What if the thing standing between you and recovery isn’t your addiction, your past, or your willpower – but your relationship with hope itself?
Dr. Ross Ellenhorn is a sociologist and the founder of Ellenhorn, widely recognized as one of the most robust community integration programs in the United States. For over 20 years, he has run what he calls a “hospital without walls” – a program where trained therapists go to school with clients, accompany them to work, help them manage their apartments, and walk alongside them as they rebuild their lives inside their own communities, not away from them. He’s also the founder of Cardea, a psychedelic-assisted therapy company operating both internationally and through ketamine therapy in New York City.
Why the System May Be Working Against You
One of the most jarring insights from this conversation is how the current treatment model removes people from the very things that promote healing. Dr. Ellenhorn points out that when we look at the research on long-term recovery, treatment compliance comes in at number six on the list of factors. Social support is number one. Recovery capital – having an ordered life, a job, a sense of purpose – is number two.
“We remove people from the medicine to treat them for addiction,” he says. “We take them out of their communities, we put them into programs, and then we send them back without much support. It’s an insane process.”
The 30-day model, he argues, is at best a jumpstart. It may offer short-term relief and some social support, but it rarely builds the self-efficacy and community connection that sustain long-term recovery. The real work happens in everyday life.
The Fear of Hope
Twenty-five years ago, Dr. Ellenhorn was running a group for people struggling to move forward in their lives when he began asking a simple question: what’s getting in the way? Almost no one mentioned their symptoms. Instead, they talked about not wanting to get their hopes up, not wanting their families to be disappointed again, not wanting to feel the specific kind of pain that comes when something you let yourself want falls through.
Those responses became what he now calls the “10 reasons not to change” – and research has since shown that fear of hope blocks motivation, disrupts decision-making, and quietly undermines even people who genuinely want things to be different. Hope, he explains, is the mindset that carries you through uncertainty toward something you yearn for. But when you have both high hope and high fear of hope, the result is anguish – like standing on a cliff when you’re afraid of heights.
From Hope to Faith – and Why Pride Is the Bridge
The antidote, Dr. Ellenhorn argues, isn’t more optimism. It’s faith – not necessarily religious faith, but the practiced capacity to move forward through uncertainty without needing proof that things will work out. He draws a direct line between faith and self-efficacy: when you believe you can handle disappointment and keep going, hope becomes less terrifying.
“A proud person has faith in themselves,” he says simply. And building that pride isn’t about willpower. It’s about having real experiences of competence – holding down a class, managing an apartment, being trusted with responsibility – while surrounded by people who recognize your value and won’t give up on you when you stumble.
“We have a system that says you’re diseased – and then says we can’t treat you if you show symptoms of the disease. You’re kicked out if you show any symptoms. That’s almost cruel.”
The invitation in this conversation is a generous one: that resistance to change is not a flaw. It’s a reasonable response to repeated loss. And that real help looks less like a clinical model and more like a community that stays.
Action Items
- Notice if you’re avoiding hope in any area of your life – recovery, relationships, business – and get curious about what you’re protecting yourself from
- Build self-efficacy in small, concrete ways: finish a task, keep a commitment to yourself, celebrate small wins that prove you can do hard things
- Look at the social support in your life honestly – not just who you know, but who actually shows up and believes in you
- If you’re in treatment or supporting someone who is, ask whether the approach is building real-world skills and community connection, or just managing symptoms
- Consider what “readiness” actually means for you – not what a program tells you you’re ready for, but what internal sense of readiness feels like
- Explore the difference between hope and faith in your own recovery – where do you still need to build faith in yourself, separate from needing proof?
Resources Mentioned
- Ellenhorn – community integration program: ellenhorn.com
- Cardea – psychedelic-assisted therapy: cardea.net
- Martin Luther King’s writings on hope (referenced in conversation)
- William James on noetic truth (referenced in conversation)
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transcript
Ross Ellenhorn
[00:00:00] Dr. Ellenhorn, thank you so much for joining me today. Yeah, thank you for having me. Yeah. So it’s so interesting. I got the email from your publicist, and they h- pointed out some really interesting topics. We’re gonna cover- … something called the fear of hope, 10 reasons not to change, and we’ll talk a little bit about readiness and recovery.
Before we dive in, maybe you could just tell us a little bit about yourself and the work that you’ve been doing. Sure. So I’ve had a program for the last 20 years. It’s basically a hospital without walls for people with really significant psychiatric experiences. Good portion of those are what’s called dually diagnosed, and we have offices in Boston, New York, and Los Angeles.
And it’s really what’s considered the most robust what’s called community integration program in the United States. So we take people that actually probably can’t do well often in a congregate setting, in a residential program because of the struggles they’re going through. And we believe that a significant part of what’s affecting their motivation actually has to do with how they’ve been treated through [00:01:00] treatment and how they’ve been treated through society because of these issues that they have.
And so we have a thing called psychosocial trauma, and how do we help people recover from the social trauma of having a diagnosis or having an addiction or those sorts of things. And so that this is a program that really goes out and goes to school with people, t- takes them to their jobs, and our whole idea is that the medicine for so much is about your social value, your sense of connection and value in the community.
