Episode 100
Revisiting Our Top Moments Pt. 2

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https://www.youtube.com/watch?v=yMPNVs1Qr2M

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Description

Our team celebrates Finding Peak’s 100th episode, part 2! In this special second installation of our 100th episode, Brandon, Lauren, and Clinton continue to revisit past moments in Finding Peaks. Our team goes over the word Addiction and how that verbiage can create issues, plant-based medication, its efficacy in its infancy stage, and so much more!

Talking Points

1. Revisiting the word Addiction
   
2. Clinton on the word addiction
   
3. Dr. Kevin McCauley on addiction
   
4. Kevin Franciotti on treatment
   
5. Dr. Bienfeild on wellness
   
6. Dr. Lerman on plant-based medication
   
7. Final thoughts part 2
   

Quotes

“That’s where we start is we say, why are you doing this, what’s the benefit of using these substances? ‘Well, I want to gain more confidence.’ Cool, let’s start over here, then. What does gaining more confidence look like for you? What can you do independently, outside of the substance use, that gives you more confidence? Maybe it’s working out, maybe it’s doing these things but replicating the same effect those substances have but outside of the substance use.”

– Lauren Atencio, Clinical Director

Episode Transcripts

Episode -100- Transcripts

Brandon Burns chief executive officer for Peaks recovery centers coming back to you with episode two of our 100th episode we’re celebrating that again here today I’ve asked everybody to wear the same clothes for convenience for the kids out there but joined by Clinical Director of our men’s program Lauren atencio hello again Lac lpcc almost all the clinical things and getting there and close Clint Nicholson Chief Operating Officer for Peaks recovery centers laclpc all the clinics all the clinical things and here we are to bring you the second part of this long but important episode so let’s Dive Right In uh so moving forward into the episode you know we have substance use disorder and we’ve talked about it on our episodes here of what kind of peak’s vision is to disrupt an industry through quality of care and disruption’s a big word certainly at the end of the day but one of the things we set out to do kind of in the very beginning of this is um see addiction as a behavior and nothing more and in the same lineup of any other mental health disorder just with different conditions in symptomology right and to remove the framework of addiction as an identity principle and refocus the conversation into what we believe or have come to know as just a mental health condition but before diving into it because we’ll know Clint’s thoughts at the end of this Clint Nicholson LPC LIC all the things was a huge not just a proponent but a huge Catalyst for our company culture to move away from this language and to really instill it and also to allow us the opportunity as a staff to really discuss and negotiate it you were going to win at the end of the day anyways because you’re the chief but but really beautifully it brought this into our company cultures without further Ado could have hit it see what Clinton has to say about this well I think specifically within the substance use worlds addiction has a sense like you’ve been alluding to a permanency like it’s something that is just always there and it becomes a part of your character it becomes a part of who you are and it’s something that and this can go I guess both ways it’s something that people start to identify with and identify as as an addict and in that sense um it’s sort of like a Scarlet Letter but it’s a tattoo it’s not something that you can rip off your clothes it’s something that you forever wear on your skin and um that starts to bring in the more shame-based narratives about addiction within our culture or within substance use and substance dependence in our culture which is that it’s some a moral deficiency right that there is something um there is a lack or an inability to control oneself that is based in weakness which is why you are this thing that we call an addict so um that’s the first part of my answer there are multiple Parts but I want to give well in a way too right the anonymous culture the thing we’re trying to bring to light the 22 million 25 million people in recovery those sort of features remained in anonymity because or maybe as a result of that negative connotation that was experienced by that we couldn’t talk about it openly because of this character trait or flower however it was perceived this is something it becomes something that I am rather than something that I’m struggling with right and it because of that I think that we um using the word perpetuates those sorts of belief systems and stereotypes and that need for anonymity yeah
I saw you both look at me so I’ll go ahead and speak that’s your cue but I thank you I do think a couple things came to mind as you guys were talking first being um that I’ve been doing this long enough now to watch the word alcoholic kind of go from a common phrase used and now we don’t use it uh in a clinical sense at all do we say the word alcoholic or alcoholism um because of that connotation I believe frankly and um and really because it also set apart other addictions or other substance use disorders apart from alcohol use disorder if you will and so um we’ve already we we have some precedent in our industry of like moving away from vernacular that begins to not make sense um or has kind of a pejorative connotation to it um the other thing that I do think though that’s interesting from the super smart Dr Harvard British guy is that even in AA there was this sense uh there’s a portion of the book that talks about alcohol reaching a point of neutrality which I think is interesting that’s before kind of the Neuroscience of it all but even even in that um uh older literature there is they do talk about reaching a point where where you like alcohol doesn’t trigger you one way or Cravings don’t occur one way or another it reaches neutrality here we are here we are back at it redefining you know addiction and I think that you know for me first and foremost like what comes up is like it’s kind of an identity crisis you know that I am this thing and always be these things and we start you know and I and I think there’s a lot of value in celebrating 10 20 30 years of recovery and these types of things but 10 20 30-year celebrations are recognition of addict and recovery from what then right um in that regard if I haven’t resolved sort of the behaviors associated with this and this is not to imply like a relapse or the potential to drink or use drugs uh again in whatsoever but if we’re celebrating recovery but still holding on to the word of addiction it seems like we have not moved Beyond those behaviors but the fact that we’re 10 20 30 years in recovery reveals that we’ve kind of moved Beyond those behaviors and the identity no longer makes sense it’s kind of my first take on it yeah I mean if you look up the definition of recovery it is a return to a normal state of mind health and something else like it has nothing to do with addiction it has nothing to do with any of those things and I think we Overlook that in a way and I like the way you said it is that we’re all in our own like process of recovery and maybe it’s not substance use maybe it’s not all of these addictions that we take on and I think what really stood out with you in that video was that I am an addict right what do we say when we go to any meeting and you open up Lauren alcoholic and then everyone says hi that’s who I am it defines who I am as everything and and with that label I am already less than in this world we’ve talked about it a lot you know hospitals um you they see alcoholic and unfortunately that person is already treated poorly because they they did this to themselves you did this to yourself right overlooking the mental