Addiction and the Unconscious Mind: A Psychoanalysis Conversation with Dr. Alan J. Coe

Transcript auto-generated from the episode audio; formatting has been cleaned up, but wording is verbatim.

Hi, I’m Cynthia Marks. I head up the Holistic Psychoanalysis Foundation established by my late husband, Dr. Bernard Bail. Welcome to And Now Love. Dr. Jason Coe is joining us today. He is a psychoanalyst a psychiatrist and a specialist in addiction issues. He is very well respected in the world of addiction treatment. And patients are constantly referred to him for help. We know how busy you are for sure. And so appreciate your time. Thank you for being here. thank you for having me. I'm glad to be here. You are one of the few who follows in Dr. Bails footsteps.

And I know how passionate you are about his work and how much you've seen it help your patients and, in fact, help you personally, right? Absolutely. That's what makes you believe of me and anyone who has experienced Dr. Bails theories and treatment. Yes. To be able to take it in personally only helps you be able to expand and be excited about sharing it. You've got to feel it and you've got to connect to it. And it's truly a unique experience. It is. And it is life changing. Absolutely. Just for a little starter, can you tell us the difference between a psychologist, a psychiatrist and a psychoanalyst?

Just so we're all on the same page here. Okay. Well, a psychiatrist goes to medical school and then does a training in psychiatry, a clinical training. Their medical doctors, they can prescribe medications. A psychologist goes through a Ph.D. program. So generally, unless they've gone through a specialized program, they don't prescribe medicines. Some can under the supervision of a psychiatrist. But psychologists apply basically strictly psychological treatments. Now, psychoanalysts can be a medical doctor or a psychiatrist or psychologist. Psychoanalysis, in its strictest sense, is an intense psychological treatment.

When Ford started it, it was four or five times a week. It still is in that way. But we've departed a good bit from that orthodoxy at this point. But psychoanalysis is, I think, important from the standpoint that it deals with the unconscious. That's what distinguishes it from a lot of the treatments that are popular today, like behavior therapies, cognitive, behavioral therapy, diabetic or behavior therapy, DVT. Well, I was going to my next question is about cognitive behavioral therapy, because it's so popular right now. We were talking about this the other day.

Can you explain that premise? Well, it's what everyone is trained in these days. It's quick, fast. But behavioral treatment, they're not interested in what goes on in the mind or the unconscious, interested in what goes in to the mind and what goes out. They deal with people's distortion of their feelings. You know, somebody may have low self-esteem, for example, so they don't feel good about themselves yet. They might be very accomplished, very good people, but they can't feel good about themselves. So CBT and CBT would undertake to change those distorted emotions or self views.

And how would that differ from Bernard's work? Vastly. Dr. Bail and psychoanalyst deal with the emotions and deal with what goes on in the mind, deals with the unconscious beliefs that make up the problem with self esteem. So it gets at the cause rather than just corrects the behavior. There's a world of difference between managing your feelings and being free from managing being where your feelings are, just automatically guiding you through life. It's feelings that guide us through life. Feelings are our instincts. So if I'm trying to deal with my self-esteem issue via cognitive behavioral therapy, would I be introduced to what triggers that and somehow figure out on a very surface level how to train myself to behave differently?

I think that's a good way to say it. It's retraining in how one handles feelings. And then if I'm using Dr. Bails methodology, I am getting to the thing that created that self-esteem issue for me. And I'm being able to release it by bringing it up from my unconscious and feeling something about it and knowing then perhaps that that doesn't have anything to do with me. That's not me. I don't have to train myself to see something that triggers my self esteem issue because I won't have that self esteem issue. Yeah, what she says is that's not me.

That's a very important way to put it, because oftentimes when we see these kinds of problems, what we're seeing is the person is one or the other parent or both parents in some way and not themselves, not their true selves. So the goal is to release that so that we can be ourselves. It's a much longer, much harder process, but it's also much more lasting as well as satisfying. It makes for a better life. So just CBT, we've got to give it its credit and it can be very helpful for some people, particularly those who I would say are so sick. It seems that almost all of us carry around some amount of trauma.

Most of us don't have, you know, a terrible, traumatic issue or two to deal with it. Most of us have trauma that allows us to live our lives. We seem perfectly fine. We may not even know we're troubled. How do we help those people who don't even know they're troubled? Well, nobody comes to treatment unless they're in some kind of pain. And it may be something. It may be as simple as you might. I don't know why my brother keeps treating me the way he does. And how can I get him to stop doing that Or my mother and I don't get along. I love her so much.

