An Interview With Wanda Malhotra
You are going to learn a lot about your triggers, responses and reactions. Going to therapy and learning about yourself will benefit you in all areas of your life. Triggers are often relational, so it is very important to identify how you react(emotionally) and respond(behaviorally) to your partner. It is well worth it to put in the effort to both react and respond differently, and you will enjoy reduced conflict and increased communication.
In a world where the journey towards sobriety is often challenging and deeply personal, understanding the pathways and strategies for achieving and maintaining sobriety is crucial. This series aims to provide insight, encouragement, and practical advice for those who are on the road to recovery, as well as for their loved ones and support networks. As a part of this series, I had the distinct pleasure of interviewing Karen Cunningham, LMFT-S.
Karen is a Licensed Marriage and Family Therapist and Supervisor in the state of Alaska. She has worked in private practice for over a decade seeing individuals, couples and families for mental health and relationship challenges. Karen’s greatest love is her family, to include her Service Pup Jasper, who has his own bio on her website. She enjoys supervising students and associate therapists, and teaches classes on a variety of topics. Her work is informed by Terry Real’s Relational Life Therapy, Drs Julie and John Gottman’s Gottman Method of Couples Therapy, and Dr. Dan Seigel’s Interpersonal Neurobiology.
Thank you so much for joining us! Before we dive in, our readers would love to “get to know you” a bit better. Can you tell us a bit about your ‘backstory’?
My dad had his first heart attack at age 47, followed closely with a second heart attack, followed by open heart surgery. He knew he had heart disease. He knew the risk factors. He didn’t exercise or eat well, and he smoked. When he dropped dead of a heart attack 15 years later, nobody shamed him or blamed him. My uncle is diabetic. He knows the risk factors, yet consumes too much sugar. When he had to have his foot amputated, people were sympathetic and offered support. Nobody shamed him. Nobody blamed him. My best childhood friend knew she had genes that put her at risk for addiction. When she was a teenager, she drank with her friend group. Today, she suffers with alcohol use disorder, and faces judgement, shame and blame, even from that same friend group. The most known treatment for alcohol use disorder reinforces this shame in its very title. AA is “anonymous;” and in its secrecy, there is shame. “Heart Disease Anonymous” and “Diabetics Anonymous” don’t exist, yet alcohol use disorder is as much a disease as heart disease and diabetes.
If you are one of the lucky ones who don’t understand addiction, consider the following- have you ever driven to work or the grocery store only to realize you don’t remember which route you took?
Have you ever sat down with your phone to quickly check email, then look up hours later to find yourself deep in the True Crime side of TikTok. My dad would sit in front of the tv and mindlessly crunch on salty snacks. My uncle would purchase foods high in sugar to keep in his house for easy accessibility, and when he couldn’t sleep he would raid his cupboard and binge on sugary snacks. This kind of normal “zoning out” is a mild form of dissociation, something that approximately 80% of people do (irrelevant but interesting- that 20% of people who don’t zone out are nearly impossible to hypnotize.) Everyone I have talked to about an addiction, whether substance or behavioral, describe a similar dissociative experience.
If we can normalize and accept that we all do things we know are bad for us, like my dad and my uncle, and if we can normalize and accept that there is not always intention behind our behaviors, like those zoned out snack-a-thons, maybe we can finally get rid of that old and tired stigma that says addiction is a moral failure.
As a Licensed Marriage and Family Therapist I work with individuals, couples and families. I wish I could say I was surprised to learn how many families are impacted by addiction in some form or another. Many, people are what I would call “functional addicts,” in that they are able to hold down jobs, coach their kids’ soccer, volunteer with the PTA, and show up for all the normal daily activities, only to go home and turn to alcohol or another substance (or behavior) to numb out. Addiction in many families is hidden in plain sight.
Can you share with us the most interesting story from your career? Can you tell us what lessons or ‘takeaways’ you learned from that?
I once worked with a highly successful world class athlete who struggled with an addiction to shoplifting. She described it as an “almost” out of body experience, where had very little awareness to what she was doing. It felt as though her arm belonged to someone else as she watched it reach out to grab a trinket and put it in her pocket. It made me think about dissociation, which is very often associated with disorganized attachment. With this client, we decided to shift our work to explore trauma, specifically pre-verbal trauma, and the disorganized attachment she had with her mother. Memories develop around the same time as verbal skills, so the experiences and knowledge infants and toddlers have are stored in a part of the brain that is very concrete. When an infant experiences a frightening or terrifying caregiver, who the infant also relies on for survival, the infant can become immobilized. The infant most often internalizes that the world is not safe, and that there must be something wrong with herself. This is what my client knew to be as true as the sky is blue. Tackling that belief became my sole obsession; I would ask her, “what gives someone value in this world?” And her response would be that nobody has to earn value; it is implicit, and that it applies to everyone, except her. I challenged her on this time after time, frequently we were both in tears, as I held space for her in which I saw her and acknowledged her value. I held tight to that belief, offered it to her time and time again, until she was ready to take it as her own. It wasn’t until we tried a very specific meditative practice, Dr. Dan Seigel’s Wheel of Awareness, that she had a glimpse of a different way of thinking. She ultimately came to see herself as valuable and having worth, without having to earn it. I truly believe trauma is at the core of addiction. Healing trauma can be at least a partial antidote, but it’s not a standalone intervention.
