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Chris Kelly-Jackels, MSW, LICSW Vice President of Clinical and Program Services at Perspectives Family

Stigma of Addiction – Working with families

Charles

I would like to welcome with us here today: Chris Kelly-Jackels, MSW, LICSW Vice President of Clinical and Program Services at Perspectives Family. Thank you for joining us. How are you today?

Chris Kelly-Jackels, MSW, LICSW:

I am great Charles, thank so much for asking me to chat with you today!

Charles:

Before we dive in to the important subject: The Stigma of Addiction, I’d like to let our readers get to know you a little and the work you do at Perspectives Family. If you would be so kind as to tell us a little about perspectives family and yourself.

Chris Kelly-Jackels, MSW, LICSW:

Absolutely! Perspectives in the largest supportive housing program in the US Midwest. 53 mother and their children live in apartment building we own. All of our families are referred to us from local shelters, all have history of addiction and trauma.

The agency provides a full spectrum of services – clinical services, chemical dependency out patient treatment, case management, after school and summer academic programming for children K-8, and social programing as well.

We work with a very long list of community providers and organizations to over come any barriers we identify.

We have employment support, job training, and vocational training relationships with providers to support the families.

This list is long..

Charles:

Wow, that is some amazing work you guys are doing. A lot of hard work which I would like to quickly take the opportunity to thank you for.

Chris Kelly-Jackels, MSW, LICSW:

the families do the work, we provide the space. We have a great team.

Charles:

Stigma. Based on the work you do I would imagine you come across it often. What is the worst thing about stigma in your opinion and how does it effect the work you do?

Chris Kelly-Jackels, MSW, LICSW:

I have been in the field for over 20 years, at Perspectives for just over 3. My background is mostly clinical work across many settings with all ages. I have been very lucky to have the opportunities I have had.
Stigma… yes we see it, feel it and it’s impact every day.

What it means to me – is a lack of education and understanding. Unfortunately those deficits are generalized across many fields and settings.

Stigma often comes with a belief that healing can not occur for all.
It can be another layer of shame the mothers and families have to battle, when the shame they already feel is unbelievable .
It can often add to the personal belief of those in addiction that there is no way out and no one to support them in healing.

Charles:

I want to ask you about something I think you are extremely well positioned to offer insight on based on the work that you do. The mothers have a rough time but I also want to ask about the children. Do you feel that they also suffer stigma in the community and possibly self-directed stigma as they get older and become more aware.

Chris Kelly-Jackels, MSW, LICSW:

Absolutely. The way others see their parents and the assumptions that are assigned to them are also a direct reflection of who the child believes they are. Mom is bad therefore I am bad.

Mom cares about using more than me, so I must not be good.
The pain we see is heartbreaking. Children we see respond in many different ways, but almost always, develop self reflections that are debilitating.
The lens they see themselves through is often handed to them but others judging their parent.
Without a chance to heal and discover their potential and understand what happened, they often grow older with a lot of anger, which presents in many different ways.

Charles:

Actually this: “Mom cares about using more than me, so I must not be good. ” Hits an important point, one I could personally relate to at one point in my life. Addiction is difficult, physically and mentally – One of the hardest things for a child is feeling like they come second to the addiction. I think in a sense at a young age this eventually causes the child to stigmatize the parent as a way of reconciliation; Mum/Dad must be a bad person … otherwise it means that they are a bad child I would imagine it can go one of two ways. How are children of addicts helped through this, to learn and understand that it is the addiction and not the whole person …

Chris Kelly-Jackels, MSW, LICSW:

I agree with you Charles, I as well have some personal experience growing up with addiction and definitely battled feeling not good enough and also feeling second to alcohol. Coming from a trauma informed perspective, I believe children begin to understand when us as providers are able to create the space, safety and the relationship they need to begin to see themselves differently.

With relationships, comes trust, and we accept information and learning from those we have connections with. This is where it begins.

Children do not understand not only what addiction is, how it impacts the body, they also are not able to look beyond and understand the trauma their parents experienced.

Education is important. to see the “light” come on when a child realizes that mom did not choose addiction over them, but did not have the skills or the support to do anything different – that’s amazing.

There are so many ways to understand addiction and it’s impact, as you said, the layers need to be peeled back. Children need the space to feel what they feel, without judgement. It is a place to start. It is safe to be scared, sad, angry… etc.. Our therapists work knowing that trauma is first and foremost for the children as well.
It’s not about what is wrong with them or their parents – it’s about “what happened?.”

Charles:

What I’m hearing is; education, time, support and acceptance are tools that help break the stigma and help these children work through these issues. I am going to use a stigmatizing statement I often hear and I would like your opinion on it: “Once an addict, always an addict.” How accurate/inaccurate is this and how do we challenge it?