And so 80% of what we do is outside the office, and we’re the alternative to a hospital residential program. Yeah I think that’s really wise. Most of our problems happen, in, in life, right? When we’re- Yeah … dealing with- yeah That’s where all the, that’s where all the problems happen- yeah
When we’re- Yeah … when we’re actually in engagement, in relationship, or out in the world. Yeah. So- That’s right. When you think about this concept of denial or resistance people think of those as sort of psychological mechanisms, something that is part of our…
But the reality is that y- you and I, if we have a bad week those are the weeks we don’t want feedback, right? [00:02:00] And so s- so denial and resistance are really about what’s happening around you less than they are about some thing that goes on psychologically for you. And our clients, and a lot of people that bad week is every day.
No sense of purpose, no sense of any kind of sense that they’re valuable in the world no sense of identity, so they wake up every morning with no sense of where they’re going. That’s a person that’s not gonna really wanna look at themselves. And so we have a system of care that constantly saying that these people are resistant to treatment without recognizing that we’ve gotta take care of what’s going on around them, i- including addiction care.
So much of what, what’s proven to really support longterm recovery are social things. If you look at the list of what causes longterm recovery, treatment compliance is number six. Social support’s number one. What’s called recovery capital is number two. Recovery capital is do you have an ordered life?
Do you have a job? Do you have things going on for you? Purpose and meaning is number three. I could go down the list. [00:03:00] S- being in treatment’s number six. And so treatment can actually help you kinda jumpstart, and it can actually give you those things I just mentioned, right? Social support, sense that you’re being valued.
In treatment, you can get those things. But the reality is recovery happens in your experience in the community. And that’s just what the research shows over and over again. It’s not a psychological isolated experience. It’s about a person building a sense that they’re building pride, this is what AA really tried to create, a fellowship, the meeting after the meeting.
All of that was about how do we create connection with people? How do we create a sense of a guild? Because that really is the s- the way in which we treat addiction. And we have this crazy system in our country where we remove people from the medicine for addiction to treat them for addiction.
We take them out of their communities, we put them into programs, and then we send them back to those communities without much support. It’s an insane process. And the same thing with mental health, that so much of what’s going on for people with psychiatric issues [00:04:00] is the suffering of not being connected.
Those people are not gonna work on their issues if they’re feeling that disconnection. And yet what we do is we send them away constantly for their care instead of trying to treat them in their own lives, yeah. Something that I see you made several good points. And one thing- that I kinda came up for me when I was listening is the treatment centers are just such a short amount of time, right? Yeah. It’s not enough. 30 days- Yeah … is not enough time to d- really do- Yep … anything. It’s maybe- Exactly … a little tiny little break and reprieve. Maybe- … it’s an opportunity to, jumpstart the process.
Yep. But you’re right. We put people right back into the environment- … that made them sick in the first place- That’s right. Without- … without treating. People that come from toxic families, they get a 30-day break, and then- … right back into the toxic family- … without changing any of those variables.
So- Yep … it’s cause, a simple cause and effect. Yeah. Yeah, it’s a strange idea to me that what we used to have p- these asylums- [00:05:00] And th- they were usually on farms or in pastoral settings. And people would stay there for a year. And, we think of those as the evil time, the bad time for care and psychia- psychiatry.
But you go to these places now the, where there’s hospitals now on the campus, and bowling alleys and baseball fields. You ask them what those were for. The staff and the clients used to play games together, used to hang out together like that for the long period of time. And there are many substance abuse programs that began that way, too.
Farm, pastoral settings, where you just basically stayed there for a year, yeah. And so you’re really beginning to build your sense of pride and connectedness again, ’cause that’s really, that’s the medicine, and w- we’re returned back with almost nothing except to go find a program, yeah. And we’re returned back with programs saying basically you should not do anything but come to this program. Don’t have a romantic relationship, don’t have a job yet. All these things that are actually the things that make us want to recover, they’re taking away, it’s really not a system that works great , yeah. There, there’s a lot of [00:06:00] misinformation that goes around in those- … programs. I’m very much- … a 12-step advocate, but- … with the idea that there’s some guidelines and some things that you need to be aware of if you’re gonna go to those. And- … a lot of it is based on reading the actual literature, not necessarily- Yeah, sure
falling in line with that particular group’s ideologies because- … groups tend to sometimes come up with their own rules that, like this idea of not getting into a relationship your first year. That’s actually- … not in the literature. Yeah, I know. I know. … Yeah … it’s funny these i- ideas that become popularized that are actually not part of the actual process or program.
Yeah. You’ll find that the things that are a part of it are becoming more and more coercive, and also, AA, you could be somebody who’s using and still go to 12 step. You might not go in drunk. Yeah. But you could use and get help about your use. We now have a system that says, it’s crazy, a system that [00:07:00] says you’re diseased, which I don’t believe.
I don’t really think it’s a disease. I’ve invented my own term for addiction and that term is addiction. That’s what it is. It’s a problematic habit. So like- It’s a problematic habit, yeah … it’s, it’s just like- Simple … so it’s just part of our habits. It’s part of our the part of our brain that gets habitually into things.
That’s not quite a disease, and then that’s a continuum, right? ‘Cause love is a habit. All these things are these things that kind of grab you- … and create urges- Continue on … and things like that. Yeah. And they say it’s a disease, and then they say, “Oh, by the way, we can’t treat you for the disease if you show any symptoms of the disease.”
