Addiction in Ultrarunning with Dr. Harlan Austin | KoopCast Episode #188

trail and ultra runners what is going on what's happening welcome to another episode of the KoopCast as always i am your humble host coach Jason Koop and this episode of the podcast is all about addiction and endurance sport and specifically within the sport of ultra running this is a topic that i have wanted to tackle for a very long time ever since the inception of this podcast in fact yet i have not found the courage nor the right expert to bring on the show to date but that all ends today my guest today is dr harlan austin PhD dr austin is a licensed psychologist with national certifications in sports psychology and addiction psychology he has two decades of experience working in both the sport and clinical psychology fields during his career he has served in many roles including performance consultant clinician program director and clinical director he has lectured and presented at national conventions on the topics of sport and performance psychology clinical sports psychology athlete psychological assessments athlete rehabilitation and athlete return to sport dr austin has also worked with a broad array of professional athletes in the nba mlb nfl boxing lacrosse ski and snowboard in addition to that he has worked with athletes or he has worked

with professionals in the health care system u.s special forces groups and high level executives and on the podcast today we want to discuss the intersection of sports psychology performance and addiction now although i have not personally suffered suffered with addiction it is a topic that is near and dear to my heart and one that i have had to grapple with in both my professional and personal circles in too many ways to comprehensively cover in this intro i dive into some of those connections during the course of this conversation and what i ultimately hope that you the listeners can come away with is a is an appreciation for people suffering with addictions and a toolkit to help anyone that you think needs it all right with that as an intro i am getting right out of the way here is my conversation with dr harlan austin thanks for coming on the podcast um as i was mentioning off air uh this has been a topic that i've wanted to do for a long long time and and honestly the very first podcast guest that i had uh that i had on this podcast was a person by the name of david clark who i know you're probably not familiar with but he was a great dear friend of mine and i had this very prototypical life turnaround story where he was uh a alcohol and drug addict as well as a self-professed fast food addict 300

over 300 pounds and then became a you know a fantastic endurance athlete and he became a you know lifelong uh lifelong friend of mine and ever since then ever since he and i you know kind of partnered up to do a lot of radio shows and podcasts together and just collaborate on a lot of different things i've wanted to to tackle this very topic but i've been reluctant to do so and also finding the right practitioner to discuss this with is kind of eluded me so far thus far so thank you for coming on and and and from the bottom of my heart i just really appreciate you taking the leap and uh discussing this with the audience i'm happy to be here so thanks for inviting me so so to start out with like just so people can get to know you and kind of your scope of practice a little bit better can you kind of describe what you do what you do professionally and then more broadly speaking what your entire group does because you have a very impressive uh organization uh built up that has a just a i was i was uh astounded by the breadth of the professionals that you have underneath the umbrella sure yeah so uh i'm a sports psychologist and i currently work with premier sports psychology which is the pretty sure it's the biggest firm in the us of sports psychologists and the the work that i do certainly kind of there's a couple of overlapping circles with it so you know my initial training experiences come from the sports psychology

lens and my doctorate is in counseling psychology with a specialization in sports psychology and so through my doctoral work the training was all aimed at becoming a sports psychologist so that allows somebody to be a licensed psychologist with specialty training and supervision in that sport and performance psychology world along my career path i also ended up working in the addiction world and getting a certification in that realm as well and then through the years of my career have had an overlap between those two worlds and certainly if we think of it like a venn diagram the world of athletes in the world of addiction there is an overlap of those two circles and it's probably a bigger overlap than there is uh in the general population when we look at those two circles um so uh premier sports psychology was uh initially founded by dr justin anderson and dr carly anderson they they um are sports psychologists that i met um you know early on in my training experiences back in the doctoral days and um they went on to create this firm that specializes in performance psychology and working with athletes of uh a lot of different levels certainly premieres worked with any number of different professional leagues organizations um olympic level athletes down to the recreational athletes and you know aspiring future stars and uh in the youth sport realm so um through the years they've grown and grown and i'm uh

you know recently transitioning to be a part of that team and i'm very excited and uh very flattered to have been invited to be a part of that team so so based on that you're the perfect prototype practitioner that's hard to say prototype perfect prototype practitioner to come on this podcast and discuss this because like i said earlier one of the things that's alluded that has eluded me in in in trying to formulate a podcast with this particular topic is just finding the right person that exists within that venn diagram overlap that you that you had just mentioned so we are going to talk about addiction in sport and addiction within endurance sport and maybe even ultra marathon specifically but before we do so i i think it's extremely important to start to lay some of the groundwork because this word addiction gets used in two very different spheres it gets used in a clinical sphere and it also gets used in more of a colloquial sphere if we kind of look at the lay literature and the lay population uh out there and everybody's out there everybody listening to this podcast knows somebody or has been uh or has experienced this directly where they've said i am addicted to something i'm addicted to sugar i'm addicted to exercise i'm addicted to whatever it is in a colloquial setting and i want to make sure that we make this distinction kind of right off the get-go just so that the audience understands kind of what we are fundamentally talking about so when you are going to describe addiction throughout the course of the next you know 60 some odd minutes of this podcast

