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Speaker 1: Welcome to the Therapy for a Black Girls Podcasts, a

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Speaker 1: weekly conversation about mental health, personal development, and all the

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Speaker 1: small decisions we can make to become the best possible

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Speaker 1: versions of ourselves. I'm your host, Dr joy hard and Bradford,

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Speaker 1: a licensed psychologist in Atlanta, Georgia. To get more information,

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Speaker 1: visit the website at Therapy for Black Girls dot com.

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Speaker 1: And while I hope you love listening to and learning

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Speaker 1: from the podcast, it is not meant to be a

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Speaker 1: substitute for relationship with a licensed mental health professional. Hey, y'all,

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Speaker 1: thanks so much for joining me for session eighty one

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Speaker 1: of the Therapy for Black Girls podcast. Today we'll be

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Speaker 1: digging into helping you explore your relationship with substances. For

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Speaker 1: today's conversation, I'm joined by Dr Delicia Pittman, whom I

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Speaker 1: had the pleasure of helping to train while she was

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Speaker 1: a student at the University of Georgia. Dr Pittman is

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Speaker 1: an assistant professor and the director of the Clinical Mental

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Speaker 1: Health Counseling Program at the George Washington University. She's also

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Speaker 1: a licensed psychologist in the District of Columbia and Virginia. Additionally,

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Speaker 1: she maintains a private practice in Woodley Park. Dr Pittman

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Speaker 1: and I discuss how you can tell if your use

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Speaker 1: of substances has become more than recreational, the steps you

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Speaker 1: can take to get help if you think you might

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Speaker 1: be struggling, how some of our cultural practices may be

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Speaker 1: contributing to masking issues with substance abuse, and how to

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Speaker 1: help if you think a friend may be struggling with

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Speaker 1: their substance use. If you hear something that really resonates

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Speaker 1: with you while listening, please share it with us on

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Speaker 1: social media using the hashtag tb G in Session. Here's

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Speaker 1: our converse station. Thanks so much for joining us today,

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Speaker 1: Dr Pittman, Thank you so much for having me. It

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Speaker 1: feels very special to have you joining me here on

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Speaker 1: the podcast. You know, so for those people who don't know,

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Speaker 1: Dr Pittman was one of my very first practical students

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Speaker 1: that I have had the distinct pleasure of helping to

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Speaker 1: usher her into the field, which has been incredibly exciting.

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Speaker 1: So I'm excited to have you here to chat with

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Speaker 1: us about substance use um. And it's not a topic

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Speaker 1: that we talked about very much on the podcast, but

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Speaker 1: definitely something that I know a lot of people are

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Speaker 1: curious about and need more information about. So I thought

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Speaker 1: we would start by kind of talking a little bit,

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Speaker 1: you know, like a lot of people will kind of

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Speaker 1: recreationally you know, I'm hanging out with friends, I'll take

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Speaker 1: a drink, I'll smoke or whatever. But can you tell

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Speaker 1: us about like some of the signs that it may

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Speaker 1: be beyond recreational use, you know, like if you're drinking

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Speaker 1: too much or smoking too much. Like, what are some

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Speaker 1: of the signs that maybe you need to really pay

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Speaker 1: attention to what's happening with your substances. Sure, I think

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Speaker 1: one of the things that comes up quite a bit

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Speaker 1: both as a professor and training therapists, but in my

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Speaker 1: clinical work is really sort of understanding some of the

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Speaker 1: early signs that you've moved out of what feels still

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Speaker 1: very recreational and is moving more into sort of problem

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Speaker 1: substance to you. So historically we would categorize it as

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Speaker 1: abuse versus dependence, and we don't do that any longer,

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Speaker 1: but we're really sort of paying attention to you primarily

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Speaker 1: first and foremost negative consequences. Are you experiencing any negative

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Speaker 1: consequences as a result of your substance? Used behavior. So

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Speaker 1: that could be anything from taking a long time to recover. Right,

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Speaker 1: so I know that some of us get older, it

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Speaker 1: takes us a little longer to recover from a night

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Speaker 1: of drinking. That could start to interfere with you meeting

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Speaker 1: responsibilities that you have the next day. And is that

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Speaker 1: happening with some regularity? So negative consequences in that regard.

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Speaker 1: Have you gotten a d U I or other possession charges?

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Speaker 1: Are you getting in legal trouble because of your substance use?

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Speaker 1: And this isn't just sort of an isolated incident or

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Speaker 1: or a poor decision, but certainly when you are out

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Speaker 1: for a night and you decide to get behind the

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Speaker 1: wheel and exercise poor judgment, we might have some concern

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Speaker 1: about your ability to really regulate or what we call

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Speaker 1: moderate even your alcohol use or your substance consumption, whether

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Speaker 1: that's marijuana use or alcohol use or some other kind

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Speaker 1: of recreational or club drug use. Um. So, legal trouble

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Speaker 1: consequences if you find that you fire more of the

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Speaker 1: substance to get the desired effect. Um, So you developed

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Speaker 1: some tolerance to a substance, and that can be cultural.

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Speaker 1: I think, particularly within the Black community, we sort of

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Speaker 1: pride ourselves on what we call being able to handle

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Speaker 1: our liquor, and so there's a social implication of that,

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Speaker 1: but that at the same time, being able to handle

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Speaker 1: large quantities of liquor is an indication that you've developed

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Speaker 1: some tolerance. In order to develop tolerance, you have to

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Speaker 1: drink a lot at that level, which could be an

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Speaker 1: indication that you are starting to move out of recreational

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Speaker 1: drug use or substance use into sort of more slippery

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Speaker 1: slippery territory. That's great information, and I do think that

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Speaker 1: that is something that people do want to pay attention to.

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Speaker 1: And I'm glad you brought up the whole cultural piece

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Speaker 1: because I do think that it warrant some conversation around

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Speaker 1: like what happens if you are like in a friend

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Speaker 1: group where you kind of feel like everybody else is

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Speaker 1: drinking and smoking, but that's not quite your thing. Can

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Speaker 1: you share any information about that, like what that might

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Speaker 1: be to be like to negotiate some of those kinds

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Speaker 1: of relationships. Sure, in those relationships, whether their friendships or

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Speaker 1: romantic relationships, can be tricky to navigate. Certainly, peer pressure

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Speaker 1: doesn't go away, you know, once you're out of college

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Speaker 1: or high school. And so if you if you find

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Speaker 1: yourself in a friends group or a social group, or

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Speaker 1: even in some cities, some cities like Atlanta and d

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Speaker 1: C very much have brunch cultures, and those like brunch

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Speaker 1: cultures are centraled around like day drinking and day parties

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Speaker 1: things like that, where it's very sort of very much

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Speaker 1: more the lies to be drinking large amounts of alcohol

