Episode 100
Revisiting Our Top Moments Pt. 1

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Description

Our team celebrates Finding Peak’s 100th episode! In celebration of this special episode, Brandon Burns brings on Chief Operations Officer Clinton Nicholson and Clinical Director Lauren Atencio to review and reflect on noteworthy moments over the past 100 episodes. From visiting trauma and touching on mental health approaches to the future of Peaks Recovery Centers and the industry, our team brings insightful and thoughtful commentary to continue pushing the industry in a positive direction.

Talking Points

1. Revisiting Traume
   
2. Alan Cook on trauma
   
3. TJ Woodward on redefining trauma
   
4. Dr. Ilardi on depression
   
5. Dr. Ilardi on tribal culture
   
6. Final thoughts on part 1
   

Quotes

“Trauma is a part of us. It’s a part of our identity, and it’s in these little pieces and moments and snippets that we actually start to cut away the tethers that bare us down based on our traumatic experiences and the identity we’ve developed around them.”

– Clinton Nicholson, Chief Operations Officer

Episode Transcripts

Episode -100- Transcripts

here we are here we are hello everyone Brandon Burns chief executive officer for Peaks recovery centers bringing to you a very special episode of Finding Peaks today episode 100. birthday cake candles all the things you know how we like to party in America sober party here at Sugar Peaks though yeah that’s what I’m talking about yeah absolutely that’s coffee coffee caffeine we’re ready to go 100th episode I’ve got the great Lorna tencio hello Clinical Director men’s program Lac lpcc yes so almost all the clinical things almost we just have a couple months I’ll be at LPC and then she can be all the clinical things from there exactly which is great and then Clint Nicholson Chief Operating Officer LPC Lac all the clinical things all things so in in recognition of episode 100 for all the viewers joining us today if you’ve watched past episodes and I say all the clinical things that’s LPC Lac the state of Colorado you can basically do what you want yeah and when you’re anything on your Lac and training shrinking you know what we can do yes I can do almost all the things with the Lac right so yeah but Lauren’s getting there yeah I wouldn’t doubt you for a second thank you all right well we don’t have uh the other hosts in town they’ve got kids they’re out of town Jason’s in London Chris is in Phoenix celebrating being away so for the sake of this episode they will have no input and that’s fair yeah so uh if in in in kind of foreshadowing how this is going to go as an episode we’ve decided to kind of go back through some reels of Prior episodes uh to kind of re-engage into some discussions that have been valuable and important to us um here at uh finding Peaks and um one of the so we’re going to go through four main topics here we’re going to talk about trauma mental health approaches to care substance use disorder and kind of the future of the industry and kind of where Peaks finds or sees itself within that sort of framework uh and uh to kick this off uh you know trauma has been kind of a feels like a two cent word in our industry at this point they didn’t work on my trauma I need to work on my trauma that’ll help me stop using drugs and alcohol the reason I keep relapsing is because I haven’t worked on this you know that type of thing but what I want to be clear about here and I think what we’ve defined Within These episodes is that uh trauma is the experience after the hardship and I think that’s really important to quantify uh in relationship to the discussion because I think sometimes we think about it as just the hardship as if we’re just going to excavate the hardship the unfortunate experience that took place and then trauma’s resolved we’re really the experience and the emotions and the story We Tell ourselves after the hardship is what trauma is uh and so before kind of diving into these episodes did I mess anything up you guys want to clean up anything in that framework or are we are we right-sized here no I think yeah trauma is really about what’s happening today not about what happened in the past so um I think that that isn’t often a misconception we think of trauma as historical and Trauma is actually something that exists in the present so really exploring it from that lens makes uh gives it just like a different feel and a sort of different perspective I agree I think that so many clients so many people in general they get so stuck in the context of the trauma of the story right we love storytelling and it has nothing to do with the story exactly what you said it has to do with the impact of an event and how we react to it in any given situation so I think you guys nailed it on the head alrighty well um uh kuv’s gonna do it first going to put us up on the screen but this first clip is um by a pass guest also a past uh employee at the highest level he was past Chief clinical officer for Peaks recovery centers his name is Alan cook LPC Lac all the clinical office as well too yeah uh the Old Guard as they might say I think he would appreciate that into his retirement but he had some uh important insights that I think uh will support this discussion and what we’re getting after here today so without further Ado Alan cook it is not the trauma that has caused them the problem it is what they took away about themselves what they believed about themselves what they believed they lost or what they believed they disempowered about themselves or what they had to protect themselves from that’s important to release and relearn because most of the time our traumas happen sometime in history that’s the nature of trauma it’s in the past and we forget that no matter when our trauma happened we were different then but we’ve anchored that trauma in that experience especially childhood trauma we were children we were helpless we didn’t have a lot of skills so we believe about that trauma that it’s true today even though our skills have changed so if I approach that from shame because when somebody grows up what they bring about that trauma is their shame well why couldn’t I take care of myself why couldn’t I stop that I must be a bad person if I can release the shame today then I can remind them that they have different skills today than they had then and Link it differently
yeah I think first and foremost for the those on the YouTube channels and witnessing that it was massive yeah I mean I had to double take like I looked at you here there I where was your mouth yeah it was under my mustache my mustache yeah yeah it was it was Hefty by how we have changed right exactly because that’s all I could think about so it’s a shame yeah it’s the shame of it all so I think Alan you know brings forward what you know we kind of discussed prior to it but I think in in adding to that right that he’s adding that that language of shame to it uh as a processor and experience and I think it’s important to validate that there’s a hardship when he’s talking about maybe younger folks who experience hardships that resulting in emotional takeaways of trauma that something took place in that time for which they were just a little kid they couldn’t protect themselves they couldn’t ask for help they didn’t have the tools and the capacity to negotiate the situation they were in in that lack of control moving away from the hardship we start to form a story about it right that uh where Alan brings the discussion to is now we’re in this future moment we have a completely different set of skill sets we have a completely different framework of empowerment um and but we’re still carrying the same story even though our condition is entirely changed and I think you know open chair and these types of clinical interventions is one example of something that allowed me to kind of in my own Journey restate my truth right and then Empower