You’re kicked out if you show any symptoms of the disease. That’s, it’s almost cruel. Yeah. So AA wasn’t, you, I wouldn’t call it harm reduction, but AA had the ability to serve people who were using, and a lot of these programs won’t do that. They’re kicking people out because they’re just focused on abstinence, and part of that’s because they’re congregate, because you’re living with a bunch of people and you can’t use.
Yeah. Yeah. So treatment centers can kick you out, but nobody in [00:08:00] 12 step programs can kick you out. Yeah, exactly. Yeah. Yeah. Treat- That’s what I mean … yeah, just to clarify, people you can’t get kicked out of a 12 step program, but you can definitely kick it, get kicked out of treatment.
Oh I apologize. If that wasn’t… That was the point I was making, so I wasn’t clear. Oh. That’s the beauty of AA. Yeah. That’s the beauty of AA. Yeah. That’s where, that’s what when you were saying where it can go wrong within institutions is it starts- Yeah … being this other thing which says basically you’re out if you use.
How can there be 12 step- And not permit the ability for a person to come back, the next day if they use- Yeah … and- Yeah. Yeah, treatment centers are problematic. So- Yeah … just to make sure that I understand what you’re talking about. So when somebody does a Hospital Without Walls, it’s a community that people are able to come and share what’s going on and is there a peer support as well as professional support?
There there’s peer support. But it’s m- it’s mostly working on your own building of your sense of confidence through a team of people that are actually trained therapists [00:09:00] who are- Yeah … helping you rebuild your life. Do things that you’re afraid of doing, do things that you’re struggling with, keep your apartment clean, w- deal with your landlord. We have people that really are struggling with serious psychiatric issues, but they’re living on their own. They have this group of people that can keep them living on their own. Okay. Because the more you can feel like you can control your life, the more willing you are to become part of your treatment, yeah. Yeah. Yeah, that makes perfect sense, right? Yeah. There’s this idea of learned helplessness that if you continue- … to fail over and over again, you’re just gonna say forget it and… That’s right. But if you can feel a sense of progress and accomplishment- … and things like that, then it’s, taking responsibility makes sense.
Yes. That’s right. Exactly right. Yeah. Tell me about this idea of fear of hope. Hope leads to disappointment. Can you give, share a little bit of context of like- Yeah … what that means and how it’s helpful? Yeah. So- The concept started, I don’t know, 25 years ago, where I was running a group in a community mental health center for [00:10:00] people that really were struggling with moving forward in their lives, who’d been in the mental health system for a long time.
And I began to ask them, “What’s getting in the way?” And rarely would they say their symptoms. It was much more about, “I don’t wanna get my expectations up and then be let down again. I don’t want to have my parents get excited and be let down again.” And they had these reasons, and they became what I call the 10 reasons not to change, and those 10 reasons were consistent.
We do it for a year, new people are in there, and they’re naming these sa- same 10 reasons. And they all seem to have to do with being afraid to hope again. So hope is the is the mindset that gets us through uncertainty towards things that we yearn for. That’s really important, right?
That if you’re about to change, the number one thing that’s gonna get you there is hope, because it’s the thing that will get you through the uncertainty between now and the change. And [00:11:00] so it’s a very powerful thing in our lives. It is constantly there with every change. And what we’ve discovered in our research because we developed a scale, a legitimate scale, for fear of hope, is that fear of hope gets in the way of that, remarkably the people in our research that have high hope and high fear of hope are in a bigger mess than the people that have low hope and high fear of hope. They’re struggling all the time. They’re like a- Yeah … a person afraid of heights on a cliff. They’re just constantly, “How do I get through this? ‘Cause I really want that thing, but I’m terrified of another experience of being let down.”
Yeah. And being let down seriously, ’cause when you hope, the thing you hope for becomes more important to you than before you hoped. And so this person has had multiple experiences of things that felt like they were life-giving- Yeah … important, not happening, over and over again. Dreams crushed over and over again.
Now, what got them to those dreams being crushed? What got them to that sense of, [00:12:00] “My life’s not working”? Hope did right? Because they followed the thing far enough. What let them down? What… they can res- if they can resist hope, they’ll never be let down again, but they’ll have to, also have to stay the same.
And over, and our research just keeps showing that, that hope has all these way… fear of hope has all these ways in which it gets in the way of motivation, and gets in the way of decision-making, because people are just so afraid of having another one of those experiences.
And so we’ve done cer- we’ve been, done published research, and the newest research we’re doing is on decision-making, and we’re seeing all kinds of stuff there that kind of gets in the way of making decisions and moving forward. Yeah, if I can pause you there, that is- Yeah … I can I’m relating that to my own life, ’cause I, I’ve been- sober for almost 32 years. By all- … I’ve been m- … married a long time, and thing- … by all measure, things are going well. But everybody- Yeah … has those crosses to bear, so to speak, where they struggle. … Certainly business has been one of those things for me, where, you’re trying different things, and it is- Yeah
it, [00:13:00] entrepreneurism is funny. It’s, … it’s such a roller coaster. It is not for the faint of heart. But- yeah … I do really relate to that sense of the fear of hope. It’s I don’t wanna try another thing- … and get my hopes dashed and feel- Yep … that crushing defeat or failure again.
