Human Up Season 2 Ep 3: Getting Unstuck and Tackling Addiction with Fr. Nicholas L. Neubauer, LCSW

This is a transcript of Human Up Podcast Season 2, Episode 3 with Fr. Nicholas Neubauer, which you can watch and listen to here:

Dave: Welcome to the Human Up Podcast. I'm your host, Dave Marlon, and it's a huge honor to me to be joined by senior mental health clinician Nicholas Neubauer. Now, Nicholas not only has been a licensed clinical social worker practicing for almost two decades in Las Vegas, treating thousands of clients, but he's also the father of a church and has had quite a congregation, and I believe eight years he's been a leader of a church. So the merging of spirituality and mental health is truly impactful, which makes it an additional honor for me to have my dear friend Nicholas Neubauer as our guest. Welcome, Nicholas.

Nicholas: Well, thank you Doctor. I appreciate the warm introduction. It seems like I'm well qualified and now that you mentioned it, I can't believe it's been two decades.

Dave: Yeah,

Nicholas: Time flies.

Dave: You had the amazing idea that instead of us just having dialogue, which we had in our prior podcast, instead we would reach out to the community and say, Hey, who has questions about mental health? And encourage people to call in, to write in, to email in and share questions they want to hear answered for us to ask them. And my understanding is you've actually got some questions for us to address today.

Nicholas: Absolutely. This concept comes from all my formative years of watching Frazier and listening to Dr. Laura when I was a valet at Attendant. So this is something that I always wanted to do and I appreciate you creating an opportunity, opportunity for us to be able to dive into this subject matter and to be able to have the experience.

Dave: Well, speaking of dive in, what's the first question?

Nicholas: Alright, first question. When someone feels stuck in life, anxious, numb or disconnected, where do you suggest that they begin?

Dave: Well, that's a good one. That is a good one. I get the sense that all of us, at some point in our life, which ebbs and flows, we all have the feeling of being stuck, whether it's in a relationship, whether it's in a job, whether it's a living situation, or it's in recurring thoughts that we have. 

Nicholas: Hundred Percent well done, well done. Well, to add to that, my thoughts when I am presented with that, and you are a hundred percent right, it is something that I see with an incredible amount of frequency. More often than not, the person knows exactly what is going on with them and why they are stuck. What seems to be the case in most instances is that the person simply does not like that they are stuck, nor do they like the circumstances that are causing them to feel stuck. And in many cases, they either don't want to address it or they're incredibly anxious about either addressing it or the outcomes in which their brain has projected are going to be true if they choose to act.

Dave: Agreed to me, the fact that we're both licensed mental health professionals who people make an appointment and come visit with us, it really epitomizes the power of having a second person who could empathetically and compassionately listen and then help you work through that stuckness.

Nicholas: 100%.

Dave: I spent most of my career now helping over 10,000 people address a substance use disorder, and many times they'll come to me and say, oh, Dave, thank you so much for helping me break free from the addiction. And while I appreciate the accolades, I actually am just a facilitator and I help them do the work to get unstuck. I suspect it's the same thing with an array of mental health conditions or stuckness.

Nicholas: Absolutely. And look, honestly, I don't mean to be overly simplistic, but if my 45,000 hours of face-to-face time doing just this, if taught me anything, it is that it is usually the simplest as opposed to the complex, that is the best place to start in trying to support somebody for whatever it is that brings them in front of me, if that makes sense. And also too, within that same 45,000 hours to directly answer this question, question, you can't do anything about it until you identify what the problem is, if that makes sense.

Dave: Oh, totally. We say the first step of recovery is acknowledging that it's problem. So when I have a person who really likes to drink alcohol and they're looking to help address this problem with me, the idea of stopping drinking, it's usually they're working six or seven different ways to address the problem without stopping. And it really makes all the problems that come along with it particularly challenging.