myself in this new condition and that framework so um without further Ado what other insights might we take away from this or what else would we want to add to you know what kind of what Alan put forward there assistant I think that one thing that he touched on is how we go back to like I’m a bad person because I have I’ve never been able to handle this in a way or wasn’t able to handle this as a kid and I think that is just a fundamentally flawed kind of thought because how are we going to put the responsibility of a kid to regulate emotions that only humans should or adults should experience right I think the other part of it too is how do we not allow those feelings thoughts behaviors whatever it is control us in our adult life I know you and I Brandon have talked about this a lot too is like we have the ability to not allow the trauma to control us but instead step in and control it and kind of take the power back which I think is the biggest thing that we try to do with clients is Empower them to find power within their trauma because it’s like you are letting this take over your life you are deciding that like this is just it for you at times and so being able to take that power back and be like wow I can change my thoughts I can change my feelings I can adapt to my emotions is so huge within that process as well I think yeah I totally agree and I think what I would probably add and um my experience with trauma is more based in sort of brain and you know when these when the traumatic event happens and we start telling ourselves this story or we start um basically incorporating that trauma as part of our identity it actually changes the brain it changes the way the brain processes information it changes the way the brain allows emotional experiences to be uh kind of perceived and processed and so trauma is not just about the thought it’s also about the physiological impact that it’s had on our ability to perceive and engage with the world so you’re really kind of through talk therapy I think you get to gain this Insight I think you get to sort of understanding begin to unravel The Narrative but it’s really through experience repetition through acknowledging in real time and in real relationships and real interactions uh how how you are responding and then how do you want to respond differently so there’s this other component as well which is a little less for me it’s it feels less mystical but um I’m just not a very mystical kind of guy so I I like uh I I see traumas through that lens and I see part of the process of healing trauma is actually healing the brain as well yeah and so uh for me I definitely I think it’s going to be important it’s coming up I you know and taking power back accountability you start to form this notion of responsibility and so I think this is going to be consistent with all of this right how do we uh how do we nurture somebody’s acceptance of their own responsibility within the journey whether it’s trauma substance use disorder mental health and so forth um and you know uh Empower them and acknowledge the courage that it takes to move forward so I’m excited to get to that but a year almost a year and a half after Allen was on the set we brought TJ Woodward yeah out from California and Los Angeles to come in and give us uh his own insights into his conscious recovery approach we did a staff training on that invited him into the studio to talk more about it and as you’ll see in the clip I could not help myself in asking TJ what is this trauma thing laid out for us because again it’s I believe it’s in alignment with what we’re doing at Peaks and what we see as a value proposition within this these clinical approaches so without further Ado DJ Woodward well you know my follow-up there is the trauma word Jason you know how much I love I was waiting for you it has a topic but you know for the viewers out there we’ve challenged trauma we’ve walked through it we’ve done episodes on it but I think you know for me in Reading conscious recovery in your text and also going through uh the experience over the past few days I think your view of trauma is correct and what I mean by that is that I think sometimes as an industry we hyper focus on the hardship the actual traumatic event itself somehow to uproot that get it out the door and then we can sort of continue forward on our journey but that’s not the focus from your description of trauma and would just love for the viewers to hear your side of that tale yeah and Trauma is you know I’m using a very broad umbrella if you will about trauma and that’s any experience honestly where we’re not seen as a whole and perfect being and so if we use that definition we can say that being on planet Earth is a traumatic experience right and so it’s not and and we talked about this a lot experience and I love that you’re asking this because it’s not what happened it is what happened but it’s not only about what happened it’s really about what I decided about myself as a result of what happened so one you know we could have the exact same experience and it could be very traumatic for you and it’s like no big deal for me right I have had experiences that would seem fairly innocuous like not a big deal to people but it was very traumatic for me not because of what happened but because it was that moment that I decided I was stupid I wasn’t lovable I wasn’t good enough and this isn’t logical right right this is not a logical process because as an adult I’m like oh I have evidence to show that I’m not stupid but I believed it so deeply that I couldn’t read well I could not write well like that idea that belief or that frequency was showing up so consistently and I couldn’t talk myself out of it so you know um I don’t remember which trauma specialist said this but trauma doesn’t show up as a memory it shows up as a reaction so the way we work with trauma and the way conscious recovery approaches it is what’s showing up for you right now what’s present within you where is this in your body can we be present with it because with addiction we’re trying to run from it right right and many of us have spent decades some of us running from the traumatic experience through addiction and if we can get a client just to be present for 30 seconds and realize oh wow I can do that that’s where we actually can start to heal the trauma without saying what happened to you when you when you were seven beautiful viewers that’s what I’m talking about right that’s what brand has been trying to say that’s what I’ve been trying to say for the last hundred episodes
and there it is yeah there it is you know wrap it up I don’t know if this is one of those things like where we’re like you know putting things out there just to get back at our own narrative here or not but I think our reality is that um I think at least my common uh experiences with family systems is that it’s this working on this trauma thing rather than the behavior in the moment and the message that we’re carrying forward and so I think uh one I mean this is how we experience trauma at Peaks recovery centers is how we talk this is how we approach it I think it’s consistent within our field when you start talking to other professionals as well too that this is the true narrative and so for like the viewers out there not trying to just insist on this is the path but to help family systems resolve for themselves what the challenge is here at the end of the day and you know uh you know without shying away from it you know the client or you know patient who comes into Peaks and says well the last treatment program didn’t work on my trauma therefore I kept using but then was using math for the last six months coming back into our program we’re not really in a position under that scenario due to the increased craving States and all the other kind of Fallout that may have come from that use in this particular example to really nurture that and so you know from here