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Speaker 1: for long periods of the day, and those are a

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Speaker 1: great opportunities for socialization. But if you find that you're

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Speaker 1: part of a friend group who maybe drinks or smokes

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Speaker 1: more than you do or than you're interested in, it

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Speaker 1: can be challenging to engage with them or to sort

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Speaker 1: of have a robust social life with that group of

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Speaker 1: friends without feeling pressure to to drink more or drink

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Speaker 1: a lot, you know. So some of the tricks are

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Speaker 1: you know, obviously, drink clear things. Clear liquors um don't

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Speaker 1: necessarily ward off getting intoxicated. They can be equally as

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Speaker 1: intoxicating as dark liquors can be. But it can be

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Speaker 1: much easier to disguise drinking something that looks alcoholic but

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Speaker 1: that's not alcoholic, you know. So for some clients, I'm

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Speaker 1: like order a tonic water like on the rocks with

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Speaker 1: some lime, it looks like you're drinking a gin and

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Speaker 1: tonic but you're not. Or order uh, you know, diet

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Speaker 1: coke with a lime on this side, it looks like

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Speaker 1: you're maybe drinking a Roman Coach, which you're not. And

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Speaker 1: so it can really help you pace how much alcohol

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Speaker 1: you consume when you have a peer group who has

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Speaker 1: an affinity for alcohol. Um smoking is a bit trickier,

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Speaker 1: so you'll have to get pretty skilled and confident at

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Speaker 1: saying no or choosing to lead certain circumstances where your

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Speaker 1: friends might be smoking and you don't want to. This

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Speaker 1: comes up a lot around like hookah and like you know,

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Speaker 1: drinking and smoking hookah and or marijuana and those sort

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Speaker 1: of all going together to sort of really kind of

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Speaker 1: exacerbate the high. They kind of create what we call

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Speaker 1: synergistic effects, and they increase the high of each other.

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Speaker 1: And so for some people that's great, and for some

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Speaker 1: people it makes them very, very sick. So you have

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Speaker 1: to know your own sort of thresholds for that and

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Speaker 1: be okay sort of being made fun of. I mean,

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Speaker 1: at some point there's gonna be something that makes you

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Speaker 1: stand out and I always say I'd rather stand out

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Speaker 1: for not doing things I don't want to do than

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Speaker 1: you know, blending in and having to deal with the

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Speaker 1: consequences of doing something I didn't want to do in

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Speaker 1: the first place. Great information, and I think that's an

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Speaker 1: interesting point. I had not thought about how the whole

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Speaker 1: brunch culture really is, you know, kind of encouraging like

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Speaker 1: all day drinking. Like you think, oh, bottomless mimoses, it's

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Speaker 1: pretty harmful or harmless. But when you think about it,

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Speaker 1: like didn't, that means you're consuming probably larger quantities of

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Speaker 1: alcohol during the day period than you typically would be

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Speaker 1: absolutely right. So if you think about the standard brunch

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Speaker 1: hours and you start brunch at twelve o'clock and you

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Speaker 1: have bottomless mimoses until three, you likely will consume at

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Speaker 1: least a bottle an entire bottle of alcohol per person.

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Speaker 1: I think folks go really pressed to get their money's

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Speaker 1: worth when you have something that's bottomless, and so you're

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Speaker 1: sort of encouraged to drink more than you might otherwise

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Speaker 1: if you were paying by the glass. Good points. Are

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Speaker 1: there other things you can think of? Kind of like

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Speaker 1: just in our culture now, that kind of encouraged is

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Speaker 1: kind of behavior. I think one of the things that

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Speaker 1: is often talked about particularly is that college graduates drink

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Speaker 1: more than any other demographic and the country. And so

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Speaker 1: as we're particularly amongst African Americans, as we're seeing larger

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Speaker 1: quantities of African Americans go to college and complete college,

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Speaker 1: you do sort of fall into the college culture of

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Speaker 1: drinking and bench drinking on the weekends, which is sort of,

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Speaker 1: you know, a really sort of centralized, clustered drinking pattern

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Speaker 1: that's sort of exclusive to the weekend, of drinking large

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Speaker 1: amounts of alcohol and abstaining during the week on some level.

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Speaker 1: So I think certainly having being a college graduate or

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Speaker 1: having gone to graduate school certainly increases your risk for

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Speaker 1: how much you drink, which certainly can contribute to drinking problems.

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Speaker 1: Things like fraternities and sororities, not in and of themselves,

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Speaker 1: but particularly the college culture around homecomings and events that

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Speaker 1: we see those can be slippery slopes for folks to

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Speaker 1: drink more than they do in their regular, like day

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Speaker 1: to day lives. And so part of it is paying

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Speaker 1: attention to those kinds of events. If you tend to

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Speaker 1: go those kinds of events and you overconsume and you're

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Speaker 1: you know, either passing out or throwing up, those kinds

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Speaker 1: of things that feel pretty benign in the moment, but

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Speaker 1: it's a pattern. It like every year we go to

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Speaker 1: this event and I overconsume and I throw up, and

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Speaker 1: that's like you normalize that could eventually become problematic, you know.

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Speaker 1: So one of the things that I always tell people

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Speaker 1: is that the outward you know, the outward effects of

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Speaker 1: alcohol that you see, you know, the throwing up, the

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Speaker 1: passing out, the like slurred speech, those kinds of things

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Speaker 1: are not actually an accurate indication of what's happening on

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Speaker 1: the inside. So your body can metabolize about one drink

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Speaker 1: an hour um, and so you generally feel intoxicated when

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Speaker 1: your body isn't able to metabolize the amount of liquor

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Speaker 1: um that you've consumed in that time. And so this

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Speaker 1: is a standard shot, which is about four ounces of liquor.

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Speaker 1: So it's not you know, we're not talking about a

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Speaker 1: large quantity of alcohol that your body can metabolized in

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Speaker 1: an hour. And so any drink that you get in

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Speaker 1: a bar is gonna be a larger amount of alcohol

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Speaker 1: than your body can metabolize in an hour. Um. You know.

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Speaker 1: So if you're able to do two or three or

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Speaker 1: four of those in an hour's time or a couple

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Speaker 1: of hours, you're gonna feel intoxicated. Um, and and then

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Speaker 1: things start to sort of fall apart from there. Those

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Speaker 1: are great measurements. I don't know that I knew all

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Speaker 1: of that information about like how much your body is metabolizing,

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Speaker 1: so great information for anybody who also didn't know that.

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Speaker 1: So I think one of the things that often comes

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Speaker 1: up is that like friends and family members will be

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Speaker 1: may recognize like some issues without drinking or substances before

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Speaker 1: we might. So what suggestions would you have maybe for

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Speaker 1: a friend or a family member who think, like, oh,

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Speaker 1: I think my roommate maybe drinking too much, or I

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Speaker 1: think my coworker maybe has an issue smoking too much,

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Speaker 1: Like what kinds of things might you suggest for them?