And I see this all the time with, people trying to get sober. I, I know- … people who try to get sober for a decade. Yeah. Yeah. Just over… and the discouragement, the- … resignation that come. It’s like, how do… I’m sure you’ve seen people overcome that period, but what- what do you see as helpful when someone is stuck in that place- … of resignation, and they’re afraid to hope again? What… Is there a bridge- … to then overcoming the challenge that has felt like such a failure? Yeah. Let me, I promise to get to that, but I wanna respond to what you’re describing.
Hopeful, if you were to test for hope, the two things they’re testing for is do you have a sense [00:14:00] of your own self-efficacy? Do you have a sense, “I can do it.” So
people with hope- What if the answer is no? D- d- i- if the answer is no, it might be because of fear of hope, right? Okay. It’s “I’m not gonna look. I don’t wanna trust myself again.” And the other, which is very important for entrepreneurship, is you find alternative pathways. A helpful person, when they meet a barrier, says, “Oh, I’m not giving up.
I’m just gonna find another way around that.” So that makes it really valuable in our lives. But fear of hope can get in the way of that. We’ve shown that people with… All the benefits of hope disappear when fear of hope’s in the way, even if the person’s hopeful, right? So how do you build a person to that place?
I hope you don’t mind, but I’m gonna go in a different direction to get there really quickly, okay? Up to you. Yes. Yeah. Up to you. There’s a thing called a threat assessment theory, which basically they’ve tested physiologically. And a [00:15:00] challenge is something in our lives where we feel like we have enough resources around us to meet something difficult.
And when we have that, we become aroused enough to pay attention A threat is when we face something difficult, and we feel like we don’t have the resources to meet it, and then the arousal goes so high we start to freak out. Okay? So the same thing can mean two different things for two different people, depending on the resources they have.
So the easy example is you’re walking i- in your T-shirt and shorts, and it starts to snow. That’s a threat. But in your backp- in your backpack, you got a jacket and s- ski pants. That then becomes a challenge. There’s all kinds of things in our lives that are called psychosocial resources that make things look less threatening, and that’s social support- self-efficacy, a sense of purpose, a sense of meaning. These things make it so the world doesn’t feel so scary, including [00:16:00] looking at yourself, right? So the way to build a sense… S- see, I’m getting there, even though I went around the, around a little bit. I hear you. Yeah. No, this is good. The way to build, the way to build hope is to build this, those resources.
Yeah. “I’m good at something. I’m… I c- because I can handle the disappointment. I’m good at something. I’ve got people backing me up.” All those sorts of things become, it becomes less scary to you because you have those things. Yeah. And for me, the number one thing that we can help people with is what’s called self-efficacy, which is, how do I build the sense I can do it, the confidence that I can- make things happen? That’s the number one thing that we can work on, and I call that faith, right? Faith in oneself- Okay … and faith in a world that can respond well to me. And that is why we should be treating more people in their own homes and communities, to help them become members of the world and become part of things and be good at something.
And that means maybe not so [00:17:00] much office-based care. Maybe that works for some people. Maybe what works in office-based care is a person feels more s- self-effec- efficacious because of it. “Oh, I, I told my, my, my counselor I didn’t drink all week, and I feel proud about that.” Maybe those things are actually what’s happening in treatment.
Maybe that’s why addiction treatment works, when it works. Is it because the person’s doing all these things about their addiction? They’re feeling like there’s people around them that support them and identify them and recognize them, and all those resources are going around them, that they now can feel like they can hope.
They can move forward, f- deal with that disappointment if it happens. And so for me, it takes, it, it takes a combination of good therapy, good care, with the focus on how to get good at something and good, good at handling life. ‘Cause that’s the other thing that happens in addiction, right? You lose, you s- you start becoming helpless.
Yeah. Unable to [00:18:00] kinda make life work. Yeah. You might be very good in one area, but basically you live in a state of helplessness, like just s- I’m not able to make things work. What a- Yeah. I see that- yeah … I see that a lot in high achievers. I tend to attract- … the high achievers.
And so these are people that- Yeah … can crush it at work- Yes … in my opinion, largely because of their ability to silo their feelings or- … disassociate their feelings. They can just go all out. And they’re really effective at work, but then they go home- … and their personal relationships are in shambles.
It’s because they- Yeah … don’t have access to those feelings that they actually, they, because they’ve shut them off, right? Yes. They’re totally dissociated, so- … people can be really successful at work and have a disastrous home life, that’s often rooted in- … drugs or alcohol or whatever.
But it’s, you can live in those two. And I think it’s very hard for people like that to recognize that they do have a lack of [00:19:00] self-efficacy- … in relationships ’cause- In other parts of their lives, yeah. Yeah, ’cause they’re so- Yeah … effective in some areas- Yeah … that it’s hard to grapple.
I, I think that’s the denial, that- … they don’t actually have self-efficacy in relationships. Yes. And even though they’re doing well at work, they may not actually get self-efficacy out of it. It, because maybe what they’re doing is chasing success. Maybe what- … they’re doing is constantly actually feeling anxious and not capable of running a life.
And the only way that they can kind of- feel okay is to get the fix of success and an identity connected to it. I’m- Yes … everybody knows me as this person, yeah. I can’t tell you how many s- retired CEOs we’ve had in my program who crumbled. Yeah. Crumbled the minute they retired.
