[MUSIC PLAYING] CYNDI BRIGGS: Well Magda,
it’s so nice to see you again. Thank you for coming back. How are you doing? MAGDA: I’m doing
the best that I can. CYNDI BRIGGS: Right. I know there’s a lot going on. And I really look forward to
delving in a little bit more deeply with you today. I think today’s session
will be helpful for you. And we’re going to build
on some of the information that we talked about during our
screening time the last time we met. Today, we’re going
to be doing what’s called a biopsychosocial
spiritual assessment. And so we’re going to look
at all these different areas of your life. And I’m going to ask you a
whole bunch more questions. And so some of it may
feel a little repetitive or a little bit tedious. But the goal today
is just to really get as clear a picture
as possible before we start making decisions
about what happens next. So does that make sense, and do
you feel ready to get started? MAGDA: I guess so. Bring it on. [CHUCKLE] CYNDI BRIGGS: Yeah, yeah, this
is all a little nerve wracking, isn’t it? MAGDA: A little bit, yeah. I just never had to do
something like this before. CYNDI BRIGGS: Yeah, it feels
it feels pretty strange. So we’ll both just take
a really deep breath and just dive in together. And of course, any time that
you have questions for me, you are more than
welcome to ask. Or if you want to take
a pause or anything, you’re in control here. So if it’s OK, I’ll go
ahead and get started. We’re going to
start with looking at your overall substance use. You mentioned last time
that you do use alcohol. Can you talk a little bit
more about how much alcohol you’re using? MAGDA: I mean, I don’t
drink often usually, on the weekends, a
typical glass of wine. CYNDI BRIGGS: OK, so just one
glass, is that pretty standard? MAGDA: Yeah, I mean, like if
I have company, one or two. CYNDI BRIGGS: OK, so one
or two glasses, and what about during the week? MAGDA: Usually during the
weekends, I’m at a bar. During the week, then
I’ll maybe go out and have a Margarita or something. CYNDI BRIGGS: OK, so you
might have a Margarita, a glass of wine or two. And that’s pretty
standard for you. MAGDA: Yeah, a Margarita
or just wine, usually wine. CYNDI BRIGGS: OK, sounds good. So you have a preference. And that’s kind of that
one to two glasses of wine is sort of the norm for you. MAGDA: Yes. CYNDI BRIGGS: OK, so
shifting gears a little bit, what about cannabis, marijuana? Have you ever used that,
or is that something that’s a part of your life? MAGDA: Oh, no, I haven’t. I’ve never used that before. CYNDI BRIGGS: OK, now
I’m going to start asking about some a
little bit harder drugs. And so I just wanted
to kind of let we’re going to shift
gears a little bit. So just let me know
if any of these things have been a part of your life
either now or in the past. So what about cocaine use? MAGDA: No, no, I have
never used cocaine before. CYNDI BRIGGS: OK, gotcha. What about stimulant use like
speed, amphetamines, anything like that? MAGDA: I mean, I don’t even
really know what speed is. But no, I haven’t had that. I’ve never used any drugs
except for what we’re going to talk about today. CYNDI BRIGGS: Right,
gotcha, gotcha. I know all of this feels
very overwhelming, especially if drug use aside from
prescription medication has never been a big
part of your life. I’m going to go through
and ask about a couple more just to be clear. Sometimes for some
people, they’ve maybe been prescribed
something in the past, or there’s been some
experimental use when they were much younger
that maybe flew off the radar. So I’m just going to check
about a couple of other things, and then we’ll move on. And so no speed or amphetamines. What about things
like inhalants? So this is often
younger people do this, like sniffing gas
or paint or glue. MAGDA: No. CYNDI BRIGGS: Hallucinogens,
like LSD or PCP? MAGDA: No, I have not done
something like that before. CYNDI BRIGGS: OK. So this next one on the list
is opioids like OxyContin. And that is something
that you’ve used. MAGDA: Well yes, that’s
why I’m here right now. CYNDI BRIGGS: The OxyContin. MAGDA: Yeah. CYNDI BRIGGS: Gotcha. Any other opioid use, such
as heroin or narcotics? MAGDA: No, no. CYNDI BRIGGS: Gotcha. So let’s go back
to that OxyContin. You talked a little bit
during our screening about your accident. Can you talk just
clarify a little bit about how the
OxyContin use began and sort of just a
