Cassie Kasowaski is the founder and CEO of Beth's Place, an outpatient addiction and mental health treatment center. Cassie discovered her life mission after suffering the loss of her mother, Beth, to substance abuse. Before founding Beth's Place, she went back to school, received a double master's, and is a Licensed Alcohol and Drug Counselor. Cassie's mission is to provide treatment for others so they can avoid the same fate. Her patient-centered care treats the person receiving care with dignity and respect while involving them in all decisions about their health.

No two people are the same, and the team at Beth's Place treats each client with compassion and is considerate of their unique needs. Cassie is passionate about working with clients and their families and offers education about substance abuse.

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Full Transcript:

0:00:00.7 S1: I feel like I understand it on a little bit deeper level, just being in the field for as long as I have been, and I understand their perspective too, you know, I really do, because I don't think we need to do treatment as many times as we have. I think we need to run a more research-based program and that it would eliminate some of these repeat, like the average person goes to treatment seven times, I don't necessarily feel like they have to... I feel like that's a little bit overkill.

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0:00:29.7 S2: Hey, this is the Wellness Essentials Podcast. WE for short. The WE Podcast is all things health and wellness. A place where women like you can come to be their authentic self and be a part of a community that supports them in their health journey in every stage of life. This is the podcast for engaging health and wellness entertainment with actionable steps you can take into your every day life. No topic is off-limits when it comes to health and women's lifestyle. Let's face it, being a woman comes with all sorts of fun. Hear real, raw conversations and teachings from experts and everyday women who have been in your shoes and get inspired to make things happen and have the tools to do so. This is the WE podcast. Hi everyone, this is Patty Post, your host of the Wellness Essentials Podcast. Today, my guest is Cassie Kasowski. Cassie is founder and CEO of Beth’s Place located in Fargo, North Dakota. Cassie, welcome to the show.

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0:01:54.5 S1: Thank you for having me. Absolutely.

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0:01:57.2 S2: Now, it's funny how we have come together now, 'cause there's been a couple of really brilliant women that referred me to you, and... I love that about this community. There is a very rich support of others... Do you feel the same way?

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0:02:12.8 S1: Absolutely, and I think the two women who have tried to connect us are two of my very best friends, and I would consider just like, yeah, like you said, brilliant women and so powerful and really believe in the power and the community of the women in the Fargo Moorhead area.

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0:02:27.5 S2: I love it. And you're helping others, so let's get into how you founded the Beth’s Place, your background, and then we'll really get an understanding of what you do at Beth’s Place. So with that, how did you get into this? What's your background? 

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0:02:44.4 S1: So it's kind of a complex story, my mother had gastric bypass in 1999, did textbook well, and back in 97, 98, 99, when they started to do the surgery, you didn't technically need to be obese, and when I looked back, she wasn't technically obese, she was overweight but not what we characterized the surgery to be now. So she was actually one of the first 50 to have the surgery in Minnesota. Did great, did fantastic. Lost a substantial amount of weight was able to keep it off, seemed to get a healthier relationship with food, because as we know, we ground down with food and we over eat and it's such a comfort thing where we're from. And around 20014-15 she started to kind of have these perimenopausal symptoms where she was really unable to sleep, she was sweating... So we were doctoring quite a bit, just trying to figure it out, all of her tests would come back that she wasn't indeed in menopause, so they're kind of like, Oh gosh. And as a woman, I think when you have anything “wrong” with you, right, when you can't do all the things, you somehow just personalize it and make it like...

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0:03:59.0 S1: I'm just crazy. Yeah, I just can't figure it out. Or you just suck it up and just keep it moving. So that's what she did. And she learned to self soothe in her own way. So my family is not big drinkers, who just weren't that family that would ever have beer, or wine with supper, we don't do cocktail hours, not 'cause we're better or worse than anyone, it just wasn't part of our family culture. We would like to cook a lot and hang out, watch movies. So we weren't looking for any sort of substance abuse signs with mom, and then in the summer of 2015, I took a drink of her water bottle and we’re at the lake and she was yelling to me to not grab it and I took a drink of it, and it was pure vodka. And I actually thought it was a joke. Just 'cause I didn't even know…what is wrong with you? Why would you do that? And I just, I can still see the horror on her face of seeing this huge secret that came out, and she instantly told me not to tell my dad...and my parents were high school sweethearts, and I walked up the hill to the lake home and saw my dad, and it's like we just...

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0:05:05.9 S1: Both knew. He had been harboring his secret, I now being the first born and only girl knew. So now, what do we do? So what she was doing is she couldn't sleep, so she started to have a Bacardi diet before bed... Well, one drink with gastric bypass equals six, it actually goes to directly into the blood stream. So it seems like somebody drank a whole bottle of liquor when maybe they've had two to three drinks because it obviously enhances everything. So we spent a lot of time in and out of treatment. And at that time, I had actually gotten into midwife school and was going back to school to be a midwife, so it was really my first exposure to psych hospitals, treatment, and I just despised it all, and I thought it was because my mom was hurting and you really wanted these answers, and the deeper I got into it, it was because I just really despised the system, I just truly didn't understand the system... Here's the problem, what's the solution? And what I was constantly told was, she has to hit rock bottom, she has to figure it out, the person has to want it.

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0:06:16.2 S1: And for me, if you're up to... 'cause she eventually graduated up to a 1.75 of vodka a day, she's not herself, she's hallucinating, she doesn't know who I am, she's presenting as almost an Alzheimer's patient, my mom was very successful in every sense of the word, she was a CEO my whole life, so I just didn't have we didn't have anything for her? You're looking at her going, who are you? Like, you know, this is gonna kill you. It was such a whirlwind. So unfortunately, she was kicked out of her last treatment facility for having one drink, so we went from a 1.75 to a relapse of one drink, and she was kicked out of that treatment facility, which is pretty standard, 'cause then that means that they're not ready... All these things, even though we know it's a brain disease, we've kicked people out and say, Well, you're not ready, you're not ready to get the treatment that you need. She was kicked out, she called me that night, I could tell that she was already drinking 'cause she was slurring her words, and we made a plan to see the kids, 'cause I had really strong on boundaries at that time, and unfortunately over the course of the weekend, I didn't hear from her, and I found her passed away on Sunday at about 9 PM, and she had aspirated because with the gastric bypass, the old surgery, you're unable to physically vomit, so you have no way of getting rid of some of the alcohol poisoning within your body. So at that point, there's a whole lot...

