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A Conversation About Addiction and Boundaries With Author Pixie Lighthorse


I spoke with author Pixie Lighthorse about her book Boundaries and Protection. Specifically, we discussed boundaries as they relate to addiction, recovery, and codependence. Boundaries and Protection is an incredible resource for anyone who is trying to figure out, as Lighthorse put it, “’Where do I end and the loved one in my life begin, and how can I honor the space between us?’”

What is the importance of creating healthy boundaries in recovery?

There are so many ways to think about recovery. Whether we’re talking about alcohol and substance abuse, or addiction patterns within relationships, our emotional sobriety directly relates to having boundaries. Simply not doing the act anymore isn’t where recovery begins and ends. If the goal of recovery is to create safety, stability, and security in your life that you didn’t get to have and was unmanageable due to addiction, boundaries is just on the menu of all the different things you need in recovery.

That really resonates with me. I’m over six years sober and the work is ongoing.

Oh yeah, it’s lifelong. It’ll never end, and that’s not a prison sentence. That’s an invitation to actually live.

It’s an opportunity to heal. I think everyone can use healing, but it makes that drive more prominent in your life.

Yeah, I think we enter recovery to learn how to soothe ourselves in healthy ways. In recovery, we do all these things self: we learn how to self-love; we learn how to self-care. Self, self, self is the center. Leaving a self-centered disease—if you want to call it that, in the old-school words—means, “Oh wow, now I have to center self in a really conscious way.” But the whole point is to tend the self so that we can be in healthy relationship, so that we can stop centering rugged and mediocre individualism.

In early sobriety, I had to get to know myself—sort of for the first time or maybe again—because I had spent so much time disconnecting from myself and my feelings. How can people start setting boundaries when they’re still getting to know their needs, triggers, and things like that?

I think language and communication can be really helpful. It’s something we engage in every day, whether we’re muttering to ourselves, journaling, or in dialogue with other people.

Language is one of the ways I’ve had to learn to set boundaries. I come from an addict household; language was weaponized. It was never used to soothe, neutralize, or diffuse. It was used to ramp up emotional states, to deflect the terrible feeling my addict relatives were experiencing that they didn’t know how to contend with. The addicts in my life are very sensitive, sensory, perceptive beings. That’s not valued in our culture, so that’s going get squashed early on—especially in anyone who is trending masculine.

So it’s about learning to take responsibility for our own bodies and lives and emotions, rather than expecting someone else to. That’s the codependence that goes hand in hand with addiction: we want somebody else to make us feel better.

Start saying loving and kind things to yourself. Then it’s just baby steps. It’s important to start practicing everywhere we can. In stages of feeling not very emotionally sober, I can blast my children, or get highly activated around something my animal does. Every time we interact with people and ourselves is an opportunity to practice empathy.

There was a quote that really stuck with me in Boundaries and Protection: “Without the desire to be here, we don’t have much to work with. The desire to be somewhere else is the phenomenon of craving that addicts report feeling beholden to, and it eventually sends them to their bottom.” I was wondering if you could talk more about that link between the feeling of not wanting to be here and addiction.

Yeah, that chapter’s called “Want to Be Here.” It really is an invitation to the reader to learn, “Maybe not all parts of me want to be here; maybe there’s a part of me that doesn’t want to be here, and why is that? Is it because I have such a low tolerance for my own discomfort? Is it because I don’t think highly of myself? Does it feel too hard?”

I don’t want to minimize anyone’s experience of those parts that don’t want to be here. But can I concede that if I am going to be here, I can ask myself to do better?

It’s hard to want to be here sometimes. And that’s a sometimes. Human beings are fluid and in flux. Martín Prechtel speaks about how in the Western world, we want things to be rigid and black-and-white. That’s a trauma response; it’s about control. “I want it to be this way all the time, or else I’m under threat.”

Or if I can’t easily figure this out, because it’s not one thing or the other.

If I can’t name it—if it bewilders me—I’m going to give up. And there’s no judgement around that. I think that’s suicidality in general, which sometimes accompanies addiction. Just feeling so worthless and low and bad, and maybe so angry.

The addict’s lament is, “I don’t want to feel these feelings; I’m going to shut them down and numb them. I want to have my inhibitions or reserves taken away. I want to use so I can be bolder.” Whatever it is, we want it our way. There’s a reason they talk about life on life’s terms. It’s because we don’t have the ability to make a static life out of being a human animal. It’s going to ebb and flow, and be very disappointing and hurtful, and very triggering to old patterns that really did us harm early on. My goal is to build tolerance for what actually is.

