Qualified Therapy: Why it's Important, How to Find it, and Why it Complements 12-Step Work w/ Dan Drake

Narrator: This is Pathway to Recovery, an SA Lifeline Foundation podcast featuring hosts Tara McCausland, who is the SA Lifeline Executive Director, and Justin B., a sex addict living in long-term recovery. We have conversations with experts and individuals who understand the pathway to healing from sexual addiction and betrayal trauma because we believe that recovering individuals leads to the healing of families.

Tara McCausland: Hey friends, I'm excited to share this episode with you with guest expert Dan Drake, who gives so much great information about why qualified therapy, how to go about finding a qualified therapist. But before we jump into that, I did want to share a few save the dates with you. So first of all, Coming up February 6th, we have something that we've never done. It'll be a Vision Cast, an online fundraiser where we will actually do an auction for recovery items that have been donated, things like journals, art, surrender boxes.

So you should be able to go to salifeline.org and register for that. Of course, it's free. It will be online on Zoom, and we hope to see you there. So you can get a feel for what SA Lifeline is up to in 2024 and have an opportunity to support this great cause and link arms with us as we continue to work to recover individuals and heal families. Also, we have our annual SA Lifeline Women's Workshop coming up on April 19th and 20th in Mapleton, Utah.

This is a great opportunity for a smallish group of women to gather and to connect and learn and heal together from the effects of betrayal trauma. So again, that's April 19th and 20th. And if registration details are not up yet, they will be very soon. So great things coming up. And by the way, if you want a little email reminder about some of these things coming up, you can go to salifeline.org and sign up for our newsletter.

And that will help you know when registration is available for upcoming events, et cetera. new blog posts and, um, other recovery tools that we're making available. We're grateful to have you a part of our community. So without further ado, here is our interview with Dan Drake. Dan Drake is a licensed clinician, a certified clinical partner specialist supervisor, as well as a certified sex addiction therapist supervisor. He has co-authored several books, including Full Disclosure: How to Share the Truth After Sexual Betrayal, and Letters from a Sex Addict: My Life Exposed.

Dan is also EMDR trained, and he is the founder and clinical director of Banyan Therapy Group in Los Angeles, California. In addition to his clinical background, he has spoken domestically and internationally. Welcome to the Pathway to Recovery Podcast. I'm your host, Tara McCausland, and I'm thrilled to have here with me Dan Drake. Dan, thanks for being here with me today.

Dan Drake: Thanks, Tara. Thanks so much for having me. I'm excited to be here.

Tara McCausland: So as a background for our listeners, if you've been listening recently, you know that we've been going through the recovery puzzle. And we have been touching on the 4 pillars, the 4 outer pieces of our recovery puzzle. And so today, we're focusing on the qualified therapy piece, which, from an SA Lifeline standpoint, we don't do in-house therapy, but we recommend qualified therapy as an integral part of the healing process. So today, we'll, we'll talk about why qualified therapy, why it matters, how to find a qualified therapist, maybe what you ought to look for, and also how qualified therapy and 12-step work together really nicely to help people on their pathway to recovery.

So, Dan, you ready?

Dan Drake: I'm ready as ever. I know this is huge, but I hope we can have a lot. I'm looking forward to it.

Tara McCausland: A lot to cover. So the first question that I feel like is important to ask is, why is it important to find a therapist who has received specialized training in sexual addiction, or betrayal trauma recovery?

Dan Drake: Yeah, that's a really good question. I think on the short of it is, let me just explain my grad school experience. I had a 2-unit addictions course, total, my whole grad school experience to be trained as a therapist. And I'm— I could be wrong. I don't know if sex addiction was ever mentioned. So in grad school— now, I hope it's different now, but at least then you find people that have had, you know, full training. And I know psych— whether that's psychologists or master's level therapists, many people don't receive the training.

You know, some do go on to get, to get further training. I guess I always wonder if you are getting further training, why aren't you focusing in this field and getting, you know, certified? 'Cause there, there are, you know, certifying organizations that give you specialized training. So I guess the short answer is why, why look for someone with specialized training is 'cause we're not trained for this in school. So you'll have people that say they're specialized when they may not be.

I mean, if for example, you look on Psychology Today in, in my area, there'll be a ton of therapists that pop up 'cause they can just do a checkbox that says, I specialize in sex addiction or whatever it says, something like that. I don't know many of those people. They aren't my colleagues that I work with. I know most of the local specialists because it's a smallish community. So I think it's really important, I think, for, for kind of anyone listening, for you to know anyone can say they specialize, but there are, you know, this is 100% what I do in my practice.

It's not a 5%, or I worked with a porn addict once, and so I can say I specialize in this. It's, this is what we do. I'm assuming you know, many people's experiences that are, that are listening, you know, unfortunately, they've— many people that have come to me have been through multiple therapists before they've come to me. They've had terrible experiences. Someone saying, well, it's just, it's just porn, you should get over it, you know, thinking somehow you're, you're being prudish, or, you know, these misguided conceptions, or not even understanding what betrayal is, or the impact of betrayal.

