S1 E9: Dr. Whitney Howzell on the Blurred World of Young Adults

Whitney Howzell, Clinical Director of the Claudia Black Center, sits down with host David Condos to explore the blurred world young adults are growing up in, how that environment affects their development, and how she helps them find connection and support.

Podcast Transcript

Dr. Whitney Howzell: Hello. My name is Dr. Whitney Howzell, and I am the clinical director of the Claudia Black Center for Young Adults.

David Condos: Dr. Howzell, thank you so much for being with us. Good to have you here.

Dr. Howzell: Thanks for having me.

David: Let’s start with introducing you, talking about your story. I know you have an interesting journey starting from public health, right?

Dr. Howzell: Yes, absolutely. I started off with health education, working in a school system with planned parenthood, doing sex education. I was the lady that walked around with the bag of condoms and pregnancy prevention stuff. Then I transitioned into working with the CDC as well as the health department. More of doing some epidemiological studies, tracking disease.

What I would do is once we track the disease, we would come up with a community initiative to address it. Cancer outbreaks to STDs to HIV rates. We would go in, figure out where the need for the community was and create the community intervention to address it. It was an adventure that was fun. That work took me from West Palm Beach, Florida, to Maryland to DC and to Philadelphia and New Jersey.

David: What was the draw for you? Looking at public health, helping the community, what motivated you in that?

Dr. Howzell: I’ve had a family mission statement on marching orders to serve. I wanted to actually go into the public health corp. The goal was to get into a public health career, join the Public Health Corps.

David: Is that an official term? “Public Health Corps”?

Dr. Howzell: It is. It’s Public Health Corps. It’s like any other military service, but it specifically addresses public health issues. They work directly under the Surgeon General. When I moved to the DC area, it was prime real estate to get a job in there and I just figured, “You know, I’ll just transition into that from the army.” I figured I would give the Army maybe three years tops and then transition in. It didn’t happen like that. Eight years later I was still in the US Army. Very proud of my service but it just is very interesting how life can take twists and turns.

David: Let’s get into your Army service now. You were a soldier, enlisted member of the armed forces and then you decided to stay for your career. Talk us through that.

Dr. Howzell: I remained in the Army Reserve for eight years total; six and two. All at Fort Dix, which is a joint base, so Army, Air Force, and Navy. I was division level, so primarily in charge of training troops who are about to be deployed.

I worked very closely with the unit’s STARRS program. It was a study that the army came up with to assess resiliency and really the initiative was directed toward preventing suicide, which is huge in the military. We know today that it’s still huge among our veteran population. I was doing that work, working closely with our EOO, Equal Opportunity Officer. Always knew in the back of my head that maybe therapy is the path for you.

I decided to go back to school again and I got another degree in clinical social work and another master’s in education and finally my PhD in human sexuality studies.

David: That’s a lot of studies.

Dr. Howzell: It just means I owe Sallie Mae a lot of money. That’s what that means.

David: Yes, I know. That’s a lot of work. Looking back at the STARRS program you said, what did that look like? What was the work you were doing?

Dr. Howzell: At the time you’re seeing people who are either deploying or from us coming back. How do we prepare them for civilian life? How do we prepare them for being deployed and a life that’s very stressful? I remember just being in boot camp with 17-18-year-olds, the amount of stress and trauma that people were coming in with, and now you’re about to go into another high-stress situation.

I think the military really knew, “We have to prepare the soldiers as much as possible. We have to give them coping skills. We just have to, one, just provide a safe environment for them to tell someone.” A lot of the initiative was, “Hey, we’re here for you. We care. Let us help. Say something, grab a battle buddy. Talk to someone.”

David: You were a person that they could come to?

Dr. Howzell: Yes, primarily it was me and then, “Okay, let me get you some outreach.” Like, “Let’s talk to the chaplain.” “Let’s talk to our social work officer.” “Let’s talk to a therapist.” “Let me get you some outside resources.” That was pivotally important when we’re dealing with the reserve side. We don’t see them every day. You’re coming in and you’re going to report one weekend a month. Maybe we see you two weeks out of the month for training and then you’re off to your daily life.