That’s huge. Especially if you’ve had different patterns—not even necessarily just substance use—of not having to feel those feelings.  

Yeah, it’s all tied together. Most people’s lives are unmanageable to start, even if it doesn’t look like they are. Internally we’re a big hot mess.

I was going to ask about codependency and addiction. The section in the book you talked about it most was regarding children who grow up in homes with addiction. Can you talk more about how those two relate?

I experienced codependence and enabling in addicts; that is the template that I was raised on from before birth. I had teenage parents who were codependent decades before anyone was even using that word, at least in my family circles.

We don’t have a lot of power over our codependence; we need each other, and yet we must tend ourselves. Some friends and family will sometimes joke, “We’re consciously codependent.” I want to be able to say, “I need you in my world, but I don’t want to need on you in an unhealthy way that takes your energy. I don’t want to entitle myself. I want to ask for something.”  We can stop vilifying our codependence by being like, “I don’t want to need anybody.”

Asking for what you want is like, “I need soothing from another person today, do you think you can do that with me or for me? Can we co-regulate? Can we put our energies together and then soothe?”

Is there anything else you want to add?

I don’t say this to plug, but Boundaries and Protection is a great starter conversation for people who are like, “Where do I end and the loved one in my life begin, and how can I honor the space between us?”

But as we start to do that, a lot of discomfort gets stirred up—whether we’re together and a disruption happens, or we’re apart and that emptiness starts to swell. Goldmining the Shadows, the book that came after Boundaries and Protection, is my voice on the matter. There are many, many, but it’s my voice on, “How can I dig a little bit deeper inside myself, so I can become more tolerant of what’s moving through me?”

The inner work is where it’s at. Being deeply interior in the process of recovery—in a way that is helpful and sweet—will make us sturdier for staying sober. Whether you have one year or 30 years, there’s going to be all that old patterning that says, “I don’t want what’s uncomfortable.”

Yeah, like you said earlier, it’s a lifelong process.

And I think we can exhale and go, “Okay right, it’s a lifelong process. I don’t have to get it all right now.” To be a human animal is to allow for all that nuance.


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As we continue to grow Amatus Health, the need to stay competitive and differentiate ourselves in unique ways is crucial. Building creative approaches to reach more people will take our company to new heights. This is why I am pleased to announce that we are officially rebranding. Our new national name, TruHealing Addiction & Mental Health Treatment, will eventually replace Amatus Recovery Centers.

You may be asking, “Why are we doing this?” This new name will give us national uniformity and help brand ourselves as a whole, which will be done in phases. You will still see our existing facility names co-branded with TruHealing for the time being.

Healing is what we do. Everyone who comes through our doors is in a moment of profound struggle in their lives. We support them through a life-changing process of healing and recovery, and they leave our facilities changed. This new name is a representation of that process. As mentioned above, it also allows us to have a national brand, which will make us a recognizable name in the addiction and mental health field.

In summation, these changes present an excellent opportunity for our organization to develop our mission, vision, and purpose. I look forward to prosperous growth as we head in a new and positive direction.


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Mark Gold
Amatus Health

Dr. Adam Cusner, PhD is an organizational psychologist by training and has brought his decade-plus experience to the healthcare field serving as the Executive Vice President of Operations for a 22-facility portfolio of skilled nursing facilities, assisted living and independent living centers across Ohio and Arizona, with an annual revenue over $250MM. While serving in this position, Dr. Cusner brought accelerated growth to these facilities, while increasing employee retention and workflow optimization. Dr. Cusner has a proven track record in the healthcare industry of providing successful leadership through his financial acumen, strategic planning, interpersonal skills, along with his ability to build strong, effective teams.


Dr. Cusner’s credentials include a Philosophy Doctorate in Organizational Psychology (PhD) from Cleveland State University, a Master of Arts in Psychology (MA) from Boston College with an emphasis on Psychology of Work, a Bachelor of Science in Psychology (BS) from Boston University with an emphasis in Organizational Behavior in Business and is a board-certified Nursing Home Administrator (LNHA). He has published and presented research articles in the field of organizational psychology at national healthcare conferences. Dr. Cusner is completing a book on organizational psychology in the healthcare field, which is expected to be published late early summer 2022. He is also a member of the American Psychological Association (APA), has served as the APA’s Division 17 communications chair, is a member of the Society for Industrial Organizational Psychologists (SIOP), and was selected as a professional reviewer for national conference research presentations.


