John Moos 5/8/22 John Moos 5/8/22

Happy Mother’s Day! Thank you for your time and your stories.

Dear Readers,

First off, I want to wish all of the mothers out there a Happy Mother’s Day! Now, everyone, I want to thank you for the gifts of your time, your trust, and your stories. I have thoroughly enjoyed reading and exploring the variety of human experiences you have shared. This will be my final post as I embark on two new ventures:

Writing my memoir.
Developing a business and medical model that focuses on psychedelic therapies to address root cause trauma, constricting patterns, and self-limiting beliefs.

If you would like to stay tuned and informed on where my creative processes take me, please continue to follow along on any of the websites and social channels (listed below). In an effort to consolidate my energies and output down, I may end up closing down social channels and/or merging website content. It is also important I practice what I preach when it comes to well-being, especially digital well-being. Time spent online has been linked to depression, anxiety, loneliness/disconnection, self-harm, and even suicidal thoughts. There has been an epidemic rise in teenage anxiety and depression, which correlates to the rise of and engagement on social media. Despite my attempts at offering content and stories that share the beauty of strength and struggle, I see countless accounts - people and products - promoting self-indulgent, consumer-focused content, or contents espousing hateful attitudes towards others with followers in the tens of thousands to millions. My actions express my priorities and transitioning off of social media will be one of my steps towards nurturing my own healthy choices. The connections I’ve made and the stories I have shared are important, so if any changes are to be made, they will be announced on the channels as they exist.

I wish you all the gifts of life, strength and struggle, and the ability to find meaning through your lived experiences.

With love and light,

John Moos, MD

Platforms:

Website: Soul Surgeon by Moos MD

IG: @SoulSurgeonMD

John Moos 5/1/22 John Moos 5/1/22

How do I grieve?

Dear John,

I just read your Acceptance post and WOW! Nothing like taking the thoughts right out of my head. After losing my parents and 14 year old dog within the past 3 years I am swimming endlessly in circles. Standing in resistance and waiting for the world to tell me my next move. I feel as though I am lost. Caring for others was a gift. Now I am almost unsure of how to care for myself without guilt.

Dear Grieving,

I am so sorry to hear about your losses. I have not had to endure the grief of losing a parent yet, but I know the pain accompanied by the loss of a loved one. Also, having grown up with dogs my entire life, I know the impact of losing a companion can be equally as devastating as losing a human family member. I want to reassure you, you are exactly where you need to be. You are in grief. Grief has 5 stages, as defined by Dr. Kubler-Ross: denial, anger, bargaining, depression, and acceptance. They are not intended to be processed in linear fashion, as you can move through and revisit each stage many times before integrating and completing your grief process. There are also various types of grief. The Columbia Center for Complicated Grief is an excellent resource for identifying the various types of grief and providing resources to help navigate it with grace. It’s important to note if you are still in your grief process or may be stuck in complicated grief.

David Kessler, a grief expert, writes about the 6th stage of grief: finding meaning. Take the time to sit with each stage of grief. Honor it and be willing to let it go. Rumi’s poem, “The Guest House” is an excellent example of this. As you do this, you will inevitably transition into the meaning-making part of your process. This isn't the cliche "everything happens for a reason." This is about finding your meaning in the pain. There is a saying, "the healing is in the hurt." No one can make the meaning for you, it is up to you to define it and make it sacred. Part of what makes life so precious is the fact that it ends. Death can be an end, but it is also a new beginning. All living things mirror this process; Fall and Winter leading into Spring and Summer. Life is cyclical and beautiful because of the full range we experience and because of its finiteness. You are not lost and you are not alone; you’ve never left yourself. If you feel unanchored or unmoored, you can also dead reckon and find yourself now. It’s easy to feel lost in the externalities or circumstances of our lives, especially when there is an inner swirling of emotion that accompanies our experiences. It can shake our foundation and leave us feeling unsteady. If you take the time you need to grieve, both in solitude and in relationship, and to release, you will find that the path to healing and wholeness will reveal itself. And, when you are ready, you can take one step at a time to reestablish your bearings and move forward.

Caring for others is a noble and admirable calling. Notice if your caring for others kept you from tending to your inner garden. Who are you when you are not caring for others? Do you know? If you don't know, you have been gifted an opportunity to really explore who you are when you are not in service to others. You may ultimately decide that being in service to others is part of your vocation, but it is important to have that service be from an outpouring of self-love first. Your integrity must be first before caring for others, otherwise, it can be a noble distraction. You have the power and capacity to do this work. I trust you and your process. This is such an exciting time for you. I wish you strength and courage in exploring your path.

With love and light,

John Moos, MD

John Moos 4/24/22 John Moos 4/24/22

How do I forgive with grace? Part 2

Dear John,

First and foremost, I am so grateful to have found you both here and on TikTok. I love the work you’re doing here. As someone who deeply loves an alcoholic who is currently in recovery (just hit 3 months sober), I find myself struggling with letting go of events from the past and moving forward with hope rather than anxiety. Anger, resentment, and other negative emotions pop up daily. Any advice on how to give grace and more importantly, forgiveness? I know how beautiful our life together can be - I’ve experienced it firsthand during the periods of sobriety - but multiple relapses have left me exhausted and resentful. I’ve dabbled in al-anon and it’s not for me. Any thoughts or advice is more than appreciated. Much love 🖤

Continued from last week…

Neither you nor I can tell your partner how to get and stay sober. They can be shown the path, but they have to choose to walk it. The only person you can control is yourself. Your relationship is an opportunity for your partner to practice and work their sobriety. If they can’t prioritize it over their addictive tendencies, you have to make the necessary choices to self-protect. This may not be what you want to hear, but it may be what you need to hear. You can't save someone that doesn't want to be saved. And, you can't risk your well-being trying to save someone else's. If, by the time you read this, your partner has genuinely changed, decided to end his suffering, and has prioritized his sobriety - that is great. An excellent source for understanding and undergoing forgiveness is The Book of Forgiveness by Desmond Tutu. I wrote about this in a post on Oct, 24, 2021, “Finding happiness and living through love? Part 2” Forgiveness is a gift you give yourself, but safety and trust are required to create the conditions for it to be authentic.

When you’re in the eye of the storm, trudging from relapse to relapse, it is hard to think or see clearly. When you’re in survival mode, your brain doesn’t function due to the unopposed sympathetic stimulation, e.g. fight or flight, adrenaline, cortisol/stress, etc. It’s a non-thinking environment; it’s a reactive, survival environment. Perhaps some time away would serve you well to gain perspective and get clear on what it is you need - not the you that is tending to your relationship or your partner, but the you that is nurturing your best version of yourself.

Your partner’s sobriety has to be their conscious choice and it can’t be contingent on your support. That is the very definition of codependency and an unhealthy expectation to put on you. It is easy to get caught in the dance of codependency, adopting the role of savior when you see a victim, but it's a depleting, constricting dynamic and a tough one to break. Their abstinence from alcohol is not the same as sobriety - there are plenty of dry drunks who are still in the same abusive cycles and can no longer blame the drink, drug, or behavior of choice. They need to find a way to tap into the unprocessed, unexpressed trauma that is fueling their addictive tendencies. Whether that be through therapy, 12-step groups, support groups, psychedelic-assisted therapies, or unconventional means -

If Al-Anon is not for you, it's important to find and talk with friends you can trust. It can be challenging to parse out and name all of the components that you are managing and analyzing internally, and on three different timelines: the past, present, and future. Try different meetings, friends, or a skilled therapist so you can talk openly and honestly about your relationship. This can help you process it all in a healthy way. Your examination and response to ask for help is spot on and incredibly courageous. You’re doing all the right things and you're exactly where you need to be. Life only gives us what we can handle, and you are capable beyond measure. I trust you, but more importantly, be sure to trust yourself.

With love and light,

John Moos, MD

John Moos 4/17/22 John Moos 4/17/22

How do I forgive with grace?

Dear John,

Dear Finding Grace,

Thank you so much for reaching out. I wrote earlier this year about this exact topic, “How do I take care of myself with an addicted partner? Part 1” and “How do I take care of myself with an addicted partner? Part 2”. The simplest answer for this complicated situation is: you have to prioritize and take care of yourself. As Glennon Doyle says in her book Untamed, “I will not stay, not ever again - in a room or conversation or relationship or institution that requires me to abandon myself.” If you find yourself in a relationship that has you beleaguered, worn down, angry, resentful, and/or abandoning yourself - you have a choice to make. You and your emotional well-being or your partner and their potential. Perhaps the kick your partner needs to be and stay sober is you choosing your well-being and leaving the relationship.

