Brandon Burns chief executive officer for Peaks recovery centers bringing episode what is it 6922 so if this is your first time viewing us you have a lot of catching up to you because we have resolved many of the world’s problems especially clinical problems uh that happen for people in the world so that’s what we’re here to do again today if you’re new to us thanks for joining us for this great episode we’ve got the the head honchos the big dogs in the room to talk about biopsychosocial model of care it’s on peak’s site many of those out there uh finding Peaks at peace recovery.com or information at findingpeaks.com okay I’ll fix it we’ll figure it out we’ll get to it but with that there’s a lot of curiosity around the biopsycho social model and that’s what we’re here to talk today against the backdrop of maybe other models that might exist in the industry we’ve got Chief clinical Officer Jason friezma LPC Lac most of the clinical things yeah yeah EMDR yeah I have been EMDR trained yes thanks for asking yeah great question Clint Nicholson Chief Operating Officer LBC Lac all the clinical things yeah sure it’s not true this is a great day for the uh biopsychosocial model because we’ve got some tiredness in the room yeah absolutely everybody’s a little tuckered out long week and here we are sleep uh important all three of these things right at the end of the day so yeah they’re here to show us what not to do and how to better walk through this as a mechanism so breaking down what bio psychosocial means so we have biological psychological and social environment who wants to kick this off I’m Kitty good news I think we start biological right biological it’s in the beginning so the bio side of things what are we doing why are we doing it why is it important I’m going to take a step back okay and model of care what is that actually referring to in uh essentially what you’re there are different models that identify what are believed to be either the cause or a highly correlative um sort of variables that promote or create addiction and so uh like biopsychosocial model is looking at all of these different varying aspects of an individual’s life recognizing that we don’t live in a Vortex you know we live in a dynamic World in that the reason for our behavior is not one thing it’s everything there are multiple components that uh that are create us as a human being and then therefore impact our behaviors so um that’s like the big big picture and that was probably the easiest one to answer so I’ll kick it off to Jason now so okay you can get down to the nitty-gritty yeah I’m a big picture guy okay well thanks for yeah uh doing that overview and I think we need to answer Brandon your your question specifically like biological is obviously um what’s going on in somebody’s body um and and particularly when we look at um depression or addiction that’s a lot of what’s going on in the brain although other parts of the body certainly would be a component of biological um component and really a lot of times people come to our program in biologically not great shape whether whether it’s from neglecting their body or literally abusing their body um that is an aspect that if that isn’t this isn’t addressed it will certainly hinder a person’s ability to uh recover from mental illness or addiction so um a biological component um clearly makes sense in our model of care and with with uh Peaks we have a robust medical team that is equipped to to handle people dealing with a variety of significant medical impairments and I would include also like the the neurological components in that as well as part of that biological component back to you back to me yeah yeah it was pretty that’s pretty good okay yeah yeah basically why don’t they call it body logical
[Laughter] if you don’t feel good it’s going to be really hard to like work on yourself from a psychological psycho emotional standpoint so you gotta that’s probably where a good chunk of the stabilization model takes place that physiological stabilization and you get things like mat Suboxone for people with opioid use disorder um you know we do you can do either like a valium or a phenotaper for people who are on alcohol use disorder or even benzo use disorder as well so there are a bunch of different um and then of course with mental health you know like stabilization through Pharma pharmacological interventions are really important and it gives you sort of like a baseline I guess so that you can start to do deeper work because if you’re super dysregulated physiologically you’re basically just I know you I want to spitting into the wind I guess yeah I almost used a different word I think that’s you know that’s a good point and just to hang on it for a second because you know and and rightfully so so much of the work or perceived work as a causal feature of ongoing maladaptive behaviors is something like a past uh traumatic event carrying out playing out in somebody’s you know life over a period of time that doesn’t resolve itself turns you know over time into a maladaptive Behavior but you know some people call it Peaks and they’ll say something like hey I gotta work on my trauma okay but I’ve also been using you know math heroin you know alcohol you know consistently daily for the past six months right so within treatment episodes we you know what what I think I hear is silly sitting around the biological aspect of this is you can’t immediately dive into it because we aren’t physiologically speaking well enough to actually participate in yeah right it’s not that it’s not an important value set um but if you you know have the stomach pains of going through an opioid withdrawal like there’s just no