Addiction, Nuances Around Comorbid Conditions, and Learning Acceptance in the Recovery Process w/ Adam Moore

In this episode of the Pathway to Recovery podcast, host Tara McCausland welcomes Dr. Adam Moore who explains the importance of recognizing and addressing multiple concurrent issues for effective recovery. The episode emphasizes the need for a holistic approach to healing, incorporating aspects like sleep, diet, and exercise along with therapy and 12-step programs. Dr. Moore also touches upon the broader philosophical aspects of recovery, urging listeners to embrace the process and find their unique healing path on their journey. The discussion concludes with practical advice for both newcomers and those who have been on their recovery path for a while, highlighting the importance of support and adaptation.

Connect with Adam on Instagram @dradammoore or go to selahealth.com

00:00 Introduction to Dr. Adam Moore
01:29 Welcome and Opening Remarks
01:52 Understanding Comorbid Conditions
05:47 Challenges in Addiction Recovery
16:28 Holistic Approaches to Recovery
27:40 Basic Self-Care and Biological Aspects
29:26 The Value and Limitations of Diagnoses
32:15 Labels and Their Impact on Recovery
33:44 Seeking Multiple Opinions
35:36 The Journey of Recovery and Acceptance
37:18 Liminal Spaces
45:45 The Importance of Adversity and Community
50:03 Final Thoughts and Advice

Chapters

• 0:00 Introduction to Dr. Adam Moore
• 1:29 Welcome and Opening Remarks
• 1:52 Understanding Comorbid Conditions
• 5:47 Challenges in Addiction Recovery
• 16:28 Holistic Approaches to Recovery
• 27:40 Basic Self-Care and Biological Aspects
• 29:26 The Value and Limitations of Diagnoses
• 32:15 Labels and Their Impact on Recovery
• 33:44 Seeking Multiple Opinions
• 35:36 The Journey of Recovery and Acceptance
• 37:18 Embracing Liminal Spaces
• 45:45 The Importance of Adversity and Community
• 50:03 Final Thoughts and Advice

Transcript

Addiction, Comorbid Issues, and Acceptance in the Recovery Process w/ Adam Moore

[00:00:00] 

Introduction to Dr. Adam Moore

Dr. Adam Moore is a licensed marriage and family therapist with nearly two decades of experience treating depression, anxiety, compulsive sexual behaviors, betrayal trauma, and helping high conflict couples. Dr. Moore hosts a podcast called Pocket Therapist where he answers questions about mental [00:01:00] health and relationships.

He has presented workshops to over 20,000 people on various mental health topics. Dr. Moore is the co-owner and clinical director of Sila Health, which offers behavioral healthcare, including therapy, medication management, and dietician services with offices in both Utah and Nevada. He's also the author of the book, Pumpkins At Midnight, A Woman's Guide to Love Dating and Marriage in the Age of Porn.

Welcome and Opening Remarks

Tara: Welcome to the Pathway to Recovery podcast. I'm your host, Tara McCausland, and I'm so excited to have here with me, my old friend. Can I call you my old friend? 

Adam: Absolutely.

Tara: My friend Dr. Adam Moore. Hey, Adam. Welcome.

Adam: Hello. I'm happy to be here and I do feel old. I'm starting to push 50 and  my body is feeling it. 

Tara: Hopefully along with that age comes greater wisdom. 

Understanding Comorbid Conditions

Tara: And we're actually, I'm very excited about what we're talking about today because I know in my [00:02:00] conversations with people who are struggling with addiction, whether they be the partner or the person themselves that's dealing with an addictive pattern in their life - often it seems to come up later, but they recognize that there's something else playing into their addiction that they didn't recognize early on. We might call them comorbid issues. And I felt like you would be great to speak to this, Adam, because I know for a while you really focused a lot on addiction recovery, but you've branched out a lot in your practice.

And I know that you know addiction and know mental health. And so maybe we can back up a little bit and you can tell us, or give us a definition of what a comorbid condition is and how that plays into addiction and sexual addiction specifically. 

Adam: Yes, absolutely. So normally when we think of the word morbid, we think of death.

But really in this context, it just means sickness or illness and of course “co” [00:03:00] means alongside. So it's, in psychology we have to have terms for everything, complicated terms for normal things, which is just funny, but comorbid just means two sicknesses or illnesses happening simultaneously. 

Which makes sense. It would be fairly rare to run into a human who doesn't have multiple problems that they're dealing with simultaneously. In fact, one of the things I used to hear a lot from the guys I would work with when they were working through their own recovery was, “Man, I wish I could just pause all of life and just focus a hundred percent on my recovery and fix this problem and then get back to real life.”

And it's funny on its own because it's like that's not how life works. There is no such thing as sectioning yourself off and then solving problems and then not having those problems when you go back to the life that maybe facilitated [00:04:00] the problems in the first place. But it's also this sort of cry for help.