Sobriety is no easy task. There are so many moments of renewal, unfettered joy, grace, and beauty, but those moments are earned by walking through the shit and re-feeling all of the repressed and unexpressed emotions that addicts have numbed for too long. Anger, rage, grief, sadness, longing, regret - they are all fair game. They can come subtly or like a 10-ton truck without brakes. When I stopped numbing, I started feeling. It was not always pleasant, and to be quite honest was often painful, but entirely necessary to accepting all parts of my life, the good, the bad and the messy. This acceptance of my emotions allowed me to recognize myself as entirely human, helping me to separate myself from the choices I made. This is the very essence of shame. Before, I was a bad person. After, I was a person who made bad choices. This separation and distinction helped me to create the space to heal and integrate my pains, my traumas, and become whole without the weight of my shame fueling my internal self-deceit. This work on its own is difficult enough. Managing an intimate relationship and relapsing through recovery only compound the degree of difficulty of both. There are many inner- and interpersonal dynamics at play, and your partner will need to be adequately resourced to show up in a way that doesn’t continue to hurt you. But, ultimately, it is your responsibility to not abandon yourself.

With love and light,

John Moos, MD

John Moos 4/10/22 John Moos 4/10/22

How can I let go of my past? Part 2

Dear John,

Not sure how this works…I saw you on Tik Tok sharing your story with such vulnerability and willingness to own your past in order to let go, that it brought me to tears. So much of what you said mirrors my own life. I’m fast approaching 45, and I’d like to release the past too. It’s just…HOW?? Regardless of my success, I still can’t enjoy it, for fear of losing it, and I’ve sabotaged nearly every relationship I’ve been in, romantic and otherwise. Never mind the damage I’ve done to my reputation over the years. I work in medicine too, and although I’m in industry now, some poor choices of the past have continued to haunt me.

First step guidance? Thanks, and bless you!

Continued from last week…

The past is there for us to learn and grow, which is why I try to avoid characterizing or labeling past experiences as good or bad, right or wrong. As humans, we are meaning-making animals. It is our super power, a gift, and what integration is all about. Integration allows us to explore, accept, and transmute our past, our pain, into a meaningful life experience. You cannot find meaning in the meaningless. If there is meaning, wisdom or knowledge to be mined from our lived experiences, then it is our duty to do it if we want to show up whole, embodied and empowered in our lives.

All of this may not be intuitive or easy, but it is important to develop the skills, the behaviors, and the discipline to grow. If you don’t know where to look or who to ask, look to the people who have what you want, who have been what you’ve been through, or have the skills and credentials to support your process. The outcome of your life will always be a battle between your new discipline and your old habits. As you let go of and integrate your past, you will start to see a new person in the mirror. At one point, I remember feeling as though I was hardly recognizable compared to the wounded, victimized, addicted version of myself.

When I was newly sober, I had to return to my job as a clinical surgeon at Keck School of Medicine of USC. This was where I spent 8 of my most self-destructive years drinking, fucking, lying, hurting, and posturing. I have to say, it was absolutely terrifying returning. Word had gotten out about some of my affairs, it was clear I was no longer at work during my 2 months of rehab, and when I returned, I was not the same person nor did I want to be. My reputation and character felt utterly destroyed and I was haunted by the consequences of my poor choices. Nevertheless, I had to return as I needed the income and I had to complete my contract. Surprisingly, it was a gift in and of itself.

There were several things that helped me transition and remain in my position for the next 7 months. One, I stopped the internal struggle and chaos that had me drinking and acting out with women to cope. Two, I built a strong foundation of sobriety and support to help me deal with the challenges as they arose. Three, I released toxic relationships that would have otherwise had me drunk, in bars, searching for women to hit on and sleep with. Four, I learned to establish fierce boundaries and was accountable for those boundaries with my therapists and sobriety group. Five, I practiced discretion on what I choose to share and with whom. Six, I attempted to and made amends to those people whom I hurt. Seven, I courageously owned my story, my pain, when it was appropriate. All of these were incredible learning opportunities for me to incorporate into my life. It was not the easy path, but it was ultimately the path that led to my greatest personal growth and allowed me to walk with my head up, with character, with integrity.

Hopefully this provides some insight into my path, which is unique to my personal journey, but contains many universal truths. It was not an easy path, and it was not a quick fix. The road was difficult, the obstacles were formidable, and there were many times I thought I would be destroyed by the weight of the pain and suffering. I wasn’t. This is the Hero’s Journey. If you are unfamiliar, please look up Joseph Campbell. Discovery, growth, expansion, and transformation are all parts of the evolutionary process. As Dr. Ian Malcolm from Jurassic Park says,”...evolution has taught us, it's that life will not be contained. Life breaks free. It expands to new territories. It crashes through barriers painfully, maybe even dangerously…” This is all part of your evolution. Just as it may feel uncomfortable, maybe even violent or dismantling, it can also be beautiful, transformative and awe-inspiring. The more you can lean into your truth, moving through the discomfort, the more you will start to experience a newfound freedom and spaciousness. You are exactly where you need to be.

With love and light,

John Moos, MD

John Moos 4/3/22 John Moos 4/3/22

How can I let go of my past?

Dear John,

First step guidance? Thanks, and bless you!

Dear Holding On To The Past,

Thank you for your kind words of encouragement. It took several years of doing the work to be able to openly and honestly share my story with humility on a larger scale. Social media and the internet is pretty exposing, but it has been some of my most rewarding work. I’ve spent time with the people posturing in their life, pretending like everything is fine or masking-up as inauthentic versions of themselves. I’ve spent time with the broken and wounded, watching them slowly put themselves back together. I’ve spent time with authentic and wholehearted individuals who unapologetically live their life, aware of who they are, and fully integrated. When you are fully integrated, you know who you are, and people’s opinions about you matter less. They matter less, not because you're apathetic, but because you know and trust who you are. Their approval or disapproval is irrelevant. Owning your story completely is a super power. Life is about opportunities and experiences, not right or wrong, good or bad. Even if the moment has passed, if you are holding onto the experience, there is still some opportunity or experience to grow from.

I want to commend you on taking the first step: knowing you have a problem and being willing to change. I don’t know the specifics of your life, but there are some things that are universal when it comes to the difficult work of releasing our past. To be quite honest, my “how” was simple: I was finally in enough pain to be willing to change. For most people, it is difficult to go through the pain of changing if things are “good enough.” The pain of changing is far more difficult (heavier) than the pain of staying the same. Life continues as it has been, avoiding the pain of change and resigning themselves to desperation and/or complacency. But every so often, an acute life event happens, creating just enough pain to tip the scales, or throw them off wildly, where the pain of changing is finally easier (lighter) than the pain of staying the same. This sacred moment is typically when change occurs. Think of it as a balance of scales:

In my experience, the things that were most difficult for me to release were the things I had the hardest time accepting in myself. It was easy to think I had accepted them, but when it came time to admit full accountability to others, that is where the rubber meets the road. I knew I was an alcoholic, made hurtful choices, lied to myself and others, used women for sex, used my then wife, used power to influence and manipulate people, and a host of other things. But, coming clean and admitting that to the people I hurt, my children, my family and friends - it gets real quickly. I learned a lot about myself in those moments when I was exposed, raw, and being judged. Character is who you are; reputation is what people think of you. Defining and growing your character can be difficult at times, but it avoids the consequences of reputation management. Reputation management is a considerable force when it comes to influencing our choices and behaviors in difficult situations.

My choices used to haunt me until I was forced to confront them head on. There is a brilliant quote by Sri Yukteswar in Autobiography of a Yogi, "Look fear in the face and it will cease to trouble you." When you know and accept your demons, you find and release your skeletons, you expose your shadow and darkness to the light - you release the hold of your past. Holding onto the past is no different than trying to hold onto the future or present. Have gratitude for the moments, learn from the experiences, and be ready to let them pass. Everything in life is ephemeral and impermanent. Experiences are meant to move through us, nurture or educate us, and leave us a better version of ourselves. They can sometimes feel like they are breaking us down, but really, if you can reframe it, they are breaking us open. I will share with you a quote of mine, “if you feel your emotions, you are human. If you are locked in your emotions, you are a prisoner.” Your freedom is your choice.

The past is there for us to learn and grow,...to be continued next week.

