Portraits in Substance Misuse and Use 3: Jeremy Boehm on Concepts, Praxis, and Stories (2)

 

 

 

 

 

 

 

Publisher: In-Sight Publishing

Publisher Founding: September 1, 2014

Web Domain: http://www.in-sightpublishing.com 

Location: Fort Langley, Township of Langley, British Columbia, Canada

Journal: In-Sight: Independent Interview-Based Journal

Journal Founding: August 2, 2012

Frequency: Three (3) Times Per Year

Review Status: Non-Peer-Reviewed

Access: Electronic/Digital & Open Access

Fees: None (Free)

Volume Numbering: 11

Issue Numbering: 1

Section: E

Theme Type: Idea

Theme Premise: “Outliers and Outsiders”

Theme Part: 26

Formal Sub-Theme: “Portraits in Substance Misuse and Use”

Individual Publication Date: September 15, 2022

Issue Publication Date: January 1, 2023

Author(s): Scott Douglas Jacobsen

Interviewer(s): Scott Douglas Jacobsen

Interviewee(s): Jeremy Boehm

Word Count: 2,523

Image Credit: None.

International Standard Serial Number (ISSN): 2369-6885

*Please see the footnotes, bibliography, and citations, after the interview.*

Abstract

Jeremy Boehm is a lover of music, art, and sports, and loves to spend time with his young family and animals on his hobby farm on Vancouver Island. Jeremy has a BA with theological and youth ministry emphasis from Calgary and furthered his education in counselling with focus on addiction for a second career in supporting those with substance use disorders. Boehm discusses: finding recovery; main methodologies; experiences of individuals coming into recovery; experiences of individuals helping those in recovery; evidence-based treatment; spirituality or religion; the “Higher Power” concept; most tragic story known; and heartwarming, uplifting story.

Keywords: British Columbia, Canada, God, Jeremy Boehm, Portraits in Substance Misuse and Use, recovery, theist, Township of Langley, Wagner Hills.

Portraits in Substance Misuse and Use 3: Jeremy Boehm on Concepts, Praxis, and Stories (2)

Scott Douglas Jacobsen: What was the start of the story in finding recovery for you?

Jeremy Boehm: After a career as a minister for fifteen years, I had the choice to relocate to another job, or seek local work. The area was perfect for our family, and relocating pointed towards uprooting the life of our children. Instead, I brainstormed other fields, and considered the environment I had grown up in, at Wagner Hills in Langley, which is a therapeutic Christian community for the healing of those with addictions. Working in recovery introduced me to people who seemed stripped of the pretense, and social-status devices in the culture around me. I was enthralled with the authentic vulnerability, and bravery of individuals who felt they had lost everything. As I feverishly studied the neurology of addiction, and the habit-structures, reward-structures, and motivation-structures of the brain, I interacted with fresh and honest people who challenged my status quo. I had decided to end my use of caffeine a year previous, and discovered just how challenging daily-cravings, triggers, social pressure, and reinventing my life, minus caffeine, could be. While embarrassed to admit how challenging this struggle was, in light of the much more difficult-to-control effects of street substances, I began to understand the commonality that all people can relate to in a struggle with change, unhealthy habits, motivation. Then as I identified how other parts of my life were out of order, I began to see that nearly all of us can relate to putting too much importance on the wrong things in our lives. When we examine these things that we place too much importance on, it can be a struggle to redefine fundamental meaning in their absence.