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Speaker 1: Or should they even intervene? That's a great question. The

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Speaker 1: if and when conversation is a difficult one. It really

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Speaker 1: depends on the circumstances. If you are living with someone

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Speaker 1: who's a friend or a roommate, you know, trying to

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Speaker 1: give them some feedback about behavior or their substance use

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Speaker 1: they're smoking. Um, if it's infringing on your levels, and

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Speaker 1: certainly you want to tell them that, like when you

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Speaker 1: smoke in the house, I don't appreciate it, or whatever

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Speaker 1: the conversation is, and trying to set some boundaries with

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Speaker 1: them and some agreements with them around they're they're smoking

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Speaker 1: or drinking. I've certainly had situations where roommates kind of

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Speaker 1: like set a trap. I don't recommend that, Um, so they'll,

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Speaker 1: you know, put a bottle of alcohol in the house

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Speaker 1: and note everyone else is in agreement that nobody will

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Speaker 1: touch it to see how long it takes for that

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Speaker 1: bottle to like empty, so that they can use that

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Speaker 1: as evidence that, like, you might have a problem because

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Speaker 1: you're the only one who's drank this entire bottle of

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Speaker 1: whatever the case may be. I don't recommend that. People

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Speaker 1: generally are quite defensive about it, you know, And so

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Speaker 1: I always try to encourage people to hold others accountable

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Speaker 1: in love, what is it that it's concerning to you?

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Speaker 1: What is it about their drinking or they're smoking that

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Speaker 1: is concerning to you? And lead from that place. Don't

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Speaker 1: lead from the place of you drink too much, but

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Speaker 1: lead from the place of you know, I'm noticing that

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Speaker 1: you're having a real hard time meeting these other responsibilities

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Speaker 1: or demands. I'm really concerned that you might be on

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Speaker 1: the custom of losing your job because you've called in sick.

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Speaker 1: And there seems to be this relationship when you when

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Speaker 1: you drink a lot on Friday, that you don't make

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Speaker 1: it to work on Saturday, and I'm concerned about that,

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Speaker 1: you know, so try to sort of lead from the

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Speaker 1: place of of concern less than the place of judgment.

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Speaker 1: And so when you attack people from the place of

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Speaker 1: their substance, that often doesn't go well. The other piece

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Speaker 1: of that is making sure that you're not enabling the behavior.

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Speaker 1: You're not buying or supplying or lying and covering up

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Speaker 1: for someone so they avoid the consequences of their substance

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Speaker 1: used to behavior. Ultimately, that just prolongs how long they

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Speaker 1: stay entangled in substance abuse. If you're you know, making

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Speaker 1: sure that they're not homeless, or you're making sure they

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Speaker 1: don't lose their job, or you know, you'd rather than

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Speaker 1: smoke at home, so you buy for them so they

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Speaker 1: don't get something on the street that's not good or

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Speaker 1: you know, dangerous. Those kinds of things are conversations that

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Speaker 1: I'm often having with parents and significant others of folks

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Speaker 1: who have substance abuse issues. And it can be really

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Speaker 1: difficult to watch someone you love um go down a

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Speaker 1: path that you don't agree with and that you think

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Speaker 1: is really dangerous for them, and they don't they don't

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Speaker 1: agree with you, or they don't see it the way

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Speaker 1: you see it. But I'd say, you know, one approach

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Speaker 1: them from a place of love and to don'tint able

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Speaker 1: to behavior. And I think you bring up an interesting

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Speaker 1: point about you know, like especially if this is somebody

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Speaker 1: who you are very close with, like a partner or

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Speaker 1: a sibling or a parent, like around boundary setting, and

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Speaker 1: you know, like how that relationship actually can be functional.

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Speaker 1: Can you say more about that? Sure boundary setting, particularly

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Speaker 1: once you're engaged with someone who has active substance abuse issue,

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Speaker 1: can be really really challenging. You know. When I'm working

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Speaker 1: with folks and recovery, even in early recovery, you know,

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Speaker 1: one of the things that that we sort of use

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Speaker 1: to conceptualize that work is that addicts work getting high

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Speaker 1: like a full time job, Like it is their job

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Speaker 1: to still say high. That is the addiction works. This

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Speaker 1: is a choice that they're making. Think the first use

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Speaker 1: and maybe even several of the subsequent uses were choices. Um.

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Speaker 1: But the way that that physiologically your body starts to

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Speaker 1: respond once you're addicted is quite different, and it's it's

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Speaker 1: more of a like a primitive response, more like a

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Speaker 1: reflex than a choice. Um. And so getting sober, getting

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Speaker 1: clean can be really really challenging because of it. And so,

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Speaker 1: you know, setting boundaries, you know, with folks who are

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Speaker 1: actively using can be challenging early on. Generally, folks once

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Speaker 1: they've been they've been lied to, they've been stolen from,

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Speaker 1: then those folks generally have no problem setting boundaries. They

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Speaker 1: just cut the person off completely. Addicts who are using

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Speaker 1: and are using an isolation, have been cut off from

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Speaker 1: their families and their support systems generally take much much

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Speaker 1: longer to get clean, you know, So thinking about like

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Speaker 1: what do healthy boundaries look like. This is maybe a

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Speaker 1: person who's allowed home for Christmas, but they're never left alone.

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Speaker 1: You know that, we don't drink with you, we don't

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Speaker 1: smoke with you. You're not you know, we don't engage

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Speaker 1: with you around whatever. The behavior that you have a

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Speaker 1: problem is, it's not a problem for us. And we

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Speaker 1: won't not engage the behavior because that feels restrictive, but

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Speaker 1: we won't engage it with you. UM. So you know,

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Speaker 1: thinking about and what emotional boundaries, not even just physical boundaries,

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Speaker 1: but what emotional boundaries do you need to set to

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Speaker 1: keep yourself mentally and psychologically well. Um, when you love

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Speaker 1: someone who's actively using, I think all too often we

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Speaker 1: get pretty emotionally entangled in in the substance users addiction.

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Speaker 1: It's like if I were enough, if you loved me enough.

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Speaker 1: I'm like, their addiction has nothing to do with you.

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Speaker 1: It has nothing to do with how much they love you.

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Speaker 1: It has nothing to do with how much they respect you.

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Speaker 1: And I hear that often. I can't believe you disrespected

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Speaker 1: Mom's house by stealing or doing this then the other thing,

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Speaker 1: And it really those factors. I certainly understand the sentiment,

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Speaker 1: but really those are are not congruent. These are folks

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Speaker 1: who generally deeply love their family and deeply have deep

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Speaker 1: regret about the things that they do when they're under

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Speaker 1: the influence or in pursuit of the next fix. And

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Speaker 1: they've burned a lot of bridges in the process. Um.

