Interviewer: If it hurts when you do that, finally here’s somebody that doesn’t say, ‘then don’t do that.’ In southern California call 1-800-222-5222. Across America, it’s 1-888-798-5222. It’s Dr. Kipper and Tilden, The Medical Show.

Drs. Khalighi’s are here from Creative Care in Malibu. Our friends, because this is the holidays we’re right in – I can’t believe Thanksgiving is here, and Christmas is around the corner. And David. My favorite thing from David is you’re just spending money you don’t have to buy presents for people you don’t like. [Laughter] Which is kind of a good way to – I forgot about that stressor. And the fact that I’m going to see my – and you know that Thanksgiving time? No matter how old you are, when you sit down at that Thanksgiving table, if you’re eighty and your parents are still alive, you’re still at the kid’s table spilling the pitcher of drinks, and reenacting all of those triggers that you had growing up. Unless you’re such an evolved human being that you’ve figured it out, and spent hours of talking it through, and had some major breakthrough with your family, which is not most of us. Correct?

Dr. Khalighi: Correct. Correct.

Interviewer: So give me some of the biggest triggers you find, and stuff that people can maybe avoid or get help with, or talk out. Because I get nervous. I start hearing it, and I know it’s coming.

Dr. Khalighi: Well, getting together with family is always stressful. Especially when there’s a lot of expectations about the holidays, and having a good time. So the triggers are always there as you just mentioned. And so you have to really know what the expectations are, what your limits are. What is it that you really want to get out of this day? So the emotional triggers are right there, and basically what you want to do is create some boundaries, and stick to your plan.

Interviewer: But when you say create some boundaries, you can’t do that alone. For instance, you’re going to a party, and you have to go to the party because it’s either family or it’s work related, and there’s going to be alcohol there. There’s going to be problems there. There’s going to be people who you know are lying about addiction. You’re going to have all kinds of stuff. You can’t send out a memo saying hey, A, I’m not coming, which is a horrible thing, tough thing, because you have to go because it’s business or family. B, you can’t ask them to remove and create an environment for you. So how do you ––

Dr. Khalighi: Oh, but you can. You can give them what your needs are. You can say to them, look, you know, drop a call. Drop a dime and say you know, I’m working on some things. I really would rather not have wine. I’d really rather not – I’m not asking anybody else to give it up, but don’t push it. If I say no, that means no.

Interviewer: Also, you go in with a plan. If you know you’re going to be around a bar, stay away from the bar. Order something that’s nonalcoholic.

Dr. Khalighi: Right.

Interviewer: So I think always when you’re in a vulnerable situation like that, you have to have a pregame plan.

Dr. Khalighi: Exactly.

Interviewer: I love _____, because she usually cuts right through the deal. I would never think to say to somebody, hey, I’m having some issues. I’m not saying don’t serve wine, but you know what? Don’t push it. That’s a great way to put it.

Dr. Khalighi: Exactly.

Interviewer: If you ask me once to something and I say no, don’t come back because Hostess is doofy. Oh, c’mon. Oh, just a little. Oh, just here. Oh, this is this. Oh, you’ve got to try the punch. Oh, just a sip.

Dr. Khalighi: Right. And you can bring your own. What is it that’s working for you? So if you like Perrier with limes in it, then that’s what you bring. You bring that, and you have that for yourself.

Interviewer: Walk in with a glass.

Dr. Khalighi: So you have a plan. Your plan is, is that you’re going to start off your holiday, and you’re going to say look, I’m going to drop a call. You know, I’m looking forward to seeing you. What can I bring? And by the way, this is my plan right now, and this is what I’m going with, and I’m going to bring.

Dr. Khalighi: Right. And the difference of course, is when you plan not to get triggered. You never can plan that, which means you know you have a plan how much to drink, and what to drink, and of course, if you’re alcoholic, you’re going to stay away from alcohol. But you don’t plan not to get triggered. And I think that’s a significant issue that comes up inevitably when you’re dealing with family members around the holidays.