I want to talk about I want to dive into personal responsibility about and your guys’s thoughts on this um but the challenge is to working on trauma whatsoever right within time limited approaches inpatient care and so forth I mean you know when it comes to an insurance company I can convey to the users out there they’re not interested in trauma care taking place in detox I mean that’s that’s you know that’s being facetious right it’s obvious it feels like but in inpatient care you know the lights are turning on a little bit that’s not what they’re interested in right they’re interested in the biomedical the stabilization those sorts of things trauma is not a biomedical condition at least to the payers in this regard it becomes more mental health or those sort of tertiary Asam four five and six criteria but without diving into that tangent you know and so forth we’re talking about limitations for actually being able to deliver these services and the requirement really becomes like okay when and where can we work on this and actually move through these processes with patient care or in I know at least I think in our experiences at you know Peaks we’re we’re giving it to him like you know throughout the curriculum but sort of a sprinkling approach rather than a very direct we’re going to sit down and do this now yeah I mean I think the generalized answer to that is that there are a lot of clients people just who are not ready to go there yet I if you throw all of these interventions at someone and say okay you’re going to process your trauma right now and we’re going to do it and they have no sense of grounding they have no sense of self they have nothing to kind of hold on to for safety they’re going to flood and we’re we are at risk for re-traumatizing those people because they’re feeling all of those same emotions in that moment and if we don’t have a way to contain that then it becomes really really messy um I think there’s this other part of it too of like everybody’s trauma the way we work on it is going to look different right if you have extensive trauma and you come in and we can’t sit down and do everything like well we can’t talk about all the trauma you’ve ever endured but what we can do is we can talk about the maladaptive behaviors that come out of that trauma we can talk about the thinking patterns that you’ve adapted because you know as TJ said I feel stupid okay you feel stupid we can we can hone in on those things we don’t have to go back in the trenches in order to allow to manage some of these symptoms that come along with it and you know not hurt them in the meantime or flood them essentially yeah you know I’m thinking about it and I’m my mind is actually going to the idea that we start working on the client’s trauma as soon as we answer the admissions line like I actually think that the way that we think about working on trauma and the way that you actually work on trauma are two very different things I think our pers and a lot of that is just kind of social stigma representation of media that kind of stuff but just by identifying that somebody thinks they’re stupid that is we’ve started the process of working on trauma because we’re starting to identify a narrative right something that needs to be disrupted even the craving state in detox when we’re working through somebody who’s going through a craving we’re working on their trauma because what they’re experiencing is a drop of the protective mechanism that they’ve been using to deal with the trauma and a rise of the feelings that they’re actually trying to push away right so we’re we’re experiencing and we start to navigate that trauma moment in real time right there in that moment we’re working on your trauma with you so I think when um I think clients can actually be a little um on I don’t know I I think that that’s this is a generalization but generally speak I think clients want that big excavation moment they want that big time of like we’re gonna go in we’re going to take that trauma or look at that trauma tell what it’s all about and throw it away and that is not how trauma works it’s trauma is a part of us it’s a part of our identity it’s a and it’s in these little pieces and moments and and Snippets that we actually start to cut away the the kind of um the tethers that bear Us Down based on our traumatic experiences and the identity that we’ve developed around them does that mean no I think you said that beautifully and I even would say too like with detox we’re working with Medical on the physical trauma of detox right you have a client come in they’ve been drinking for 10 years and they are know that they’re walking into being sick our medical team has come up with a beautiful way to support them through that our clinical team is checking in every single day I think you said it so beautifully as like we’re just we’re doing this every step of the way without them even knowing and so to say oh I need to work on my trauma exactly what you said trauma goes nowhere it’s there it happened it’s it’s it’s all about how you then perceive yourself moving forward no I do think it’s important to give the client credit that they have to have that moment of I want to work on this I want to change like there’s the in the end uh you know the the goal of any therapy is change right and so if for them to be able to show up and just say I want to do this different that is really the a huge first step and that’s what again like triggers the phone call and then we answer and it’s like cool well you’ve just started your trauma work right you know we’re already there you’re on a journey with us at that point right yeah I think it’s important to highlight kind of in the sense of you know uh around these three words action thoughts emotions right that the first step in dealing with that is to call a place like you know Peaks and say I need help and to negotiate that and that’s a step forward in accountability recognition absolute problem and responsibility that I’m going to do the next step whatever that is so I can start negotiating the other two principles of thoughts and emotions but you arrive at a place like Peaks and what ends up happening right 30 days later it’s like I feel great I’m gonna go back home and live with Mom you know without the extension of all the things we still have to work on at the end of the day you can feel really good really protected really empowered in a place like uh Peaks once all the you know sort of fighting us at the end of the day kind of kind of calms down at the end of it and and the reason I talk about responsibility and accountability as harsh as it may sound or it might seem like maybe I’m belittling you know past patients who walk through different programs maybe they over promise and under delivered maybe they said we’re going to do trauma whatsoever and they didn’t do anything of the sort and they threw the 12 you know steps at them or whatever the case might be I can understand where or appreciate where our industry as a whole might be off-putting uh in that regard but there are very real scenarios where patients come in know they have to continue to work on that and stop doing that and what I want to inspire here because I think it’s consistent it’s one of the great values I I think of the 12 steps is that accountability and representation of responsibility and holding people to that but the kind of framework I want to set up for it is that I get why it would be challenging to sort of like move forward in the process right because I have this thing that I know that works or it works most of the time or at least for me in this context you know smoking pot doing hair whatever it is I know what that is as miserable as that is at least it’s comfortable because I know it right and I think what our patients often want is okay when I’m doing this clinical intervention I want to see so far out where this is going and the promise and recognition that