how how are you viewing that how are you viewing that and are you taking it strictly from a clinical diagnosis or does it encompass a larger umbrella yeah it's a great question because it really does have this two realms of meaning the popular psychology of the popular language realm and certainly the clinical lens that we look at things through you know the interesting thing is there's not a diagnosis diagnosis in our clinical manual with the word addiction so if someone has an alcohol addiction it's not a clinical diagnosis you would ever get in a medical chart substance use disorder severe or alcohol use disorder severe is the clinical term for that and so um i think that addiction as a disease model is something that the clinical world speaks of and understanding what happens to the brain and how the brain has changed when there have been repeated addictive behaviors typically associated with a chemical but not always sometimes it's associated with a behavior or a process and so we call those process addictions and we have chemical addictions so those are ones in which we look at there being a problem in somebody's life as a result of what's happening and that problem is biopsychosocial in nature so it's not one thing it's not one area but multiple areas of somebody's existence that are clinically significantly impacted in a negative way so you mentioned earlier that you exist at

this unique intersection of sport and addiction and right out of the gate one of the one of the things or one of the aspects of my aspects of my professional life that has compelled me to want to do this podcast for a very long time is my professional experience where i have had over the course of the last almost 20 years now i've been a coach for over 20 years as a professional and i would say for about 18 to 20 of those at any one point in time my athlete roster has about 30 percent of its population that has recovered from or is in recovery from whatever vocabulary we want to use there any number of addictions right some of them are eating disorders some of them are alcohol addiction some of them drug addiction some of them kind of all three and i've coached athletes kind of on both sides of that uh of that process meaning while they were an addict unknown to me even as a coach when they went through rehab and then kind of come out of rehab i even have that experience and so it's been mysterious and perplexing to me from a number of different angles and the first one i kind of want to approach it is just the sheer proportion so you mentioned that it might be more so than we give it credit for what should we be giving it credit for is this something that that more people are being affected by then we could then we can kind of comprehend yeah if we're talking about athletes we can look and compare them to the

general population of folks that we wouldn't lump into the category of serious athletes and let's not worry about whether we're talking about professional or not professional but people who are serious athletes who have an athletic identity and if we look at the general population there are some varying statistics but anywhere between 12 and 15 percent or so of the population will be able to be diagnosed with a substance use disorder at some point in their life and we know that by comparing those populations that the athlete population has a higher rate than the non-athlete population of being able to be diagnosed with a substance use disorder at some point in their life and there are several factors that contribute to that but we do know that we see higher incident rates of addictive disorders substance use disorder diagnoses within the athlete population so what so so my experience kind of matches up with that and and and here's kind of what here's here's ultimately what i want to try to convey during this podcast or basically produce during this this podcast is i want to i want athletes and friends of athletes and coaches that are out there listening to this to have some semblance of a toolkit because this is something that i i gotta be honest with you i was woefully unprepared for and i still am under equipped for in my professional career and if you would have told me when i very first started that over let's just say over 25 percent right my experience is about

30 percent but over 25 percent of the people that you would actually work with during the course of your professional career has has experienced some form of addiction i don't know if i would sign up for that job because once again that's not how we're classically trained as coaches we're trained in physiology and you know there's a little bit of sports psychology and things like that but that's a really remarkable statistic to just take into account from the onset for anybody who is thinking about working with athletes in any type of capacity yeah it's a lot especially if you're thinking that in working with this population i'm somehow going to be responsible to help them with that yeah and and that's that's a big ask right and and i think from the coaching perspective i would want to say that you know being able to help someone is is certainly not going to be under the purview of what you need as a coach but what you want to do to be a great person is to be able to connect people to the help that they may need and so i think when folks are in the realm of coaching of pretty much anything in the athletic world it could be athletic trainers it could be physical therapists the ability to understand what maybe some signs and symptoms are is a really valuable tool so that you might be able to help refer but you can't refer someone to help unless you can identify some of the signs first and so that ability to identify and then just recommend

refer help connect somebody to people that might have a little bit more knowledge about what the change process and how to help them with that change process might look like is is a really valuable thing for folks in the sport world okay we're going to come back to the signs and symptoms in just a little bit so let's let's earmark that and tuck it away for just a second but i want to come back to this intersection of athletics and addiction and you mentioned that that the athletic population is at a higher risk why exactly is that or do we know why that exactly is like why do athletes and maybe even particular endurance athletes have this higher you know risk associated with with that particular population yeah it's a great question it is the question in the world of addiction in sport there's not a simple answer to the question certainly we can talk about some of the factors that other researchers have identified and thought to be contributors it's not a simple thing to say well this is it for everyone and so that's what makes it so complex to work with this population but certainly if we look at it from a lens of everything happens within a social context and and that's a part of this and so often folks who are in a social world in which they're striving and they're trying to go hard and they're trying to achieve there's also a reward part of that story the celebration and so culturally in a lot of sports just turn on the tv and what happens when somebody