Yeah. There was no shell around them. Mostly men, that, that- Yeah … just they haven’t developed relationships, they haven’t developed anything else, and that thing’s gone, and they become regressed, infantile in how they- Yeah … behave, yeah. They’re really starting over. Yeah. Yeah, I have, yeah
some [00:20:00] CEOs on my roster that- … are very strong at work, but, struggle- Yeah … in the relationship area because they’re- Yeah … so identified with work. Yeah. That makes a lot of sense. Yeah. So tell me a little more about the faith part. You mentioned self-efficacy and faith is- like trust and surrender, and this- Yes … and- … you don’t really have any evidence that you can do the thing yet. Yes, exactly right. Yeah. Yeah, exactly right. So faith is to trust as hope is to optimism. So trust is, you have verifiable sense. It’s based on, it’s based on on things, the things being strongly proven on some l- that’s why you get ve- verify it, right?
And validity means strength. It’s the sa- it comes from the same word as valor. It’s, validity means strength. Oh. Yeah. Faith is where you’re dealing with uncertainty, but still moving forward as if you’re trusting. Just like optimism means everything’s gonna be great, hope isn’t everything’s gonna be great.
Hope [00:21:00] is I can get to that thing and that I’ll be okay if it doesn’t happen, ah. That there’s a me- That’s the ticket … moving forward through uncertainty that will survive whatever happens. This is, Martin Luther King really fundamentally understood the complexity and the beauty of hope, because that’s what he was constantly saying, was, “Not everything’s gonna be great, necessarily.”
“But we’ll get there. We’ll get somewhere. I might not even be there when you get there,” he said, and it was all about this idea of how do I keep people hopeful, but not e- everything’s gonna be beautiful, it’s this we move forward, and so faith is, I don’t think we can work on a person’s hope.
And sometimes we don’t have to, because they have enough hope in them. But to deal with fear of hope, we have to have greater faith in ourselves, greater belief in ourselves. And- There’s ways in which the way in which we treat people actually destroys that by making them feel like they’re broken, like something’s wrong with them, like they’re tainted.
And by [00:22:00] removing them from the world, that can make them feel like they’re, that they have ability and they can do things, and so to me it’s really kind of fundamental element that we need to try to do. And sometimes that doesn’t mean we’re doing it with them, but at least we’re not putting them somewhere away, you know- to get care. That we’re serving them in the community. We’re making sure they’re okay, we had a guy who was in school and was close to graduation, and didn’t tell us, but the last few months he’d been drinking. And finally told us. And so he needed to go to detox, and the detox said, he really needs to go on IOP after this, which would’ve meant he wouldn’t have finished school.
And we were like, “No, that’s not… He needs to finish school.” Yeah, paint a picture here. Yeah. Now, that requires a team that can surround itself around him. Maybe more, maybe more testing w- you know urine tests and things like that. M- [00:23:00] much more conversations with him about how he’s doing and things like that, seeing him in the evenings after school, maybe driving him to and from school, right?
But not putting him somewhere where he can’t have access to the ability to build more pride in himself. Yeah. And so that’s, pride and faith, these things go together, a proud person has faith in themselves, yeah. And when you… A lot of times when people hear the word faith- they connect that to religion or spirituality. Yeah. How do you think about that? I think that there are elements- I think that in many ways, religion was trying to, religion is and was trying to do a lot of important social things for us- Yeah … independent of whether you believe in God or not. It was creating a sense of collectivity a sense, a sense that we’re all in this together, which when we lose that, we start to fall apart.
Our world and our country’s falling apart ’cause there’s no in this together. And it created these ways of helping people move through [00:24:00] uncertainty. So religion’s big on hope. And faith is training yourself to live with uncertainty. If it really is what we’re talking about, faith is I can’t prove there’s a God, you’re gonna have to have faith in the God.
That’s training the faith muscle. Yeah. And so I think we in, because I’m not, I’m not sure where I stand on religion, but I’m a sociologist and I think we invented religion for those purposes, to help us learn how to deal with uncertainty and how to stay connected to each other, and so that’s why I think it’s there in religion, it can get- Yeah … contorted and harmed it, by religion, but it’s also there to help train us to, to have faith and hope, y- yeah. I think out, even outside I agree with that. And- Yeah … I would say that in the realms of spirituality, like- if you’re sort of- … not really you believe in God, but you’re- … not really subscribing to any particular dogma- … you can still ha- really leverage this idea of faith in a higher power, the universe- … spirituality- Yeah … in general. And it really- Yeah … kinda serves the same [00:25:00] function.
Yeah, it does. That’s right. Yeah. Yeah, absolutely. Yep. And we can find it in other places too. We can find that kind of sense of spirituality in art. We can find it all over the place, this sense of- Yeah … connectedness and, there’s a, there’s a- I give these talks th- this area that I’m writing about called holding.
It’s holding is a psychological term for how you help a person hold themselves together on some level. That, that- … emotions aren’t bad. Emotions are beautiful. Yeah. They become bad when they overwhelm us to the point we start to fall apart. We lose our sense of self, and so holding is the thing that gets us through that. And when I give these talks, I always ask the audience “What’s the truest thing you know?” Nobody says the theory of relativity. Nobody says, “I’m standing on ground.” Nobody says, “I’m breathing.” They say, “Love, connection.” Oh. So the things we actually know best, the things we know are true, aren’t things you can prove.