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Speaker 1: And so you know it's not often a reflection, any

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Speaker 1: accurate reflection of how they feel about anyone who's close

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Speaker 1: to them. Um. But those of us who are clean

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Speaker 1: and sort of take their addiction quite personally, and and

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Speaker 1: that can be really really challenging and really dangerous as well.

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Speaker 1: Great new information. So I do want to spend a

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Speaker 1: little time, because you know, marijuana has become legal in

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Speaker 1: some states, you are seeing more and more around edibles,

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Speaker 1: so it definitely feels like there is more heavy usage

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Speaker 1: of marijuana. UM. So I do want to spend a

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Speaker 1: little a time kind of talking about, you know, like

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Speaker 1: the impact that marijuana actually has on our system and

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Speaker 1: things that people maybe need to be paying attention to

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Speaker 1: in in terms of consuming marijuana. Sure, I mean so

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Speaker 1: one of the things that I like to point out

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Speaker 1: as the difference between decriminalization and legalization. So some states

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Speaker 1: marijuana has been decriminalized, which is essentially just loosening the

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Speaker 1: criminal penalties that are imposed for being in possession or

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Speaker 1: being found in possession of marijuana, which is still means

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Speaker 1: that the manufacturing, the growing, and the selling of marijuana

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Speaker 1: is still very much illegal. Um. And then there are

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Speaker 1: states that have legalized marijuana, which lifts and abolishes laws

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Speaker 1: that that banned both possession and personal use, and so

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Speaker 1: those are the states that are going to have dispensaries

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Speaker 1: that you can go into and purchase freely. So those

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Speaker 1: are very clear distinctions. One of the other things that

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Speaker 1: I often like to highlight for our folks is just

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Speaker 1: because marijuana is legal in your state doesn't mean it's

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Speaker 1: legal for your employer. So um, and we saw this

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Speaker 1: a lot in states first started legalizing marijuana, is that

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Speaker 1: employers would randomly you weigh their employees. Um, you still

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Speaker 1: cannot show up to work under the influence really at

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Speaker 1: most employers and so and that is grounds de termination

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Speaker 1: in most states that are at will states. Just because

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Speaker 1: being in possession of marijuana is legal in your state

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Speaker 1: and you show up under the influence, your employers still

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Speaker 1: as well within the right to terminate your employment because

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Speaker 1: of it. So that's important to know. The other piece

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Speaker 1: around marijuana use, there really isn't a whole lot of

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Speaker 1: data to substantially there's any increase in marijuana use, which

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Speaker 1: is an argument for folks who are against legalization and decriminalization.

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Speaker 1: And there you know, that's been one of their big

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Speaker 1: arguments is that it's you know use is going to

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Speaker 1: increase and it's gonna be rampant, and we're telling young

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Speaker 1: people that it's okay to use, and there really hasn't

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Speaker 1: been any data to substantiate that people are using more now.

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Speaker 1: People are using more publicly, certainly, but it hasn't in

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Speaker 1: fact increased how much people are using. So to dispel

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Speaker 1: another myth around marijuana uses that it's not addicting, marijuana

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Speaker 1: is absolutely addicting. Marijuana can cause what we call physiological dependence,

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Speaker 1: which is like your body having cravings and or withdrawal

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Speaker 1: when you cease using substances. So marijuana, like all other

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Speaker 1: substances out there, can create physiological dependence, but they can

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Speaker 1: also create psychological dependence. I see a lot of what

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Speaker 1: we call self medicating with marijuana. People who have depression,

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Speaker 1: people who have social anxiety or other forms of anxiety,

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Speaker 1: will smoke a little bit to help get them through

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Speaker 1: a day, get them through a social event, those kinds

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Speaker 1: of things, and early on you may derive some benefit

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Speaker 1: from that. Now, prolonged marijuana use will often become counterproductive.

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Speaker 1: So for folks who maybe we're using it for social

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Speaker 1: purposes and now they smoke a little every day or

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Speaker 1: multiple times a week, may find at some point that

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Speaker 1: it stops becoming effective for the management of whatever social

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Speaker 1: anxiety or social phobia they had, and it might also

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Speaker 1: exacerbate their anxiety and disrupt this. So it's not uncommon

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Speaker 1: for folks who have been using marijuana with some regularity

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Speaker 1: to start to experience insomnia. It can exacerbate depressive symptoms

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Speaker 1: as well. Um, you know, so you have to be

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Speaker 1: really mindful of any existing mental health issues that you're

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Speaker 1: currently managing and your marijuana use, particularly if you're also

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Speaker 1: taking you know, antidepressants or other medications to manage any

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Speaker 1: other mental illness. They can also have sort of crop

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00:21:27,920 --> 00:21:30,480
Speaker 1: cancel each other out and so you don't really get

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Speaker 1: any benefit from either, which means you're sort of at

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Speaker 1: score you started sort of at square one again. So

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00:21:35,160 --> 00:21:37,320
Speaker 1: it's great information, and I do think it's important to

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Speaker 1: kind of highlight, you know, like sometimes people will be

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Speaker 1: taking like an antidepressant and they are you know, drinking

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Speaker 1: a lot or smoking a lot, and like you said,

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00:21:45,560 --> 00:21:48,000
Speaker 1: you're effectively kind of canceling those out. So you do

405
00:21:48,080 --> 00:21:50,560
Speaker 1: want to make sure, um that you're paying attention to

406
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Speaker 1: like what your physicians is, uh, in terms of like

407
00:21:54,040 --> 00:21:58,080
Speaker 1: drinking and smoking in connection with whatever medications you're taking. Yes,

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Speaker 1: And one of the things that I tell my clients

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Speaker 1: all the time is to be honest with whoever is

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Speaker 1: prescribing for you. They're not gonna like leave and call

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Speaker 1: the police because you smoke a little bit of pot.

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Speaker 1: So if you're smoking a little bit or a lot

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Speaker 1: of it it or drinking a little bit or a

414
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Speaker 1: lot of it, you need to tell them because it

415
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Speaker 1: certainly will impact what they prescribe to you and how

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Speaker 1: much of it they prescribe to you, because you could

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Speaker 1: be putting yourself um medically at risk by taking some

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Speaker 1: of the medications that we use to manage mental illness,

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Speaker 1: most of which are not just used to manage mental illness.

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Speaker 1: So one of the things that I teach my students

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Speaker 1: is that there are very few medications on the market

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Speaker 1: that have a singular use. So we use a lot

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Speaker 1: of blood pressure medications, anti convulsants, which are anti seizure

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Speaker 1: medications to manage mental illness. And so you have no idea.

