What's Your Relationship to Substances?

Published Oct 31, 2018, 7:00 AM
For this week's episode, we're helping you explore your relationship with substances. For this conversation I was joined by Dr. Delishia Pittman. Dr. Pittman and I discussed how you can tell if your use of substances has become more than recreational, the steps you can take to get help if you think you might be struggling, how some of our cultural practices may be contributing to masking issues with substance abuse, and how to help if you think a friend may be struggling with their substance use.

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Welcome to the Therapy for a Black Girls Podcasts, a weekly conversation about mental health, personal development, and all the small decisions we can make to become the best possible versions of ourselves. I'm your host, Dr joy hard and Bradford, a licensed psychologist in Atlanta, Georgia. To get more information, visit the website at Therapy for Black Girls dot com. And while I hope you love listening to and learning from the podcast, it is not meant to be a substitute for relationship with a licensed mental health professional. Hey, y'all, thanks so much for joining me for session eighty one of the Therapy for Black Girls podcast. Today we'll be digging into helping you explore your relationship with substances. For today's conversation, I'm joined by Dr Delicia Pittman, whom I had the pleasure of helping to train while she was a student at the University of Georgia. Dr Pittman is an assistant professor and the director of the Clinical Mental Health Counseling Program at the George Washington University. She's also a licensed psychologist in the District of Columbia and Virginia. Additionally, she maintains a private practice in Woodley Park. Dr Pittman and I discuss how you can tell if your use of substances has become more than recreational, the steps you can take to get help if you think you might be struggling, how some of our cultural practices may be contributing to masking issues with substance abuse, and how to help if you think a friend may be struggling with their substance use. If you hear something that really resonates with you while listening, please share it with us on social media using the hashtag tb G in Session. Here's our converse station. Thanks so much for joining us today, Dr Pittman, Thank you so much for having me. It feels very special to have you joining me here on the podcast. You know, so for those people who don't know, Dr Pittman was one of my very first practical students that I have had the distinct pleasure of helping to usher her into the field, which has been incredibly exciting. So I'm excited to have you here to chat with us about substance use um. And it's not a topic that we talked about very much on the podcast, but definitely something that I know a lot of people are curious about and need more information about. So I thought we would start by kind of talking a little bit, you know, like a lot of people will kind of recreationally you know, I'm hanging out with friends, I'll take a drink, I'll smoke or whatever. But can you tell us about like some of the signs that it may be beyond recreational use, you know, like if you're drinking too much or smoking too much. Like, what are some of the signs that maybe you need to really pay attention to what's happening with your substances. Sure, I think one of the things that comes up quite a bit both as a professor and training therapists, but in my clinical work is really sort of understanding some of the early signs that you've moved out of what feels still very recreational and is moving more into sort of problem substance to you. So historically we would categorize it as abuse versus dependence, and we don't do that any longer, but we're really sort of paying attention to you primarily first and foremost negative consequences. Are you experiencing any negative consequences as a result of your substance? Used behavior. So that could be anything from taking a long time to recover. Right, so I know that some of us get older, it takes us a little longer to recover from a night of drinking. That could start to interfere with you meeting responsibilities that you have the next day. And is that happening with some regularity? So negative consequences in that regard. Have you gotten a d U I or other possession charges? Are you getting in legal trouble because of your substance use? And this isn't just sort of an isolated incident or or a poor decision, but certainly when you are out for a night and you decide to get behind the wheel and exercise poor judgment, we might have some concern about your ability to really regulate or what we call moderate even your alcohol use or your substance consumption, whether that's marijuana use or alcohol use or some other kind of recreational or club drug use. Um. So, legal trouble consequences if you find that you fire more of the substance to get the desired effect. Um, So you developed some tolerance to a substance, and that can be cultural. I think, particularly within the Black community, we sort of pride ourselves on what we call being able to handle our liquor, and so there's a social implication of that, but that at the same time, being able to handle large quantities of liquor is an indication that you've developed some tolerance. In order to develop