advantage to engaging in an EMDR session or anything of that nature I mean if you’ve been doing mess and you’ve been up for three days doing it or child work is going to be really tough because you’re going to be very tired yeah and it’s just we should wait we should wait yeah like you need to take a nap first yeah and then I it’s the Maslow’s hierarchy is another way of kind of looking at it or framing the biopsychosocial model and it’s just the idea that you have these basic human functions that have needs that have to be met before you can sort of climb the pyramid towards self-actualization and so that biological those biological functions like shelter food water are Again part of that Foundation like they really make uh they create the scaffolding that we can kind of build from throughout the rest of the treatment episode well I think of the word I’ll borrow a word from the emergency department triage right where when people go to the emergency department um after a car accident that isn’t the time you want to get you know a mole looked at it’s probably when you’re dealing with some acute injuries and that sort of thing and oftentimes when people are coming into Peaks like there’s some acute physical symptoms that are going on that just need to be addressed before we get to the looking at the mole if you will yeah or the inner child yeah and and of course right you have the biological distress you know markers of addiction and mental health disorders on top of it you have the psychological impact of removing yourself from your last use at the end of the day as well too right so you come in you’re feeling like crap but you also have this intense pull psychologically to want to be doing so so I think we can you know the viewers can hear out there how this kind of really starts compounding on itself and you can see how complex this really becomes to treat as a condition because even if the person physiologically wants to be well um the greatest resource to them you know especially in substance use disorders was the drug of choice in the background that would alleviate that symptomology for them and so there’s this tug and pull relationship of wanting to feel well but experientially speaking the medicines we’re using are different from what the brain is originally associated with so there’s a conflict there and out of this just using that kind of as a bridge into this psychological aspect and so let’s talk more about the psychological component of it yeah sure and so um you know part of we actually when people come to Peaks and it’s standard in the industry we do biopsychosocial evaluations like where we kind of look at all these aspects of a person’s life and and they do tend to be pretty in-depth and the psychological part is certainly looking at mental health issues and and even beyond the ones maybe people are initially presenting with you mentioned the minigo trauma like that is uh you know it’s fairly ubiquitous and and it’s a word that gets thrown around a lot but it for a good reason because a lot of people do endure a fair amount of trauma but it but it is beginning to look at um once we were kind of through some of that biological things it is looking at those components of the of the psychology if you will
yeah I think I had something brilliant to say and I forgot right yeah okay yeah yeah well mic drop yeah for sure yeah Jason did good yeah but it but in the right in the in the way that it’s it’s compounded right if an individual does have something you know coming out of the pandemic like you know severe anxiety or they were isolated and it led to a depressive State and through that depressive state in isolation the liquor store was across the street and then they added the alcohol to it and you know it starts compounding in that way and then the social aspect at the Bottom Rung the isolate you know the isolatory feature of it you know we’re talking about somebody who’s getting hit at all three levels of this over a period of time and then walking out into the world and I think we can start to hear the real conflict and challenges that it takes within this because when somebody enters an episode you know like Peaks whether it’s a 30 or a 45 or a 90-day stay through the levels of care throughout that process we’re we’re battling a lot of different things and it’s and it feels kind of nearly impossible to start addressing like every single feature alongside of it and so we get a lot of intensity especially in the first two to three weeks of any treatment episode code you know you know for me I treat an AMA within the first two weeks when you know it’s really a condition of the first few days but within that time frame I think we’re recognizing the craving States and for the viewers out there who are familiar or not familiar with insurance policies and basis right how do you point at bio in Insurance terms biomedical conditions right that are leading to or requiring an inpatient stay or a detox day at the end of the day the reality of a biomedical condition namely for insurance I mean alcohol has easier components of it right you can send some of the emergency room you can say okay we have psoriasis of the liver and inflamed liver and these types of things but those are things that are going to heal in time you know in the absence of drinking as well so they don’t hold a ton of weight as a biomedical condition right and craving state is the largest biomedical condition that insurers really lean into and over time we want to see those craving States go down but at the same time like other diseases that exist out there or other other you know medical conditions we can’t open the hood of the brain and go there’s the craving