So you find— I mean, we've just found people we've had to undo kind of institutionalized trauma that's, that comes from, from the actual therapist, even maybe well-meaning. I'm not saying they're not well-meaning. They just don't understand many people. So that's a short answer. But yeah, anyone can say they're specialized. Not many people actually are.

Tara McCausland: Right. Well, and I've said before on this podcast that not all therapists are created equal. You might liken it to, if we're talking about receiving specialized training in this area. Like when we have a physical issue, if we're having like digestive problems, we're not going to go to the heart doctor, right? There's very specialized training for our physiological issues. And we seem to understand that. But it seems like in the therapeutic world, there's some confusion about, oh, well, they're a therapist, so they must know how to deal with this stuff.

Dan Drake: I 100% see that. I usually try to use medical analogies because I think we may— it makes sense for us. I wouldn't If I had a heart issue, I'm not going to go to a general practitioner. I want to go to a specialist who does this. This is what they do. And I would say for myself personally, and it probably came through more wisdom over the years, I thought I could do more than I actually could until, you know, some of my wisdom that I've learned over the years is knowing what I do well and then referring out for the things that I don't do well at or other areas that I'm not specialized in.

Why reinvent the wheel or try to force something when there are people that specialize in certain areas? Let me find you the best help. And I think either it might be a therapist's optimism at best, maybe their own kind of pride or lack of education, or maybe their fear somehow that gets in the way of them saying, you know, I might not be the right fit for you. There is somebody who I do know, this person.

Also too, I don't know, especially for your listeners, I found, I found this to be the issue too. Sometimes people will choose a practitioner of faith. that becomes even more important than a specialist who isn't of faith. And that's a trickier, bigger conversation, I understand. But I find sometimes, you know, yes, of course, you want to have someone that respects your belief system, your morals, your values, of course. But sometimes there are people that, you know, profess to be specialists in an area that really aren't.

And they, you know, even if they share the same faith, doesn't mean they're actually going to steer you in the right direction. So I understand that's a big, complicated issue. And I'm not suggesting it's either or. I mean, hopefully it can be both and, but I also see that being an issue for plenty of clients too.

Tara McCausland: I really appreciate you bringing that up, partly because in this world of YouTube and Instagram influencers, it's amazing how people of a certain faith, they might draw a certain audience because of their faith, and people will just kind of Take what they have to say as just hard truth because they they are of the same faith tradition, and then they put themselves out there as a specialist or as the authority on this subject. Yeah, we could probably talk for a while about that.

But in one of our previous episodes, I just cautioned our listeners like go out seek for good information, but really vet those people who are the big names influencers who are saying follow me because XYZ, and that might include because. I believe the same things you do religiously.

Dan Drake: But I, even on that point, I, as a therapist, even if someone shares my, even if they're part of the same faith tradition that I have, and maybe even the same congregation or whatever, I don't presume to think that we actually are talking about the same things. I still, I still want to get to know, I mean, I still won't assume, yes, sure, we might have a common language, we might understand things. But even, I don't know, I guess I still don't assume that We're all on the same page with, with all this stuff.

And I love what you said, clients are consumers. Clients should vet the therapist. You should vet your therapist. You should know, does this person ask the questions? You're interviewing them, you know, and they're also interviewing you. Are you, are you the right client for me? Are, am I gonna be the best fit for you? But I think there's this kind of, I, I don't know what you'd call it, interview process, I guess, where we can see, are we the right fit to work together?

Just because you got a referral name or you're desperate, you don't have to go see that one person. You can see maybe this isn't the right fit. Let me, let me talk to somebody else. And I always say, you know, especially after betrayal, as a therapist, I've learned over the years that I can't and shouldn't expect trust right away from a client. You know, I hope I'll show myself trustworthy. I'm pretty confident I will. But I never expect it because why would I?

You know, people have been betrayed or they've, they've been wounded by other professionals in the past. So let me show myself trustworthy through my actions and through kind of my commitment, dedication. But that hopefully that I guess that goes to one of, one of these pieces of humility. As much as you can have some humility with a provider too.

Tara McCausland: Well, the next question here, I think, as you had suggested, as you were answering the first question, you get a lot of people coming to you who have been through multiple therapists. And so how do you go about finding the right therapist? And what are some maybe, and maybe this is a tough question for you to answer, but what are some red flags that the therapist that you're meeting with might not be the best fit for this particular issue?

Dan Drake: Yeah, good question. That is a big question. I mean, and I'll just refer people back to your website if they don't know. I mean, you have questions to, to ask your therapist, things to be thinking about. How do you vet, you know, qualify how you qualify your therapist. So there are some really good resources you have, so I'd follow those. You want to look at experience. So I, I think that's a good part. You, you talk about experience.

Sure, you don't want to have someone new. That said, experience enough, you know, even if they're specialized, you want to also know— how do I say this diplomatically— people that have been doing this for a long time may not be up with current, what's current. They may not understand. They may not be Like, for example, the field shifted, what, 10, 15 years ago from a co-addict model primarily to then we understand that there's— we understand the impact of betrayal.