It's, “I don't like trying to solve multiple problems at the same time.” It's really difficult because I don't know where one ends and the other begins. And of course, in the mental health world, when we talk about comorbidity, there's obviously a little bit of additional anxiety that happens for the therapist, for example, because it's like “Uh oh. I can't just focus on one thing. I've got multiple things going on.”

But I would say that most people, if you really got down to it, most people would have comorbid something. And even if it's not a mental health diagnosis, it could be comorbid trauma from their past. It could be a comorbid addiction and financial problems they're running into.

[00:05:00] It could be family dynamics. There's lots of reasonably healthy people who have incredibly chaotic and I would say sick family systems that make it hard to be normal because they're surrounded by chaos at all times. So I think comorbidity is just a way of describing the fact that nobody has just a problem. We've got a lot of problems and they're all happening at the same time. 

Tara: Great definition. I think that's now easily understood. It's a funny sounding term.

Why should we bring awareness to the fact that all of us are walking around with these comorbid issues, playing into how we react to the world and our behavioral patterns? Why should this matter, especially when it comes to pornography and sexual addiction?

Challenges in Addiction Recovery

Adam: In the book, Alcoholics Anonymous, in the beginning pages, it talks about [how] rarely do people that follow our path basically not [00:06:00] find healing, but then it says, there are such unfortunates or something like that.

Right? There's a few people that do this and then don't get better, and it's like we feel really bad for them. I think about that a lot because it would be, I think, profoundly easier if the solution to a problem were one path. I just do this one thing and it fixes my problem and my problem goes away, and then now I don't have that problem.

But a lot of times people will be into their recovery journey and thinking or saying out loud, “This just isn't working. I'm doing the steps, I'm following the program, I'm doing the things that I'm quote unquote, supposed to be doing, and I'm just not seeing the results I'm expecting.”

Some of that could be just impatience. This is supposed to go faster. I should be able to predict [00:07:00] the trajectory. But some of it is [that] it turns out you have other things going on. A lot of the time you have to think about addiction as both a symptom and a problem. So it is a problem that creates other problems, right? 

It creates relationship problems. It creates problems of how you perceive yourself, how you interact with people. But it's also often a symptom of other problems. Therapists in this day and age, trauma’s the big thing. It's what we all talk about. 

If you go back 30, 40 years, people were talking about codependence. If you go back a long time, it's, I don't know, they had blood sickness and they needed leeches or something. There's always something going on in the mental health or the medical fields, the more popular things to be thinking about. 

And if you think about the idea that if you [00:08:00] read The Body Keeps the Score, which is the defacto book on the effect of trauma on humans, we can reasonably expect that the way we react to the world is likely to be the result, at least in some ways, of our traumatic life experiences.

To ignore that or to not be aware of it makes you vulnerable to thinking, “I am the problem. The problem originates with me. It's not affected by anything else other than just my core defectiveness as a person. And I just need to get better at fixing my problems and then I'll be okay.” And I think that keeps people stuck in a lot of ways, number one, because there's a lot of self blame that happens.

But number two, because then you're not really thinking about the other things you probably should be addressing that could be getting in the way of healing. And I see this a lot in practice because we [00:09:00] humans are terrible at doing two things simultaneously or it's impossible for us to focus on two things simultaneously. That's probably a better way to put it. We have to go, okay, let's focus briefly on this and then we'll turn our attention to this and then we'll go back to this other thing. 

So in early recovery, usually I'm just trying to put an emotional and mental and behavioral tourniquet on whatever is happening for people. So it's like, “Alright, let's just get these behaviors at least semi managed for now. Then let's educate you on how this is happening and why this might be going on. And later down the road, then we can start to develop some self-awareness of how it is that you got here and why you're stuck.” 

And that's when we really start to dig into things like, “Oh, it turns out you also have a fairly serious depressive disorder going on,” or “You have massive anxiety, or you have PTSD because you grew up in a very chaotic or abusive household,” [00:10:00] or whatever it may be.

And sometimes the healing doesn't really start to kick in until people are transitioning away from just, “How do I fix my behaviors?” to, “How do I really understand what else is going on?” 

Tara: Thank you. I was listening to a presentation, and he was talking about, similarly, there are a lot of layers to what it is that we're dealing with when it comes to addiction. Oftentimes it's like, where do we even begin, right? When there are so many layers and you talk about this tourniquet so that people can just like start managing and functioning better.

But he said, “I have to help people if they're dealing with pornography or sexual addiction, I have to help them get sober first in order to start addressing some of these other things. Because the addictive behavior is just, the brain is just not working properly in order to do this other healing work.

I wondered if you could speak to that and if you agree with that and how, [00:11:00] when we're trying to recover from addiction, [and]we have these other issues that do need to be dealt with, but we can't do it all at once? 