health part of it that this man is drinking because he’s trying to support a family of five is drowning in bills is drowning in his own childhood trauma and doesn’t know how to get out of it why do we just say you’re not as important as the other guy sitting in the room because he’s an alcoholic it just takes the value of being a human away like I’m no longer a human at that point to anybody and I think that is a huge problem that we face well and I think now that I think about it even more in my sort of brilliant outtakes there uh I think that it also I think explains some of the popularity and power of the of the rooms of the 12-step rooms because you do you walk in you say I’m an addict and then everybody says hi and you become a part of something you become you’re fine you’re accepted into this little tribal culture of people like you that are separate from the rest of the world and not only is it true sort of socially but then you get into the treatment world and you actually have again we have substance use treatment and then we have mental health treatment and they’ve been these two separate things for so long because one couldn’t possibly be like the other if you’re an addict your problem is that you are a bad person yeah it’s not that you have hard problems it’s that you are actually just a a bad individual why don’t you just stop yeah there’s a weakness to you that even in our uh the the medical field and we see this in ERS a lot we see this in um in a lot of real and just but we would probably consider objective spaces where medicine is just medicine right but people who have who go to the ER with uh an active addiction are um and with substance use disorders are often treated quite differently you know they’re looked at as suspicious as as a nuisance as some sort of a threat a threat to culture sure rather than or in society rather than a part of it so we really see um the the impact and the sort of uh the the social connotations that this concept of being an addict is rather than I am somebody struggling with substances you know there are people that’s and and I think [Music] um we have to change that we absolutely have to change it and I don’t think that you know bringing this to Peaks and bringing this to the Peaks culture it wasn’t hard because I think everybody already knew I think our culture was one of acceptance and love anyways and I think we were so when you work with marginalized communities in the disenfranchised for long enough you just get so angry and you get so tired of it and at some point you have to you make a change internally that we’re just not gonna do it the old way anymore because the old way is stupid it’s wrong it doesn’t work and it’s actually doesn’t even make sense so um I don’t think I didn’t have to try very hard to bring this to Peaks I think Peaks was that that pump was primed just through the passion and love and and the people that we had working there and it’s the volume has been turned up way more than I ever could have even imagined yeah well and even our substance use primary clients they come in and they feel so seen because they’re like finally it’s just it’s not just the alcohol like at that I’m not broken in that way right like you guys see and you understand my anxiety and my depression and my bipolar and any of these things like you guys get it you’re not just making me a problem because of my substance use and and that’s where I think we Thrive too is like they feel very very seen because it’s not just like okay here’s a coping skill to make you stop drinking it’s like hey let’s talk about that anxiety that always leads you to that drink and it’s like yes that’s it yeah and and nurtured at or nurtured nestled within kind of the center of this as a treatment program too like we you know the reason I talk about it is kind of an identity crisis because it it creates passivity about future poor behaviors yeah absolutely and we hear it all the time like well you know I’m sure you know my wife because I got the attic brain can’t stop that or you know I continue to lose my jobs you know and whatever because you know my attic brain and it’s not to be facetious here but you don’t hear people go well I cheated on my wife because of you know my depressed brain because my anxious brain right you know in that type those these mental health features are not carrying forward as an identity now the identity of recovery is carrying forward but with a much different sort of feel to it at the end of the day that’s non-excusatory and it’s more celebratory in that way of things and I think that’s this is what happens when we take a word like addiction and apply it to self right it starts to inform Behavior rather than the ability to change and move away from and even though we might be 30 years from our last drink we’re still suffering in a variety of different ways absolutely right and the word addict has not helped us resolve anything else yeah and the fact that we use recovery solely to refer to um like substance use is just so ridiculous you know it limits what it means for us to we are all in a state of recovery you know we’re always we’re always recovering from something and and um I I think that to to limit that that concept and that um in that celebration that comes with um living a life in recovery or becoming or experiencing what it means to be in recovery is um it really short changes the entire system right and so we’ve this idea that and again I think we started with this like two and a half years ago really this idea of why do we keep these two worlds so separate why is substance used and why is mental health why are we living in this dichotomous world when it is all one thing we are all suffering and whether we are handling it through uh through drinking or if we’re handling it through gambling or handling it through um you know having uh Affairs we were just doing our best to figure it out we’re we’re we have a behavior that we’ve adopted that is allowing us to try to at the very least get through the day but we can do better you know if we can just focus on that underlying issue that is that impulse that’s pushing us forward we can actually figure out what the hell is actually happening and really going on yeah and I think using the word recovery universally right like when we call the clinical team when we call families we make it a point to say hey this is your recovery too yeah this isn’t just this guy or this girl over here like it’s for you as well and just being able to see what does my recovery mean what does a recovery from mental health even going into like the different verbiage we use in the sense of like cravings I think the thing that people think about when they think of Cravings is oh I need a drink right now no the Cravings is just a desire to feel differently I just don’t want to feel this way anymore so what do I know fixes that alcohol substances whatever it is so that’s why we again we put it in a box this is all it means is that you want alcohol or drugs no it means that you just want to feel different and that’s it and so being able to really start to change that verbiage as a whole I mean I think industry will help to put the mental health and just know that substance use is a symptom of mental health we are treating a mental health issue and you just so happen to use substances along with that mental health issue whereas depression as a as a Counterpoint just what you know already said it just shuts you down yeah it tells your brain it’s time to go to sleep just sit in the room and sort of that way but uh there’s uh that’s the symptomology of the underlying condition is to put them in bed and shut them down whereas on this side it just looks different because they’re experiencing all the mental health anguish but more in a position of power to achieve the goal of lowering that pain tolerance and we know what works in America a couple drinks and then you know uh some nachos at Applebee’s or