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0:07:42.5 S1: Right then that I consider it a whole break of self, a whole breakdown of spirit. My mom was a teen, my parents were teen parents having me, so I was very, very, very close with them. So I just  told her before I zipped her up in a body bag, I told her, I'm gonna do something. This needs to change, this completely needs to change, I'm making it sound a lot simpler than it was... It was pretty much the worst Lifetime movie you've ever seen, and a lot of therapy. I lost all my hair, I lost my lashes, it was a lot of inner self-work to get to the point of here... So I went back to school, got my double Master's in clinical mental health and addiction counseling, and then continued on to do PhD work and opened Beth’s Place in my mom's name was Beth, and I wanted a place that was person-centered, I wanted a place that was research-based that had the best possible outcomes to really work, so I travel quite a bit to see what other facilities are doing outside of the FM area, if our recovery rate is only 7% like...

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0:08:47.9 S1: Gosh, that's so morbid. Right, it's so morbid. What are other places is doing...

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0:08:52.6 S2: And I had, I just wasn't exposed to it.

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0:08:55.2 S1: Right, so now you're looking at it going, Oh my gosh, it's not just poor socioeconomic status, it's not just other cultures, I was completely eyes opened to this whole other world of people suffering and suffering in silence. You don't get the ribbon, you don't do the walks, you don't do the talks, you do nothing, you just go into a church basement

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0:09:16.0 S2: And fix yourself because that's what you need to do. Yeah, I'm choked up hearing your story, you are so brave. What you just mentioned, can you elaborate on that, of going to the church basement, are you referring to someone that willingly goes to AA?

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0:09:40.6 S1: So I'm gonna get hate mail 'cause I always get hate mail from talking about AA... If you believe that having six Pringles every night keeps you sober, rock out, do it, I don't care if you go to AA every single day and it keeps you sober, rock out, I do not care, I just want your sober... Right. Bottom line, I want to get to happy and healthy, and what I mean by church basement, which a lot of people take it, you just... That is AA.

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0:10:05.3 S2: I mean, just that underground basic shame of struggling with your mental health and substance use

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0:10:11.2 S1: No one knew my mom was sick, so at her funeral, everyone kept coming up to me and saying, I'm so sorry your mom took her life. Yeah.

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0:10:18.5 S2: And I was like, Well, she did, but she didn't... We just assumed it had to be suicide...

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0:10:25.6 S1: Right, and as she completed suicide, because that is more acceptable than... Because now we've moved into that, but that's a little bit more acceptable than no, she drank herself to death. What's the difference? What's the difference? But we didn't talk about it. None of us did, and not 'cause we were embarrassed, I don't feel like my brother or my dad were embarrassed, but you didn't have a solution, so you're talking about it with no solution, like, Okay, we've got 10 days clean out of seven different treatments, so how is she doing, good? I think? fingers crossed. I mean, it's just such an odd thing, versus you go through chemo and you're like, we have 13 left, 12 left, 11 left and everyone celebrates it, versus recovery, you're like, this could be the first one. We could have 17 more. Hoping she makes it, I don't know. So you don't talk about it.

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0:11:23.3 S2: Did she go through one, that time at the lake, did you then have an intervention with her?

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0:11:30.6 S1: Yeah, we did numerous interventions and they were met with a ton of hostility and embarrassment, which we not being educated at that time, just did not understand... We didn't understand why she was so angry. Why was she mad at us when now we know that the pre-frontal cortex is obviously, it's re-routing, it's saying that she's not safe anymore, so she has to protect herself and get back to what is getting her safe, and at that time it was alcohol. It was no longer us, so that's so hard not to personalize when you're a family member going, we're all sitting here and we’re broken and we're all bawling. Dad is crying. Never see my dad cry. Jakey is crying. Never seen Jake cry since he was little. You're sitting there, you're not crying. What is going on? I understand deeply how family members just get mad, just get mad... Cut people off, say, Go figure it out, I get it. Because your drug down with them, it feels like... And it's hard to boundary up with expectations without personalizing those expectations.

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0:12:41.7 S2: My personal story, we did an intervention with my mom as well, and so... 22 years sober now. Yeah, that's awesome. Yeah, she's awesome. And then my dad and my brothers are sober, and on October 25th, I just say The Lord took away any urge for me to drink, I don't know what it was, but I had some things I was praying for, and it was something that... I just haven't drank since. Good for you. Yeah, I look at it as a big accomplishment, I didn't set out to accomplish that yet, but I think looking back to that intervention that we had with my mom, I think you and I have different experiences here because I think she knew... And she was crying out, she wanted the help, the world was just kind of just revolving and she was crying out for help and no one was helping her. And when it to came interventions... Almost like a sigh of relief, like, Thank you. Right. He did Fairview Services where it was all out-patient treatment and still does AA. Awesome. My brother did AA for a while. He's like, I don't need it. It's not something for me.

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0:14:01.4 S2: Every experience and every individual is different. If someone is encountering an addiction, what do you prescribe? Would you give a whole plethora of options, it seems so confusing to me.

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0:14:16.7 S1: So a person-centered treatment has really the best physical outcome, so what that is is I'm basically assigned just by nature, it's just my soul, I love data, I love stats. So if you're looking at... Let's take, for example, the biology of man, we are set up to control our circumstances and provide. So a man is set up to control his environment and then provide... So if he goes into AA, that you have to give up to your higher power, you do all these things, depending on where that person is in their own personal journey, they either can lean into that and not take it so literal. Or they lean into it, and then maybe they relapse or they have all these different things happen, they personalize it, so it really depends where that person is in their biological story. Right, so when we sit down with people and we have... Where we complete the comprehensive assessment, we look at when was your first use, your first use of drugs or alcohol is really gonna compartmentalize where your brain is actively at... And if you've ever sat in a group and someone says, I started using it 14, I started using at 15, and then if you watch me interact with them and we're in this confrontation, they will interact just like they're 14 years old, that's basically when your emotional intelligence and some of that piece stops developing, so your body grows and your emotional intelligence is at14...