Adam: I, because everybody's path I think is unique in some way, right? I've never been a fan of saying, look, there's one way to do things and it goes in this order, and you just do it this way. It would be so cool if that were true. It just hasn't been in my experience in two decades of being a therapist.

So that's why sometimes people say, “Doesn't it get boring just doing the same thing every day?” And it's not the same thing. It's never the same thing. It's always unique. It is nice to know that we humans are alike enough that I don't have to reinvent the wheel every single time I sit down with someone and go, “Who knows what's gonna happen here?”

There are lots of similarities, but there are enough things that are different that I think everyone has to come to terms with the idea that their healing path will be unique to [00:12:00] them. Which means for some people, absolutely the behavioral issues have to be addressed first. They're going to have to have some behavioral interventions, things like personal boundaries or bottom lines of what they will and won't do.

Really simple things like, “I'm just not going to stay up and stay awake after everybody in the house is asleep. Or if I'm feeling triggered, I'm not going to keep it to myself. I'm going to share it with somebody else,” right? Or “I'm going to confront the things I've told myself to give myself permission to keep stepping down a path of relapse, and I'm just gonna start being honest.”

Those are behavioral changes that often have to happen first because trying, like you're saying, trying to get to, “Let's talk about the fact that your father was abusive,” [00:13:00] or let's talk about the fact that you don't trust anyone for various reasons.” They're just not ready to do that. A lot of times people who end up addicted to anything, it starts young and it becomes the primary coping mechanism.

And so they never learn self-soothing in healthy ways. They just stay stuck emotionally. Sometimes, I think you could see it as staying stuck as an emotional teenager. And if you're always turning to that addiction, you never really get a chance to try other paths, to try other alternate approaches to self-soothing and to coping.

So it's hard to take an emotional teenager and say, “Now let's do all of this really difficult, painful, uncomfortable work and I'm sure you'll be fine.” On the other hand, I have worked [00:14:00] with people over the years who cannot make any meaningful progress behaviorally. They're relapsing very consistently, very regularly, and at the sign of the slightest amount of distress they're right back into old patterns.

And I have said to folks like that we may need to skip the behavioral interventions and really start digging into the challenging emotional work, because I don't know that you have a fighting chance right now of setting a boundary for yourself because you're so sensitive to whatever these triggers are, these emotional triggers, these social relational triggers that you go right into your child self and you start going to self-protective mode. Or “I can't trust anyone,” or “I'm taking my ball and going home" type of [00:15:00] thing. 

So it's a little bit different for everybody, but I do generally agree that for most people, we've got to at least get their brains reset to some degree by not being constantly, in this cycle of relapse to where they can think straight.

If you've ever seen or been involved with an intervention for, say, a substance user, a lot of family members will say, “This isn't my child. This isn't my brother, this isn't my sister. It's like a different person. When they're in the middle of all of this, they're irrational. No one can help them.”

I see this with eating disorders too. You'll see someone with say, anorexia, really severe anorexia. It's nearly impossible to convince them of anything other than exactly what they believe and how they see the world. And so it's incredibly challenging to try to make any changes [00:16:00] when they're in the middle of that.

So that's why there's that detox process. And they'll go inpatient and be forced to eat through a feeding tube or whatever, until their brain starts to heal. And I don't know what the mechanism [is], I don't know what's going on in the brain. I'm not a neuroscientist, but it's pretty obvious from observing it that there is something that happens where you are no longer your normal self when you're deep in the cycle.

Holistic Approaches to Recovery

Tara: So at SA Lifeline we talk about this recovery puzzle that we might call a path, if you will, of recovery. But we know for a fact that qualified therapy alongside 12 Steps seems to have a much better long-term effect as far as long-term healing for folks.

It's hard to give an ideal example, I know Adam, but, just work with me for a second. 

Adam: I will try.

Tara: Say you have a client come in and [00:17:00] they've been doing 12 Step for a while [and] they're not making a lot of headway. Maybe they've even been doing therapy for a while.

How would a multi-pronged approach in a holistic lens help them? And what, where might you start as a therapist to try and get some traction? 

Adam: Perfect. That's an excellent question, and I think it's really helpful for people like you're mentioning who feel stuck, who have been in it for a while, who feel like maybe this isn't working for me.

It's really easy for people to say “That approach is dumb and it doesn't work right and so therefore I'm gonna go find something else,” or “Nothing works,” or “I'm just so fundamentally broken that it may work for everybody else, but it's not gonna work for me.”

One of the most basic things that people should be thinking about is just the fact that their body is a machine that requires certain elements to function [00:18:00] properly. So are you actually getting good sleep, reasonably good sleep? Are you feeding yourself foods that are actually useful and helpful? We just got off of Easter here and I've got a whole basket of candy in my room, which I dip into. I would say I'm addicted to sugar. I think that's a reasonable thing to say.