State and we just got to unpluck that thing and get it out of there and so within treatment episodes with even within a biomedical you know or a biopsychosocial model uh in that regard it becomes really challenging just to really try and address all of these types of things especially because one of the first things we’re going to experience right is resistance in the process and and it’s a natural resistance it’s a discomfort something was working not sustainably but working just enough as we’ve talked about on past episodes where kind of pulling that back you start to re you know arrive at this conflict and oh I don’t need that I need this other thing but we’re trying to stay well we have to do these things so we can arrive at this thing like trauma work right at the end of the day um anyways trying to do a little tangency no I think I I I came back okay yeah I think to speak to one of the key components of the biopsychosocial model is this idea of a coping mechanism right and really looking at the substance use as a behavior really at is a coping mechanism that is uh it’s just very maladaptive but it’s how the individual is typically managing stress anxiety sometimes trauma uh you know emotional dysregulation whatever the case may be and also physiological symptoms I mean somebody may actually have chronic pain as well if they’re and they are have opiate use disorder just through dependence so when you look at it as a coping mechanism rather than as something that I have an addiction that is inside of my brain that I have to like unplug like you were talking about it gives a different it helps you see that the person a little bit more holistically you know to use a another word that people love to throw around so and we did an episode on that yeah sorry that was episode 5 yeah look it up something that’s something yeah yeah um but so I think that it just and it helps to highlight that all of these things are connected right like that that biological component bleeds into the psychological component which can actually be of feedback to the biological component and then you bring in the social aspects which are um the the external environment and all of the stimuli that are just constantly being bombarding the individual and you’ve they’ve got this one saying this maladaptive yet effective coping mechanism that we very rudely take away immediately and uh to I think that there’s an expectation that that healing happens a little bit more quickly than it really does and people think it’s you know 30 days and it’s more like 18 months before you really start to see some pretty significant shifts in in the brain um so but yeah to your tangent first two weeks are really hard yeah it’s pretty rough and our medical staff and residential staff and clinical staff are absolutely brilliant in those first two weeks because it can be very um it’s hard on everybody yeah it creates a tough environment so we had we kind of talked do you want to hit I did I did want to hit the one thing because I don’t want to I don’t know if we’re pivoting off of this but the social component is really important absolutely and it sounds like probably the most obvious thing maybe to contemplate as we consider this model but it is the people can’t get better in a box right you you mentioned cirrhosis and and I think about I’ve I’ve talked to a lot of clients over the years who I’ve talked to with cirrhosis and they’re like I can never drink again because my liver will fail but it didn’t prevent them from drinking before so then we add on like maybe you’re depressed and all that but on top of all that like what is your support system and what does that look like and how do we nurture that and how do we uh we spend some time in our curriculum contemplating like who is relationally in our life and how do we want to bring healthy people closer and how do we create space for that by pushing maybe some of the more negative or less positive people and things in our life further out and that that component of the biocycle is social model I think is pretty significant yeah to contemplate I think it’s actually the most dynamic really I think because it is the thing that you have well it depends you have either a lot of control or very little you know like to to pluck somebody out of this really safe um healing environment for 45 days where they just are they feel good they’re clear-headed they are they’re on the the they’re taking the first steps on the path towards long-term recovery and um they’re doing so in the safety with people who love them and care about them and really want them to thrive and and we pluck them out of that and we put them right back into their old environment and to think that that’s not going to impact I don’t care how much individual work you do and how much Insight you gain and how much uh how much you’re able to sort of reframe your world and see things more clearly man that external world is just going to come racing back and it’s going to trigger everything around you including those old synapses and thinking patterns and behaviors um so if you’re not acknowledging that social component if you’re not actually really Preparing People by walking them through like hey guess what what happens when you have that first fight with your partner yeah like what happens because that used to happen every single night before you got here so what’s how is that not going to continue to happen moving forward and what is the new coping strategy that you’re going to use if you’re not addressing that then I think you’re you’re missing one of the most crucial pieces of actual long-term recovery and to that point I think it I think if you’re going to do bio