I’ll be fine when I get to the other side of this journey you guys are putting me on because this is a strong pull here but what we can’t do is walk them through that whole journey that is their journey to walk through right at the end of the day and the only person who can do that is the individual taking responsibility for that path is discomforting it is but clinically speaking of course right that’s what Aftercare is for Community is for the rooms are for all of those nurturing components to instill and help guide that person forward so with that thoughts ideas insights I think I just want to add a little bit too is that like trauma responses can also be very praised in the world as well and so they’re very much overlooked and our clients like to fall back into those patterns because they’ve been praised so they think about like hyper vigilance anxiety those different things if I’m guilty of overworking all the time and because of that anxiety because of that fear of not being good enough but my also my whole life have been praised by that so how am I going to look at something that I’ve that is really much benefited me but is also kind of detriment to me as well I think it’s all about looking at Trauma from every angle and how it’s good how it’s bad how it’s affected you how it’s made you better in a way you know all of these different aspects and like you said there’s just no way this can be done in 45 days there’s no way this could be done in a year like trauma work is years of work and you have to consistently take responsibility for yourself you have to consistently challenge those thoughts are there embrace the emotions when they become uncomfortable like this is the hardest work you’ll do and there’s such big reward at the end because of it yeah I mean the initial reward is like like total emotional discomfort and physical discomfort at the same time yeah I mean like the initial uh so when you’re looking at like a kind of a reward pathway it’s not very effective early recovery it’s very very hard and we also live in this wonderful shame-based society which just kicks people right back into those old patterns it starts it will actually turn up the volume of the the narratives and stories that people have started to develop about themselves regarding their past traumatic events so I mean there are so many things that push against an individual who is on this journey and I think that what we really see in early the early stages of treatment is just this desperation you know like they’re just we don’t talk about how to be healthy in our culture we don’t talk about what it means to be whole we don’t talk about what we look at wholeness as like a joke almost it’s like oh you feel good about yourself well there’s something wrong with you you know it’s like you must be on something and it’s like no no no no we’re we really almost belittle the what it means to to to go through the the S the suffering that helps you get over the suffering you know and there is a uh and it feels very antithetical and it feels um really contradictory at the same time I think we see it all we see it every single day that there is this moment of I have to walk through the Shadows to get to that light you know yeah um it goes into what you were saying too is like we live in a society as well of instant gratification so right I didn’t get sober because they didn’t work on my trauma well that’s not really how it works you can’t just work on your trauma and then everything’s cured and I think sometimes our clients do get so fixated on like okay this empty chair is going to cure me I’m going to feel better everything all my thoughts are going to go away and it’s it’s so much more than that that I think it can be a little bit defeating at times because it’s like man I did all of this work and I still feel the same sometimes that’s not normal and it’s about kind of accepting that as a process and I think that that’s part of our actual program is this kind of and this is goes back to like act as well like just sort of radical acceptance you know it’s like no I’m gonna I’m not gonna leave here like perfect in fact if I’m trying for Perfection I’m setting myself up for failure so there’s this kind of realistic um kind of you know uh I don’t know I love kind of stuff like this like it’s very pragmatic my favorite word um approach where it’s like no this is gonna be this is the beginning of your journey you know and your recovery actually starts when you leave it’s not while you’re here while you’re here we make it it you’ll see the light you can see that it’s there that there is this opportunity there is this path forward but you have to walk in on your own you know like we we can give you some tools man and and we can really and we can help you see that you are valuable and worthy of this journey but we can’t make the journey for you yeah totally and you know one quick metaphor here before kind of moving on is it comes from you know I’ve been talking to you about a clean the dopamine Nation book but it it it’s a it’s a it’s an exploration of dopamine and how it works and it’s in its foundation is dopamine works like this in in the dopamine centers of the brain wherever they’re located I’m not a neuroscientist but they’re in there somewhere and the whole goal of building or or any biological structure is to be in homeostasis is to not be too much on the side of pain or too much on the side of pleasure when it’s too much on the side of pleasure it tries to Resort back to pain to get it centered and that’s that type of thing and that’s where we experience with individuals who start using opioids on the pleasure side of thing to quell pain in the background actually end up experiencing more pain because the dopamine centers of the brain are trying to regulate it back to homeostasis so as oddly as it is when we shoot for the thing that gives us the surplus of feel Goods they’ll draw it down to that is that it’s going to pull us right back there that’s the process of homeostasis and so if that’s true you know when people use drugs and alcohol to quell that we know if this is true about dopamine that drugs and alcohol will never ever ever ever resolve the issue of trauma or provide so much you know relief that you’ll never experience the pain again and oddly enough the more you use drugs and alcohol the more the pain is going to increase absolutely and so it starts to lose its foundation like we’ve talked about gabramonte episodes and so forth it almost works so close so close so close
and that unless we’re talking about a fairly rare situation in which somebody just needs trauma work right somebody doesn’t abuse drugs and alcohol somebody doesn’t have depression anxiety they can go right in the trauma where you start working on it right but the reality and that might not be true but we’re talking about rare exception too where what I’m getting at where a monotherapy intervention is going to work for the individual to um decrease suffering find that homeostasis and then they’re back out there in the world the complexity of the patients we see I don’t think is that case and so we can’t just work on the trauma just like we’ll learn now in the mental health approaches we can’t just give them the pills you know to a quell mental health anguish that’s not going to work right we need sort of a collective action here and again the reason kind of for walking the viewers on episode 100 here through these approaches so um without further Ado diving into the mental health approaches into care here we know that one in four Americans uh in the United States are on psychotropic medications right now in America 25 one in four people in America one in 20 children in adolescents are on similar medications and of those one in four adults nearly half are on ssris to manage depressive episode from 1995 as we’ve talked about on the Stephen elardi episodes it’s also realized in the dopamine Nation book it’s