Tara: You and many others. 

Adam: I came across it honestly. My mom is an absolute sugar addict and so is her dad. It's easy to do because you get immediate results - “Man, I feel so much better.” When you're young, you can do it and it's “Eh, this doesn't affect me.” Now I eat sugar. And I'm like, wow, I feel like I'm gonna die. 

But a lot of people aren't taking care of their bodies. They're not getting any exercise. It's very easy in the modern era to sit at a desk all day, to stare at screens all day, which most of us do, and to not really get very good sleep. If you're a parent to multiple [00:19:00] kids, you know that, especially as they start getting older, it's like they don't wanna sleep either. They got a million things to do. 

And that's the starting point. And a lot of people wanna blow that off, but they don't realize, we talk about people being hangry, right? Like you're so hungry that you become irate, you treat people poorly. It happens with sleep. If I am sleep deprived, I'm much more likely to end up actually having a legit panic attack, either in the middle of the night or sometimes in the day, because I start to spin out of control about all the worries that I have as a parent and a business owner, and just a human in the chaotic world we live in.

But if I'm sleeping better, I notice that it just works better. So I would say, start with that. And I gotta tell you, it's excruciatingly difficult to get a person to change any basic habits about their sleep, food, and exercise. It's crazy that [00:20:00] people just hang on to their habits with how they manage their bodies, like it's life or death and even though they know it would make a big difference.

For a long time I got really poor sleep. And it hasn't been until fairly recently that I finally just had had enough. I was sick and tired of being sick and tired and I fixed my sleep and it was like overnight, I felt so much better. It was like, “What was I doing all these years?”

I knew it would have this effect, but I just didn't, I didn't want to put the effort in or I don't know what it was. So I think that's a place to start. Sometimes people have things going on biologically that you might be able to discover with a physical or a visit to a doctor, right? There are things that happen biologically to people that change the way they experience emotion or change the way they think, change the way their body reacts to things. So it's worth looking into the [00:21:00] biological. That's a whole other rabbit hole. 

Then you have 12 Step and therapy, which should compliment each other. It's interesting though, and I think it's worth mentioning - In the mental health therapy world, it's easy for people to say the solution is neurological, biological, with your brain, or it's an emotional problem. And so we solve it through these therapeutic interventions. And you might even run into lots of therapists that say spirituality is irrelevant, or it's just a construct that people can use, that can help them, et cetera.

And in the 12 Step world if someone's very hardcore, you talk to a hardcore AA person, they would say “Therapy is irrelevant. It's completely pointless that you keep trying to solve your own problem or you keep trying to have humans solve your problem [00:22:00] and you just need to turn to God and your higher power or God will simply take the problem away.”

And so it's a debate almost on a religious level with how intensely people feel about these things. I like the word holistic. I like the idea that you're mentioning that you need to look at yourself as a being that has a whole series of needs and a potential whole series of challenges or sticking points or problems.

And so if a person's stuck in recovery, I would say if the therapy isn't working for you, then meet with someone else. I've actually said that to numerous of my own therapy clients and the conversation goes like this. “Look, I've been working with you for maybe a year or two now, and there's some areas where you're stuck. It's completely feasible that we have reached the limit of what I am [00:23:00] capable of doing for you, or the limit of what the dynamic of our relationship is capable of doing. Healing wise I've already said everything that I can think of, you're not gonna hear anything new outta my mouth. And the dynamic between us has gotten sort of very predictable. So you should try seeing if something else would work.”

Because all therapists have access to the same tools. Sure, there are different ways of implementing things or occasionally somebody will come out with a new therapeutic approach, but the truth is they all derive from the same fountain of basic ideas of how humans heal and get better.

A lot of the time, therapy is less about what interventions you're doing and more about the relationship between you and the healing person. I don't know if this is an overly morbid thing to say, but I often say that as humans, we're all dying right now. We are [00:24:00] all dying every minute. So in a lot of ways, therapy is just very long-term hospice care. 

I'm just sitting with you while you're dying and I'm helping you to support you in that process of slowly dying. I'm helping to make you more comfortable. I'm helping you to come to terms with some things that maybe you're not ready to come to terms with. I'm helping you to make peace in your relationships. And that can't be done with Chat GPT, right? People use Chat GPT now to help diagnose themselves and other people. They're using AI for therapy. And that's great if all you want is an intervention that someone else wrote down, and then AI is going to scramble it around and tell it back to you.

But what it can't do is be a human and sit with you and it can't give you that feeling of support that only another human being can offer. And I think that's the real value [00:25:00] of therapy. It's because you can find out anything and everything I know on the internet as a therapist, but what you can't do is sit down with me with AI and you can't sit down with any other therapist.