psychosocial approach you have to have a family component too absolutely as many clients as uh can benefit from it and that can be biological yeah it could be biological or family of choice whichever yeah absolutely yeah yeah it might be uh building a family of choices absolutely but teaching new Dynamics and new ways to communicate that that don’t involve shame or control and contain good healthy boundaries I think is such a key component yeah family work is actually really good at IOP because that’s when the client is back in the home and they are experiencing all of those things that uh they were really convinced they had to work through and already resolved while they’re in treatment and then ah crap it all comes back up again and not only are they experiencing the same internal issues the family’s seeing the same behaviors and so everybody gets really scared and it actually takes a lot of practice that’s I think that’s the other thing about recovery that people don’t really talk about a lot it’s really about practice it takes time to re-learn how to live your life yeah and uh yeah so I think again um that social component just has to be reiterated yeah it it it reminds me and for the viewers out there we did an episode with Dr alardi and Sebastian younger Sebastian younger the author of tribe and freedom and War and a few other books that we mentioned in that episode but in the try book he goes that length to describe trauma symptoms for veterans and 80 of uh PTSD is short-term PTSD for veterans within the event taking place and within two years and what we discussed on the episode is how adaptive it actually is to form a behavioral response around it you know so if you’re in a war zone for example and a guns are going off and it happens you know rapidly you want to get on the ground and you know crawl and get out of the way and move towards safety but now you’re at a birth kids birthday party and a balloon pops and you’re doing the same type of thing well in the war environment right of course that is an Adaptive trait and it’s bleeding over well the hope is that in time that’ll resolve itself um you know organically in the that way what it comes to for long-term PTSD for the 20 of veterans suffering with the long term is we go from an Adaptive feature and years later we are still with every pop in the room right crawling on the ground and trying to find that sort of safety so the the thing that I really want to draw the attention to out of that is we’re talking about a behavior and we can create an awareness around the behavior right within a setting through talk therapy through a variety of different ways but if we are within the treatment episode we’re in that safe place and we’re on the world where balloons are popping and that type of thing so now we move into the social aspect of things and I think this is what is often missed like when we think about it right we were talking about it earlier the pink Cloud event that kind of takes place in treatment New Perspective I believe I’m self-actualizing I believe I’m getting insights that have never had in before around my condition that causes the correlations to my condition and so now I’m just going to go out into the world but what we what we cannot change in a Time limited episode and this is true across any treatment program or rooted behaviors it requires this practice this an ongoing mechanism right in the outside world and I think that’s what makes the challenge that’s so difficult is a challenge and as we were talking about earlier you know family systems why wouldn’t they let you know Johnny go back home and live in the basement again because he sounds different he looks better than he’s ever looked before and he’s talking better and he has all these goals and ideas and things that he didn’t have going into you guys great job now come home and we greatly miss the challenge in the time it’s going to take to really coordinate those behaviors and all of the communal and you know Outpatient Treatment modalities are going to be required to support the individual as they go through that as and especially as they encounter new challenges along the way absolutely or so yeah I mean all of those old behaviors and patterns are they’re gonna pop right back up again unless you I mean there’s this old and again when we were talking earlier this old kind of 12-step adage that you know if you want to get sober you only have to do you only have to change one thing and that’s everything yeah yeah it’s so so tough it works but the idea is that you have to actually nurture change pretty uh like you have to be really intentional about it and actually and look at the things that you can change I mean then it goes all the way back to the Serenity Prayer my gosh this is turning into a 12-step episode which I mean we’ll get out of it it’s a throwback yeah well I actually think it’s a perfect segue okay to what uh what may be missing from the biopsychosocial model yeah yeah absolutely um okay we deal with their body we deal with their brain we deal with the people around them but there’s this other piece that I think you know we you and I were pretty enamored by that conversation at the Symposium I’m talking about how uh adding that Fourth Kind of uh Dimension to this approach means helping people find some meaning and find um some mindfulness in different ways I think can be um a great uh adjunct at least to this model or uh and maybe a critical adjunct well it gives it sustainability right like it gives it longevity because you’re talking about identity purpose meaning things that actually uh become their foundational values that you hold on to and that you can and that are actually pretty