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0:15:41.5 S1: So what do we do at 14 when we're confronted? We talk back, we throw a tantrum, some of these stages of change that we know... So long story short, I work with every brain, completely different, completely different. I ask them what they want, I treat them like humans. I don't make them feel like garbage, my entire team, I shouldn’t just say myself, my entire team has been trained on that, what do you think you need? And then it's interesting because the dynamic shifts, the dynamic shifts to I’ve lost my job, I’ve lost my family, but I don't trust myself, I don't know if I can never not drink again. Okay, perfect. Can we get 60 days? Can we do 20 days? Can we do one week? Okay, we'll do one week, so it's really interesting, especially with my men, 'cause they will say, Yeah, I'll give you 60 days of not drinking, I can do that, right. And they'll get 60 days and they'll say, I'm gonna go out this weekend. And this powerful exchange happens when you go, You know what, you're the author of your own life, you go and do that, and then you come back on Monday and I wanna know how it went.

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0:16:45.0 S1: And I have to tell you at least 95% of the time, they'll come back and say, it wasn't worth it. But it's so different than me saying, Nope, you're not ready, if you drink this, this and this, and this is gonna happen, because what we know about the brain and the pre-frontal cortex is that all decision making is gone. It no longer works, you're not able to assess some of that fight or flight, you're not able to tap into that pre-frontal cortex piece, your brain actually diverts and blood actually stops flowing to that area of the brain. So looking at them going, well make the right choice. Make the right choice. Like you should know. They can't... Yeah, all they know when they walk in is that you're a professional that is gonna take away four hours of their day or longer, so they are already... They're boundaried up. They're boundaried up and they're ready to fight, and not everyone, but a lot. And they don't want to do that. So we work really closely and, nine times out of 10, I would honestly say that we don't have much kickback with it. You don't have kickback with the…?

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0:17:54.3 S1: We don't have much kickback with really meeting them where they're at, because that one, you outline everything and you don't do it in a shame-based thing like a... I'm hearing from you that lost your job, you've lost your family, like do you feel like alcohol is any part of that, do you feel like amphetamines are any part of that? And they'll say, Well, yeah. Okay, well, what's your plan? Like, what are you thinking? Well, I really wanna get a job. Okay, so maybe inpatient isn't your time right now, so I'm gonna set these boundaries on you because we all need boundaries and we all need structure. So you have three weeks to get a job, you have to be here every single day. If you're not, I'm gonna recommend that you go to inpatient. Does that work for you? So we boundary and structure, and then they're like, Okay, yep, that works. And it’s these attainable goals to build self-esteem, to build self-worth, to realize that you're not an other... You're not an other... We all suffer from mental health to some degree, obviously some of that is way more detrimental, like my mother, but some of us just have that baseline anxiety, depression or habit of coming home and having a glass of wine, we all self-destruct in some ways, so I don't treat it really any different than any other form of self-destruction.

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0:19:04.9 S2: It's almost like we don't have the awareness that it's self-destruction either... I love that question that you ask of, Okay, you lost your job, what is consistent... What should be taken away? And you need to make the decision for yourself. Not have someone tell you that. About the shame, I can't imagine being in a treatment program and then getting kicked out. For you to recognize that and then change the status quo because from a business perspective... I can see why they do that. I mean, they're running a business and they wanna see a success rate, right. But you're taking it from a completely human experience and the realities of what people face in addiction...

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0:19:52.8 S1: Thank you for that. And I think also, we have state statutes, we have to go on. I'm a state facility, I have a state license, so I think that's the other common misconception, is that any facility that takes insurance is gonna have a state facility license, meaning I have to fall under all the guidelines of the Department of Health, and an auditor comes and she'll say, Why did you have Joe in treatment for six months when he's only come once a week. So once you learn to, I don't wanna say comply, but understand what they're trying to go through too, because a lot of providers have drained the system, right, they’ve kept people in treatment for way too long, or they run their insurance through the mill, so now they really buckled down on it, you have to follow that person-centered model, make sure their treatment goals are aligned, so then when she comes... Her name is Leah. When Leah comes, I can say, I yes, I kept Joe in treatment, but here's his seven other goals that he kept, and this is why... So this is progress from him, we're off of amphetamines, we have our own apartment, here are his goals.

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0:20:54.7 S1: We don't wanna mess with it before, so we kick people out because it's just the model of care that we've believed in for so long, and again, it's gotten a lot of people clean. But it's not a one-size-fits-all.

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0:21:07.9 S2: Healthcare is not. I'm a huge advocate of, we should empower people, we should have not a single system for everyone. Right, exactly. The team at Checkable Medical is famously fussy about what goes into their bodies. Optimal health at every stage and every age is key to living a life you love. Choose better supplements with superior ingredients and simple, easy to absorb formats that fit into your daily life. Feel your best with Checkable Wellness. If you're ready to get started, check out Checkablewellness.com for more details. Your healthcare begins at home. Are you in Fargo or West Fargo?

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0:21:56.1 S1: The clinic is in Moorhead, and then we moved out to Oxbow. We're actually in Oxbow effective in November, so we're doing a whole remodel. Doesn't that look fun?

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0:22:05.8 S2: Oh my goodness, look at that.

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0:22:10.8 S1: We're ambitious. Or stupid, one of the two.

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0:22:16.6 S2: I know it's not stupd. Alright, so tell me more about Beth’s Place, Cassie.

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0:22:23.8 S1: So Beth’s Place is a non-residential level of care, meaning that we have partial hospitalization, which is five days a week, intense outpatient, which is four days a week, low intensity, which is two, and then relapse prevention and individual counseling. So the first step always is coming in for that comprehensive assessment in finding out and working with your clinician of what level of care best serves you. So we've had Maslow’s Hierarchy of Needs forever, right. We know we can't get people sober if they're gonna come out of inpatient and be homeless, so I think that's the other huge piece of person-centered, so we work directly with the client and figure out like, Okay, what is this gonna look like? What can you obtain to... This is where I clinically feel like you need to be... And again, we just don't really get much kickback for it, 'cause people are reasonable when they feel like they're being treated like a human, so we have the Moorhead location and then East Grand Forks, and my goal is to open five more this year. That's incredible. Pretty lofty goals. I’m a mover and a shaker, so I really want to bring Beth’s Place to different rural communities, I want people to access more care, I want people to reach us if they just...