So try something different. And I do want to also mention that, a lot of times we talk about the placebo effect as being a bad thing. It's “oh no, it's placebo, it's fake.” But in reality, placebo simply means hope or expectancy. It's the idea that I have a belief or a hope that something is going to get better.

And placebo is generated by believing whatever it is I'm about to do will make a meaningful difference and then taking some kind of action and it produces real outcomes. So I think placebo is great. I don't think it's anything bad at all. And if you have come to no longer [00:26:00] truly believe that the actions you're taking are going to make a difference, then you have to change.

You have to shift your actions into something you can buy into again, something you can believe in and something you can take action on, because that's actually what's going to motivate you and to create visible experienceable changes. So don't be afraid to try something new, a new therapist, a new approach, a new way to perceive, even if you're like, let's say a person's staying in 12 Step, but they feel stuck right.

Then think about it differently. Think about it, as an example, as I'm not here to fix my problems. I'm here, for right now, I'm just gonna support other people. Or maybe I've been coming at it wrong and I've still been treating 12 Step, like a series of buttons I press to get what I want out of the vending [00:27:00] machine. And instead, I need to actually truly surrender and let go of trying to fix anything. And that's a different approach to the same set of behaviors, but maybe can produce a different outcome. 

So I think if people are willing to continue to invest in things that have worked for others, but be willing to also mix up how they perceive it or how they're approaching it. Ask other people, “Hey, why does this work for you? What is it about this? What's your perception of it? How do you make meaning of it?” They can still keep participating, but may get a different outcome. 

Tara: Okay. A lot there. 

Basic Self-Care and Biological Aspects

Tara: So I just wanted to maybe summarize a little bit for our listeners. Let's start with basic self-care folks. If you're not making the progress that you want to make, how is your sleep? How is your diet? Are you exercising? Like these really, again, basic things that we know we ought to be doing better [00:28:00] most of the time. But I like that approach of just, let's look at some of these basic self care pieces before we try and dig up all these other like old traumas to see if we can make a difference there.

And then that biological aspect, going to the doctor, seeing if there is some physical aspect that is contributing to your current experience and your current behavioral patterns. So basic but helpful. Also, as people are going to therapists and at SA Lifeline, we are so grateful for good therapists.

We call them qualified therapists, people who know their stuff. And we know that not all therapists and not all therapy is created equal. So I do appreciate that you suggest that if what you're doing isn't working, try something new. I do have a follow up question before we move on to something else though.

Because I have heard enough stories from partners specifically where they've said, “My husband, he was doing recovery work [00:29:00] for X number of years, and then he got this diagnosis of being like a DD or having this other comorbid issue.” As a therapist, would you recommend that people do some type of an assessment to look for other issues that they may not be aware of?

Is there something out there that kind of is an overview of what other issues might be playing into this that you might be unaware of?

The Value and Limitations of Diagnoses

Adam: The most comprehensive thing you could do would be to go see, say a psychologist, do a battery of assessments, spend eight hours, $2,500, whatever. And then they'll give you this 10 page write-up of all of the results of all the different assessments. And that could help. On the other hand, and I hate to throw my own profession under the bus, but there's a reason that we say we're practicing because mental health [00:30:00] is as much or more art as it is science. We understand some things about the brain or we think we understand them, to try to pretend that human beings really, truly understand ourselves is a joke.

I hate to bring quantum physics into this, but there's this experiment called the double slit experiment where they fire electrons through these slits. And it's the reason that we now understand that light is both a particle and a wave. But the most fascinating part about the experiment is essentially the photons or the light particles show up where you expect them to show up. If you put an observer on one of the slits, different things happen than if you're just seeing what you know where they land at the back.

And the reason that matters is because in a lot of ways, we see what we want to see, we experience what we want to experience, [00:31:00] and the results of psychological testing are affected by. How I perceive the meaning of the testing when I'm taking it, and in some ways what I want the results to be and how the psychologist, for example, reads the data.

And so is there such a thing as objective measures of what is happening psychologically? With me, I don't think so. And one of the reasons I know this is because I've met lots of folks who are in therapy and I'm the seventh therapist and I say, “Have you ever had a mental health diagnosis?” And they say,”Yeah, I've got nine of 'em. Depends on who you ask.”

They're like, “I've been diagnosed with borderline personality disorder, narcissistic, autistic, major depressive disorder and generalized anxiety disorder and PTSD,” or whatever. It's a reminder that our system that we use to categorize different mental [00:32:00] health issues is not great. It's the best we can do. So I think there's actually a lot of value in a diagnosis, and there's also a lot of value in letting go of diagnoses.

Labels and Their Impact on Recovery

Adam: It's the same opinion I have of the word “addict.” I think there's immense value in it, and I think there's sometimes value in letting go of the label and not letting it define you.

As an example, there are people who get stuck because they refuse to accept the label of addict because they remain in this state of “I don't really have to do anything about this because I refuse to accept this label.” And when they accept the label, then the action starts, they start to do something. I think there's immense value in that. 