David: Kind of getting thrown between those two worlds, back and forth.

Dr. Howzell: Yes, I know that can be very stressful for a younger person. It can be very dishevelling, so you need that added support or more over just somebody to say, “Hey, I see you. Do you need something?”

David: What were some of the main issues that you were seeing people come in with?

Dr. Howzell: A lot of family of origin issues. If you’re talking about a young person joining any service, you’re trying to develop a concept of self. You’re looking for, “What is this thing that I’m supposed to be doing with my life?” Maybe I figured out this school is not for me. Maybe I just want a way to serve in any capacity and naturally serving one’s country isn’t a very explicit way to do that, right?

David: It’s finding your identity and finding value.

Dr. Howzell: Absolutely. You even notice that with older people who came in. There is an innate desire for humans to serve in general. I think that’s part of connection and you would find that a lot with service members.

David: I know you mentioned you saw some trauma in that work as well with the service. Was it sexual assault, PTSD?

Dr. Howzell: Absolutely. While the STARRS Program was initially directed toward preventing suicide, you get into, “Well, why is this coming up for people?” We would hear about the gamut of sexual assault, whether male or female, drug use, things that were compounding on top of the service or maybe on top of the combat that they just saw.

David: On top of the stress.

Dr. Howzell: Yes. Complicated trauma is real.

David: As you’ve described your journey so far in this story, you were in a place where you were able to be a person that they could turn to, but you had to facilitate them getting the right help. Then eventually you decided to make that switch and become a therapist. Talk us through that.

Dr. Howzell: Halfway through my service, like I said, I went back to school and I entered into a dual-degree program. There was a clinical track and education track. I obviously chose the clinical track because I wanted to be a therapist. Finished at Widener University in Philadelphia, Pennsylvania, and immediately got licensed and started working.

David: You got your doctorate in human sexuality?

Dr. Howzell: Yes.

David: What about that specifically spoke to you and then what did it teach you about human sexuality?

Dr. Howzell: Everyone from the time they’re born to the time they leave this planet, you’re a sexual being. That doesn’t necessarily mean we’re talking about the behavior act of sex. We’re talking about intimacy, we’re talking about healthy relationships, we’re talking about bonding in a healthy manner. We’re talking about developing your sense of sexual self and being able to express it in a healthy way. I saw more of that dealing with my adolescents at Child Guidance than working with any couple or adult.

David: Really?

Dr. Howzell: Yes.

David: That taught you more about what that looked like in the real world?

Dr. Howzell: Yes, absolutely. I think the freedom to work with an adolescent or young adult, in general, or the flexibility because they’re so open. They’re looking for guidance, for acceptance. I personally think that when we’re talking or we’re on this renaissance of sexuality and being able to express it, young adults are more open than I think any age group. For a lot of them, it’s what they’ve grown up with and seen all their life. It’s a societal norm now if that makes any sense?

David: Yes, and so fast forward to what you’re doing now. It sounds like having a background in working with people, finding their identity and service, in the army, in sexuality, that would have a lot of overlap with the young adult population you’re working with now. Would you say that?

Dr. Howzell: Absolutely. It’s definitely a hodgepodge, and again, it feels great to work with a population that’s so open to expanding their horizon. Not as it applies to, let’s say, attraction or orientation, but who I am as a sexual being, or beyond that, who I am as a person. I’ll say again, that the best work that we do at the Claudia Black Center is around developing a concept of self in all facets.

David: Let’s dive a little bit deeper into the Claudia Black Center right now. It’s working with young adults age 18 to–?

Dr. Howzell: 18 to 26, and they come in with a gamut of issues and disorders. I think the cornerstone or the work that we treat is emotional trauma, unresolved emotional trauma, young adults who have dual diagnosis and addiction issues.

David: What are some of the major challenges, the main issues that you see cropping up again and again?

Dr. Howzell: Although young adults, they’re flexible, and they’re open-minded, they are also in that in-between stage where they really want their autonomy but they’re still so dependent on mom and dad. I think the biggest barrier that we are more challenged with is rebelliousness.