wins we could go from car racing to a a nba championship or many different examples and you see after they win the championship what do you see they're shaking a champagne bottle popping the top spraying everyone around them and that is something that is i think throughout many many many different sporting contexts the idea that there's a reward that comes at the end of this certainly it's ice cream when we're talking about t-ball and youth soccer but it evolves over the years and much like the general population that starts to experiment with celebratory social settings and using alcohol and drugs the sport folks are no different but they have a life in which celebration has more of a calendar to it there's more opportunities for us to be all working towards the same goal together we're all striving and when we achieve hip hip hooray that's something that gets built in and it creates the opportunity for folks to start to pair celebration and this key point in development when adolescents are experimenting in the world and particularly in our country here as we see that happening in the teen years people are getting more and more serious with sport in those years and you can start to see how those celebrations start to be modeled after what they see in others who have been in sport now um that's one side of it of course there's the other side of that too which is let down and what happens when we don't win and how that's devastating and then what gets role modeled around folks when you

aren't feeling good when you're feeling sad and again this is where we look at the social context in which people are in and if we have a greater uh community in which people use drugs or alcohol for self-medication and you have an athlete who grows up in that community and then they are feeling sad or feeling let down because they lost the big game because they're having a tough season because they didn't run as fast as they wanted to run they follow the models that are around them and so that social component of yeah medicate when you celebrate and medicate when you feel bad is there in a social context and athletes are growing up in the same social context as everyone else the difference is they're also in this world in which there's these opportunities for successes and failures maybe more often than some of their peers because of what happens through the nature of competition huh i hadn't thought about that before that just simply because of this emotional athletic roller coaster that you're describing of the wins and the losses and having to go through those that somehow that is like it's almost like a flywheel right to transpose that those highs and those lows and use a different mechanism essentially to achieve them from sport to drugs and or alcohol is that kind of what you're describing there mm-hmm certainly certainly and again the role modeling that's around culturally this is a thing in our country addiction is a thing in general 15 of the population are dealing with this but even more than that are using drugs or alcohol in those ways they maybe don't qualify for a diagnosis but they're using

them in those ways and so athletes who have this accelerated opportunity to feel those highs and lows may start those habits earlier because they're just getting you to experience it more often in their lives well and also i have the experience of you know i i work with a lot of very high caliber athletes but i also work with a lot of amateur athletes that have the same characteristic where they are all in they their whole life revolves around whatever they're training for at you know at that one particular time and there's a behavioral analog of being all in to to what i've also seen how they treat drugs and or alcohol right they take that all in mentality and they translate it over to a different you know portion of their life and have kind of the same behavioral pattern but underneath a substance as opposed to underneath an action where worth is worth is training and it's always been hard for me to pick up on that or decipher that because i kind of know them through that personality you know what i'm saying yeah yeah and you're making a great transition from the social piece to this to the biological piece to this so there is a biological component that's also there for athletes that may not be there for the general population at the same levels and that is that striving and getting the rewards that are innate participation in sport right so the wiring the hard wiring in the reward system in the brain that's releasing dopamine that says oh that feels good right we access that through participation in sport

i mean in particular we're talking about ultra marathon running right it's this chasing that high the runner's high that's there well there are real neurochemical things that are happening with that and so folks who tend to engage in sport get neurochemical rewards for engaging in sport there's medicine in exercise right it's a clinically proven treatment for depression and so we know that it does something it changes neurochemicals in the brain we get more of those happy chemicals that are released and so some people and it's a percentage of the population who engage in exercise behaviors are going to get those and they're going to say oh that feels really good i need more of that i need more of that not everyone who engages in exercises becomes addicted to exercise but a percentage of the population is just like not everyone who drinks alcohol or smokes marijuana becomes a substance use disorder diagnosis person but a percentage of them does and so folks who are engaging in the rewards of sport certainly have some percentage of them that are going to end up responding to that dopamine release from a win from the runner's high from just benefits of it in a way in which they're going to keep saying more more more i want more of that okay so we're going to kind of get into signs and symptoms now this is a good transition point because i don't want everybody to come away with oh well if you like you just mentioned if you start exercising you're predisposing yourself to becoming addicted to to exercise just if you start drinking you're predisposing yourself to become