That’s called [00:26:00] noetic truth. That’s called noetic truth. William James talked about that. So much of our lives is based on noetic truths even though we don’t think so. We don’t talk about it that way. Yeah. Until you ask people that question. And so faith allows us to believe in those things, to say, “I have faith that I’m in love.” ‘Cause you can’t prove you’re in love. Yeah. But this thing in me tells me that’s there, and I know it more than anything else, yeah. And so faith helps us be in that world of the kind of unsaid, unthought truths in our lives, it’s the…
Those are the first truths we knew. Babies aren’t sitting around going hey, it’s 12:00. I- it’s about time I get fed.” They know, “I feel this terror about being hungry.” And they don’t question it. They’re not like, “Am I hungry or not?” They’re just there, knowing this. There’s all these unthought knowns- Yeah
That become sort of language later on. But that, that, that stays with us all our lives, the unthought [00:27:00] knowns, these areas that we just know. When you were- Yeah … talking about kids y- they’re so present with their emotions, and they don’t- Yeah … judge their emotions.
Yeah. They just feel their feelings. And I have, on multiple occasions, been out in public, and you hear a child crying, and I’m a little jealous. I- yeah … would love to be able to just feel my feelings and throw a tantrum in public. Yeah, that’s right. That’s right. Yeah. But- Yeah … you gotta rein it in.
They’re, they’re- Yeah … so honest about how they’re really feeling. Yeah. And then they get a… And then they keep it moving, yeah. They feel their feelings, and they keep moving. Yeah. And they can’t w- work well with people. They can’t- … m- make money. In other words we have to mature, and when we mature- Yes
y- we lose some of that other stuff. But we have to, like- yes … I would never wanna romanticize we should all be childlike, the s- Yeah … the… it’s i- because children don’t are not that oriented towards mastery either, yeah. They may wanna master things, but it’s not like that’s the thing that make…
they’re like, “I’m gonna be self-sufficient. I’m gonna run my own life.” That’s not what they’re [00:28:00] thinking about. No. And at some point, we have to be that, and so it takes a different way of thinking, more fact-based thinking, yeah, for sure. Yeah. We, you also talked about one of the things I wanted to ask you about was readiness and recovery.
Can you talk… A- and some of the bullet points around that was around collaboration, pride, and being authentic. And, what kinda made me think about that is, little kids are authentic, but we do… There is a an appropriateness and a maturity about managing your feelings. But sometimes I feel like we get so over-regulated with trying to manage our feelings that- we lose the ability to be in touch with what our aut- our authentic feelings are- Yeah … which can prohibit people from being, speaking your truth and things like that. How do you think about those things a- as it relates to readiness and recovery? Yeah. I think that when I look back on m- my career, I think that the thing that I’ve been most interested in is why [00:29:00] and how people can metabolize help Right?
In other words- Yeah … help can be given to you, but if you’re not an active participant, it’s like giving a baby a bottle. They’ve gotta suck for it to work. If you’re not an active participant in it, nothing’s gonna happen. It’s always a collaboration. Care is always a collaboration. And by the way, what I want for my clients is the ability to metabolize care.
I don’t care if they go to treatment. If they wanna see a shaman, if they wanna fall in love- Yeah … I don’t care. Yeah. Because the reality is, if you were to do therapy with somebody and spent the whole time worrying that they’re not accepting your care, and then they start to, they’re basically done with therapy.
Therapy is, how can you learn to be the person who can take in care, who can let the world affect you- … in a way that keeps you going? And so for me, readiness is just a powerfully important thing, and so those things like they, certain, the cycles of change and the stages of change and all that kinda stuff, we end up forgetting about it in the mental health system and in, and the addiction system.
‘Cause we say basically, “Go to this [00:30:00] clinic, get this model, and you’ll do better.” That, that, that model is really great for somebody ready to change. Exactly. It doesn’t mean much if they’re not metabolizing help. And so how do we get people to metabolize help? That’s what we should be working on. Yeah. How do we help them become the person?
And that gets back to all the things I’ve been talking about. You help them by having them learn to have greater pride in themselves. How to have some sense of value in the world. You do things directly in the world to help them do that. But then they’re, then they might be able to accept your help.
Otherwise, it’s the treatment isn’t really h- having much effect, I don’t wanna say this in a causal way, but people who recover from addiction on their own have longer term recoveries than people who recover from their addiction through treatment. But the the causal problem was, I’m not saying don’t go to treatment.
But people that do it on their own are building that self-efficacy and pride, and then they’re able to accept help at some [00:31:00] point. They’re moving forward, and so readiness is this powerfully important thing that I, we all know about. We’ve all learned about the stages of change, but we don’t do it s- systems-wise.
And then there’s another kinda readiness, which is the way we talked about earlier, where basically people are told, “You’re not ready for work right now. You’re not ready to have your cellphone in this program. You’re not ready to fall in love. You’re not ready to do all these things.” And what you’re doing when you say that is you’re not ready to have the medicine for getting well, because getting well- Yeah
requires connection. It requires- Yeah … competence. It requires all these things. And so to me you’re not ready to leave this program. When you leave that program, if you got the right services, that’s actually where you should be. You should be not in the program, and so those, tho- that, that’s what I mean when I talk about readiness, is both internal readiness and the way in which the system kinda tells people, “You’re not ready for this.