With my new career, to educate myself, I read the ‘Big book’, and was shocked at how important the content is for our culture, so many years after its publication. I began to lose my prejudice against ‘AA’, and to lose my former assumptions about addiction. I learned that trauma was the common denominator in people I counselled, and that ‘alcoholism’ was not solved by improving self-control. I also began to learn evidence-based practices, to supplement the old-fashioned counselling I had seen practiced in churches, so my college-days love of psychology returned. However, I began to become disenchanted with what I began to understand as a cognitive solution for some who identified themselves as ‘insane’ in their addiction. From a neurological point of view, the damage substances like alcohol caused in long-term use, seemed to remove any hope in the power of a cognitive solution, even if there was one, since the neural damage from prolonged use could be devastating.  At the same time, I began to recognize the value in rational emotive behavioural therapy for myself, and in mindfulness exercises and the power of self-talk. I went on to study counselling and a world of help was opened to me. However, I began to see that there was a rift between knowing and doing. This took me back to my roots at Wagner Hills, where I studied the concept of ‘therapeutic community’, the technical name for a community my father founded for healing in addictions. People took part in a work-program, with a spiritual approach to long-term healing. The ‘doing’ rather than learning approach, proved to lead to more effective outcomes compared with those I encountered in ‘recovery.’ The focus seemed to be a key difference. My research in the neurology of focus and desire confirmed that successful outcomes were prone to come from refocussed desires, rather than repressed ones, and that the brain seemed to heal best from reinforcing happy healthy habits rather than fighting with bad ones. My growing appreciation for the very model I grew up with at Wagner Hills, led me to network with like-minded people in hopes of furthering this vision. I currently work in rehabilitation to support people’s mental health and in their substance-use disorder.

Jacobsen: What seem like the main methodologies utilized in recovery systems in Canada?

Boehm: A menu of mindfulness practices, and psychoeducation with forms of cognitive behavioral therapy (like SMART’s rational emotive behavior therapy), have merged, mixed, and are replacing the existing 12-step foundations that have existed for decades through the recovery world. Clinical practice also seems to be replacing a heritage of peer-to-peer counselling and support group forms, yet these groups and meetings still thrive, through pandemics and cultural shifts. The current approach seeks to replace a ‘spiritual solution’ that ‘works’ through ‘surrender’ and finding support among peers through a ‘higher power,’ with a clinical approach that empowers, and erases shame. In the medical world, a different approach has also shifted the culture of recovery entirely with the advent of ‘harm reduction.’ With the attitude of providing the greatest care and safety our society can give, to those with substance use disorder, safe-using supplies, and safe injection sites with safe-supply of medical-grade versions of street drugs. In conjunction with mass distribution of harm-reducing naloxone kits, and education to practice safety, this method aims to eliminate stigma,and put people first.

One aspect of harm-reduction is medication offered as a support for recovery. Many recovery and treatment centres utilize opioid replacement or opioid agonist therapy approaches alongside traditional abstinence-based programs. More progressive still, is a movement to normalize drug-use. In this thinking, substance-use is not viewed as a disorder at all, but is part of a  normal human experience to medicate pain and trauma with drugs/medications, as has been practiced over time. Harm reduction in this scope, aims to safely and freely supply drugs and medications of all kinds, for those who choose to medicate their trauma and pain with them.

The methodology of a recovery centre that asks participants to surrender their phones for social-detox, provide urine-test, participate in classes, and receive support in cessation from their ‘drugs of choice’, has undergone some significant disruption and changes in recent years, as these cultures and ideologies crash into each other. Prejudice, stigma and judgement can be found within those who attempt to help those with substance-use-disorder when conflicting ideologies clash, and people’s approach becomes polarized into camps, rather than listening to each other’s experiences and values. While spirituality has always and still plays a major part in the process, recovery centres have needed to modernize their approaches in ways that meet the standards set by health authorities. This has resulted in a reduced-emphasis for spirituality, 12-steps, abstinence, peer-counselling, therapy from past trauma, and a greater emphasis on evidenced-based techniques, and clinical practice, including counselling forms that deal with the practice of the here and now, rather than what happened in the past. The stereotypical revolving door has left some cynical of the results of recovery, while, on the other hand, the outcomes of opioid agonist therapies have left opponents cynical of a medical approach.

Many of the individuals I meet with who struggle with substance-use disorder, report that a treatment centre is their best option and, depending on what stage they are in, may report that they are working up their courage to attend one, again.

Jacobsen: What are common themes amongst or between the experiences of individuals coming into recovery?

Boehm: In the past, the theme of ‘surrender’ was a major emphasis of recovery. The thinking was that a person needed to come to grips with the fact that they couldn’t do it alone, proved by the fact that despite their attempts, they were still unsuccessful. The solution that was proposed, was that a person surrender to a higher power with the help of others around, and through a system of steps, a person evolved from blaming and denying, to supporting and giving their recovery to others. With research, modern counselling methods, and mindfulness practices, such as breathing exercises, and forms of distress-management, the current major theme replacing these past themes, is one of empowerment through skills and mental tools.

