Understanding Process Addictions: Insights from Addiction Recovery Coach Dr. Kenneth Markowitz

Rachel Kugel: Hey, good morning. I’m Rachel Kugel and this is Rachel Defends You. Today I have an incredible treat for you. We are gonna learn so much from Dr. Kenneth Markowitz. He is with me today via Zoom, and he is in Pennsylvania. He was practicing for many years as a board certified pediatrician, a medical doctor, and he’s now charted a new path as an international master addiction recovery coach and the founder of North Star Recovery. Thank you so much for being with me today. I’m so eager to hear your story.

Kenneth Markowitz: Thanks. I appreciate you inviting me on, and it’s a pleasure to meet you, Rachel.

Rachel Kugel: I’m a doctor’s daughter, soI also say thatclose to my heart is the understanding that it is very hard to be a medical professional and things like, overwhelming stress, addiction, all of these issues, really impact as you know, I’m a criminal defense attorney focusing on DWI. I represent a lot of clients that are doctors, nurses, EMTs, and radiologists. The work that is done in the medical field is maybe the most stressful that can exist. It raises existential questions and philosophical questions, scientific pressures. It really is a perfect storm for these issues to manifest.

So I think that you must have an interesting story.I don’t really know your full story. How did you go from board certified pediatrician to the path you’re on now?

Kenneth Markowitz: Right. That’s a very good question. So as you mentioned, I was in clinical practice for a long time, for 18 years. And took care of a lot of kids who had a lot of behavioral issues depression, anxiety, ADHD with the big ones. I also saw a lot of kids who are already struggling with failure to launch.

So even before they got into their college age, years or beyond, really struggling to figure out what they wanted to do with their lives. And so, just in general, that was kind of a background for me to dive into this type of work. Because I always had interest in that.

I always had interest in helping kids with those types of issues, even in college.

Rachel Kugel: I feel like now more than ever too, you know, these ADHD. I mean it’s like when I was a kid, I don’t think anybody was diagnosed ADHD.

Kenneth Markowitz: It was unusual. And part of it I think is just recognition of the condition, but also part of it may be just exposure to technology and how technology has really changed our attention span and our ability to focus and concentrate to a degree. So the jury’s still out as far as what exactly causes ADHD but there are certainlyMultiple different factors that do. Also, when I was in college, I was a psychology major, so I just really kind of hovered toward this type of work.

I struggled with my own issue with addiction. My addiction was not to a chemical, but it was to pornography. My addiction started back when I was in college and I didn’t know any better. When I was in college the internet was really in its infancy, but even in its infancy, pornography was already online and it was already accessible.

Rachel Kugel: It just took longer to get to it. You had to dial up.

Kenneth Markowitz: Exactly. It had the dial up mode. I found it when it was still in text form, like they didn’t even have pictures or videos online. And then when the internet evolved, it was a whole different world.

There were really no barriers to finding pornography. It was readily accessible wherever you wanted it, and certainly you didn’t have to go out and get it, it just came into your home. So it made the addiction that much more potent because the internet really accelerated it.

And there are people in the addiction field, specifically sex and pornography addiction field, who have written about Patrick Carnes being the father of this field. He specifically dedicated a book to the effect of the internet on sex addiction, and it serves as an accelerant to the addiction.

Both in terms of how quickly it develops the addiction as well as the intensity of the addiction and the intensity is a really important part of this. I’ll get back to that ‘cause I kind of talk about my story. So,I basically lived a double life for decades. During the day I was married, father of two daughters, pediatrician, very active in my community, and really looked like quote unquote the model citizen during the day. And then at night I was online watching porn for hours. The problem with pornography addiction and addiction in general is that it never just lies dormant. It doesn’t just sit in one modality.

So for example, with drugs, we often talk about marijuana being a gateway drug to harder drugs over time. Well, the same thing happens with pornography. You start with the bread and butter type of stuff, and it eventually starts leading down a path toward watching things that you never really had any interest in and may not even have interest in now, because addiction seeks more intensity over time, you just find yourself watching it.

So for some people that leads down the road to watching more violent pornography or more what people would call, I guess, you know, just more intense.