Nicholas: No, without a doubt. Because look, those compulsive behaviors that you described, that's where you get anxious, numb, and disconnected. And the reality of it is there you are, you're compulsively doing all of these things to try to offset that sense of being stuck and you're doing much more harm than good. Meanwhile, the problem itself, unidentified and unaddressed continues to grow and continues to cause the harm that it's caused. That got you there.

Dave: So we both agree that the first step is to help define the problem. We also have teed off the fact that reaching out to mental health professional to help process it with them could also be a really good tool to help people break through from this

Nicholas: Stuckness a thousand percent. And look, can you go to family and friends and people that you trust in your life and have a conversation about what you're experiencing? I wouldn't discourage that one bit. It is a wonderful place to start, but I would highlight as powerful as a mechanism it is and cathartic as it can be to share, to just encourage people to take that extra step, make an appointment with a mental health professional. Because the difference that you're going to get is that you will not be receiving advice and you will not be receiving feedback specific to your problem that is emotionally or practically charged from somebody who has whatever interest they have in your life.

Dave: That was beautiful. And the fact that they're not coming to us for advice, I think it's worth elaborating on that.

Nicholas: Yes. And look, I will be the first one to acknowledge that some of my amazing colleagues within the same scope of practice in my professional community, the unfortunate reality is, is that some of those folks do offer advice. And there's certain words that I would encourage patients to be on the lookout for and to be mindful of when they're working with a mental health professional to where if a mental health professional is saying, you've got to do this, you must, you have to, you should. Those kinds of things, look, that's advice, encouragement. I encourage you to do so or to ask further questions to try to help guide and support somebody in their own decision making process. Those are the kind of differences in languages that you want to be mindful of to ensure that you could be the best advocate for your own health and your own support in regards to providers that you're working with.

Dave: I wholeheartedly agree. And to me, to go back to substance use, it's even more acute there because when somebody comes to me with a drinking problem, I know that saying you should stop drinking is 100% unhelpful. They hadn't thought of that. Huh? Me giving advice, I recognize that isn't helpful. What is helpful is me asking you questions and saying, so tell me about the reason you came here to see me today. And then me soliciting from the client what their problems are, and maybe I'll address this in different dimensions of wellness. So it's affecting your relationship. Oh, so it's affecting your work. Oh, it's affecting your health. Oh, it, it's affecting your spirituality. Now I could solicit from you the client. So what do you see as the common element in all of these problems affecting your dimensions of wellness? And then I'm helping the client come to a realization or an understanding on their own because I'm sure their mom or their partner has already told them what they think and they're not coming to me for what I think they're coming for me, for me to help them.

Nicholas: Absolutely. And what you just did there in that articulation, you described hallmarks of our professions and our ethics. You described insight oriented and you described client-centered, and that's exactly what we're here to do. But I do think too that as far as what we responded to the initial question, so whomever stuck in Las Vegas may be, I hope that that provided them useful information to help create some motivation and a pathway for them to become unstuck. And I would also like to take this as an opportunity. Since you brought up substances, we certainly have received some questions in regards to substance use, abuse and recovery. This is a great question for you. What do you wish families understood about addiction and recovery that they often don't?

Dave: Well, thank you. And that was a smooth segue.

Nicholas: I feel like I'm biting my tongue.

Dave: The first thing is that it's not up to you to change another person's behavior. And somebody said this to me with my son early in recovery where I said, I want him to do this. And people stopped me and they said, Dave, you don't own or control your son. You have a relationship with them. Now, the only thing that I can control are my own boundaries. I can't control a loved one. I can't control a friend. I can't control a patient. What I can do is I can control the boundaries I have. And to me, that's a critical element that be conveyed to anyone who's saying, Hey, you got to help me. My wife's drinking too much and I need to change her behavior. And you know

Nicholas: What? If I could comment on that, I couldn't agree with you more. And the reality of delivering that to somebody is that that is the very last thing that they either want or expecting to hear, but it is a hundred percent what they need to hear and what is going to benefit them greatly from hearing.