You’re not ready for [00:32:00] that.” You want- Yeah … you wanna see somebody change? Watch them fall in love. They change. Yeah. I- Yeah. Yeah … I met my husband when I was five months sober, and it’s been 30- Yeah. Did you? Yeah. Yeah … 30-something years. Yeah. Yeah. Yeah. They’re horrible in, they’re horrible in therapy, people in love.
They’re- They’re just glowing. They don’t wanna talk about anything. They’re just like, it’s a drag when you do therapy with them ’cause they’re just like, “There’s nothing to talk about,” give it a minute. Yeah. Then they’ll do it. That’s right. Exactly right. Exactly right.
Yeah. Yeah. So that’s the process, is how do we really take seriously the idea of where a person is in the relationship to change. Yeah, okay. And to me, that’s almost more important than taking care of the symptom or the addiction. Because if you get them to be ready, they’re gonna do the right thing.
They’re gonna figure out how to rebuild their lives. I’m much more interested in that than symptom reduction. You’re like, you can’t get to [00:33:00] that- Yeah … without them being ready. You gotta get them to that place, yeah. I feel I feel like creating safety for somebody- is a big component in them- … being ready. If they feel- Yeah … safe to- … be honest about what’s really going on, then- … then we can, have discussions about reframing ideas or- Yeah … changing limiting beliefs to liberating beliefs. But it’s like safety is a huge component for readiness to change, like having the courage to change.
Y- yeah. I think on some level that safety is also related to trust. Is the person caring for me trustworthy? And- Yeah … and there’s a couple elements in that. Y- like I said, I’m writing this book on holding, and a lot of holding has to do with this. And one element is, can this person handle me?
I’m not gonna feel safe if I feel like when I do something, this person gets freaked out or sends me to another program or says you need a higher level of care. All those things are saying to the client that they’re [00:34:00] too scared to deal with me. Yeah. And the other is, will this person not just protect me from the world, but protect me from me?
And so safety doesn’t always mean, love and care. Sometimes it means being strict. We don’t wanna use it as a way to harm people or as in, in psychiatric, in, in psychiatric, it’s just sometimes used as revenge. This person acted bad in the unit, so we have to set limits.
It’s a, but saying no, that’s dangerous for you,” is safety building. So we, we don’t wanna create systems that are just soft. We wanna create systems that can push back, ’cause you don’t trust somebody who won’t protect you from yourself. Yeah. Yeah. You see them as something’s wrong with them, something’s weak about them, y- Yeah … the p- you have to have integrity to work with someone. You have to… This is, this person has integrity. They’re gonna, they’re gonna push up against the bad things I’m doing, yeah. Yeah, I think that’s really important. I’ve been accused of being a little direct sometimes, but- Yeah … I feel that creates security because if I’m I’m not [00:35:00] a brutally honest kind of person.
Yeah. I am in the camp of honesty without compassion is cruelty. B- but also I feel it’s a responsibility to be honest with somebody, and sometimes say the hard truths, because- … when I’m, when I do that, then they will believe me when I say something good about them.
Exactly right. They’ll believe you because they trust you, ’cause you were honest with them. That’s exactly right. Yeah. Yeah. I try to resist this certain person invading my thinking, because he invades everything, but we know of somebody who will do obnoxious things, and no one will do anything to stop him.
And he’s crumbling. He’s just falling apart. He’s going insane. Because he knows he’s doing crazy things, and no one’s saying that’s bad. And it’s destroying him. I don’t feel great compassion for him, but it’s destroying him. He’s falling apart. He can’t believe what a screwed up world this is that it will not stop a man like him.[00:36:00]
And so then he takes it an inch further because he wants to see somebody step in. He takes it an inch further, nobody steps in. And that must just be terrifying on some level. Just “What is this place that I live in where nobody stops me?” Yeah. And we need to be doing that with our clients when it’s right, and we need to be judicious about it because we don’t wanna also become punishing.
Punishment’s a different thing, yeah. Yeah. Yeah. All these issues are so complex, and I think it- … this is why experience matters, yeah. I see a lot of, I see a lot of online coaches, people newly sober wanting to be coaches and- Yeah … with a couple years of sobriety, and I’m like, “Ugh.”
Yes, absolutely. Absolutely. That makes me very nervous. It’s- Yep … experience is really important. Yep. Our field is a little bit like lawyers and real estate agents in the sense that you can be really bad at it [00:37:00] and make… and be very successful And you can be really good at it and not be that successful.
Yeah. And actually, if you’re really bad at it but good at marketing- that’s- … you could be really successful … I was gonna, I hate to say that I heard this one guy talk about visibility beats ability. And that’s what I s- I know, isn’t that sad? Yeah. It’s like you see all these- Yeah
online influencers, and- Yeah … and in every space too, it’s the podcasters, it’s the authors, it’s the people- … on social media that are good at marketing. But you scratch the surface, and you’re just like, “Oh, my gosh, this is really scary.” Absolutely. Yeah. Yeah. But it’s, they have, they are good at visibility.