Rachel Kugel: It has to get crazier, right? Otherwise it doesn’t give the same rush the same way that someone addicted to drugs and alcohol eventually, you know, four beers might do it initially, then you need six, then you need eight. The same is true in porn or anything else, or shopping.

You can start in a vanilla way, but eventually it’s not enough.

It moves to places where you never thought it would move to. So there’s the additional challenge of there is no way to stay off the computer or phone.It’s almost like alcohol addiction is harder than a hard drug to get rid of because alcohol is everywhere, you know, celebrations, dinner meetings, romantic evening, everything has alcohol. And this is even worse because we’re on a computer right now, you kind of can’t give it up completely.

Kenneth Markowitz: Right, exactly. It’s part of life nowadays. And you mentioned alcohol, not only is it all over the place, but it’s socially acceptable. And so for people who are trying to stay away from drinking, you’ll have people out there who are like, oh, come on.

Just have a drink or two, right? It’s like it’s not a big deal, you know, everyone’s doing it, and you get that social pressure that exists in those environments too. While the pressure isn’t there to watch pornography, the social acceptance is there.It’s changing, but nonetheless, for a significant period of time, it was definitely gaining more acceptance.

And so there was that coupled with just the ease of accessibility and the anonymity too. So it definitely lends itself to an easy addiction to find yourself struggling with. For some people, pornography addiction can just stay with adult pornography, but for others it can lead to going to seek out prostitution, for example, or watching child abuse material or going to adult chat rooms and looking for more of a real experience that way. It usually kind of leads towards looking for more intense or real experience. And so for me, it eventually led to going to adult chat rooms.

Unfortunately not everybody in an adult chat room is an adult. I crossed the line, had a conversation with someone who was underage and ended up having legal ramifications and of course the end of my career. Surrender of my license. It was a really rough time.

This happened about two and a half years ago. When everything fell apart, exploded, I should really say. It took my family completely by surprise. They had no idea what was going on, and that’s a function of just how easy it is to hide this addiction.

It was a really tough go for a significant period of time. But thankfully, my family and I are still together and we can talk about that too.Which is a significant tribute to them and who they are. I’m very grateful.

They must see the real you as well. Even when you didn’t for a moment, they must have really believed in you and saw who you really are as well. Yeah, for sure. I appreciate that. And that’s true.

Thankfully my case ended with two years of probation, as opposed to anything more significant like jail time. So, very grateful for that too. I think everything moved in the direction it’s moving because I took ownership for what I did right away.

I surrendered my license. I didn’t even argue that in any way.knew my career was over. What I did was completely contrary to all my morals and ethics, and what I believe in. I think that was one of the hardest things for me to deal with, that I could really sink to a place where I never thought I’d ever go.

I’d see people getting in trouble online doing stuff like this, and I’m like, well, I don’t do that so I don’t have anything to worry about. That’s not me.And that’s part of the danger of addiction because we don’t think that it’s gonna happen to us, and it eventually can happen to anyone.

I took ownership right away. I’ve been in recovery now for about two and a half years, really since my arrest. And what does that mean for me? It means going to a 12 step program three nights a week. It means seeing my therapist regularly and making real change in my life.

Changes in how I manage my emotions, how I manage my thought processes, how I manage my day. When I have downtime, there’s no just sitting on the couch and scrolling through my phone. There’s no using my phone as entertainment, unless I’m watching a football game or something.

I use my phone and my computer as a tool. for specific purposes and then that’s it. My wife used to go to bed on her own and then I would be up at night doing what I was doing. There’s none of that anymore.

There’s going to bed at the same time. There’s making sure that I’m doing all the right things that hold me accountable for my addiction and making sure that I remain in recovery. I surely say holding myself accountable for my recovery. That’s really where I’m at. And just making sure I’m doing all the right stuff.

The other thing that’s also very helpful for me, not for everyone who’s in recovery, is that I am Jewish and observant, and so religion plays a big part of my recovery. I go to synagogue every day. Prayer becomes part of gratitude for me, and that’s a really important part of recovery.

And also just a lot of thought work that goes on.