tolerance, you have to drink a lot at that level, which could be an indication that you are starting to move out of recreational drug use or substance use into sort of more slippery slippery territory. That's great information, and I do think that that is something that people do want to pay attention to. And I'm glad you brought up the whole cultural piece because I do think that it warrant some conversation around like what happens if you are like in a friend group where you kind of feel like everybody else is drinking and smoking, but that's not quite your thing. Can you share any information about that, like what that might be to be like to negotiate some of those kinds of relationships. Sure, in those relationships, whether their friendships or romantic relationships, can be tricky to navigate. Certainly, peer pressure doesn't go away, you know, once you're out of college or high school. And so if you if you find yourself in a friends group or a social group, or even in some cities, some cities like Atlanta and d C very much have brunch cultures, and those like brunch cultures are centraled around like day drinking and day parties things like that, where it's very sort of very much more the lies to be drinking large amounts of alcohol for long periods of the day, and those are a great opportunities for socialization. But if you find that you're part of a friend group who maybe drinks or smokes more than you do or than you're interested in, it can be challenging to engage with them or to sort of have a robust social life with that group of friends without feeling pressure to to drink more or drink a lot, you know. So some of the tricks are you know, obviously, drink clear things. Clear liquors um don't necessarily ward off getting intoxicated. They can be equally as intoxicating as dark liquors can be. But it can be much easier to disguise drinking something that looks alcoholic but that's not alcoholic, you know. So for some clients, I'm like order a tonic water like on the rocks with some lime, it looks like you're drinking a gin and tonic but you're not. Or order uh, you know, diet coke with a lime on this side, it looks like you're maybe drinking a Roman Coach, which you're not. And so it can really help you pace how much alcohol you consume when you have a peer group who has an affinity for alcohol. Um smoking is a bit trickier, so you'll have to get pretty skilled and confident at saying no or choosing to lead certain circumstances where your friends might be smoking and you don't want to. This comes up a lot around like hookah and like you know, drinking and smoking hookah and or marijuana and those sort of all going together to sort of really kind of exacerbate the high. They kind of create what we call synergistic effects, and they increase the high of each other. And so for some people that's great, and for some people it makes them very, very sick. So you have to know your own sort of thresholds for that and be okay sort of being made fun of. I mean, at some point there's gonna be something that makes you stand out and I always say I'd rather stand out for not doing things I don't want to do than you know, blending in and having to deal with the consequences of doing something I didn't want to do in the first place. Great information, and I think that's an interesting point. I had not thought about how the whole brunch culture really is, you know, kind of encouraging like all day drinking. Like you think, oh, bottomless mimoses, it's pretty harmful or harmless. But when you think about it, like didn't, that means you're consuming probably larger quantities of alcohol during the day period than you typically would be absolutely right. So if you think about the standard brunch hours and you start brunch at twelve o'clock and you have bottomless mimoses until three, you likely will consume at least a bottle an entire bottle of alcohol per person. I think folks go really pressed to get their money's worth when you have something that's bottomless, and so you're sort of encouraged to drink more than you might otherwise if you were paying by the glass. Good points. Are there other things you can think of? Kind of like just in our culture now, that kind of encouraged is kind of behavior. I think one of the things that is often talked about particularly is that college graduates drink more than any other demographic and the country. And so as we're particularly amongst African Americans, as we're seeing larger quantities of African Americans go to college and complete college, you do sort of fall into the college culture of drinking and bench drinking on the weekends, which is sort of, you know, a really sort of centralized, clustered drinking pattern that's sort of exclusive to the weekend, of drinking large amounts of alcohol and abstaining during the week on some level. So I think certainly having being a college graduate or having gone to graduate school certainly increases your risk for how much you drink, which certainly can contribute to drinking problems. Things like fraternities and sororities, not in and of themselves, but particularly the college culture around homecomings and events that we see those can be slippery slopes for folks to drink more than they do in their regular, like day to day lives. And so part of it is paying attention to those kinds of events. If you tend to go