We Are Here to Make Good Trouble

This is At the Margins — a publication about addiction, recovery, behavioral health, and the systems that shape all three.

It is written from rural northwest Iowa, where the gaps are widest and the work is most unforgiving. It is written by a clinician, a counselor, a researcher, and someone who has spent nearly a decade (professionally) sitting with people in the hardest moments of their lives inside systems that were not built for them.

This is not a neutral publication. It never will be.

The field I work in was built in living rooms and church basements by people in recovery who refused to leave their neighbors behind. That inheritance is worth fighting for. These pages are where that fight gets named.

Two columns will live here. At the Margins examines rural practice, underserved communities, and the structural forces that shape who gets care and who doesn't. The Wounded Healer is more personal — the reflective space where clinical identity, lived experience, and the cost of this work get named honestly.

If you're a clinician who has ever felt the system working against you and your client simultaneously — you're in the right place. If you're in recovery and you've never been given a real explanation of what's actually happening in your brain and why the process works the way it does — you're in the right place. If you're exhausted and still showing up — you're in the right place.

Subscribe if you want to stay close. More soon.

— Gus