Rachel Kugel: There’s so much, both my personal life and my work, a lot of people I deal with are in recovery. I’m a big proponent of things like AA. In fact, I think it’s one of the only things that actually works long term and I don’t care what the addiction is, it’s the same model, whether it’s drugs, alcohol, sex, whatever.

And a lot of that is making it your message, no longer being ashamed, secrets die in the light. Right? And I think that’s number one. And then making it a mission where instead of it being something that you’re embarrassed about, it becomes something that is part of your mission here.

And also, I can’t help but notice as I learn different things about recovery and AA and those principles. So much of it comes out of religion in general, but hey, I mean I’m Jewish. Ours is the oldest.

 So how is that not one of the recovery, but isn’t that the Ode Movado nothing that is the same thing as understanding that everything comes from God. And as you learn these principles, you realize that they are rooted in principles that are thousands of years old and that everybody needs to get through their life because whatever the addiction is porn, alcohol, whatever it’s all escapism.

It’s all because you can’t deal with, you know, life is uncomfortable. It ain’t easy.

Kenneth Markowitz: Absolutely. And so I don’t require from my clients that they have spirituality or religion. However, I will say that it certainly makes recovery easier.

The AA model is, I agree, a great model because it does focus people on centering their recovery around spirituality which is very valuable. If you go through the steps, of course there’s a lot of talk about God or higher power.

It’s really what I tell people ‘cause I have sponsees who are struggling with the concept of a higher power. They’re like, well, how can I continue in a 12 step program if I don’t really believe in that? I’m like, your higher power doesn’t have to be God necessarily, it has to be something outside of you.

Rachel Kugel: It’s just not you. Right? Which if you find yourself in any of these situations should be obvious to some level that your judgment, not so great. It’s like whatever judgment you need to put in place of that.

Kenneth Markowitz: Exactly. And I tell them it’s like I’ve heard people in the room saying that your higher power could be the doorknob. It has to be something outside of you, you recognize you can’t do recovery by yourself and you need something else to help you. It could be the group, it could be your sponsor, it could be anything other than just your own mind and your own emotional state.

I think 12 step is a good place to be. And so getting back to,how did I go from my career’s over and now what am I doing next?

 So I started out, I knew I wanted to continue to help people because that’s why I wanted into medicine in the first place. I can’t do that as a pediatrician anymore, but I still have a lot to offer. So I started doing consulting work for attorneys who practice med mal and personal injury.

I had a number of firms where I was helping, but then I learned about coaching and the more I learned about it, because I had no idea what coaching was. As far as what I knew about recovery, it was 12 step. It was your therapist. It was for people who needed to be in a residential or detox program. I had no idea about anything beyond that.

I learned about coaching and I was like, this sounds very interesting. I learned more about it and I’m like, this is for me. This is my calling. I even think it was probably my calling even more so than practicing clinical medicine, because what I really enjoyed about the clinical medicine part is talking to families, understanding what they were going through, and trying to help them through it.

And so kind of looking at coaching and what coaching’s all about. It’s a lot about action. Someone has an addiction. I need to know how I’m going to live in recovery day to day. What I do is help them understand how to do that and put that into practice.

Rachel Kugel: So it’s a lot of understanding the addiction, understanding how the addiction applies to the individual, and then developing relapse prevention plans. And then most importantly, putting that into their everyday practice long term. So that really spoke to me. That binds a lot of the different modalities and the different skills that you came to the table with already.

And then it also takes, I mean, the fact that you do have a personal experience must make you so much better at what you do in a variety of ways. A, because you’ve been there. But also because, you know, I find with clients, they’re dealing with a lot of, especially the good people. That’s the thing, people think you deal with, like criminals or whatever.

The good people that find themselves there are the ones that are the most, you know, they’re gonna be filled with shame. They’re gonna be, you know, all these things which don’t benefit anything. Guilt, shame, whatever. And you know, I imagine the fact that you not only have been there before, but holding a doctor is like, you know, especially a Jewish doctor.

You’re held in such high esteem. And I think that for someone going through something like this to be able to look at you and see that you found yourself just as fallible, but also have found a way to still do great. To still be good and meaningful and to still make money and to say all the things.