She's not going to be here for much longer. What can I do to change that relationship? And those seem like small things, but if you dig deep, those could be signs of something bigger that you're just doing across the board. And once someone comes for one of those smaller issues, then they can likely tackle the bigger trash barrel. I can go as far to say it certainly improves one's relationships, not only with oneself, but the people who are important to them. In this category of people that you're talking about that aren't so sick, maybe they're having trouble in their relationship or their marriage or their children or the boss or something.

They begin to see maybe middle age, late middle age that I keep doing the same thing over and over, and it's not turning out well for me. They start to realize that there's a problem within their personality, and that's not going to respond to CBT. That requires a more in-depth treatment. Wouldn't it be nice? And I think that Dr. Baily spoke to this, at least with me. If everyone from a very young age understood that they had a mother's imprint and maybe this can happen decades from now, and that wouldn't be considered so much an impediment, as much as something that you can attend to and you can work on through life.

If we just all come with this and we're always going to be figuring it out and we're not bad people, we just got this little extra bit of stuff or something. That's why we're talking is we want to educate people. Who better to educate? But our young. Yes. And let them know from the beginning that they have this from their mother, like their mother got from their mother. It may not be them. That's the point of this treatment is is to sweep out the trash so you can truly be oneself. If they find themselves doing things that they don't want to do or feeling things that they don't want to feel, or having complications in school or with Playmate, something's wrong here.

Why do they keep doing this? It doesn't seem to do well for me. I'm not satisfied. But me and a lot of us just keep marching on because, hey, that's what life is. Yeah. And, you know, if we can reach young people, they have a lot of trouble with peer pressure. And not to mention, you know, teachers and so forth, where there's a lot of pressure growing up. It's not as carefree and fun as we might think. And I think becoming less and less so. gosh, yeah. Yeah. With with social media and the pressure that that puts on individuals. Yeah. No longer individuals.

They become social media out of a trance. this is how I'm supposed to look. okay. I think I need plastic surgery. You know, people getting plastic surgery in their twenties. Really? But it's happening because they're supposed to look a certain way. And be a certain way. And. Be interested in a certain thing. And obviously, we're very divided because of what we think we're supposed to be interested in, what we've been trained to be interested in via social media, etc.. But I wanted to talk to a little bit about addiction and how you help people overcome that.

And I say overcome rather than train themselves to deal with it so much. And maybe I'm wrong. I help free them. Okay. Just as we can be freed from the tyranny of our imprint and our parents, so can they be freed, which is a big difference between mastering it, controlling it, which is what AA and a Narcotics Anonymous say. Look, just don't use it. CBT all over again. It's great. I think the most valuable part is the fellowship where you bond with people who are on a similar path or mission in their lives, and that is to stop using. Big support group.

Yeah. So in your practice, does that come into play? People are working with you to free themselves and going to AA meetings or are they? I definitely encourage her. Very important because they need that support. The kind of people that come to my attention are seriously addicted, some for the vast majority of their life. So they need to get a whole new social group together for themselves. They have to leave all that behind. Everything has to change in their lives. You know, the people they hang out with as well as their mind. Change can happen if you continue to use, you'll stay stuck both socially and chemically.

You're addicted. You got to have it. First things first, you have to get them off the substance. Whether that's a detox or whatever it takes. You have to give them enough time to dry out, whether it's alcohol or right now, fentanyl, which is killing so many people. The whole point of using is to not feel the pain. We all, in our way, do the best we can to avoid pain. It's human nature. They talk about the hype after they've been using for a couple of years. They don't get high anymore, but they get now so they don't have to feel. I helped them to get more comfortable with their feelings.

I take them as far as they can go. And are you taking them as far as they can go via their dreams? I do dream work. Generally, people will start to dream after they get clean. Certainly some of them need medication to deal with their feelings being so overwhelming that they need some relief from that. Their powders are bombarded with intolerable feelings, so we tap that down. We don't want to erase it like they were doing with their substances. So those can be used in conjunction. Dr. Bails theory. And in order to get to a place where you can actually listen to that work, some medication to take away that overwhelmingly terrible feelings. yeah, it's my theoretical background.

And that approach allows me to understand people from all walks of life, all types of psychopathology. So and I bring in as much of that as I can. And some people take to it, some people not so much, but I think it appeals to everyone in some way or another. And from, you know, being a psychiatrist, psychoanalyst and addictionologist, it's so helpful to me to connect with them at an unconscious level with their feelings. And they they get that. And that's the hook, and that's what keeps them going with me. So some of these cases have converted into very nice psychoanalytic cases who are doing dream work and who have a good amount of time being sober.