Chris Kelly-Jackels, MSW, LICSW:

My reaction to that statement is – that’s not for me to decide. that is a personal belief, good or bad, that only an addict can decide if it is accurate. Recovery is possible for all, how one recovers is determined by them as well. If an addict believes they we always be an addict, and that fits into their definition of recovery, I support that. I just do not believe those outside of the addicts heads and heart have any place determining if that is true or not.

I hear it often Charles, and my response is always the same. How do you define that? Is your definition of an addict that same as mine? theirs? Is your experience the same as others?

It gets people thinking, but regardless, it is a judgement, and judgments don’t heal. They are barriers.

Charles: Earlier you said “It’s not about what is wrong with them or their parents – it’s about “what happened?.” In many cases people with substance abuse disorders have co-occuring disorders, from veterans with PTSD to childhood trauma, victims of rape etc however it is all to often that we see the following sentiment: “They made their choice, this is who they want to be, why should we accept them? – How harmful is this stigma? As a practitioner that spends so much time helping and working with people with subtance abuse disorders how do you feel about such sentiments, how do they make it harder for people suffering to recover?

Chris Kelly-Jackels, MSW, LICSW:

It infuriates me Charles. It is nothing but a judgement. Who are we to say what others want to be? How do we know about another’s choices and what options someone had. There is always a story, and if you listen you will hear it.

We all need accountability, but again, you or I are not in charge of what should look like. Choices are made, yes, but the story is in the how, why, and what other options or skills did the person have?

I remind others that we need to step back and realize that many times, the choice to use or whatever is sometimes the only “thing” a person knows.

We can all think of times when we did not have choices, or felt as though we didn’t, couldn’t see the other options, didn’t have the support to make other choices, and that is accepted. But when we are talking bout something “bad” or something ” I would never do” it is very simple to determine a person must have wanted it. that couldn’t be further from the truth.

Charles:

Employment. It is clear that one of the most important things in recovery is for the substance abuser to eventually re-integrate , be able to earn a living and be a fully contributing member of society. Whatever end of the spectrum an individual falls on, from stigmatizer to open arms, understanding and accepting all would like to see the person with a substance abuse disorder on the right track. On this note seeing that everyone is somewhat aligned … In some cases substance abusers will have criminal records due to their addiction and possibly other things they did as an addict in search of a fix. (I hate that word fix) Well on to my question. How do we best help them re-integrate, what steps are taken to break the stigma in the eyes of employers. How important is it that they have someone advocate for them; to be seen as a whole person. How important is it for HR and small business owners to better understand addiction. How often does stigma act as a barrier in achieving exactly what we all want – which is a positive contributing member of society?

Chris Kelly-Jackels, MSW, LICSW:

Employment – yes at times it is the largest barrier we see. At Perspectives we have employment counselors that work in the community, developing relationships with employers, yes advocating for employing the women we serve. It is difficult, smaller employers have options at times, larger companies do not as you know. For those that do, we offer support for the employer and the employee, job skills coaching, etc.. It is EXTREMELY important employers see someone as a hold person, not “a criminal.” They are a person first, who committed a crime. Some have done what they were required to do, and have not had additional charges.. but others have a much harder time overcoming the stigma of a criminal. As a society our laws often inhibit exactly what you said, becoming a contributing member of society.

Charles:

I want to dig a little deeper here; you mentioned the stigma of criminal. What is it that A) A recovered/recovering addict can do to better help break the stigma they have on them. What in your experience do employers find as acceptable, what is that milestone or action that can help an employer understand that a person is a whole person not just a mistake or a condition?
B) You mentioned that our laws often hinder – what laws specifically are the most damaging. Are there any changes you would make if you had the power to; that would help us all achieve the goal we ultimately want. Which is less people suffering from addiction and more people becoming contributing members of society?

Chris Kelly-Jackels, MSW, LICSW:

A) A lot of it is time, and personal confidence (which comes as healing/recovery happens) and experience. I honestly believe anyone seeking to overcome any barrier, does so with behavior and someone to give them the space to do so. A milestone, in my opinion, is again the education of each other, creating a relationship so others, we, can experience for ourselves that “this person is ok, they are not scary.” The change often has to happen on the employers side if the other side is doing their to demonstrate they are a valuable employee, same as you and I have done. .