something like that right and then it progresses into a condition that we’ve historically referred to as addiction but really as a behavior it just looks like a disorder now absolutely yeah and I think if we the the sooner we can get there we can realize you know this desire to feel different is a craving it can be a craving for alcohol it can also actually be suicidal ideation yeah like it can be a craving to die like we we are so afraid to talk about that yet we have this sort of we have this epidemic in our young people where they are chasing whatever they’re chasing that craving they’re looking for that different feeling they’re looking for escape and they see that as an escape because it’s within their means if we don’t start seeing that and talking about that as as a craving or a craving State we are going to continue to see this problem get worse and worse and worse so I think that there are and this is obviously maybe this is episode like 107 or something like that but um I just think it shows the importance of us getting out of these boxes that Lauren was talking about I’m really starting to have difficult conversations that are more much more Universal and much more rooted not in 100 year old belief systems but in what we understand about now and today and sort of the world in in type of suffering that people are living in currently yeah I love the way that you said that of like suicidal ideation because we don’t talk about that it’s like oh we don’t talk about that like that’s the ultimate thing right but yet we have millions of people dying of fentanyl overdose every single day and we aren’t talking about that the same but it’s still a substance like craving or whatever it is right and they know that they’re at risk for dying so why aren’t we approaching that the same way as suicidal ideation even too I like that yeah absolutely and and ushering this forward too that you know our our next guest that we’re going to bring up in this video uh was uh Dr Uh Kevin McCully senior fevos at uh world renowned program The Meadows in Wickenburg Arizona and he’s a disease model expert in the way of addiction and he kind of came into the world as a position in this sort of Apex moment of the choice model being taken over by the disease model and you know we’ve talked about it one of the greatest advantages of the rooms is that notion of accountability and responsibility you know right or wrong it’s present and centered and and extremely productive for those that you know sit within the system and you know we’ve been talking about personal responsibility as we move through this because the reason that’s so important to me and I think in pornos of Peaks is like we it ends up turning into victimhood right if you’re not going to change you’re just going to use this as you know excusatory mechanisms we can’t do anything with that there’s no ability to sort of move forward this is why we separate out hardship from the experience of it as well too because everybody in the United States of America I don’t care who you are I mean we’ve seen Millionaires and billionaires go through challenging times right everybody experiences hardship everybody experiences suffering your suffering might be independent of mine but we’re suffering it might even be greater than mine but I still suffer too in the process and so I think what Society is calling on especially around addiction or substance use disorders excuse me please is okay we understand yeah that you’re suffering at this level so what are you going to do to kind of move this forward in this way and in this episode uh here that we did with Dr Kevin McCully I think he gives light into how we can take responsibility for a situation that feels uh so difficult to move away from so coof hit it that that silent question that people have faced with addiction or you uh are steeped in that are asking themselves quietly why did I do this how have I arrived here in that sort of moment and it sounds like when you arrive you know in that you know the the Harvard of Prisons there at the end of the day you’re asking yourselves like how the heck did I get here at the end of the day and um and it seems like right that there’s this Apex moment if I’m reading the history of our of our industry correctly where you’re asking yourself a question that’s being that’s coming from the choice model that existed and it’s this sort of beautiful Apex moment unfortunately you’re sitting in the cell in this Apex moment reading that book but the choice model is about to collide with the disease model and I’m just curious how that resonates with you and if that’s accurate as I can experience because you you shoot out of the gates on the other side with all of these positive things that you’ve done on behalf of the industry and your expertise in professionalism and so what was it like just to be a part of that that moment and not only experiencing it on the societal level but at that patient level as well too right well I mean this is this is the question that’s fascinated me I mean where does responsibility come into it where does blame come into it um the way I Envision addiction is that it’s a disease of volition and I use volition as kind of a catch-all term it’s not just the doing of something it’s the why what drove me why did this option pop into my head what is what is the menu of options that I’ve got to deal with this what are the affordances that my environment provides me to be able to meet this Challenge and then once I do it did I do it well was it effective and importantly what’s the effect of my social environment having done that all of these things together I consider the Rube Goldberg machine of volition and probably at the core of this is the problem in addiction which is my value calculator is broken and so the whole driver of why I should choose this versus that is off and and I think this this idea of the Bayesian brain I’m only just starting to grasp it but every value calculation that the brain makes contains a probability calculation and so what I have a tendency to do is not only overvalue drugs but overestimate the probability that they’ll work out as I have imagined and I undervalue the consequences that result and I underestimate the probability that those consequences will in fact come true I get the math wrong so there’s a certain part of my recovery that I just have to let go of I’m not going to have control over the Thunderclap craving or the the twists and turns I can’t seem to make that big decision I’m not going to use drugs anymore if I could I would have done it right and most people do do that and I should say that and most people who have addiction they kind of mature out of it over time they make some changes and they just don’t do it anymore but for the person with active addiction who can’t make that the only choices that I can make are sort of peripheral choices that change the probability field and that is where do I live who are my peers what is my job you know these are things that I do have control over and so it became clear to me that I can’t make the big decision but I can break that big decision down into a thousand little decisions and each of those are easier to make and if I make enough of them they will add up to the big decision and that’s where I think responsibility enters into it once my addiction is moving and I’m craving and I’m using you know I really uh it’s not that I won’t be held responsible for the consequences but I don’t think that that I have the same degree of choice men’s Raya if you like the intent which is what the prosecutor will look for right not just that bad things happen but that I intended for that to happen I don’t think that’s present in the craving person with addiction who’s craving but if I had failed to keep that community of recovering people in my life if I had failed to meet the the normative standards that are expected of a physician in recovery those little decisions are where