So there could be codependency, co-addiction, but also there's this huge thing of betrayal and rupture. So if someone isn't really— they've just been doing the same thing for, you know, multiple decades, they may not be interested in the current, you know, shifts and learning. If you can get a sense maybe from their website, maybe it's not direct, but what— where are they with their kind of current thinking? Are they aligned with, with what's new in the field.

For me personally, I want to keep growing. The day that I say I know everything and that I've got this all, please tell me to retire. I tell people because then I've stopped being helpful because the field shifts all the time. So we all want to know, are they continuing to learn and grow in this area? So experience helps, I think, and openness. So get a feel. And The nice thing is these days we can, we can sort of vet therapists before you've even met them.

You can watch videos if you can. Sometimes, you know, sometimes therapists won't have content online. That's, that's okay. But do you get a sense from their website what, what type of person might they might be? So character does make a difference because yes, therapists have modalities, but you also want to get a sense who is this person? What's my gut impulse with this person? Do they have a certification? So that's another big thing we talked about.

So there are multiple different ones. The biggest one I know would be the CSAT, Certified Sex Addiction Therapist. That's the most comprehensive certification out there. And that makes— if someone's gone through the CSAT training, they've gone through typically 4 modules of training, which is 20 days of training. They've had to do, you know, multiple hours of supervision post-training. So there's a lot of— Yeah. It's not just you go through a 4-hour course and you get a stamp or something.

You have to actually do a lot to do it. So that's for someone working with the addict. But also there's the APSATS, which has certified clinical partner specialists or certified partner coaches. There's some other ones out there. I know Sash has one. Doug Weiss has his. There's other certifications too. But those are some of the big ones. So if someone's specialized is really important. Some red flags, let's see, what are some red flags? I would say, again, I think, how do they treat you?

How do you feel? So use that information. So if you're a betrayed partner, and, you know, for me, I think for anyone working, let's say if I'm working with the addict, I always want to make sure that everybody that's in the kind of Even if I'm not going to be working with a partner, I want to make sure the partner feels safe with me. Because, because I also, I'm not just working with one individual I'm working with.

Usually I'm working with this person in context of a couple and a family. So if you're a betrayed partner, do you have any access to that therapist? Or is there, is there some sort of channel? Maybe it's not direct, maybe it's through your own coach or therapist. Is there a way that, you know, does this person collaborate? Yeah. Or are they sort of an island? And I find if the therapists that are kind of the island, that gets more problematic because we're dealing with a relational rupture and that needs— and family, you know, there's a lot of moving pieces.

So how collaborative are they? You know, so sometimes people as part of a team helps that collaboration. I'm just looking through your questions, actually. I mean, I don't want to reinvent the wheel with some of these, but some of the— Some of the flags. What's their view of pornography, or their view of— do they align with your values is going to be an important one. If someone's saying all porn is wrong, and this person's saying, well, porn's not the problem, it's our shame about porn, then you're gonna have a value misalignment, which is going to be probably problematic.

Or where do they see the problem in the relationship? So I'm trained personally as a systems therapist, so marriage and family therapist. My My training was if I have a couple coming in to see me, then my focus is working with the couple. So the couple's the problem, or there's a problem in the coupleship means 2 people had a part in that problem. If someone's coming from that frame, that may be fine theoretically down the road. But that's not what we're dealing with right out the gate with betrayal and sex addiction.

We're dealing first with there was a rupture. that, that the addict caused typically through lies and deception, through their secretive behaviors that created damage. So that, that this kind of destructive, emotionally abusive behavior created damage in the relationship. And if I don't address that rupture from the beginning, and I assume there's 2 people with 2 equal parts, then, then it's a problem because we haven't actually named that there is an injustice that went on. And there's, there is kind of victimization, for lack of better words.

not intentional. I'm not trying to say the addict meant to do it, but that is what happened. So I think what's the— if you can ask what the therapist's sort of theoretical framework is and how they handle betrayal or betrayal trauma. I mean, even that term betrayal trauma, what their understanding of it is, will help you get a sense. And someone who says, well, I'm trained in X couple's model, and this is how I approach it, it might be fine down the road.

But Usually, we still have to address the rupture that happened right here before we can actually get to those pieces. So I'm usually concerned when I hear someone thinking they're going to bypass any of the pain that the betrayal caused.

Tara McCausland: So just as a review, and I will reference our list of questions that we have on salifeline.org to vet a therapist, but some of the things that you said that I think are worth repeating, someone that is up to date in the most recent research and development and understanding of sexual addiction and betrayal trauma is really helpful. I like also how you, you talked about, like, how do you feel? Use your feelings, your intuition as a barometer of, is this even a good fit?