Dr. Cusner is an advocate for his employees and is drawn to the tie between culture and quality. His extensive strategic and operational skills have delivered a high degree of success across all department levels. Dr. Cusner facilitated the establishment of an in-house financial team to provide billing and collections, accounts payable, vendor management, along with financial reporting. This provided $1.5MM annualized savings. Further, he developed department efficiencies for: Medical Staff recruitment, service-line growth, quality and safety, corporate accountability of budgetary expectations balanced with direct reporting to investor groups.


Dr. Cusner coordinated the financial turnaround of a 300 bed CCRC (skilled nursing, assisted living and an independent living center) in Arizona, which has been epitomized as the most financially challenging state to manage CCRC facilities. Dr. Cusner also strengthened the business growth of the Ohio facilities by 12%. He was recognized by the Governor for demonstrating a “care-conscious approach” during COVID, when Dr. Cusner carefully consolidated facility residents to accommodate staff and improve clinical care. Dr. Cusner demonstrates a results-driven culture by delivering a high-quality level of care and employee engagement.

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Yaffa Atias is the Director of Special Projects at Amatus Health. Atias is a leadership professional with a decade of experience in healthcare. She holds a BA in interdisciplinary studies from Thomas Edison State College, and a Master’s in Healthcare Management with a concentration in project management from Stevenson University. She completed her graduate capstone at Mosaic Community Services, now an affiliate of Sheppard Pratt.


In her role at Amatus, Atias leads and manages interdisciplinary team projects, creates solutions for any operational gaps, and continually strives for quality improvement in all processes. Atias led the organization’s COVID-19 preparedness strategy, resulting in all facilities remaining operational, and in 600 employees being retained as staff without resigning out of fear. In her role so far, she implemented licensure for three new states.


Atias believes Amatus Health and TruHealing stand out because every employee, from corporate to center staff, has a real passion for helping people. Atias shares this passion, “My natural compass always tugged me to behavioral health. I’ve always been fascinated by the human psyche. I have also been intimately privy to those suffering from mental illness and substance use. I later understood that my experiences weren’t unique, and quickly realized how pressing the need really is to effectively prevent and address. Moreover, how life-changing proper intervention truly is.”


Atias was born in Los Angeles, California and grew up in Israel and Maryland.

Melissa McCarthy is the Vice President of Business Development at Amatus Health. With a decade of experience in the behavioral healthcare and addiction treatment industry, McCarthy is passionate about recovery. She has her finger on the pulse of marketing trends, with the end goal of helping businesses grow so they can serve more people in need.


McCarthy has worked at large enterprise recovery centers across the country spearheading business development teams. She has a wide range of experience, including transforming a third-party digital marketing and client acquisition services company into a full-continuum behavioral healthcare provider, managing several successful rebrands, and growing annual revenue fivefold.


As VP of Business Development, McCarthy leads a team of over 20 business development professionals nationwide. She manages client acquisition, coordinates in-service trainings with various referents and hospitals, and presents at conferences on addiction and mental health disorder treatment.


“Sadly, many individuals die waiting for access to life-saving behavioral healthcare services,” says McCarthy. “I am in relentless pursuit of better—better access, better care delivery and better outcomes. I consider it a privilege to work in an environment where miracles unfold daily.”


McCarthy lives in Maryland with her daughter.

Hometown: Saugus, MA


Passions & interests: The greatest passion of mine is being able to dig into the work with men in early recovery. There is nothing better than witnessing and being a part of the change. My journey in long-term recovery has taught me to value the little things in life that I am now able to do. I love to do anything that allows me to be present with my wife, family, and friends. My wife and I enjoy traveling, trying new foods, and taking long motorcycle rides with our friends. If I am not on the road working or with my wife, I am studying or playing softball.


The best part of my job is being able to show up for my team and clients; they all mean the world to me. I get to brainstorm and strategize with tons of different personalities. A lot of the team does not know, but I love learning from them. If I am not learning something about our industry or workplace, I am certainly learning how to effectively collaborate with different types of individuals.


Together, we can change the narrative and be a part of the solution to better treat those trapped in the problem.

Allison was born in Columbus, Ohio and was raised in South Florida. She graduated from the University of Florida’s College of Journalism and Communications. After college, Allison started working at the largest talent agency in the world, William Morris Endeavor. There, she learned marketing from top leaders specializing in global PR and endorsement campaigns, in both the Latin and English markets.


Through strategic public relations and creative campaign concepts, Allison has secured more than 200 national broadcast and print media placements for behavioral healthcare organizations. She brings over 15 years of marketing and PR experience, with a strong background in leading communications strategy for addiction treatment and behavioral healthcare facilities. In her role as VP of Communications, she oversees branding, public relations, social media, marketing, events, and content creation.