I’m culpable and and could be you know held culpable if I if I’m not careful absolutely as you know I I got sober in a very very strict abstinence-based 12-step tradition I appreciate the fact that that is not the only tradition um and but I but I tried to do what the doctors around me did and and by using that that culture of recovery and those expectations of recovery I think that that’s you know that was the one decision that I made that helped me get out of this but I can’t say well I chose to get sober I just I don’t believe that it was that simple yeah was that I Dr Kevin McCauley’s just so well spoken but I love what he’s talking about there I mean the first thing I want to draw attention to is like some people just mature out of this the world presents a new job an opportunity I’m done I want kids I want a family this sort of thing and we kind of move away from it and what he’s highlighting there is disease-ish you know right there’s a conflict that’s taking place there but for those who can’t or uh are not empowered or lack capacity to move forward in that way the issue then becomes this this overvaluing this uh probability calculator this value calculator he talks about is broken and I’m uh increasing the probability that the drugs will work this time and undervaluing the consequences that are results from it and so what he’s stating is in responsibly speaking you aren’t going to put down drugs and alcohol I’ve been using for months years decades or whatever and just move away from that the big decision is nearly impossible we’re not asking for responsibility accountability right then I don’t even think the rooms are right at the end of the day what he’s going on to say is I can make decisions elsewhere though I can change my environment I can move into a sober living home I can pursue a job that exposes me less to drugs and alcohol I can go back to school but find a sober and safe you know sorority or something like this right that exists within the community I can do all these little tiny thousand things that will start fixing my broken value calculator in the background simply by pursuing these I didn’t resolve the big thing but with enough of these things in place my value calculator is starting to fix itself and eventually he’ll go on to talk about things like neuroplasticity but feels powerful feels right feels true yeah I think this brings up the idea that um you know I was talking to Tyler Kaya the other day our case manager and and he said I had asked a client kind of in front of him you know uh what’s why do you use like why like what does it do for you that’s positive because we only do things that really benefit us at those points and so you know we have the clients who say like it gives me confidence I can finally talk to people I can finally you know talk to this girl or it it lets my emotions come out because I’m so used to numbing them all the time all the time I think that’s where we start is we say why are you doing this what’s the benefit of using these substances well I want to gain more confidence cool let’s start over here then what is gaining more confidence look like for you what does what can you do independently outside of the substance use that gives you more confidence maybe it’s working out maybe it’s doing these things but replicating those same effects that the substance has outside of the substance use and so that’s kind of what it brought up for me a little bit is this idea of instead of just saying don’t do that like how can we get that same feeling without the substance being in there and how can we avoid the relapse in general by putting you in a space that will actually promote confidence or promote Community those different things yeah absolutely and I think um you know listening to listening to him speak it really to me I’m sorry I just clicked on my mic so I’m learning cover I’m learning uh it’s this idea of um recalibration right that really we are uh on one hand people want recovery to be like look I’m just gonna I’m gonna take out the problem and I’m gonna put it over here and it’s just gonna go away and then I’m magically fixed and it’s like that it’s this one big act this big you know cathartic experience and it’s actually not that it’s a a million little acts that actually that help us to to sort of recalibrate how we engage in the world and the same is true very much so for trauma and and for doing trauma work you know you are it’s it’s about all these tiny little choices and experiences that start to change the brain and that start to sort of re if you want to get into neuroplasticity you know this is where it starts to come in right the brain literally starts to reform itself and you start to develop these new neural Pathways that where your value system and the reward systems are are geared in a completely different way and you start to in what was once uh the the sort of overvaluing of alcohol all of a sudden and the sort of undervaluing of the consequences that that gets flipped on its head right and so um as frustrating as this might sound for people and I know it’s very frustrating for our clients it’s a time thing right it’s about time this this is a process it’s repetition it’s um there is a very uh real and intentional decision-making thing that has to happen there are choice is a part of this but it’s typically um you know to his point not the choice of oh I’m just gonna stop drinking you know it’s it’s the all of those tiny little choices around it that eventually get us to our final goal and get us and get us into that state of recovery when tiny choices even being you know we’ve had a client we’ve had actually several clients in the past who had specific chairs they drink in every night right it’s a routine it’s a ritual those different things and so we had a client a while back um who had a chair that he sat in every night when he drank and so he got home a lot of the Peaks guys he went through the program with went out and they had like a ceremony they burned the chair they got rid like there’s been clients who just get rid of it they re a big thing we tell clients to do when they go home redecorate your house a little bit because if you’re sitting in the living room every night drinking you’re going to go back in that living room and that part of your brain is going to be like hey we know what we’re doing now like we get a drink now you know and so moving the couch to the other side of the room moving the TV yes little tiny things that you can do in order to protect yourself and also not allow your brain to say I know what’s next I know where we’re going right right yeah yeah the associations in the it and again it’s it’s one of these things that we can you know when you dive into the science and all in the brain chemistry and all of this like it feels so complex yet at the end of the day it is almost this simple right the smallest little in you know uh the smallest of moments and the smallest of changes in the process add up to a lot in relationship to what the brain is expecting next in the process and you know and and we’re talking about action first right change the room now what are my thoughts now that I’m sitting in this room without this chair and this is reorganized and what’s coming up for me emotionally right um and craving States I think what the the math on it’s like 10 to 15 minutes and then before they you know resolve themselves so you know what would it like to take the action of craving I’m just going to White Knuckle it sit here for 10 to 15 minutes and I know at minute 16 if that doesn’t work for me I’m calling my sponsor and I know at minute you know 30 after talking about my sponsor if that’s not resolved I’m gonna go walk in the park where I didn’t use drugs or alcohol you know and those types of things until I can move through this with enough time and energy and persistence and doing it over and over again right we will be able to get to the other side of the craving in