With love and light,

John Moos, MD

John Moos 3/27/22 John Moos 3/27/22

Did you use AA to get sober? Part 2

Follow-up question continued from last week…

Dear John,

Yes, I find it therapeutic. I am a veterinarian that specializes in emergency and critical care. I got a couple of DUIs and then missed a day of work due to intoxication. So, that was my breaking point. I didn't lose my job or license but I was exposed. I knew I had to change. I contemplated rehab but I was a daily drinker so I needed something I could do everyday. I got a great sponsor and things were great. I really found the program beneficial until people began taking advantage of me. I guess I allowed that? Then, I met this guy in the rooms. Red flags were there but I am an empath. I thought oh how nice I am sober now I met someone. He wanted emotional support and "friendship" but not a relationship. He had been so hurt in the past he couldn't give his heart out. And I became the problem because he never wanted anything but some sort of ally. I finally realized he was a narcissist.

I just didn't know that people like that existed I guess. Naive I know! My dad was an alcoholic and a narcissist so I guess I am attracted to those. Anyway, now, how do I trust anyone in there other than my sponsor? Sorry for the long text!

Dear Recovering,

Thank you for this additional information. To give you a quick resource, I posted recently on my website about when it's too early to share and be vulnerable. There may be some nuggets here that are helpful:

When is too soon to be vulnerable - Part 1

When is too soon to be vulnerable - Part 2

One thing to remember, as you are getting sober and in recovery, is to make sure you rebuild your foundation first before you start tending to others. I am a major empath (a pisces + number 2 enneagram), so I get it. It was always easier for me to take care of others instead of working on myself, but that kept me in a codependent dynamic. It also meant that the energy I could be using to restore my wholeness was going out to other people. At the end of the day, we only have so much energy and time to expend. If we are giving it to others, it may feel good, but it is often a distraction to keep us from facing what is uncomfortable within us. I know that was the case for me. It also fed my self-deceit and illusion that I was a good person because I was “giving” so much. The reality for me was, I used giving and “selfless” acts to feel better about myself. It was my own form of narcissism, needing validation and recognition to meet the conditions of my giving. AA and SAA are filled with people trying to undo the patterns of their pasts and create healthier relationships with themselves and the outside world. It is also a group of imperfect humans, struggling with their own traumatic lived experiences, with a variety of resources to support them. Some may be in the rooms as a condition of probation, contracts to live in a sober-living, or forced to be there by loved ones. My point is, not everyone is fully intent on releasing their addictive tendencies and do the long, arduous work of working through the steps and becoming whole. Sponsors and therapists often recommend not getting into a relationship for 6+ months once you’re newly sober. You are raw, susceptible, oftentimes our love cups are empty - it only takes a little love and affection to start to fill that cup up and convince you that you’ve found a soulmate. For myself, I practiced complete celibacy/abstinence for a year and half. This was ensured through polygraph testing and consistent therapy. Eventually, I needed to reconnect with my body, understand my impulses, and learn to regulate myself. Only when I was whole, was I ready to date someone. This is what it took for me to truly find myself, my intimacy, and a healthy sense of sexuality.

You will start to trust others, when you learn to trust yourself. If you focus on yourself and your healing journey, the clarity, intuition (soul guidance), and answers will come. You will learn to love yourself first, and a supportive partner will fit into your life that supports the best versions of each other. And, don’t beat yourself up if you get it wrong. Life is about learning, growing, and finding meaning. There is no bad relationship, just an opportunity and a teacher. If you find that you are making the same mistakes over and over, take a break and seek outside counsel. There is a lot of wisdom out there to lean into, and I am more than happy to offer my experience and wisdom, learned and earned.

With love and light,

John Moos, MD

John Moos 3/20/22 John Moos 3/20/22

Did you use AA to get sober?

Dear John,

I am a recovering alcoholic and I have been in AA. I have found some of the members to be predators in the rooms. I am having trouble dealing with that. I was wondering if you used AA to get sober?

Dear Recovering,

I'm happy to hear that you are in recovery and prioritizing your sobriety. I'm also saddened to hear about your experience with AA. There unfortunately is a subculture of people who bring their character defects into the rooms of AA. Yes, there are people who take advantage of others, exploit vulnerability and rawness, and those who don't stop their codependency and/or abuse of themselves and others. AA is a program with a set of tools run by people, and attended by people, who can be gravely flawed. With that being said, there are also incredible people living exemplary and aspirational lives. I attended AA during my earlier years - it served as a great example to learn introspection, accountability, and humility (along with intensive therapy and my time spent in rehab). It was a great place for fellowship and meeting like-minded individuals in a judgment-free zone (mostly). I also used Sex Addicts Anonymous (SAA) to address my lying and infidelities, which helped me lean into a deeper level of accountability and integrity. I worked specifically with a trauma-informed sexologist, which as fun as it sounds, was an extremely uncomfortable process. The rigor was exponentially more intense than standalone therapy or 12-step work, and helped me to transcend my addictions with a renewed integrity. Right around 2 years, I left the rooms of 12-step because of personal concerns with self-limiting beliefs and adages echoed in the rooms of AA that I found counterproductive to my growth and development. I also got tired of people telling me I was a relapse waiting to happen when I wasn't consistent with weekly meetings. I didn’t need people projecting their judgments onto me when I knew in my heart that I was building a solid foundation, prioritizing myself, my sobriety, and my family in healthy ways. I had 2 kids from separate marriages and a full time job as a surgeon. It wasn't easy making weekly meetings, but I attended when I could - and it helped.

Comparing AA to SAA, I’d say SAA was a much more intense experience requiring uncompromising transparency and accountability in my humble opinion. Regardless of how effective a tool is, e.g. 12-step, therapy, rehab, etc. there will always be human beings in the room with the imperfections. Your safety and trust in the people and environment is requisite to you being able to be open, authentic and vulnerable about your personal struggles. One thing is crystal clear - if you don’t feel safe, you shouldn’t be there. Period! You have to be in an environment where there is trust and commitment to the collective good of you all. Trust happens when your fellow peers care about your outcome as much as they care about their own. If someone is praying on you, they care only about their own outcome, which is the definition of selfishness and not an ideal setup for you to drop into vulnerability and transparency. I am not sure what your geographical opportunities or constraints are, but there are usually more than one meeting in certain areas. If driving a short distance to a bigger city is an option, you can try those rooms as well. If you find that all of the rooms you are walking into are problematic, it may be safer to work with an individual therapist first to help you build your foundation and learn to erect ironclad boundaries when in the rooms. It is not easy work, but well worth it.

Follow-up question from Recovering coming next week…

With love and light,

John Moos, MD

John Moos 3/13/22 John Moos 3/13/22

How do I take back control? Part 2

Dear John,

A little about me to frame this whole thing. I am 60 years old, I live in Maine, where alcohol is available on every street corner and grocery store. It is a constant temptation. I have family members that also have drinking issues. I have had more life trauma than most and I know that has left deep scars for me.

My current concern is- I have tried many times to stop drinking. I can't string together two days. I have a job (changed differently now) due to my drinking and the damage that it has done to my confidence and self esteem.

I have never had a DUI or been arrested. I don't go out and drink in bars anymore (did when I was younger). I drink at home only. I don't keep alcohol in my house because I can't control myself once I start. I do however stop every day after work and buy wine. I drink a bottle (sometimes two) each night. I do have some blackouts where I can't remember the night before when I wake up.

I desperately want to be alcohol free and start focusing on having a more positive enjoyable life. Yesterday on my way to work, I vowed and prayed I would not stop on my way home and buy a bottle. I thought about it all day long and kept repeating the desire and pledge to stop drinking.

However, when I was driving home it was like my car was on autopilot and before I knew it, I was buying wine.

I have not gone to AA, I have tried WFS, an online support group for women. I need to stop this self destructive cycle and learn self love. The self loathing that goes along with this illness is non- relenting. Remorse and guilt.

How do I take that step and take back the control that alcohol has over me?

Regards,

Tempted and Trying

Continued from last week…

Admitting I had a problem was the single most important step to recovery. That is why it is the first step in 12-step programs such as Alcoholics Anonymous (AA). Once I did that, with humility and full accountability, there were no false pretenses to manage, no lies I could tell myself or others, I could ask for help from people who had been through it before, and I could finally unpack the reasons I had been drinking, fucking, lying, and numbing for 2 decades of my life. I believe the three most important requirements for meaningful change are: 1) introspection, 2) accountability, and 3) humility. For many, the rooms of Alcoholics Anonymous are a sanctuary of accountability and humility. The people in those rooms role model these three qualities by working the 12 steps of recovery. I have deep love and gratitude for my time in the rooms of AA and SAA, even after I stopped attending shortly after receiving my 2-year sobriety chip. I am currently over 6 years sober and have no desire to ever take a drink.