Dave: And we say benefit help get some peace from letting go. I often say, because in addition to me having a substance use disorder, I also suffer from codependency. And I had to go through an extensive recovery, through a recovery process to address my codependent needs and desires was that I didn't let go of anything unless it was filled with claw marks because I tend to hold on too tight to things I love, and when they won't succumb to what I know is the right thing for them, I tend to work harder and longer to try to help

Nicholas: Them. Absolutely.

Dave: Even though it's counterproductive and it often just pushes them away,

Nicholas: I'm going to make this work for both of us. Right? That's right. One of what I was biting my tongue over as it relates to the question is that what I would really appreciate people to understand is that addiction is a disease. I always try to use real world examples to help illustrate points to people because it's what I do. But if you're familiar with, I don't know, the comic book character of Venom, it's essentially this piece of material that infects its host and then the host is now under the influence of this other entity that makes decisions and puts the host in precarious situations or essentially causes harm and just overrides the organism in which it's embodied. And that is exactly what addiction is. Oftentimes families, people who are in support roles with people who are suffering from addiction, they simply see it as that the person has a behavioral problem.

They generalize it that something's wrong with the person or that the person is actually choosing this life of addiction for themselves and they make judgments about the person as opposed to understanding the disease. So when I'm working with families, when I'm working with people with substance abuse or use disorders, I always want to emphasize the physiological model, the disease model of addiction to where I can create that platform, that construct of understanding to where it allows us to look at what it is that we're dealing with through the lens of its not being a person making a bad personal decision, and that the person is bad themselves, that this is your loved one, this is the person that you have known, loved and shared a life with that is simply suffering from a very complex disease that requires treatment, care, patience, boundaries, a lot of other things that are incredibly challenging in the work of having a relationship and trying to support somebody to getting sober, to getting well.

Dave: I agreed. I like your venom analogy. I haven't used that one. I have two that I want to insert here. One is when I was about 11 years old, I swam out to a sandbar with my friend Michael, and it was a long swim. And when I got to the sandbar, Michael, who is much bigger than me, he decided to play a bully game and hold me underneath the water. And I was like, it just barely made it there and was like I was struggling. And when my buddy held me underneath the water, even though he was a dear friend, I loved Mike. However, I started punching him and kicking him, and if necessary, I would've lied to him. I would've done anything I could to get what I need because I am physiologically dependent on oxygen.

Nicholas: That's right.

Dave: Now I have seen thousands of children and husbands and wives come into me for treatment, and I realized very quickly that they are physically dependent on alcohol or opioids or something. And then we have a loved one who's saying, why are they lying to me? Why are they kicking or punching or stealing from me feeling like a victim? And then I have to explain that my buddy Michael, me punching them with all my might did not degrade that I still loved him, but gosh darn, I was going to go get some of that physiologically dependent oxygen that I needed. And my thought about him was secondary. And I recognize that many of our clients come in particularly with opiate use disorders, that they need those opiates every day. And if they have to lie to you, steal from you or punch you, they didn't want to do it.

That was a first order of importance that they needed to engage in. And you also hedged a little bit when you said, what do these people need? And you said they need support and boundaries. And to me, the only thing a person with a substance use disorder needs is treatment. Treatment is effective for helping people get well. And if you have a loved one who is addicted, they are physiologically dependent on a substance, the only thing they need is transportation to treatment because you have to get them to a place that could use this disease model and a medical system to help get them well.

Nicholas: Well, doctor, surprise, surprise, the way that you speak, you sound like a subject matter expert. And also too, if you don't mind, I will go ahead and never mention venom again. I'm going to use the swimming out to the dock with Michael's story moving forward. Well, look, I definitely think we have a knack and we're in the right field, we're on the right track, stuck in Las Vegas. Certainly got what they needed and whoever provided us that question, that's a wonderful answer. I'm going to go ahead and move us into something a bit closer to the heart. How about that? In your experience, what makes a relationship truly resilient during times of stress or loss?