David: Rebelling against the clinicians?

Dr. Howzell: Yes, the clinicians, their parents. They’re rebelling against the world, they don’t want people to tell them what to do. At that age I make up a lot of people thought, “I got this under control. I know what I’m doing and I don’t need your help.”

David: “You don’t understand me.”

Dr. Howzell: Right. “You don’t understand– You’ve never been 18 before. Even though you’re 35. You just skipped over the whole developmental stage.” It’s challenging in that developmentally speaking until someone turns 25-26, their frontal lobe isn’t even fully developed. Imagine when you have that and then you add trauma on top of that, and then you add substance use or any type of process addiction, so I hold empathy there.

There’s a lot going on in their head, in their world, and they’re just trying to figure it out. I think that, not just with our population but it’s par for the course with anyone dealing with unresolved trauma or addiction issues, that denial and resistance are a big part of the beginning of their recovery.

David: How do you break through? How do you reach somebody who is resistant? Who is standoffish about that.

Dr. Howzell: I pull on my old social work adage. Just say, “You meet people where they are. Maybe you’re not willing to embrace a label of addiction but can we acknowledge that these behaviors are at least problematic?” I experienced that too in working in other areas at The Meadows, with Gentle Path. Sex addiction is still such a taboo, even with our younger people. “Okay, I’m not going to hold on that it’s an addiction but can we say that this is problematic for you? This is affecting your-“

David: “Well, what are the results?”

Dr. Howzell: Yes, “Have there been long term consequences?” What’s interesting for young adults is there often hasn’t been that yet.

David: Yes, there hasn’t been enough time passed to see that.

Dr. Howzell: Exactly, so they’re stuck in that, “That’s not going to happen to me”, or “I got this under control.” Again, just meeting them where they are, asking them, “What are your treatment goals?” We’re really, really collaborative with them. Like, “What do you want to work on?” “If it’s not this thing– If this is the thing that mom and dad are pushing you on, imagine that this is the time where you get to be completely selfish. There has to be something.” Just trying to extend that olive branch and step into their world has been helpful.

David: You mentioned the family involvement earlier. Describe that dynamic, because these are adults. A lot of them, I imagine are still either very involved with their family or how does that play out?

Dr. Howzell: Yes, again, it’s that in-between stage where there are two extremes. They’re either really enmeshed, meaning I have to control everything that my child does in an unhealthy manner and can’t relinquish any of that to either let them fall flat on their face, or either let them develop their autonomy in a healthy way, or they’re really avoiding. “I’m going to send my child to your program for 45 days and you better fix them.” Which is not real.

David: “I don’t want have anything to do with it”, basically.

Dr. Howzell: Right, or just the expectation of this is a cure. As if for any form of addiction, we have a magical pill. That’s just going to be fixed in 45 days, which we know is unrealistic, particularly if you’ve been at this addiction or you’ve been in your trauma half your life.

David: Another element that comes to mind when thinking about young adults, this population, is what it’s like to be a young adult in this day and age as opposed to 10 years ago, 20 years ago, 50 years ago. How has that constantly changing, the technology, how does that change your job? How do you approach that?

Dr. Howzell: Sure, keeps me on my toes. It keeps our clinical staff on their toes, and I’m so glad you mentioned the word technology. Again, this is one of the first generations that have grown up with all facets of technology; being computers, internet, video games, television, social media. I didn’t have that, at least you know. I remember coming of age with-

David: We didn’t have it as constantly with you all the time.

Dr. Howzell: Exactly, so I think there is this almost social divide in that, what is healthy and what is not? What is socially normative to them and what’s not for us? I take things like tech addiction, which is a big thing. For someone who’s had an iPad in their hands since they were two years old, how do you tell them that, that’s not okay? What do their social skills look like with other people face to face? They handle conflict different, if they even know how to handle conflict at all, if they even know what a healthy relationship looks like outside of a DM.

