In this episode of Recovery Talks, Kathleen is joined by occupational therapists Sally Wasmuth, Ph.d., OTR, and Victoria Garcia-Wilburn, DHSc, OTR. Over the years they have found strong connections between theatre, addiction and recovery. They discuss theatre productions they have put together for the Spirit & Place Festival taking place in Indianapolis November 1-10, and how theatre can be a powerful tool for those living in recovery. Read the full transcript from the podcast below or listen to it here or on iTunes or Google..
Kathleen Gill: Welcome to Recovery Talks, a Fairbanks podcast where experts from Fairbanks Treatment and Recovery Center, located in Indianapolis, Indiana, take time to discuss unique aspects of addiction, substance use disorder, and recovery, as well as other relevant issues with our guests. I’m your host, Kathleen Gill. I’ve worked at Fairbanks since 2007, and I am a woman living in long-term recovery.
Kathleen Gill: Today on Recovery Talks, we are joined by occupational therapists, Sally Wasmuth and Victoria Garcia-Wilburn. Over the years, they have found strong connections between theater, addiction, and recovery. Today, we’re talking about theater productions they have put together for the Spirit in Place Festival in Indianapolis and how theater can be a powerful tool for those living in recovery. Thank you so much, both, for being here. Sally, tell me a little bit about yourself.
Sally Wasmuth: Okay. I am an occupational therapist. I’m also an assistant professor at IUPY in the department of occupational therapy. Before that, I was a research fellow at the VA here in Indianapolis. And before that, I was a clinician in New York City in a rehab hospital.
Kathleen Gill: And Victoria?
Victoria Garcia-Wilburn: I am Victoria Garcia-Wilburn. I’m also an assistant professor at Indiana University, Purdue University, Indianapolis. Prior to that, I was at the University of Indianapolis as an academic fieldwork coordinator. And prior to that, I worked in healthcare administration as a clinical liaison.
Kathleen Gill: Thank you, both. I’m just going to open this podcast up with how in the world does theater and recovery from addictions go together.
Sally Wasmuth: That’s a great question, Kathleen. It doesn’t in most circles. But it was something that came about when I was a research fellow at the VA. I knew, as an occupational therapist, that it was important for people to engage in meaningful activities to promote mental health, to promote physical health, to promote good social relationships, and really to promote recovery and addiction, which was the focus of my research at the time. What I didn’t know was what occupation I wanted to study. I knew that I wanted to implement an intervention that involved people in recovery doing something meaningful, but I didn’t know what that was.
Sally Wasmuth: Fortunately, I’m married to a theater professional who has brought me into the theater several times, and I have also, by default, had to watch the theater process unfold. I was really fascinated by that process, and I started to see some natural links between what happens when you do theater, and what was being said in addiction recovery literature and science. Just to give you a couple of quick examples, addiction science shows us that there are neurological changes that happen when we use drugs compulsively. Literature suggests that doing things that involve our executive system, so high order tasks like memorization, having to be present and talk to other people, having to organize your time. Those executive tasks can actually rewire some of those neural networks that get pathologically changed when we use drugs.
Sally Wasmuth: Theater made sense to me there. It also made sense in the way people and addiction often become isolated. And theater requires people to be among other people. The last thing I’ll say is, theater requires you to look forward, whereas, addiction is very impulsive and immediate. Being in a six-week theater project requires people from day one to be thinking about oh my gosh, I’m going to do this on stage in six weeks. In those three ways, it seemed like a natural fit. And the way they came together was just really serendipitous. It just kind of hit me one day.
Kathleen Gill: That’s interesting. And I find this so incredibly fascinating. Sally and I met, what, about four years ago, 2015? You were working on a production called Altered. And you were utilizing space at Fairbanks to do your rehearsals. Tell us a little bit about that show and what that was about.
Sally Wasmuth: Okay. Altered was written by the wonderful Ben Asaykwe, who is a local playwright here in Indianapolis. And it was written ape for this project. I created a six-week protocol where people in early addiction recovery would come and rehearse the play, Altered, for six weeks. We would talk about the script. We would talk about how it relates to our lives with an occupational therapist and with one professional actor and a professional director.
Sally Wasmuth: And we rehearsed Altered for six weeks and then performed it in the community. And then at the end of the show, the people in recovery who acted out the roles would the come onstage as themselves and participate in a question-answer session with the audience to really share their experience of being in the production and their experience of addiction. With the goal really being that addiction isn’t just about recovery of individuals, it’s about reconnecting with the surrounding community and helping the community see that addiction … The life that people live in active addiction is something that we can all maybe start to understand a little bit more or relate to a little bit more as members of the community. That was the goal of the script when Ben wrote it, to make these themes about addiction accessible and understandable to anyone in the audience.