Dave: That's a good one. And to me, relationships go through stages is, and having been in a relationship for many years, I recognize that there's this romantic kind of enthralled stage that over time, years transitions into a partner, and I like to call it the friend stage, but really having a trusted friendship. And I think it's an important which stage that you're in because I recognize that those change. But if you are with a long-term person and you're going through some hard times, I would use the typical responses of you should communicate letting your partner know, and I'm as guilty of this at home as anybody where I'll be under a ton of stress and it'll take days or weeks or months of me carrying the burden before my partner will say, Hey, what's going on? You've been shut down for months and then I'll talk about it. And once I do, almost never do, they say, well, gosh darn you. How dare you get into financial hardship? Or How dare you have trouble at work? They don't bite me or bark at me at all. What they do is say, oh, thanks for sharing, because I was thinking you didn't love me anymore. I was thinking that I understood

There was other problems. So letting 'em know and kind of going back to your first pearl of this podcast was helping identify the problem when you have a problem, finances or security or some fear, sharing that with your partners so they know so they could be supportive, they could be understanding, and they could help you walk through that. That's really important.

Nicholas: I love that. I love that. What I would like to add to that if I could, is that when you speak of resiliency and relationships, look, no matter how much you love somebody or how simpatico or a good match or even the odd couple, they come in all shape and forms our relationships. Look, they're nuanced, but they're incredibly powerful influences in our lives. But as it speaks to resiliency, during times of stress, grief, hardship, whatever else it might be, I would be absolutely remiss if I did not encourage folks who are insignificant relationships with others. And these can be romantic relationships, these can be familial relationships, these can be friend relationships. My strongest and most meaningful encouragement would be that in good times, because you wouldn't have a relationship if there weren't some periods of good times. In the good times, in the down times when everything is fine, communicate with one about, Hey, when we're in a stressful situation or if I'm feeling disconnected or if something significant happens in my life, this is my preference in which how I would like you to support me and vice versa, how would you like to be supported?

Because the way that I like to be supported when I'm going through whatever I'm going through, that is not the way that my wife likes to be supported when she goes through whatever it is that she's going through. So what can happen, which only makes matters worse, is that if I'm going through something and my wife is supporting me as though she likes to be supported, it's antagonistic to me and it's frustrating to her. It's almost like a love language kind of vibe. So again, the encouragement is to have those conversations in good times because once you get to the hardship, it's too late. And now we're just trying to throw pickles at the window to see what sticks, to try to mitigate whatever the potential damages could be when we could be effectively supporting one another. Outside of that. It is always a good opportunity when we don't do things the best way, the first time or reasonable argument, we fail.

So if we are in a relationship and we've been through something difficult, and you know what? We didn't handle it the best. It turned into a larger blowout or whatever else it might've been, well, as soon as the water's calm and the sky's clear, which they always do, that creates a perfect opportunity again, in the midst of returning calmness to say, Hey, let's look back at what we didn't do great and why things got so sideways. How could we learn from the not best attempt? What can our takeaways be to where when inevitably we are in these circumstances again, how could we be better and use that as an opportunity for growth, which that is always what is going to keep a relationship resilient, fresh, and healthy. You have to grow together.

Dave: I love that. I recall having some of my psychology categorized with my partner and realizing that I might be an eight, but she's a three. And recognizing as you talked, that what might be the way your wife wants to be comforted when things are not going well, that might be the opposite that you want. While if times are stressful, my wife might want me to give her the credit card and say, Hey, go shopping. While if I'm not having a good day, if you told me to go shopping, I would see that as an act of war. Absolutely. Without doubt, that's the last thing I would want to do. So recognizing that we have different psychologies that's right. And different drivers for us, that was very good advice. Any tools you would recommend for couples to be able to help determine what their psychological archetype might be.

