What It's Like to Work With Me

My job is to create an atmosphere of safety, compassion, and hope necessary for you and/or your family member to engage in therapy to confront what is probably one of the greatest challenges of your lives. I respect your courage in seeking help and the trust you’ll be placing in me.

My Approach

My approach to therapy is self-empowering and collaborative: we'll work together to identify your strengths and develop tools and strategies that will help you address and overcome the challenges you are facing.

We'll also be solution-focused, meaning we'll work to establish specific goals and develop a plan for you to achieve them.

I take a holistic approach, focusing on helping you feel better emotionally, physically, socially, and spiritually. I'll help you figure out where and how to begin based on what you want to accomplish in therapy, and I'll offer options to help you take steps forward.

Moving Forward With Hope

Based on what you want to accomplish in treatment, I’ll help you figure out where and how to begin, and I'll offer options for you to gain some traction so you can make additional progress.

I’ve become a better therapist by witnessing my clients’ honesty and courage, sharing their life experiences and knowledge, and becoming a partner with them in their unique paths in recovery.

I look forward to the opportunity to work with you.

Steve Martorano 
The Behavioral Corner is produced in partnership with Retreat Behavioral Health -- where healing happens.

The Behavioral Corner 
Hi, and welcome. I'm Steve Martorano, and this is the Behavioral Corner; you're invited to hang with us as we've discussed the ways we live today, the choices we make, the things we do, and how they affect our health and well-being. So you're on the corner, the Behavioral Corner. Please hang around a while.

Steve Martorano 
Hi, everybody, welcome. Again, it's the Behavioral Corner. Welcome. I'm Steve Martorano, the resident keeper of the Corner. What we do here is the conceit is we're hanging out. And we run into interesting people, we hope you find that to be true, we certainly do. And what we do is talk about everything. I like to talk about this podcast as a podcast about everything. Since our behavioral health is affected by everything, it's made possible by our underwriting partners Retreat Behavioral Health. In any event, what we try to do is shed a little light on something that people hear a lot about, but maybe really don't understand what's going on. I mean, we are in a couple of crises here in this country, certainly, substance abuse and overdose deaths, as a result, are crisis proportions. And so as a co-occurring mental health situation, we're at an all-time high for problems in that area as well. In the 10 years, we've done this program, in my limited experience, I have seen things change with regard to treating all these problems. The changes are incremental, and our guest today will tell you that they're not nearly sufficient enough. Barry Lessin is a licensed psychologist, and a certified advanced alcohol and drug counselor. He works with young people and their families. This is a family disease, for people who've been impacted by substance abuse disorders and other related mental health issues. He has over 40 years in the field as a clinician, Administrator, educator, researcher, and public health advocate. And he's here to talk about the changes he has seen and the shift in his approach to those problems. Barry Lessin. Thanks for joining us on the Corner.

Barry Lessin 
Thank you, Steve. It's great to be here. And I remember listening to you back in the day. And I'm glad to see that you're still doing good work.

Steve Martorano 
Well, thanks. Thank you. I'm always grateful that anybody is, you know, remembers the program, and you remember from way back and are courageous enough to admit that they're that old. Anyway, thanks for joining us. So yeah, there, things have changed. I like to say, and I've said many times that all stories of substance abuse, and treatment are the same, except they're different. And the differences are getting...are getting, at least in terms of treatment, are getting more pronounced. Tell us about in a kind of thumbnail and sketchy way, what you've seen in terms of changes over the four decades, you've been in this field.

Barry Lessin 
Sure, sure. So I can say a little bit about my experience from the beginning. And what got me to this point? And because it reflects the change. And it really is a paradigm shift in how it's another way of looking at how to work with substance users and their families. So I was a psychologist working with individuals and families in a traditional when I say traditional, its size fits, treatment approach. And 2011, I was feeling pretty burnt out looking towards like down the road, what my career was going to look like as a provider working in the addiction field. And a couple of things happened one thing...one thing that was happening was that I was feeling not very successful in working with my clients, they were dying from an overdose, and I felt like I didn't have a lot of answers. And it was very painful to continue doing this work. And then my family, on a personal note, my nephew was struggling with substance use and mental health issues that my family turned to me. And using the traditional model of looking at substance use as an issue and requiring that he do rehab, create boundaries, and do tough love and I realized that it became a disaster. My nephew has done really well since then, he's got 15 or 16 years in the recovery community. But what I became aware of was that the model was not working the model that I was trained in and that the majority of people were using, and they're still using it to some extent. So what I began to do is I began to look outside of the traditional models and found that there are other approaches that people are using in substance use. And I began to look at the wider context, of substance use in our country and the world in terms of drug policy and understanding that in 2011 it was the...it was the 40th anniversary of the war on drugs. And I wasn't aware of that concept before, and when I began to educate myself I realized that the war on drugs is to war on people. Have sworn families. And the focus is on not. It's a sort of social-political issue of not looking at substance use and providing treatment for people but looking at ways. The idea that substances were bad, was problematic, and the prohibition model became something that would be oppressing people and discriminating against people. And in terms of the treatment world, the idea that you have to stop using drugs, or else you can't get well, I was working with a lot of adolescents and young adults, and to tell a kid when they're 15...17 and tell parents that they are addicted, and they have to stop using drugs. And that real life wasn't really very realistic. So I realized I needed to make a change to incorporate some other ways of working with people to engage people in treatment.