Kenneth Markowitz: Exactly. And so I think it’s important for people to know, like you said, in society. If you’re in professions, medicine specifically, involved in community, you’re kind of held on to a certain level. There’s a certain regard, right? For sure. And a certain level of esteem, I guess. And so that just means that when something like this comes out, you fall that much harder, right?

I know there are other professionals out there who are struggling with that, who are really, they’re at low places and they’re really struggling to dig out of it. And so I think it’s important for people to know that you can dig out of it, you can find a new direction.

You just have to have the right foundation moving forward. Hope is really important and determination.

Rachel Kugel: Yeah. And it certainly doesn’t hurt to have some good coaches and mentors as well.

Kenneth Markowitz: It certainly helps to have coaches and mentors too. Yeah.So is this a method? Like did you get trained in it? Did you create it? How do you talk your way to a specific, you know, what is an international master addiction coach? Right. So it’s a certification title that comes through the Addictions Academy. The Addictions Academy is a certification slash education program, run by Dr. Cali Estes in Florida. It’s a private company, so it’s not like state certification. It’s a little different. But she does provide really quality programming. And so I learned about her program. Had a number of conversations with her, sounded like a good fit.

And so I went for certification through her program. And the nice thing is thatI still have my MD degree, that doesn’t go anywhere. The license is a different story, but the MD degree sticks around. So between that my clinical experience and now having the educational background in and so the International Master Addiction Certification provides really a number of courses, a number of areas of coaching.

There’s life coaching, substance use disorder, process addictions or behavioral addictions like pornography, shopping, gambling, et cetera. It provides a lot of education in different areas and I feel comfortable helping people across the board when it comes to whatever addiction they’re dealing with.

I think my wheelhouse is certainly the process addictions, but I have clients who are dealing with issues with marijuana, which is becoming a much bigger problem, by the way.

Rachel Kugel: Yes, it’s sure again, ‘cause it’s also easier to get socially acceptable. It’s a different ball game than it used, so also way stronger.

Much stronger. Yeah, for sure. It’s not the way that they were smoking at Woodstock, let’s put it that way. It is a much stronger thing. It’s easier to come by and it’s something kind of everyone’s doing. I’m in New York City, you walk on the street, you smell it as you walk down the street. But is there a difference? I had not heard the term process addiction. I mean, obviously I’ve heard of pornography addiction, I’ve heard of gambling.

I’ve actually heard of the underlying, but that term process addiction was kind of new to me. I was researching it in preparation. Is there a difference in a process addiction versus a substance abuse? Is there a difference in it in general? Is there a difference in how you look at it and work with someone?

Kenneth Markowitz: The nuances are different, but the overall addiction cycle is pretty much the same. So people go from warning signs hitting them to triggers. The trigger is leading to cravings, cravings leading to ritual, ritual leading to use. And then of course there’s the shame that comes afterwards.

So that cycle pretty much exists for any addiction. What’s different is, what you’re addicted to. And so obviously you have your substance addictions, but then with process addictions or behavioral, other than food, you’re not ingesting anything.

Rachel Kugel: Well, I was gonna ask, is there an equivalency in terms of physical? ‘Cause obviously one of the challenges if you’re coming off drugs or alcohol is there’s physical, mental, social, and psychological, but then there’s also the physical. Is there still a physical?

Kenneth Markowitz: There are physical withdrawal symptoms, but there are certain, generally speaking, significantly more mild than what you get with like coming off of, you know, fentanyl or coming off of alcohol or benzos. I mean, it’s a whole different story.

But people definitely, there’s fatigue, there’s irritability, that could be crave, you know, continued cravings, which adds to the emotional response. So you definitely have some element of withdrawal. But on a different level. What’s really similar is just that the cycle is the key.

Rachel Kugel: As far as process addictions, there is still some controversy with regards to it. So the DSM-5 recognizes gambling as a true addiction when it comes to process addictions. The other ones, they’re really still looking for additional research on. I was gonna say, even sex addiction, I feel like that’s surprisingly talked about.

And there’s centers you can go to and how many celebrities talked. I feel like that’s been around a while and it’s not a recognized diagnosis.

Kenneth Markowitz: Believe it or not, it’s actually not a formal diagnosis. They see it more as a compulsive behavior as opposed to a true addiction.

