The Missing Conversation welcomes you to the third and final installment focusing on the balanced use of medication. This is often the neglected side of the discourse surrounding America’s relationship to opioids. There are significant dangers on both ends of the spectrum being either too loose or too restrictive. Robert and Dave discuss how to optimize our best relationship with sleeping and pain medications that can change our quality of life immensely. Not only are we emotional beings but we are chemical as well. There is a lot of talk about the mind-body connection, but not so much about the psycho-chemical connection. We are much more chemistry than we realize. Finding a balanced use of medication is an act of self-love.
Robert speaks to this issue in a way that few people can. After his kidney transplant 23 years ago it took him 350 experiments with his medication to reach a surprisingly peaceful equilibrium. It has become part of his lifestyle and through his experience would like to offer others hope to keep trying and advocating for themselves with the help of friends, family, and doctors. It is important to respect your own uniqueness in this process because experimentation more often than not will be necessary. Robert addresses the fear and hopelessness that often accompanies this process, and how to not let that stop you. Medication can be a part of our chemistry that can make all of our systems operate in harmony. If you or someone you love is suffering from sleep issues, anxiety, chronic pain, or trauma, this series of episodes is for you.
Mentioned in this episode
Dopesick (TV miniseries)
The Global Bridge Foundation
Note: Below, you’ll find timecodes for specific sections of the podcast. To get the most value out of the podcast, I encourage you to listen to the complete episode. However, there are times when you want to skip ahead or repeat a particular section. By clicking on the timecode, you’ll be able to jump to that specific section of the podcast
The Missing Conversation, Episode 80.
Robert Strock (00:00):
Medications used in balance is a gift to us all.
On this podcast, we will propose critical new strategies to address world issues, including homelessness, immigration, amongst several others, and making a connection to how our individual psychology contributes and can help transform the dangers that we face. We will break from traditional thinking, as we look at our challenges from a freer and more independent point of view, your host Robert Strock has had 45 years of experience as a psychotherapist, author, and humanitarian, and has developed a unique approach to communication, contemplation, and inquiry born from working on his own challenges.
Robert Strock (00:48):
Thanks again so much for joining us at The Missing Conversation where we do our very best to address the most pressing issues that the world’s facing today, and where we look for the most practical, inspiring programs, innovative ideas and people to support survival on our planet. As we talk about the balanced use of medication, it’s critically important to understand that there are significant dangers on both ends of the spectrum being either too loose or too restrictive. Before prescribing medication, doctors need to exercise great care in determining if a person has an addictive personality and therefore may risk severe danger from being offered this prescription. Like many of us saw in the TV series, Dopesick. In these articles, we’re focusing on the people who cannot access the medications they need for issues, such as insomnia or severe pain because doctors are reacting too conservatively. The side that has to do with saving lives in dealing with the abusive opioids is very well covered in the media.
In The Missing Conversation, we discuss issues that are often overlooked and not discussed. In this case, the other side of the opioid use is what we’re addressing here. It isn’t often that we’re asked to be able to hold both extremes together and see the serious problems on both ends, but that’s exactly what we must do to explore the opioid issue. Medication, when carefully dispensed, and given to a properly screened patient who requires it for better health, can be a life-changing solution. We need to think for ourselves to support our doctors to support us. Please note that all content and media on The Missing Conversation is created and published online in our podcast for informational purposes only. It should not be used for diagnosing or treating a health problem or disease. If you’re seeking medical advice, you should consult with a licensed physician or other qualified health provider regarding a medical condition.
Today we’re going to do the final episode on how we can optimize our best relationship to sleeping and pain medications, including controlled substances at our greatest times of need that will inevitably grow more if we are fortunate enough to live a longer life. We are especially focusing on when we face ongoing pain, sleeplessness, and what the potential solutions may be that can change our quality of life immensely, if we can learn how to be balanced. We’re going to explore making our best efforts to be open to experiment at this time of great need to use medications within the parameters of safety from the medical profession and not go to either extreme of addiction or trying to go cold turkey without help that is available through sensible use of medication. Before I go on further, I’d like to introduce Dave, my partner at The Global Bridge Foundation and dearest friend for over 50 years.