addicted to addicted to alcohol and i want to set this up with a with a personal story and this person would not mind me telling the story it's out there in the public and he and i've had many many dialogues about this and i think a lot of the old school ultra runners will actually recognize this this person's name so in the mid 2000s i coached this guy named jim hoffman and he was a reasonably successful ultra marathon runner he placed very high in western states very high in wasatch and i coached him for years he and i had a fantastic relationship i went over to his house a few times every year and hung out with him and his family and we did these you know all these training camps and stuff like that and from one day to the next he literally disappeared off the face of the earth like like honestly i could not get a hold of him i went i traveled out to utah to his house to go track him down short of hiring a private investigator and went through every means necessary to to try to find him and to make a long story short it turns out that during our coach athlete relationship which lasted years and we were very tight this was not a strictly remote relationship i like i said we had many many personal interactions where we're doing camps and things like that during the entirety of that he was addicted to heroin and he was showing up at races still high and or hung over on heroin and still performing actually kind of quite well like remarkably well and i was completely oblivious to all of this and so after he emerged from getting sober which is why he you know which is why he kind

of went off the the face of the map so to speak and why i couldn't get a hold of him he went through and he told me all these things like this whole thing like the whole the whole story right he's making amends and i felt like an idiot for not recognizing anything and the one piece of comfort that that he offered is like listen uh addicts are really good at hiding their addictions and i didn't give myself any comfort in that i i honestly i beat myself myself up a lot for missing whatever i should have found and so it's with that personal story that i kind of lean into this when coaches are working with athletes or you just have a running friend or a running buddy what are some of the things that they can actually look towards to start to decipher this to to to at least get a fix on you know what maybe i should at least bring this up in conversation or get them some help or whatever because it has certainly been an area that i even in the most intimate coach athlete relationships that i've had and this was a really good example of one where i knew him very well i completely missed the boat completely 100 missed the boat so what would you say to people out there that that are going to have a similar experience certainly if they if they encounter somebody who who uh who's going through something like this well there's a lot of nuance to what may show up for somebody who's dealing with addiction and and and your friend was quite right in saying that you know it's their job to hide this so they're very good at it yeah right it wouldn't perpetuate if folks weren't really good at keeping it

out of uh the sunlight so to speak yeah um but you know there are some screener questions and and this is where i think there's an interesting transition between the worlds of chemical addiction and uh we could even use this for um exercise addiction but there are there's a screener that we use that's called the cage c-a-g-e and it's just four questions and those four questions are ones in which if you have two out of those four that it's kind of like a little red flag going off that you answer yes so they're just yes or no questions and i'll just walk through it real fast because it's so simple and so easy and again c-a-g-e is the cage and the first question is um have you ever felt a need to cut down on your drinking and this was an initially developed for alcohol use so um but you can insert cut down on your drug use cut down on your exercise um but that's that cut down one is one of the questions to to look out for have you ever felt that you should cut down and that's asking the individual this um the a on here is is about annoyed and this have people annoyed you by criticizing your drinking drug use exercise right so have you thought about cutting down have you been annoyed by other people criticizing the way you're engaging in said behavior third one the g is guilty have you felt guilty about your drinking drugging engage in xyz

behavior here and so has that been something that's made you feel guilty personally and then the last one and this one is a little bit more unique to what we would see with alcohol use disorder but is have have you had an eye opener that's the e but have you ever first thing in the morning needed to use or engage in behavior to help yourself feel right to help yourself feel okay kind of to stay off a hangover with the alcohol world but any any drug you could insert that there and perhaps behavior so those are not necessarily questions you have to use as a screener for everybody but you can keep in mind that that simple cage thing and notice if there's two out of this four that are present that that this probably could use further investigation it's not a diagnosis tool it doesn't say oh xyz if you got two it means you have this diagnosis it's just these are red flags and if there's two or more it's clinically significant and chances are something's going on so let's say you had somebody who tripped a couple of those red flags right and i'll put a link in the show notes to this questionnaire uh so people can kind of go look it up for them for for themselves then what so if you have a couple of positives there i think at that point what we want to do is we want to say hey let's look at your overall biopsychosocial health and see how it relates to your performance so we're going to use the sporting context here and when we talk about biopsychosocial health the easy end when we're talking about performance is to

start with bio what's going into your body what are you doing to fuel what does that look like and then we get a real honest input on that and if we find out well yes i'm drinking are you drinking are you taking substances like that look and and the idea is i'm not having this discussion even if if you're a coach from a place of acute accusation or judgment it's just about let's do an honest assessment of biologically what's happening what's all going into the system so that we can use that data to help us find the ultimate performance path for you you can also jump over to all right what's going on with your thinking what's going on with your feeling what's happening outside of practice how are you know what what are the mood states you're in and and we're just gathering information this information is all going to relate to somebody's ability to perform at their best and then of course social again is there problems in your social life if somebody's got addiction usually each one of these areas we're going to start to have some data that is is going to be um dysfunctional but what you're what you're suggesting that sorry not to interrupt though what you're suggesting is is the person on the other end picks one of those avenues biopsychosocial and investigates it a little bit further and completely plausible for somebody like myself right i have a biological bias if you want to you know think about it like that you completely dig into the biological side of it if it's a friend they could probably dig into the social side of it right just a friend your friend talking to a friend hey listen