those kinds of events and you overconsume and you're you know, either passing out or throwing up, those kinds of things that feel pretty benign in the moment, but it's a pattern. It like every year we go to this event and I overconsume and I throw up, and that's like you normalize that could eventually become problematic, you know. So one of the things that I always tell people is that the outward you know, the outward effects of alcohol that you see, you know, the throwing up, the passing out, the like slurred speech, those kinds of things are not actually an accurate indication of what's happening on the inside. So your body can metabolize about one drink an hour um, and so you generally feel intoxicated when your body isn't able to metabolize the amount of liquor um that you've consumed in that time. And so this is a standard shot, which is about four ounces of liquor. So it's not you know, we're not talking about a large quantity of alcohol that your body can metabolized in an hour. And so any drink that you get in a bar is gonna be a larger amount of alcohol than your body can metabolize in an hour. Um. You know. So if you're able to do two or three or four of those in an hour's time or a couple of hours, you're gonna feel intoxicated. Um, and and then things start to sort of fall apart from there. Those are great measurements. I don't know that I knew all of that information about like how much your body is metabolizing, so great information for anybody who also didn't know that. So I think one of the things that often comes up is that like friends and family members will be may recognize like some issues without drinking or substances before we might. So what suggestions would you have maybe for a friend or a family member who think, like, oh, I think my roommate maybe drinking too much, or I think my coworker maybe has an issue smoking too much, Like what kinds of things might you suggest for them? Or should they even intervene? That's a great question. The if and when conversation is a difficult one. It really depends on the circumstances. If you are living with someone who's a friend or a roommate, you know, trying to give them some feedback about behavior or their substance use they're smoking. Um, if it's infringing on your levels, and certainly you want to tell them that, like when you smoke in the house, I don't appreciate it, or whatever the conversation is, and trying to set some boundaries with them and some agreements with them around they're they're smoking or drinking. I've certainly had situations where roommates kind of like set a trap. I don't recommend that, Um, so they'll, you know, put a bottle of alcohol in the house and note everyone else is in agreement that nobody will touch it to see how long it takes for that bottle to like empty, so that they can use that as evidence that, like, you might have a problem because you're the only one who's drank this entire bottle of whatever the case may be. I don't recommend that. People generally are quite defensive about it, you know, And so I always try to encourage people to hold others accountable in love, what is it that it's concerning to you? What is it about their drinking or they're smoking that is concerning to you? And lead from that place. Don't lead from the place of you drink too much, but lead from the place of you know, I'm noticing that you're having a real hard time meeting these other responsibilities or demands. I'm really concerned that you might be on the custom of losing your job because you've called in sick. And there seems to be this relationship when you when you drink a lot on Friday, that you don't make it to work on Saturday, and I'm concerned about that, you know, so try to sort of lead from the place of of concern less than the place of judgment. And so when you attack people from the place of their substance, that often doesn't go well. The other piece of that is making sure that you're not enabling the behavior. You're not buying or supplying or lying and covering up for someone so they avoid the consequences of their substance used to behavior. Ultimately, that just prolongs how long they stay entangled in substance abuse. If you're you know, making sure that they're not homeless, or you're making sure they don't lose their job, or you know, you'd rather than smoke at home, so you buy for them so they don't get something on the street that's not good or you know, dangerous. Those kinds of things are conversations that I'm often having with parents and significant others of folks who have substance abuse issues. And it can be really difficult to watch someone you love um go down a path that you don't agree with and that you think is really dangerous for them, and they don't they don't agree with you, or they don't see it the way you see it. But I'd say, you know, one approach them from a place of love and to don'tint able to behavior. And I think you bring up an interesting point about you know, like especially if this is somebody who you are very close with, like a partner or a sibling or a parent, like around boundary setting, and you know, like how that relationship actually can be functional. Can you say more about that? Sure boundary setting, particularly once you're engaged with someone who has active substance abuse issue, can be really really challenging. You know. When I'm working with folks