Robert, thank you. And I can’t emphasize enough how this particular subject has been neglected in our world and so critical in our lives and of course, especially you. Um, and I think you can speak to it in a way that that very few people can and, uh, I look forward to, to finishing this particular part of the series.
Robert Strock (04:35):
Thanks Dave. And yeah, when you’re talking about really being involved, there isn’t a day in my life right now where I’m not having two or three conversations a day that relate to the subject at hand. This is really a part of my lifestyle and yours as well. So I’d like to briefly review the three psychological types of people, uh, that really how they respond to the possibility of taking medications. So the first type of, of person is what I would call phobic, which means they’re afraid that maybe taking medication is gonna have side effects or maybe they’re gonna get addicted and they may have a pure view that I’m somebody that wants to not use medications cuz it’s too complicated and too dangerous. The second type is one that would be much more familiar to most of you, that would be addictive and that would be pretty self-explanatory.
Somebody that really does not have the sensibility or control to be using medications in a balanced way. They aren’t following doctor’s orders, they’re going above the amount that’s recommended or they’re taking it for too long. And the third category of people are people that are balanced that recognize that, yeah, it’s scary to introduce anything into your body, but it’s also terrifying to imagine that I may be going for the next 20, 30 years of my life not being able to sleep well or I might be in pain for the rest of my life. And I certainly want to find a way to balance my chemistry that follows doctor’s guidance so I can optimize a chance of living a quality of life that would be most fulfilling.
I just wanna ask you to address, it’s part of, but a subset of the, the type of person that’s phobic. There’s a, a sense of hopelessness, a try and a fail, a try and a fail. I don’t know anybody like you in the sense of the number of experiments, uh, that nuance daily life and quality of life. And it’s easy to get discouraged, easy to give up.
Robert Strock (06:50):
It’s such a critical point and it’s something I, I definitely will go into more in later in this episode. But when you move beyond just being afraid and kind of frozen in your fear, then it does naturally lead to some experimentation. But it’s so common that we’re all so unique that it’s gonna require oftentimes multiple experiments. And the sense of helplessness or hopelessness or despair is so easy unless you have a model or you have someone communicating with you that it’s critical that you really respect your own uniqueness. And for example, if you’re talking about sleeping medications, you may need more than one. You may need two or three in very small doses. And it’s not a complete science, it’s an art form. And that art form is gonna require a tremendous amount of experimentation for some people. Some people are gonna be lucky, they’re gonna nail it the first time.
But it’s very important that we realize that medication is really a part of our chemistry that can make all of our systems operate in harmony. And of course there are many that will not do that. But when we start to understand that medications used in balance and hitting the right zone in our body is a gift to us all, and we just mustn’t let fear or despair or helplessness or hopelessness or even a sense of grandiosity that I’m going to get it on the first try, that’s so important in developing our balance that we realize, no, we need to keep persevering. We always start at the lowest dose possible and then work up to see if it works. So even when you’re using one medication, let’s say for sleep or for pain, we’re starting really, really low dose. And for most people that’s way too little.
But for some people that are hypersensitive, that’s the way to go. So that’s the way we always start and then gradually move up. So when I talk later, which I will about having 350 chemical experiments in my 23 years since my kidney transplant and my reaction to the medications, I’m talking not only about 350 different medications, I’m talking about 350 experiments that were changes of dosage as well as changes of different medications. So all of this became very personal more than 23 years ago when I had my kidney transplant medication, which caused a severe insomnia where I slept for an hour a night for six months. And if you let that in, of course that’s gonna leave me in a state of complete exhaustion. And, in a way that’s complicated to understand because you haven’t experienced it, the speed was going on while I was exhausted.