you know like what's going on like what's going on socially is is that what you're am i reading through the the the lines correctly enough there is that what you're recommending yeah exactly and again from the sport performance perspective starting with the biological makes a lot of sense from a friend perspective you can start with the social but the idea is if we're talking with an athlete the reason why we're gathering this information can always be linked back to their performance because all of these parts impact peak performance and when we're thinking about somebody who's dealing with addiction and we want them to make a positive or healthy behavior change we have to meet them where they're at where they have motivation to do so folks who are dealing with addiction don't respond to the message of stop doing that that's bad for you they know that right it's like oh i didn't realize heroin was bad for me thank you for that knowledge i will change my behavior now friend that's not how it goes people know that it's not good for them so what we want to do is we want to meet them with a goal that they are motivated to achieve and so with athletes performance often not always but often performance is one in which they're very motivated to achieve and then what we do is we start to develop an incongruence between the behaviors they're engaging in and the goal they're trying to achieve and if addiction is a part of that that's the incongruence so here's what a lot of people are thinking this is certainly what i'm i have a little bit of this thought going through the back of my

head right now should they just punt it to a professional meaning if i know i have you know a friend an athlete whoever that i think needs a little bit of help should i be the one investigating this as an untrained eye and i'm saying that is i'm kind of saying that for the audience that's thinking that should they be the one from an untrained eye being being the person to investigate it or should they just try to punt it over because i've heard both sides of this because as you mentioned the last thing addicts want to hear is what's bad for them because they already know that right and sometimes punting it over to a professional seems like counterintuitive to that end point so like what do you say to that what do you say to the people out there that just want to simply turn it over to somebody else that's not a bad plan i think the key is making sure that you're joining with the one that you have concern about rather than coming from a place of there's something wrong with you you know something that could be shame based it's about i want what's best for you there are some people out here who who could really be beneficial for that um if we go towards the goal that they are motivated to achieve you can say if it's an athlete hey have you ever thought about connecting with a sports psychologist they might be able to help you achieve your goals biologically you seem to have everything dialed in based on what you're telling me and xyz but we're we're just hitting some ceiling here what about that i think that referral over to somebody who does have experience or expertise in the area is is always

appropriate to do how it's done i think there's there's nuance right if it's done in a a recommendation versus a requirement yeah yeah it's typically better punt is probably not the right analogy to use is what i'm getting what i'm getting from that yeah like like just hey listen you need to talk to this person i don't want to deal with this like you need to be an active if you really are you know concerned about your friend or your you know your coaching colleague or your athlete or whatever bringing bringing helping them to get the right resources and you being a conduit to that i guess that's the better word conduit you being a conduit for that it's probably a better tact i think so yeah because shame is such a component of addiction the person who's suffering with the whether it's a process addiction or the chemical addiction they are experiencing a lot of shame and having somebody who tries to counter that shame with support is really helpful and really valuable do you need to let somebody hit the proverbial rock bottom before this before this recommendation or before this intervention or can you catch them before that cliche rock bottom piece yeah there there certainly is an existing cliche about that and i'm glad you mentioned it because it's out there oh they haven't hit rock bottom and for some people um that rock bottom maybe they lose their job and for someone else that rock bottom might be that they're homeless on the street and the through the years i've had working um with and

around folks in addiction and many of which know way more than i ever will um there is a saying that stood out to me that i thought was really helpful and it's that you can choose when to get off that elevator right the bottom floor for one person is not the bottom floor for somebody else so there is no you know rock bottom that is everyone agrees that's rock bottom somebody who's in the throes of addiction can always find a way to go lower and it doesn't have to be though you can choose when to hit open the door on that elevator and get off there i i i really like that that that as a better analogy it's like you can choose what floor to get off on in order to in order to course correct because we've all we've all heard that before oh you just need to let them you just need to let them hit rock bottom and i've always had a me personally being as you know a lot of people will say i'm not empathetic but i actually really am me being an empathetic person that means you have to let them get worse that's like it gets by coaching nature right to like let somebody actually get worse intentionally when you know that you can help them get better and so i've always kind of like wrestled with when i have had people that i know need some sort of help like what floor i personally can intervene intervene on right like how how low can i like actually let them go so i like that guidepost of you don't necessarily need them to hit rock bottom in order to in order to create that course correction yeah that'll be their rock bottom then yeah for sure that's when they made that

