Jaime Welsh Vinck has been working in substance abuse treatment for more than 20 years. She’s the president of the Meadows Behavioral Health here in Phoenix, which, among other things, offers inpatient and outpatient treatment for people struggling with addiction.
Vinck knows many people are scared to admit to themselves that they might need help, and they often don’t have a clear understanding of what effective intervention would look like. Her new book, “The Rehab Playbook,” is an attempt to demystify and destigmatize the process of rehab and recovery.
Vinck spoke to The Show recently and said one of her goals is to discourage the idea that people need to hit rock bottom before they seek treatment. She hopes the book can help people recognize concerning behaviors in themselves before things spiral out of control.
Full conversation
JAIME VINCK: I refer to them as inflection points. And, you know, I believe that rock bottom is a dangerous game to play, especially when you’re talking about someone that has a great deal of resources.
And I highlight one of my former clients where, you know, we actually had to bring his bottom to him because he could have stayed running and gunning. He could still be out there right now because there was no end to his resources.
SAM DINGMAN: Can you drill down a little bit for us, Jaime, on the difference between that rock bottom idea and this inflection point idea.
VINCK: Sure.
DINGMAN: ‘Cause I think people may be able to imagine a rock bottom, you know, somebody losing their housing because of their addiction or, you know, perhaps getting involved in a violent situation, things of that nature. But give us an example of an inflection point.
VINCK: Sure. An inflection point to me would be someone blacks out for the first time and they wake up and they don’t remember how they got there, and they realize, “oh, my goodness, it’s OK now, but I’m in a very dangerous, precarious situation that could have ended up a lot worse than it is.”
DINGMAN: Right. “I survived this, but if I stay on this trajectory, I might not survive it next time.”
VINCK: Exactly. And, you know, the continued use in spite of negative consequences, you know, that’s one of our diagnostic criteria when we look at substance use disorder, mild, moderate or severe. And if we think about being able to go and get some help, ask for help, change some things about our lives before those things happen, before we have all those negative consequences, that can truly be a lifesaver.
DINGMAN: One of the other things in this vein that you write about at great length in the book is how to have those conversations with loved ones in your life. And you really sketch out, you know, precise things that you could say to, for example, I think one of them is you imagine somebody saying, “mom, I recently blacked out from drinking. I want to make sure that doesn’t happen again. I need your support.”
It seems like there is also then a value to a potential parent in that framing, reading that and not reacting by freaking out or chastising the person who’s saying this to them, but rather meeting them where they are and helping them take the next step.
VINCK: That’s exactly right. And that whole notion of meeting someone where they are is something that’s very important from a therapeutic process and something that I’ve seen change significantly since COVID. And going to therapy, having mental health support, owning the changes in our behavior that we’re finding downright scary. That’s something that’s new since COVID.
DINGMAN: Can you say a little more, Jaime, about how COVID helped kind of usher in this new paradigm? Is it because during the lockdowns, people were perhaps a little bit more confronted with their behaviors?
VINCK: Yes. And there weren’t as many places to hide. And, you know, depression was extremely prevalent, anxiety. And then also drinking increased considerably during that time. Having said that, then there were also a lot more virtual options that were created to support folks during COVID .And, you know, we’ve got Talkspace and BetterHelp and all of those things where it was very easy to get yourself an online therapist.
And, you know, that’s wonderful. And any support that we can get is always good support. And we have become more flexible as an industry in terms terms of point of entry for treatment. There was a time maybe 10 years ago where if someone wanted help, the only option would be residential treatment. And if they were not willing or able to go for whatever reason, they would be looked at as being resistant and defiant.
And that’s where, you know, the old school mindset, well, then this guy’s gotta just hit his rock bottom.
DINGMAN: Well, staying in this vein of destigmatizing these behaviors, moving away from making people feel shame. A big part of that is this phrase that you’ve used already in our conversation, substance use disorder, which already is a different way of talking about this condition than addiction.
VINCK: That’s right. It is a chronic condition. And the language that we use really matters. You know, if we refer to people as addicts, if we say they’re dirty or clean. And that was all really the, you know, the language that was used perhaps 10 years ago. And so being able to revise that has really helped us in terms of getting people the care that they need.
And also, you know, explaining it to family members, because that language, you know, you’re an addict, you’re dirty, you’re clean. That sort of thing makes it appear as though it’s a choice. And it’s not necessarily a choice.
DINGMAN: Right. But I could also imagine in terms of this idea of deciding to seek treatment in some form at an inflection point rather than at a rock bottom. It’s much easier in my mind to say to yourself, “I think I might be using this or that substance in a disordered way,” than to say to yourself, “I think I might be addicted to this thing.”
I mean, that’s a much more dramatic conclusion and scary conclusion to have to reach completely.
VINCK: And you know, the other really important component to look at is that the co-occurring disorder, you know, what else is going on, why are we using the substance or the behavior? You know, it’s not just about a substance. There’s other types of addictive behavior, problematic behavior, you know, gambling, porn, shopping, all kinds of things.
And so to be able to have that honest dialogue with ourselves. Is this behavior problematic? And what am I masking? What have I, what am I covering up? And oftentimes what we find, it’s depression, it’s trauma, it’s anxiety.
DINGMAN: So, Jaime, I have to ask you, I mean, I could imagine somebody finding out that you, who are the president of Meadows Behavioral Health Care, where you treat patients who are in the midst of substance use disorder. I could imagine somebody being maybe, I don’t know, skeptical about a book like this, thinking that the idea is just to try to recruit people to come to a treatment facility and that they might think to themselves, like, well, “I don’t have the money to do that, or, you know, that I don’t have the resources to make something like that happen.”
What would you say to somebody who might be hearing about somebody like you writing a book like this and having a thought like that?
VINCK: Well, that’s fair. And what I would say to that person is, yes, I hear you, but read the book because I provide so many different options and I don’t really care where someone goes to treatment. Just get help. Whatever it is that you can do, reach out your hand, someone will take it. You know, I talk about going to 12-step meetings. It doesn’t cost a dime.
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