Steve Martorano 
Let me stop you right there before we go any further into where that discovery or that insight takes you and go back to this notion of the traditional model. Am I right in assuming that, again, in a nutshell, this traditional model was based upon the bedrock belief that abstinence was the only way?

Barry Lessin 
Well, yes, but I think it's like a size fits. And it was substance centric, as opposed to person-centered, or family centered. So I was trained, and everyone is trained in a professional way, as a psychologist, social worker, and Counselor. There's a humanistic psychology, Carl Rogers, non-judgment of clients, focusing on the person. People are doctors and lawyers, pastors and students and athletes and members of the community, and siblings and grandparents, and somewhere in the picture may have issues with substance use. So rather than focusing just on the substance use, it's how I was trained and how we were all trained, the narrative of the substance comes first, and that became prominent, and we lost track of the human being in the picture trying to get some help.

Steve Martorano 
The loss of the individual is a characteristic of any process that becomes militaristic in nature. In other words, if you declare war on something, you're saying, there is a bigger goal than just the individual, you know, there's collateral damage, if we're at war, unfortunately, some people are going to be heard that shouldn't be, you mentioned the breaking point of, you know, the 40th anniversary of the war on drugs before anything therapeutically could change. As a society, we had to get it out of our heads that this was a criminal justice problem. And shift over into this is a medical promise a public health issue was that the biggest change that's occurred in the past 40 years? 30 years?

Barry Lessin 
We're moving in that direction, certainly. So the laws have changed in terms of providing Naloxone for people, easy access to Naloxone, for people who need it, and its for sale over the counter in many states and many communities. There are laws that will require them won't arrest you. If you witness an overdose and you're calling the police. There's, in New York City, there's the first safe consumption site which is which allows people to come in and use drugs in a setting where they are going to be provided medical attention, or food or be able to connect with housing or any other resources that they might need. So that's a public health approach that reflects the model of engaging people where they're at and having a more inviting....them into a therapy process or inviting them into a process of getting well. And the traditional model of, you know, it's like you have to do it this way. It's very prescriptive. It's like authoritarian or paternalistic. Going to therapy is not it's a very difficult thing to do. It takes a lot of courage. So you want to make it inviting, you want to make...you want to meet people where they're at and invite them in. So that trend is happening.

Steve Martorano 
Let me ask you about the other thing that I think has shaped, your paradigm shift, and that is this notion of harm reduction. What does harm reduction mean to you?

Barry Lessin 
So, harm reduction. It's a philosophy that acknowledges the rights and uniqueness of each person and empowers people...empowers me to work with people in a collaborative way, so they can begin to make some lifestyle and behavior changes. It's based on the knowledge that all human beings will engage in behaviors that carry risks, and they have a right to make choices. And harm reduction shifts the focus from attempting to restrict or prohibit behaviors to reducing the negative consequences of behaviors. It's the foundation of a lot of public health policies because it places the self-empowerment of the person at the center.

Steve Martorano 
Wasn't harm reduction the point of any kind of treatment from you know, even the dark ages of treatment to today where it's a more humanistic notion, but it was always about reducing harm, right?

Barry Lessin 
Well, we wear sunscreen, we use helmets, and we need seatbelts and condoms, this is stuff that's incorporated into our lifestyle. But in substance use, there's this sense of, we kind of forget about that. And we look at it has to be this way, because it's moving away from the individual.

Steve Martorano 
Let's talk about some of the types of disorders that you deal with and how your treatment has changed. Regarding each of those, you deal with all sorts of substance abuse issues, alcohol, drugs?