decision to change another thing that came to mind while you were speaking about that though is that no one has the power to make somebody else change or stop what they're doing and and it's helpful to remind folks who are seeing your friends struggle is that you can't control it you can't make it stop you can recommend you can provide support you can try to connect them to help but it's really important to to know that that we can't control it and we can't cure it for somebody else that that's the journey they're going to have to go on we just want to set up the conditions that make it more likely they go on that journey that's been honestly personally when i've had friends and athletes where i've had a relationship with them from tip to tail as i just mentioned right the hardest part is the middle because it has to happen across the other person who's trying to fix themselves it has to happen on their timeline not on yours and they have to eventually kind of figure it out for themselves and that could take a month a year two years ten a decade in some cases yeah and it's hard sitting on the other side of that because you want to do everything for them but yet you are you are kind of like helpless as to when that timeline is actually going to transpire it is it is really a helpless feeling that folks and loved ones around somebody dealing with addiction experience okay so i want to move to another area you know we've been we've used this percentage you know upwards of 15 or in excess of percent of the general population is going to experience some form of

addiction and that is probably heightened in the athletic population that means that somewhere on the other side of that are people who have gone through the process right and are recovering recovering addicts and if i mess up the vocabulary for this because i've heard it explained a couple of different ways whether you are recovered or are always recovering please please correct me um but in the since we are dealing with the population that inevitably has to train a lot for those people who have gone through that process and are recovering there's this notion of trading one addiction for another they're trading their alcohol addiction for an exercise addiction they're trading their drug addiction for a training addiction they're trading whatever substance addiction that i can't come up with right now for the addiction of finishing races and getting this big dopamine response right from the completion of the event or the celebration of the event as we mentioned earlier is that something that is healthy or should we be cognizant of i want to get your your professional opinion on that because i've heard it i've heard it from so many people in in the community that and outside of the community that how you're just trading one addiction for another and i don't know what to think of it yeah well there is the potential that you could shift from a chemical addiction to a process addiction and they could also be as destructive but you could also shift from one chemical to

another chemical you know both of which everyone agrees are destructive and so it can get complicated um i think that the the answer is it depends on what it looks like it can be problematic to shift and continue to engage in an unhealthy way with that new recovery behavior of exercise but i think that the benefits of engaging in exercise and running in ultra marathons versus methamphetamines it's it's it's not not even comparable and so it's a scale of risk that we're dealing with and yes you can have a problematic relationship with the behavior it could be sex it could be gambling it could be exercise the same way you had a problematic relationship with a chemical the key is that somebody does that internal work to understand the processes that are happening within them right what's happening with my thinking and feeling am i able to understand what my psychological needs are and how the behavior i'm choosing to engage in is meeting those needs and are there ways in which i'm engaging in this new otherwise healthy behavior in an unhealthy way and so i think that the risk of that switch the rewards are so much greater you know i would hate for someone to hear this and say well if i'm just going to get addicted to exercise i'll stick with meth you know like no we're not going to take that perspective engaging in a healthy behavior is is

is encouraged and it's going to do some things to help with psychological healing but we don't want it to just stop with oh i'm changing from this to this right there has to be internal work that's done so that somebody's behavior on a day-to-day moment-to-moment can be intentional it can be based on being congruent with their own values and it can be goal-driven but they can also be open to feedback from the world about what other people are seeing in the way they're engaging in that yeah so you mentioned the work right the work that it takes to to the internal work that it takes to to to get sobering and stay sober and any any of my friends or any of the athletes that i've worked with that have that have gone through some form of rehab or it's in a clinic or they go to aaa or some combination of of all of the above they always talk about the work and they come out of that process having a greater appreciation for the athletic work that they do being not such a big deal compared to the work that they have done and continue to do in rehab and and and beyond so your point of you can't just remove the substance and and ask for everything to get magically better certainly that is a component of it you also have to remove the substance and then figure out what was going on underneath the surface i think is a really sit is a is a really salient point in in this whole discussion and in particular

for people who are trying to help other people out you can't just remove them from the situation or take the stuff out of their bedroom or kind of whatever you want to do you also have to get them help psychologically as well agreed agreed and and that's that's an ongoing process yeah and the thing that i love about that is that that so matches up with an athlete mentality that this is always a continual process improvement i can always learn more about me better respond to the thoughts and feelings i have and make sure that i show up and behave in a way that matches who i want to be the same way that i can always work on improving my athletic performance so there's great transferable skill set here that one can use who loves pursuing greatness as an athlete that they can apply to themselves and pursuing greatness as the best version of them that they can be so i asked you this question kind of in a different like in a different context right are athletes more susceptible to being to becoming addicted to something do they also have greater better outcomes on the other side of it because they have this inherent skill set that they've developed through their athletic endeavors or even a career if they're a professional athlete do you see that as well i think it depends on what is the context in which they're doing this in so athletes in general tend and especially if we're talking about high level elite athletes they do tend to have a greater amount of resources around them