We're all individuals and we all go at our own right. And in the direction we'll go in. Yeah, we can't control our patient. All we can do is help them control themselves. Do all addiction issues stem from the mother's imprint? Or let's say you go to the doctor and you've had this terrible back pain and you start being delivered the painkillers for that and it feels good and you become addicted. Is that still coming from the mother's imprint? It does for all the people who become addicted to opiates. And obviously, blimey, there's an even greater number of people who just use them to treat their physical pain.

By the way, they're very good emotional pain killers, but they don't become addicted. Most of them don't. Yeah. So I call them sort of accidental addicts, but if once they realize it, that should be an easy person to treat you just detox them and they go on about their life. But often, oftentimes it taps into a problem that they never thought they had or they want to blame the doctor. Certainly some of that might be valid, but truth is very confusing. So an addictive personality, which is this phrase that's out there all the time, is you could more say than that.

Like you were just suggesting. There's a group of people who take these medications for the back pain and they're never troubled by it in terms of an addictive issue. But those who then find that it soothes them emotionally are covering up or hiding away from something that needs to be dealt with. And it's just so much nicer to have that nice, numb feeling. That's what they find. And opiates don't have a lot of cognitive problems, so you can function on them. And when you're free from pain, you know what? I actually feel better. I can work better, I can concentrate better.

But it catches up with them in one way or another. So since addiction is growing, how do we turn the tide? How do we start to make a difference? I mean, I'd like to say that we just need to rush this information out and get everybody on board and inform all of them. But we can't do that fast enough. I grappled with that question myself. It's a public health problem. Alcohol. Unless you're just a flat out terrible alcoholic from the beginning where it's just counter comes on gradually, that's the most natural course. And then you fight from back.

Then age. You're drinking every night and you're getting more than just a little bit bombed, but you're able to get up, go to work. But sooner or later, that breaks down. The incidence of alcoholism is, number one, addiction. Or most of your patients coming to you with alcohol issues that kind of match what you just said, where they've reached middle age and now they realize they sort of can't get through. I see them at all ages. But yes, generally something happens in middle age where the bottom drops out the job. They're really there. Know. And then that's a wake up call, you know, where the spouse is.

Just I'm not putting up with this any longer or the person realizes they can't I can't keep going like this or the consequences are going to be severe. Or they start to have medical issues related to their. Sister. So when your patients have gotten clean and the next step is this therapy with you, how do you see progress? How do you see them? I'm going to point to Bernard's theory. How do you see your use of his work helping them? Is it is it super gradual or is it just dependent on the individual or people beyond getting clean? Are they willing generally to take the next step or is it just somebody told them they had to do this, they're clean, they know they can do this now on their own.

They're back out at their job and living their life. Some people, that's all they want. And if they can do that, God bless them. Can they do that? Some people can. I think they see all over whatever pain they work now and they're able to go ahead and function and get what they want out of life. Not everyone wants to go deep. Surprising is that that is to you. And I know a lot of people just want to keep it simple and superficial. But how do they find another way to seal it off? I mean, if they were successful with addiction and they're able to kind of numb themselves so they don't have to think about it or feel it, what other way is there that?

I can't think of one that works outside of Dr. Bail's work. It's human nature, I guess, is the best answer. Although most people do not get sober and aa most people get sober on their own just sort of go about their business. But there's some, you know, for example, in AA, there's some people who go to a AA, there are a few years, they've got all they want made out of it. They've built a life that's satisfying to them. They just go about their business. There's some people who are devoted to their entire life and to being sponsors and taking spouses, and they walk around with ten years and that's everyone goes, Wow, that's a badge of honor and wisdom.

Well, they know. AA That's great. And if that works for them, that's fine. So we are. Yeah, I guess another way to put it is the defenses against the, the pain become re established. They're okay living that way. Shocking to you and I that they wouldn't want this but there are people who don't they can go on about their business with Dr. Bail and I always talked about is how long is it going to take to change the collective imprint of society? Well, hundreds of years. But if we start with the youth, if we improve the imprint, we automatically improve everybody if we treated our women.

Probably already said a lot about this. Can always say more about women, how important they are, and if we treat them well, how that will make a giant change in this world. That's right. So for now, in order to get to the youth, we have to get to the young adults who are thinking about bearing children to the mothers. And they need to be treated well. Across the globe. And that's hard to attain. Especially during their pregnancies. In general, when you're treating your patients who have had addiction issues and they want to come to you, do they usually recover well?