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Speaker 1: You think you're taking a medication that's for depression, but

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Speaker 1: it's you're taking a medication that is actually used to

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00:22:51,280 --> 00:22:55,040
Speaker 1: treat seizures, but it manages your particular kind of depression

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Speaker 1: really effectively. And so you may be doing harm to

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Speaker 1: yourself unbeknownst to you and your prescriber because you haven't

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Speaker 1: been forthcoming about your substance use. UM. So I'd much

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Speaker 1: rather a client tell me, yeah, I drink about three

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Speaker 1: glasses of wine every day when I get home, so

433
00:23:12,480 --> 00:23:15,040
Speaker 1: that when I'm working with them to help them manage

434
00:23:15,080 --> 00:23:19,080
Speaker 1: their depression or a depressive episode or some anxiety or

435
00:23:19,560 --> 00:23:22,760
Speaker 1: you know, a bipolar disorder, that I actually have all

436
00:23:22,800 --> 00:23:26,080
Speaker 1: of the pieces that I need to be effective for them. Um.

437
00:23:26,119 --> 00:23:29,520
Speaker 1: And so not giving your prescribers that information is like

438
00:23:29,640 --> 00:23:31,840
Speaker 1: asking them to put a puzzle together and tying one

439
00:23:31,840 --> 00:23:33,800
Speaker 1: hand behind their back. Um, So don't do that to

440
00:23:33,840 --> 00:23:38,320
Speaker 1: yourself out there who who may find yourself doing some

441
00:23:38,400 --> 00:23:41,960
Speaker 1: of that help us help you as your medical team.

442
00:23:42,000 --> 00:23:44,879
Speaker 1: I try to be as collaborative with my clients as

443
00:23:44,920 --> 00:23:48,480
Speaker 1: possible around their care. So aligning with them and really

444
00:23:48,560 --> 00:23:51,760
Speaker 1: understanding sort of what they're doing to cope UM day

445
00:23:51,800 --> 00:23:54,240
Speaker 1: to day between sessions is really helpful for me and

446
00:23:54,280 --> 00:23:56,399
Speaker 1: for some of them the things that they're choosing. I

447
00:23:56,440 --> 00:23:59,200
Speaker 1: don't endorse that I can't co sign the things they choose,

448
00:23:59,280 --> 00:24:01,560
Speaker 1: but it's helpful for me to know about what they're

449
00:24:01,640 --> 00:24:04,800
Speaker 1: using and what kind of benefit or not they're experiencing

450
00:24:04,840 --> 00:24:07,600
Speaker 1: from it. Yeah, and I'm really glad that you pointed out,

451
00:24:07,640 --> 00:24:09,359
Speaker 1: you know, the fact that your doctor is not going

452
00:24:09,400 --> 00:24:10,600
Speaker 1: to like run out of the room and call the

453
00:24:10,640 --> 00:24:13,520
Speaker 1: police because you're like smoking, right. I mean, it's really

454
00:24:13,560 --> 00:24:15,520
Speaker 1: just more important for them to know the information so

455
00:24:15,560 --> 00:24:19,120
Speaker 1: that they can make the best decisions for your treatment, right.

456
00:24:19,200 --> 00:24:21,680
Speaker 1: And they may they may tell you probably should stop

457
00:24:21,680 --> 00:24:24,800
Speaker 1: doing that, or I'm not going to prescribe this medication

458
00:24:24,880 --> 00:24:28,480
Speaker 1: for you because your alcohol uses too is too high

459
00:24:28,560 --> 00:24:30,560
Speaker 1: and your risk is really great, and those kinds of

460
00:24:30,560 --> 00:24:32,520
Speaker 1: things where I need you to moderate your alcohol use

461
00:24:32,800 --> 00:24:34,679
Speaker 1: so you know, come back in three weeks so that

462
00:24:34,720 --> 00:24:37,240
Speaker 1: we can see you know, how you're doing. Kind of

463
00:24:37,240 --> 00:24:40,880
Speaker 1: a thing. But I find that the most physicians these

464
00:24:40,960 --> 00:24:45,280
Speaker 1: days are really able to have, you know, more productive conversations,

465
00:24:45,320 --> 00:24:47,280
Speaker 1: and I think that's really changing. I think healthcare is

466
00:24:47,320 --> 00:24:51,280
Speaker 1: really changing. Um More healthcare providers are really getting on

467
00:24:51,320 --> 00:24:54,440
Speaker 1: board with harm reduction approaches as opposed to abstinence approaches.

468
00:24:54,440 --> 00:24:56,400
Speaker 1: I can tell you not to drink but the likelihood

469
00:24:56,440 --> 00:24:58,639
Speaker 1: of you not doing that over again is low. So

470
00:24:58,680 --> 00:25:00,880
Speaker 1: as opposed to telling you not to drink, I'm gonna

471
00:25:00,960 --> 00:25:03,480
Speaker 1: arm you with some information to make a decision that

472
00:25:03,560 --> 00:25:05,879
Speaker 1: I hope is in your best interest, you know. And

473
00:25:05,920 --> 00:25:08,520
Speaker 1: so if you're you know, taking your world beutren with

474
00:25:08,920 --> 00:25:11,159
Speaker 1: a cavernet in the morning, we need to have a

475
00:25:11,160 --> 00:25:14,760
Speaker 1: conversation about that, because that's gonna impact how much of

476
00:25:14,800 --> 00:25:18,600
Speaker 1: that medication is actually getting getting into your body to

477
00:25:18,680 --> 00:25:20,640
Speaker 1: do what I needed to do to manage your depression.

478
00:25:20,880 --> 00:25:23,440
Speaker 1: Got it? So what would you say, dr Piven for

479
00:25:23,480 --> 00:25:25,440
Speaker 1: the person who may be listening and has kind of

480
00:25:25,520 --> 00:25:28,720
Speaker 1: hurt all this great information you've shared and is thinking like, oh,

481
00:25:28,760 --> 00:25:30,520
Speaker 1: I may need to look at like how much I'm

482
00:25:30,600 --> 00:25:33,119
Speaker 1: drinking or how much I'm smoking, Like what kinds of

483
00:25:33,160 --> 00:25:36,000
Speaker 1: things um like, what would be their next steps? What

484
00:25:36,080 --> 00:25:39,200
Speaker 1: kinds of things should they be thinking about inconsidering. Yeah,

485
00:25:39,240 --> 00:25:41,560
Speaker 1: I generally liked to encourage people to start with a

486
00:25:41,640 --> 00:25:45,000
Speaker 1: simple tracking exercise. So track how much you drink, like,

487
00:25:45,040 --> 00:25:47,560
Speaker 1: accurately track how much you drink, right, so I know