Based on my experiences with those in recovery, a timeline could be sketched to describe the landscape of those in stages of readiness for recovery, including the individual’s age, amount of attempts, emergencies, and deaths of loved-ones to addiction. Many that stuck with their programs had the motto, “It’s this or I die.” On the other hand, many young first-timers explained how the court, or a wife that didn’t really understand the situation, had forced them to ‘deal with’ something that they already had under their control. I never encountered someone who had been a part of the fad of ‘interventions’ that happened twenty years ago or so, but have heard many reasons for people entering recovery.

Jacobsen: What are common themes amongst or between the experiences of individuals helping those in recovery?

Boehm: Many have ‘been there’ and are helping others out of a lifestyle they had experienced and felt was horrible. Others, like myself, can relate to a life that can get in disorder, and find it important to support people in desperate circumstances. With the brain restructured, and pulled by the immense gravity of relapse, following long periods of substance use, outcomes can be very discouraging. Those of us in the world practice enormous self-care to persevere through the discouragement and tragedy we encounter. It seems that overdose is common, and even death seems to get less attention than ever. With these conditions, and the deplorable suffering for those we care for, many rely and trust in a higher power for spiritual sustenance, and learn many ways to self-care in a career that can easily lead to burn out.

Jacobsen: How much does evidence-based treatment play a role in Canadian treatment?

Boehm: Thankfully, I doubt there is a place where evidenced-based treatment isn’t practiced to some degree. I had heard that years ago, there were recovery centres that used 12-step models, exclusively. Only one book was provided – the big book. It is of course possible that such places still exist, but I am not aware of any. As research has informed the education and climate of recovery, punitive methods have thankfully disappeared, to be replaced with helpful trauma-informed models that understand core reasons that people use substances to cope with life.

Jacobsen: How much does spirituality or religion play a role in Canadian treatment?

Boehm: I would say that spirituality plays a major role in the roots of recovery in 12-step models and programs, nearly 90 years-back, and has informed substance-users that recovery is something that is not accomplished independently. The role of religion is that it seems to have offered a lot of funding, and support for the development of recovery centres. For example, I know my dad used to tour churches to tell people about the therapeutic Christian community he founded, and congregants would volunteer to financially support or visit Wanger Hills and serve there. Spirituality, as defined by 12-step groups, has always been inclusive, and has facilitated the resistance many have formed toward religions for various reasons. Practices such as prayer, played a major role. For example, AA meetings end with the prayer of serenity “God, grant me the serenity to accept the things I cannot change, the courage to change the things I can’t, and the wisdom to know the difference. Prayer books often accompanied AA literature. The stereotypical setting for a meeting was a church, as churches often had free or cheap rental fees, big coffee urns, and demonstrate accommodating attitudes to those in recovery. Today, in recovery centres, Spirituality may include “Smudges”, and First Nations Spirituality is often honoured and encouraged.

Jacobsen: What is the role of the “Higher Power” concept, or even the concept of God, in some treatment systems in Canada?

Boehm: In a 12-step framed model, the role of the Higher Power, is the power to change for the person who feels powerless. The concept of God is the unconditional loving receiver of the rejected person who has broken every promise and provided pain to every relationship in their life. God is also the one person who can never be fooled, who stands as judge, but also as the one who forgives, and frees the person to forgive, to let go of their need to control others, to let go of their pain, and let go of the painful actions toward others, and can provides a new identity that can do good to those who were harmed. In a setting I worked in, I was surprised to see that videos from pastors and priests were viewed, along with other religious ceremonies. I encountered some in recovery who said “I’ll try it all, anything that works!” Other places focused more on breathing, meditation, and viewed religion and spirituality as a means to the end of sobriety. With this mindset, religion was used as a kind of evidenced-based practice. What I mean by this, is that if religion brought results, it was considered a positive therapy to add to the menu of recovery. At Wagner Hills, God is the centre of the programing and framed everything else. Music directed toward God frames each morning. Then through the day, clients work together with others, to act justly, value-people, and help to work for the world that God designed it to be. Focus on a relationship with the loving God, which when focussed on creates a love for others, diminishes selfish-destructive-desires, and is the essence of the actions and behaviour of everything practiced at Wagner Hills.