Kathleen Gill: And it was so delightful to watch the people, the performers. Each week, they’d become more and more confident in themselves. And they’d come out smiling, and they’d have this proud feeling that they would carry with them. And I got to see that grow and grow week over week. That was a beautiful and very unique perspective of watching somebody change in their early recovery.
Sally Wasmuth: Yeah, and it’s always really fun for us to as the clinician and as the theater people because we set it up so that we’re all participants. There’s not like a therapist and a patient. It’s just all of us together doing theater. So we grow too and we get excited about it, as well. It’s kind of this growing together with all of us at the same time.
Kathleen Gill: Win-win.
Sally Wasmuth: Yes.
Kathleen Gill: Then in 2017, Fairbanks submitted an application to participate in the Spirit in Place Festival. And at that point in time, we joined forces and reconnected, and created another performance called, I’m Doing This for the Rest of My Life. Tell our audience about that performance.
Sally Wasmuth: Sure. That was the first of many projects that have now resulted from that initial project that both of us have done. That was the first one. It was a really exciting time. This is when we took theater and used it in a different way. Instead of the goal being to help individuals recover, the goal became to promote occupational justice and to educate communities about stigmatized conditions and different societal issues. This first one was about the opioid crisis and addiction, in general.
Sally Wasmuth: And it, basically, was the product of me and Victoria going out into the community and gathering occupational narratives, which is a tool that we use as occupational therapists. Gathering those narratives from people who were in recovery from opioid use disorder and also other behavioral addictions, food addiction, sex addiction, all kinds of different addictions. Taking those narratives and handing them over to Tom Horan, another wonderful playwright here in Indianapolis, who took those scripts and really tried to maintain the natural voices of those participants, but crafted it into a theatrical production, which we then put on stage with, this time, professional actors instead of the people that were in recovery and created a professional theater production. Again, followed by a talk-back just to kind of educate society about that experience and to serve as a platform for community conversations about the opioid crisis.
Kathleen Gill: And that performance was nothing short of amazing. It was really incredible. And that is where I had the opportunity to meet Victoria. My first question was how does theater and recovery from addiction go together? And still, one, even after a couple of years of knowing you ladies, I continue to struggle to put occupational therapy and recovery from addiction together. Victoria, share with us a little bit about how that works.
Victoria Garcia-Wilburn: Yeah, I think what really drew me and attracted me to Sally’s work is the strong emphasis on community. Like Sally, I too am married to an artist. The arts really brings people together. I was very intrigued about how she was using theater to bring the community together and to get these raw narrative accounts. As an occupational therapist, we are highly, highly skilled and educated in active listening and empathetic listening. And so in this process of empathetic listening, the person who’s telling the story is the owner of power. When we’re thinking about addiction recovery, we think about this dynamic of provider and patient. And when you’re doing this discipline called narrative medicine, and that’s actually out of Columbia University by the researcher named Rita Charon, it places all the emphasis, and ownership, and power, and drive, and direction to the client, which is very opposite of how we teach medicine, how we teach any sort of healthcare.
Victoria Garcia-Wilburn: That really, I’m the one that comes in the room as the provider, and I’m the fixer. I’m the doer. I’m the person who helps heal. And the discipline of narrative medicine and occupational therapy have this perfect fit because we believe that the person has already the solutions in them to sustain recovery, to promote recovery. We’re just not doing a great job listening. Once we’re able to draw out that empathetic listening, we can help the client reformulate new patterns and roles and routines, and even identities of who they are to see themselves in recovery.
Kathleen Gill: That is just amazing, and thank you for that description. I used to think that occupational therapy was teaching somebody how to open a jar after an injury is how I had related to occupational therapy.
Sally Wasmuth: Right, and I would say to that, the roots of our profession are actually in mental health. Occupational therapists were frontline providers of World War I veterans who had, at that time we would call it shell shock. Now we know that was post-traumatic stress disorder. We would use activity, which is occupation and the doing of that, to draw people out of that shell shock. So there is power and validity in being heard and being able to do. The roots of our profession are in mental health and so we are mental and behavioral health providers.
Kathleen Gill: That’s amazing. How critical telling the story, for somebody in recovery, owning that story, and even though that story sometimes there’s so much shame that goes with it, that power that you’re talking about is that if they can name it, and claim it, and say it, and then be able to move on, there is real healing in the storytelling piece.
Victoria Garcia-Wilburn: And I think for me, you know, Sally has developed this amazing intervention with theater. And being in the audience of some of her productions, we can all relate to aspects of somebody’s life struggle. Whether we’re in addiction or not, there are all highs and lows to our life, and it helps to normalize and de-stigmatize those that are in addiction and those that are not affected by addiction yet.