There are people who have gotten stuck in the term or the idea of an addict and have leveraged it to [00:33:00] say, “You just have to accept me as I am, because this is just [like] if I had cancer or if I had lupus or whatever. I have this thing and it's not, it either is who I am or it's not who I am. It's just this thing I have. So just leave me alone. Stop bothering me, stop expecting me to do something. I just have to come to terms with it.”

So you can both utilize labels to benefit yourself in terms of generating movement toward healing, or you can utilize them to benefit yourself to generate absolutely no movement and asking people to leave you alone. 

Now we come back. And we say, “What do we do with all this information?” 

Seeking Multiple Opinions

Adam: And my answer would be to get some opinions. Get some opinions from mental health professionals. You're welcome to get opinions from spiritual leaders or folks that focus in on that area of your life.

[00:34:00] Get opinions from colleagues, friends, people in your recovery group who've experienced this before. You can even ask Chat GPT if you would like. Here are my symptoms. What do you think I have? Take a look at it. And if the idea of depression motivates you to do something, which is funny because depression is the ultimate anti motivator. But if the idea of anxiety helps you to perceive the world in a way where you say, “I'm going to do something about this.”

If you realize that you may have post-traumatic stress disorder or  traumatic childhood experiences and that helps you understand yourself better and it starts moving you, if it is fuel toward growth, then do it. Utilize it. Don't get stuck on, “I'm depressed now. I'm going to obsess over this thing.” Just utilize it for [00:35:00] movement. 

And there's lots of places you can look and grab a list of symptoms and you can say, “Okay, I'll use these symptoms to help me figure out what likely diagnoses I have.” Great. If it is helpful, then use it. If it is not helping you, then fine. You can take a pause on it and come back to it later. 

Tara: Okay. 

Adam: I can see I'm really blowing your mind. It's really troubling you. 

Tara: No, I'm trying to consider how the listener might be feeling as they're hearing you.

The Journey of Recovery and Acceptance

Tara: And what I do really appreciate, Adam, about your perspective is that I think it takes a lot of humility to be in this space of uncertainty of the path. Not uncertainty necessarily. Maybe that's not the best word, but like a recognition that it's not going to look the same for everyone. And answer A is not necessarily [00:36:00] going to be the correct answer for everyone.

And that can feel really either horrifying and frustrating or somewhat liberating. And just this recognition that there are a multitude of possibilities of what could be going on with me, but also a multitude of possibilities of opportunities for help and growth, right? And so it's all about perspective.

And so I really like how you tied that up with if it's helping you, if you can utilize it for some momentum and movement, great. But you can always ask yourself, “How's this working for me?” And if it's not working, then we get an opportunity to think through it and make a shift. 

And I think recovery work can feel, I speak more from the perspective of someone observing it more than anything, it can feel so frustrating because it's going to take a lot of [00:37:00] time and shifting and adapting. It's not going to be a six week program or even, “I'm going to work the steps and go to therapy for a year and I should be good if I check all the boxes.”

It just isn't linear, so let's talk about a timetable for healing and what can we hope for with all this uncertainty.

Embracing Liminal Spaces

Adam: I love what you said, that it can either be horrifying, actually I would say it's both horrifying and liberating simultaneously. People who are listening to this usually are probably here because they're here for answers, right? It's like I'm listening to this podcast because I want some answers from an expert in the field, right? Or people who have been doing recovery for a long time. I think it's so I can maybe put this in a microwave and get done faster, right? 

And the idea here is that the answer isn't in finding the fast, efficient solution. The answer [00:38:00] is actually coming to terms with what it means to be human, what it means to struggle, what it means to be in this space that you were talking about that feels like “When is this going to end?”

There's actually a great term for it called liminal space or liminality. And a liminal space is this threshold or this transitional place in between two places. It's in the midst of a coming of age ritual. It's, you're in school, but you haven't graduated yet. It is, you have things left to do until you can check a certain box off, but you're not done. The reality is almost all of life is a gigantic series of liminal spaces, and as soon as you complete one thing, you've probably already started 14 other things. 

I do martial arts, which is a crazy thing to [00:39:00] do at 47 because I am no longer limber and flexible and all those things. So it's a real challenge, but it's been a childhood dream of mine and it's a dream that's persisted.

And I eventually was like, “I'm not getting any younger. I better start this thing now.” And it's such a beautiful thing to walk in and to know absolutely nothing at all. I have little 14-year-old kids teaching me things and I have to call [them] sir and ma'am, and it's a very different space.

My favorite two hours of my week is at the studio and being a beginner and knowing nothing, and I don't know if I'll ever make it to black belt. I don't know if I have it within me. It's a many years long process and it may require skills. It certainly requires remembering stuff, and my [00:40:00] memory is beginning to not function like it used to.