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0:23:39.1 S1: Need to work out a payment plan and they can't afford to go any place else. I really, really, really love what I do, I love my team. So we work really hard and we are incredibly busy... Thank God, it took a second. I used to sit when I first opened and didn't have a single patient and I’d bawl my eyes out at my fax machine.

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0:24:03.8 S2: You would have quit if you didn't have that hunger and that desire to make a difference...

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0:24:10.4 S1: Yes, I do, and it's just like anything. We're really habitual where we go eat, we're really habitual with our doctors, so having a new place in town, private practices typically don’t make it... They don't make it, it's really hard to kinda get up and going, marketing is incredibly expensive, so you don't have some of that income to do that. So I just kind of hustled, I did it old school and dropped everything off, sat and faxed everyone, begged basically, and then I started to get one and then two, and then... I mean, it took... It took probably a full... Almost two years. Wow, good for you. Before we could kind of start to make it, I also struggled with... And I think a lot of women do, asking for money. Yeah, they come in for their assessments or they come into treatment and they're homeless or they're hurting, and I'm like, That's okay.

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0:25:06.3 S2: You don’t need to pay. Oh, but I need to pay my bills.

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0:25:12.2 S1: I know. And so the business side of it, was a big learning curve for me. I didn't have any formal training in business besides watching my family, so I had to wrap my head around that if I don't collect money, I'm not gonna be able to keep the lights on and then it serves no one. Right.

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0:25:31.2 S2: Did you... Out of curiosity, are you able to take non-profit dollars or are you able to take donations?

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0:25:39.4 S1: We can take clothes, not monetary. Okay, we can take some donations, we can't take financial donations at this time, if we did the 501c part, which we'd talked, you know quite a bit about, it would open to that, I'm just not... I'm a provider through and through, so I'm not gonna hit the street and go and ask for money, I just... I wouldn't be good at that part, so financially, I'd have to have someone like a Patrick curve that could do that for me. Yeah, so it’s on the horizon, we talked about it, but isn't on my list of to do right now. Is it reimbursed... Is treatment typically reimbursed or is it a fee-for-service? It depends, it depends on what provider you have, Stanford, Expansion, Stanford, any of those key map insurances are typically really good. Blue Cross North Dakota takes a little bit longer. Sometimes we have to submit quite a bit of documentation, and again, I get it, 'cause a lot of different facilities, we're keeping people in treatment for a long time with little to no progress, so they also don't wanna pay.

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0:26:44.1 S2: That's so frustrating though, because if you have heart disease, they would cover a treatment to take out cholesterol or calcium in your arteries, right, you could go home and continue to eat Whoppers every day, multiple times a day, that has to be frustrating.

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0:27:03.3 S1: Yeah, it is. I feel like I understand it on a little bit deeper level, just being in the field for as long as I have been, and I understand their perspective too, I really do, because I don't think we need to do treatment as many times as we have, I think we need to run a more research-based program, and then it would eliminate some of these repeat. Like the average person goes to treatment seven times, I don't necessarily feel like they have to... I feel like that's a little bit overkill the seven times. Seven times, and that's hoping really that you don't pass away in between zero to seven. Right. That's a lot.

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0:27:40.5 S2: At what point do you recommend someone seek treatment versus dealing with it on their own?

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0:27:49.2 S1: I'm such a lover of my field and profession, so I always think going in talking to someone, that's another church basement myth, right, that you're gonna come in for your assessment and we're gonna ship you to Jamestown and a van’s gonna pick up or you're gonna go away. Yeah, it's really hard to get someone committed, I tried numerous times to get my mom committed, and it's really, really difficult, so I always recommend going and talking to your professional... And just say like, This is what I'm doing, what do you think? And we actually have that quite a bit, we have a lot of CEOs and higher up people that come in and go, This is what I'm doing, I've socially been drinking quite a bit. Do you think I have a problem? And I'm probably a little bit different than a lot of providers, I don't like identifying things as problems, I don't like labeling things kind of like you were talking about with your drinking, is it because you were an alcoholic, is it because you were substantially maybe gonna lose everything, or does it no longer serve you? Yeah. Does it no longer serve you? Change your relationship with alcohol just like you...

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0:28:49.6 S1: Change it with food. We're all plus 40 now, I can’t eat pizza a night. Yeah, yeah. So is it because I have an eating disorder, or is it because it no longer serves me... I also hardly drink. It just doesn't serve me. I feel like I get anxious. Is it because I'm worried I'm gonna possibly be an alcoholic because of that genetic component? No, I don't even think about that. I think it's an insecurity of mine that I really had to work through if I was in public having a glass of wine, and I felt like people when they started to know who I was, were like, Oh my gosh, she drinks... Do you think… All those things that you would tell a story to yourself, and I'm like anyone that knows me knows that I don't...

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0:29:31.7 S2: Yeah, one thing with alcohol that I found even in the first few weeks was I really love to cook, as you were saying, your family likes to cook, so my love language to my family is making food for them. It's so fun, right? Getting a recipe together, and then get your creative side, and then when they eat it, it just brings me joy when they love it, but when I took alcohol out this time, which I've stopped many times before, but this time was... I don't know, it was so different. 'cause it's almost like I was so much more aware of my feelings. Maybe it's the over 40, I'm mature now. Right. I realized that as I was cooking, I was like, Oh, I should have a glass of wine, 'cause I was thinking about things that I didn't wanna think about anymore. I wanted to shut my brain off from work or from relationships that were tense, and it took a few weeks to get that anxious side of me of like, No, you don't need… feel through that and understand why you're doing that, that's how my mom drank, was she started drinking when she was cooking, and she was a really small person, and so two glasses of wine, she was already feeling it.