There are many tools you can use to address your relationship with alcohol. AA is one. Therapy and coaching is one. Psychedelics are one. Group work is one. But, remember, a tool is only as effective as your ability to use it. My recommendation, for simplicity sake, is to find a local AA group and attend. Your first visit will be the most challenging, but be open to see the people, hear their stories, and find what resonates. There was no greater catharsis for me than being ready and willing to say, “my name is John, and I am an alcoholic and sex addict.” I accumulated a substantial amount of shame and guilt through self-abusive drinking, lying to myself and other, having affairs, one-night stands, sleeping with prostitutes, and hurting those that cared for me. No matter where you land, how deep your whole, or the weight of your shame and guilt, you can climb yourself out of that hole. You can find light in the dark. You can find hope in the despair.

You mentioned in your question that you used to go out and party, but now drink when you're alone. Isolation and disconnection is a key element of addiction. The antidote to addiction is not sobriety, it is connection. Some people are able to get sober alone, whiteknuckling it through abstinence, but retaining their alcoholic beliefs and patterns - a common state known as being “dry drunk.” Finding a community that supports you and pulls you out of your isolation will only serve to support you and your recovery.

It was Henry David Thoreau who said, “The mass of men lead lives of quiet desperation. What is called resignation is confirmed desperation.” I can sense the desperation and resignation in your story, but also the hope. The desire for freedom from your dependency on alcohol. Your story doesn’t have a major bottom or episodes of intense pain, yet. As I have said before and has been echoed in many rooms of 12-step groups, “your bottom is when you choose to stop digging.” I encourage you to put down the shovel. Your bottom can be now. It starts with an acknowledgement and declaration of a problem. A problem that is greater than your willpower. Only then can you start the march back to wholeness, to redemption. I believe in you! I have seen so many people transform their lives when they are ready and willing to take that first courageous step. You are not alone - we see you and we love you!

With love and light,

John Moos, MD

John Moos 3/6/22 John Moos 3/6/22

How do I take back control?

Dear John,

However, when I was driving home it was like my car was on autopilot and before I knew it, I was buying wine.

How do I take that step and take back the control that alcohol has over me?

Regards,

Tempted and Trying

Dear Tempted and Trying,

It sounds like you are clear on what you want, i.e. a life without alcohol. But, the habit and compulsion to drink is stronger than your will power at this point. Your situation and struggle is very familiar as I was an alcoholic. Some may say that I am an alcoholic in recovery, but I find that I relate more to the label of being a former addict as I choose not to be defined by a narrow label or my darkest struggles. However you choose to see or label yourself is your choice - what is important to cultivate is a language around your choices, examine the nature of your relationship with the substance or behavior, and be humble enough to seek help from those who have been in similar situations.

Alcoholism and addiction can manifest in many ways. You can be addicted to substances, e.g. alcohol, drugs, food, etc., or to behaviors, e.g. shopping, pornography, sex, work, etc. Dr. Gabor Mate defines addiction as having 3 distinct qualities: 1) craving the addictive substance or behavior, 2) engaging in the addictive substance or behavior to experience pleasure or relief from pain; and 3) the inability to stop the substance or behavior. Based on this criteria, it sounds like you have an addictive relationship with alcohol.

Alcoholism can present in many ways. I was a mix of many types: the social drinker, the obnoxious drunk, the sophisticated drinker who learned about beer, wine and spirits to impress, the party animal, the day drinker, the drink to forget or numb, and many more. I always thought I was different because I was “functional,” didn’t require eye-openers, and wasn’t a cirrhotic in end-stage liver disease. But, the fact of the matter was, I spent an inordinate amount of time preoccupied with thinking about alcohol, reminding myself not to drink, justifying why I could drink, counting how many drinks I could have, wondering when I would have my next drink, where it would be, what it would be, and my personal favorite - trying to convince myself how or when I could drive when impaired to not get in trouble for drinking too much. I had several people talk to me about my drinking. I rolled my car after drinking underage in college, luckily only hurting myself and totaling my car. I avoided at least 2 DUI charges, was arrested 2 times for being drunk in public, and spent many nights blacked out or sleeping with random people, while single, in relationships, and married. I thought putting better parameters around my drinking would help, but I always found ways to bend the rules or create an exception. It wasn’t until my life imploded after getting caught having innumerable affairs that I was in enough pain to admit I had a problem, both with drinking and my relationship with sex.

Admitting I had a problem was the single most important step to recovery…to be continued next week.

With love and light,

John Moos, MD

John Moos 2/27/22 John Moos 2/27/22

How do I heal from a sexual trauma? Part 2

Dear John,

Thank you for this opportunity for healing.

How do I heal from a sexual trauma? This person was supposed to be my safe haven - my biological father. At the time, he was my most favorite person.

I’ve noticed that I pick men like him. It makes me feel dirty because he did such disgusting things to me.

Is it okay for me to pick men that remind me of my biological father and if not how do I not pick them? We always had fun, connected deeply, etc. This incident happened 23 years ago and I am just unpacking it now.

All my best,

Trying

Continued from last week…

Integration, the final part of the work, is what happens as you revisit and reclaim the fragmented memories of your traumatic lived experience. You will eventually develop a context and timeline for your dissociated memories. You will begin to understand that you were not to blame, that your innocence was exploited, and that the people responsible for protecting you failed. You will begin to forgive without condoning those involved. You will be able to name and cultivate safety, erecting boundaries as necessary and releasing or nurturing relationships that support you. You will be able to name and cultivate the conditions you need to heal and thrive. You will be able to talk about your lived experience, including your sexual abuse without a charge or fear hijacking your system. You will be able to make choices free from self-limiting beliefs of constricting patterns adopted from your developmental traumas. You will begin to understand what is your choice and what is an imprint from your childhood. Integration is the process of becoming whole, owning your story, and doing so confidently and humbly. It is not easy work, but it is worth it.

As you move through this work, and understand your sexual abuse more intimately, the answers will become apparent on why you pick people who remind you of your father. It can be extremely difficult to hold two truths: 1) that your father sexually abused you, and 2) that he may have been a good father in other regards. This is very confusing and oftentimes laden with shame-based beliefs. Also, most perpetrators of sexual abuse groom their targets. Grooming can be disorienting and confusing as well as it usually involves lavish gestures, gifts, quality time, and attention in order to exploit and manipulate. This extreme manipulation can be enough for survivors to never trust themselves or completely disconnect from their gut instincts and intuition.

I don’t believe people are one thing or the other, i.e. all good or all bad. People are complicated with their own life stories and traumatic lived experiences. Your father has a story, but that does not condone or excuse his choices. I bring this up because I imagine, despite his sexual abuse, you are conflicted about feeling or acknowledging any redeeming qualities of his. Perpetrators of trauma can appear kind, endearing, charismatic, attentive, and present. Sometimes these may be authentic and other times they could be exploitative and manipulative. When you say that you pick men that remind you of your biological father, it is easy to understand that parts of your dad were likable and that other men may remind you of those parts. But, parts don’t make a whole. You have to look at the whole picture to differentiate the forest from the trees. As you work through and understand your abuse, I think it will be clearer when you can name and understand your experiences around this.

It sounds like you are on the precipice of an incredible self-discovery. Your insights and awareness are the keys to unlock the doors of your freedom - freedom to choose clearly and from the imprints of your survived sexual abuse. If you intend to unpack your sexual abuse, it may be helpful to hold off on managing a new relationship with another man for now. Your sole focus should be on supporting and loving yourself. As you deepen your intimacy with yourself, reclaim your wholeness, and release your trauma, you will be surprised how clear things get. It is a process of restoring alignment from your head to your heart to your gut. Your self-trust will deepen and the answers will come more clearly as your intuition comes back online. You are resilient beyond belief and I believe in you. True, meaningful change can feel uncomfortable, but I promise you that it’s worth it. You are a survivor and I honor you as such!

With love and light,

John Moos, MD

John Moos 2/22/22 John Moos 2/22/22

How do I heal from a sexual trauma?

Dear John,

Thank you for this opportunity for healing.

How do I heal from a sexual trauma? This person was supposed to be my safe haven - my biological father. At the time, he was my most favorite person.