yeah coaches social support teammates all of those factors and maybe at the professional level financial and you know other things that are available to them which do help and create a better chance for success and the other part that's there is the physical health piece right if somebody's an athlete usually there is a protective factor that's happening with some of the physical health issues that may be associated with other substance use disorders that are taking longer to show up just because the baseline of health is higher and that's also going to help them in that long-term recovery process now that's not to say that just because you're an athlete you're you're going to get better easily right there's plenty of examples of athletes who have uh died and not made that recovery process occur yeah and and normally it's because they're applying the same level of intensity to their addiction as they did with their training it's like i've always thought it's this double-edged sword right because you're so intense in one area of your life you're going to transfer that to the addiction side of things but then at the same point you you should at least have the skills to bring yourself out of it because you've been so disciplined as an athlete and you should be like more intuitive about your you know relationship with everything as an athlete but it just it kind of just goes to the whole complexity of it because sometimes those outcomes are great and other times and we've seen you know professional athlete stories where this is the case sometimes those stories do not end very well yeah that's true that's true and um you know but it is important for folks to know that if we look at the whole population of folks

people who suffer from substance use disorders if we look at everyone there's a stigma out there that that there's no hope it's a hopeless case people relapse it's not going to happen but the reality is most people recover so most people more than half get better are there people who die yes are there people who struggle their entire life and never are able to find recovery sure but most people are able to recover it does take time it does take tries at it right different attempts at treatment trying again and again and again but most people can make it and i think that's that's lost often in popular culture and and i think stigma that exists um often makes it seem like people can't or don't and the reality is most people do and and that that hope that installation of hope about that process is really important for people to hear yeah and one thing that i've always heard uh from from athletes and friends that have gone through that process is this might take me a few times they they go into it with the expectation whether they inherently know it or whether a part of their treatment and i'm guessing it's more of the latter a part of their treatment conditions them to hey listen you in order to be success successful at this you've got to be willing to continually try and then try again if you do end up failing the first time or the second time or the third time and i always thought that that's like kind of remarkable like going into it and going you know what like i don't i don't it's almost like a race i don't know if i'm going to finish or not right i

don't know if i'm going to get i don't know if i'm going to get to this particular finish line this particular like treatment finish line or not but if i don't i'm going to pick myself back up and go through the process again yeah resilience is key being able to to do the bounce back recognize that i'm not going to give up and and again i i love working with athletes because that mentality is a strength that they have that they've used in a different context so often and tapping into that is such a useful tool to help folks who are battling this chronic relapsing disease and i always like to highlight that because of stigma and addiction and substance use disorder diagnoses the idea of a relapse has such a negative connotation but if somebody had cancer somebody had diabetes and they were trying to get treatment for that and then there was a relapse and they came back there's not the message to them that oh you didn't try hard enough yeah right and the reality is no we just increase the medicine let's give more medicine let's go at it in another angle until we beat this disease and i think that that same mentality should be equal across these different diagnoses and if we take that stigma out and just recognize no this is a this is a medical diagnosis and we're gonna keep fighting we're gonna keep treating it until we get it into full remission i i i i i like these athlete analogies that we kind of keep coming back to where you can take things from the training process and then also from the

competition process and then apply them into a setting like yourself setting like what you work in where you're working with athletes that are in the middle of uh in the middle of addiction is there anything else that's that has been remarkable to you as a practitioner specifically working with athletes at any part of that continuum that's important for people to to to know out there who might have a friend or might themselves be thinking about something like this something that the first thing that came to mind when you asked that question was identity so athletic identity is something that it starts to get instilled really early in the life of an athlete and a lot of times where we see addiction start to pick up is when there is some threat to the athletic identity and it's a way of coping so you can think about this in context of a catastrophic injury a major failure in sport an inability to continue up to the level that they want to continue at with whatever sport that they're in uh the uh a retirement that's coming up really fast towards them and a lot of these stressors are a threat to identity of me i athlete and to cope with that the self-medication starts without ever actually knowing that's what's happening and that i'm i'm afraid i'm going to lose who i am because i am an athlete and sport defines me and so that identity