on the Sebastian younger episodes from 1995 to 2015 we have a significant increase in the amount of medications that individuals are receiving psychotropic medications for mental health anguish and yet the problem has not persisted not one iota it has not dropped it has not come down right and so we’ve talked about on these episodes um you know that these interventions like an SSRI may work anywhere from 15 to 20 percent or excuse me 15 to 30 percent of the time yet 75 percent of adults in America are treated with just pills alone 15 to 30 percent efficacy 75 percent of the population suffering right we know in the maths they’re pretty basic it’s not working and so what we aren’t challenging here is whether or not it works for some people sure and it does help especially in our spider web approach of quelling symptomology now we’re going to hit them with movement and talk therapy and you know know all of that type of stuff but we know it’s not sustainable in and of itself and on its own and that’s what we’re trying to draw attention to by bringing on guests such as Dr Stephen elardi a PhD clinical researcher on depression wrote the book The Depression cure and he does his clinical research out of University of Kansas and I think he’s on to something you know Clinton you stated something there’s something wrong with our society in the way we shame people right and uh Dr lard is going to go as far as to call it a disease of civilization there’s something about our contemporary Society for which we are not biologically suited for so without further Ado let’s Dive Right into uh the illardi episode hit us curve why are the depression drugs not as effective as we wish they were I mean they certainly help a lot of people don’t get me wrong millions of lives have been improved but they’re not the game changers for many people that we need them to be that we want them to be why not in part because when you give a drug like our ssris nris to ramp up serotonin signaling very often you’re simultaneously pushing down on the dopamine system that’s why we have sexual side effects is one of the most common side effects right you’re pushing down on the on the reward circuitry well that’s not really what we want in depression so we need to augment that effect with other things and you know because we’ve talked about it a lot that I’m a big big proponent of the idea that there is no magic bullet in depression there’s no single thing fancy word monotherapy there’s no monotherapy approach there’s no magic drug that’s going to completely cure forever a person’s depression most of the time there are you know rare exceptions but the drugs have a place they have a role but we have to augment it we have to do all the things we can’t just rely on the one thing we can’t rely on the monotherapy so that’s that’s just the first promise I wanted to put out there I know they’re a lot of different so I’m curious now too you know and certainly we’re presenting to the team earlier which is so grateful for was so informed on educational but why why how are we in a situation in which I mean maybe it’s just speaking science or we just don’t have the application for it yet but why don’t we have drugs that do the dopamine thing rather than the serotonin we do okay so the one that probably a lot of the audience have heard of is is the generic Is bupropion yeah the the trade name is either depending on whether you’re taking it for smoking cessation or depression the trade name is wellbutrient in for depression or or zyban for smoking cessation same drug and the problem is that depression is often and by often I mean over half the time accompanied by a lot of anxiety and if you give a drug like Wellbutrin it’s like oh okay so we’re going to ramp up dopamine that’s good we’re going to ramp up reward signaling that’s good occasionally a patient will even have spontaneous orgasm
there was a Gray’s Anatomy episode by the way for interesting yeah um so it’s no joke it can ramp up reward signaling but it can also ramp up anxiety okay because the circuits are kind of cross-wired a little bit which it’s a long story we don’t have to go into but so um well what else can we use well stimulants right ADHD meds like um like Adderall like methylphenidate Ritalin like Vyvanse all these drugs also ramp up dopamine can they be helpful in depression yes absolutely are they commonly used no why because well they’re Controlled Substances a have a high addiction potential or at least moderate addiction potential B but C they also ramp up anxiety and so a lot of prescribers are very loath to use them even though we’ve got these dopamine deficits in depression that if anything a lot of times the medications that we’re throwing at depression can make worse so then it’s like all right well what can we do that’s non-pharmacological to ramp up dopamine and it turns out thank God there are lots of things like physical activity like ambient sunlight exposure which is about 100 times brighter than indoor lighting and light is a drug literally photons of light are drugs that hit specialized receptors in the back of the eye and the retina that have a broadband connection to the center of the brain the hypothalamus and they not only re-normalize our body clock which gets out of sync and depression not only regulate our sleep regulate our hormones but kick up dopamine signaling so we probably all had this experience we’ll go out on a bright sunny day like we happen to be enjoying today um if we go on a long hike or something regardless of the activity level we feel energized we feel stimulated and often we have better focus because of that sort of stimulant-like effect when people are depressed though what do they do they they don’t go outside they crawl into a cave their brain is giving them a signal to shut down pull away withdraw and part of effective clinical work with depressed populations is validating for them like look your brain is telling you that you’re sick your brain is telling you just like when you have the flu get away from everybody crawl into a cave lick your wounds rest tight for a couple weeks till you heal and when you have the flu that’s great listen to the brain when you have depression that’s the last thing in the world you want to do because that’s going to make it worse and so a lot of the threading the needle with depressed patients is validating yes of course you feel like shutting down yes of course you don’t want to be around other people yes of course you have no energy and you have no initiative and you’re suffering and you’re hurting but we have to partner together to help you not listen to these signals from your brain that are actually broken signals right now and if we can if we can pull off that particular clinical trick then we’re actually ramping up dopamine signaling and that’s the part that I think so many people don’t get they’re like well wait a minute if you have a brain chemistry problem the only possible way to fix it is to throw drugs at it or to you know put some powerful magnets on the brain and call it TMS or you know do electroshock there if you’re something very somatic but what we know from the realm of Neuroscience the realm that I’m trained in is experience changes the brain and activity changes the brain and the food we eat changes the brain and our ambient light exposure changes the brain so all the things we think of as like oh my grandma could have told me to go get some fresh air my grandma could have told me oh go get some sun Oh Be Active the grandma didn’t know that this is like powerful powerful psychoactive sort of intervention