Do I even get along with this person? Right? Open to collaboration. I've heard on a few occasions where an addicted spouse will come home and tell the betrayed spouse something that was said between them and the therapist that might be really hurtful and, or even not consistent with what's happening in the relationship. And that person, the betrayed, has had to go back to the therapist and say, is this really what you said? So I think that being open to collaboration with other therapists, being willing to have dialogue with the betrayed spouse And then this, I feel like, is so key— the value alignment.

I can't tell you how often you hear horror stories about people walking out of therapists' offices, and they excuse the behavior as, oh, well, you just got caught, everybody does this, or porn's not the problem, as you said. So I think those are all really good, uh, suggestions. Um, and then for those who are interested, on salifeline.org, if you go to our recovery puzzle, And then you just scroll down to the qualified therapist piece. There is a download that you can get just free right there for you, questions to qualify your therapist.

So I don't know if I would be so bold as to like actually like take that into your first therapy session, but just so you're aware as you're feeling out that relationship initially.

Dan Drake: Well, even if you do, and I appreciate that, even if you do, what's the therapist's response? Do they start to get defensive? Do they, you know, If someone brought that in, I would feel like, okay, is this an inquisition? Maybe, maybe. But, but the spirit of it, I'm like, okay, so if I can get to this person really wants to make sure that I'm safe. And so here it's safety, right? We're trying to find a safe fit that I can trust who's actually going to help us move in the right direction.

If I could get that spirit of it, that would help. I have had people come in with, even before meeting with me, they'll fire off like 5 questions. I wouldn't do it in email. It's worth, it's worth seeing the response. I have had that come to me in email and I'll respond and I, I'm not offended. I just think it's like, okay, you're trying to vet me, probably because, you know, there's, there's a lot of people that, that do harm out there.

If you're seeking a specialist, and it's nothing against this organization, they just take a different stance. It's important to find a sex addiction therapist, not a sex therapist. So certified sex addiction therapist, not a certified sex therapist. 100%. And I just have to say that. And again, nothing— I think sex therapists do amazing work. But what their goal is, is a little bit different than what my goal would be. And usually they can— they'll do things that later down the road that can really support couples.

But this is a huge mistake that I think a lot of people make, and they're seeing a sex therapist, then they're working on their sex life when the betrayed partner is kind of like, I'm reeling from the impact of this betrayal. I'm not ready to talk about sex right now. So just, just something to be aware of, you know, depending on what you're needing and where you, you are. to understand if that person actually does understand, because sex therapists actually don't take a sex addiction model.

They've been public with that.

Tara McCausland: Yes, thank you so much for bringing that up. There are people that I feel like have become big influencers in this realm that are sex therapists, not sex addiction therapists. So we kind of want to stay in our lane, right? Yeah. So we can really help people.

Dan Drake: And this is also confusing. That's the other thing I want to say. If you look, and I put a graphic, and I'm sure they're changing all the time, there are different people and also depend on what part of the country or the world you're in. Some people don't take sex addiction as an actual model, they discount it, and they have their own approach. So Doug Braun Harvey in San Diego, out of control sexual behavior. I like Eli Coleman up in Minnesota, he talks about it more by like compulsive behavior and not sex addiction.

So there's different people all over the country. Bill Herring's model, I think, is, is great. I think it's chronically problematic sexual behavior or something. So just so you know, the specialist field often isn't even in sync yet. So it's still a little bit confusing. Yeah. That's why I like these questions, because it helps you, helps you get a sense where that person is. And again, taking that in and self-empowerment. How do I feel with this person?

If I'm triggered by this person, is that related to the person? Or is it something, you know, something that gets activated? This is worth looking at.

Tara McCausland: Yeah. So then a big question that often comes up, and you said that sometimes you are working with couples simultaneously, what are your recommendations regarding individual versus couples therapy depending on the stage of the healing process?

Dan Drake: It seems like it should be a simple question, but it's really complicated. The traditional approach had been let people do their own individual work for a season, let's say a year even, and then we come together to do the couples work. That is one approach. And it works on some level because I think there is a lot of individual healing to do prior to working on couples issues. I will say, and I heard John Leedom— he's a therapist— he said this at a conference.

I heard him say something to the effect of, I don't know much about geometry, but what I do know is parallel lines never intersect. And so, I do think there's a world if we're doing just separate work for a season, and I actually don't see the parallel lines not intersecting, I actually see them usually verging further apart. Mm-hmm. So someone like Carole Jurgensen Sheets, ERCOM model, if anyone's aware of that. She basically— it's a newer approach to— well, I'm gonna botch it— Early Recovering Couples Education Model.

Shoot, I'm probably just butchered that. But anyway, it's a model for how do we help couples maybe not do couples therapy, but help them deal with safety stabilization issues, help them move closer together so that it's not You know, I don't have the luxury. We can't put people in bubbles for a year. They're living together. And if the addict isn't understanding betrayal or betrayal trauma, or what the partner's, you know, trauma experience is, we're gonna have big problems, and it's going to create ruptures all over the place and in the family, how that intersects.