In her spare time, she loves cooking, boating, yoga, and traveling. She and her husband Bryan reside in Boca Raton, Florida.

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Avi Burstein is VP of Clinical Services at Amatus Health. He manages all therapeutic programming at all facilities nationwide.


Avi is originally from New York, and graduated from Ferkauf Graduate School of Psychology. He brings over 13 years of experience in the Behavioral Healthcare Industry, in both the public and private sectors. He is passionate about therapeutic communities and the fellowship they foster between patients. Through his work in LGBTQIA, urban, rural, and religiously observant populations, Avi recognizes that each patient is unique. Therefore, he strives to ensure clinical approaches, staffing, administration, and education meet the expectation of each community Amatus Health serves.


“Our work must also include ending the societal stigma surrounding such conditions by building safe and supportive networks that include clients’ families whenever possible,” Avi said. “By valuing change and owning imperfections, we can strive to be better providers and walk through the door of recovery with our clients.”

Avi Burstein is VP of Clinical Services at Amatus Health. He manages all therapeutic programming at all facilities nationwide.


Avi is originally from New York, and graduated from Ferkauf Graduate School of Psychology. He brings over 13 years of experience in the Behavioral Healthcare Industry, in both the public and private sectors. He is passionate about therapeutic communities and the fellowship they foster between patients. Through his work in LGBTQIA, urban, rural, and religiously observant populations, Avi recognizes that each patient is unique. Therefore, he strives to ensure clinical approaches, staffing, administration, and education meet the expectation of each community Amatus Health serves.


“Our work must also include ending the societal stigma surrounding such conditions by building safe and supportive networks that include clients’ families whenever possible,” Avi said. “By valuing change and owning imperfections, we can strive to be better providers and walk through the door of recovery with our clients.”

Marty Markovits is the Chief Information Officer at TruHealing. He oversees the people, processes, and technologies of the whole organization to ensure the business is running smoothly.


Markovits grew up in Brooklyn, NY (which he calls “the greatest city on Earth”) and graduated with a degree in Clinical Psychology from Queens College.


Markovits is a veteran in Information Technology within the healthcare field. He ensures that IT processes are simple, cost-effective, and secure. His expertise spans the entire healthcare domain, from billing and claims, to clinical, to Human Resources. He says, “My passion is to provide fully automated and operationally meaningful Business Intelligence analytics, with absolute data integrity.”

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Hometown: Savannah, GA


Passions & Interests: I spend my time outside of work with my wife and children and am actively involved in various community needs and causes.


The best part of my job is knowing that we are creating a safe, healthy, nonjudgmental environment where people can come and better their lives. There is nothing more satisfying than helping others learn to live again and piece their lives back together as they become strong, productive members of society.

Together, we can bring families back together and promote healing and well-being.


With over 16 years of proven executive leadership and driving company growth, Mark Gold’s momentum for success isn’t slowing down anytime soon. He serves as the CEO of Amatus Health, one of the fastest-growing, behavioral healthcare organizations in the country.

Possessing an excellent handling of clinical compliance and high performance standards, Mark established 14 CARF/JCT accredited addiction and mental health treatment centers and three ancillary healthcare businesses. Mark’s natural leadership skills as well as his creative thought process to generate new revenue strategies make him one of the most sought-after professionals in healthcare. Mark has a track record of leading organizations to outstanding ROI on overall portfolio performance. In addition, his expertise includes workforce planning, growth revenue, high client and investor satisfaction.

Aside from daily business oversight, Mark invests in his staff and helps build their professional development. His commitment to his colleagues and employees toward advancement and inclusiveness helps them achieve goals, builds connections, and provides a competitive advantage in the healthcare field.

Corporate and Charitable Leadership

Mark has been instrumental in building healthy communities and providing access and quality healthcare to underserved populations. His service in the community is a testament to his passion and selfless dedication to the cause of eradicating addictive disorders and stigma.

He launched several prevention and education programs and created the first-ever “Social Justice” scholarship fund of over $750,000.00 to help communities of color into inpatient drug treatment. Mark says, “The best part of my role is the knowledge that what we do impacts countless lives, with far-reaching effects,” he said. “It is incredibly rewarding to be part of a team that guides individuals onto a safe and accessible path to healing and recovery.”

He is a board member of Ahavas Chaim, a non-profit that offers at-risk teenagers crisis intervention and mental health support. He is also a committee member of the organizations Bonei Olam and Chai Lifeline Mid-Atlantic.

Personal and Educational Background

Mark studied Talmudic Law at Yeshiva’s Mir Yerushalayim in Israel. In Mark’s free time, he loves snowboarding, boating, and spending time with his wife and children.