Barry Lessin 
You know, addictions, they're not always substances, so they're what's called process addiction. So yeah, gambling, overeating, sex.

Steve Martorano 
You deal with those as well?

Barry Lessin 
At this point, my practice is mostly substances, but the process of engaging people in treatment is similar to the process of the therapies that are offered, or there's a lot of overlap, and there's more standard. If you again, focus on each person's coming in...a lot of people will come in, and they may have addictions to multiple substances, or they may have, they may be overeating in a dangerous way. Or there might be some gambling. Things you see aren't in a vacuum, there's often overlap. So it's, it's focusing on what's the situation with that person, and looking for ways to provide the proper treatment approach to help them.

Steve Martorano 
I guess what is my question trying to ask is when someone comes in for treatment with you for whatever the issue maybe? Or how quickly do you arrive at the notion of, well, I can't just tell them, they've got to stop, I can't just begin with this abstinence thing, or do you never approach it that way, you know what I mean?

Barry Lessin 
If it's person-centric, and or family centric, and wanting to engage people into treatment, people were going to come, and they're gonna say, "This is what I need to work on. This is what my concerns are." And it understands that people have a relationship with substances. And a relationship is it there's a history like a relationship with a person, there's, there's a history to it, there are benefits, and there are negatives or downsides to it. And people don't necessarily see substance use as an issue. But if you talk about it, in terms of a relationship with a doctor, be able to point out what the consequences are, or what there are benefits to using substances. So being able to talk about it in those terms, it's less threatening, and people can link it to other behaviors that that they're concerned about. So work with kids. They're not going to come in and say I have a problem with substance use, they're gonna say, I can't sleep at night, I'm being bullied. I'm having pressure from academics. I feel like I may have I may be gay, it's like, that they're struggling with, and they're willing to deal with that, then but the substance use is, so let's get on board with that. Let's talk about that. Tell me more about that. And what do they want to work on? What do people want help with and engage in a trust? It's like, they're not going to trust the process. They'll trust the process more if they're, if I'm meeting where they're at, and I'm, I'm working with them on what they want to work on.

Steve Martorano 
Right. It's the process looks like it's in the service of dealing with what they say is troubling them, then it's something they're more likely to go along with, rather than this is about getting you to stop smoking so much marijuana. I guess I can sound like the cart before the horse for some people, right?

Barry Lessin 
Yeah. And one of the things I learned and one of the things that is that we know now about how people change is that there's something called the Stages of Change. And there's research done over the last 30 years, about how people across different conditions, medical conditions, and substance use it's really about behavioral lifestyle change. They go through periods of change from what we typically call denial to be more aware of the problems. It's called contemplation. You're not really ready to change, then there's a preparation where you're beginning to think about ways to change, "Yes, I have...I need to do some I'm not sure what to do," and then putting it into action. You can't force that process you come in, and you I'm encouraging them to begin to work on the things that they will work on to increase their motivation to be able to change the things that they want to change and give them some confidence and feeling empowered to be able to make some small positive steps. And that moves them along that continuum of wanting to change.

Steve Martorano 
Does your client base is it made up primarily of parents calling you for help?

Barry Lessin  
About that 50% of my practice are families, and the families are either the parents themselves who have a loved one or a child who is using or the family that sometimes often the half of those people about a quarter I have families with the loved one or kid is working with the family and then the other 50% are people that are just individuals that are coming in on their own.

Steve Martorano 
With the age group of young people that you see?

Barry Lessin 
The middle school at 14, on up. When kids start having issues with...I work with a lot of kids with ADHD or with some academic issues, or some kids whose parents are discovering they're on the spectrum. And there may be substance use that may not be substance use, but it's looking at the larger issue. And sometimes, it's a more prominent issue. So a lot of times kids coming in 14...15, they're beginning to experiment with substances, you know, putting the parents at ease to know that there are things that they can do, once they get an understanding of what's the deal with their kid, and...

Steve Martorano 
And what's really what's going on? Yeah, I'm certain that every generation is looking, every generation of adults has looked at the circumstances around their children or grandchildren, and thought, gee, it's tough to be a kid. It's hard to escape the notion that there's never been a more difficult moment than right now. To be a young person. Do you agree with that?

Barry Lessin 
So I'm biased because I'm not a young person. And I always think that you know, you always hear that every generation complains about the younger generation, or it's like, this generation is worse. I think, coming out of the pandemic, which was a, you know, obviously a once in-100-year century thing, and then the political climate of what's going on where there's just a lot of uncertainty, I think it is much harder for them now than it was before there's the challenges are different.