Kathleen Gill: Sally, you mentioned that your work is on the stigmatized elements in our community. What other types of works are you doing?
Sally Wasmuth: Yeah, well, right now we have a project about the experiences of discrimination from black women in our community who have experienced discrimination in healthcare. Victoria actually did one on experiences of postpartum depression. And I am also doing a project, not like the Spirit in Place one, but like Altered, with clients from the Eskenazi Health Transgender Health and Wellness Clinic. So they are getting a chance to be the actors in a six-week intervention.
Kathleen Gill: Wonderful. After the Spirit in Place production in 2017, Victoria, you were very instrumental in partnering with Fairbanks again for the 2018 production of Pain and Purpose, which was all about the intersection of parenting and addiction. Share with our audience what that performance was about.
Victoria Garcia-Wilburn: Sure. Subsequently, during one of the interviews, we had met a member who had worked at Hope Academy at that time. Thus began my relationship with the recovery high school, Hope Academy, here in Indianapolis. It was just amazing walking through adolescence and addiction and seeing the different dynamics between themselves, their parents, their community, and their ability to transition on to young adulthood after high school.
Victoria Garcia-Wilburn: I really wanted to understand that dynamic further and I chose to use, again, narrative medicine utilizing this narrative interviewing and taking sets of different parents that had a child in addiction during adolescence. That work has really been, I think, the lifeblood of now will be, probably, the rest of my career in looking at adolescence and parenting and the loss that occurs. I can’t speak for every state, but I can only speak for Indiana. In Indiana, our highest risk category of addiction is those in adolescence. The age of first use is 12-years-old.
Victoria Garcia-Wilburn: If you can think about substance use at 12-years-old up until 16, 18-years-old, you’re in and out of intensive inpatient, outpatient stays. All of the life skills that you’re learning, both physically and mentally are kind of absent. So that in that parenting dynamic, you’re really stuck at that place before in which your child was in addiction. You have this memory of who they were before and your aspirations, and dreams, and hopes for them are now different because they’re in recovery, and so there’s this ambiguity.
Victoria Garcia-Wilburn: I had stumbled upon a theory from, her name is Boss, and she has a theory call Ambiguous Loss. And the Theory of Ambiguous Loss says that I’m here, but I’m really not here. So somebody can physically be present, but emotionally be absent. And it’s actually some of the most difficult grief to recover from because there is no closure. As I was doing these interviews, I could see that theme of ambiguous lass through these accounts.
Victoria Garcia-Wilburn: What I’m working on now is a research project of a lot of parent groups and seeing if there’s something similar findings. In the discipline of occupational therapy, I have created a term that’s called co-occupational ambiguity because the roles and expectations that we have for each other within our family are now blurred. It’s an interesting concept in theory, and so I’m excited to continue to work through this research. But I think the work that has derived from these projects has been so fruitful and things that we have both come across that I don’t think we would have ever imagined.
Kathleen Gill: Right, right. At Fairbanks, the parents that you talked to were from our Thursday night parent support group. And there were several parents who were willing to share their stories. Not only for the addict or the alcoholic to identify and get real with telling their story, the disease of addiction affects an entire family. And so it’s critically important for the family members to be able to share their story their journey through that, as well.
Victoria Garcia-Wilburn: Right, I think it’s important to note that my research was separate and independent of the production because, in the production, all of those stories were parents that had given just this great amount of transparency. But I agree, it’s a level of recovery that we don’t fully acknowledge because addiction does affect everyone, especially the role of a parent and that of a child.
Kathleen Gill: Yes, so that performance in 2018 was primarily, we had a family where they had last a child due to addiction. We had a family where their child was incarcerated due to addiction. And we had a family who had witnessed their child find recovery and sustain that. It is a lot of different paths and a lot of different stories blending all together to put that production together. Victoria, I see you at Hope Academy once a week these days. Tell us what you are doing with Indiana’s only recovery high school.
Victoria Garcia-Wilburn: Yeah, I just feel really privileged enough to have them as a community partner. I think we work very closely together to enhance the programming that’s offered at Hope Academy. And occupational therapy is just one way in which students can benefit. We work on real tangible things like higher life skills, occupations or tasks that they used to do before addiction that they have never come back to, and so helping them reintroduce them to those occupations. There was a student there that used to previously cook and bake with her friends before she started using. And she had never entered the kitchen again since being in recovery. There was like five years between the last time she actually followed a recipe.
Victoria Garcia-Wilburn: Her and I got in the kitchen again, and just to see the smile on her face that she was doing something that she used to do and that she can still do that. And just seeing the level of independence and ownership that it brings toward a student, I think, is really powerful. Occupational therapy, for sure, has a place in the recovery high school model.