Those are some of the challenges but understanding that we’re not going to be quick to say, “This is an addiction, this is problematic,” but again, I go back to, “How is this affecting your world?” How does this affect your interpersonal relationships? Can you get work done after you’ve been on a video game for 10 to 12 hours? Like you said, there’s definitely a cultural evolution.

What I’m experiencing with dealing with young adults is there is extremes, they’re very black and white thinkers or we teach them to be black and white thinkers and they live in a very gray world where everything is blurred and they’re just trying to figure it out.

David: Yes, and I like how you describe that cultural division or whatever it is. Whereas, somebody who has grown up with mobile devices or internet for their whole life, as long as they can remember, what they perceive as being a relative normal is going to be different.

Dr. Howzell: It’ll probably be different in 10 years.

David: Exactly, yes, it’ll keep changing.

Dr. Howzell: In 10 years, and I’m willing to bet that they’re more amendable to adapting to the culture than we are, so as clinicians we know we have to constantly stay on our toes about what are appropriate interventions to problematic or compulsive behaviors as it relates to technology, as it relates to substances, other process addictions or even in intimacy in relationships?

David: When you see that tech is causing a problem, how do you approach that? What does the long-term plan look like? I feel like a life without tech– Tech abstinence is not possible.

Dr. Howzell: It’s not possible, yes.

David: How do you do that?

Dr. Howzell: Moderation. Again, I go back to asking very basic questions. Is this affecting your day to day living? Can you get up? Can you eat? Do you remember to go to work? Are you having other social interactions with someone that’s not in your headphones or screen time? Are you able to hold down a job? Is your health okay? Those very, very basic questions around what does problematic tech use look like, firstly.

Again, meet them where they are in a sense. Because it’s so normative, that can be really offensive to someone, or people who are very, very early in their recovery particularly young adults, they go to extremes.

By moderation they may hear, “I can never use this again.” Which you’d be evil for saying that. We pitch very early, what do you want this to look like? I go back again to the making of someone who’s building their self-concept. To get to where you want to be, what does that need to look like? Perhaps to do that you might have to let go of whatever vice that you’re using to cope with.

David: I think one interesting aspect of this that you touched on earlier is, being a young adult in the culture that we have now, how that affects how you build relationships. You said, it’s more than being someone in your DMs. How do you get them to understand, that’s not a relationship or that’s different than what other people might think of, as a relationship?

Dr. Howzell: One of the things that we specialize at the Claudia Black Center is dealing- with developing relationships and moreover with how you handle conflict, i.e. bullying, is a big thing. There are a lot of thumb thugs in the world, right?

David: Yes, trolls.

Dr. Howzell: Right, trolls absolutely. It’s very easy to scream at somebody or send out a mean message from a screen or from your keyboard. It’s different when they’re in front of your face and I can’t tell you how many times I’ve seen patients who just can’t ask for their needs and wants outside of some sort of medium or divide. We practice a lot within, I’m sure you’ve heard this from other clinicians here at the Meadows using the talking and listening boundary, but what I like about that the most, is the ability to focus on your feelings. Like, “When someone did that to you, how did that make you feel?”

They would find it easier to send an emoji. Like, “Let me send the angry face or–” I don’t know, a thumbs down. I know that sounds corny, but any type of emoji or mean rather than expressing how they’re feeling. Being able to one, sit in their own emotions and actually being able to tolerate somebody else’s, whether it’s good or bad, negative or positive is really difficult for them to do, primarily for those who’ve been submersed in the tech world.

That’s a pretty good indication that either something problematic is happening or it’s about to. Catching them this young and the ability to step out of that and just give them new strategies and ways to communicate with people, is big.

David: Then to kind of bring it around to a hopeful– Now to end, what is your goal or what do you view as–? I know success is very individualistic for each person, but what do you view as a good outcome? What is your goal at the Claudia Black Center?

Dr. Howzell: I glean on access and awareness. I won’t pretend to be able to save everyone or for any patient to have some huge epiphany, but just the awareness that they take away from the work that they’ve started is big. It’s big. They either come away with, “I know I have a problem and I’m not ready to address it”, or “I know I have a problem and I have more work to do.” I think that is a huge accomplishment. No matter what the very clinical treatment goals were, if we can just implant that seed that one, you’re supported.