Chris Kelly-Jackels, MSW, LICSW:

B) If I had the power to change laws… hmmm.. interesting thought. 🙂 I don’t claim to be an expert in a legal field by any means, but time lines often are something that are hardest to overcome. The “wait” people have if they have a felony on their record is long. We have many moms who are working hard on recovery and have the skills to work, but have a felony, so they cannot find anyone who will hire them. Or have a minor theft charge, and now they can’t work at a place that handles cash or merchandise .. It is a fine line, which crimes are less scary than others… I actually had a co-worker that was “released” because the state uncovered a minor possession charge that was about 9 years old.. nothing since, crazy.

Charles:

Maybe we need to look into ways to label (normally a bad thing) but to label individuals as low risk – at which point their records should possibly be hidden, expunged. Alternatively maybe we could look at laws that make pulling a criminal record etc the last phase – maybe a more need to know approach.

As an example – Minor infraction may stay on record for 10 years but after 3 years it would not be available except in extraordinary circumstances.

Chris Kelly-Jackels, MSW, LICSW:

Yes, all of those are great ideas. We try to help the women expunge and it is very very difficult.

Charles:

In short maybe some things should not be public knowledge but rather only on a need to know basis.

Chris Kelly-Jackels, MSW, LICSW:

I would like to see something change with time lines for some charges, I agreed. If I steal or get a DWI, it doesn’t mean 7 years later I am still a drunk and a thief.. exactly what we are talking about.

Charles:

Ultimately though, I think rather than hiding it is more a matter of educating employers and helping break that stigma – yes people fall down, yes people make mistakes and yes people change.

Chris Kelly-Jackels, MSW, LICSW:

Amen Charles. people fall and people can and do get back up.

Charles:

Active user vs someone who used in their past is a distinction that I would like to see made in our communities and I am certain so do you.

Chris Kelly-Jackels, MSW, LICSW:

Absolutely.

Charles: Chris Kelly-Jackels; I really appreciate the time you have taken to discuss this important subject with me, I agree that probably the one of the most effective ways for people to see each other differently (be it an employer or anyone for that matter) is to actually get to know the person. I had a closing question planned for you but based on our conversation I would like to ask you a different question. I will make an admission: At one point in my life a long time ago, I tried to understand why a parent may choose their addiction over a child. I think other children can be at risk of making the same mistake. The lack of information led me to explore first hand what it is that is so great about drug X,Y and Z. This emerged from self-directed stigma; drugs are better than me, I am bad or something to that effect. What can society do to help this be avoided, would you advocate for more education in schools? What would you advise a co-parent or a loved one of the child?

Chris Kelly-Jackels, MSW, LICSW:

Thank you Charles for giving me the chance to talk about this with you. And – thank you for sharing a part of your story with me. It is a common occurrence, I think it is sadder though that it is almost expected… another stigma. I do think more education in schools would be a positive things, but my bias is that the education needs to come from someone who is educated in the topic. I would never teach algebra for example.. teachers need more education in their training and they need to stop being taught that behavior is “fixed” with prescriptions and discipline. A soap box of mine… anyway.. As providers we owe it to those we serve to challenge our own judgments – educate ourselves around trauma – attempt to understand. I talk to parents a lot, and have for years. My approach with them is “Let’s start where we have things in common. I believe you want to be a good parent, most do. I know you love your child. I do not question that. Do you know what to do? Is everyone telling you what to do? What do you want to learn? What do you want your child to know about you and your fears for them? ” The conversation, the listening – that’s how relationships promote healing with ourselves, each other, and with other children. Parents love their children, sometimes they do not know how to show that or are too scared of rejection. education and space to connect – that’s where it all starts.

Charles:

I do have to keep you for one last moment – In my question I meant a parent or loved one that is not suffering from substance abuse. – I appreciate the answer you gave and with this very last clarification I think it is great we would have covered both (The parent that has suffered substance abuse and the loved one trying to help.)

Chris Kelly-Jackels, MSW, LICSW:

Oh.. sorry. the lack of knowledge and understanding causes fear and a ton other emotions. First, a parent or loved one that is not suffering from substance abuse is normal with their fears, anger, sadness, disappointment.. we have to allow all of those feelings. Second, there is always more to the story. Those who are “watching” someone throw their life away so to speak are scared, rightfully so. Places need to be established for them to learn about addiction, trauma and about themselves. Programs need to always have options for families, more than AA for family member or loved one. therapists such as myself in the field should always offer space for family and loved ones if appropriate, to heal together. Parents and loved ones need to know that with the fear there is hope, always, and things do change, and can change, and seeing things through a different lens can makes things much more clear, and lead as all to make more informed decisions for ourselves that are safe and in the best interest of all, be it at times those decisions are harder than other times.

Charles:

Thank you so very much for joining us today; your insight has been extremely helpful and I look forward to sharing our conversation with others that can benefit from it. On a final note, thank you so much for the work you do at Perspectives Family.

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