general sense of how long you’ve been using that? MAGDA: Well, about two
years ago, I was injured. I had a back injury
while carrying a patient because I’m a nurse. And I was prescribed
OxyContin for about a year. But about six months
ago, the doctor canceled my subscription,
sorry, not my subscription, my prescription. Sorry, I’m a little bit nervous. And yet I just had to find
other ways of having it CYNDI BRIGGS: OK, gotcha. And so what I’m
hearing is there’s a couple of things going on. You’ve talked about
this accident. But also you’ve had back
injuries in the past. So there have been multiple
instances where OxyContin is really kind of come
to the rescue for you where that’s the pain gets to
be so much, that that’s the one thing that really helps you. And you mentioned that
you’ve tried different ways of getting your OxyContin. Can you talk a little
bit more about that? What are some of those ways? MAGDA: Well, I know someone
who can get that for me. And I do my best
not to overstep. I mean, I know that it’s not– I know that’s not
necessarily legal. It’s just been really
hard for me lately. CYNDI BRIGGS: Yeah,
yeah, I hear that. You’ve kind of had thing upon
thing over the past few years. And it makes it really
difficult to let go of some of that OxyContin use. MAGDA: Yeah, I mean it’s
hard to wean myself off of that because the
pain keeps coming back. CYNDI BRIGGS: I hear you. I can hear the exhaustion when
you take that deep breath, and you sigh, it’s
just exhausting. And trust me when I say this. You are not alone. This is a struggle for
so many people right now. OxyContin is a highly
addictive drug. Unfortunately, it
works really well, which is why people
are prescribed it in the first place and also why
it’s so hard to stop using it and cut back on use. And so what you’re
dealing with here is really common among people
who struggle with chronic pain and find themselves
using opioids or OxyContin to a
point that really makes it difficult to stop. MAGDA: Yeah. Yeah. CYNDI BRIGGS: Yeah. You’re definitely not alone. So let’s put that over here
to the side for just a second. There are a few more questions
kind of other drug use. I just want to make
sure we explore all the possible
avenues real quickly. So the next one is
Valium or phenobarbital. Have you ever been prescribed
those or use those? MAGDA: No. CYNDI BRIGGS: OK, the next
one is steroids or cough syrups that include
steroids, any of that use? MAGDA: Oh, no. I mean, I’ve had
cough syrup before and had steroids when I
had poison Ivy a while ago. But I don’t normally use that. CYNDI BRIGGS: OK, gotcha. That was like a one time thing. OK, and then what about
smoking or chewing tobacco? MAGDA: No, I have never smoked. CYNDI BRIGGS: OK. Have you ever injected
drugs using needles? Has that ever been
a part of your life? MAGDA: Never. CYNDI BRIGGS: OK, that’s
actually a really good news. That can be a real– that can be really
challenging for folks from a medical perspective. So that’s very helpful to know. And it sounds like it’s
definitely not your thing. MAGDA: No, yeah,
fortunately, not my thing. CYNDI BRIGGS: So intravenous
use is one way to use drugs. What about snorting drugs, so
in other words, inhaling them? Has that ever been
a part of your life. MAGDA: Oh, never, no. CYNDI BRIGGS: OK, so I
feel like we’ve really honed in on OxyContin is
kind of the main problem. I think you were aware of that. And it certainly seemed to
be going in that direction from our screening. So let’s explore this
a little bit more. What I’d like to talk to you
about now are what are called triggers. And so these are the
things that kind of make you want to use or feel
like it’s almost like an itch that you have to scratch
when you get this feeling. So for some people,
triggers are things that happen in their life. It might be a smell. It might be an experience. It might be a memory. What kind of things
are triggers for you? As you’ve been trying to get
off the OxyContin a little bit, what kind of things,
what kind of triggers make it difficult for
you to cut down or stop using the OxyContin? MAGDA: I guess, I don’t know. It’s just like always
popping into my head. And I guess maybe when
well, obviously when I’m feeling pain. And my initial reaction is
OK I’m having back pain. Take some OxyContin. And I take it every four
hours, 40 milligrams. And yeah. CYNDI BRIGGS: OK. MAGDA: Sorry, four
hours, I was, sorry. CYNDI BRIGGS: OK it