I’ve noticed that I pick men like him. It makes me feel dirty because he did such disgusting things to me.

All my best,

Trying

Dear Trying,

Thank you so much for your vulnerability and courage to explore this question. I recently completed a 6-part series exploring the unexpected consequences of sexual abuse involving a parent/guardian. The series can be found at dearjohnmd.com/stories between 11/14/21 to 12/19/21 and may help lay the foundation for deepening your understanding of your traumatic lived experience and the legacy of patterns it can create. I have attached the links below for your convenience:

Healing from sexual trauma, or any trauma for that matter, is a process of initiation, regulation, and integration. This is big work, and often requires the guidance of skilled professionals. This may be uncharted territory for yourself, but it is work that has been done by countless survivors of such abuse. Your story and lived experience is very personal; no one else has gone through your unique set of circumstances. But, there are universal truths and skills to help you navigate this in a way where you can be free from the patterns and maladaptive coping skills necessary for you to have survived such violations as a child.

It is no simple task to initiate this work. Initiation starts with awareness - knowing that you were abused. Knowing that you survived sexual abuse can create awareness hell: a state in which you feel paralyzed or self-critical because you know you need help, but can’t figure out how to get the help you need. The antidote is usually twofold: self-compassion and guidance. Self-compassion helps to unburden the cycle of self-judgment and criticism so you don’t harm yourself further. Guidance is the act of humbly seeking and asking for help from a skilled professional. There is an incredible resource, The Courage to Heal: A Guide for Women Survivors of Child Sexual Abuse by Ellen Bass and Laura Davis that can help you develop the language to better understand your trauma and lived experiences. Developing the proper language and understanding of your lived experience is essential to clearly work through your trauma, help you to understand the boundaries you need to heal, and avoid the risks of retraumatization as you open up these old wounds. Apart from this book, other resources that would be incredibly helpful and supportive are therapists who specialize in sexual abuse and trauma-informed care. Another tool would be local support groups in your area. Both of these tools would help nurture your sense of connection and trust to yourself and others. If trauma is created in relationships, it is vitally important to heal it in relationships.

Regulation involves doing the work. As you move through your sexual abuse history, it is important to understand your triggers - stressors or stimuli that throw your body into fight, flight, freeze or submit. It is unopposed sympathetic nervous system as a result of fear or terror. When experiencing trauma, it is common to dissociate from yourself so you can survive the event. Some people go numb, some blackout, others feel like they leave their body - it is different for everyone, but there are common themes. The problem with traumatic dissociation is, while it helps you live through the traumatic experience, it creates memories or experiences in your life that are not associated with your historical timeline. What that means is, when you are triggered by something that reminds you of your abuse, e.g. a smell, situations, words, partners, etc, it can feel like you are reliving your abuse in the present moment. Your body will go into a dysregulated fear-based response as if you were being abused in the here and now. Regulation involves understanding and labeling those triggers so you can avoid the dysregulated state. The regulated space where you can learn tools and understand your triggers is called your window of tolerance. When you are dysregulated, e.g. fight or flight, freeze or submit, you are outside of your window of tolerance, flooded, and unable to work through the relived trauma. Working with a professional can help you to name your triggers, increase your window of tolerance, and learn new tools to stay regulated as you work through your sexual trauma.

Integration, the final part of the work,...to be continued next week

With love and light,

John Moos, MD

John Moos 2/13/22 John Moos 2/13/22

How do I retrieve lost memories? Part 2

Dear John,

I grew up in a middle class neighborhood...a carefree tomboy, totally comfortable in my skin and was lucky that my best friend from the ages 3-10 lived across the street from me…he’s important to know in my story as he was diagnosed with cancer in HS.

My mother...Around the age of eight /nine I began asking my dad what’s wrong with her & he’d always say, “When you’re older and more capable of understanding things I’ll explain it then”

One summer night, when I was 10, my mom woke me up and said my dad wasn’t feeling well and we were all going to the hospital. We lived about 10 minutes away from the hospital and for the first five minutes of the drive my dad with sweat dripping down his face was looking back at my brother and me assuring us he was fine…he began making these loud God-awful choking noises and then began desperately gasping for air...I was watching him have a massive heart attack .

Fast forward hours later, doctors came out to say it’s nothing but miraculous he survived this heart attack. I knew something terrible in me changed. My dad died a few months after the heart attack on an operating table after undergoing bypass surgery. I was 11 years old. My mom was mentally ill also and no family came around.

When I was in my early 30’s I had lunch with my father’s sister, whom I had no relationship with ever, and she informed me my memory was forgetting one HUGE part. Apparently I saw my dad laying dead in a hospital bed and my brain completely erased that memory from my consciousness.

Any suggestions to help me retrieve this memory as I believe a lot of my patterns of behavior (fears) are circling back to a place in my brain I can’t even remember.

Continued from last week…

There are many ways to access these types of memories. Therapists can help you access this information, and multiple disciplines can assist. For traumas stored in your body, Somatic Experiencing or Hakomi can help retrieve elements of these repressed memories. Eye Movement Desensitization and Reprocessing (EMDR) has been shown to be more successful with chronic Post-Traumatic Stress Disorder (PTSD) than some traditional methodologies. Internal Family Systems is another psychotherapeutic discipline which can help honor and integrate the internal roles you had to create to navigate those painful life experiences. There are other somatic healing modalities such as breathwork, sound baths, creative expression (dance, drawing, writing), and body work that help us tune into and access parts of our body and psyche. And, lastly, working with psychedelics is another opportunity to access these memories. I have a health and wellness clinic in Los Angeles, Greenlight Metamorphosis Center, that works with ketamine to catalyze transformative change in people’s lives. There are many psychedelics, when used in the right context, can facilitate and amplify deep internal healing. Many are given in social, cultural contexts as part of indigenous practices, such as Ayahuasca, Ibogaine, and psilocybin. MDMA, commonly known as Ecstasy, is showing tremendous benefit in populations affected by PTSD. These medicines, when given in the right set and setting, guided by a skilled provider, are helping to create the conditions for the body and mind to heal. I would encourage you to consider this if it feels in alignment with your healing journey.

From everything you have described, I can understand and empathize deeply with what you’ve experienced. You have persevered through your fears, now honoring the realization that you want to be free from these self-limiting beliefs and constricting patterns. You are on the right path. You are courageous beyond belief. As you do the work of becoming whole, reintegrating these painful experiences and retrieving your memories, you will experience pain and discomfort. The act of becoming whole is not all sunshine and rainbows. But, the act of becoming whole is imperative to live with integrity, free from your patterns. Without this work, it can feel like life is happening to us - the victim’s perspective. We are at it’s mercy, subconsciously reacting to events as they transpire. Through this work, you will realize that life is happening from you, shifting from victim to Creator. Victor Frankl famously said, “between stimulus and response there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom.” You can have that space; you can have your freedom.

Despite your fears and inability to recall or retrieve traumatic memories, you trusted yourself and your instincts to heal. You are reaching out for help and willing to explore a period of life that was defined by trauma. You’re on the right path; exactly where you need to be. Keep taking the steps, one at a time, and you can’t go wrong. It’ll be surprising to look back and see how much you’ve grown and changed by following your heart, trusting yourself, and finding your freedom.

With love and light,

John Moos, MD

John Moos 2/6/22 John Moos 2/6/22

How do I retrieve lost memories?

Dear John,

Any suggestions to help me retrieve this memory as I believe a lot of my patterns of behavior (fears) are circling back to a place in my brain I can’t even remember.

Dear Releasing Your Fear,

First, I want to acknowledge what incredible bravery it takes to re-explore such a painful moment. Your life may be impacted by fears, but it takes real courage to explore this openly with curiosity and a willingness to be free of your fears. Up until the time we start to individuate in adolescence, our parents hold an almost God-like, omnipotent place in our psyche. I know that I at the age of 41 still thought my dad was invincible until he started limping with severe osteoarthritis and accidentally fell a few times. The fact that you confronted your dad’s mortality first-hand at such a young age, with both the witnessing of his near fatal heart attack and his passing after an unsuccessful cardiac bypass surgery, is enough to disrupt your trust of reality and shake the foundation of your safety to the core.

