S2 E6: Sean Walsh on Changing the Narrative Around Behavioral Health

When Sean Walsh began his recovery journey in the late 1990s, he could never have imagined where it would take him. So now as he leads Meadows Behavioral Healthcare into the future, how does he hope to change the way we think about addiction, trauma, and mental health… and the relationship those issues have with healthcare?

Podcast Transcript

Sean: Hello, I’m Sean Walsh. I’m the president and CEO of Meadows Behavioral Healthcare.

Interviewer: All right. Sean, thank you so much for being with us today at the Rio Retreat Center on The Meadows campus in Wickenburg, Arizona. Thanks for joining us.

Sean: I’m excited to be here.

Interviewer: All right. Well let’s start by introducing you. Sean Walsh the person, tell us about your story. I know you have some history with recovery yourself. You can start there.

Sean: I’m a person in long-term recovery. I got sober young. Got sober at 18, which is I feel very, very fortunate and blessed and lucky in a lot of regards to be able to enter into recovery at such a young age. That also can tell you what type of 18-year-old I was, to end up in that crisis.

Interviewer: That you had gotten to that point so quickly.

Sean: Exactly, it doesn’t usually happen by accident. Usually progression tends to be a little escalated, but I was pretty resigned to the fact that I probably wouldn’t live to see young adult, 2021. I was okay with that. I thought I’d seen enough of life and my disease had taken me down pretty fast. I started using at a very young age and found myself in some trouble and ended up in treatment and ended up getting introduced to recovery. As a young adult, I think like a lot, but particularly young adults, had a few relapses. It took me probably about nine months of being in and out.

Then I finally got sober, stayed sober, took the suggestions and really have been in this field almost since then. Got my first job in the field when I was 19, so pretty much been it’s all I’ve ever done. My last last job outside of this field I was 18 and a cook in a resort.

Interviewer: Feels like a long time ago now.

Sean: It’s all I know. It’s all I’ve ever done.

Interviewer: Looking back at your recovery, your journey, what was it that finally clicked for you? What worked? What has made it last so long?

Sean: Well, I think it was a combination of things is I was really fortunate when I was young to get plugged into what I think 12-step programs are intended to be, and that I did some counseling and then also got plugged into a 12-step group that I went through the steps. I did the step work immediately. I talk to some people early in recovery who takes them two years to get their fourth step done. I was doing my fourth step at 30 days when I was just– Had a sponsor and a group of older men who really took me under their wing and just showed me what recovery was like.

I was really fortunate. Then the other part that’s really a humbling God thing, is the way I looked at it, is the outpatient program I got involved in was all based on the Meadows model. I was 18 years old and I got handed my first copy of Facing Codependencyby Pia Mellody, and went through an outpatient individual counseling with some individual therapists who are really trained in the Meadows model. To be 24, 25 years later, sitting here in my seat at the Meadows and get to sit at the table with folks like Pia and other senior fellows is pretty humbling and surreal.

I think I was really fortunate that sense that really early on, and particularly even just developmentally while I was a young adult, I was getting into my core issues. I was looking at that family of origin. My therapist at the time was the executive director at the Meadows for 15 years. He was doing work with me and a lot of the things that make us who we are. I was introduced to Claudia and Patrick Carnes and Pia and was going to Meadows sponsor this, what got me on fire to go into this field, become a therapist.

Interviewer: Became your foundation.

Sean: Absolutely. I told Pia that when I came on board about eight years ago, that she’s impacted my life, my recovery in more ways than she’ll ever know. She has for many people around the world. I think that was really pivotal in the fact that I was able to maintain some sobriety at a young age is that early on, I learned that it was about a whole lot more than just not drinking or drugging, that it was about dealing with those kind of core issues and learning how to live life sober and all the things that contributed to my use in the beginning.

I think it was that, a combination of good 12-step understanding, what it means to live as a person not using recovery, and then also getting underneath some of that deeper stuff.

Interviewer: I know another piece of the puzzle for you is your faith. You actually even went to the point where you did some training at a seminary. Talk us through that, what role did that play in it for you?