so there we are uh super grateful to know Dr lardy had been able to befriend him now and knowing him for I think almost uh six years now and uh there’s something you know in in the few in this next clip we’ll talk about like his schtick and that type of thing but um you know that you highlighted Clint there is something big about disease of civilization right you know there is a schtick there is a narrative that you know is being concluded here where Society is really affecting the individual in a really large way that when we look at tribal ancestral selves and societies we don’t really see the same symptomology and if we did we would have died because we had no interventions like Peaks recovery you know medications moving all that type of stuff uh but in what we’re speaking to and why that was the first video is uh it’s it’s again you’re hearing it from him okay we can throw these monotherapeutic strategies at people but look at all the complications you know with it uh that you would you know be careful where you take Wellbutrin in the world right in that regard as he’s as he States but um it it might be the case rarely though that the SSRI is going to help clean up a lot of the situation but in reality it actually comes with a lot of baggage potentially it doesn’t mean we’re not going to use it it just means we need to be aware of that and find alternative Solutions and what I think he is conveying and I think we’ve adopted from that spiderweb approach is kind of thrown you know the kitchen sink at the individual between physical exercise let’s get you up if we can’t get you in front of the sun let’s shine a light on you you know we’re going to use TMs but we’re not going to treat it as a monotherapeutic strategy uh you know in that regard and I think that’s the essence of this but in a world where you can go say drink alcohol and maybe quell that to Britain more immediately though it’s not sustainable I think we’re constantly in pursuit of that and as a society have sort of trained ourselves well you know the new Bro Science cold bass we’re just going to jump in some cold water and resolve all of our issues in the world you know based on bro science so I haven’t read any clinical research on that but whatever [Laughter] but it’s out there folks read about it apparently it’s a big deal um we’re not going to be able to do these straightforward very simple things to resolve very complex issues and suffering is a complex feature of our humanity and so I think that’s the that’s the initial delivery there from you know Dr alardi we have a solution but it’s not the solution and we got a lot of challenges in front of us so how do you guys see this now as you know within Mental Health primary patients that were taken into Peaks um what are we doing differently what what matches about this um and are we in in disagreement at all about this no I I you know I think it goes even back to the personal responsibility aspect of things as well um very transparent right now when I first um heard Dr alardi speak I think some of my clinical therapists like claws came out a little bit where I was like it’s not that easy to just go outside when you’re depressed you know and um but as I’ve as I’ve gotten to know him and got to know his approach a little bit more it directly ties into the personal responsibility of if I want to manage my depression I do need to get outside I think even for me personally like I was selling I’ve been doing CrossFit regularly now and I told someone the other day how much I hate that it works because it does all of these things they really do work for us and it’s kind of the way that we were made to be is move and be outside in these different things and so I think going back to personal responsibility is a lot of our program is hey man you can sit in this bed all day or you can get better or we could go on a five minute walk together and just see the sun sun for a minute and then you can go back to bed if you need having the movement team has been huge we have an activities team that is very intentional individualized that will say Hey you know you struggle with getting out of bed why don’t we just get out of bed and move our bodies for five minutes it’s just a very intentional approach that I think is more helpful than we could ever imagine yeah yeah it’s it’s this weird like it’s more it’s comp it’s complicated but it’s also really simple like there’s the um well I mean I just want to address the elephant in the room I was wearing the same outfit today I just almost to a TV almost the jacket I have a different very similar jacket and these are actually different boots but very similar boots I just realized I buy a lot of the same stuff so I’m learning a lot about myself right now exactly yeah oh my God that was really beautifully put yeah I think it’s uh you know when we talk about something like depression in particular and um we don’t know I mean we really don’t like honestly being on this Earth is an absolute nightmare sometimes but it’s also a beautiful experience you know there’s just this magnificence to it and and we live in this sort of dichotomous realm and bounce around and we float around in the middle and we we struggle and we’re alone and then we’re connected and then we’re lonely even when we’re connected I mean there’s so many different ways in which we engage with the world and so this idea of like a mono therapy being uh like you can do one thing and feel great all the time like even the things that do work like similar to that like substances don’t work like it’s just not a real thing um it takes everything it takes a village it takes multiple different approaches to try to help feel better and it also takes um it takes action on your own part to want to to heal you know uh it’s the the sort of like wisdom of your grandmother that already spoke to it’s wisdom because it’s true you know like it’s there’s true wisdom there and I think that we like to over complicate things because we like to feel complex you know we want to be complicated it makes us feel more special it makes us feel more unique and there is so much pressure in society to be special and unique and goodness gracious what would it be for us all just to admit that we’re still pretty basic you know like it’s part of the evolutionary cycle goes we’re still kind of in the beginning portions of this whole thing so why can’t we accept that like why can’t we accept fresh air is actually kind of important sunlight’s kind of important you know yeah walking around the block is actually that’s pretty good maybe you should really focus on you know not eating all everything from a drive-through you know like these are things that um problems that we’ve created for ourselves and I think the solutions are usually right in front of us at the same time once you get into that state of depression once you get into that state of of sort of hopelessness and helplessness it is so dark and it is so heavy and there is in no way shape or form am I taking away from the absolute torture of it and that’s when you need other people around you to help you get out of it because if you can’t get outside by yourself then you go to a place like Peaks and you have somebody come in and say I’m going to walk with you like you can’t do this alone right now but you can do it and we’re gonna and then you get into the idea I think elardi also kind of just broke to like repetition really healing is about repetition it’s about practice it’s about constantly engaging and forming new uh Pathways within the brain and forming new behaviors forming new thoughts forming new beliefs forming new narratives um and we do all get to a point where all of us will get to a point in our lives where we can’t do that on our own and so I think that there is this uh as simple as it as maybe the um the treatment might be it does not take away from the absolute treachery and horror of the actual illness itself that gets you there so yeah yeah well in you know we we talked about it on the the Sebastian young air episodes and for the viewers out there Dr lardy was on that episode it was it was great um you know we talked about we reviewed the uh 2012 study of the addiction uh Journal of Medicine you know that talked about we are in the most sedentary