can get confusing. I think whenever we start
talking about medical stuff, it’s like a lot of numbers
and amounts flying around. And it can definitely
get confusing. But it sounds like
you’re describing it’s popping in your head a lot. It’s something that’s
sort of on your mind. And you’re really aware
of that next time you get to take your dose, that
that’s really prominent for you and that this pain is what got
you started in the first place. So is that pain
still there for you? MAGDA: Yeah, yeah the
pain is still there. My physical therapy
is just not helping. And my recovery
from my car accident is just taking so long. And sometimes, when
I feel nauseous if I don’t have it
after four hours, I start to feel my
back pain again. And I start to feel nauseous
like really, really sick. And I don’t know. It just, it helps
alleviate that. It makes me feel I
don’t know, everything is much more euphoric. And I can just forget about
all this struggle for a while. I don’t know. CYNDI BRIGGS: Yeah. Well, it makes sense
to me that you’re keeping your eye on
the clock if you’re starting to feel nausea, which
is a really unpleasant side effect. And then also, you’re talking
about how that OxyContin really kind of brings you
up a little bit. It helps you, you use
the word euphoric. It helps you just feel better. So those are both
really reinforcing things that would
make you want to use. Are there any other
things that make you want to use besides the things
you’ve already described? MAGDA: I guess just
like conflict in general if in fighting with my husband
or even if we don’t fight, but I’m feeling the
tension around everything that’s not great with us. I don’t know. I just, it helps makes
things not a sucky as they already are. CYNDI BRIGGS: Gotcha. Yeah, yeah. It makes it feel more
manageable for a little while. It takes that edge off. MAGDA: Yeah, I guess
so and exactly. It does kind of just
help take the edge off. It really does. CYNDI BRIGGS: OK so
with all the stress it sounds like you’ve
been experiencing, especially the past
couple of years with the injury and
then the car accident and then the conflict with your
husband, all of those things get together could really
create a lot of disruption for anybody. So one thing I always like
to check with my clients is if you’ve ever had
moments of thinking about harming yourself,
such as suicidal thoughts, any kind of self harm,
anything like that that’s concerning you. MAGDA: I mean, I don’t– I mean, I’ve had days
where I’m depressed, but no, never planning anything. CYNDI BRIGGS: OK, so some sense
of depression, feeling down, but no active thoughts of
hurting yourself or killing yourself at this point. MAGDA: No, no. CYNDI BRIGGS: OK, so another
piece is sometimes people want to engage in self harm
like cutting themselves without actually being suicidal. Has that ever been
an issue for you? MAGDA: I mean, it’s
not the standard like cutting or burning. But sometimes, I just want
to slam something down. And it’s not really harming
myself, but I’m just angry. CYNDI BRIGGS: Yeah, OK. MAGDA: I don’t know. CYNDI BRIGGS: Yeah, yeah. So no thoughts of cutting
or burning yourself with cigarettes or
anything like that. MAGDA: No, I mean, I
don’t smoke, so no. CYNDI BRIGGS: OK, but
you get that feeling like you want to just slam
something down like you get so much energy and maybe
some frustration that you just want to throw something. Have you ever thought about
throwing something at a person? Has that ever been directed
towards someone else? MAGDA: I mean, I’ve
definitely wanted to throw a book that’s
next to me at my husband when he’s yelling at me. But I’ve never premeditated any
malicious or violent actions. So it’s not really, no. CYNDI BRIGGS: OK, so you have
that frustration that you wish you had an outlet,
but you don’t have sort of serious thoughts about
doing real harm to anyone else. MAGDA: No, I mean,
thoughts are thoughts. But I’ve never contemplated
them or like I said, premeditated anything, so no. CYNDI BRIGGS: OK I’m going to
switch gears just a little. You mentioned sort of with the
conflict with your husband, and sometimes when he’s
yelling, and you’re arguing, you just get really frustrated. And so what I’m wondering
is if you’ve ever had any concerns about someone
else harming you like if you’re feeling safe at home,
if you’re feeling like your own well-being may