The opposite of addiction is fellowship. If I can have a patient walking away from the Claudia Black Center knowing, “I have a community that will help me whether I’m doing good or bad”, mission accomplished. They’re walking into an environment where they’ve not been safe to even say, “I’m sad today”, or “I’m angry at you mom”, or dad or brother, sister, whatever. If we can do that, if they can just walk away just a little more emotionally aware of themselves, I mark it as a win.

David: Yes, so it’s kind of zooming back out, looking at the bigger picture here. What’s one thing you wish the general public understood more about the reality of being a young adult, going through this, the trauma and recovery in mental health? All those pieces.

Dr. Howzell: This might sound like a cliche, but that there’s hope and they’re not broken. Each person’s life path is different, but just knowing that you’re not alone too. I think that for a lot of young adults in particular for their families believe, “This is just unique to my family system. It’s just happening to me.” Which is why, again, we glean so heavily on peer support in community at the Claudia Black Center as well as in the addiction world, period.

Just knowing that you’re not by yourself, this is just a very, very small blurb in your life. For some people, you’re going to have to work at it. It’s going to be a journey. It’s a marathon, not a race and there are people out there to support you.

David: There is help, you can come out better on the other side.

Dr. Howzell: Absolutely.

David: For someone listening who wants to dive into this even more, what would be one of your favorite books, favorite resource on this-?

Dr. Howzell: That’s a tough one.

David: You can pick more than one.

Dr. Howzell:I can pick more than one? Okay, thank you. Not to be biased, but Changing Course by Dr. Claudia Black. For me, reading that book was an eye-opener, although I’m not in recovery myself. I did have family members, particularly siblings and parents who struggled with that. For the first time reading something that spoke to me about experiencing what it’s like to be in a family system where there is addiction and trauma was huge. It’s a huge eye-opener. Again, I go back to, “I’m not the only one.”

I would say that my absolute favorite book about addiction and recovery is Addicted to Chaos. I think it speaks to our young adults a lot. There’s this extreme thing, “I got to go hard in the pain.” You know, “I just can’t eat one cookie. I’m going to eat 35 bags of Oreos and I’m going to do it on YouTube and Instagram and go viral.”

Just helping them understand that although it’s not a substance that you’re addicted to. There are emotions, there are other processes that are just as powerful and can quickly overtake your life. We see that. How many times do we see that with celebrities? Particularly young adult celebrities. Intensity is real and it’s addictive.

David: All right, I’ll wrap up with this final question. What would be a favorite piece of advice that someone gave to you that you’ve used in your life? Something that you find yourself passing on. What would be something you want to leave with someone listening?

Dr. Howzell: You can’t do it by yourself. I hold on to that. No matter– If it’s work, it’s life in general, building relationships and having somebody either hold your hand or hold you up is really, really important. There is a campaign going around now, I don’t know if you heard, it’s called Check On Your Strong Friend. If you’ve been like me in the past where you have this positive impression management and everyone thinks “she got it together”, but you’re like a duck where it looks smooth on top but underneath is just paddle, paddle, paddle…

David: You want to be the one who’s like, “She definitely doesn’t need help”?

Dr. Howzell: Yes, “I got to hold it together.” I would say just being open and vulnerable to support. I work on it daily as I’m sure most people, in particularly my young adults. I would never kind of preach or educate them with this if I wasn’t walking on that journey myself.

David: Dr. Whitney Howzell as the Clinical Director at the Claudia Black Center for young adults, which is part of Meadows Behavioral Healthcare in Wickenburg, Arizona.

You can find out more about how they approach helping young adult men and women heal from trauma and addiction at www.claudiablackcenter.com.

To check out more episodes of this podcast and to find all kinds of other resources and tools from Meadows Behavioral Healthcare, visit beyondtheorypodcast.com. Finally, thank you for listening and I hope you’ll join us again next time for another episode of Beyond Theory.