and recovery, even in early recovery, you know, one of the things that that we sort of use to conceptualize that work is that addicts work getting high like a full time job, Like it is their job to still say high. That is the addiction works. This is a choice that they're making. Think the first use and maybe even several of the subsequent uses were choices. Um. But the way that that physiologically your body starts to respond once you're addicted is quite different, and it's it's more of a like a primitive response, more like a reflex than a choice. Um. And so getting sober, getting clean can be really really challenging because of it. And so, you know, setting boundaries, you know, with folks who are actively using can be challenging early on. Generally, folks once they've been they've been lied to, they've been stolen from, then those folks generally have no problem setting boundaries. They just cut the person off completely. Addicts who are using and are using an isolation, have been cut off from their families and their support systems generally take much much longer to get clean, you know, So thinking about like what do healthy boundaries look like. This is maybe a person who's allowed home for Christmas, but they're never left alone. You know that, we don't drink with you, we don't smoke with you. You're not you know, we don't engage with you around whatever. The behavior that you have a problem is, it's not a problem for us. And we won't not engage the behavior because that feels restrictive, but we won't engage it with you. UM. So you know, thinking about and what emotional boundaries, not even just physical boundaries, but what emotional boundaries do you need to set to keep yourself mentally and psychologically well. Um, when you love someone who's actively using, I think all too often we get pretty emotionally entangled in in the substance users addiction. It's like if I were enough, if you loved me enough. I'm like, their addiction has nothing to do with you. It has nothing to do with how much they love you. It has nothing to do with how much they respect you. And I hear that often. I can't believe you disrespected Mom's house by stealing or doing this then the other thing, And it really those factors. I certainly understand the sentiment, but really those are are not congruent. These are folks who generally deeply love their family and deeply have deep regret about the things that they do when they're under the influence or in pursuit of the next fix. And they've burned a lot of bridges in the process. Um. And so you know it's not often a reflection, any accurate reflection of how they feel about anyone who's close to them. Um. But those of us who are clean and sort of take their addiction quite personally, and and that can be really really challenging and really dangerous as well. Great new information. So I do want to spend a little time, because you know, marijuana has become legal in some states, you are seeing more and more around edibles, so it definitely feels like there is more heavy usage of marijuana. UM. So I do want to spend a little a time kind of talking about, you know, like the impact that marijuana actually has on our system and things that people maybe need to be paying attention to in in terms of consuming marijuana. Sure, I mean so one of the things that I like to point out as the difference between decriminalization and legalization. So some states marijuana has been decriminalized, which is essentially just loosening the criminal penalties that are imposed for being in possession or being found in possession of marijuana, which is still means that the manufacturing, the growing, and the selling of marijuana is still very much illegal. Um. And then there are states that have legalized marijuana, which lifts and abolishes laws that that banned both possession and personal use, and so those are the states that are going to have dispensaries that you can go into and purchase freely. So those are very clear distinctions. One of the other things that I often like to highlight for our folks is just because marijuana is legal in your state doesn't mean it's legal for your employer. So um, and we saw this a lot in states first started legalizing marijuana, is that employers would randomly you weigh their employees. Um, you still cannot show up to work under the influence really at most employers and so and that is grounds de termination in most states that are at will states. Just because being in possession of marijuana is legal in your state and you show up under the influence, your employers still as well within the right to terminate your employment because of it. So that's important to know. The other piece around marijuana use, there really isn't a whole lot of data to substantially there's any increase in marijuana use, which is an argument for folks who are against legalization and decriminalization. And there you know, that's been one of their big arguments is that it's you know use is going to increase and it's gonna be rampant, and we're telling young people that it's okay to use, and there really hasn't been any data to substantiate that people are using more now. People are using more publicly, certainly, but it hasn't in fact increased how much people are using. So to dispel another myth around marijuana uses that it's not addicting, marijuana is absolutely