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0:30:54.3 S2: I'd share this with you because I just feel like now that I'm aware of this, I see so much in society that I related to, and then I accepted... That is like, Oh, mommy wine time, and I just need my wine time with the girls, and now that I don't have it, and like, Oh my gosh, my relationships are brighter, I don't have this looming feeling in the morning when I wake up. That's like, Oh, you shouldn't have drink that, or, you have a headache. Well, you had too much wine, or I need to eat to then make myself feel better... I don't know, there's so much it's so rich and sometimes I don't even have words to describe how it has affected me in the last 100 plus days.

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0:31:43.7 S1: Well, the cultural implications behind it, like you were speaking of, that's just really what we do, and I think it really takes you going to war with yourself to figure out what you want... that we’re closer to the end than the beginning, you know. The reality... What do you want it to look like? We're getting into really busy ages with the kiddos... What do we want that to look like? And for alcohol, especially, I mean it takes years before you form an alcohol use disorder, it's not like amphetamines where it's zero to 10. I mean it could take years, it can take 20 years, and women, especially because of our body fat content, we're not meant to actually drink alcohol at all. So we have an increased chance of becoming an alcoholic because our body does not metabolize it, so I think it takes such a self-aware person that is okay to say I don't drink and this is why, and be okay with whatever people do with it, whatever people say about it. It's always normally based off of their own insecurities, right. Yeah. So I think once you work through some of that and you're okay with that, I had that moment actually, and we took a girls trip to Nashville, and I personally get normally really sick with alcohol, so I had two Trulys, I felt like garbage. Trulys. I’m a real B-A.

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0:33:05.4 S1: Felt like garbage. Just didn't feel good, and we were talking in the morning and I felt this knee-jerk reaction to apologize for not being fun, even though I was fun, I didn’t do anything, right? But I felt that need of being like... But everybody had so much fun. And then there's me, I'm just the nerdy one, I'm just the one that doesn't really wanna drink, but I wanna go listen to music and I wanna have fun or eat good food, and I started to apologize actually to Amanda and stopped myself, and I just said, No, that's a lie. I actually do think I'm fun that... What I'm talking about is I am deeply, deeply fearful of ever leaving my kids like my mom left us... I said because I'm the only medical one in my family, and thank God I found her and not my dad or my brother, 'cause I really don't think that they would still be on this planet, I really don't... It was too much. Yeah, so that's my reality. I don't feel like I'm gonna become her. I don't feel like she was an alcoholic, but it's what she died from, that I have to be mindful of that because a glass of wine, when you have a super manic busy brain, like mine, it quiets it, and that can become a habit real quick.

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0:34:15.9 S1: Yes. Oh, absolutely.

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0:34:18.8 S2: I'm curious, what was Amanda's response?

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0:34:22.0 S1: Amanda also had... Her mom was also a teen mom, so I think me losing my mom obviously was... It hits close to home. Right, and Amanda's a really special, neat person as far as she doesn't have to experience something to understand that empathy piece. A lot of us have to walk... To teach through empathy, you have to go through it, and she's one of those that doesn't... And she just said, Nope, Cass, I completely understand. And she teared up too, and nobody was giving me crap, right. It was my own thing. It was my own thing, it was my own piece going, I would love to just go get drunk and be free and do all the things, but I don't like who I am, and I don't wanna feel sick the whole next day, so I'm just not going to...

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0:35:06.7 S2: And you don't need to. I think that the beautiful piece, something that you're saying right here that even I struggle with, I’m going to my first conference, I don't know in a couple of years now in Miami. And so I'll be reconnected with a lot of people that traditionally, we've gone to conferences and once you're done watching all of your talks, then you go out and you have happy hour and dinner and drinks, and I'm not going to. I'm very firm in that, and I'm just like you in Nashville, you like to enjoy the scene, but in the back of my mind subconsciously, I'm like, I'm not gonna be that same person that they know, like I'm not gonna be this like chatty and I'm gonna be more listening. I love that you're saying this because it's embarrassing to talk about it with other people, and I talk about it with my husband who is not a drinker, so I have that nice support when we look at abuse or reliance on substances, it is shameful, like... And maybe they're gonna think I'm an alcoholic. Or something bad, I did something bad, I got a DWI or something.

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0:36:22.4 S2: Wow. What does stigma like

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0:36:24.8 S1: Psychologically, and I think that women thing right, too, of you just... You think you can do all the things and you can't. You can’t... And then we get into our 40s and we're having these mental breakdowns and our marriages are falling apart and all this stuff, and it's like, what's your role? What's your role in it? Because you've been preaching that you take care of yourself, you've been preaching that you set boundaries, we teach our kids this right? They're watching it, they're watching. Can you... Do you actually... Do you actively preach to take care of yourself and that fear of what others are going to say, because a lot of people do. I don't wanna downplay that, a lot of women especially, talk poorly about other women, they're unable to sit in their own stuff, and if you're one of those women, I’ve said it before. I have someone right when I, I don't know, did something, got some award and someone said I went to the OB, but for anyone who doesn't know the OB is like a club for 20-year-olds downtown that I went every weekend, and oh my gosh, did my feelings gets so hurt, I don't know the last time I’ve been to the OB, probably 2001.

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0:37:33.8 S1: It was such a random fib, but it was all of her stuff, right. It was just her going, Why does she get this? And I don't, but I was telling you before, I have a 100 million degrees and I am still awkward, so giving me an award is just... I know for Amanda it’s like whew! Every time I get off a microphone, I avoided a PR crisis. Whew, okay, get her down. Get her down. I'm actually the opposite. I forced myself to be extroverted when I really used to think I was... And then the healthier I've gotten, I'm like, No, I'm actually not. I'm actually not extroverted, not at all, I'm actually a lot more introverted, I like to read, so I think being okay with who you are, just being okay with who you are and if you drink and that's your thing, do that, but be okay with it because anything you do is gonna come with some level of feedback, and if those people aren't serving you and they're not meant to be in your life, then you need to find new friends... Yes. Find new friends. Find people that serve you.

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0:38:42.2 S1: You shouldn't leave feeling yucky, you know, you just shouldn't... You should be like, No, this is who I am. Like no, she didn't drink in Nashville, she’s a loser. Like, it's okay, but she's still really fun, and she might have woke up at 4 am and went for a run and did all of her reading...

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0:38:59.5 S2: So that piece of finding new friends. What do you recommend to your patients? Because that's a huge thing, you’ve known these people for years, you use together, being lonely is super tough. How do you work through that with your patients?