But it doesn't matter to me. I'm not there to achieve an outcome. I'm not there to arrive at black belt. I'm there simply to learn. I'm there to grow. I'm there to experience, and if I start worrying about, “Oh, this is going to make it slow down the process,” or “I'm not going to make it at the next test, and then I'm going to have to wait three more months,” then it becomes laborious and miserable.

If I'm just there and saying, “This is an opportunity to grow,” and I'm in this liminal space. If I'm in between the guy that had not started martial arts and wherever I'm going to end up, then it's irrelevant how long it's taking or whether I'm stuck or why I'm stuck. And that's a strange thing for people to think about in a recovery process because everybody in recovery is [thinking] “I can't [00:41:00] wait till this is over.”

And I would say the real learning doesn't happen when you grab the bullet points from the podcast and implement them to get better. The real learning comes when you accept the fact that it's a process and it's your process. You didn't ask for it, but it is what you're doing right now. So embrace what you have to do.

It doesn't mean that you're not going to suffer. Buddhism has this beautiful idea that life is pain. Life is pain. Pain is not a bug in the system. It's a feature of the system. It is painful. Suffering happens when you refuse to accept that life is pain. You suffer when you're fighting against reality, and that's one of the most beautiful principles of 12 Step is acceptance, right?

It’s this idea of life on life's terms. I just come to [00:42:00] accept what is, and if you can embrace the liminality of your situation, if you can embrace the space you're in and say, “This isn't about hurrying up and getting out of the pain I'm in, it's about accepting the fact that this is where I am and I just have to take the next right step.”

And I don't know what the next right step is. So I'm just going to take the next step or a next step, and that's the best I can do. And I'll live more in the moment rather than obsessing over, “When am I going to get out of this?” Then you're living. If you're always living for the future, if you only live for when you're exiting the liminal space and in some predictable place, you will never live. You will truly never, you will be perpetually miserable. 

And I will say that is one of the features, the most unfortunate features I see of people in therapy is, and I'm not a believer you should be in therapy your whole life. Please [00:43:00] don't do 25 years of weekly therapy. That's wild. It's fine to be in and out. I have lots of clients who come and they see me for five sessions and then I don't see them for two years, and they come and see me for 12 and then I don't see them for three years. That's great. I'm glad I can be there as a support person for you. This isn't about saying I have to do X, Y, and Z for the remainder of my life.

It's about what am I doing in the present moment? How am I living in the here and now? And how am I turning the here and now into life, whatever that may be. Learning and growing and understanding and feeling and experiencing and all those beautiful things. And even finding beauty in the pain.

And if you can do that, then you will always be alive. You'll always be living, and no one can stop you from having a beautiful life. Even the person that you're married to, who you think is ruining it, [00:44:00] there's nothing they can do to stop you because if it's not them, it's something else or someone else causing you pain.

So embrace the whole thing. 

Tara: Wow. I can just hear some betrayed partners saying, “Oh, I hate what this guy's saying,” but I know, absolutely and not just our betrayed partners, but those who are really struggling and clawing, looking for real relief from addiction, until we can come to accept that on some level everything is going to feel very hard. 

I might even suggest truly joyful moments [are hard] because that in itself can be fearful. Like when is the next shoe going to drop? Because fear is what is driving us. And so I just, for our listeners, I'll even just say this episode did not go in any way, shape or form how it was going to go. That being said, I'm really grateful for what you have shared with us today, Adam, because I, again, I think so much of what [00:45:00] our recovery experience is going to look like is going to be based upon our hope for recovery, our willingness to change and adapt when things aren't working and to keep going with this level of acceptance. 

And it's the serenity prayer, right? God grant me the serenity to accept things I cannot change, the courage to change the things I can't, and the wisdom to know the difference and to really be able to trust that in time there will be wholeness.

But that doesn't even look like an absence of pain because life will always present challenging situations and it's the perspective and attitude that we bring to it. So did you have any final thoughts before I ask you the last question? 

The Importance of Adversity and Community

Adam: The only thing I would add before you ask the last questions is as humans, we actually need adversity.

We need challenges, we need pain. [00:46:00] The movie Wall-E, is actually an interesting examination of what happens to us when we remove all barriers to getting everything we want, exactly when we want it. And it's a huge problem. The end of the movie is, we're going back to the world we destroyed and there is one plant and we've got to find survival.

And that's when humans really thrive. We shouldn't be looking for an absence of problems. We shouldn't be actually looking for the easy road. We should be actually embracing the problems as the thing that keeps us alive, as the thing that motivates us to change. And that's a really hard philosophy to embrace when you're in the middle of suffering you [00:47:00] had not anticipated.