So it was agitating, it was depressing. I felt a lot of helplessness, I felt a lot of hopelessness, but the only chance I had was to keep going on and experimenting. Now, earlier in my life, like most healthy phobics, because it’s not crazy to be phobic because you’re entering into the unknown world of medications. But it is limited to stay with it and not be an experimenter. When I was young, I was proud that I didn’t take any medications. I did not see myself as taking medications in this lifetime. So I identify with a lot of you that start off with the belief that it’s much better to be pure and to be self-reliant. So there’s a lot of respect for you that are phobic and it’s more like I am concerned, but I also am concerned about my sleeping; I’m also concerned about my pain;
I may also be concerned about my anxiety. And all of these require really listening carefully that medications can be our best friends when they used in the lowest dose possible with medical guidance and with perseverance. So it was so clear that the speedy sensation that was automatic from the moment I took the transplant medication 23 years ago was going to be something that made my chemistry completely altered. And it meant basically, emotionally, I was fucked unless I looked for an alternative, I needed to be an experimenter or I was in a situation that would be similar to somebody that has chronic pain for the rest of their life or chronic sleeplessness in a major way for the rest of their life. And having been in the field, I at least had the knowledge to know that there were alternatives that I could try, even though it didn’t mean that I wasn’t going to be in deep despair believing, oh, this didn’t work, this didn’t work, this didn’t work.
And I knew for sure that I was gonna need to take the transplant medication for the rest of my life. So I didn’t have the luxury of thinking, okay, I’m gonna do this for a year and then it’ll be over. And similarly, people that have accrued lengthy periods of time where they’re suffering with sleep, and I’m talking to you that are experiencing this or suffering with anxiety or suffering with pain, this is so important for you to realize you can change the quality of your life. There’s a very good chance with your own uniqueness that you will have to be, as Dave was encouraging, in kind of an animalistic experimenter, at a very low dose, unless you’re one of the lucky ones. So I continuously experimented for the next 15 years from the transplants and gradually was able to sleep three hours, three and a half hours, ultimately four and a half hours.
And I still didn’t feel good. And so it still required even more experimentation because it got me a third to a half of the way to having a life that where I could feel good feelings, but I still had major compromise of my quality of life. Now I’m not the point here, you’re the point. What matters is you looking right now at whether sleep or pain or anxiety, and to some extent depression too, although that’s a bit more complicated because there have been times in the, the profession has handed out antidepressants to all kinds of people, so that’s an area where I’ll put that in a slightly different category than anxiety, sleeplessness and pain. But for some people it absolutely is still gonna be critical that you persevere with antidepressants. And it is complicated because antidepressants more than anti-anxiety or sleeping medications or pain medications frequently requires a longer period of experimentation, a lot of changes of dosages.
So that perseverance is still gonna be very much needed. So I hope as you’re listening to this, you’re asking yourself, am I having trouble sleeping? Have I settled for four and a half or five hours a night or waking up for two or three hours in the middle of the night and being tired on an ongoing basis? Or am I dealing with a level of pain that’s compromising my, my life? Now the reason why I’m speaking with a bit of authority, it’s because I’m now 23 years from having my transplant, and 350 experiments later, and I am sleeping seven to eight hours a night on a reliable basis. I’ve also found something when I wake up in a haze, an exhaustion, and a hangover, I’ve found something that’s also helped me become alert during the day and night. And so I am someone who has found a successful method of utilizing and experiencing chemical balance now for the last seven years.
But it’s quite a load. I doubt very many of you will ever have to go through the amount of experiments or be able to take the amount of medications I need to find a tweaking of balance where I take five sleeping medications at a very low dose. Now I say that because you might need to take two or three, at a very low dose, and you may find there’s nothing exactly right. And in some ways you need to be, in many ways you need to be your own advocate and your own doctor, or you need to find somebody, whether that’s a psycho-pharmacology or a educated friend that really is ready to go on this journey with you to optimize your quality of life and to advocate for your quality of life. This is not something you should do, like it’s a moral standard, this is something if you really hear the message, oh good, I have hope.