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0:39:18.9 S1: I think healing in general, right. Substance use or not, healing and getting healthier yourself, like you're talking about going to the conference. I bet in a couple of years you'll probably be able to go out with them, you know, and you'll want to... And it won't maybe affect you quite as much as it is right now because you're protective of your new found healthiness, so I think with your healing journey... What is it, it depends on what we have, right? So if we're working with someone who has amphetamines, you have to cut out people, face some things and you just do. Drug dealing is a business and it's a really profitable one, so they are gonna find you, they're gonna convince you, they're going to, talk about triggers, they're gonna be calling you, getting new phones if you block them, all these different things. Right, so you really have to cut off people, places and things and then maybe find a new job. The bar industry, the restaurant industry is really loaded with drugs or alcohol, so... Let's get you out of there. Let's get you out there and find you a new job. That’s setting you up to fail, you put a pizza in front of me every day and expect me not to take a slice.

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0:40:17.1 S1: It's gonna happen. Clearly, that's a great analogy. It’s going to happen. Even if I know that pizza is gonna give me the flu, I'm still gonna have a piece, I'd rather risk the flu because your brain is fundamentally set up to keep you safe, it's not set up to keep you happy, so I always break it down in the aspect of nanograms. This is where my nerd part comes out, this is when Amanda starts to pray. So if you look at the human brain, we have 20 to 100 nanograms of happiness. We talk about all the time, right? Your dopamine, work out, eat healthy. We have 20-100. People normally sit in that range between 40 to 60, that's just kind of where we are, not too high, not too low, maybe need an SSRI to bump us up, alcohol is gonna bump you to 150 to 200, amphetamines is gonna bump you to 1,500 to 2,000. So what happens is that prefrontal cortex stops talking to the midbrain because it says, No, I found the ultimate safety, the ultimate safety is at the bottom of that bottle and at that drug. Bottom line, because the brain isn't weighing pros and cons anymore because it took away that prefrontal cortex. It’s no longer turned on, so the only thing that's running is that reward circuit, that's it, so that's when people lose their jobs, lose their families, pass away, and then we look at it as this big moral dilemma.

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0:41:44.6 S1: They had to be a bad person. When the reality is, their brain isn't working. Right, right. That doesn't excuse the behavior, but that's the symptomology of disease, you lie steal, cheat, you don't become yourself because your brain is turned on to fight. Yes, it's just turned on. Because it's saying, Where is that? I liked 150 to 300. I liked 1,500, get me there. Get me there.

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0:42:11.3 S2: But then when... Let's say that you start drinking at five every day and then you are done drinking at 10. What happens from 10 PM until five? What is your emotional state?

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0:42:24.9 S1: Within the body? Yeah. So the body is obviously getting rid of it 'cause alcohol especially is posion, so that's where people who start to drink, my mom, for example, to sleep better, don’t, who don’t actually don't hit REM. So your blood sugar is off, you’re anxious, you wake up anxious. Your whole body is fighting to get rid of something that's not supposed to be in there versus taking care of your vital organs and restoring those cells. So the first response is to get done with everything, kind of like when you go into hypothermia, your ends freeze, your fingers turn black, your feet turn black, but your heart is good because the body is set up to protect your heart and just protect your brain, so everything else will go first. So any form of poison, it's gotta get out, so you don't wake up restored... So when you drink, your nanograms actually drop down to that 10 to 15. And that's where that depressant comes in, so you feel lethargic, you're tired, you're anxious, and we don't place it on the drink, right, because you set your boundary drink from five to 10, you maybe didn't get drunk, so it can’t be the drink...

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0:43:32.1 S1: Yes. Can't be the drink. That's what

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0:43:35.2 S2: I was always telling myself. Like oh, you're getting older. Oh, you're so stressed. Is that rationalizing? Are we really good at rationalizing our behavior?

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0:43:45.9 S1: I think we always are. I think life... I don't care if you have my story, your story, everyone in this life doesn't get out of it without going through pain, right? So life gets really hard and it's tiring, and you're constantly trying to fight with your brain to just be okay, to just be okay, and eventually we wanna escape it, and you can't fault people for that, for that glass of wine or that extra piece of pizza or you have copious amounts of trauma, so you start using amphetamines because booze no longer does it. Right, so we just kind of keep upping the ante of what we need to do to get safe instead of sitting in your stuff, truly sitting in it and going, Gosh, you know, I’m kind of a mess. I'm kind of a mess. I don't know myself, I run from emotions, I'm really quick to anger. I mean, all these different things that we go through, we’d much rather just blame it, we’d much rather blame it on people... I sat with a young woman a while ago, and her parent passed away from the same thing mine did, and I didn't go to liquor, I didn’t go to liquor to quiet my head, and unfortunately she is, and I just looked at her and said is gonna bring that person back?

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0:44:59.1 S1: Is it gonna bring them back? No. If you die just like them, will it make your pain less... Are we gonna continue this generational cycle of pain? And if you're okay with that, then be okay with that, then own that, but then let your family free because you have no intention of getting better then.

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0:45:20.8 S2: The reverbial effects of addiction hits the next generation.

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0:45:27.9 S1: My dad and my brother and I, we all had to fight, we all had really bad suicidal ideations and thoughts and deep, deep, deep sadness that comes with regret when you can't save someone from themselves, it hit us all and it hit us all hard, and unfortunately, we really all handled it our own way, and then eventually kinda came back together, but man, it took a lot of work. It took a lot of work because you blame yourself. You blame yourself. I was sitting in her, with that room, her home was full of feces, there was 1.75s everywhere. My beautiful, educated mother was laying on the floor like a piece of garbage, people were stepping over her body, it was the absolute most horrific environment I had ever been through, there's no physical way to get around the fact of, I could have done more, I could have done more, and the reality is, the people that fight addiction are the ones that go to war with themselves, there's no way out of it, there's no magic medicine, there's no treatment, it is literally sitting with yourself and going to war with yourself because life is not fair, and it's hard to explain that to people without them feeling like you are not giving light to their trauma, you know...