some way and I I do I actually think that like by focusing on all the little things that is what helps you avoid having to White Knuckle I actually my my Association was sort of white knuckling it is that I just want to get rid of the big thing right now rather than I actually have to put in the work all the time every second of every day it’s very tedious fashion I have to be present aware and engaged and make sound Decisions by recognizing who I am in this moment and and that is actually what is going to get me to my end goal as opposed to just if I just hold on tight enough I’ll get there it’s like no they’re you it’s not just the idea and this is why wanting to quit isn’t enough to quit you know there are very few addicts that really want to be addicts like it’s it’s not it’s a thing you know um it’s weird right uh but it’s why you can’t just the desire to quit isn’t enough right like that isn’t What It Takes it’s these hundreds of thousands of millions of little things in between that we actually have to focus on and that we have to look at that that will get you to that end game that will get you to that end goal and again socially that is not how we are geared we are geared for the the Panacea the the one answer the one shot the one response that works right now um so yeah it’s tough I think it also goes into Perfection as well right I think a big major factor in this process is or barrier I guess is shame is that I can’t expect to do things perfectly moving forward I I kind of frame it sometimes as this idea is like I’ve had the same thinking patterns for over 20 years and if I really think that those thinking patterns are going to change within a one month two month three month period it’s kind of a little bit ignorant of me to think because this is something I’ve been practicing my whole life and so there has to be a moment of Grace in there as well that says okay I’m going to revert back to Old patterns I’m going to revert back to Old thinking patterns behavioral patterns any of these different things and I have to find Grace to say okay I know what it went wrong there I know what I have to do differently next time and instead of going to a place of like I’m never going to get this I’m stupid all this stuff because I’m just perpetuating that at that point and that’s why saying small is so important in early recovery is because if you’re trying to get the Big Goal within 45 days you are going to be disappointed you are you have to start small it has to be hey what’s your morning routine look like let’s start there and that’s it and it seems so small and it’s like oh I’m you know I got to get everything I can out of this program that’s valuable as in like as much as it doesn’t seem like it it really is to know my morning routine is absolutely everything in order to overcome my mental health yeah and what is likely going to be the first experience of any first time changes right especially you know hanging out with our patient demographic and it’s even for myself too you go to make that change I’m getting up at 5am you wake up at 5 a.m no drugs or alcohol is the first thing it feels kind of [ __ ] stupid This is Gonna Change it yeah stupid therapist you know that kind of like you know sort of thing but it’s the process of it eventually we get the sunlight on and now we’re moving and we’ve walked the dog and we got the kids to school like whatever it is moving forward it’s just the beginning of a very long process and the initial feeling of it is because the brain already has a solution it’s not a good one it’s not even a great it’s not not even a valid one but you know it has that in the background and so even though we know this is a painful experience like we talked about the beginning of the episode The Brain wants to revert back to it because we don’t know what this path looks like absolutely and when we first put our you know shoes on and step out on that path it feels kind of stupid and we just need and I want to acknowledge that and it takes courage to move Beyond those moments and not to feel shame in those moments and to go you know what I know what the easier thing is Peaks didn’t work my therapist was stupid and this is never going to work for me oh it’s the trauma that’s what I should have worked on treatment absolutely yes trauma it’s always the trauma there it is coming back so um I’m going to hit the I’m going to hit the uh we’re not going to review this clip on the other side of it but I did want the audience to uh review because uh Dr Kevin McCully was in the Apex moment of this Choice model it’s a disease model has championed the disease model there but Gabor mate has kind of brought in this new sort of relationship of well it’s not new but the the the model of pathology that all of these little parts right are leading up to kind of the issue and you know gabramonte’s kind of claim to fame right as I understand it is that we’re all traumatized for sure at the end of the day and for that reason in those hardships um that’s what’s driving kind of the illnesses and the things that we’re experiencing but there’s a sort of collision there with the disease model because it’s no longer a thing sort of stuck in the brain it’s all these processes that led to this moment at the end of the day and so I’m gonna hit the viewers with Dr McCauley’s insights onto this potential transitioning and models that we’re experiencing as a nation and uh so hit it Cove you know uh you know the thing that comes up we talked about a little earlier again it’s referencing Gabriel Monte is a big figure in in the substance use disorder space Mental Health primary space and for a lot of great reasons he’s writing some incredible books but the it seems like we’re at this new sort of Apex moment right we did Choice into disease and now we’re you know and then now we’re in this moment of I wouldn’t know what to call it but under the language the disease model of pathology versus processes right and gavar mate seems to be really pushing that its process is not pathology and through your lens right I’m curious you know for the viewers out there what does that mean to you and how do you how do you see this positively shifting this and how much of do you see the disease model still resonating even under maybe this new lens if it is this new Apex moment where we’re sure it’s complex um the trauma narrative is a powerful narrative and it’s given voice to many people and I think it’s a it’s a you know something certainly that I suppose it’s having a moment right now so it doesn’t matter what I think um and I definitely appreciate Dr mathay’s humanity and all of his work and the power of his writing it’s important to understand that Dr mate is a Canadian and the things that work in Vancouver do not necessarily work in the United States if you said harm reduction 15 years ago your career was over you would never get funding you would always be on the periphery the political you know Wasteland um doing very good work harm reduction has always been the national policy of Health Canada and so because Canada has a more Public Health understanding in general because people were actually willing to put on Mass Canadians are just nicer people than Americans I think they are more higher evolved life form quite frankly because they can say things like sorry right Americans can’t do that so you’re never going to get safe injection sites or safe Supply into the United States and so I think it’s important to understand the the possibility landscape that operates in a country like Canada and how it’s different from the United States um and that would be that that sort of embedded nature of addiction I I certainly do respect the idea of not just reducing addiction to pathology to understand these processes I would like to know more about that I’m saying that the processes that are possible in Canada may be very difficult in the United States doesn’t mean we shouldn’t try doesn’t mean we shouldn’t try