addicting. Marijuana can cause what we call physiological dependence, which is like your body having cravings and or withdrawal when you cease using substances. So marijuana, like all other substances out there, can create physiological dependence, but they can also create psychological dependence. I see a lot of what we call self medicating with marijuana. People who have depression, people who have social anxiety or other forms of anxiety, will smoke a little bit to help get them through a day, get them through a social event, those kinds of things, and early on you may derive some benefit from that. Now, prolonged marijuana use will often become counterproductive. So for folks who maybe we're using it for social purposes and now they smoke a little every day or multiple times a week, may find at some point that it stops becoming effective for the management of whatever social anxiety or social phobia they had, and it might also exacerbate their anxiety and disrupt this. So it's not uncommon for folks who have been using marijuana with some regularity to start to experience insomnia. It can exacerbate depressive symptoms as well. Um, you know, so you have to be really mindful of any existing mental health issues that you're currently managing and your marijuana use, particularly if you're also taking you know, antidepressants or other medications to manage any other mental illness. They can also have sort of crop cancel each other out and so you don't really get any benefit from either, which means you're sort of at score you started sort of at square one again. So it's great information, and I do think it's important to kind of highlight, you know, like sometimes people will be taking like an antidepressant and they are you know, drinking a lot or smoking a lot, and like you said, you're effectively kind of canceling those out. So you do want to make sure, um that you're paying attention to like what your physicians is, uh, in terms of like drinking and smoking in connection with whatever medications you're taking. Yes, And one of the things that I tell my clients all the time is to be honest with whoever is prescribing for you. They're not gonna like leave and call the police because you smoke a little bit of pot. So if you're smoking a little bit or a lot of it it or drinking a little bit or a lot of it, you need to tell them because it certainly will impact what they prescribe to you and how much of it they prescribe to you, because you could be putting yourself um medically at risk by taking some of the medications that we use to manage mental illness, most of which are not just used to manage mental illness. So one of the things that I teach my students is that there are very few medications on the market that have a singular use. So we use a lot of blood pressure medications, anti convulsants, which are anti seizure medications to manage mental illness. And so you have no idea. You think you're taking a medication that's for depression, but it's you're taking a medication that is actually used to treat seizures, but it manages your particular kind of depression really effectively. And so you may be doing harm to yourself unbeknownst to you and your prescriber because you haven't been forthcoming about your substance use. UM. So I'd much rather a client tell me, yeah, I drink about three glasses of wine every day when I get home, so that when I'm working with them to help them manage their depression or a depressive episode or some anxiety or you know, a bipolar disorder, that I actually have all of the pieces that I need to be effective for them. Um. And so not giving your prescribers that information is like asking them to put a puzzle together and tying one hand behind their back. Um, So don't do that to yourself out there who who may find yourself doing some of that help us help you as your medical team. I try to be as collaborative with my clients as possible around their care. So aligning with them and really understanding sort of what they're doing to cope UM day to day between sessions is really helpful for me and for some of them the things that they're choosing. I don't endorse that I can't co sign the things they choose, but it's helpful for me to know about what they're using and what kind of benefit or not they're experiencing from it. Yeah, and I'm really glad that you pointed out, you know, the fact that your doctor is not going to like run out of the room and call the police because you're like smoking, right. I mean, it's really just more important for them to know the information so that they can make the best decisions for your treatment, right. And they may they may tell you probably should stop doing that, or I'm not going to prescribe this medication for you because your alcohol uses too is too high and your risk is really great, and those kinds of things where I need you to moderate your alcohol use so you know, come back in three weeks so that we can see you know, how you're doing. Kind of a thing. But I find that the most physicians these days are really able to have, you know, more productive conversations, and I think that's really changing. I think healthcare is really changing. Um More healthcare providers are really getting on board with harm reduction approaches as opposed to abstinence approaches. I can tell you not to drink but the likelihood of you not