And that's why groups like SA Lifeline exist. It's why therapy exists. It's why we live in families, because the ultimate torture is suffering alone, but suffering with other people is a completely different experience, and it makes it tolerable. So we need to embrace the experience of bringing humanity into ourselves and suffering together, and that's the human experience.

Now I'm ready for your final questions. 

Tara: Good. Love it. And maybe I'll ask if people want to connect with you, Adam, I know you're insanely busy, but where would they go to find you? 

Adam: I am technically on Instagram, although I don't post very often. It's just Dr. Adam Moore. No periods or anything.

I do have a podcast that I keep meaning to start back up again, but it does have a good number of episodes. It's called Pocket [00:48:00] Therapist. And I own Cila Health, which operates as Utah Valley Counseling in Utah County, as Alliant Counseling in southern Utah and as Las Vegas counseling in Nevada.

And people can go to Utahvalleycounseling.com and we've got therapists that can help. I used to be a lot more available where if people wanted to reach out and ask questions, I could answer those. It's a little harder, but I don't get a ton of direct message requests on Instagram anymore.

So if somebody wanted to ask a question and sneak in a direct message, I might be able to, I might be able to sneak in and respond, but those are the places where you can see what I have going on. 

I do have a book. I always forget that I wrote this because it was such, it was probably the most laborious and difficult thing I've ever done, maybe even more than my PhD, which was up till that time, the worst thing I'd ever done in my life. But it took six years and it's called Pumpkins at [00:49:00] Midnight. And it's on Amazon and it's an interesting sort of mix of narratives of real people in recovery that we interviewed with very specific, much more than I've given today, steps and processes of how people tend to work through the recovery process from addiction and from betrayal trauma.

And that's another way to hear more of what I say, but much more concrete than the way I've talked today. 

Tara: But you're saying it's not all philosophical with you. There's some more concrete stuff that you do.

Adam: There's lots of concrete things. But like you said, this podcast didn't go the way I thought it was going to go either.

Tara: Then it must have been God led, we'll believe that. 

Adam: We trust the process always. And we trust whatever happens. I try not to plan too far ahead because I don't know what the right thing to say is until it's coming out of my mouth. 

Tara: Yeah. No, that's good. It was great. Before I let you go, [00:50:00] Adam, we like to always ask this bookend question.

Final Thoughts and Advice

Tara: If we've got somebody listening and they are brand new on their path of recovery, what would you say to them? And perhaps we have somebody listening that's been working recovery, either from addiction for a while or from betrayal trauma. What might you tell them? 

Adam: So for people who are just starting out, pay attention to people around you, but don't put people on pedestals. So never look at a person and say, “That is how I should pattern my recovery.”

No one's path is going to be the same as yours. And so if yours is lining up with someone's, even if you idolize that person, or see them as a type or a pattern to follow, let your own recovery be its [own] process.

Because if you get caught up in this idea that there are people who I have to [00:51:00] replicate, you will forever have a very different experience and you will feel like you're doing it wrong. And that's probably not true. Still observe the people around you, [and it] will teach you what it means for them to be in recovery. And then you'll discover on your own what it means for you. 

For people who've been walking the path for a while, I would probably say, “Welcome to real life.” As children, we have this idea, this idealized concept of what life is going to be. And I often say adulthood is a trap. It's a terrible trick.

Because we think we know what it means and we think, “Oh, I'm going to have all this freedom and I'm going to do whatever I want and I'm going to have a perfect partner who loves me infinitely and who meets all of my needs.” 

And none of that ever comes true the way we think it's going to. So recovery [00:52:00] and the path that you're on simply is life and it will never look exactly the way it looks today. And I think that's a really important concept. We say all the time that the only thing constant in this world is change, right? I don't know who originally said that, but it's such a brilliant idea. No matter what you have happening right now, it will change.

It may not change as fast as you want, but life has a way of completely upending whatever is going on, and suddenly something that was such a big deal to you becomes essentially irrelevant because something else is now taking all of your time and energy. And sometimes things that you thought you would never work through get spontaneously resolved. And sometimes you have to work through things with immense labor and you get done and it doesn't feel as satisfying as you thought because you had to put so much work into it, [00:53:00] like yeah, this is the natural result of the insane amount of work I put in. So I don't feel like I got the prize like I thought it was going to feel like.

So just embrace the moment, do the next right step, whatever that is. Just take a step and never ever do it alone. Make sure that you're surrounding yourself with as many trusted people as you can. And sometimes people that you think you can trust become untrustworthy for periods of time or permanently, and we have to grieve and mourn that. And then you find the next person and you move on to that next phase of life. And instead of obsessing over, “How can I get out of this?” I would say,”How can I live in this moment, this exact moment?” and I will deal with the next moment when it comes. 

Tara: Thank you so much Adam. I've learned a lot today. I believe, I know this will help many people. So thank you so much for your time, Adam. Appreciate you. 

Adam: Happy to help. [00:54:00]