Oh good, it’s possible. I can have my unique chemistry be considered. Now, as an example, one of the things that happened for me that was shocking, I had a root canal and I found out when I used pain medication for the root canal, I felt better than I had since before the transplant. So I asked my doctors, my psycho-pharmacology, could I use the lowest dose possible and see if it still had the same effect? And sure enough, now for seven years I’ve been able to accomplish that. Now I’m only saying that because you may find that one experiment that’s not traditional or might be traditional could make all the difference in the world. And the key is to stay hopeful or at least cautiously hopeful enough to experiment until the experiments run out. Because my experience is in working with well over a hundred people now is that 90 some odd percent of them have been able to improve their sleeping and pain, which is the majority of people that I’m working with, that are working with their doctors as well.
And they’ve been able to improve that and their quality of life has dramatically changed. So the key thing is for you to inquire honestly about your own patterns and see how this applies to you, my experience is that over half have either a sleeping issue, have a pain issue, arthritis, an anxiety issue, have death, they’ve lost somebody, especially as we get older, that this is something that is more needed by more people than half. So it’s very likely this applies to you or certainly those that you love, and especially as you get older, and I don’t want to be saying this only for people that are older because for many people it happens through trauma. It happens because of hormones, it happens because of losses and episodes in your life, divorce, bankruptcy, where you have a severe situation and chemistry can help you in those situations, more likely temporary rather than ongoing.
Just wanna reflect on that last point for a moment. Having been through trauma and never having it occur to me in that part of my life that there was relief in this way, never even thought it, I’ve had times in my life where little or no sleep for weeks because of circumstances, it didn’t make me my best when I was during the day after not being able to sleep to deal with my circumstances. So, it wasn’t even that I had, as you describe, which I identify with. And early in my twenties, maybe late into my twenties, ideal that I shouldn’t need or take medication. It’s just that it never occurred to me. And I hope the people listening see this tool as something that can be, to handle an episode. It might be weeks, it might be a month, it might be a month and a half, two months, whatever it may be. It isn’t necessarily a forever thing.
Robert Strock (19:53):
Exactly. And phobia is not something that is usually conscious. What’s conscious is I don’t like taking medications. You know, I’d rather do it naturally. Particularly true in spiritual groups, religious groups of thinking that it’s almost like, uh, sacrilegious to do this. So it’s not normal. I don’t think any of you out there listening are thinking, oh, I’m phobic. But you probably would see I’m resistant or I don’t really trust it or I don’t trust big pharma and for good reasons. But on the other hand, they’re lifesavers in the right situation, which is for almost all of us, gonna be true at some point. It’s so important that we recognize that we are psycho-chemical beings. And I’m gonna say it again, we are psycho-chemical beings. And what I mean by that is if we, our chemistry isn’t balanced, it’s gonna affect our psychology, it’s gonna affect our mood, it’s gonna affect our quality of life.
And there’s a lot of talked about mind-body connection, but not so much talked about psycho-chemical connection. And if you’re really understanding the essence of this series on medication, you’ll see how important it is to realize we are chemistry. And balancing this chemistry is like taking vitamins or health supplements when it’s done intelligently. And the fears or concerns about addiction are easy to safeguard if you aren’t an addictive personality because you are not gonna go outside of doctor’s orders, you’re not gonna take more than what’s suggested and you’re not gonna take it longer than what’s suggested. One of the subtle things, and now I’m dealing with psychology, is that we not identify with the feelings that we have when we’re really anxious or we’re not sleeping or we’re in pain, as I am in pain or I am anxious. Instead, we need to learn that my chemistry is imbalanced and that is leading me to be in pain, that’s leading me not to be able to sleep.
And I need to find a way to balance our chemistry. And the reason why that’s important is because when we don’t completely identify with these terrible feelings of exhaustion or pain or, or anxiety, and we have a bit of a capacity to observe it, that’s the key to what Dave was emphasizing earlier of being able to have the independence to persevere. And so instead of saying, I feel exhausted, I’m encouraging you to say my chemistry is imbalanced and that’s leading me to feel exhausted, but I’m the one that can observe this and, and given that I’m the one that can observe this, I’m also the one that can take charge. I can look for the best doctors, I can look for an advocate, I can be an advocate. I can keep growing into recognizing that I am a psycho chemical being and I can be a free agent if I don’t completely identify with the feelings that are so distressing.