doing that over again is low. So as opposed to telling you not to drink, I'm gonna arm you with some information to make a decision that I hope is in your best interest, you know. And so if you're you know, taking your world beutren with a cavernet in the morning, we need to have a conversation about that, because that's gonna impact how much of that medication is actually getting getting into your body to do what I needed to do to manage your depression. Got it? So what would you say, dr Piven for the person who may be listening and has kind of hurt all this great information you've shared and is thinking like, oh, I may need to look at like how much I'm drinking or how much I'm smoking, Like what kinds of things um like, what would be their next steps? What kinds of things should they be thinking about inconsidering. Yeah, I generally liked to encourage people to start with a simple tracking exercise. So track how much you drink, like, accurately track how much you drink, right, so I know that when I pour a glass of wine at home, it does not look like it does in the restaurant, right, And so a lot of it is paying attention and having an honest dialogue with yourself. You know, one of the things that I, you know, say all the time in my own practices, you can't change your truth until you can stand in your truth. And whatever that truth is, it may be ugly, um, but you've got to be able to stand in it before you can work to change it. So if you can't have an honest conversation with yourself about your substance use, you're not gonna be able to have an honest conversation with anyone else about it. So just start with a simple tracking exercise. How much are you drinking? What's your drink of choice? Like, what do you like to drink? Do you like to drink red wine? Or are you like a white wine drinker? Are you a brown liquor drinker? They all have different what we call alcohol by volumes, and so how much of them you consume can also on some indication, give us some indication about a drinking problem. So if I have a client who tells me, yeah, I generally have like three seven and seven versus a client who tells me, I have you know, three midori sours. Those are very very different cocktails, and so that to me can even give me an indication of their drinking tolerance. You know, if you're still standing after three seven and seventh versus passed out after three Midori sours, that can give me a lot of information. So start by tracking your own alcohol use. Um, if you've had any negative consequences. Are you calling out of work, are you canceling plans with people you care about? You know, if you have children or pets that you that require care and attention and you're not meeting those responsibilities, those kinds of things can be on the more sort of severe end of red flags. But you know, start by tracking the other pieces. Once you're tracking, you know, try to moderate your use. So if you go home every day and you have a glass of wine and that's part of your wine down, try doing that three days a week instead of five or seven days a week and see if you're able to do that. Some people think that they're able to do that. I enjoy wine. I drink a glass of wine because I enjoy it, And when they try to moderate it, they really find that they have developed some physiological tolerance. So on the days that they don't drink, they really crave it, particularly if you drink around the same time. It's part of your evening routine. You get home, you take your shoes off before your wine, and like you know, that's part of your routine. Your body may start to create it, which could be an indication that you elked up some um physiological tolerance. So those are two pieces that you can start with. The Other piece of that is if you know that you have a substance use problem and it's sort of getting out of control, and you're aware of that, seek treatment. You know it's not it's it's generally not this process by which you're just gonna stop cold turkey and never pick up alcohol again. And you know, you know you're gonna go to the Christmas parties and be the person who doesn't drink. You may eventually get there, but that process can be really difficult on the front end of recovery. I'd tell folks all the time, if you hang out at the barbershop, long en if you're gonna get a haircut. So if the folks you hang around with are heavy drinkers or heavy smokers, and you think you can just hang around the same people, places, and things you did when you were engaging in those activities, you might be setting yourself up for a failure, you know, so trying to sort of change some of the people, places and things that really encourage your substance use. So yeah, I think those are probably the three things I would say to start with. Yeah, I think that it is agree it store for people UM. And I know before before we started recording, we talked a little bit about UM like A A groups and in A groups. Can you talk a little bit more about what those groups are and how they could or might not be helpful. Sure, A groups and A groups they have been around for for decades and decades their Twelfth Step oriented groups, and they are their non therapeutic groups, which is what I think is really important people to know. A groups and in A groups are generally facilitated by other folks and recovery and so it is a community of clean and