488
00:25:47,600 --> 00:25:49,200
Speaker 1: that when I pour a glass of wine at home,

489
00:25:49,280 --> 00:25:51,800
Speaker 1: it does not look like it does in the restaurant, right,

490
00:25:51,800 --> 00:25:53,600
Speaker 1: And so a lot of it is paying attention and

491
00:25:53,640 --> 00:25:56,199
Speaker 1: having an honest dialogue with yourself. You know, one of

492
00:25:56,200 --> 00:25:58,520
Speaker 1: the things that I, you know, say all the time

493
00:25:58,520 --> 00:26:00,960
Speaker 1: in my own practices, you can't change your truth until

494
00:26:01,040 --> 00:26:03,520
Speaker 1: you can stand in your truth. And whatever that truth is,

495
00:26:03,680 --> 00:26:06,080
Speaker 1: it may be ugly, um, but you've got to be

496
00:26:06,119 --> 00:26:08,359
Speaker 1: able to stand in it before you can work to

497
00:26:08,440 --> 00:26:10,399
Speaker 1: change it. So if you can't have an honest conversation

498
00:26:10,440 --> 00:26:12,879
Speaker 1: with yourself about your substance use, you're not gonna be

499
00:26:12,920 --> 00:26:15,399
Speaker 1: able to have an honest conversation with anyone else about it.

500
00:26:15,520 --> 00:26:17,800
Speaker 1: So just start with a simple tracking exercise. How much

501
00:26:17,840 --> 00:26:20,080
Speaker 1: are you drinking? What's your drink of choice? Like, what

502
00:26:20,119 --> 00:26:21,919
Speaker 1: do you like to drink? Do you like to drink

503
00:26:22,320 --> 00:26:25,399
Speaker 1: red wine? Or are you like a white wine drinker?

504
00:26:25,560 --> 00:26:29,520
Speaker 1: Are you a brown liquor drinker? They all have different

505
00:26:29,880 --> 00:26:32,920
Speaker 1: what we call alcohol by volumes, and so how much

506
00:26:32,960 --> 00:26:37,200
Speaker 1: of them you consume can also on some indication, give

507
00:26:37,280 --> 00:26:39,879
Speaker 1: us some indication about a drinking problem. So if I

508
00:26:39,920 --> 00:26:41,840
Speaker 1: have a client who tells me, yeah, I generally have

509
00:26:41,920 --> 00:26:44,959
Speaker 1: like three seven and seven versus a client who tells me,

510
00:26:45,400 --> 00:26:48,440
Speaker 1: I have you know, three midori sours. Those are very

511
00:26:48,560 --> 00:26:51,880
Speaker 1: very different cocktails, and so that to me can even

512
00:26:51,960 --> 00:26:55,159
Speaker 1: give me an indication of their drinking tolerance. You know,

513
00:26:55,200 --> 00:26:58,119
Speaker 1: if you're still standing after three seven and seventh versus

514
00:26:58,119 --> 00:27:00,520
Speaker 1: passed out after three Midori sours, that can give me

515
00:27:00,560 --> 00:27:02,520
Speaker 1: a lot of information. So start by tracking your own

516
00:27:02,560 --> 00:27:05,800
Speaker 1: alcohol use. Um, if you've had any negative consequences. Are

517
00:27:05,840 --> 00:27:10,040
Speaker 1: you calling out of work, are you canceling plans with

518
00:27:10,359 --> 00:27:13,320
Speaker 1: people you care about? You know, if you have children

519
00:27:13,560 --> 00:27:16,520
Speaker 1: or pets that you that require care and attention and

520
00:27:16,520 --> 00:27:19,320
Speaker 1: you're not meeting those responsibilities, those kinds of things can

521
00:27:19,400 --> 00:27:22,840
Speaker 1: be on the more sort of severe end of red flags.

522
00:27:22,880 --> 00:27:25,080
Speaker 1: But you know, start by tracking the other pieces. Once

523
00:27:25,080 --> 00:27:27,919
Speaker 1: you're tracking, you know, try to moderate your use. So

524
00:27:27,920 --> 00:27:29,520
Speaker 1: if you go home every day and you have a

525
00:27:29,520 --> 00:27:31,520
Speaker 1: glass of wine and that's part of your wine down,

526
00:27:31,920 --> 00:27:33,800
Speaker 1: try doing that three days a week instead of five

527
00:27:33,920 --> 00:27:35,600
Speaker 1: or seven days a week and see if you're able

528
00:27:35,640 --> 00:27:37,879
Speaker 1: to do that. Some people think that they're able to

529
00:27:37,880 --> 00:27:40,199
Speaker 1: do that. I enjoy wine. I drink a glass of

530
00:27:40,200 --> 00:27:42,439
Speaker 1: wine because I enjoy it, And when they try to

531
00:27:42,480 --> 00:27:44,840
Speaker 1: moderate it, they really find that they have developed some

532
00:27:44,880 --> 00:27:47,760
Speaker 1: physiological tolerance. So on the days that they don't drink,

533
00:27:47,800 --> 00:27:50,240
Speaker 1: they really crave it, particularly if you drink around the

534
00:27:50,280 --> 00:27:52,960
Speaker 1: same time. It's part of your evening routine. You get home,

535
00:27:53,000 --> 00:27:55,040
Speaker 1: you take your shoes off before your wine, and like

536
00:27:55,240 --> 00:27:57,800
Speaker 1: you know, that's part of your routine. Your body may

537
00:27:57,800 --> 00:27:59,679
Speaker 1: start to create it, which could be an indication that

538
00:27:59,720 --> 00:28:03,920
Speaker 1: you elked up some um physiological tolerance. So those are

539
00:28:03,920 --> 00:28:06,760
Speaker 1: two pieces that you can start with. The Other piece

540
00:28:06,800 --> 00:28:08,560
Speaker 1: of that is if you know that you have a

541
00:28:08,560 --> 00:28:11,720
Speaker 1: substance use problem and it's sort of getting out of control,

542
00:28:11,800 --> 00:28:14,800
Speaker 1: and you're aware of that, seek treatment. You know it's

543
00:28:14,880 --> 00:28:18,560
Speaker 1: not it's it's generally not this process by which you're

544
00:28:18,560 --> 00:28:22,159
Speaker 1: just gonna stop cold turkey and never pick up alcohol again.