Steve Martorano 
Well, it's always struck me that a major distinction is the 24-hour, seven days a-week, nonstop need to be a kid, to be competing with your peer group, and making sure you fit in. When you and I were young, there were those same pressures, but they were like a nine-to-five job, when you got home, you could be yourself. But these kids do not have any respite from from this intense pressure to fit in. How has that environment impacted young people in conjunction with the legalization of marijuana?

Barry Lessin 
So one of the things that...that has helped me with the paradigm shift is to acknowledge that good parenting hasn't changed in 40 years. The principles of being able to maintain a connection with your kid and be loving, and being able to take care of yourself so you can be more effective, and establish some values and principles that will help your kid and your family move through the normal developmental process, in its healthiest way as possible. Getting back to those roots. So you know, being able to do that, regardless of whatever the challenges are. It's empowering the family. It's empowering the parents. So whatever way so, I feel it's important to be able to work with the family, because of the parents are feeling less anxious and the parents are feeling more confident, they're going to be able to parent the kid better. In some ways, it's, you know, it's a complicated problem. But I look at it as very basic things. It's like helping parents feel more confident as a parent.

Steve Martorano 
In that context, are you saying that now that marijuana is not only legal in many, many places, but it's legal for recreational purposes, shouldn't have an impact on parenting and...

Barry Lessin  
So about four or five years ago, I still got calls from parents who were very freaked out, very anxious, and upset because their kids were smoking pot, and maybe they were doing something else. So there's been a shift with medical cannabis being legal in Pennsylvania and starting in 2019, when it was more available. The idea that the narrative of the war on drugs that drugs are bad has shifted, recognizing that the majority of people in our country acknowledge that cannabis should be legalized in some form. So looking at cannabis as medicine, and when I work with parents, helping them to talk to their kids, so they can begin to tell them why are they smoking pot. Why are they using drugs? And a lot of them will say, I'm feeling anxious, I'm having trouble sleeping, I'm feeling depressed. Some of those conditions anxiety, and post-traumatic stress disorder, are qualifying opioid use disorders qualifying conditions to be a medical cannabis patient. So this shift has been from cannabis as a dangerous, scary jargon. Oh, my God, what do I do to actually look at his medicine and get more comfortable with that concept what do you take medicine for you take either a doctor to get medicine for depression get medicine for anxiety? So it's been easier for parents to see that and to be more able to help their kid and...

Steve Martorano 
Yeah. At least...at least open to the idea I mean, there was a time when marijuana was classified by the government and still is at some level in the same category as heroin. I mean, it's crazy. And I would tell people who say, you know, you can't treat the opioid disorder by telling people to smoke marijuana. I said if you asked ten sets of parents whether they would rather have their children using opioids or marijuana, what do you think they'll say? They'll say marijuana. So I hear you about lessening the impact of the evil of marijuana. And thinking of it more as medicine makes sense. But you deal with kids that, as you say, are medicating themselves with with marijuana. And tell me if I'm wrong here. The abstinence model is a declaration to somebody coming to a person like you and saying, my kids using drugs. The absence model says to them, Well, unfortunately, that's going to be the case for the rest of his life. He's going to be addicted to a substance for the rest of his life. And you just have to manage that. Parents reject that. They just recoil from that your branding, my child is a lifelong cripple. Has that changed in your mind and treatment? Can you tell parents to look, so we can get it to a manageable point? It's not all or nothing.

Barry Lessin 
And other conditions besides substance use, if you look at people with diabetes, people with asthma, people who have cardiac problems, when you go to the doctor, the doctor is going to say, let's look at your individual health, your history, and your motivation. And let's develop a treatment plan based on that. What do you need to do,. You're not going to say you need to get a. I need to get a triple bypass. And we'll schedule that for you. They're going to start with some diet and exercise and their medicine. So in the substance use world, it's unfortunate, the one size fits all model. It's like let's start with something that it's like focusing on the substances and exploring the reasons and giving tools and strategies to be able to manage that better. And I wanted to say that there's a lot of infighting among treatment providers, when they look at it as a dichotomy, like abstinence or not absence. And some kids cannot use it, some people cannot use it, and some people can use it for the rest of their life, but you don't start there. You start with where they're at. Try to make it as safe as possible. You educate them and give them some tools to manage the reasons for why they're using substances. And if they want to start with moderation, something kids sometimes it's obviously it's not healthy. I don't recommend any kid to use cannabis. It's a developing mind. And it's not something that, but that I would, I'm going to recommend, but they're going to do it. So if they're going to do it, let's look at making it as safe as possible and reducing the harm.