Interviewer: Well, there are also triggers. You know what? We’re triggered now, aren’t we? The anticipation of this for a lot of people is just as bad as the reality of it for people.

Dr. Khalighi: Right. Right.

Interviewer: So if you have a family member or a friend, or it’s you, isn’t it about now? The anticipation is as bad as the event itself.

Dr. Khalighi: Right.

Interviewer: Is it now when you should be really heightened awareness?

Dr. Khalighi: And in some ways we don’t. We really remember how grueling it can be, and we don’t remember how difficult it could be. So I think of it as kind of like labor. I’ve had four kids. You know, you forget. You go through it. It’s painful, it’s awful. You make it through and as time goes by, you kind of forget how bad it was until it hits you again.

Interviewer: And also, it’s what Peter said. You become an eight-year-old in that setting, and you want those people to like you. No matter how they created you, you still want them to like you.

Interviewer: Can I bring up something we talked about yesterday when we saw each other yesterday. You guys are a real value. You know, there’s a lot of wealth to the relationship. And I think it enters in here, too. And David was the first one in an addiction setting with me saying you know what? You can’t punish somebody who’s an addict. You’ve got to realize it’s an illness. That’s a huge thing for a lot of people. I don’t think you can say it enough. Because I think a lot of people even though hearing it, it’s hard for them to do that because there’s punishment, there’s anger, there’s resentment, and all of that stuff.

But I had another oh wow moment with especially this time of holiday, with you know, there’s this tough love thing that a lot of people are pushing. Which is you have to punish the person, which again goes against what I learned from David initially. And cut them off, let them on their own, let them do their thing. And you had said, you know what? Everybody needs nurturing. Everybody needs help. Everybody needs somebody they can count on. Healthy people need people they can count on is the way you put it.

Dr. Khalighi: Right.

Interviewer: Can you imagine somebody who’s got issues and broken. So let’s talk about, how do you find that network? We know triggers are happening. We know this is an immensely difficult time for people. How do you search that out? What do you do at this point?

Dr. Khalighi: I think it depends upon how strong a relationship and bond you have with your sponsor. So hopefully everybody has in their corner, if they’re going through or have been through recovery, they have a sponsor. They have someone who they can turn to when things go bump in the night to say hey, you know, I can’t handle it. And that’s what AA gives you. That’s what that model gives you. It gives you somebody to hang onto or hold onto, or something to hang onto at 3:00 A.M. when the rest of the world is conceivably asleep.

Dr. Khalighi: Right. Now one distinction. Tough loving doesn’t necessarily mean punitive. Tough loving is you create boundaries and you stick to them. They don’t necessarily have to be punitive. And nurturance has to come naturally, like you know, you said David had mentioned.

Addiction is a serious disease, and it kills every day. The person is already struggling. You don’t want to make that struggle even worse by creating unreasonable expectations and boundaries for them. You have to be nurturing, you have to be loving. Just like your other kid who doesn’t have an addiction issue, you have to be creating some loving and creative boundaries that doesn’t feel punitive.

Interviewer: You also have to realize that people that struggle with addiction generally don’t have those support systems. They came from a home oftentimes that was broken. They’ve managed to disconnect with people that were close to them, and it’s hard to stay in touch with people that have addictive disorders. So they come to the table without a big support system.

Dr. Khalighi: They alienate a lot of their supports. They’ve burnt a lot of bridges already.

Dr. Khalighi: Right. And understandably so, because the family, the loved ones, they’re burnt out. They’ve extended, they’ve extended, they’ve extended, they’ve tried.

Interviewer: Well you also said something yesterday, and I remember a lot of stuff you say. When a parent, when they rely on a parent or a family member to have the relationship with them as the person who is the one that’s going to help them out, there’s so many queues and so much history there, and so much other stuff going on that it usually gets in the way of the message.