In reading through your question, I am deducing that your dad held a particularly significant role in your life. Not just from his ability to show up and be a dad, but also in his ability to protect/shield you from the consequences of your mom’s mental illness. The graphic and dramatic events that you witnessed preceding his passing are enough to instill a heavy dose of fear and disrupt your sense of safety. Coupled with the loss of your protector of your mother’s mental illness, it is easy to understand how your sense of safety could feel grossly compromised. Over the years, without processing this trauma or having someone help you through it, your distrust of the world and it’s safety can grow exponentially, magnifying any circumstances into something terrifying.

The selective omission of your memories around seeing your father dead is not surprising. Children will self-protect to avoid processing painful experiences and emotions. This is known as dissociation. Dissociation is a mental process or strategy people use to avoid having to process information or events that overwhelm their resources. We often can’t access painful experiences in our memory if we have never processed them. In order to properly integrate those experiences, we have to be willing and able, or have someone assist us, to reconnect with those painful memories, emotions, and experiences so we can re-integrate them back into a congruent life timeline. This is the process of integration or becoming whole. It is taking the fragmented pieces of our life, consequences of trauma, and accepting them for what they were. If you don’t have someone who can help with that, e.g. a parent, a sibling, friends or family, or access to professionals, these experiences in our life get compartmentalized and stored in fragmented ways in our psyche. Because they are not processed and categorized properly in our timeline, when we are triggered by something that reminds us of those traumatic events, we can re-experience them entirely like they are happening all over again at the very moment we are triggered. It can be overwhelming, exacerbating the fears of reconnecting with painful experiences and setting us up to be wary and avoidant of new experiences or uncertainty.

It is an assumption on my part that if your mother was preoccupied with her own mental health illness, she may not have been present to help you process the tremendous pain you were experiencing. Left on your own, you did the best you could. You boxed up your pain and stuck it in the recesses of your psyche. This works until it doesn’t. It sounds like fear is a constant theme in your life. A self-limiting pattern that keeps you from truly experiencing the world. You don’t have to be a victim to the fear or live a constrained life. You have a choice, and your freedom lies in re-exploring and revisiting these painful memories.

To be continued next week…

With love and light,

John Moos, MD

John Moos 1/30/22 John Moos 1/30/22

Am I capable of being sober? Part 2

Dear John,

I am reaching out because I randomly fell on your page. I am in healthcare and I am struggling with my drinking. This isn't new for me. I have been to treatment and AA. I appreciate your transparency. It's very inspiring to me. My addiction of choice is alcohol. When did you finally see the light? I feel like I am never going to see it. It's been a good 10 yrs for me. I have been to treatment enough to practically teach it but as we all know self knowledge avails us nothing. I love the rooms of AA and have had amazing support but that hasn't kept me sober either. Sometimes I get scared that I am not constitutionally capable of being sober. Did you ever feel this way? Did you just have a moment where a light bulb came on?

Continued from last week…

I assure you, you are fully capable of being sober. You started this life sober. Through the accumulation of developmental trauma, maladaptive coping strategies, and forces often beyond our control, we learned that alcohol (or other substances and behaviors) could be an answer, when in reality they never were. Addiction is difficult to get a handle on because the behavior or substance almost works all of the time. Alcohol or any addictive behaviors cannot be options. It is not about committing the act, asking for forgiveness and making amends. It happens, but it makes the road back to redemption so much harder and longer. For me, a relapse would have been a declaration to myself and others that I am a fraud and my integrity is meaningless. What value would my forgiveness or amends have then? Do I wait until there is no one to forgive or make amends to because I’m all alone? Most importantly, can you forgive or make amends to yourself when you can’t trust yourself? I won’t go back to that place. It was too painful to go through once, and I certainly won’t do it again.

I would say that my “a-ha” moment came when I checked myself into rehab and started to unpack all of the lies: the lies I told myself, the lies I told other people, the lies I lived and breathed for decades. Rehab didn’t transform me, but it did help me allocate the time necessary to start the work I needed to. I worked with a skilled therapist during this time who helped me empty every single lie, name every single transgression, and every single sexual encounter - all of it! It had to be complete and honest because I was polygraphed after I made the extensive list to validate its truth to the best of my knowledge. When I shared all of the terrible choices I had made over a 36 year period, I crushed my ex-wife, but also felt relieved. I didn’t want to hurt her further, but what were my other choices? Minimize the pain I’d caused? Hold onto the darkness and keep perpetrating traumas? At some point, I had to put the sword down and stop hurting myself and others. It may not be comfortable walking out of the hole we create, but it certainly beats being trapped down there forever, alone and in the dark. I didn’t get a chance to keep things in the dark, hide things in the recesses of my psyche. I had to empty out all of the darkness and was gifted an opportunity to fill it back up with light. After hurting myself, my family, and so many others around me, I got a chance to start over. My life was small, simple, and I was alone for a while after that day. But, after a few years of doing the work, making healthier choices, and living with integrity, life became magnificent. I restored my integrity, shared with my kids my struggles and how I overcame them, transcended the label “addict,” met the most amazing woman whom I am engaged to, and created a platform to share openly and honestly about the pain I caused and the reparations I made to become whole.

Today, I am living my values. My life is full of integrity. I am honest with myself and others, and feel whole regardless of my messiness. I feel nurtured by positive thought, positive words, healthy foods, healthy habits and healthier relationships. I play for the fun of it, with my love, my kids, and in life. Stillness reminds me to eliminate distractions, be present, stay attuned, be mindful and take solitude when needed. I have restored my connection to myself, co-created a deep love with my fiance, repaired and reinforced bonds with friends and family, cultivated an incredible community, and have a deeply personal connection to nature and Spirit. I no longer resemble the addicted version of myself, but I know I have that capacity within me. It’s not about banishing the darkness from me or refusing to acknowledge its presence, but rather about compassionately accepting it and releasing my dependency from it. Those survival strategies no longer work. For myself, life is too magnificent in its infinite beauty and complexity to numb and distract my way through. And, while it is not always rainbows and butterflies, I’d take leaning into the discomfort and pain of a challenge or obstacle over the pain of burying and/or ignoring it.

I know you can do it. Your curiosity and inquiry is the touchstone to tremendous change. The world needs you whole. I truly believe that some of the most amazing and dynamic people are the ones who have struggled intimately with pain and addiction. If you ever need help, don’t be afraid to ask. I know where you’ve been - I have been there before. I see you and I love you!

With love and light,

John Moos, MD

John Moos 1/23/22 John Moos 1/23/22

Am I capable of being sober?

Dear John,

Dear resilient one,

Thank you for reaching out and being brave enough to ask for help. I want to acknowledge the tremendous work you’ve done: going through treatment and making your way into the AA rooms. I was a “12-stepper” for almost two years before I chose a different path. The rooms were critical to helping me talk openly and honestly about my struggles. They created a community for me when I had none. And, it was an incredible reminder to see newcomers come into the room, broken, afraid, and confused, but also courageous and willing. I attended both AA and SAA (Sex Addicts Anonymous), and I have to say that SAA is like a master class in accountability and sobriety. Behavioral addictions can be particularly exposing when being rigorously honest as we can’t blame a substance, but exercising my accountability muscle over and over was vitally important. Not just that, but being in fellowship with people who didn’t judge or condemn me was equally important to owning my truth.

When I hit bottom, I hit hard. The pain of landing where I did: shattering my family, hurting people I loved, missing my daughter’s 8th birthday because I was in rehab, the loss of friends and family, and the shame and embarrassment was enough for me to realize that I never wanted to go back there. For me, alcohol was no longer a choice and neither was infidelity, lying to maintain a duplicitous life, pornography, or paying for prostitutes. If any one of them were an option, all of them were. It’s not that a “slip” or “relapse” would have been so terrible compared to what I had done, but the violation of my integrity would have. I worked hard to create a new community, one filled with people who supported the best version of myself. I distanced myself from people who supported me drunk, acting inappropriately, or engaging in any of the myriad of behaviors that degraded my worth and that of others. I worked hard to repair the damage of those willing to accept my atonement. I worked harder to maintain my integrity and let my life be a living amends. I have been around close friends and family who’ve struggled with sobriety and relapses, pushing those closest to them away, ending up isolated and alone, and some of them ultimately dying. I never got to the point of stashing bottles, needing eye-openers, or liver failure, but I drank enough to put people in danger, numb my shame, and distract me from the real work of getting whole.