Which I don’t think you mean that that remedy doesn’t include addressing real life issues in certain circumstances, that there may be a need to address a relationship or a legal situation or whatever it may be.
Robert Strock (23:25):
Yeah, thank you for making that clear. Of course, we need to do all of our mental health work. We need to persevere in our personal life and be as sensible, as strong and as vulnerable to be balanced, to work everything out we possibly can. This is a last resort, a last good resort. The first resort is do everything we can to have a quality of life, develop good habits of eating, exercising, relaxing, working, being focused. And each of us have our own unique sense of balance. Find our balance. That’s always a prerequisite. But when we’ve done that, and that’s really what has come to both Dave and I, very early on in our life when we worked with schizophrenic patients, they were doing their best, but they were psychotic. And so it was very evident that our idealism got a little bit shattered, but at least we put it off on people that were psychotic, at that stage.
We knew that some people definitely needed medications, but for you that are listening, yes, you need to do your work. We need to be dedicated to create our own quality of life and then see that chemistry is a potential gift for us, when we see that as our ally and that we, if we can do a level of disidentifying with the emotional state we’re in when we’re in chronic pain, when we’re in chronic result of sleeplessness, or chronic anxiety, we can then start to see, oh, my chemistry’s not balanced, it’s possible with the ingestion of this chemistry, I could be my best self again. In this time period, these last seven years have been equal to the best quality of life years of my life because I’m sleeping because I have a balanced chemistry. And I promise you, we all have that capacity if we can learn not to be completely overwhelmed by the pain, by the anxiety, by the sleeplessness.
So I ask you to just inquire in yourself right now, do you get this understanding of you being chemistry and that the chemistry poses as your identity when you’re in severe circumstances, like I just feel exhausted, which leads to being unmotivated, or I’m just in pain all the time and my life sucks. And so if you can observe that and retain the possibility that your chemistry can be altered to where this doesn’t have to be a lifelong condition and you may solve it as I have many times and be a moving target. And so you might have to go back again and go back to experimenting again, but remember, this is an act of self-love. This is an act of self-compassion. Being able to say, my chemistry is challenged and I’m going to keep experimenting until I can get the kind of support that will regulate my body, is such a loving statement.
Now I’m asking you to reflect again. Does that make sense to you? Or are you someone that has such a strong moral or ethical or religious standard that’s saying, no, I wanna do it naturally. If you are, you are who I’m trying to speak to. I’m really trying to speak to everybody because I believe that almost all of us are gonna have one of these conditions and are gonna be in this situation where we can be an experimenter and not let our feelings rule us. And in this case, we’re talking about a wisdom, a quiet capacity. Once you’re able to observe this and see that this is a healthy alternative by following our doctor’s guidance, by consulting and by revealing what we’re experiencing, then we’re gonna be giving all of ourselves more of an option to have a life that’s dignified all the way through our final days.
And so as a sense of self, I see saying to myself, I am the responder to how I feel. I’m the responder to how I sleep, not a victim of it. I’m the one that can respond to it. I am the response to my pain more than just the pain itself and I’m seeing clearly that I need to explore thoroughly my options to be chemically balanced. I am not defined by my feelings and conditions, but more so how I respond to them. Can you identify with that? Can you see what a blessing, what a gift this could be if you adopted the realistic assumption that we are chemistry and we have a new age of being able to explore, in a safe way, to recognize our psycho-chemical beings and therefore chemistry as our friend, if we understand that we can do this sensibly. Sleeping, pain, and end-of-life issues, and even chronic issues, early in life are complicated and it’s so worth devoting your attention to a new way of thinking and acting. The quality of our life is going to be dependent on this open attitude for most of us more than once. What else could be more important? Not only for ourselves, but also for those that are around us, as they will obviously be affected by our well-being or lack of it or our suffering. So I wish this for all of us and I hope this is really taken in by you, both to your heart and your mind. And thanks so much for your attention.
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