I think there's a role of getting into couples support if you can, if people have the resources and availability. I wouldn't call it couples therapy, though. And we may call it couples triage or managing safety in the relationship. I think couples therapy, when you seek out a couples therapist, there's— it tends to be we're working on our communication issues or our relationship, which I think is further down the road. Right now, we're just trying to help build security and stabilization back in the relationship early.

Tara McCausland: Thank you. Yeah, I'm sure that that is a lot more complex than give it a year and then you can come together.

Dan Drake: Well, because people are— I mean, week in, week out, things are blowing up because addicts don't understand what the partner's going through. And they don't get it. And they make things worse usually until they understand.

Tara McCausland: Yeah. One of the primary reasons I see for having a therapist, especially early on, is for this event of disclosure. Disclosure can be really traumatic for the betrayed partner. And so I'm curious, why is it helpful to have a therapist aid in the preparation of and the delivery of a full disclosure?

Dan Drake: That's another good question. Janice Caudle and I created some disclosure workbooks for couples. We didn't ever set out to do this much work on it, but we realized how poorly these things can go. And also we thought, you know, it can get really expensive. My recommendation is to have 2 therapists, one prepare the partner, one prepare the addict or the disclosing person, which that can get expensive. We understand. So we created workbooks that could be used for people that, you know, if they have a guide, maybe it's even a clergy member.

And we're doing trainings not just for therapists, but also for coaches and also for, for other professionals, because we understand disclosures don't just happen for those that can afford it in the therapy office, it can happen elsewhere. So that said, having a guide, a trained professional guide to help through, or a qualified therapist, usually I recommend that because one, If I'm preparing the addict, for example, it's to help that person, help him to share the whole truth.

If he starts to get defensive or go into shame, to help try to manage that as much as we can, take breaks if we need to, to help keep him present and empathetic and open and vulnerable. So that part, and also on the partner side, it's to help the partner stay grounded and regulated, not dissociated, or, you know, just really help support them. So we have advocates there. But on the, the prep side, we know unfortunately, and I'm sure I, I hate to think it, but I'm, I'm positive people listening, they have gonna have experience of trickle disclosures.

I don't even call those disclosures. I call those confessions. Mm-hmm. Um, usually prior to this full disclosure, we find people share either too much information or not enough information. So our job as professionals is to help kind of titrate that to get to get all the information that the partner— what does the partner want to know? What don't they want to know? I do a written disclosure process, so it helps the addict. I'm working on also any rationalizations or minimizations or justifications or blame-shifting stuff.

I'm editing all that out, or too much detail, graphic detail. All that stuff I'm trying to filter out so that the partner gets everything that they want to know without, without it sounding like Can I give an example? I don't want to be too graphic. Yes, please. Like, in my first review of a document, I might have something like, in March of 2005, when you were 6 months pregnant, I blah, blah, blah, blah, blah, filmed the sexual act.

If I see that as the addict's guide, I'm trying to think, how's the partner going to read that? How's the partner going to hear this when they're listening to it? Most partners, most women I am going to hear, oh, so it's my— I was 6 months pregnant. And, you know, you're blaming me, basically. So anything related to the partner I'm taking out. So forget the 6 months pregnant. If the partner wants to connect that together, they will. But I don't want in any way to think, well, you know, it's because you were pregnant and you didn't want— you didn't want sex with me.

So that's why I did this. So that's— I'm trying to filter all that stuff out. And I'm talking to the client about that, saying, Your job is to be fully transparent with this information, fully accountable with this information without minimizing or blame shifting. So that's, it sounds, it sounds obvious, but it takes actually a lot of work and revisions to, to do that because addicts, it's scary to put all your information out there. So they try to hedge it a little bit.

Yeah. But I, I think giving the support so that hopefully it's accurate, the, the, the client does a deeper dive. So it's, it's all the information out there. We talk about polygraphs added to this. Yeah, there's adding those things possibly. So there's a lot of reasons, but I think because most people when they do it on their own, there's usually, it's usually not done well. It's either too much information or not enough typically.

Tara McCausland: Yeah. And that trickle disclosure or AKA confession, I think tends to add right to the trauma. Oh yeah. That's great spouse, which is what we're trying to do. We're trying to Diminish that as much as possible.

Dan Drake: Yeah. Thinking medically, if I, if I'm going through, do I want to go through multiple partial surgeries to get the issue solved? You know, and then I heal up a little bit after that surgery only to find out, no, there's more. We still have to go back in there and take out some more. And then, you know, no, there's more, there's more, there's more. I mean, each of those things we know, any data that I've seen on disclosures, that's the most traumatizing form of disclosure is the trickle down.

Like, because we start to build, we think, okay, I finally have some security. This is the foundation. Oh, no, wait, my foundation crumbles again. There's not a foundation. It's— there's more. I have a partner, even more becomes the M word. That's really— the word more is triggering. Because the addict would say, oh, wait, there's more. So even that word itself is now triggering.

Tara McCausland: Or I have something to tell you.

Dan Drake: Yeah. Oh, right.