Sean: I mean, that happened early on. I think like many of us, I came into recovery, not a person of faith, a lot of baggage around faith. It took a lot of work to take me through that second, third step process that there was something. It really was the steps initially truly understanding what it means to be powerless, that this disease is bigger than me. This disease is bigger than even things like love and the things that I may care about in my life. As I became a therapist and even as I got married and had kids, just understanding what that looked like.

Even after I was already licensed, had my degree, was pretty well off on my course where I thought my career was. There’s a program in a local seminary that had counseling program. It had some professors that were some pretty well-known deep thinkers, and I just didn’t take it for a degree. I went in there to start soaking that up. That was really how I envisioned my recovery continuing to grow, was just continuing to foster that faith. It’s been a part of my story from the beginning.

Interviewer: The Meadows has obviously meant a lot to you. How would you describe one or two things that makes the Meadows different, for someone who’s not as familiar with it as you are?

Sean: I think the big– There’s two ways. I mean, one is what I mentioned even in my story a little bit, that the Meadows really pioneered the way 43 years ago with looking at underlying core issues and trauma. I think in the last maybe 8 years, 10 years or so, the prevalence and the impact of trauma has on mental health or behavioral health in general is on everybody’s radar and everybody. The more we understand about the brain and the more modalities we have that impact those things, everyone’s going, “It’s all about trauma,” and not just with substance use disorders, but with eating disorders, or process addictions, or anxiety, or mood disorders.

Meadows’ always led the way with that. That even when it wasn’t real popular. I share a story often. I remember my second job interview when I got licensed, and I was for a therapist position in an outpatient program. The clinical director was interviewing me, the clinical “What are you going to do if a patient comes in and tells you that they’ve been molested most of their childhood?” I was little thrown back and I’m new therapist and this was a primary substance abuse place.

I was going, oh, thinking about my answer and before I could say anything, he said, “I’m going to tell you what you going to do. Nothing. You don’t go there. That’s not your job. Your job is to teach them how to get sober. They deal with that in stage two recovery. They deal with that or they get the year or two sober. You do that now, you’re going to overwhelm them, and you’re going to trigger them, and you set them up to go back and relapse.” I was like, “Okay, good.” Because I don’t know what to do with that, and I don’t want to do, I’m scared of that.

That’s how a lot of addiction recovery has operated for the last 50 years. What the Meadows and our senior fellows really look at is that those aren’t mutually exclusive. If we don’t get into those core issues, and we don’t bring some healing and recovery to that, that person’s never going to get a year sober. They’re going to continue to relapse and struggle, or maybe they can scrape together some sobriety, and they’re going to start to act out in another way. What the Meadows has always done is dug into core issues. What’s driving this behavior? That can apply and work, whether it’s substance abuse, or eating disorders, or codependency. That’s a big one. That’s what the model is.

When you hear the Meadows model and what Pia had developed in the model of overview, developmental maturity, it was really groundbreaking and pioneering. Over the last, again, 10, 15 years, the science and the research and the evidence is supporting that and showing, wow, that was onto something. The other part is our senior fellows that we’ve been really fortunate over the years and that really all started with Pia, and then it was John Bradshaw and Patrick Carnes and Claudia Black, and these pioneers, just having industry thought leaders that were writing the books I was reading in grad school, or that are doing the research right now that will influence the next generation of grad students for 10 years.

Patrick Carnes is Fulbright Scholar doing research on the genetics of sex addiction right now in Canada. Bessel van der Kolk’s pioneering away. The affiliation and the ability for us to have a team of 12 industry thought leaders that are intimately involved in our programs, that they train our therapists, they train our staff, they help us do program development when we want to go roll something out or launch something or enhance. We’re really, really fortunate.

I was sitting in a meeting with Patrick Carnes probably like six years ago, and we were out with a PR firm. We were talking about it as PR person has no idea of our industry, he was asking what that meant. He said it best and I’ve stole it from him ever since. He said, “There’s about 18 or so people in our space that are really doing the research, writing the books that will influence those next generation of grad students.” He said, “12 of themwork at the Meadows,” and I was like, “Wow, that’s true.” [chuckles] I’ve been a live wire to a lot of treatment centers. I’ve been to a lot of places around the country, and a lot of people do a lot of similar things.