Kathleen Gill: Fantastic. What should we know about occupational therapy?
Sally Wasmuth: Every time Victoria and I partner with virtually any organization in the community and bring occupational therapy services there, that community site is devastated when we leave. They want to know how they can keep an occupational therapist within that site. Victoria and I’s work has really become focused on obtaining grant funding to create positions. And I just think anyone listening to this podcast or anyone that is passionate about addiction recovery or wellness in general, should know to help get the word out that our legislators and our community needs to know hat these services are available because there is a major provider shortage. If we can get the word out to legislators and to donors and funders that these services are really valued, but are not supported at this time, I think that would be a good message for us to share.
Kathleen Gill: Is there anything else you want people to know about your work?
Sally Wasmuth: There was just a moment earlier when you were talking about the power of storytelling, especially for people recovering. And one thing that one of our participants said that has always stuck with me was that he has told his story several times in meetings to other people. But in this specific project, he told his story to us, and then we gave that story away to a playwright. And then that story was given to an actor. And then that story was projected back to him. And he said that was a really, really challenging vulnerable experiment, but also incredibly powerful because not only did he see his story projected back to him, but it was now something that he didn’t get to edit anymore or he didn’t get to control what was being shared.
Sally Wasmuth: Even to bring back that theme of powerlessness in the 12 steps of the 12 step program, he experienced that powerlessness with his story in a really paradoxically powerful way. And I think that’s always stuck with me that he shared that. So I just wanted to share that with you all.
Victoria Garcia-Wilburn: Yeah, and I would just add to that, when I was doing one of the interviews, the person that was being interviewed shared that they had never told their story in that way because they had never felt like they had the ability to say everything, that they weren’t being judged, or analyzed, or critiqued during that process. Because when Sally and I complete many of our qualitative interviews, we really try to not say much. Would you agree with that? We really try to let this be just an authentic account from the person that’s telling it. I think there is just such power to that whole art if you will.
Kathleen Gill: You mentioned about the young man who was seeing his story projected back to him, what kind of feedback are you getting from your audiences who view these performances?
Sally Wasmuth: Let me just speak to the experience of live theater because I think it’s truly something special. When we’re at a theater, we’re doing something that’s quite different from most of the things we do with entertainment today. Right? We’re usually on Facebook where people can edit themselves and present an image. We are watching TV that’s edited, and perfected, and made to be at a certain speed. With live theater, it’s all real. You’re there with the actors in real-time. You, as an audience member, are a part of the production. The actors are with you. The actors are affected by you. You’re affected by the actors. It’s kind of this fully immersive experience.
Sally Wasmuth: I think that, in and of itself, sets the audience up for a certain kind of experience that can truly impact them. But I would also say that all of these theater projects are written in a way that aims to either one, tell something very truthful and raw, or two, tell a script that was specifically written almost like thematic, or broad, or vague way so that almost anyone could relate to what’s being shared. So the feedback that I get from audiences is, I actually don’t know anyone with an addiction, and I’m not addicted to drugs myself. But that character Narcissist or that character Icarus when he flies too close to the sun, I could totally relate to that excitement, and I totally understand that.
Sally Wasmuth: I think, obviously, from people who have direct experience, they cry, they feel very powerfully moved. They’ve shared. I constantly get emails that the productions have moved me to tears. I would say it’s the people that don’t know anyone with addiction who are moved, that kind of speak to how powerful I think these productions can be.
Kathleen Gill: The important thing is that we are starting dialogue. The stigma creates such a barrier and so much shame goes with it. And this is such a unique way to talk about it and present it and start the conversations. And so we are very, very grateful for the partnership that we have been able to form with you both at Fairbanks. And I hope that we continue to start conversations. Sally and Victoria, thank you so much for your time and joining me today.
Kathleen Gill: At Fairbanks, we like to say, together we can. So that’s an open-ended statement that means we can do more together. How would you fill in that blank?
Victoria Garcia-Wilburn: Together we can change our community.
Sally Wasmuth: Gosh, there’s so many words that come to mind. I think together we can grow, together we can heal. I think maybe the one that sticks out the most is together we can see each other. If we approach each other and really listen and look, that’s a powerful spiritual experience, that connection I think that’s kind of the heart of recovery.
Kathleen Gill: Empathetic listening, we all need to embrace occupational therapy it sounds like. Thank you again, ladies. This has been Recovery Talks, a Fairbanks podcast. If you or a loved one needs support in the journey of recovery, the experts at Fairbanks Treatment and Recovery Center are here for you. Visit our website, fairbanksrecover.org for recovery resources, or call 800-225-HOPE for immediate help. Thanks for listening.