need to hear? What do they want to say? We like to talk at people, but how often do we listen to others, let alone ourselves. So it's a lot of here's how to actually dialogue with your mind. Here's how to talk to. It's couples therapy or family therapy for all of the chatter inside your head, which is my favorite form of work because it moves the needle.

Joe Sanok 00:25:48  You know, it's interesting how many interviews people talk about, you know, looking at a younger version of yourself or an older version of yourself like that. You know, even someone five years ago, how much they would be proud of where you're at now. Like, Brit, you've you've written all these books and this and that, and it's like.

Joe Sanok 00:26:04  But then we get wrapped up into our daily things that we get stressed over. Whereas the 5 or 10 years ago self would be like, I can't believe what you've done. And then looking at, you know, the 60 or 70 year old version of yourself back at you, it'd be like, wow, like you were so healthy or you, you know, your kids were little or like all these things and it's like, it's so funny how that exercise, I feel like in the last couple of months, I probably had 3 or 4 guests, which, you know, for the listeners, that's all over the place because we we don't always chronologically, you know, release our episodes. But, it's just it's interesting when there's these, like, kind of core lessons that, you know, even if someone's talking about marketing, you know, they go back to, and then it seems like it just keeps popping up over and over.

Britt Frank 00:26:49  It's and that's because, again, it's the reason it's in our language.

Britt Frank 00:26:52  Part of me feels this way and part of me is doing this other thing. Why can't the parts of me all get along with each other? It's a very human dilemma. And when we approach our problems, especially addiction, with this, you have one mind and it's either normal or disordered. It's either, you know, pathological or it's doing what it's supposed to do. We miss out on all of these tools and resources that are laying on the ground, waiting for us to pick them up. Inner dialogue is one of the most powerful tools to feel better, feel more in charge of your life, feel more in control of your choices. And it's free, and you don't need any specialized training to be able to do it or to help someone else do it.

Joe Sanok 00:27:36  Well, Brett, the last question I always ask is if every private practitioner in the world were listening right now, what would you want them to know.

Britt Frank 00:27:43  Oh I love that question. I would want everyone to know that our job as therapists is to manage our own parts so they don't show up in therapy.

Britt Frank 00:27:53  If you're feeling afraid for a client or overwhelmed by a client, or worried about a client to the point where you're not eating or sleeping. That's a sign that your own therapist parts are in need of attention. Attending to my therapist parts has made a huge difference in how I practice and how I feel, so I hope every therapist remembers you have parts too, and they show up in the room and they need attention too.

Joe Sanok 00:28:17  So awesome. Well, if people want to get your book, if they want to learn more about what you're thinking about and talking about, where should we send them.

Britt Frank 00:28:24  Yeah. So many voices in my head. You can buy my book. Align your mind anywhere you buy books. My website is. Com or find me on Instagram where my parts like to leave me there for hours at Frank and I'm happy to chat with you if you want to DM me.

Joe Sanok 00:28:39  So awesome! Thank you for being on the show.

Britt Frank 00:28:41  Thanks for having me.

Joe Sanok 00:28:50  Well, if you want to be around other therapists that are growing their solo practice, that are leveling up, that are doing Ted talks, that are building sustainable solo practices, you're going to want to hang out in our membership community.

Joe Sanok 00:29:05  You can read more over at practice of the practice. Com for membership. we have some openings where you can join us soon. and depending on what track you want to be in, we've got our sustainable solo practice track. We've got practice launch, group practice, boss. And we've also got people that are building audiences and going beyond private practice. So no matter what your phase of practice is, head on over there. You know, we also couldn't do this show without amazing sponsors like Therapy notes. Therapy notes is the best electronic health records out there. They will help you switch over from your current EHR. they also give you two months for free or just money off if you use promo code Joe at checkout. they are phenomenal. They help with automated billing. it's going to make it easier to outsource your billing. So many reasons to switch to therapy. Now, let's just head on over to therapy notes. Com read about it and at checkout. Just use promo code. Joe. Thank you so much for letting me into your ears and into your brain.

Joe Sanok 00:30:01  Have a great day. I'll talk to you soon. Special thanks to the band Silence is Sexy for that intro music, and this podcast is designed to provide accurate and authoritative information in regard to the subject matter covered. It is given with the understanding that neither the host, the producers, the publishers or guests are rendering legal, accounting, clinical or other professional information. If you want a professional, you should find one.