We all have this alphabet soup approach if we all do these different modalities or interventions. David Anderson, our executive director at the main campus, often says it’s the spaghetti at the wall approach, which I loved and said, “It’s whatever sticks,” which is true in a lot of regards. One patient may really resonate with EMDR, and that may do a lot of work with them. Then they do 12-step, and then we have family component. We have all these things that we know work, or part of the recipes for recovery. The difference is that underlying all of that is this model, so that it gives patients almost a foundation, almost a vocabulary, a specific language that they can gauge their progress through.

Even when we do EMDR, we do 12-step. As that therapist is working with them and they’re doing a first step in group, they’ve been trained in the model and what we call Post Inductive Training, PIT so that they’re going to say like, “Oh, hey, doing that first step, sounds like you just went one down. That sounds like that’s caution number three, that’s esteem issue.” They’re going to see everything through this lens of developmental trauma. Even the equine, they go out to the equine arenas, they’ve got master’s level, equine therapist out there, but guess what? The model is on a tarp out in the arena.

That is a big differentiator is, everybody does EMDR, lots of people do somatic experiencing. We’re really fortunate that we have the founder in creative somatic experiencing on our team, but even while they’re doing see or somatic experiencing, they’re doing it and having that model as this overview blanket to help ground the patient.

Interviewer: Looking at how this plays out, looking at the patients, their families, who oftentimes when they’re coming to the Meadows for help, they’re at the lowest point, they’re in a very hard place. What do you hope that all this work, all this preparation, all this training, what do you hope that that leads to them taking away? What do you hope that they take away?

Sean: Yes, it’s funny. When we went through that program development process about seven years ago, we came up with like, what’s our goal? What’s our mission with every patient? It’s tricky, because we treat so many things. You can’t say sobriety, because we have about 40% of our patients that come that aren’t substance use disorder patients. We have patients that may come just for an anxiety disorder or just for trauma. As an organization, our mission, our job is to provide hope and healing. That applies to the eating disorder, the process addiction, inpatient, outpatient, that I want our patients and our families, because their families are patients.

They’re alumni of our treatment and program to leave with hope, because often they’re coming in hopeless. They’re coming in on the worst day of their life. To remember that, and we go to every new employee orientation, and we try to charge everybody with the mission of what we’re about and to remember that patients who are coming to us, are coming generally at the worst time of their life. Remember what you were like in the worst day of your life. Like generally, we’re not real gracious, we’re not real understanding, we’re not real compassionate, we’re weak, maybe you’re impatient.

Then they’re coming with a lot of trauma, maybe some addiction, maybe some mental illness and to balance good customer service and to treat a customer like a customer, but then at the same time give the grace that’s allowed to have them be at their lowest point, because oftentimes in this job it can become a job. It’s a J-O-B. We want a team, and most people who come into this field are coming because the calling, they cannot come here for a paycheck. They’re coming because they want to help bring hope and healing. I tell people often in the new employee orientations, I’m guilty of that.

I’ve come into many places, and we have our own stuff going on our own life, and I just put on my work hat. I’m not really engaged, I’m checked out, and I don’t want that. We don’t want that. We want to have a culture we can tap on each other, be able to lean on each other. If I’ve got crisis, my own stress going on my own life, I need to be able to count on my co-workers, because if we show up in that interchange, and whether that interchange with a patient is at the lunch line, or whether it’s at housekeeping, or whether it’s in group, or with my psychiatrist, or what have you, just knowing how critical that is, that again, they’re looking for hope and healing.

My convicting story of that is I was working at a place and was sitting down with someone, that day it was a J-O-B. I was a little checked out. I went through the motions, and then the next day this patient came in, sat down with me and he said, “I just want to thank you,” blah, blah, blah. He said, “I came in here– ” It was an outpatient setting, wasn’t residential. He said, “I had a gun in my mouth.” He said, “I was done,” and he said, “I’m just looking for something– “

Interviewer: In the parking lot?

Sean: In the parking lot.

Interviewer: Oh wow.

