“Identify which family members foster feelings of comfort and safety and to seek out those that enhance emotional stability,” With Dr. Caitlin Simpson, LCSW, LCADC

I had the pleasure of interviewing Dr. Caitlin Simpson, LCSW, LCADC (MSW Fordham University and DSW Rutgers University). She has twelve years of experience specializing in the field of addictions and co-occurring disorders, with a focus on the co-occurrence of trauma. Currently, Dr. Simpson is the Director of Clinical Operations at Footprints to Recovery, a nation-wide collection of evidence-based drug and alcohol treatment centers with facilities in Arizona, Colorado, Illinois, New Jersey and Pennsylvania. Under Dr. Simpson’s clinical leadership, Footprints to Recovery has earned the Joint Commission’s Gold Seal of Approval® for Behavioral Health Care Accreditation and operates multiple levels of care (inpatient medical detox, partial hospitalization, intensive outpatient and outpatient) to thousands of clients throughout the country.

Thank you so much for doing this interview with us! What is your backstory?

I was born and raised in a small beach town in New Jersey. Being that the beach is one of my favorite places, I have continued to live in one of the small local towns with my two children. I pursued my undergraduate degree at Monmouth University and quickly found myself engrossed in their social work program, which has proven to be an unbelievably fulfilling career path. Following completion of my undergraduate degree, my first position as a social worker was as a substance use counselor. It was there that I found my true passion, which led to the decision to further my education at Fordham University (MSW) and Rutgers University (DSW).

As my career advanced, I found myself in various roles having the opportunity to build clinical programming and being able to provide innovative clinical care. I began to focus on the co-occurrence of substance use disorders and post-traumatic stress, as well as other co-occurring mental health disorders. My goals became focused on how to effectively integrate evidence-based treatment, holistic approaches, and progressive treatment modalities to treat all aspects of a person, not just the addiction or mental health related symptoms. In my current position as Director of Clinical Operations at Footprints to Recovery, a national addiction treatment provider, I have paid close attention to the interconnectedness of mind, body, brain and spirit, which has allowed us to build a comprehensive paradigm supporting overall health, wellness and recovery.

With the holiday season almost over, many people have been visiting and connecting with relatives. While family is important, some of them can be incredibly challenging. How would you define the difference between a difficult dynamic and one that’s unhealthy?

All families experience conflict and/or stressful situations at times.

In a healthy family system, issues are resolved with positive communication, respect and understanding.

Difficult family dynamics often have a foundation of healthy functioning, and therefore, negative emotions are temporary, have minimal impact, and are specific to a situation. An unhealthy family system is characterized by consistent conflict, poor communication, isolation, tension, and anger (amongst other elements). Furthermore, an unhealthy family system often has long-term impacts on physical and emotional well-being, as well as negative implications on relationships established outside of the family system.

Families have a large part to play in our overall mental health. While some members may be champions for wellness, others may trip triggers. What advice would you give about engaging both types of relatives?

Engaging with either a champion for wellness or a relative that is triggering can be challenging, overstimulating, and emotionally exhausting. If any relatives fall into one of these two categories, limit the length of the conversation and keep the topics light. If the conversation starts to become overwhelming or triggering, have an exit strategy, such as excusing yourself to get a glass of water or use the restroom. It is also important to identify which family members foster feelings of comfort and safety and to seek out those that enhance emotional stability. If the family dynamic is one of great difficulty, contemplate arriving late and leaving early to limit exposure to an unhealthy environment.

We often hear about “toxic relationships.” Do you believe there is a difference between a toxic family and an unhealthy one? If so, how would you advise someone to handle a toxic family member?

Unhealthy family dynamics tend to have moderate, long-term negative impacts, such as consistent symptoms of depression and/or anxiety. A toxic family or family member has a significant and immediate negative impact that has the tendency to disrupt healthy daily functioning, in addition to long-term negative implications, such as poor relationship patterns and stress related medical issues. Toxic relationships require firm boundaries, clear communication, limited timeframes of engagement, and if necessary, disengaging from the person altogether.

Can you share about a time where you helped someone overcome a challenging family member?