You are a successful individual. Which three character traits do you think were most instrumental to your success? Can you please share a story or example for each?
The three character traits most instrumental to both my personal and professional successes are compassion, empathy and kindness.
What I want to be remembered for, as long as I am remembered, is kindness. Gabor Mate is the world’s leading expert on understanding and treating people struggling with addiction. Although a clumsy paraphrase, the concept I take from his work is to say, “I am sorry you are in so much pain, and it feels like the only possible relief is alcohol/shopping/sex/drugs.”
Empathy is having an understanding of how another person feels. It can be incredibly challenging to see another person’s perspective, especially when the topic is highly charged. Those pesky emotions get in the way and the logical part of the brain shuts down in deference to the amyglada, a more primitive part of the brain that is responsible for our fight or flight system. When we are able to remain moderate in the presence of another person’s discomfort, we are much more likely to be able to explore their perspective. This is what every human on earth craves; to be heard, to be understood, and to be validated.
I can find compassion when I remind myself there is nearly always pain driving someone’s poor behavior. Nobody is crazy to themselves; everything makes sense in your own mind and your own story. When I struggle to be compassionate, I try to identify and connect with the young innocent child they once were. I wonder what the world did to bring them to their present state.
Are you working on any exciting new projects now? How do you think that might help people?
YES! I am starting a company, Kiwicalm, selling a series of “Mental Health First Aid Kits” for kids, adolescents, adults, couples, and ideas keep coming for additional demographics. We all experience our own version of fight, flight, freeze, faint or fawn. In the moment, when someone is overwhelmed, especially when children are overwhelmed, their pre-frontal cortex goes “off-line” and they are using a more primitive part of the brain. As many coping skills as there are, in the moment, nobody remembers what they can or should do. So I’m building kits to turn to, much like you would turn to a first aid kit for a band-aid for a skinned knee, and within these mental health first aid kits are items specifically curated for each age group to provide concrete tools they can use to regulate emotions.
Ok, thank you for all that. Now let’s shift to the main focus of our interview. How would you advise individuals who are contemplating the journey to sobriety but might be hesitant or unsure about taking the first step? Are there key considerations or strategies that can make this initial phase more manageable?
Giving up something that you have relied on to relieve pain is terrifying. It’s natural to fear that you will be left with the same depression, anxiety, fear, grief, anger or existential dread that drove you to use, only without the coping skill/defense mechanism/trauma response that you have depended on to feel better. It is so important to be specific and concrete about what you are planning to use as substitute coping methods. The feelings that drive you to use are not going to go away initially; so you have to have a plan. Some suggestions are: take the dog for a walk, make a sandwich, do a meditation, listen to music, watch a favorite show or movie, have a relaxing bath, stretch, do yoga, journal, or work on a puzzle.
Another consideration when you are detoxing off of chemicals your body has become used to is that it can be painful and even deadly if not done under medical supervision. Do not try to quit cold turkey, although I never understood what people have against turkey, cold or hot. Medical experts should be involved to support you as your body withdraws from chemicals or drugs, and there are many medications and techniques that can help with the symptoms your body will go through as you detox.
Sobriety often comes with its unique set of challenges. Can you share insights on how individuals can effectively navigate obstacles or triggers that may arise during their journey? Are there specific tools or support systems that you find particularly helpful in overcoming these challenges?
The idea of sobriety is to remove the addictive substance or behavior from your life. Some are easier than others. For someone struggling with substance use disorder, not keeping the substance in the house would be a good strategy. However, there are some addictions that won’t work with. Eating disorders, for example, because everyone need food to survive, and it’s possible every meal, snack, social event, shopping trip, and so on can be a trigger. Advertisements for alcohol are everywhere, and many tv shows celebrate drinking as something fun, normal, even expected to do with a group of friends. When going to dinner at someone’s house, the first question typically asked is, “can I get you something to eat or drink.” Imagine how challenging all these reminders of the thing you’re trying to avoid can be. Setting up a plan with a support person ahead of time is crucial. Have a planned response to use when someone asks you if you’d like a drink. Have a soda or juice in your hand to fend off questions and offers for a refill. Think about sharing that you are now sober. Most often people are very respectful and those that aren’t might not be the best friends to hang out with.