Steve Martorano 
I mean, I have, so you know, our generation has some experience with the recreational use of marijuana. And I tell people, I mean, I've looked sometimes taken aback by the swiftness with which it's changed in the money that's driving a lot of decisions about marijuana. I am convinced and hope you agree that nobody should go to jail for 10 years, over a substance like marijuana. On the other hand, no one can expect to learn algebra if you're stoned going into the algebra class at 13, unless you're sort of inclined mathematically, you know, marijuana takes you someplace else. I'm heartened to hear, that you're not recommending to people that they don't worry about marijuana. It's got to be handled right.

Barry Lessin 
So there are myths and stigmas associated with it. So there are kids that I work with, and there are adults that I work with with who everybody's different. Sometimes smoking it you become so impaired you're not able to function. But there are kids that I work with, and there are adults that I work with, who will use it at a level where they are able to be more productive. And everyone...and cannabis is a medicine. It's a substance that is very unique to each person because we have this endocannabinoid system as a part of our body that produces the similar chemicals that are similar to plant medicine. So everybody is different.

Steve Martorano  
Our guest is Barry Lessin. He is a licensed psychologist and a certified addiction counselor. By the way, that's a unique combination. I would recommend that people looking for help get to somebody with those kinds of dual credentials because they are it's two different disciplines. Barry, a couple of other things, you formed a nonprofit. Are you still active with that nonprofit family?

Barry Lessin 
So I...back in 2011. When I became aware of the public health issue, I got involved in nonprofit work working with different nonprofits, trying to educate parents and families initially when people have lost their loved one to overdose use to create some support for them and being able to empower them to become advocates themselves to help them change the arc of the problem to make it...less to make it less harmful. I stepped away from that in 2019. So I'm just working exclusively in my private practice.

Steve Martorano 
And finally, just I don't know whether you have an opinion upon this or not, it just popped into my mind talking about cannabis. We may be on the cusp of some real changes in terms of psychedelic psychiatry or mental health tools. Ketamine is always lumped into that. I know it's not a, strictly speaking, psychedelic, but it's sort of in there. I know that some of the other drugs, MDMA, are in clinical trials, and they've had some great success with that. Do you think we're going to see a big change in terms of using things like psilocybin mushrooms, even LSD, therapeutically in the near future?

Barry Lessin 
Yeah, so like you said, MDMA is already in advanced clinical trials, like psilocybin, and is beginning to be researched. MDMA in the next couple of years, and then psilocybin is probably going to be in the next four or five years. And again, so it's, these are plants. These are plants that have been used as medicine and in other cultures for 1000s and 1000s, of years. So you can talk about the change, there have been a lot of changes, and in some ways, it's the dominoes are slow to fall, but they're beginning to fall in a better direction.

Steve Martorano  
Barry Lessin. Thanks so much. We will, of course, on our site, have contact information for Barry. Your practices totally now tell telemedicine

Barry Lessin 
Right.

Steve Martorano  
And you and your client base comfortable with being able to do it this way remotely?

Barry Lessin 
So it's not for everybody. It's for people who...it's for people who want and need to be somebody individually, I think there's a value to that for sure. But it provides, there are some advantages to it. So provides, I work with kids and families. Some of them are in college, and some of them are estranged from their families. So I can actually have families together during, you know, having to separate Zoom links. So it allows there's benefits, and for me, it's a lot more benefits than...

Steve Martorano 
I think as we get more comfortable, more comfortable with this stuff, it's going to become a wholly different thing. People...some people probably prefer this. Thanks so much, Barry. Appreciate your time and like to have you back on again anytime you'd like.

Barry Lessin 
Love to. Thanks a lot, Steve.

Steve Martorano 
Thank you all as well. Don't forget to look for us wherever you find your podcasts and they're all over the place. Last time I checked, there were four or 5 million podcasts. We're just one of them. When you find this, please hit the subscription button. We appreciate it. See you next time on the behavioral corner.

Retreat Behavioral Health
Retreat Behavioral Health has proudly been serving the community for over ten years. Here at Retreat, we believe in the power of connection and quality care. We offer comprehensive, holistic, and compassionate treatment from industry-leading experts. Call 855-802-6600 or visit us at www.retreatbehavioralhealth.com to begin your journey today. 

The Behavioral Corner 
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