Throughout my career I have had the opportunity to help many individuals and families cope with difficult dynamics. Family dynamics tend to be a prevalent topic when an individual is engaged in any aspect of mental health and/or substance use treatment. Processing through early childhood experiences, dysfunctional family systems, and toxic relationships is an essential element of the therapeutic process. Through this therapeutic process, the ego (sense of self) begins to strengthen, fostering a space for emotional growth and behavioral change. As each individual restores to a place of emotional and physical well-being, the ability to effectively cope with unhealthy family systems becomes more manageable, and continued growth and healing can occur. For example, as a person heals and develops that sense of self, it becomes possible to engage with family members with little to no emotional impact. In other cases, the appropriate course of action may be to disconnect from unhealthy family members.

Managing mental health in high stress situations is challenging and although gatherings are only a few times a year, they can make a major impact on overall wellness. What 5 strategies do you suggest using to maintain mental health when faced with an unhealthy family dynamic?

1. Plan Ahead — Prior to engaging with an unhealthy family system, determine an arrival and departure time and stick to it. Make sure to have an exit strategy established so that if the need arises, leaving is not an obstacle.
2. Maintain Boundaries — Attempt to engage in conversations that are comfortable for YOU. Don’t hesitate to respectfully let a family member know that now isn’t the time or place for a discussion that you are uncomfortable having. Communicate clearly and consistently.
3. Establish Support — Take some time to reflect on past family engagements and identify which family members fostered a safe and supportive environment for you. If comfortable, reach out to those individuals ahead of time and plan to attend the event with them or arrive at the same time. Simply knowing which family members are healthy and unhealthy to speak to allows you to strategize your interactions ahead of time.
4. Keep a Clear Perspective — Remember that unhealthy family members often have the propensity to evoke negative emotions and/or attempt to place their own unhealthy emotions on others. Practice simple mindfulness techniques to remain in the present moment and to ensure appropriate reactions to those family members that historically don’t make you feel good. Taking some deep breaths and reminding yourself that IT’S NOT YOU can help keep an appropriate perspective.
5. Recovery Time After the Event — Self-care is one of the best ways that we can love ourselves. Do something that makes YOU happy, that provides a sense of calm and relaxation, and that increases your emotional and physical well-being. Take the time to reset yourself and ground yourself in the person that you are proud to be.

What advice would you give to family members who are allies of someone struggling with mental illness at these gatherings? How can they support strong mental health without causing friction with other members of the family?

It’s always helpful to ask a loved one how they would like to be supported. If they are unsure, let them know that you are available, and when at a family event, check in with them periodically.

Often times, the conversation of offering support and letting your loved one know you are there for them can make a significant difference to that person.

What is your favorite mental health quote? Why do you find it so impactful?

One of my favorite quotes which relates to my love for the beach and the ocean, is:

“You can’t stop the waves…but you can learn to surf.”

I find this to be impactful because it speaks to the perception of control. Life has periods that are good and bad, which ebb and flow like the tide. We can’t always control all situations, but we can learn to “ride the waves” and effectively manage our reactions and responses.

If you could inspire a movement or a change in mental wellness, what would it be? How can people support you in this mission?

If I could inspire a movement it would be to spark the notion that there are BETTER DAYS AHEAD. In a world that is often characterized by negativity and stigma, our message needs to ring loud and clear that hope is alive, and recovery of all kinds is possible. I am sure we can all think of a family, friend or loved one that is impacted by a mental health and/or substance use disorder. Let’s stand together, advocate, and bring a message embodied with positivity, love and support that we are all equal, hope is stronger than fear, and that there are BETTER DAYS AHEAD. To support this mission join with Footprints to Recovery on social media by utilizing #betterdays.

What is the best way for people to connect with you on social media?

I can be found on LinkedIn or on the Footprints to Recovery’s website: www.footprintstorecovery.com. If you’re looking for additional information related to mental health or addiction, Footprints to Recovery provides helpful content and resources on both Instagram (@FootprintsToRecovery) and Facebook (@FootprintsRehab).

Thank you this was so inspiring!