when people ask if addiction is a disease at least 15 years ago people would say well we really have to you know let the doctors answer that question okay if you get the doctors in the room and you ask them that question they’re going to turn to the pathologists mythology is an amazing field five years of training after medical school that’s as much as a general surgeon and then there are usually more specialty training that you can get in addition to that there’s an old joke that uh surgeons know nothing and do everything and Internal Medicine doctors know everything but do nothing and Pathologists know everything and do everything one day too late you just understand the the massive fund of knowledge that a pathologist must have and a pathologist sees disease as injury whether it’s a big injury like a broken bone whether it’s a molecular injury right I don’t think that we should give up on the pathology model just yet because if you’re really trying to understand how things like structural racism housing discrimination not expanding Medicare actually create inflammatory states that lead to disease your best way of linking those two worlds is with the disease model is with that pathophysiology and that’s why I’m kind of interested and I don’t know much about it this idea of psychoneuro Immunology that that that really the very same inflammatory state that occurs in the lungs of a person dying of covid is occurring in the brain of a person who’s been traumatized or has addiction or has schizophrenia it’s just happening at a much lower grade over years and so um we don’t want to give up on the pathology model because it’s also been the most successful human endeavor ever it has doubled the human lifespan in a hundred years and so I understand that it’s that it’s an annoying model that it’s highly reductive no one likes to be reduced that it’s purely materialist and it doesn’t understand so much more doesn’t understand the Ecology of how disease plays out but there’s a lot to be mined there how does housing discrimination cause disease your best way to understand that is with a pathology model so I would like to talk about both of those things I would like to know more about both of those things I think that they’re actually much less divisible if you take a public health ecologic approach to disease so with within our industry I think one of the major things that at least I’ve highlighted that we wanted to move away from is this you know coercion and independent philosophies of treatment right you’re going to come to Peaks and all you get is the 12 Steps why because that’s how I got well and that’s what I believe I was on a call with some executive you know leaders in the state of Colorado the other day and I was talking through some of these things and like the challenges of the 12 steps as a monotherapeutic value medications are monotherapeutic and one of the guys at the end was like hey my time’s really important I don’t want all these opinions coming up but the issue and what was intentional what my trauma response was was that I’m not coming from this from a position opinion these are real facts these things in and of themselves do not work for everyone and we should acknowledge that as an industry and open up the path to what we are talking about here is a spider web approach and so before diving into it I just want to throw this video up from a past episode where we negotiate you know coercion and independent philosophies as uh being in between us and the patient at any given time I believe this was an episode we did together with um Kevin Francis if I’m wrong about that report and we’ll shoot it back in but kuv hit it happy to blow up that ship because I literally was bailed out of County Jail brought to the Long Island drug and alcohol abuse research Resource Center uh sat in front of a lovely woman who was doing her best to keep my parents calm um but she recommended a couple of places and the next thing I know I’m whisked away off to that no autonomy no say I mean did I have a right at that time was I pissing people off in my life who am I to be entitled for that but is that really the pretext to an engagement in therapeutic care that we want the treatment center that I did go to out in Long Island was essentially a place where I could get drugs and I met the people that I could get drugs from because I was not interested in abstinence at the time yes I’m not saying that to brag I’m not saying that that’s what I deserve to be doing I’m just saying that was my mindset so why would I be at a place where I’m supposed to be in a controlled environment and yet my main interest is in hooking up with the other people who aren’t taking this seriously and can help me get some stuff so after a few days I left and and I came back home had a challenging moment you can imagine with my parents to try to advocate for myself in a healthy way but still as an unhealthy person yet again like what other medical condition would require that somebody who is being treated poorly through the treatment model offered him and yet is still struggling with his own pathology has to become his own Advocate I mean any any family member of a loved one with cancer or complex diagnosis that argues with insurance companies about coverage knows what I’m talking about that’s essentially what happens in addiction and so you know when I did go to a place that I had more of a say in I chose a a rehab that was in a more secluded environment in Upstate New York it was a nicer campus a little more laid back but I didn’t really know what I was doing so during my intake process I got all the same kind of scare scare tactics oh this is how many drugs you’ve been doing and you’re only in your mid-20s yeah you’re going to be dead by 30. like who sets you up for success by by giving you that Doom and Gloom mentality and the whole notion of sitting in a room with 40 people and the facilitator says you know look to your left look to your right one of them is going to be in jail the other one’s going to be dead are you going to be clean or back here again these Scare Tactics things do not work so a year later after leaving an environment like that relapsing within weeks knowing I’m bottoming out again why would I just want to go back to that knowing that my parents spent like tens of thousands of dollars on that experience and I’m gonna ask them to buy more yeah no I need a different approach and that’s kind of what this measure is allowing us to do that’s what my path and my story led to and so even as a practitioner today as a licensed addiction counselor I feel like I predominantly work as a systemic harm reduction provider like I need to educate parents educate clients educate people on the devastating void left by ineffective treatment interventions that people like me are trying to carry the weight for absolutely beautifully stated and I think the word that comes up for us at Peaks a lot and what we’re really trying to engage with out of proposition 122 is namely Innovation we are stuck in a variety of ways as an industry couched in some of those kind of horrible ways of approaching patient care look to the left look to the right type behavior and this is an opportunity to take something at least for us right something like a 90 day you know let’s just to you know do a quick couching in terms of like a major depressive disorder where cognitive behavioral therapy as an evidence-based approach can take 90 days to punch through that rumination right for the individual and these plant-based medicines might give us the I don’t say might I don’t say strongly that they will give us the opportunity to kind of punch through the ego whatever it is that we want to couch the terms in in a much faster way and then for this next one then we’ll jump into the discussion with it here stay with me you too yeah we’re there yeah great energy Cube can bring in more energy drinks if you guys need it but we got an independent