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0:46:52.6 S1: And that's not what I said. So reiterating and going, No, you have every right to use amphetamines, you have been sexually abused your whole life or physically abused your whole life... I get it. But now what? Right? Now what?

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0:47:06.3 S2: This part of your life to live

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0:47:08.8 S1: 1920s, totally different. In 2022, when you have the ability to go to college, you can learn a new trade on YouTube, I'll go to war with you, let's fight. Let's go, you tell me why you deserve it, like Let's go, but you're gonna lose, so I hope you have your big girl pants on, 'cause I just don't wanna hear it.

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0:47:29.8 S2: You have a relationship... Practice of medicine. From hearing you. That's what it sounds like. Do you identify with that?

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0:47:38.2 S1: Yes, and I've had lots of students that have come and sat in and my office manager, she's like, Hi, Oprah, how are you?  I think I just look at people and I'm like, Well, you look like a mess, and I laugh like... I mean, they know it’s you, right?  My gosh, you might as well laugh until we cry. Let's just get better. Your brain is running the show and it's not working out too well. Are you happy? I haven't met any addict that's like, No, this is who I wanna be. I love this, I love it. Everyone wakes up and looks in that mirror... Right, the cycle stops when you look in that mirror and goes Not anymore. Not anymore. She no longer serves me. This is the last day I'm waking up like this. But then if the next day you do it again, it's okay, you just keep going until you get so sick of yourself. Yeah.

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0:48:33.9 S2: I actually do look in the mirror and I'm like, Wow, you look so much healthier, and I almost can't remember looking in the mirror before because I don't think I was actually like... I don't know, I'm identifying myself differently. It’s strange.

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0:48:49.8 S1: Yeah, for me, just being trained clinically, I always look at people's skin and I already knew you didn't drink because you have beautiful skin. Oh, thank you. I always look at the deep black circles under the eyes. Yes, because of that dehydration, you don't notice that we just put it on, getting older and you're like, No, no, we've aged ourself, because that's a symptom over drinking, so you could always tell.

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0:49:15.4 S2: The dark circles was like... I just thought that it was my... Just how I was. Like, oh wow, my family has dark circles or... And telling myself that.

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0:49:26.3 S1: Yeah, when really your body, your liver has been working over time and hasn't been able to restore any of your normal blood flow because it's getting rid of all the alcohol.

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0:49:37.6 S2: I've been talking a lot about this in a lot of our content, and I have shared... I shared when I was 90 days sober, and then just 100 days just seems a lot to me, and just sharing how good I feel... And it does feel a little bit like it is scary to say, as I say, Well, is this gonna be forever? And I told myself that once I was done with this fundraising piece that I... When I raised 4 million dollars, then I can do what I want, but I'm gonna be sober during that 4 million, and then I raised the 4 million and instead of drinking, I went to a yoga class. I went and got some good steaks and we made these fun sprtizers with the kids and celebrated and danced, and I did not even think about it until two days later that I was like, Oh!

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0:50:32.3 S1: Yeah, I remember I granted myself permission to drink again. Yeah, so cool. 'Cause your relationship has changed. Okay, your relationship has changed with it, it no longer serves you, and I'm so... and I think I touched on this already, so big on labels, not calling yourself an addict, if it helps you... Sure, but aren’t we all? Aren’t we all self-destructive in some way? I know a lot of people, just like you know a lot of people and you're like, Oof you're unhealthy. And counselors, counselors are really unhealthy humans, I've had a hard time even hiring counselors just to be like, have you worked on your own stuff, because it's really easy to sit with other people and be like, oof, at least I'm not them. Okay. Well, have you sat in your stuff? Yes. Behavior is a behavior, it doesn't matter if you have a substance in your choice. Behaviors of behavior, whatever you do with it.

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0:51:29.8 S2: I could literally talk to you all day, Cassie, about this. I find it fascinating, you are so approachable and for being so brilliant, you are really relatable

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0:51:40.5 S1: Thank you. See, Many? I hope Mandy is listening to that. See?

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0:51:46.2 S2: She knew that we would have a spark and I’m glad that I have met you... My last question is around a substance that a lot of young people are using and that's Adderall, and in learning more about ADHD, and I know that people are using Adderall, and to me, that just doesn't seem like something that is a good thing. And I'm wondering, from your clinical perspective, self-diagnosing and saying, I want a Adderall prescription, and then having a dependency on that... What does that look like to you?

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0:52:24.5 S1: So it's gonna vary, right? I for sure have undiagnosed ADHD, probably could have really benefited from Adderall when I was a kiddo, but played a lot of sports instead. My youngest completely is me through and through. Has a hard time. Busy brain wants to go. So we actually just had a meeting at his school and his teachers actually suggested that, and I stopped and just said, But why? He's also a little boy. There's no behavior, there's no violence. There's nothing like that. He just wants to get up and move. And we now have this whole generation where we don't like our boys or our men to be men, but then we also confuse them and tell them not to have emotions either, so I felt kind of in the middle. I think there is a lot of people that really, really benefit from any sort of ADHD med, but there's also non-stimulant ADHD med, I tend to gravitate towards that more than I do the stimulant, because to me, when you added an extra stimuli, like for myself, I am the last human that would need Adderall, I would not sleep, I would be ping-ponging and all night...

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0:53:29.6 S1: That is the last thing that I need, but what I probably benefit from a non-stimuli acting... ADHD medication. Probably. It would help me concentrate. So I think wherever it fall, so my Brody, for him to be able to concentrate on school, am I there yet where I feel like he would benefit from a medication... No, we're trying other things. We're talking, we're writing. He's in a lot of sports. We're doing a lot of that. What would I be opposed to it at 13 if our grades are dropping, we can't concentrate... Yes, but I would do the non-stimulant med, I would... I would have a hard time with watching him be crawley and knowing that I induced some of that by opening him up to medication because now again, we pumped our nanograms up to seek... Oh yeah.  Everything comes down to brain chemistry, and now we've pushed it to seek... So how do we get off that? How do we not constantly look for that 150 nanograms? So I really want Brody to learn some of those self-soothing skills before we open up into it, and we talk a ton about that in treatment, some of that emotional intelligence, what are you actually feeling? What are you actually going through...