Sean: 50 feet outside my door. That rocked me to my core, because I sat there and I was like, “You know what? If I was honest, Mike, I wouldn’t hear. I was checked out. I was gone. Like I did your admission. I did this. We did a first group, but I was worried about my stuff.” Again, we’re human, we can only do that, but it gave me just a daily reminder of, you never know where they’re coming, what they were doing five minutes before they’re with you. It’s probably a safe bet in our industry what they were doing five minutes before you wasn’t great, and they’re coming in pretty broken.

We instill hope that, “This will pass, it can get better, you can do this, we’re here to help guide you in that process.” That’s kind of global. Beyond that, clinically, we looked at what our goal is, and we wanted to increase resiliency and regulation, because again, whether it’s a substance abuse patient, and whether it’s an eating disorder, or whatever the process addiction may be, or mood disorder, if we can increase a person’s regulation, meaning their central nervous system’s more regulated, whether that’s through biofeedback, neurofeedback, or a lot of the interventions that we do, they’re going to be better equipped to be successful in recovery.

Then if we can increase regulation, they’re going to be better equipped to be successful in long term recovery, even if that’s recovery from anxiety, or that’s recovery from substance use disorder. Everything we do in our process, we looked at from the time a patient wakes up, to the time they go to bed, is it with a goal of increasing resiliency and regulation? Even things like yoga or maybe an ancillary service that are great and some physical activity, we look at through that lens. We say, “Okay.” Well and again, one of the benefits of being part of organization say, “Okay, well our yoga instructors, let’s send them through Bessel van der Kolk’s trauma-informed yoga training.”

So that it’s doing it, again, looking at this actually increase in your regulation, [crosstalk] changing your central nervous system. Those were the high level. We want people to leave more regulated, more resilient, and with hope and healing.

Interviewer: Looking at a bigger picture kind of question now. What’s one thing that you hope the general public could understand better about this? What’s a misconception, something that people are missing that you’d like to impart?

Sean: I think the biggest challenge that we still face, I think it’s getting better, but is that stigma around mental health in general, is the fact that oftentimes we only look at something like treatment and whether that’s, again, something intensive, like a residential stay, or a week workshop, or a outpatient, is that that’s something you need because of some crisis that brought you to that point, instead of the fact of looking at the fact that this is something we all deserve. This is something we all– It’s part of the human condition that trauma is going to happen. We all experience it, we all have our own as part of generally everybody’s narrative in one fashion or other.

Some are more acute than others, some may bring you to something like a residential, but to get rid of that stigma, that there’s something wrong with you, there’s something that caused this to come in, just instead of looking at this like health care. Looking at this like definitive–

Interviewer: Definitive aspect. Yes, exactly.

Sean: That I would love and I think that’s the goal. I think there’s people in our industry, and I think people that have a public platform that are being really brave and coming out and talking about their mental health. They’re talking about their struggles with anxiety, and it doesn’t have to just be this celebrity that got their third DUI or went in rehab or some of those experiences, but just saying, “Yes, we all struggle at one point or another in our lives.” We know the statistics that, what percent? Is 10% of the population struggles with substance use disorder from a diagnostic criterion, and only about 10% of them get treatment, but we know beyond that, just the impact of whether you’ve had a family, you’ve had a loved one, you’ve had a season where you struggled with this, and that it’s health care.

Again, it’s not the failure of willpower. It’s not. That’s my hope and goal, that we can get there. Just like you go to see your primary care physician, or you go to a chiropractor, or you look at your diet, as far as overall healthcare, that mental health care falls into that. That this is a brain issue. It’s brain disease sometimes, and that treating it is no different than taking care of your diabetes or taking care of your diet.

Interviewer: Looking at two tips that we can leave the listeners with. First, what would be one book, favorite resource, something that you could pass on to somebody who wants to dive a little bit deeper into this?

Sean: Yes. It’s two, it’s tough. I think about the more influential books in my life and in recoveries got in this field. There’s the big book of Alcoholics Anonymous, because I look at that, that it’s coming up on almost 100 years ago. The profound insights that Bill Wilson and the early folks had on what addiction and just recovering gentleman looked like 100 years, it was unbelievable. Nothing can touch it, but then and again, I’m not biased, [chuckles] would be Facing Codependence, Pia Mellody’s first book.