philosophy rant I believe it’s my rant uh but let’s hit him with it yeah absolutely I you know one of the things I’m like boiling in my thought bubble hear about it I am we talked about it in the curriculum you know meeting a little bit uh this past week uh Lauren or I brought it up hopefully the room got what I was putting down but you know you you break your arm right and you go into the emergency room uh the costs are fixed there’s generally a timeline for it this MD is going to treat it the same way this MD d-o-m-d and so forth right you know with slight variations maybe on the the movement of the scalpel right but at the end of the day there’s a Common Thread for how to do that our industry has hey we can fix that broken arm we can fix the behavioral issues that are going on but we have a pretty particular philosophy about how to do that right it would be like as insane as walking in the emergency room and the guy you know the doctor’s stating look I’m gonna fix this we’re going to go under the knife but when you wake up it’s not going to be in a cast because I don’t believe in Cass you know you’re just gonna have to sit really still but I promise this will actually heal better than without the cash trust me you know like you’re going all that sort of thing and so absurdities aside you know it it’s these individualized philosophies within care that become so restrictive right and so um and and create that coercion mechanism that I think is off-putting for a lot of individuals who participate in treatment episodes right what is it like for somebody to come in the Peaks and instead of us just being like hey this is our philosophy and this is what you have to do like these are the things we’re doing how can we make this the most beneficial experience for that it’s still has restrictive features in it but it’s less restrictive than a full-blown philosophy at the same time if we had something like the advantages that will come out of proposition 122 to give that intervention on the front end you know post detox it’s got to be appropriate of course like all of these things are going to be set up to engage with this thoughtfully on the other side of that what about these aspects of our care do you really want to engage in or you know what is the next step if not these levels of care you know out there in the world that we can connect you with that’s going to make this meaningful and reinforce reinforce that autonomy approach to care so why I had that uh kind of initial thought and talking about well Brandon you’re just giving us opinions at the end of the day what like what I want the world that is watching this around the world episode 100 popcorn and soda just waiting for Brandon and to bring this episode forward uh at the end of the day uh is that um what you’ve heard from this episode today is that yes medications don’t always work 15 to 30 percent efficacy yes the rooms don’t always work for each individual yes there are limitations to you know talk therapy yes Society is causing a major issue here what are we not doing along the way right we are not stating no 12 steps we are not stating no medications we are not stating no talk therapy we are not eliminating the things that lack efficacy we’re seeking to improve upon the efficacy if medications work for somebody who can stabilize them for a moment so we can do talk therapy you get medications right you step into Peaks recovery centers a little too much mental health stuff going on you want to engage in some you know meetings and rooms we’re going to put that in front of you at the end of the day right it’s the ability to kind of maneuver toward the patient’s needs and give them access in these restrictive care environments and what is missed historically in our industry is people call you know family systems and then we’re going to get them well no yeah we do all those things but then we’re just going to put them in the rooms at the end of the day yeah and we have such a history of that and that’s the thing that I seek to disrupt and the thing that we want to move away from I think the rooms at times look at medications like that’s drug seeking therefore we can’t use those things it might be drug seeking but if it gets me closer to give somebody four milligrams of Suboxone to do talk therapy to start working on issues that reduces their capacity or future interest and the desire to use something that’s probably laced with fentanyl that may kill them
literally harm reduction that’s what we’re trying to do right yeah trying to reduce the harm like you said we have I mean statistically I’m sure it’s up a bunch but death’s happening every day do this I mean primarily opiates right and so how do we get in front and I think you said it greatly too is like why do we keep telling people what works best for them like it’s not absolutely I don’t know what works best for you or you I probably sometimes know what’s best for me and if everyone around the table is telling me I don’t how much shame am I being in am I inducing at that point again right am I if I’m sitting around the table and I’m like no guys listen like I know that this is going to help me and everyone around the room is like actually it’s not then how am I ever supposed to be empowered and believe in myself it’s just not going to work out that way so well and we have this horrible pattern of taking uh like you were just saying Laura taking the healing power away from the individual rather than handing it back to them like it’s like no you can’t do this like everything you’ve done is wrong because we can tell by the fact that you’re here with us right now that you’re a bad person you do things wrong so I’m going to tell you how to do things right and if you do them exactly how I tell them to you’re going to become a better person like it’s completely disempowering and it gives there’s no self-efficacy there’s there’s no moment for that individual to say and and to really embrace the the fact of the matter that they are responsible for their own healing like they need to be an active participant in this process or else it’s just not going to work you know um we we have this saying in the in the uh field of therapy you know like meeting the client where they are everybody says meeting the client where they’re at but that is just poor grammar but so yeah meeting the client I know yeah meeting the client where they are are we ever really doing that you know like it’s so rare to find a program that actually sees somebody where they are and starts with all right what do you need like where what do you want what has worked for you where are you in this process rather than walking in and saying all right I’ve got a hole I’m going to tell you exactly what you need to do that’s nonsense it’s just absolute nonsense so the problem with true client-centered care is it’s time consuming it’s expensive and it is the again it goes against the sort of social current of I can get this somebody I just need you to tell me what to do you know like just tell me what to do I’ll do it I’ll be cured um so again that the things that work are the things that people don’t want to hear work you know it’s just like it’s like CrossFit like yeah I hate that it you just hate that it works but good Lord if it doesn’t you know so you look great thank you absolutely no thank you