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0:54:43.7 S1: I'm sure they love having a therapist for a mom. Please stop talking to to me. I just had bad day, nothing you did. So we walk and talk through a lot of that, because even last night, he couldn't go to bed, he was just ready to ping-pong, I'm like, go to a quick shower right down your day, and in his day, a kid had called him weird, so he wouldn't have verbalized that to me. Super normal thing. That’s how kids talk, he's in third grade, but it hurt his feelings, but he's not old enough yet to tell me that hurt my feelings, and now I'm in my brain going, How do I not be weird? How do I not be weird? And I just thought I said, Are you weird? He said, Kind of it. I was like, you are... You're really weird. Yeah, you actually drive use all insane, you’re actually really, really weird. That's just how God made you. So let's just rock out with that, mom's weird too. Yep, this is what it is. So I think that acceptance piece is so powerful for me before we added meds, if we have to add in meds...

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0:55:58.0 S1: Great, there's no shame in that. I'm on Wellbutrin, I am a really busy, irritable human, so I need something to take the edge off, then that's okay. I have no issue saying that, 'cause if not, I will go, go go like the Energizer bunny. So... And that's not good for any... and it's not healthy, and I've tried all the other things. So I think every one of my staff members is on Wellbutrin, were basically reps for it. Wow, I don't even know what it is. It's like an anti-depressant, but it works really well in my... Depression presents more as the inability to concentrate versus sadness, I don't really get sad, I'm not sad, but I struggle to a chart that maybe would take me an hour, maybe takes me two... So that's what I know. I should probably add in some things, I'm trying all the other things, and it's not working. So again, just knowing yourself and being okay.

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0:56:50.8 S2: Yeah. And if you're self-medicating other ways, then you're not gonna know yourself that way...

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0:56:55.9 S1: Yeah, 'cause the glass of wine works, someone last week and they were just crying, they felt so bad from suffering from alcoholism, and I'm like, But it works, it works, right? And he was like, No, it does. So it can make sense.

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0:57:15.1 S2: The kind of way of talking to someone in there and they're walking in their pain of it... Okay, what you did wasn’t bad, you're not a bad person.

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0:57:24.2 S1: And I think we forget, especially in mental health and substance abuse, they're paying for a service, and we're also given people's family members, that's a big responsibility, you have to truly know yourself, know how to take care of yourself, and you leave the day because we listen to trauma, we listen to the worst stories that you could possibly imagine that you only see in movies... What do you do with that? 'cause you gotta get rid of it somehow. It's gonna sit on your body, it's gonna sit in your brain, so what do you do... You really have to work through that so that when someone comes and they're sitting in front of you and you have someone's mom, someone's dad, someone's son, that you can say, We're gonna figure you out, we're gonna get you to where you need to go, and we're not gonna let you leave here today until you do.

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0:58:08.2 S2: Oh, that's awesome. So, Cassie, what are some words to leave us with. You shared so much today. This is such an amazing conversation. Thank you. Like some final words of inspiration or... What would you like to leave us with?

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0:58:24.5 S1: Oh gosh, you know what I would just say that that help is out there. That help us out there, the FM community is really filled with amazing treatment facilities, amazing mental health facilities, and also, if your suffer from mental health or you suffer from addiction, be your own advocate to the best of your ability, and if you're unable to say you're so sick, find someone that's safe for you to be your advocate, the therapeutic relationship is really gonna be your key to overcoming whatever you're going through, so if you're with someone and you don't care for them, you need to find a new therapist and that's okay. That is absolutely okay. My personality type is very type A, and I'm kind of a hard hitter, I'm gonna find out what's wrong with you and we're gonna hit it, I'm not gonna let you leave that room until we do... That's not for everyone, so you might have to go with a different therapist, so I always put that disclaimer out there too, if you're ready to work and hit it, I’m your girl, if you're kind of in the middle, my other counselor, Addy’s your girl.

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0:59:21.6 S1: So where do we wanna be? And if you’re with Addy, you're like, No, I need Cass now, then that's where we kind of work as a team and we staff every week together, so I think being your own advocate, don't just give up... You go to Prairie and you don't like it, go somewhere else. You go to ShareHouse, you don't like it, go somewhere else. You keep trying until it works for you, because living with a life of mental health and addiction, you don't need to suffer alone, you just don't. It’s not for anybody. You just don't

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0:59:49.3 S2: Completely agree. You're not alone in this.

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0:59:51.8 S1: No, not at all. I mean, 33 people a day pass away in the FM community from alcoholism. Wow, that's a lot. And we don't see that in the paper. And what we see is the opioid crisis... Wow. 33 people a day? 33 people a day. So it's a lot, but we don't wanna talk about it, and I do attribute Beth’s Place success to the... I've been in about... We did a women of the year, we did all these things like I just kinda came out of the gate, middle finger up going, Oh no, we're getting people help. We’re coming in. Let's do this. Good for you.

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1:00:30.4 S2: Well, I'm so proud of you, and thank you for being a part of the new community that I'm a part of, you've definitely made your mark and helped so many people, you have a wonderful reputation to follow. Thank you, thank you. Absolutely, it's a pleasure talking with you. Thanks for sharing your story and thanks for relating... Helping me relate mine to yours, I think it brings... For me, it brings a lot of comfort to hear other people's stories, and I hope that someone listening knows that there's help out there. What's the best way for people to get a hold of you?

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1:01:09.4 S1: If they need a comprehensive assessment, you can book online at bethsplacerecovery.com, you can always call the clinic... It's open five days a week at 701-566-9965. That would probably be the best way. Right when you come in, we obviously have to screen you to make sure that you're safe and in the appropriate level of care, so that first thing is always gonna be the comprehensive assessment, it's nothing to be worried about it’s just how us clinicians gauge where you need to be so we can set you up to succeed. Well, thank you so much, Cassie. Thank you.

‍1:01:40.9 S2: You’re a wonderful guest, thank you. We hope you enjoyed this episode of The We Podcast as much as us. If you want more wellness goodies, head over to the WellnessEssentialsPodcast.com for show notes, links and resources mentioned in today's podcast. Remember to hit subscribe on your favorite podcast platform to get all the wellness details as soon as they are released. Cheers to living your healthiest and happiest life.