Yep, which means they’ve put a lot of energy into that and not into- … their humanity and how to relate to people. I have I have another company that, it’s a psychedelic company. We do psilocybin work in out of the United States, and then we do ketamine in New York City. And I’ve been aghast at the psychedelic movement.
And all the people who think they can go to a training and become what’s [00:38:00] called a space holder. Yeah. A trip sitter? And it’s Yeah. And do you know how important you are in that moment, to walk this person through it? Yeah. Yeah. Do you know what skill it takes to have a person feel like you’re there present in a way that’s gonna get them through that experience?
Yeah. And it’s terrifying. P- when someone, some kid raises their hand and says I’m a space holder,” I’m like, “Oh, man.” Yeah. It’s just scary. I’m a huge advocate of psychedelic-assisted therapy. My- … my son went through it, and he- Oh, yeah … he had suicidal depression, and- Whoa
and he did a talk through his school. And he, from the podium, was like, “This saved my life.” He, we saw him do a total 180. Wow … but he had- was it ketamine or? No, he did psilocybin. Oh, yeah. He w-… I s- I had interviewed somebody on the podcast who had a lot of experience.
Yeah. A lot of experience. Really. And so I was lucky that I had access to somebody who really knew what they were doing, somebody that was- Yeah … really qualified. And he did the three, the Johns Hopkins [00:39:00] protocol? Yeah. The h- the three heroic doses. He had a day in between. Yeah. And when he came back, I was like, oh, he came back a different person.
But then I had to edit that and go, “He came back himself.” Yeah, that’s right … more, yeah. And he’s- Yeah … he’s done so well. It’s been a couple, two, three years since he did it, and he’s a diff- he’s doing very well. He was- Yeah … really struggling for a lot of years. Yeah. And he’s been doing really well because of it.
That’s- So I’m a huge advocate. But again- Yeah, that’s beautiful to hear. Yeah … again, with appropriate support. Yeah. Yeah. A- and it’s and what we believe, and I believe in our program is it’s appropriate support, and it’s more than that. It is the center of what’s going on, that the psilocybin means nothing if the person’s not able to make a connection with you during it in a way that walks you through it well.
And the being walked through is as profoundly important as the [00:40:00] trip. They used to talk about this thing called set and setting, and the setting is- Yeah … what happens during the trip, and they used to say, and Timothy Leary used to say, “That’s actually more important than the drug,” and so it really is an art form in how you get a person through these experiences, and people aren’t treating it that way. It’s becoming just another thing people do to fix people, and it’s it’s it’s losing its ability to think about it as an art form where you’re doing a process that’s helping a person kinda rebuild themselves, yeah. Yeah. I think it’s not for everybody, but I- Yeah … I would say that for those that, that are good ca- I know it’s contraindicated for some people with bipolar or- … schizophrenia, stuff like that. But so but if you’re a good candidate and you have good support it’s so important to just…
i’m not a doctor. I don’t play one on the internet. But to I would say that it’s important to do your research and make sure that engage somebody that has a depth of experience, for sure. Yes. Yeah. And you’re right. It’s not for everyone.
I think it’s especially good for [00:41:00] where your issues, your issue is ruminative, where your brain is stuck in a certain mode- Yeah … which makes depression and anxiety sorry, depression and addiction primed for the effect of this thing that enters novelty in your life, the- … these things are all about creating novelty again and makes your brain ready for that, I think it can be very powerful. Yeah. Super powerful … it’s been oversold, but it’s, it can be very powerful. It is. Yeah. Yeah. Yeah. I think we’ll fi… it’s just like anything else, it’s like the pendulum swing for… Yeah. We were super restrictive, so the pendulum was over here.
Now it’s- … being mainstream, so it’s a panacea- Yeah … for everybody. Yeah. So I think, hopefully we’ll find the balance and be rooted in some wisdom, … in, in time. I think there’s a lot of people who do it responsibly. I would imagine you’re s- Yeah … somebody who can guide people in that direction.
But, … I think we’ll find the balance. It’s not a panacea- Yeah … for sure. No, it’s not. No. It’s not a magic bullet, yeah. It’s not. No. Yeah. No. Awesome. Listen thank you so much for your time today. Yeah, absolutely. If people are [00:42:00] interested in learning more about you or working with you, do you have a hub, a website, or anything where people can reach out to you?
The best bet is probably through my main company, which is ellenhorn.com, and they can reach me through the email on there. They can find out about me through Google. Yeah, you’re all over the- And then- Yeah, you’re all over Yeah. And then, and then- I’ll leave some specific links.
Yeah. And then the the psychedelic company, which I’m very proud of, I think it’s a really smart place, is called Cardea, C-A-R-D-E-A. We love the idea that it ends with D-E-A. .dot cardea.net, I think it is .net. Okay. I’ll look it up and put the- … for people who are driving I’ll put- all this all in the show notes, and at odatchat.com. That’s where I’ll put all the links to all your things. But thank you so much for your time today. Yeah. This was actually super helpful, and I appreciate the nuance to really complex situations. Help is available. There i- this is [00:43:00] very nuanced, and a- and I think it’s important for people to get help from people who understand that complexity.
So- It is … I really appreciate your support- Yeah … and your time today. Oh, it’s fun to do. I feel invigorated and alive and- Yay … starting out my day, yeah. So thank you. That’s awesome. So thank you. Thanks so much. Okay. Thanks.
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