Tara McCausland: Do you have— do you have a few minutes? I need to tell you something. Yeah. Well, I'm— I think that workbook that you mentioned might be of interest to our listeners. And so I'm going to link that workbook in the show notes. Sure. And link to your website, etc. Thank you. Well, so maybe this is too broad of a question, because I'm sure that it's variable depending on the couple. But could you walk us through what people might expect with the therapeutic process from kind of start to maybe a year out?

Okay.

Dan Drake: Is that a good question? It's a great question. I'm just thinking, and this is where I start to think like, this is sort of pie in the sky for those that have resources. So yes, I don't, I don't presume that everybody can do this. So I just want to say that ideally, if someone's coming in and they're in a relationship, which typically is the case, then usually the betrayed partner needs support, the betrayer, the addict needs support, and the coupleship needs support.

And usually that's— I like to have it with 3 different therapists if possible, not the same person. So that's pie-in-the-sky ideal. I understand that can get expensive and not realistic for some, so I'm just— I, I get that there are other options. So that's not— doesn't just have to be that. But for the addict, the addict does need some support. So I try to get them— and we'll go to this in a bit, I'm sure— but go get them linked to 12-step community pretty early if I can.

Because that's where they're going to do a lot of their healing. I'm going to hopefully take some of those pieces and start helping them build, you know, relapse prevention plan, more top-down. What went wrong? Like, why? What happened here? Like, let's shore up the foundation. Let's, let's get some sobriety recovery tools built. And then my job is to help that person twofold. One is to get the recovery and then also help them to restore the relationship where there's been an attachment breach.

So that's complicated. Everyone comes in with different levels of understanding and empathy. And if I have someone who's more narcissistic, they may not get it. And I have to teach them what happened and what betrayal trauma is and what you're seeing. And this is normal and, you know, all that kind of stuff. Hmm. So there's a lot of education, but then there's usually trauma work underneath it. So getting to do that trauma work with the person.

Um, the couples we already talked about a little bit early on. I think the first year to me is more how do we build safety in the, the coupleship, start to rebuild trust, honesty. And that's— I can share this too if it's helpful. A new book I have is on the intimacy pyramid. It's a, it's a conception I thought of a while ago for disclosure, but I think it works with basically rebuilding. And there's 5 layers to it.

So first, honesty. We're trying to rebuild honesty. then safety, then trust. After that, we rebuild vulnerability and intimacy on top of those, those 3 things. But I think the first year, I really want to focus on the bottom 3. So we got to rebuild honesty, some conception of truth and honesty, which is usually disclosure. I don't know how we rebuild anything if we don't— if this— if we don't know if it's the full truth that we're working with.

Again, I'm not gonna— I wouldn't force a partner to do disclosure if she didn't want to, they didn't want to. But I really want to focus, how do we, how do we build and rebuild safety back in this relationship and trust? Those are the things I'm focused on. So boundaries would come in, have the partner, you know, understand boundaries, the addict understand their own boundaries, and how do they, they build their own tools and support? That's super vague.

Is that— we can go into way more detail if you want. But those are some of the things I'm thinking.

Tara McCausland: No, I think that that's helpful. Those 3 pieces as the foundation, the honesty, The safety, the trust that you're really working on, and certainly the boundaries that come in so that we can create safety, right? Because there are going to be patterns within that relationship where both people will feel unsafe. Obviously you can't say, well, on week 1 we're going to be doing this, because if we're working with living, breathing, evolving human beings. I'm curious what your thoughts are on what we ought to expect as far as how long couples who are doing their work, and of course, we'll have setbacks, but doing their work, how long should they expect to be in the therapeutic process?

Dan Drake: So I will say this, and this, this number gets thrown around a lot. Pat Carnes, when he did his research, he was saying 3 to 5 years for couples. That's the kind of standard. And what many people will say. My experience, though, I do think the addict needs something consistent. I don't know that the addict needs long-term therapy forever. I think that person, if they've done the work, and they have built up a solid tool, I think that's where 12-step can come in and a community.

So they don't need a therapist for the accountability support, long-term, or, or even, even to kind of work through what's usually underneath the sexual behaviors is either trauma stuff, if they've worked through some of their trauma, you know, maybe it doesn't have to be perfectly, but, you know, when are we ever Done working through stuff, we could always benefit. But I think if they've gotten it and then they've established these tools for themselves and if they're implementing it and they're working this stuff on their own with their team, I found partners kind of come and go.

So they may not need as much ongoing. Maybe they need some, some support right now and then they kind of do their thing, then come back. There's generally 3 phases and that's what the APSATS model takes is Judith Herman's 3 phases of healing. So the first is safety stabilization. Yeah. We really want to focus on safety stabilization. Then the next big piece, and this is where a lot of couples stall, is remembrance and mourning, is that second phase.

That's grief work, that's trauma work, that's integrating the pain. And that's where the addict also needs to start learning. It's not this— my story, my experience has really also had an impact and harmed my partner. So they need to be able to not only heal from their own stuff and the shame that their behaviors— that they've had over their behaviors, they have to hold space for their partner and the partner's pain and grief. And then family pain and grief too.