Nicholas: Oh yeah. I mean, since you brought up archetype, I mean, we could always start with Youngian masks, a Google search, could, those are pearls from Carl Jung that do archetypes. That's very literal. That's how Jungian broke his down. Other methods would be, oh gosh, the test that Brigg Stratton, is that it? Or is that a lawnmower company? The one that gives you the demand? I apologize, I was kind of mixed up. Myers-Briggs is great, but there's multiple personality instruments that are available out there. Everything from left brain, right brain to I'm a blue and I'm a green, those kinds of things. But my encouragement with any of those instruments is to, before you dive in and take it as the gospel, understand a bit about the instrument, and also to do take it with a grain of salt, just like anything you would research online, use your own critical thinking and use it as a tool, not as the gospel.

Dave: A hundred percent agree. And I think the results of the tool that I've always found most useful is just that we have different frameworks and recognizing that my partner who I'm trying to communicate well with, and I'm trying to love and support that they are seeing things through a different frame, a different lens, and any of those tests, just the fact that when you took the same tests about our moods and our attitudes and our perspectives, that we answer the same questions, but we come up with different scores that helps identify that all of us are the summation of both our genetics and all of our experiences, and all of us are unique and different.

Nicholas: Thousand percent. Alright, look, you and I beacons of healthy relationships. How about that? I'm going to call Brooke after this and let her know how healthy I am. Alright, doctor, so let me ask you this. How can we tell the difference between everyday stress and something that might need professional attention? And I guess, let me open it up again, doctor, how can we tell between what if I'm just being normal, if that exists, what if it is actually time for me to, should I go see somebody? How can I tell?

Dave: I really like going through those wellness dimensions that I mentioned and I'd say, is it affecting your sleep? Are you sleeping through the night? Are you eating healthy, well-balanced meals? Are you going to work? Are you on time for work and you're performing well? Is your relationship good? Do you have a good relationship with your partner according to you and your partner? Do you feel like you have a real spiritual connection? Are you enhancing your spirituality if you are wondering or concerned that your stress is making you late for work or it's not having you sleep well or it's harming some of your relationships, stressing well the amount that it's affecting your activities of daily life. Those are the indicators of whether or not it's time to see an expert to get some help to help address those symptoms.

Nicholas: Well, doctor spoken like a true psychologist. I don't even think that the DSM says it any better.

Dave: So

Nicholas: Look, I have nothing to add. I would just say that almost like final jeopardy. You're correct, that answer is right.

Dave: I'm not going to let you off the hook that easy because I know you've helped patients that I've known that I've sent to you to help address a pervasive stress disorder and that these are upstanding, highly successful people. So I think one, normalizing and recognizing that all of us have some amount of stress and that it ebbs and flows, and I guess it's important to identify it, but once it's identified, what are some tools or one of them, what are some pearls that you utilize to help them?

Nicholas: Well, look, I mean as far as once you get to the identification component, and look, I really do, I try to be patient with that process because there is a spectrum of folks and it's always what works well with one patient might not work well with another. So to some degree, there's folks that do want to come in and they really want to get to the etiology of it. They really want to know where it comes from and why is this happening? And look, this is kind of where the therapist in you ultimately leads down to, well, it goes back to your childhood, right? Or this is due to your relationship with your mother or it's from a trauma from your mid twenties. Or look, it's a physiological thing that's genetic and that it's like your hair color. It's not something that you chose, but it is something that is present within you that therefore it is incumbent upon you to be a good steward of and to be aware of and to care for as a larger part of caring for your corporate self.