545
00:28:22,359 --> 00:28:24,399
Speaker 1: And you know, you know you're gonna go to the

546
00:28:24,440 --> 00:28:27,119
Speaker 1: Christmas parties and be the person who doesn't drink. You

547
00:28:27,200 --> 00:28:30,440
Speaker 1: may eventually get there, but that process can be really

548
00:28:30,480 --> 00:28:33,560
Speaker 1: difficult on the front end of recovery. I'd tell folks

549
00:28:33,560 --> 00:28:35,160
Speaker 1: all the time, if you hang out at the barbershop,

550
00:28:35,160 --> 00:28:37,240
Speaker 1: long en if you're gonna get a haircut. So if

551
00:28:37,280 --> 00:28:40,080
Speaker 1: the folks you hang around with are heavy drinkers or

552
00:28:40,120 --> 00:28:43,360
Speaker 1: heavy smokers, and you think you can just hang around

553
00:28:43,560 --> 00:28:46,080
Speaker 1: the same people, places, and things you did when you

554
00:28:46,120 --> 00:28:49,640
Speaker 1: were engaging in those activities, you might be setting yourself

555
00:28:49,720 --> 00:28:51,560
Speaker 1: up for a failure, you know, so trying to sort

556
00:28:51,560 --> 00:28:53,640
Speaker 1: of change some of the people, places and things that

557
00:28:53,800 --> 00:28:56,760
Speaker 1: really encourage your substance use. So yeah, I think those

558
00:28:56,760 --> 00:28:59,000
Speaker 1: are probably the three things I would say to start with. Yeah,

559
00:28:59,000 --> 00:29:01,480
Speaker 1: I think that it is agree it store for people UM.

560
00:29:01,520 --> 00:29:04,200
Speaker 1: And I know before before we started recording, we talked

561
00:29:04,240 --> 00:29:06,760
Speaker 1: a little bit about UM like A A groups and

562
00:29:07,320 --> 00:29:09,239
Speaker 1: in A groups. Can you talk a little bit more

563
00:29:09,240 --> 00:29:11,720
Speaker 1: about what those groups are and how they could or

564
00:29:11,840 --> 00:29:15,640
Speaker 1: might not be helpful. Sure, A groups and A groups

565
00:29:15,680 --> 00:29:18,680
Speaker 1: they have been around for for decades and decades their

566
00:29:18,760 --> 00:29:23,040
Speaker 1: Twelfth Step oriented groups, and they are their non therapeutic groups,

567
00:29:23,040 --> 00:29:24,960
Speaker 1: which is what I think is really important people to know.

568
00:29:25,000 --> 00:29:27,160
Speaker 1: A groups and in A groups are generally facilitated by

569
00:29:27,160 --> 00:29:29,680
Speaker 1: other folks and recovery and so it is a community

570
00:29:29,680 --> 00:29:32,520
Speaker 1: of clean and sover support and every you know a

571
00:29:32,600 --> 00:29:36,960
Speaker 1: A in A UM, alcoholics, anonymous, narcotics anonymous. You know

572
00:29:37,000 --> 00:29:39,600
Speaker 1: there are alan on groups for children of spouses of

573
00:29:39,680 --> 00:29:42,720
Speaker 1: substance users, things like that. So there are lots of

574
00:29:42,760 --> 00:29:47,400
Speaker 1: twelve Step meetings. Generally there are meetings in every city

575
00:29:47,440 --> 00:29:49,880
Speaker 1: every day, multiple times a day. So if you find

576
00:29:49,920 --> 00:29:52,960
Speaker 1: that you really need some support, that you're really craving

577
00:29:53,040 --> 00:29:56,760
Speaker 1: something to drink or smoke um, and you can't access

578
00:29:56,760 --> 00:29:59,240
Speaker 1: any of your own supports, if you're still very early

579
00:29:59,280 --> 00:30:01,440
Speaker 1: to the process, you always drop into an A or

580
00:30:01,480 --> 00:30:03,400
Speaker 1: an n A meeting as long as it's an open meeting.

581
00:30:03,480 --> 00:30:05,320
Speaker 1: You can do that, and you can get online and

582
00:30:05,320 --> 00:30:07,800
Speaker 1: google them and find them wherever you are, so they're

583
00:30:07,800 --> 00:30:12,000
Speaker 1: a great resource. However, they are not for everyone. Many

584
00:30:12,080 --> 00:30:14,840
Speaker 1: A and n A groups are rooted in a faith tradition,

585
00:30:14,920 --> 00:30:17,040
Speaker 1: and for some people that's great, and for others it's not.

586
00:30:17,320 --> 00:30:19,440
Speaker 1: All A and n A meetings are not rooted in

587
00:30:19,480 --> 00:30:22,560
Speaker 1: a faith tradition. The step the twelve step process. The

588
00:30:22,600 --> 00:30:25,840
Speaker 1: first step is to recognize that you're powerless over your addiction.

589
00:30:25,880 --> 00:30:28,480
Speaker 1: And for some people you know that connects to a

590
00:30:28,560 --> 00:30:31,560
Speaker 1: higher power, and for others it doesn't. And that doesn't

591
00:30:31,640 --> 00:30:35,440
Speaker 1: jive well with some people, and so there's no condition

592
00:30:35,480 --> 00:30:37,360
Speaker 1: to work the steps. Is what we call it, working

593
00:30:37,360 --> 00:30:39,440
Speaker 1: the steps, the twelve steps to go to an n

594
00:30:39,440 --> 00:30:42,080
Speaker 1: A or a A meeting or meeting of your choice,

595
00:30:42,440 --> 00:30:44,840
Speaker 1: but you can certainly find a sponsor and work the

596
00:30:44,840 --> 00:30:47,760
Speaker 1: steps and do all of those things, so you know

597
00:30:48,160 --> 00:30:51,280
Speaker 1: they are generally going to meet in pretty nondescript places.

598
00:30:51,600 --> 00:30:56,600
Speaker 1: Churches are often spaces that meetings happen because they can

599
00:30:56,760 --> 00:30:59,960
Speaker 1: use the space for free community centers, those kinds of things.

600
00:31:00,120 --> 00:31:02,280
Speaker 1: So it's not like there's a sign outside that says

601
00:31:02,320 --> 00:31:04,480
Speaker 1: you're walking into an a a meeting, which is great

602
00:31:04,560 --> 00:31:09,240
Speaker 1: for UM confidentiality and privacy, but again, you know you're

603
00:31:09,320 --> 00:31:11,640
Speaker 1: gonna walk into a room maybe with a bunch of

604
00:31:11,640 --> 00:31:13,720
Speaker 1: people you don't know, or maybe just a handful of

605
00:31:13,720 --> 00:31:16,000
Speaker 1: people you don't know, and some people are really uncomfortable

606
00:31:16,040 --> 00:31:18,960
Speaker 1: with that. So I really try to respect how um

607
00:31:18,960 --> 00:31:22,160
Speaker 1: difficult it can be to to utilize a resource like

608
00:31:22,200 --> 00:31:24,960
Speaker 1: a twelve step meeting for that reason, particularly for folks

609
00:31:25,000 --> 00:31:28,400
Speaker 1: who are still very very private about their struggles. The