um so I I really I really appreciate what Kevin was saying there and I think that you know our I I love that Peaks has we have adopted a philosophy we have our we have an opinion and our philosophy is that all philosophies have a place every opinion matters um but in the end it’s got to be up to the client you know and our job is to facilitate how to help the client best serve learn how to serve themselves you know in the end we have to we’re going to cut ties at some point you know this isn’t a permanent relationship we’re not going to be in your life forever you’re going to have to figure out how to do this on your own and if we’re giving you tools that you’re never going to use then we’ve done nothing so um yeah I really I think that it’s uh it’s going to be a huge shift for the industry to take this on um I don’t know I’m a pessimist by Nature even though I’ve been kind of like in an optimist moment so maybe it’ll work I don’t know so we’ll see yeah and what what we’re talking about is going to work here in in kind of taking this episode out is uh so here in the great state of Colorado because they started the medical marijuana movement they were second to the Psychedelic movement behind Oregon but I think from comparing State statutes and in that regard I think Colorado is doing this fundamentally better and more correctly and allowing it to be more of a therapeutic value than some other distracting values that I think come up in the organ system that’s for the viewers out there to debate yeah yeah for sure here I man talking about no philosophies and I’m giving my philosophy anyways at the end of the day where proposition 122 is passed here in the state of Colorado fairly overwhelmingly just shy of 54 of the population voted it in place it’s referred to the natural medicine Health act which allows for uh well uh instigates decriminalization nation and past criminalization so if you are in prison for you know possession of psychedelics you are going to get released in this process if you possess psychedelics and you’re in your backyard and a cop comes over and says what’s this party about and you have them in your hand you’re not going to go to jail for to receive a penalty for it now and you can grow it yourself right so it has some of these sort of tension features we’re not going to dive into it because on the other side of it it has a therapeutic value right and we can bring those into settings like Peaks recovery centers like outpatient clinics and mental health centers and these types of things and the real value proposition we’ve been talking about responsibility and accountability throughout this episode and it feels like at the end of the day right that action first step I have to make a decision to do this next thing is painfully hard and as challenging It is Well you get to a place like Peaks recovery we take the thing that was working for you you’re immediately back in a state of suffering and outside that thing it’s difficult because you don’t have all the probabilities that McCauley Dr McCauley talked about set up already you don’t have all the things all you know is I need I’m craving and I need that right now and I lack control and I want to get out of here what my hope is is that somebody can put that next foot forward to say okay I’m gonna get this Insight I just have to detox right in the process and then I have to work with you know Lauren or Jason or Maddie or anybody else here at Peaks recovery centers to identify the goals of this set and setting I’m about to put myself into which is to ingest psilocybin and go on the Psychedelic Journey now with a therapist and a doctor present we’ll see the full scope of Staff that’s needed for this moment but I think the Hope here is that um you know I’ve had personal experiences certainly in the black market of using something like a psychedelic like psilocybin and all out pain about that without waxing War Stories of of doing you know mushrooms is that it did give insights not everything that I was going through was always clear you know some things were wildly confusing right but that’s the point of the practitioner being there and supporting us but it it got into things that I think upon reflection of it had I had a professional around me I might have been able to actually do something with the information I was receiving but to the point of choice I think if we set this up correctly and we work well with the patient and set up that set in setting and clinically guide them they can arrive in those moments and discover for themselves that’s what I need to be working on when I leave this session that’s what I need to be doing oh and look what else is coming up for me and what I mean by that right is it could take hundreds of days of talk therapy to gain insights into a situation without individuals getting frustrated in the Pro that’s not what it’s about why are we talking about that oh that’s what it’s about and I think to kind of put a pin in it here is that is the ultimate hope for me that it will create a weight an awareness for which guides the individual forward and showcases that path of opportunity not in something to be fearful of but something like I can see myself walking down this path and on the other side of it again sitting with the therapist saying I got this stuff in a row and I’m ready to work on it and I’m actually excited about it and I know what that next step foot forward is case management whoever how do you help me go yeah yeah I think you explained it perfectly is a path forward to work on it I think that what we have to be careful with uh you know medication assisted interventions at times is that I think we get this idea that it’s just going to fix everything like ketamine psilocybin um any of these different things it’s like oh I’m going to fix it but I think you said it perfectly if like this is what I need to work on it gives us insight into oh there’s the maladaptive Behavior there’s the part of me that doesn’t feel healed and so how do I in my regular State of Mind start working towards healing that part of me and instead of assuming that all of these different interventions are going to fix you I think one thing we tell clients hugely is that like if if you’re saying we need to fix you you’re implying you’re broken and how do we View broken within the human mind right there’s just no cut and dry thing of like you’re a broken brain you’re not a broken brain it’s not a necessarily need to fix it’s a need to adapt and change into what works for us and what helps healing and what kind of allows the suffering to fall off as much as I can yeah I think the what I’m really excited about as we move into sort of this psychedelic realm is um part of it is the language the idea of Journey right like this is the beginning of something not the end of something and I think when people go to treatment they think they’re going to the end of something but they’re actually going to the beginning of something yeah and we need to be okay with that like we have to start we have to take away this idea that you’re going somewhere like you said to be fixed it’s that’s not what it’s about you’re going somewhere to discover you know what you need to work on and you never stop working on it um psychedelics are not again they’re not a mono uh a mono approach a monotherapeutic approach it’s it’s not a Panacea it’s it’s a part of the journey and it’s a part of the journey that helps you dive through some of the barriers of the ego that otherwise would take weeks maybe even months through talk therapy to get through why wouldn’t we want to take that on why wouldn’t we want to look at that but also I think it starts to open up uh parts of our world of the therapeutic World in general that we don’t touch on or we touch on very in a very limited way and for me that would be the role of like spirituality the role of identity of purpose of sort of the existential journey of The Human Experience these are really profound things that we can actually start to look at with um I I don’t know I guess I think they kind of look frowned upon or poo pooed upon or they seem they’re so um this is I guess maybe the most mystical that I’ll I’ll I get in my life but I just think that there is something about that path in the that part of the journey that really does teach someone how to be their own healer you know like we have to stop telling people that they have to look outside of themselves for help they have to start looking inside of themselves and so um you know I’m really as a clinician as somebody who’s in this industry as somebody who h