Which is kind of interesting because a core component of addiction is compulsion. So I’m not really sure why they’re splitting those hairs necessarily. But nonetheless, they’re still looking for additional research.

That said, there is research out there that shows, and even imaging research that shows that people who are struggling with sex addiction or pornography addiction, do show brain changes that are similar to what you see with other addiction. So I’m not really sure what they’re waiting for.

Rachel Kugel: It would seem to me more, again, I have zero medical experience. However, it would seem to me that would be more obvious than gambling because of all the physical and all of the hormone, everything that happens in the brain when you’re talking about anything related to sex, whether it’s actual sex with a human being, sex addiction and what comes with that.

But it would seem to me that clearly has a brain chemistry process that’s up. I mean that we know.

Kenneth Markowitz: Yeah, exactly. And certainly the porn industry knows that, and even the marketing industry knows that. I mean, look how the marketing industry uses sex to sell everything almost.

So they certainly see that it definitely has an impact on people emotionally, mentally, and cognitively in general.

Rachel Kugel: It makes a difference too, because I am an attorney and I can’t help but think that a lot of process addictions in the same way that substance abuse can lend itself to legal trouble.

Whether it’s a DUI, whether it’s crimes related to possession, whether it’s stealing to get whatever. Process addictions can also lead, I mean, gambling obviously can be illegal, you could steal to get the money, whatever. Certainly sex can find its way into there.

You could end up with shoplifting. So it seems to me that from a criminal law standpoint I wonder if you have ever consulted on criminal cases? I’m wondering if there isn’t in terms of mitigation. By not looking at it through a DSM-5 lens, we’re giving people more criminal responsibility than we might if it were a physical drug.

Kenneth Markowitz: Right, exactly. It’s a very important point because with process addictions, one of two things either happens, it either doesn’t get recognized that someone’s dealing with it, which can have consequences or it becomes minimized too.

Meaning that it’s not seen as dangerous. There are no side effects. This, that, the other thing.

Rachel Kugel: Right. Or everyone has been, looks a porn or everyone’s wife shops too much, or everybody in a football pool or whatever.

Kenneth Markowitz: Exactly. A hundred percent. And everything you mentioned is a consequence of process addictions.

Like you said, if you look at sex and pornography, there are certainly legal ramifications that can come from that. Gambling, you can lose everything just from gambling. Even with food, food addiction has consequences, can lead to heart disease and diabetes. Diabetes and heart disease are within the top five causes of morbidity and mortality across the country.

These all have serious potential side effects, and end results that people either aren’t noticing or don’t want to notice because we enjoy some of our behaviors, right?

 People like to bet on sports so there’s that element of either minimization or lack of awareness. I’ve heard of situations where people were being treated for chemical addictions and they had process co addictions.

And they weren’t noticed. And while they’re in treatment, they’re on their phone.

Rachel Kugel: Yeah, I’ve seen that. Addictions also morph. You know, someone could, their drug of choice could be cocaine, but in the right setting, they’ll take whatever you got.

Or maybe they’re in treatment and they’re handling the cocaine thing. It’s hard to get, now they’re unconnected to their sellers anymore and all these things. But you know what, all of a sudden they start buying random stuff and spending too much money. If you don’t watch out, it kind of twists and turns.

Kenneth Markowitz: It’s fair to be a pure alcoholic. Absolutely. Because then you’re just dealing with that. There’s a lot of whack-a-mole with this and I’ve seen that. I’ve seen personally with myself, I mean, I deal issues with food also.

Sometimes people use one addiction to enhance the other addiction.For example, with gambling addiction, why are people serve drinks for free when they’re gambling, right?

Because it enhances the experience. I’ve heard plenty of stories where people combine coke and sex or alcohol and sex. Right. They use that to enhance the experience.

And those things definitely come together and cause a greater problem.

Rachel Kugel: Yeah,that’s really incredible. It’s true and interesting and the only thing I’m saying is by not making it a DSM-5 diagnosis, when somebody does find themselves in a criminal situation, even, you know, somebody upstanding citizen, someone like yourself.