malnourished um you know uh poorly nourished you know I’m running out of all the neat terms that all these people do to describe contemporary Society yeah but at the end of the day you know even in the book uh dopamine Nation uh you know that I’ve recently jogged through a few times uh it talks about that we are sitting more we are sitting 50 percent more today than we were in 1950. and that’s just a 70-year history never mind what the sitting today looks like for our tribal past in that regarding to the to a large stick out there what he’s doing is he’s reviewing tribal cultures trying to locate in DSM-5 language did they have states of depression did they experience anxiety bipolar disorder schizophrenia all these types of things and what he’s discovered in his research zero rates of depression zero rates of anxiety so all of this basic grandmother’s stuff is what we were doing back then so what has changed and for him it’s civilization has changed and our biology isn’t suited for it so without further Ado we’ll get into this next three minute clip uh Cube where Dr elardi brings us close to that sort of uh tribal moment we we would have been obliterated as a species yeah tens of thousands of years ago we never would have made it we never would have lasted this long so we know given how debilitating depressive illnesses we know that our ancestors had to be way less vulnerable than we are why why do we not have genetic protection there should have been massive selection pressure to give us antidepressant circuitry to mimic the antidepressant effect of all of our best meds and other best practices why don’t we have it we didn’t need it why because the antidepressant was woven into the fabric of our lifestyle just like by the way interesting maybe maybe interesting side note
did you know that primates that subsist on fruit and you’re going this is really random Steve I hope you’ve got a pointer there are primates relatives of ours who only live on fruit they’re called frugivores the genetic machinery that they would normally use to make vitamin C did you know that most primates have genetic Machinery that their bodies can make their own vitamin C but when they became frugivores now they were getting so much vitamin C in their lifestyle that there was genetic drift and all the the genetic Machinery to make vitamin C was allowed to basically drift and turn off there are all these mutations that accrued and it doesn’t work anymore but it’s still there it’s a genetic fossil it’s in our DNA right now every one of us sitting around the circle have basically vestigial vitamin C Machinery in our DNA doesn’t work anymore even though our ancestors long since went away from being frugivores they don’t have the genetic Machinery anymore so now we have to get the vitamin C from our diet right it’s kind of like that with us with depression our ancestors had they were like frugals they had all the protection everything built in and now our environment has radically changed why because technology because we learned to become agrarians and then finally we had the Industrial Revolution and the life that our kids sleep today would have been unrecognizable to our ancestors they would look at it and they would be like this might as well be on Mars it’s so different so what do you take as the most taxing feature in the in the change right I I you’ve talked at least in and while I’m present with you’ve talked a lot about uh the fight-or-flight response yeah as the most taxing feature and we have it in the tribal culture certainly there they have it we also there’s a genetic code set right and then we are living in the industrial world and what is the what is the tension there what’s creating the most yeah I love that yeah so I mean it turns out we talked about this a little bit earlier that the single most important driver in terms of the Neuroscience of depression is not a deficit of Serotonin the single most important driver is the brain’s runaway fight or flight stress response that just will not shut down
yeah and for all the viewers out there if you’re watching Jason freezeman you saw him that’s what woke looks like [Laughter] he was like that’s it it rang a bell so anyways joking about Jason because he’s not here he’s not here we love him and we love him dearly Jason yeah um but so you know for the viewers out there you can you know you can go back and review all of the episode obviously he’s going to do a much deeper dive into it but there is a framework for which we’re operating here that there’s something about the society that we live in this Con that’s causing us to live in our limbic system on a day-to-day even a moment-to-moment basis um where compared to tribal culture right if a lion shows up in your tribe you gotta get that line out or you want to be in the fight or flight mode right yeah these various sort of simplistic things but now it’s like uh I don’t like my job I’m not satiated I’m malnourished I can’t afford living I have no friends I feel isolated covet happens even more isolation lack of friends lack of communication all these types of things and it seems like out of that broadly speaking that the driver here is contemporary Society is not providing safety in the way that past tribal culture kind of insured as a very organic way of living life and that’s why it’s not recognizable and it’s causing many people uh to suffer in very extraordinary ways across society and I think that’s where I’ll stop there as far as like the point goes but I think what we’ve done here at you know peaks in general is try to say something like yeah we want to throw the spiderweb approach because we recognize the uh amount of energy that any given patient’s receiving from civilization like whatsoever they’re getting hit on multiple fronts it’s it’s like very rarely like I’m just here because my mom sucks yeah you know it’s a lot of things they’re getting hit with and it also points to the challenges of coming at this with any sort of monotherapeutic approach so absolutely yeah life is rough man like we live I mean safety like really we want to like that’s not a thing like we none of us are we don’t I don’t even know if our society really encourages safety I don’t even know if it strives for it at least not American culture I think it we we put more um we invest more in the idea that I can face up to anything and that I am like I can defeat the world than we do that I live in a safe place where I don’t have to worry about that um we I think we value um the the sort of active Warrior much more than the Peaceful Warrior and because of that we’re constantly living in a state of having to protect yourself and and having to protect yourself I mean especially if you’re living in um in the fight or flight moment constantly it’s exhausting you know and it and hormonally in neurologically it’s really unhealthy to constantly be in that state yeah yeah and just to build on that I I think that we are we live in a world at least within America where you’re constantly trying to prove you’re enough right like if you think about social media you’ll post a picture and then you go back you see how many likes you have you’ll look at it within one minute right and that like is supposed to prove that I’m enough it’s supposed to show everybody that I’m good enough and pretty enough I’m smart enough I’m I’m doing good things in the world I’m doing all of these things like we’re constantly just trying to prove ourselves but I think the question we don’t ask enough is to who like who are we trying to prove ourselves to right and so it’s become and I think you said it perfectly before is just we live in a society of Shame like you always have to be better than the person sitting next to you when why are we in a competition why aren’t we working better together and I like the tribal aspect of things because it’s like no I Need You To Survive so I have to align with you we have to figure out a way