theme i think is really valuable to help folks to round out that that despite whatever level of competition that one's in that athletic identity can maintain and we're going to use that athletic identity to have success in a relationship to sport and competition that's going to be ongoing throughout life and yes it will evolve and change as all things do but one doesn't have to let go of that athletic identity and so that theme has come up a lot and i think it's important to recognize and understand how valuable it is to folks who have an athletic identity so take that identity lean into it and then change it to the current context is kind of what what i'm what i'm hearing from you for athletes that are going through that natural transition point yeah and recognize that they use it we see this a lot like i know the olympic training center has put a bigger emphasis on athlete transitions from their kind of olympic lives to their post olympic lives and kind of arming them with resources and nobody has the perfect has kind of the perfect answer to it but it really speaks to how that change in identity especially when the identity is very strong and we do have it with with athletes and i'd say that's even particularly heightened with olympic level athletes who have represented their country um those those changes can be quite abrupt and quite uh uh and quite quite a remarkable transition from one side of it to to the other with an athlete yeah especially ones that aren't chosen yeah there you go because sometimes you have a choice in that and uh many times you don't and

when you don't get to make that choice it's even harder unbelievable okay let's let's wrap up here you talked i want to give the listeners out there a little bit more of a toolkit to kind of work from so we already mentioned the the cage screening tool and went through that what are some other resources whether they be websites or clinics or questionnaires can we kind of arm the listeners with to to to wrap up with and i'll put links to all these in the show notes and people can go and peruse them at their uh at their leisure yeah one of my my favorite websites is recovery answers dot org recovery answers dot org and this is a great resource with information about addiction peer-reviewed articles all of it is delivering information in a really easily consumable way um it's put together by dr kelly out of harvard uh probably the lead addiction psychologists uh you know in uh one of them in in the field of addiction psychology and really easily consumable information about the process of addiction what's happening with it and in recovery what that looks like how to seek treatment i just i think that's the great resource that anyone can log into and a lot of easily accessible information for folks perfect another website that's great when it comes to finding a treatment facility or treatment center is the uh samsa samhsa.gov and and this is uh a national organization that essentially is like a clearinghouse

about addiction treatment and waste access treatment there's easy 1-800 numbers on there there's easy treatment center finders and they're going to connect people with well-established and um safe places to seek addiction treatment that have been vetted by samsa this national organization so i think those are two great resources i have used that by the way have you yeah this is my my caveman toolkit i'm glad i'm glad that one came to the top for you yeah yeah it's it's it's easily used and then there's another website that i think is is a nice resource and it's called um addict to athlete and it's a d d i c t t t o athlete dot com and this is a kind of a group of people talking about that process of people who are in recovery um who were addicts and now they're using sport as a you know a healthy means to to recover from that and you know those those are i think important on different levels right so the first website that we talked about is about education like learn let's understand what we're dealing with here get all the information right if you're yourself or you know somebody doesn't matter go there get the information the next one is going to connect us to ways to to treat or do something about this and then the last one is about that sustained long-term plan to connect with a community because connection and community is a really protective factor when it comes to people who

are trying to seek recovery from addiction having other folks that they can share their experience with being able to connect um be inspired and then also inspire other people are really valuable when it comes to the process of finding that long-term recovery from addiction for folks i really resonate with that three-prong approach uh like i said i appreciate a lot i i appreciate that a lot because as i mentioned earlier i've had pretty much caveman tools with this which is mainly relying on the network that i have right i've gone through this experience where i have a good group of athletes that have all been through something like this and my default is is to ask one of them i'm thinking i'm thinking this what should i do right and now me and the listeners out there have a little bit more uh a little bit more of a systematized uh uh resource list out there to to go and check up on as well yeah you know no one makes the journey alone that's that's really important dr austin i really appreciate you coming on the podcast today uh this means a lot to me i hope it means a lot to a lot of the listeners out there uh where can they learn a little bit more about you and your practice premier sports psychology dot com they can find out about the practice there and and see a lot of the different services and ways they can connect um we have practitioners located in you know multiple different locations and we certainly have the ability to do telehealth care and connect folks to uh providers if uh they're outside of the you know if they want to do something in person and there's not

somebody from premiere that can work with them well like i said i appreciate you coming on the podcast and more importantly i appreciate what you do for the community and you're certainly getting put in my digital rolodex of people that i can reach out to so i'm sure we'll have some correspondence in the future given previous track record and some of the statistics that we just talked about yeah anytime all right folks there you have it there you go much thanks to dr austin for coming on the podcast today and helping me and hope hopefully helping you the audience understand this process psychology and behavior of addiction whether that be due to a chemical or even a behavior like running or exercising or even training as i mentioned in the intro this is something that i have had to contend with and to grapple with in both my personal circles as well as my professional network as well as the athletes that i've worked with and it's always something that i have tried to become better at understanding as a coach and as a person i would be remiss not to mention one individual during the closing of this podcast that has helped me the most with this throughout my life and it's somebody that is sadly is no longer with us david clark is somebody who has inspired me throughout the entirety of my personal and coaching journey he taught me more about people who live with addiction and the things that they go through and the things that they have to think about throughout the entirety of that spectrum david i miss you brother this podcast goes out to you i hope to meet you on the other side that is it for

today folks and as always we will see you out on the trails