They’re not necessarily given the same, I don’t wanna use the word benefit, for lack of a better word.They’re held to a higher level of responsibility. There’s not an acceptance that there’s a disease here underlying, or a process underlying. We have courts that are especially designed drug courts.

Somebody who has a drug addiction and commits a crime as a result of that drug addiction, because that’s a recognized medical, psychological issue you know, is treated differently.

Not to say they’re not held to account, but they’re treated with more understanding. Maybe some more compassion, maybe some more mitigation. Somebody with a sex addiction or a gambling addiction, there’s no sex court. There’s no gambling court.

In drug court they clap for you when you’ve succeeded. It’s a whole thing I’m telling you. And I’m not saying it’s easy. I don’t mean to minimize, you know, drug court’s an incredible thing and it’s very difficult for people and not every client can do it.

You have to really be committed and interested in recovery and all this. Yeah. But the point very different experience than someone, you know, dealing with a judge looking at a sex addiction crime. So I’m just saying I think when we talk about whether it is accepted in the medical community as a diagnosis, I think that has ramifications in real life and in courts. And,again, I am a lawyer, so I have to address that because it makes people not necessarily get the same compassion and mitigation.

Kenneth Markowitz: I agree. I can attest to that firsthand. My attorney when we were going through my case was really fighting hard for pretrial intervention. If I was dealing with a drug issue, I’m sure I probably had a much stronger case to be granted pretrial intervention.

Because my case dealt with a sex related matter and sex offense, as hard as she fought it, they weren’t gonna budge on it. This is with my case, without getting into details, it was really kinda set up.

Ideally for me to be able to go into that program and it still didn’t happen.

Rachel Kugel: So, it just shows it’s not about you as an individual client. It’s about the way society is looking at that type of behavior. They’re looking at that type of behavior through a different lens, and maybe that will change.

I mean, there’s been a lot of people that have been open with their stories. Charlie Kirk, for example, spoke a lot about porn addiction and obviously he became controversial, but very well loved in his community and the religious community as well.

So I think, you know, maybe this is something that the more people that speak out and the less it’s in the shadows, maybe it will become that. That work process addiction, I think is important. I’m an attorney who works with addicted people a lot. And I had not heard that term.

So I think it’s really interesting. And also because a lot of people also that watch my stuff will be lawyers. Do you do medical legal consulting in connection with criminal cases? If someone’s looking at mitigation or do you feel that, does that work in, given the background?

Kenneth Markowitz: I would be more than happy to do that for sure. I actually had one attorney, who I connected with who was a defense attorney who was very interested in using me for his cases. I never panned out, but he was, and I was all for it. I was more than happy to help him.

Rachel Kugel: I could see it for mitigation too, like a lot of times you talk about trying to get PTI or whatever we’re trying to explain our case to the prosecutor to change that perception of our client because they’re seeing it as just, a piece of paper, with some facts on it.

They don’t see a whole person. It’s very important to try to flush that out and someone like you would be uniquely qualified to help an attorney draft mitigation argument that might move very much out. So something to think about.

Kenneth Markowitz: Well, that’s actually part of the reason why I’ve been part of my outreach.

I’m a little old school this way. I like to reach out first by phone call and then by digital. But a big part of my outreach was connecting with criminal defense attorneys, and letting them know that I exist. Because if they have clients who are looking for help, I could help them, but I could also, like you said, write a narrative about how they’re doing with their coaching.

It’s like they’re showing up to their meetings. Working the program, doing their exercises, where I’m seeing actual change or not. They need to know that too.

Rachel Kugel: A hundred percent for sure.So when someone does come to you, either on their own or by referral, is it a long term? Like what’s the general program? Is there a program? Is anything different depending on the person? How does that work?

Kenneth Markowitz: It is very individualized. There are certain standard exercises I like all my clients to do. ‘Cause I think it’s just important for recovery. So when we talk about recovery and sobriety, those are two different things. So there’s sobriety, which is you’re not using your substance anymore. But recovery is making change in life.

Right. Sobriety is encompassed in recovery, but recovery doesn’t necessarily, and because you’re sober doesn’t necessarily mean you drive drunk, like you said.

Rachel Kugel: I know many people personally and professionally that might be physically sober, but not spiritually sober.