I think there's, depending on how much the kids know, where that discovery happened, and there's long-term stuff. But that's where I think a lot of couples get stalled along the way is through the grief journey. So how long does that take? Man, I wish I could say. Some couples Some couples and families kind of progress quicker based on where they're at. Some take longer based on, you know, what the needs are. I don't have a good number.

I could— I just have the— I know the 3 to 5 years, but I don't think— I find it's not like you have— you wait 5 years and it's all bad, and then 5 years happens and that's all good. It's incremental. I think— Right. Any of this stuff, we're working day by day. And you'll see progress. And if you're not, that's another problem we need to address. But there should be some progress, maybe not perfectly, not linearly, but that there should be growth and healing and we're moving through these phases.

Tara McCausland: Yeah. And I think the main thing that causes me to ask that question is because I do think we often want a quick fix. We want the magic pill. We want this to be a fast process so we can get back to our real— not our real life, our normal life. And we hear that a lot. in, in 12-step, like, early attenders will be like, okay, how long do I have to do this? Yeah. And so to help them understand, you know, right now the pain is acute, and it's going to take some time to get out of that acute, uh, pain, that acute trauma.

It will shift if you're doing your work, and you'll find that you don't get triggered as often, or when you do get triggered, you'll have the tools to, to move out of that. However, I think Just in our day and age, you know, our microwavable Amazon Prime culture, the length of time that it takes to really heal from that. It's not just like a surgery and then you're done. This is over a period of time. And we'd have to go in with this type of mentality, but recognizing that even though this isn't a sprint, it's a marathon.

There are benches along the way where we can stop and pause and there's joy, even joy in this journey. And that's kind of hard sometimes to get across to people who are really in like the beginnings, the trenches of this.

Dan Drake: I think that's a really good point, especially around the pain. Because if I'm in acute pain, thinking of I'm going to be, I won't get relief for 5 years. That's not what we're talking about. This is couples rebuilding to a new relationship, you know, and hopefully one that is even stronger than they had before. Of course it's, mm-hmm, it's not the same. So sometimes I use the word rebuild and then I've had some partners say, we're not rebuilding, we're building.

You know, it's not even a re— it's a build. So that takes time. If your, if your house burned down, you're not gonna build it tomorrow. You're gonna, it's gonna take some time. It's gonna take a lot of time to, to rebuild, but it won't be this horrible pain and you won't get any relief. I, I actually, I certainly couldn't do this work if there wasn't hope for couples. I see the, the beauty of it. Couples that are, that really work through this and forge a new relationship is pretty beautiful.

Mm-hmm. But yeah, I think, I think being very delicate with yourself, very compassionate, and giving yourself that space is really important.

Tara McCausland: Yeah, thank you. Well, our final question before our final, final questions. So you have alluded to 12-step a couple of times through this, which I appreciate. Here at SA Lifeline, a subset of SA Lifeline is SAL 12-step. And we offer betrayed women and addicted men free trauma-sensitive, sponsor-essential, God-centered 12-step. And this is where we often focus as an organization because this is what we offer that's unique to some degree to us. But when we're talking about kind of bridging the gap between qualified therapy and 12-step, sometimes people can't figure out how do they work together?

Do they? Do they work together? And what is the role of the, the two of them in helping us on this pathway to recovery? Because to be frank, Dan, we often find ourselves having to explain to therapists, really, we're not in competition here. We're here to help those who are suffering get some really good long-term healing. But what, what is the role of 12-step? And how does that work with therapy?

Dan Drake: How could it or should it or, you know, That's such another good question. I— and again, it goes to— this is something whenever I speak at a conference, I, I always try to, to, you know, petition the professionals, let's have professional humility here. Because I love 12-step. I think it's amazing. I think every human being could benefit from doing 12-step work. Just, it's about being a better human being who, you know, the world would be a better place if we all did 12-step.

Forget an addiction, whatever. I think anyone working the steps is going to be a better person. I've personally— it doesn't happen all the time, but I have collaborated directly with sponsors with clients. Because let's say, let's say for example, around someone's 9th step amends, we may have differences of opinion in terms of— especially if that amends going to the betrayed partner, I may have some feelings and, you know, professional input on what I think. Ultimately, it's not my amends to make.

It's not— I will defer to the sponsor for that. But I may give some feedback as how I know the partner, what the partner's expecting, and, you know, some, some of that. So I think they work synergistically because I'm generally meeting with a client once a week, maybe 2 times or 3, you know, rarely. But like someone can have access to a sponsor, have a phone list, have people they can call, other brothers that they can call, you know, or sisters daily at any time.

They have, have someone helping guide them. That's just, it's a different level of support, accountability. I'll be an accountability person, you know, whether that's through Covenant Eyes or some other software, I'll do that. But I just think there's something that, that a sponsor provides that a therapist just doesn't, or the 12-step community. It's just so different than even group therapy. Because group therapy, yes, there's a, there's a definite benefit to it, because you can have feedback, and we can work through the intimacy issues.

