Jess Vivenzio, LCSW: The Work Beneath The Work

This month we're featuring Jess Vivenzio, LCSW, a therapist NFR recommends wholeheartedly, both personally and professionally. If you've had the chance to meet Jess, you already know: her energy is vibrant and her warmth is palpable. We asked her to share a bit about herself in her own words.

I'm Jess, a transplant to Fairfield County from Western Massachusetts. I originally moved here for undergrad and grad school, and I ended up loving the work I was doing and the people I met enough that I never left. I grew up in a family of first responders, including police and Air Force, and I think that definitely influenced the kind of clinical work I'm doing today. Being in that world from a young age gave me an early understanding of the culture and some of the things that come with it, which has become a really important part of my work.

When I'm not in the therapy office, I'm usually somewhere in the community. I'm on the Norwalk Crisis Response Team supporting families who have lost someone to suicide or an untimely death, or with the Fairfield County Trauma Response Team supporting first responders. And when I'm not doing either of those things I'm probably walking my dog with an iced coffee in my hand. I almost always have a true crime documentary or podcast playing in the background, unless I'm reading my Kindle. One of the things I'm most grateful for in this work is the people I've met along the way. I've met some truly remarkable humans who have impacted my life in ways I never could have expected. I've learned a lot from the people who have trusted me with their stories, and I really don't take that for granted.

It was during my MSW graduate school field placements, working with adults living with substance use disorders and co-occurring mental health diagnoses, that I realized this was an area of work I was drawn to. Once the interest was sparked, hours of researching and reading the work of Gabor Maté, Bruce Perry, and Johann Hari followed. It was in this space where the perspective of getting curious and asking clients "What happened to you?" rather than "what's wrong with you?" became engrained. In the early years following graduate school I was a clinician, then manager of a trauma-informed, gender-specific Intensive Outpatient program for women experiencing co-occurring substance use and mental health diagnoses. Sitting at the table with these women who had experienced tremendous adversity and survived so much trauma felt like an honor, and the only way to provide them the therapeutic support they deserved was to keep learning and keep showing up for them. This is where my focus on working with clients who have experienced trauma and developed post-traumatic stress injuries really began. From there, I realized that alongside working with clients on co-occurring disorders, I wanted to focus time and training on supporting first responders as a way of giving back to the community that helped raise me. With all of my clients, our work is rooted in a trauma-informed, strengths-based perspective: helping people understand their nervous system, develop more effective ways of coping, and regain a sense of control over their lives.

For so many people, substance use has become a way of surviving, regulating, connecting, numbing, or avoiding what otherwise feels unmanageable. It has over time become an adaptation to manage life. That said, it is often a "band-aid" with short-term relief and long-term consequences. When substance use has become a tool for coping and self-regulation, we can't ask people to give that up without doing the work that comes along with implementing more effective skills in its place. When someone has spent years managing pain or uncomfortable feelings with substances, actually slowing down enough to bring awareness to it can feel both relieving and terrifying. The first step in any type of trauma-informed recovery treatment is helping someone feel safe enough in their own body and in the therapeutic relationship to begin noticing what they feel, what they need, what their body is communicating to them, and what their coping strategies have been doing for them. In our therapy space this looks like stabilization, nervous system regulation, and building physical and emotional awareness. That can include somatic work, grounding and self-regulation skills, CBT or DBT-informed strategies, motivational interviewing, and eventually trauma processing when someone has enough stability and readiness for it. With teens especially, we can't expect them to have the language or insight to immediately tell us what is happening internally. Their behavior is the communication we need to be paying attention to. I also believe it's important not to make readiness for change an all-or-nothing concept. Someone may not be ready to stop using substances entirely or talk about their difficult experiences, but they may be ready to sleep better, feel less angry, have fewer fights at home, or find one thing that helps them feel more in control. That can be our window of opportunity to support the person without requiring them to be completely ready to commit to something so different from what they're used to. This is also a great opportunity to use EMDR therapy as an intervention, because it does not require detailed accounts of traumatic experiences for healing and symptom reduction to take place.

I think it's important to hold two truths at the same time: a young person may be struggling in ways that are genuinely hurting themselves and the people around them, and their behavior may be a response to a family system, environment, or experiences that also need attention. Parents: this doesn't mean you are the problem or you are to blame. It's important to shift away from the narrative that there is someone or something to blame and instead work to accept the reality of the situation so forward progress can be made. My role when supporting a family isn't to decide who is "the problem." It's to create enough safety for each person to be honest about what they're experiencing, understand the function of the behavior, and help the young person develop healthier ways of coping. Families need support, education, and the right to set boundaries to protect themselves too. Sometimes supporting a teen means helping them find language for things they haven't been able to say, while also helping parents shift from "How do we get them to stop?" toward "What might this behavior be communicating, and what can we change about the environment around them?" Boundaries and accountability are still important. The work I do with the family system is about making those boundaries about safety and values rather than shame or punishment.

Recovery from a substance use disorder isn't something that happens in isolation. One of Johann Hari's most well-known ideas is that "the opposite of addiction is not sobriety. The opposite of addiction is connection," and I think there's a lot of truth in that. The person struggling deserves to feel safe, heard, and understood, and their family and support system need support too. Recovery is so much more than stopping the substance use. It's about helping someone build a life that feels worth staying present for, while helping the people who love them find their own way forward too.