Jacobsen: What has been the most tragic story known to you?

Boehm: I supported a young person with mental illness, who had very little idea of the dangers of the drugs that he began to experiment with. He was found, sadly days after he died alone, and was missed deeply by friends he was so generous to. The inclusion of fentanyl in nearly every street drug, and the extreme-risk it presents, have made naive experimentation so lethal. In cases like his, he was gone, before I, or many of his friends, knew that he was even trying substances.

Jacobsen: For a happy ending, what has been the most heartwarming, uplifting story of success in treatment known to you?

Boehm: As a child, one of the most memorable clients from my fathers healing community for those with addictions, for obvious reasons, was a wonderful man who had one arm. He was so joyful, and played with my brother and me, with such enthusiasm, attention, and kindness, while he amazed us by throwing perfect spiral football passes. His joy was contagious, and still is, as he continues to help others nearly forty years later. I guess a good ‘heartwarming’ story should have a dramatic before-and-after story-arc, so the reader could fully appreciate the contrast of a changed-life. I have no idea what his ‘before’ story was, only that he was from a First-Nations background and must have arrived at Wagner hills to overcome addiction in his life. I think of this story, because it literally warms my heart to just think of him, and the joy he gave me and my brother, in his new found freedom at Wagner Hills. It is heartwarming to think that he is still giving that joy away today.

Bibliography

None

Footnotes

None

Citations

American Medical Association (AMA 11^th Edition): Jacobsen S. Portraits in Substance Misuse and Use 3: Jeremy Boehm on Concepts, Praxis, and Stories (2). September 2022; 11(1). http://www.in-sightpublishing.com/boehm-2

American Psychological Association (APA 7^th Edition): Jacobsen, S. (2022, September 8). Portraits in Substance Misuse and Use 3: Jeremy Boehm on Concepts, Praxis, and Stories (2). In-Sight Publishing. 11(1). http://www.in-sightpublishing.com/boehm-2.

Brazilian National Standards (ABNT): JACOBSEN, S. D. Portraits in Substance Misuse and Use 3: Jeremy Boehm on Concepts, Praxis, and Stories (2). In-Sight: Independent Interview-Based Journal, Fort Langley, v. 11, n. 1, 2022.

Chicago/Turabian, Author-Date (17^th Edition): Jacobsen, Scott. 2022. “Portraits in Substance Misuse and Use 3: Jeremy Boehm on Concepts, Praxis, and Stories (2).” In-Sight: Independent Interview-Based Journal 11, no. 1 (Winter). http://www.in-sightpublishing.com/boehm-2.

Chicago/Turabian, Notes & Bibliography (17^th Edition): Jacobsen, Scott “Portraits in Substance Misuse and Use 3: Jeremy Boehm on Concepts, Praxis, and Stories (2).” In-Sight: Independent Interview-Based Journal 11, no. 1 (September 2022). http://www.in-sightpublishing.com/boehm-2.

Harvard: Jacobsen, S. (2022) ‘Portraits in Substance Misuse and Use 3: Jeremy Boehm on Concepts, Praxis, and Stories (2)’, In-Sight: Independent Interview-Based Journal, 11(1). <http://www.in-sightpublishing.com/boehm-2>.

Harvard (Australian): Jacobsen, S 2022, ‘Portraits in Substance Misuse and Use 3: Jeremy Boehm on Concepts, Praxis, and Stories (2)’, In-Sight: Independent Interview-Based Journal, vol. 11, no. 1, <http://www.in-sightpublishing.com/boehm-2>.

Modern Language Association (MLA, 9^th Edition): Jacobsen, Scott. “Portraits in Substance Misuse and Use 3: Jeremy Boehm on Concepts, Praxis, and Stories (2).” In-Sight: Independent Interview-Based Journal, vo.11, no. 1, 2022, http://www.in-sightpublishing.com/boehm-2.

Vancouver/ICMJE: Jacobsen S. Portraits in Substance Misuse and Use 3: Jeremy Boehm on Concepts, Praxis, and Stories (2) [Internet]. 2022 Sep; 11(1). Available from: http://www.in-sightpublishing.com/boehm-2

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