sover support and every you know a A in A UM, alcoholics, anonymous, narcotics anonymous. You know there are alan on groups for children of spouses of substance users, things like that. So there are lots of twelve Step meetings. Generally there are meetings in every city every day, multiple times a day. So if you find that you really need some support, that you're really craving something to drink or smoke um, and you can't access any of your own supports, if you're still very early to the process, you always drop into an A or an n A meeting as long as it's an open meeting. You can do that, and you can get online and google them and find them wherever you are, so they're a great resource. However, they are not for everyone. Many A and n A groups are rooted in a faith tradition, and for some people that's great, and for others it's not. All A and n A meetings are not rooted in a faith tradition. The step the twelve step process. The first step is to recognize that you're powerless over your addiction. And for some people you know that connects to a higher power, and for others it doesn't. And that doesn't jive well with some people, and so there's no condition to work the steps. Is what we call it, working the steps, the twelve steps to go to an n A or a A meeting or meeting of your choice, but you can certainly find a sponsor and work the steps and do all of those things, so you know they are generally going to meet in pretty nondescript places. Churches are often spaces that meetings happen because they can use the space for free community centers, those kinds of things. So it's not like there's a sign outside that says you're walking into an a a meeting, which is great for UM confidentiality and privacy, but again, you know you're gonna walk into a room maybe with a bunch of people you don't know, or maybe just a handful of people you don't know, and some people are really uncomfortable with that. So I really try to respect how um difficult it can be to to utilize a resource like a twelve step meeting for that reason, particularly for folks who are still very very private about their struggles. The other side of of being in a room with complete strangers, and they're complete strangers, you may never see them again, so you can sort of take from the group what's helpful and leave the rest out fear of like running into these people again. You don't have to attend the same meeting, but many people do. Many people find what we call a home meeting. It's the meeting they go to at the same time every week, and so you know, trying to pay attention to the pros and cons. And I the kind of person who can, you know, step into a meeting and take from it what works for me and leave the rest or Am I a person who really needs to feel a sense of community among people that I know and people that I trust UM and that can give your engage for whether or not some of these an A and A meetings are good for you. In the advent of technology, they're now online meetings and you can be anonymous in an online meeting, so you can still sort of tap into the community and get the support that you need and share or not share without having to see anyone UM or sort of out yourself in that way as well. So another option is to participate in an online meeting. Great resources. I didn't know that they had online meetings now, so but it makes sense. But where we are in the country right with the advancement in technology, it makes sense that they would have it absolutely. So where can people connect with you? Dr Bittman, Can you give us information about your website address as well as any social media handles you'd like to share. Sure. I am a DC based psychologist. My practices in Woodley Park, Um right across from the National Zoo, so it's a great location, metro accessible. You can get to my website at www p sp DC dot com. That's Paradigm Shift Psychological DC dot com. Perfect and anything on social media. I'm not on social media. I need she's not on social media. We may be able to pressure to get on there, but now you can visit her at the website. Well, thank you so much for sharing all this information with us today. I really appreciate it. Thank you so much for having me. Definitely, I'm so grateful Dr Pittman was able to share her expertise with us today. To learn more about her and her practice, visit the show notes at Therapy for Black Girls dot com slash Session eighty one, and please make sure to share your takeaways from the episode in your I G stories or on Twitter. Be sure to use the hashtag tb G in session so that we can find them and share them. If you're looking for a therapist in your area, be sure to visit the therapist directory at Therapy for Black Girls dot com slash directory. Don't forget to check out our Therapy for Black Girls store to grab a T shirt, a mug or a sweatshirt. You can find it at Therapy for Black Girls dot com slash shop. And if you want to continue this conversation and join a community of other sisters who listen to the podcast, join us over in the Thrive Tribe at Therapy for Black Girls dot com slash tribe. Make sure you answer the three questions that are asked to gain entry. Thank y'all so much for joining me again this week, and I look forward to continue in this conversation with you all real soon. Take good care all hot ear oft

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