10 years is a long time to be struggling with anything, especially yourself. You must be tired! I am sure you could teach others the workings of treatment and recovery, but it isn’t about thinking your way through it. You are right, self-knowledge avails us nothing, otherwise we would all have been strong enough to stop through sheer knowledge and will power alone. For me, the light came on when I was in so much pain, I wasn’t sure I could go on, but knew I had to. It was about feeling the pain. It was about realigning my head (mind) with my heart and my gut (instincts/intuition). It was about developing a relationship with something bigger than me (Spirit). It was about getting real and granular with my values, which are integrity, nurturance, play, stillness, and connection. As I am sure you’ve heard a number of times before, “your bottom is when you choose to stop digging.” For me, I reached a point where I just couldn’t lie anymore. It was exhausting maintaining the compartments of my private, deceptive, compartmentalized life and that of my public one. It was a scary thing owning the entirety of my truth, but you are only responsible for your truth, not other people’s interpretation of it.

To be continued next week…

With love and light,

John Moos, MD

John Moos 1/16/22 John Moos 1/16/22

How do I take care of myself with an addicted partner? Part 2

Dear John,

My boyfriend of 3 years is a recovering alcoholic, and he just started his AA journey about a year ago. He has relapsed a couple times, one time after 3 months, and one time after 6 months of sobriety. I knew intuitively each time he relapsed, but he lied to me about it, and made me feel like I was crazy, until I had actual proof of it. This has caused a lot of hurt and drama between us. I love him very much and can see his incredible potential, if only he can get through this. Do you have any advice for me in navigating this situation, and how I can best support him while also taking care of myself?

Continued from last week…

One of the most important lessons I learned during intensive therapy while in rehab was this: all addictive behaviors stem from a disorder of integrity. Integrity can mean how honest you are with yourself and others. It can also refer to the state of being whole, undivided, and fully integrated. Addictions don’t happen in a vacuum. There are always traumas in one’s early life that predispose people to addictive tendencies and behaviors. Trauma does not occur because something bad happens to you; it occurs because something bad happens to you and you are, or feel, alone. There is a saying, “trauma isn’t what happens to you, it is what you are left with.” When trauma occurs, it is often too painful to experience or process so your mind dissociates from the experience as a survival instinct. However, without the right tools or people to help us reintegrate those experiences and pieces, we will remain fragmented, dis-integrated, and compartmentalized. Boxing, hiding, labeling, avoiding, and numbing our feelings or experiences become viable ways of coping because we’ve learned to do this in the past and it worked. This is the foundation of dis-integration or fragmentation that makes sobriety and recovery work so difficult. Drugs, alcohol, and addictive, distracting behaviors also become enticing options to avoid the pain and/or difficult work of recovery. I love Julie Holland’s, MD, PhD, description of addiction in her book, Good Chemistry, “you can never get enough of something that almost works.” Treating the symptoms without addressing the root causes of trauma will inevitably fail. This is the aptly named “white-knuckling” or “dry-drunk” phase because externally the individual isn’t drinking, but their behaviors and tendencies haven’t changed. It doesn’t matter how strong you make the walls of a house if the foundation is compromised - it will eventually collapse.

With respect to your boyfriend and his continued relapses, struggling with addiction and recovery isn’t a reason to abandon someone. You cannot prevent anyone from hitting their bottom and it is deeply compassionate to be there to lift a loved one up. There is a common saying in 12-step, “your bottom is when you stop digging.” And, while you cannot prevent him from hitting bottom, you have a responsibility to yourself to establish boundaries so you don’t land with him. Sometimes the most compassionate choice to make is preventing yourself from being hurt or drowning with your partner. His repeated relapsing and lying is a form of abuse and trauma, especially the gaslighting. Gaslighting is when someone sequentially and consistently negates and erodes your intuition and instincts. This happens every time your intuition senses that something is off and he lies to protect his deceptive, compartmentalized life. This is particularly detrimental because it teaches you to ignore your gut instincts and intuition, forcing your head, heart and gut out of alignment. It starts to blur the lines between what is real and what is a lie. No relationship is worth you compromising yourself or your self-trust. A boundary can look like you giving him the space to establish his recovery without allowing yourself to be hurt. It can look like an ultimatum, but it is not, when done with clarity, kindness and grace. It is the ultimate form of self-compassion, self-protection and strength.

You mentioned you can see his potential and that you love him. I would encourage you to be willing to release any expectations of the future and take inventory of what is occurring in the present. Sometimes love looks like giving space instead of bringing closer. You have to love yourself more than your partner to avoid the wounded dance of codependency. Your well-being, safety, and sanity has to take primacy to his, especially if he is compromised and struggling to restore his own integrity. In a codependency dynamic, you will give endlessly to your partner and the relationship until you are depleted and drained. There is a reason in safety briefings on airplanes that flight attendants instruct you to put on your oxygen mask first. Your safety has to be the priority. Do not fall victim to the dreaded drama triangle (The Power of Ted), playing one of the roles of savior, victim, or perpetrator. Embracing the role of creator is the only off-ramp from the path of drama. When you choose yourself first in a loving and wholehearted way, the outflowing of love that emanates is the medicine this world needs.

I empathize deeply with the situation you are in. There is no easy answer, but I trust you to make the right one for yourself. Stay in the relationship for those moments of love and possibility, but risk the gaslighting, abuse, and suffering. Erect boundaries to self-protect, give him the space to hit bottom, and you risk feelings of guilt and abandonment. You may be blamed, criticized, and judged. Your partner is compromised and in need of help. Enabling him to continue his abusive patterns is not helping him take ownership of his life or you to find stability and safety. He has to be the captain of his ship, no matter how much you want to take the wheel and know how to navigate him back to safe shores. And, while this may be one individual’s question, I am certain it rings true to so many grappling in the arms of addiction. Don’t hesitate to reach out. I wish you all the strength, compassion, and courage to stand firmly and confidently in your truth.

With love and light,

John Moos, MD

John Moos 1/9/22 John Moos 1/9/22

How do I take care of myself with an addicted partner?

Dear John,

Dear Concerned Partner,

I can empathize deeply with what you are experiencing. I was fortunate in my recovery to have hit bottom hard and stayed committed wholeheartedly to my sobriety from that point onward. However, I have known many friends in recovery who’ve experienced debilitating relapses, some of whom struggled to the very end, eventually losing their lives. These struggles are heartbreaking, especially when they involve the people we love the most. With addiction, and recovery, I cannot tell you what will work. I can share my experience and let you know the factors that fueled my addictive behaviors, many of which tend to be universal.

In order to shift the discussions on addiction, it is important to reframe the conversation to a trauma-informed perspective. For many years in the past, and currently, it is widely thought that addiction is a “choice.” There is some truth to this, but it is a narrow perspective. As a former addict, I made all of my choices and faced all of the consequences. However, in the grip of addiction, navigating past traumas and avoiding existential shame and pain, it didn’t feel like I had a choice. For many individuals, pre-verbal and developmental traumas set the stage for a life of addictive behaviors, trying to salve old wounds that may not even be in our conscious awareness. Many leading physician/scientists are trying to reshape our thinking around trauma, neurodevelopmental biology, addiction and attachment, e.g. Gabor Mate, MD, Judson Brewer, MD, PhD, Peter Levine, PhD, Bruce Perry, MD, PhD, Gordon Neufeld, PhD, Dan Siegel, MD, Resmaa Menakem, and many others. Addictive behaviors are a temporary solution to a pain. Dr. Gabor Mate has developed a course, Compassionate Inquiry, which starts by reframing the question, “why the addiction?” to “why the pain?” This subtle shift is enough to dive below the surface defenses and touch the core of our deepest wounds when we allow it. Bruce Perry, MD, PhD, has been featured on Oprah and recently released a book that reads like a conversation between these two thought leaders, What Happened To You? Conversations on Trauma, Resilience, and Healing. This important piece of work helps to reframe the idea that we are flawed, broken, or defective people, but rather survivors of a wide range of traumatic experiences, many that occur before we have any conscious awareness, with a wide variety of coping strategies, both constructive and deconstructive. If anyone would like to explore this more, please let me know.

Early in my recovery, I went to both Alcoholics Anonymous (AA) and Sex Addicts Anonymous (SAA). I was a “stepper” or a “12-stepper,” which refers to the 12 steps of recovery that are taught in these groups. They are a recipe for success, no doubt. However, they are only as effective as we are honest with ourselves. Self-deceit is a powerful force, and unless we are rigorously honest with ourselves, we will tuck shame, excuses, and fear away into the dark recesses of our lives. I could not restore my integrity without walking through the lies, shame, pain, and suffering I had caused. Baring my soul raw required accountability, insight and humility in an authentic way.