Kenneth Markowitz: Exactly. I like the way you put that. You hear about the drive drunk, but I like what you said better.

There are standard things I like to do, but then it’s really very individualized ‘cause everyone’s recovery is different. And so we really get into the nuances of their addiction cycle and understanding what their unique warning signs are, what their unique triggers are and so forth.

And then once we have a good understanding of what’s going on there. Then we really start developing that true relapse prevention plan and helping put that into place. So there’s a lot of individuality when it comes to it. And as far as how long people are with me, a lot of it has to do with the client.

There’s some people who, for example, wanna get their relapse prevention plan in place, learn how to do it, and then out the door, right? And that’s how they wanna work it. And that’s fine. I always leave the door open for them if they want to come back. But then there are others who feel that they need more of a semi-regular check-in, for how things are going.

So it’s either dealing with something that they’re struggling with, and they want advice on that, or just help them really work through it. It’s really a function of asking the questions to help them think it through.

Sometimes they just need that or they wanna, just stay, you know, connect every week and just continue to work on putting their relapse prevention plan in place in their regular life or also work through certain things that come up that they’re really struggling with.

So it really varies from one person to another. On average, most people go with coaching for six to 12 months.

Rachel Kugel: Is there a difference between the term, I’ve heard the term like sober coach? Is there a difference between sober coach and what you do?

Kenneth Markowitz: Very similar. Sober coaching is basically the same as what I’m doing. I’m not sure if sober coaching does specific life coaching too, so that might be a difference.

Rachel Kugel: You take a little more 25 foot view of someone’s life and really help. That’s interesting.

Is it only for the wealthy? ‘Cause I know probably insurance doesn’t cover it. Is it the kind of thing that most people could do? ‘Cause I know sober coach, I usually read that in connection with celebrities.

Somebody move into their pool house. Are you trying move into someone’s pool house or is this the kind of thing that anyone needing treatment could get?

Kenneth Markowitz: Yeah. That’ll be more of a companion. Sober companion is moving into the pool house for sure.

But that I’m not doing, at least not yet. Who knows where the future will be. As long as it’s a nice pool house. But anyway, pretty much anyone can find a sober coach. Different recovery coaches will work with different clientele, right?

So you have some people who are really more dedicated to those who are struggling financially, others who will take more of a middle approach, and others who are looking to work with professionals. I do focus more on professionals because I think I have a lot to offer them because of my own personal experience.

So that’s kind of like my wheelhouse, my bread and butter, so to speak. But I certainly have clients who are not professionals. They’re just working and have various jobs and I cater my fee schedule to them. I work on a sliding scale, so it’s not just like, oh, I’m gonna charge X and take it or leave it.

I really do try to work with people.

Rachel Kugel: Yeah, imagine you end up in a community once you’ve trained in the same way that other professionals are in a community. And if someone did reach out to you and you felt you weren’t the perfect fit, it’s better that they should call you and reach out and you should say, let me find you.

Kenneth Markowitz: That they help you find the right place. Exactly.

Rachel Kugel: Is there any myth about recovery that you wish you could just erase?

Kenneth Markowitz: It’s a good question. Yeah,I think one of the myths, or maybe some confusion is whether or not someone can actually be healed from their addiction. As opposed to the addiction is always there and you have to constantly work on it. I’m in the camp that it’s always there. In my mind I think about it as modern day treatment for HIV. So why is that?

With the medicines we have nowadays, people can live long lives. And their viral load can become undetectable. But do we really know whether it’s truly there or not? Like what happens if a person goes off their medicine? We don’t necessarily know. And I don’t think that anyone in medicine would say, well, let’s try it, see what happens.

Because that could be a death sentence. So, I look at it the same way with addiction. I think that you can get it to a place where a person can live their life in sobriety, confident in sobriety, and in recovery and really get their mindset to the point where their addiction could even be revolting to them in a way.

And ultimately I think it’s where we wanna get to it’s like, oh, I have no interest in that whatsoever. But does it necessarily mean that the addictive tendency isn’t there? Does it mean that you’re not gonna become addicted to something else? Does it mean that something somewhere down the road’s gonna trigger you to look at it again in the light that you looked at your addiction while you were in an active addiction.