Do they end up wanting to continue to pursue this type of therapy? A good many do, yeah. I would say it's all a matter of the fit my skill as well that I can talk to them and connect with them about what's really going on in their lives. Why are they having trouble at work? What is it about their personality that gets them in trouble? Same for relationships. And do you sense that any of these people then wish to carry this information out into the world so that it's not just exclusive to their own wellbeing, but they sense that they can talk about this offer this up to other people that are close to them.

They refer page that for their friends and family. Yeah, well, and we've spoken here to a couple of young psychologists who are all about Dr. Bails theory, which is so exciting. So they're very excited to help bring this to our audience and hopefully even more than our audience. And I'm just thrilled that there are some young people that are practicing via Dr. Bails methods. absolutely. We need more. Yes. Because that helps the emperor and gets the word out why they help the emperor. And we want to educate the public. I still feel and I'm proud of these people who are doing this, that they are up against a wall in terms of their peers in that this type of work is not really where it's at right now.

I don't think there's any easy access to and understanding of Dr. Bails work outside of Dr. Bail's little world. You can't go to school and learn about this. Yes, that's. Right. So it's impressive that these younger people want to walk this path. You know, we live in a society of we want quick answers, results. Psychiatry's pretty much turn its back on psychology there. They consider themselves brain doctors. They prescribe medicines they don't even know the patient they see in 15 minutes, some even shorter. And that is how you match. You know, maybe they ask about symptoms and then move on.

They don't they don't know anything about their lives. That is so sad. And obviously, I'm not against medication, but by neglecting the psychological and the unconscious, in my opinion, they're being mistreated and done a disservice and harmed. It seems to be just another way of pushing down or numbing the emotions or the feelings. That's right. So when you are treating your patients and you're seeing success, you know, a little glimmers of an understanding or you're helping them find out who they really are and watching them operate from that place, what does that do for you?

How does that how do you feel? I love it cause I love it when I can connect in a meaningful way to a patient. Are you able to learn from them how they interact with other people and these patients that perhaps you've known for a long time, can you see a shift in their families, in their communities? yes. No doubt about it changes them and it changes the people around them and their lives become more satisfied. That's what it's all about. So back to youth and education, this education that would be important so that our youngsters understand the trouble with addiction.

Where should that education come from? From our parents, our schools, everywhere. The government needs to take the lead on this. There's another National Institute of Drug Abuse and there's also a companion organization that alcoholism it's all there. All the information's there. Why don't they put it out there? So what is being done with all that information in those organizations. Besides on the website, people who are interested read it. I don't know how many people read it. And who knows of these organizations in the first place don't. Like most things.

They don't become politically exposed yet until it affects votes. Is the United States top of the list in terms of the amount of addiction? I I'm not really sure. Probably. Probably. We have a way of bastardize and everything, taking it to the extreme. But to be sure, Europe has a lot of problems or question about it. Asia is starting to be affected with it. And in the United States, is it largely due to our leniency? Is it some way as a country that we behave and what we find acceptable? Are we in a place where we have to do more mind numbing than other places?

I think so. We always want to push the envelope. Yeah, we're the leading edge of the Western world, particularly California. I'm absolutely at the western edge, geographically speaking, everything gets taken to the extreme. So when a when a patient comes to see you after they've cleaned up, are your sessions with them similar to those that you have with people who come to you who don't have addiction issues? Do you sort of say, tell me what's going on in your life and listen to them the same way you would with a person who doesn't have an addiction issue?

Of course, from the beginning, even when they're still using. So you actually meet with the patients while they're still using. Right. Or who are in rehab or getting detox. But some out there. Yes. Are you saying I don't exclu them from treatment. My hopes aren't too high for them either. You don't want to stop using. Okay, let's talk about it. What's it doing for you? How is it impacting your life and your mind? And for some of us, it will always be important enough to keep doing because there's some reason we don't want to get to what's. I can't deal with.

It's. It's too deep, it's too primitive and it's too painful. But really, we humanity has created that situation. We as mothers, as caregivers, have created that world for that person where they're that stuck. That's true. Because it can't really come from any place else, right? That's right. Are some of us genetically inclined to have the possibility of being addicted to something than others genetically without reference to the imprint? It's really about the imprint. I think it's the vast majority is the impression. I think the imprint has the force and power of genetics.

And that's just to say nothing about the epigenetic and how the imprint changes genetic. Can you for us describe what epigenetics is? It's the modification of genetic propensities by external factors. It's not just the genes as they are, but they can be modified. I believe that. Dr. Barnes they're working on the imprint modifies the epigenetic. So you often hear that this person is addicted to alcohol and so was their father and their great uncle. And so it must be genetic. The whole. Families. Isn't that just the ongoing imprint or set of imprints?