to make this work because if we don’t then we’re both going to separate and die yeah we all die exactly yeah like in I mean you can it’s you just in back in the I mean you just had to be good at getting the water you know you didn’t have to be good at like taking a selfie like finding the right whatever I don’t know what do they call them fonts but when you put oh uh filters filter yeah I don’t have social media I’m not going to last in the society I have 100 accepted my fate there and honestly I think I feel better about it but uh um we just we have there’s so many like random um just constructed expectations that we run into every single day and we’re not designed for that pressure Evolution from an evolutionary standpoint we grew up way too fast or at least Society did you know and then we constructed this world of I don’t know I guess we’ve we’ve replaced safety with productivity and with to what you were saying earlier instant gratification yeah right like that’s in it really has um I think that we are just showing the very vulnerable very vulnerable aspects of that change and it shows up in our mental health and it’s uh not getting any better so and one of the one of the challenges that and I think you highlighted something there it’s you know the society is about productivity so the way we try to counterbalance the pain of overproductivity is we try to put these annoying messages on our phone that says oh my wife’s away right now you know or if the phone’s on silent but that’s not the problem with the cell phones it’s it’s yeah we’ve resolved maybe the productivity issue but to Stephen larney’s point the sun helps us know to wake up and when it goes down that tells us to go to sleep right but as the sun’s going down our screens are going up so it doesn’t matter if we’ve dislodged the product I’ve kept work over here because that’s on silent but you’re just scrolling through the screen I don’t know how productivity has gone down in any way shape or form and we’ve ignored the initial issue this brightness in my face isn’t working at 10 45 at night yes I think another thing that I I heard in a podcast I’m not gonna I don’t know which part podcast so I apologize everybody um
is that rejection triggers the part of the brain that kind of tells you that you’re gonna die because way back when we needed each other in order to survive if we were rejected or we were alone we would most likely die and if you think about this idea of productivity proving yourself shame we’re always being rejected in every interaction we have because we’re always trying to prove ourselves or people are trying to compete with us and so there’s not real connection there either which veers us off in the wrong direction as well man you are speaking to this man it’s existential brain right now I get to see he’s like ooh death yeah that is Bleak as hell and also I’m glad pieces for sure yeah and so and here we go well there’s we only have so much time on this episode so if you all want to hear my existential noise there’s plenty of episodes yeah episode 200 we will celebrate and all the insights into it but in in keeping uh you know the the path forward here you know responsibility and accountability to a situation right action thoughts emotions next right so it would seem um it would seem like I don’t know like I lack emotions to say just like like kind of I think our shame-based society just like get over it get out of there get the sunlight on your face and that type of thing I want to again honor the courage it’s going to take here absolutely to get well because it’s gonna suck and that’s kind of the core promise of our industry right in the very beginning what I can promise you is it’s going to feel terrible but we’re going to work from there as a foundation like outward and forward right so it’s discouraging to think like the first thing okay well hit me with the monotherapy you know we I’ve heard family assistant be like well the pastor he was so stupid he prescribed the wrong medication it takes four to six weeks for the men to work in the first place so if John need to responded day one of the new medication there might be some evidence there that something differently is going on right we also know that the second tertiary medications have less efficacy than the first medication in that regard so uh chasing the medication kind of lineup there is ineffective but more to the point I know we’re trying to seek out that first thing that’s going to release this and give us relief from our condition but it’s going to start with a little bit of suffering absolutely it’s going to take courage to lean into that responsibility take the action just to find yourself in a place like Peaks where we’re kind of nagging you just to move for five minutes and you know I really I think Lauren you were the way that you were speaking about um needing to belong to a tribe is is really resonating with me right now especially when you’re uh with what you’re just saying Brandon part of the suffering I think that people experience while there is definitely physiological suffering when you first start ESP if you’re in going through detox but part of the mental health portion of suffering when somebody first comes in and is in that stabilization period is this like feeling of absolute loneliness right being completely disconnected and when we start to see people feel better is when they start to feel connected again when they start to become a part of the milieu when they start to become a part of the community when they start to become a part of of you know the the Peaks tribe as if you will and that is when you start to actually see a transformation or the beginning stages of somebody really starting to transform and and and find their and finds that that first little glimpse of light you know and it goes back to uh the idea that the opposite of addiction is connection and you know and what we say is the opposite of suffering is connection so um I I really think uh you know just rehashing and kind of going back to these these videos and these kind of Concepts has been is really interesting because it does I think really shed a light on the importance and value of of just being a part of you know and how so many people who come to us are are really in this this stage of um or space of just uh really desperate loneliness So and I’ve said it before on one of these episodes but that is such a major part of our program is the community unity and the connection absolutely I mean the way that they speak to each other I’m EV these past couple Millions we’ve had always refer to each other as a brotherhood like this is we’re a Brotherhood we’re in this together we’re we’re fighting together and there’s just so much relief in knowing I don’t have to do this alone especially when someone’s coming in and they’re like I’ve been doing this alone for 20 plus years and I just can’t anymore
beautiful beautiful and you know and I and I think it has it’s been fun for me to kind of roll through these episodes too because it it it’s so much ingrained in company culture this concept of tribalism like we’re a tribe like when I say you know deer tribe you know we lost somebody close to Peaks or you know deer tribe or under attack insurance companies you know dear tribe right we’re um we’ve Incorporated that into our own company culture because there is a sense of safety and belonging that arises from it we can talk about difficult things why because I feel safe to do it and I feel like um they actually care when I bring up the you know the issues and things born and I think that also I think not just for me I think we know that falls to our patients at the end of the day they see us working well in that together and it’s inviting for them uh in that way uh so uh if for the viewers out there if you want to get close to what are those tribal aspects look like and then where can we find it in today’s society and how would we