be in danger because of someone else. Any concerns there? MAGDA: Someone else
harming me like paranoia? CYNDI BRIGGS: No I
mean, that’s certainly important to consider, but
not necessarily paranoia, more like a legitimate
concern, like are you worried at all that
someone else might cause you harm, be it your husband,
any abuse in the home, anything like that? MAGDA: I mean, no. I’ve never actually
thought that anyone is going to cause me
harm like actually going to cause me harm. I mean, sometimes when
my husband and I fight, he can be a little bit scary. But he’s never said anything
that he’s going to hurt me. And he’s never threatened
me, and I’ve never been threatened by him or
anyone in my family, so no, no. CYNDI BRIGGS:
Thank you for that. I know this is really sensitive
and can be tough to talk about. I appreciate your honesty. Are there any weapons in your
home like a handgun or anything like that might be of concern? MAGDA: Oh, no, absolutely not. CYNDI BRIGGS: So no guns,
any other kinds of weapons? MAGDA: I mean, we
have kitchen knives. That’s about it. CYNDI BRIGGS: OK. Have you ever felt threatened
by someone with a knife, or have those ever felt
threatening to you in any way? MAGDA: No, they haven’t. And no, I have not. CYNDI BRIGGS: OK. Thank you again for being
so honest about all that. I know these questions
can be tough, and these conversations
can be hard. My primary goal is just to
make sure that you’re safe and you feel like you’re in
the best environment to heal, to recover, and to start to
feel better from all of this. MAGDA: That’s good. So I mean, is this going–
are you diagnosing me already? CYNDI BRIGGS: Well, I’ve
asked a lot of questions. And again, I appreciate you
taking the time to answer them and to be so honest about it. What we want to do is take
all of this information and put it together with
the screening results that we did in our last session
and come up with a plan. And so the goal
here is to really get a strong sense of things so
that we can build a scaffold so that you’re able to begin to
make steps to feeling better, to making the changes
that you want to make, and to start feeling a bit
more in control in your life so that your physical
well-being improves, your relationships improve,
and just overall you’re feeling better. And to getting
off the OxyContin, and so that you
feel that that’s not so much of a control
in your life, but also that you
feel comfortable and that you’re not
in pain anymore. So that’s what I’m thinking. How does all of that sound? MAGDA: That sounds great. Yeah. CYNDI BRIGGS: OK, OK, great. So let’s take what
you’ve told me and work together to come up
with a plan that works for you and to get you in a little
bit of a better place. MAGDA: OK, I just, sorry
I just wanted to make sure I understood what
the next steps were. CYNDI BRIGGS: No, absolutely. This is really important. You’re asking really
good questions. And it’s really
important that you feel comfortable with
everything we’re talking about and that it seems like
it makes sense for you. How would you feel about
making another appointment and coming back, and
we can talk a bit more? MAGDA: Yeah, I mean
that sounds fine by me. Hopefully, we can find
a solution for this. CYNDI BRIGGS: Yeah,
I hope so, too. And I think everything
what I’m hearing so far is that you are a very
self aware person. You have some really
good supports in place. You’re engaged with your medical
community with your doctor. You have a husband who
has been paying attention, is concerned about you. You’ve got overall,
your lifestyle sounds like it’s pretty healthy. And you’re here. You’re motivated. You’re making some decisions
about your well-being. So I feel like the
solutions are out there. I feel like the
solutions are in here. The fixes may not
always be easy. There may be challenges ahead. But I do feel that we can set
up a framework for you that can really support you. MAGDA: I really appreciate that. And I’m definitely
ready for this. CYNDI BRIGGS: Yeah, I hear that. All right so how
about we schedule an appointment for next week? MAGDA: OK, yeah. That sounds great. CYNDI BRIGGS: That sounds great. And then what we’ll
do is get together, and we’ll start putting
that framework in place for you to start feeling better. MAGDA: OK. I appreciate that so much. Thank you. CYNDI BRIGGS: For sure. Yeah, my pleasure. I’ll see you next week. MAGDA: OK, bye bye. [MUSIC PLAYING]