But regardless of any of those avenues that you take, ultimately you get to the point of what in the hell are you going to do about it? And regardless of what somebody comes in for or why they're coming in for that or how they got there, inevitably the rubber has to hit the road and that is where you have to do something about it. So we have problem identification and then we have our objectives. So we know what the problem is, we know how it's affecting us, and we also know what we would like to do about the problem, or at least hopeful as to where we can get ourselves to be, to help mitigate all of the things, all of the ways that the problem is affecting us. I typically like to start with if it's something that is physiological or that falls in the line within a mental health disorder and even things that might not fall into categories of pathology but are still affecting the person, I do think that it is always constructive to start by creating a platform of dialogue with a patient to where, okay, we identified the problem, but we also then want to identify and understand how it is affecting that particular person so that they can recognize the things that are occurring within the behavior of their thought or the outward behavior of their lives, the choices that they're making, how they respond and react in certain situations.

So we can hold accountable what things belong to, whatever it is that might be afflicting us. And again, that's where it becomes an extraordinarily unique process. You've got all kinds of theoretical evidence-based models that one can use, but again, just as though that CBT and a CBT approach might be great to work with patient, Tammy, you then say, well, hey, that worked great for Tammy. Let me take it over here and to try to work with Deborah on it. However, Deborah doesn't have buy-in to that. She doesn't seem interested in that or she just really seems not connected to that. So what I typically like to do as the next order in that process is to try to understand with the patients by offering different tidbits of ways that we can conceptualize it or directions that we can take to try to identify what resonates with the patient, how well they receive it, and how much equity they have into the ability to say, yeah, you know what? I'm with you there. And they have a sense of motivation to engage in the process with all of the other metrics kind of stamped down and tapped out in regards to, yes, this is the way that we're going to move forward, and reminding them that the work of therapy is what happens in between the sessions and off we go.

Dave: Wow, that sounded awfully pragmatic as far as a levelheaded logical approach to deal with something that's blocking you or any mental health challenge that you have.

Nicholas: And again, going back to one of the opening conversations that we had today is that that is one of the hallmarks of therapy is that we aren't just talking about the weather. You are talking to an educated, trained professional with experience under their belt that is working with you in an evidence-based data and studied, supported way to support you through whatever it is that brought you to them in the first place. That there is a science behind this. There is functions and mechanisms to our profession, and that is the benefit of taking whatever might be afflicting you to a professional. It's kind of like why if my car breaks down, you know what? I saw the guy next door turning wrench and I could go ask him about it, but I'm probably going to be best served by just taking my car to a mechanic and actually getting it fixed in a reliable way.

Dave: I'm amazed that I used to run Solutions Recovery and we had pretty good success rates, but here at Vegas Stronger where I work now, that 77% of patients who come to us with a substance use disorder are able to remain abstinent for one year after getting therapy from us. I mean, that's an optimistic and an outcome rate that really instills hope that even if you think you are hopeless and destined to a life of drinking or a life of using whatever substance it is that this treatment that Nicholas and I are talking about, it totally works. Not only is it pragmatic, not only is it a process, not only are we using multiple therapeutic techniques that are evidence-based, but the results speak for themselves. They're highly successful. Nicholas, how could people get in touch with you and how could people get questions to you to add? So we could address these in our next episode.

Nicholas: Well, the best methods would be is that my name, which may or may not be published on the podcast, but my name@gmail.com is the absolute best way to get in touch with me professionally, personally, whatever else it might be. So Nicholas neubauer@gmail.com is an absolute wonderful way to get to me directly. There's several other mechanisms that lead back to that same avenue. I could be found on Psychology today. I could be found on the Neubauer Mental Health Services website, which is www NHSL v.com. Or you can simply call Neubauer Mental Health Services and ask for Nicholas and I'll give you a shout back.

Dave: Awesome. Same for me. I'm David dot marlin@vegasstronger.org. You could also reach out to vegas stronger.org or connect with us. We're on six different social platforms and we look forward to hearing questions, and we look forward to an episode next month where Nicholas and I address your mental health questions.

Nicholas: Thank you everybody for letting us be a part of your day and for providing us questions. I do hope that we are helpful because after all, that's what we're here for. Thank you, doctor.

Dave: Thank you, Nicholas.