Again, looking at really outlining what codependency was, through the mid-’80s, that was a new term to us. This idea of these underlying core issues that impact everything. The beauty of it, and I think it’s the best that outlines the model, is that regardless of the issue– Because too often, I think there’s a lot of recovery texts out there and ones that are better for sex addiction, or eating disorders, or anxiety. Again, you could see that whatever I may be struggling with, you can plug it into that model and realize that it fits, it works. That those kind of secondary symptoms that happen are often driven by these core issues. So, those are profound ones.

When it comes to the stigma aspect of it, of changing that, there’s a book by a psychiatrist called A First-Rate Madness, where he profiles different leaders throughout our time. They’re all in a struggle with mental illness. Winston Churchill and Abraham Lincoln and all of these different significant, profound leaders and show mental illness, addiction, and how, again, oftentimes that contributed to their greatness, but also was this kind of Achilles heel if they didn’t treat it, but it helps take that stigma away. That we’re like, “Wow, some of the most amazing, productive, powerful, influential leaders in our history struggled with this.” That’s again getting rid of the stigma of we all do.

Interviewer: Yes, and just that mental health isn’t proportional with success. There’s-

Sean: Absolutely not.

Interviewer: -people are all across the spectrum.

Sean: Absolutely.

Interviewer: All right, we’ll then wrap up with this. What’s a favorite piece of advice that’s meant a lot to you, that you find yourself passing on?

Sean: Early on I was, and particularly because I was so young, I was a skeptic. I didn’t believe in the hype. I didn’t believe these people who presented this hope that life could be better and that you can recover from these things. Someone sat me down, and he said, “Look, what do you got to lose?” He goes, “Give it 90 days. You just give it a shot, but give it a shot, like really do it.” He goes, “If you’re not any happier, if your life’s not any better, go drink, go drug.” Some of us are sicker than others, but in my mind, I was like, “I’ll show you. I plan on drinking my 91st day.”

I was like, “You got to do the deal. Go to counseling, go to 90 minutes, 90 days, work the steps [crosstalk]. Get rid of– Don’t just white knuckle it, live the same life you’re doing, because you’re going to be miserable, but do that.” For the first couple of months of my recovery would sit around and he would say, “How long you have sober?” I’d be like, “Oh, 64 days, but I’m only staying for 90.” I told people that, and at 90 days, I wasn’t healed. Life wasn’t perfect, but I was happier, and I was– I still wasn’t all in, I was doing the one day at a time, but I said, “I’ll give it 90 more.”

That old lifestyle, that old way, whatever that substance was, behavior was, compulsive thing was, it’s never going anywhere, it’s always going to be there. It wasn’t working real well for me,so someone just chant like, “What do you got to lose? The choices you’re making the life you’re living right now don’t seem to bring in a lot of peace, contentment, serenity, try this. Then it doesn’t work, go use.” That took the weight. I was like, “Oh, okay, because I just struggle with this,” like, “Well, I’m not– I can’t be sober for the rest of my.. Yes, I guess we were young. I was like, “I’m not going to be sober my 21st birthday. Who stays sober when they turn 21?”

Your head can just run with you, and that just-

David: It’s overwhelming, yes.

Sean: -gave me permission to relapse. Just to say like, “I’m not committing this the rest of my life.” That’s again the whole one day at a time and all the cheesy sayings we have in recovery. It was just a practical way for me to go, “I can do this,” or, “Let me– ” I couldn’t deny the fact that I was miserable. I was not happy. I didn’t have peace and joy and contentment in my life. He could see that in my eyes, and I saw something in his. I was like, “All right,” and again, had a spite almost a little bit. I’d be like, “Screw you, alright, I’ll show you. I’ll give it 90 days, and I’m getting loaded on my 91st day.” Well I was 22 years ago, and I still haven’t got loaded because things keep getting better.

David: Sean Walsh is the CEO of Meadows Behavioral Healthcare, which offers integrated trauma and addiction treatment at locations in Arizona, California, and Texas. Learn more about Sean and the rest of the Meadows leadership team at meadowsbh.com.