610
00:31:28,440 --> 00:31:30,800
Speaker 1: other side of of being in a room with complete strangers,

611
00:31:30,800 --> 00:31:33,040
Speaker 1: and they're complete strangers, you may never see them again,

612
00:31:33,080 --> 00:31:35,080
Speaker 1: so you can sort of take from the group what's

613
00:31:35,120 --> 00:31:37,720
Speaker 1: helpful and leave the rest out fear of like running

614
00:31:37,760 --> 00:31:40,480
Speaker 1: into these people again. You don't have to attend the

615
00:31:40,560 --> 00:31:42,960
Speaker 1: same meeting, but many people do. Many people find what

616
00:31:43,000 --> 00:31:44,760
Speaker 1: we call a home meeting. It's the meeting they go

617
00:31:44,840 --> 00:31:47,640
Speaker 1: to at the same time every week, and so you know,

618
00:31:47,720 --> 00:31:49,400
Speaker 1: trying to pay attention to the pros and cons. And

619
00:31:49,480 --> 00:31:52,160
Speaker 1: I the kind of person who can, you know, step

620
00:31:52,200 --> 00:31:54,200
Speaker 1: into a meeting and take from it what works for

621
00:31:54,240 --> 00:31:56,000
Speaker 1: me and leave the rest or Am I a person

622
00:31:56,080 --> 00:31:58,400
Speaker 1: who really needs to feel a sense of community among

623
00:31:58,440 --> 00:32:01,520
Speaker 1: people that I know and people that I trust UM

624
00:32:01,560 --> 00:32:03,360
Speaker 1: and that can give your engage for whether or not

625
00:32:03,840 --> 00:32:05,920
Speaker 1: some of these an A and A meetings are good

626
00:32:06,000 --> 00:32:08,640
Speaker 1: for you. In the advent of technology, they're now online

627
00:32:08,640 --> 00:32:11,120
Speaker 1: meetings and you can be anonymous in an online meeting,

628
00:32:11,160 --> 00:32:13,320
Speaker 1: so you can still sort of tap into the community

629
00:32:13,360 --> 00:32:16,040
Speaker 1: and get the support that you need and share or

630
00:32:16,120 --> 00:32:19,920
Speaker 1: not share without having to see anyone UM or sort

631
00:32:19,920 --> 00:32:22,880
Speaker 1: of out yourself in that way as well. So another

632
00:32:22,920 --> 00:32:26,680
Speaker 1: option is to participate in an online meeting. Great resources.

633
00:32:26,760 --> 00:32:29,080
Speaker 1: I didn't know that they had online meetings now, so

634
00:32:29,360 --> 00:32:31,040
Speaker 1: but it makes sense. But where we are in the

635
00:32:31,120 --> 00:32:35,160
Speaker 1: country right with the advancement in technology, it makes sense

636
00:32:35,160 --> 00:32:39,040
Speaker 1: that they would have it absolutely. So where can people

637
00:32:39,120 --> 00:32:41,760
Speaker 1: connect with you? Dr Bittman, Can you give us information

638
00:32:41,760 --> 00:32:44,280
Speaker 1: about your website address as well as any social media

639
00:32:44,360 --> 00:32:48,360
Speaker 1: handles you'd like to share. Sure. I am a DC

640
00:32:48,520 --> 00:32:52,640
Speaker 1: based psychologist. My practices in Woodley Park, Um right across

641
00:32:52,680 --> 00:32:56,560
Speaker 1: from the National Zoo, so it's a great location, metro accessible.

642
00:32:56,720 --> 00:33:01,080
Speaker 1: You can get to my website at www p sp

643
00:33:01,600 --> 00:33:06,640
Speaker 1: DC dot com. That's Paradigm Shift Psychological DC dot com.

644
00:33:06,680 --> 00:33:10,240
Speaker 1: Perfect and anything on social media. I'm not on social media.

645
00:33:11,240 --> 00:33:14,040
Speaker 1: I need she's not on social media. We may be

646
00:33:14,040 --> 00:33:17,200
Speaker 1: able to pressure to get on there, but now you

647
00:33:17,240 --> 00:33:19,840
Speaker 1: can visit her at the website. Well, thank you so

648
00:33:19,920 --> 00:33:21,960
Speaker 1: much for sharing all this information with us today. I

649
00:33:22,000 --> 00:33:26,600
Speaker 1: really appreciate it. Thank you so much for having me. Definitely,

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Speaker 1: I'm so grateful Dr Pittman was able to share her

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00:33:29,520 --> 00:33:32,959
Speaker 1: expertise with us today. To learn more about her and

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00:33:33,000 --> 00:33:36,440
Speaker 1: her practice, visit the show notes at Therapy for Black

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00:33:36,480 --> 00:33:40,800
Speaker 1: Girls dot com slash Session eighty one, and please make

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00:33:40,840 --> 00:33:43,520
Speaker 1: sure to share your takeaways from the episode in your

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00:33:43,520 --> 00:33:47,080
Speaker 1: I G stories or on Twitter. Be sure to use

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00:33:47,120 --> 00:33:50,520
Speaker 1: the hashtag tb G in session so that we can

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00:33:50,560 --> 00:33:54,280
Speaker 1: find them and share them. If you're looking for a

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00:33:54,360 --> 00:33:57,560
Speaker 1: therapist in your area, be sure to visit the therapist

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00:33:57,640 --> 00:34:01,760
Speaker 1: directory at Therapy for Black Girls dot com slash directory.

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00:34:02,800 --> 00:34:05,240
Speaker 1: Don't forget to check out our Therapy for Black Girls

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00:34:05,280 --> 00:34:08,799
Speaker 1: store to grab a T shirt, a mug or a sweatshirt.

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00:34:09,440 --> 00:34:11,759
Speaker 1: You can find it at Therapy for Black Girls dot

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00:34:11,840 --> 00:34:16,279
Speaker 1: com slash shop. And if you want to continue this

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00:34:16,360 --> 00:34:19,759
Speaker 1: conversation and join a community of other sisters who listen

665
00:34:19,800 --> 00:34:23,000
Speaker 1: to the podcast, join us over in the Thrive Tribe

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00:34:23,360 --> 00:34:27,080
Speaker 1: at Therapy for Black Girls dot com slash tribe. Make

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00:34:27,120 --> 00:34:29,600
Speaker 1: sure you answer the three questions that are asked to

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00:34:29,719 --> 00:34:33,480
Speaker 1: gain entry. Thank y'all so much for joining me again

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00:34:33,520 --> 00:34:36,040
Speaker 1: this week, and I look forward to continue in this

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00:34:36,160 --> 00:35:03,240
Speaker 1: conversation with you all real soon. Take good care all

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Speaker 1: hot ear oft