Maintaining sobriety is a long-term commitment. From your experience, what are the essential factors that contribute to the sustained success of individuals on this journey? Are there lifestyle adjustments or mindset shifts that prove crucial for the ongoing pursuit of sobriety?
Substance use disorders affect the entire family, and taking a family approach to sobriety can help. Enlist the support of family members and close friends. Let them know your triggers. Talk about your strategies. Be transparent about your challenges. One thing I dislike about AA is the “anonymous” part; it can feel as though addiction is something to be hidden, something shameful. Addiction is a disease, and just as there is no Cancer Anonymous, because there is nothing shameful about cancer, there is also nothing shameful about addiction.
Based on your research or experience, can you please share your “5 Things You Need To Begin, Navigate, & Sustain Sobriety”?
1 . Community. One of the reasons 12 step programs are successful for many people is that it provides a community and within that community, members find support. Anyone recovering from addiction would do well to find a program that resonates with them and consistently attend meetings or appointments.
2 . Addiction is a chronic disease. As with any chronic disease, there may be times where the disease flares up. Having a lapse is no different than someone with Irritable Bowel Syndrome (IBS) eating a bowl of ice cream and regretting it the next day. Unfortunately the old and tired stigma still exists in some circles, and some people stubbornly hold on to the belief that addiction is a moral failure or a weakness. Distance yourself from people who don’t understand.
3 . Recovery comes in stages. Sobriety and recovery cannot be reduced to “yes I’m sober” or “no I’m not sober.” You will need support. Enlist your friends and family members to help in whatever way they can. Find a pal to attend meetings with you, or ask a family member to accompany you when you run errands so you don’t seek out what you’re fighting to give up. Early in recovery you may need a lot of support, and for many people asking for help is difficult. Remember that addiction affects everyone in the family system, and recovery works best when you have as much support from friends and family as you need.
4 . You are going to learn a lot about your triggers, responses and reactions. Going to therapy and learning about yourself will benefit you in all areas of your life. Triggers are often relational, so it is very important to identify how you react(emotionally) and respond(behaviorally) to your partner. It is well worth it to put in the effort to both react and respond differently, and you will enjoy reduced conflict and increased communication.
5 . It is human to want to escape painful emotions. Feelings, however, are stubborn and don’t usually go away until they have been fully felt. With a trusted therapist you can uncover the trauma that sits at the core of your addiction. I have never come across an addict without a history of trauma. When you swallow your feelings, or push them down, they remain within you, and eventually need to come out. It is much like going to the bathroom. What goes in must come out. We know to excuse ourselves and take care of a full bladder at the appropriate place and time, and we can also learn to express emotions appropriately. It does nobody any good for you to take an emotional shit in the middle of the living room. So before emotions inside you reach a critical level, find a qualified therapist to work with to provide a safe and appropriate outlet.
Community support plays a vital role in the journey to sobriety. How can individuals find and engage with supportive communities or resources that align with their specific needs and goals? Are there online platforms, local groups, or initiatives that you recommend for fostering a sense of connection and understanding during this process?
There are many programs available to help and support you in your sobriety. Research what is available within your community. Technology provides 24 hour access to meetings all over the world. Take some time to find the program that resonates best with you.
What is the best way for our readers to continue to follow your work online?
I can be reached through my website, www.karencunninghamtherapy.com or email, kcunningham511@gmail.com. I will be launching my Mental Health First Aid Kits soon, so please visit my website to sign up for emails so you can be notified when they are available.
This was very inspiring. Thank you so much for the time you spent on this. We wish you only continued success.
About the Interviewer: Wanda Malhotra is a wellness entrepreneur, lifestyle journalist, and the CEO of Crunchy Mama Box, a mission-driven platform promoting conscious living. CMB empowers individuals with educational resources and vetted products to help them make informed choices. Passionate about social causes like environmental preservation and animal welfare, Wanda writes about clean beauty, wellness, nutrition, social impact and sustainability, simplifying wellness with curated resources. Join Wanda and the Crunchy Mama Box community in embracing a healthier, more sustainable lifestyle at CrunchyMamaBox.com .
Karen Cunningham, LMFT-S, On How to Begin, Navigate, & Sustain Sobriety was originally published in Authority Magazine on Medium, where people are continuing the conversation by highlighting and responding to this story.