But in a 12-step meeting, you get to learn how to be vulnerable and have, have your strength come not through sharing the world as you want people to see it, but you're showing, you're showing your vulnerability, you're getting help and support from other people that are there and their voice. Even if I have a professional voice, their voice is going to have a lot more weight because they're in it and they're going through it. So there's just something so beautiful about peer support that I think is amazing.

And I don't think we work at cross purposes. And quite honestly, quite honestly, there's no way as a therapist that I can speak to someone the way that you know, a peer or a sponsor can. There's just a way they can get in there differently than I can. I don't think we're doing the same work. There is some potential crossover if the community is giving feedback in terms of what the person should do in their relationship.

Or, you know, I think it's not so clean. There's crossover. Mm-hmm. But if we all have this spirit of we're trying to help this person heal, and we may have different I don't call it advice. I don't call it, but for lack of better words, advice to give. I think the team can work together. I see the 12-step community or their sponsor as part of their recovery team. Right. I'm a part of the team. I am not the team, you know, and the therapist that thinks they are the team and it's, this is my ship and, you know, everyone else kind of comes under my ship.

I mean, that's an approach, but I think, I think again, having some humility that we are all parts of the team trying to help this person and this relationship, you know, whether it's the partner or the addict, At the end of the day, then it's, it's really making sure that the therapist, maybe they have the professional experience, but I think the whole— it's the whole team. Like, I see sponsor, I see, you know, accountability partners, I see we're all part of the same team.

I'm not, I'm not the, the team, I'm part of the team. So I think that's really a critical conception to keep in mind, because The 12-step community has so much more availability, and it's more cost-effective, obviously. So there's a lot of resources and benefits you get from it and the support you can get ongoing at, you know, any time. There's all that available where therapists are just not as available.

Tara McCausland: Right. Perfect. Well, thank you. And yeah, I really like how you frame that, that we are on a team and that every person on that team plays a specific role. And One can't replace the other. But I think that as you described, recovery work is really expensive. And 12-step is free. And it's a long-term resource, and a community of people that can be there for as long as you need them and beyond, right? Yep. So thank you.

Appreciate you explaining that from a therapist's point of view, we are working together in this. We're not in competition. We don't have to be territorial. There's enough to go around, certainly.

Dan Drake: And I don't know how to ask the question, but does, does the therapist, maybe another way to vet, another red flag, does this person seem territorial? Do they seem based on like all about competition or do they have a spirit of openness and inclusivity and collaboration? Yes. Now, how you quite get that just from a question asked, but you may get a sense of that, that person. So I, I think it's important.

Tara McCausland: Well, you can ask that question. And I believe it's the final question on the, that list of questions that listeners can download to vet a therapist. The last one is, how do you feel about 12-step? And I also understand that just like not all therapists are created equal, not all 12-step groups are created equal. And so you might have to shop around there too. True. But yeah, again, I appreciate this explanation from you, Dan, because we need, we can And we need to work together on this problem for the rising generation that has grown up with phones in their hands.

We're going to have a lot of work to do as a community to heal. Well, as our wrap-up questions that I always end with, we like to ask because we have people who are listening who are on the beginning of their journey and others who might be more mid or kind of long-term. What would you say to the newcomer, someone that's just stepping onto this pathway of recovery? And then what would you say to the person that's been doing this for a while?

Dan Drake: For the newcomer, I really, my heart goes out to you because I know this place can be confusing, volatile, especially for the partner. This is, this is so confusing. It's a world you, you, a community never thought you'd have to be a part of. And here you are. So it can be so earth-shattering. But I think for everybody, give yourself a lot of grace, compassion, really try to one foot in front of the other. There is hope.

It won't be like this forever. So the kind of chaos and uncertainty and the volatility is part of the early phase, but that's where, you know, we, we build safety, we build honesty, we build trust, and that can, it can really go a long way towards, you know, repairing a foundation and healing the relationship. So don't be discouraged early on when it feels so overwhelming and daunting. Just, just really be be encouraged. For someone long-term, how do I say it?

And this is specifically for, for the, the addict. Don't get cocky. I found the 2 main areas where I see people struggle the most is early on and then later on when they think they've got it all. So they start to let go of some of the supports. So there, that doesn't mean you have to do the same level and depth treatment or whatever the whole time. But just be careful if we're, if we're taking off scaffolding, are we ready to, to, is this building going to stand on its own?

What other supports do we need to do? So I just, I would say really, and, and my, my phrase that I say all the time to clients, there's no cruise control for recovery. So just because you think you've got it and you think you put it in cruise control, if you think you've got it in cruise control, that means you're slowing down. So just, you always have to keep your foot on the gas and keep vigilant.

So that's what I'd say.

Tara McCausland: Wise words. Thank you so much, Dan. It's really been a pleasure. Appreciate all you've shared with us today. And thank you for your great work in this realm. It's needed. So thanks again for being here with us. Thanks, Tara.

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