To be continued next week…

With love and light,

John Moos, MD

John Moos 1/2/22 John Moos 1/2/22

Stop talking about cheating!

Context from Dear John:

The following exchange occurred after I posted a video on TikTok. It was one of several very honest videos exploring my infidelity, addictions, and the consequences of my choices. A viewer wrote, “stop talking about cheating.” I responded with the following, “curious - is there something you’d like to hear? Have you been hurt or wounded? Are you bored or are the topics bringing emotions up?” What transpired was a respectful dialogue that could have been mired in conflict, assumptions, and misunderstanding. As we close out 2021 and enter into 2022, I am reminded that we are always gifted opportunities to start anew, shed assumptions, and lead with curiosity instead of condemnation. I thought this was a beautiful example of accountability, mutual respect, curiosity, and the power of pausing. When we paused and got curious about one another, it opened us up to understanding and compassion. If either of us would have reacted instead of responded or taken offense and shut down, we would have missed an opportunity to deepen our understanding of one another and nurture our shared humanity. This exchange wasn’t about perfection, but rather imperfection, accountability, and reparation. It was beautifully authentic, vulnerable and human. Thank you!

Dear John,

I wanted to apologize for my message [on Tiktok] to you, I said “stop talking about cheating”. I know you must be in therapy and when things are hurting us…..we need to talk about them, otherwise we drink and do stupid things to numb or cover it up. Masking the pain doesn’t work especially with alcohol or other drugs.

I also had mentioned maybe for you to give advice on different topics. My request may be somewhat ridiculous as you yourself are trying to figure this all out.

What I meant to say is this….women who are dating want to hear from real men and what they want, find attractive, what red flags to run from etc. You may be able to help a lot of women with that advice. Talking about cheating is therapeutic I suppose but also can also be counter productive.

Dear Honest and Accountable,

I want to thank you for reaching out and extending an apology. Your email and some other comments have made me realize a context as to why I'm doing this is important. The incidents I'm describing happened over 6 years ago. I haven't been in traditional talk therapy for about 4 years now and my posting on Tiktok is not about processing my pain - I've done that, repaired the relationship ruptures I could, and am now engaged to an amazing woman. My experience through addiction and healing has been a major motivating factor in pivoting my career from trauma surgery to trauma healing. I'm opening a healing center that works with psychedelic and somatic healing to effect meaningful and substantial change in people's lives. My mission is to create the conditions for the body, mind, and soul to heal. My vision, liberating people from the prison of their traumas, constricting patterns, and self-limiting stories. I have received numerous emails and comments asking for more content so they could better understand what happened to them and maybe relieve some of their confusion and pain, so I want to honor that. But, I'm completely open to discussing any and all things.

I have every intention of exploring what it was like for me to start dating and owning my history with integrity. I hope and imagine that this will show men, and women, that owning your shit doesn't have to mean a life without love or connection. In fact, it's quite the opposite - when I owned my shit, all the darkness, I felt more grounded and embodied in who I am, which made it easier for people to trust me, especially my fiance. I don't completely understand your comment that women want to hear from "real men." I can assure you, my honesty and transparency is about as real as it can get.

With all of this said, is there something that you'd like me to explore? I'm open to suggestions and feedback, and thank you for taking the time to reach out.

Dear John,

I’m sorry I’m not sure why I typed “real men” I meant men. I think my mind was going faster than my fingers. One last thought….. maybe you cheated on your wife because she wasn't destined to be your soulmate, the universe saw something different for you!

Best of luck to you in your new journey with I’m sure a beautiful person.

Have a great day!

Thank you! The universe definitely had a different direction in mind for us both, and apart from the pain I caused myself and others along the way, I wouldn't have changed a thing. As the incredible poet, Andrea Gibson, says in her book, You Better Be Lightning, “sometimes grief is the fastest route to truth.” I wish you the absolute best and please don't hesitate to share any future feedback, suggestions or comments - publicly or privately.

With love and light,

John Moos, MD

Resources:

Andrea Gibson Instagram

John Moos 12/26/21 John Moos 12/26/21

Trauma happened; I feel angry!

Dear John,

I worked in trauma critical care and flight for years. I have four grown children. My mother-in-law has lived with me for years. I’m now home but will go back to work soon…My 27 year old son was shot in a senseless drive-by while helping someone get out of his car. Open laparotomy, small bowel resection. He is doing better, but still open. My mother-in-law had a few [heart attacks requiring stents and surgery with complications in her lower legs also requiring surgery]. I’m trying to take care of [them] both. This happened two weeks ago, but now I feel angry. I’ve never felt like this. My son is a good guy. He’s a cancer survivor and training for his first MMA fight. I’m so mad that the people responsible did this. I cry a lot and feel helpless. I just needed to tell someone. My husband doesn’t like complaining. I just feel mad and sad. Thank you for listening. Your Insta is great.

Dear Mad and Sad,

Thank you for reaching out and being willing to share your sadness and grief as well as your anger and frustration. Based on what you’ve shared, this makes sense. What you're describing and experiencing is overwhelming. Having conducted literally hundreds of laparotomies with open abdominal wound management, I have worked with families trying to make sense of the brutality, violence and trauma. During crisis, it is common for our field of vision to narrow, to lose perspective, and search for meaning. Humans are meaning-making beings. It is in our nature, and our responsibility, to derive value and meaning from these traumatic experiences and challenging life obstacles. Earlier in my life, when crisis hit, I would feel like a victim. Life was happening to me. I had no choice, there was no meaning, and I felt helpless. After my lowest point of my life, my breaking point, the dark night of the soul or sacred moment - however you choose to refer to it (everyone has a low point) - I was broken open and found an ability to surrender my will to that of life. Setting aside my resistance and humbly accepting the circumstances that were around me, I was able to see clearer, stay calmer, and make choices instead of reactions. Many emotions arise during this time. Emotions are messengers, and all are welcome - think of Rumi’s The Guest House. Take the time to acknowledge, honor, and be grateful for your emotional range. It is turning towards and processing these emotions that allow us to integrate these traumatic lived experiences instead of compartmentalizing or fragmenting our reality.

There are many other elements layered into your question: the rage/anger of the senseless violence perpetrated against your son, his loss of autonomy, the uncertainty of his and your mother’s outcomes, the transition of autonomy to dependence of your mother, and the inability to feel heard and supported by your husband. Any one of those, a significant challenge and adversity to experience, explore, and resolve. All together and at the same time, I can imagine it feels overwhelming, possibly crippling. I have heard this said to me a thousand times, and I have offered it up several times more, “you are exactly where you need to be.” I don’t mean that as an aphorism, but as a reminder that life’s rejection is God’s direction. There is always possibility; an opportunity to reframe our experience and broaden our perspective. You are resilient beyond belief. You cannot change any of the circumstances, but you can always choose how you show up, which perspective you hold, and the meaning you make from it all. In every adversity, there is also a gift or an opportunity. It is up to every individual to find the gift or opportunity and grow from it. The healing is in hurt. This could look like asking your husband to hold space and support you as you process all of the changes. It's not complaining; it's an opportunity to connect and be together in the pain. Otherwise, you're just alone. That has to be difficult for the both of you. For your son, it could be showing up and surrendering any sense of control or the need to immediately know "why?" Your presence, attunement, and compassion is the most healing gift you can offer him. We often never know, but there is a saying, “the most beautiful things lay on the other side of fear.” Trust that on the other end of this could be something amazing for him and his life. For your mother, as she undergoes procedure after procedure, imagine what she is experiencing. Constantly reminded of her ailments and mortality, losing her independence, and facing the finiteness of her life. You do not and cannot take on her experience, but you can grace her with your presence and support. Remember, you do not have to give all of yourself to everyone. It is important throughout this time you find time and balance for yourself so when you do show up, you can serve from a full cup. It's a delicate balancing act, but I know you can do it.

I wish you all of the strength, courage, compassion, resiliency, and perseverance to continue to weather these storms. And, I hope you use these life stressors as opportunities to connect with and deepen your intimacy with your husband, your son, and your mother-in-law. If your husband is resistant, then perhaps another: a close friend, a family member, or anyone else you trust. If there is absolutely no one, building that relationship, trust, and intimacy with yourself to hold that loving space for yourself will be imperative. Keep your head high and your heart open - you can and will get through this with grace. I sincerely appreciate you reaching out and sharing your humanity. Wishing you all the best!

With Love and Light,

John Moos, MD

Resources

Guest House | Rumi video poem (Calm)