I think so. I mean, I always ask about family history in the context of not just getting the medical family history, but also the addictive history and psychiatric history and all of that. But it tells me more about the male. You are the environment that these people grew up drinking was normalized. There are plenty of people who grow up, terrible alcoholic parents, both of them. And they say to themselves, I will never drink. They don't drink. Now, usually there's another caregiver. They help them modify their imprint to see that there is some love out there and there is somebody who cares about me and who shields me from the violence and tyranny of my parents, alcoholism.

They know that there's a different path. Somehow they get that. It doesn't mean they escape without deep wounds. Because who wants parents who don't care about you? But perhaps that loving support from outside that set of parents, it's something that you're not getting from those parents. It also shows you what it means to be without that addiction, that this kind of fabulous feeling back and forth, this is what I want. And those two over there don't have that. And I'm never walking that path. Well, but it's usually like your grandmother. I've also seen caregivers take over who don't want to be caregivers.

And that's a very sad. Yeah, sure. Struggle for that individual in that sort of care. That they just go from one bad caregiver to the next. Foster systems, a good example of that. Do many people have a good experience in foster care? Is it more positive than negative? I don't know. Again, hard to say. I see the troubled ones and I don't know the statistics, but yeah, it's a rough scene when you have to be taken away from your parents. That's a huge blow to a child. I think adoption is a huge blow. You know, once they find out, well, if my mother had locked me in, she wouldn't have given me up.

How could she do that? But yet these children need to be cared for, and in the best of all worlds, loved by a new family. Right. But that new family has a big challenge because not only do they need to raise this little person in the most loving way, they also need to be aware of this little person's imprint. That's right. It must be more difficult to get to that imprint when someone's been adopted because you can't really see clearly a frame of reference because they don't have it in front of them. It's not something they're dealing with every day.

A mother, a father, a brother. An argument that brings to light some amount of trauma. The trauma is before you have this family. How do adopted people get to their own imprint? Same way everyone else starts talking about it. So it's the same thing where you, you may be interpreting a dream and visiting different ideas about that dream until that patient says I think that's it, that fits and then you can explore that. But you don't have any real world to refer to like, yes, well now you can see that you don't have this self esteem because your mother didn't ever feel like she was treated properly.

If you know that birth mother, you could see that. But not knowing that birth mother. It's really important for that adopted person to really rely on what they're feeling. True. Yeah. If they have good adoptive parents, it can make all the difference in the world. But it's it's still a tough, tough situation. Because I see. And I see somebody. Well, though, I think that there are pregnant women who love their baby. It breaks their heart in a huge way to give up their baby. But circumstances demanded it. And then there's some that are just this fetus.

This child within me is a nuisance and ruining my life more than a nuisance. I just want nothing to do with it. Get it out of me so I can go on about my life. And those are the ones that get the wrong impression. That seems unbearable and a lot to take care of. Maybe don't get good adoptive parent. Maybe you start to act up, become unmanageable, start having problems as a juvenile boom. You end up in the foster system. Yeah, they don't want them either. So a lot of things can go wrong. Very wrong. Well, we all have this idea of the perfect picture.

Two kids and a dog and a house in the suburbs, whatever that might be. But that might not really be our picture and we might not do that very well because we are not doing what we're meant to be doing. We're doing what someone told us we should be doing just inside of those parameters. You're not being your true self, so you can't be a loving, helpful person because you're on somebody else's path. Your mothers, your fathers. That's how it is. Thank you for being here. I so appreciate you sharing your love of Dr. Bail's work and the positivity that you see it can provide to the world any ideas you have about getting this message out that you want to share with me, I will listen.

First of all, it's a great pleasure to. Be here. Thank you. And talk about these issues. We could probably go on for hours and one way or another. Yes. And I can't stay on track because you say one thing and it leads me down another path. And I really do need ours. We can do it again sometime. Okay. But I don't have any great ideas about it. I'm not a politically motivated person, but we've got to figure out some way to make it popular and appealing to people. And probably the place to start is with our educators. I think so. And perhaps a little bit here where doing this out of a love of Dr. Bail's work because we've had our lives changed by being able to apply his theories to our existences and how we're not doing this for money or to get votes or anything.

We're just wanting share this beautiful bit with as many people as we can, and if we can catch on to a few people who can share it yet again and those people can bring it back to their therapist or talk amongst themselves or think about their dreams, or at least going to try for that here. This is the beginning. It is. I hope so. So thank you again and thank you, audience, for listening to us. Let us know if you have questions and follow us and keep listening. Thank you. Thank you.