 I don’t think anyone can say that. I think that complacency in recovery is still a dangerous thing and I think people continually need to work on themselves and,not talking about major changes every day, small changes every day is what matters.

And being vigilant with the thought work and the tools that are necessary to maintain active recovery. So I think that’s lifelong.

Rachel Kugel: It’s also those character defects that spiritual sobriety is like that you could be physically sober, but even if you’re physically sober for a really long time, I think much of those character defects that led one to be the type of who led one to have the issue are still there and can pop up.

Whether that’s selfishness. Selfish is a big one. And addiction, I find. And I think, those things, if you’re not still working your recovery or have someone to check in with, like you, for example, those are things that even if you’ve been sober a long time, can pop up and affect marriage, business, all those other things that really do matter at the end of the day, what else matters right?

Then, the happiness, family, marriage. Those things can be affected.

Kenneth Markowitz: I totally agree. It’s really important that recovery is more than just not using your substance. It’s really changing who you are and how you interact with other people.

Rachel Kugel: In the few years that you’ve shifted your life and been working on this, you have changed countless lives. Is there one story or something that still gives you chills, gives you hope. I mean, obviously not with names or anything, but is there anything that makes you wake up and keep doing this day to day?

Kenneth Markowitz: I wouldn’t say it’s a story where I was successful. You know, there’s a general feeling that you don’t learn from your successes. You learn from your failures. So I wouldn’t necessarily call this a failure, but that said, I know I had a client.

Somewhat recently who, college student, was really more failure to thrive, but was struggling with the substance use disorder also. And so we started working together. Everything was going great, and then suddenly he fell off the grid just outta nowhere, just completely fell off the grid wasn’t answering, my text wasn’t showing up to scheduled visits.

I started talking to his parents about what was going on ‘cause they were involved. They obviously gave me some understanding as to his pattern and how he behaves. And this is part of it. But what was rewarding for me was that I was able to help them and help him get the help that he needed.

It was a struggle. It wasn’t easy because he had gone through programs before and felt that the programs had failed him. His parents felt that the programs had failed him because he was left on his own. It was going from this cocoon of safety to, okay, you’re out there. Good luck to you.

It was really hard to get him back to that place where he’d feel ready to try your program again. And I feel like that was an accomplishment for me because that took a different skillset to get him and his parents confident enough to move forward.

And so that really stands out, maybe because it was just recent, but also because of those other reasons. Thankfully he’s in the program and he is a private. 

Rachel Kugel: It also kind of shows the lesson that it’s not all or nothing, and it’s not necessarily success measured by perfection.

There’s very rarely a straight line road. I think it also illustrates that point, which is to say, someone else might have looked at that same story and said that kid was a failure.

 But you know, understanding that the path of any of these types of issues for people is never straight and having the wherewithal to, just like as a family member, you wouldn’t give up on someone who had cancer. Right? You don’t just throw out somebody

 So, I think getting someone to reengage illustrates a ton of great points. I can’t thank you enough for coming on today and for sharing honestly and candidly, your story, which I think is so helpful to professionals, to lawyers and doctors, to individuals going through it.

And you’re such a shining example of what can be turned around and take something bad and make it, you know, my whole thing, even with my business, ‘cause my law firm is DWI defense, which is controversial and I get a lot of, you know, Thanksgiving dinner, like, how can you do this?

Nobody’s pro drunk driver. Right? One of the big goals that I have is to build something that takes something bad and makes it a force for something good. Whether that’s through conversations with people like you through charity, helping someone get well, helping someone get through a tough time, whatever.

Kenneth Markowitz: I really think you’re an example of someone who’s done that. 

Thank you very much. I appreciate that, Rachel. It was great being here. Tell me how people can contact you as well. I’m gonna put all the links also.

Kenneth Markowitz: Absolutely. I have a website, nsrcoach.com. My phone number and email are on there, or they can contact me through messaging me there. Those are the ways to get in touch or reach out to me on LinkedIn.

Rachel Kugel: Thank you so much. I can’t thank you enough.

Kenneth Markowitz: Thanks Rachel.