Dr. Khalighi: Right.

Interviewer: Where they’re reading verbal queues, they’re reading signs from you, misreading stuff. That that’s not the best relationship to be in.

Dr. Khalighi: Right.

Interviewer: So this is the time of the year to find – get the help. The other thing, the big thing yesterday that we talked about and I want to bring up here, too. I know Creative Care. Modeling. You had mentioned this before. Modeling behavior. People who are addicts and people who are having problems usually come from an environment where they don’t see how proper decisions are resolved. They don’t see how a day should be started and finished. Where they don’t see motivation. Where they don’t see any kind of consequences to their actions. That when you go into a facility or you get help, whether it’s rehab or whether it’s sobering, whatever it is, when you get your help, you need to see proper modeling behavior, which is subtle and osmotic, you get it. It kind of gets absorbed. And not just a strict, rigid do-this, do-that, because that’s not really helping a person.

Dr. Khalighi: Right.

Interviewer: Just that is not going to help you push that ball to the next level. It’s just like when you’re a kid. You’ve got years and years of nurturing, and through you know, trial and error. You’re seeing how your parents are living. You’re seeing the world around you. And then you make choices and you’re slowly pushed down into the world, and through all of that information, you now are hopefully a functioning individual.

Dr. Khalighi: Right.

Interviewer: If you don’t get that in treatment, if you don’t get those kinds of queues, then when you leave treatment, you’re probably not going to be any better off. You haven’t really accomplished anything other than stay clean for a little bit.

Interviewer: Speaking as a medical doctor, people that have underlying mental health issues so that they’re depressed, they’re anxious – again, the holidays bring that out. I think it’s important to speak to your general practitioner about what can you do. There are some non-addictive treatments and options that we give people that will help them through these very difficult times. So don’t be afraid to ask for help. Not just from your AA family or your sponsor, but look to your doctor who can also offer some nice alternatives.

Dr. Khalighi: Right. And it’s not just – you can extend that reach. I think Bill Clinton said you don’t necessarily look for a resolution in every situation, but you look to push the rock up the hill a little bit. And for many people, that rock at the holiday time is loneliness. And that loneliness can trigger all kinds of fear, and anxiety, and depression. And so if you’re trying to push that rock up the hill a little bit, maybe you turn to a church, or a synagogue. Or maybe you look in your local newspaper and you see who’s having a holiday mass, or who has an open house, and you try and get yourself there so that that rock of loneliness, you just kind of nudge it up a little bit. You don’t have to resolve the situation, and it doesn’t have to resolve particularly during the holidays. Maybe that’s a long-term goal. But a short-term goal can be to reach out in one way on one day and make it to a church, a synagogue, a meeting, a public place where you have your cup of coffee there, and have that be the first step.

Interviewer: And you’re not alone, and it’s great first step. So there’s things you can do. Listen, if you want information, Creative Care of Malibu. I’ll give you the number. You can also click on our site. I would say the good looking guy with the full head of white hair is Dr. Kipper. The guy next to him with the nose is me. Click on that and it’ll take you right to Creative Care. You can gets you there. And also their number, 800-832-3280. They are, as you can hear, a really amazing resource because they’ve only been dealing with these issues for twenty-plus years. I learn a lot all the time, and I learn a lot from David. I learn a lot from both of you guys. It’s a pleasure. Especially if anybody listening right now goes, yeah. Just listening to this conversation is a trigger for me, you should reach out and get the help that you need.

Again, it’s 800-832-3280. Go to our site and click on that. Do what you need to do. But if it resonates with you even a little bit, you shouldn’t wait. You should take care of it and kind of nip it in the bud before the holidays, because the holidays are now upon us.

We’ll be back to take more of your calls at 800-222-5222 in L.A. and Orange County. Everywhere else, 888-790-5222. This is The Medical Show with Dr. David Kipper, and Peter Tilden.