good at redirecting uh thought redirecting Behavior because you start to live outside of values that you’ve really committed to and um yeah I think that it’s uh a really I’d never heard of that spiritual component until we were at the Symposium and um you know and talking to the psychiatrist it actually the the word spirituals can be heavy sometimes and it has a lot of um you know mixed connotation so but having it almost be it’s almost like biopsychosocial existential as this other component because it is a search for meaning at that point and that is something that um you once you learn that you have control of that that that’s actually within your power to identify and establish that is um that’s a tool that’s an amazing coping skill like that’s an amazing tool because you can reframe pretty much anything at that point so um yeah I loved it I love that concept which is a philosophy now yeah so what’s existentialism yeah so existence precedes essence right hey go take a bathroom break yeah bathroom break kids this is going to take a while yeah uh so we’re this is great this is directional I was I was worried about you guys you’re all tuckered out at the beginning but you guys are really coming into your own here so I love it I think before we get into you know how is this model namely beneficial or as a contemporary you know model of treatment how it’s beneficial and why we use something like this or why we call it integrated care and get into those features let’s kind of just quickly you know thumb through maybe what other models you know might be because I think the other models that we might speak to are conflating um that oh well I got my SSRI or my snri so like why do I even have to do this talk therapy thing right at the end of the day and you know if the symptomology is suppressed right through the disease model let’s say and we’ve talked about it on past episodes I mean go back The Dark darlardi episodes on Dr Kevin McCully a senior fellow at The Meadows spoke directly to the disease model of care and charitably in the episode always curious about what he can learn and add to the model as an experience but if we believe as a world that ssris control serotonin levels and serotonin is leading to depression then I should just be able to go to a place like Peaks get the ssris and be on my way but we’re learning that these monotherapeutic values aren’t you know efficient not even really sufficient in and of themselves and really lack outcomes by themselves 85 percent of all uh of of Mo of individuals who are suffering from major depressive disorder are just simply using ssris that are only 30 percent effective uh in that regards to do the mass it’s ineffective right at the end of the day so um but maybe we can just quickly jog through model of care that or the disease model of care the choice or moral model of care and just see how these things are maybe still sitting in the psyche of family systems that think okay these are the things that are actually true and so the output should be ssorizo get rid of the depression because we’re sending them to Peaks and they’re going to sit with you know the psychiatrist position and so forth yeah which one do you want I’ll just start and then you clean it up okay cool okay so I mean I think I think there are I think there’s room uh in the field for different models of care right like I don’t think I don’t think we have a corner market on this concept of biopsychosocial uh existential model of care but I think um when you look at it you know like AAA um arguably is a kind of combines a medical model of care calling alcohol is a disease and you have an allergy they use that terminology kind of along with the moral model where like uh you’re screwing up quit screwing up right and to be honest with you there there are people in this population there are people that that makes the most sense to them that like that matches like kind of on the screw-up I I can admit that every day and um I’m gonna go and uh confirm my moral shortcomings frequently and that confession uh and then a book kind of can guide me through that moral shortcoming and community and that’s what a has always done and that is a great component of a as well but um so I think there’s room for that there are people that really even that come through Peaks that are like I can’t wait to get back and get to my AAA meetings because you guys don’t offer it enough here and and I need um because I need to say every day that I’m an alcoholic and I’m powerless over alcohol in my life’s unmanageable and like those things um that could be really helpful for some people um the problem is I think with that is it’s really exclusionary whereas I think other models I think can be more inclusionary and I think to your point the medical model which just says it’s a disease and so therefore there’s a solution to this malady um usually in the form of a medical intervention that also seems to fall short but again it can be helpful for some or it’s an important component part of the biopsychosocial model of care yeah and I think that both of those models actually also have this kind of assumption that the addiction will always be within you right like you will always have this disease or you always have this moral defect that will forever make you susceptible and forever identify you as an addict like it’s I need to I’m so so and I’m alcoholic like those both of those models really lean into character and identity and they kind of Define it for you so they’re I mean while you’re talking Jason a a actually has a bio psycho and social component it really does it just is sort of umbrella around a kind of moral um or Choice based um I don’t know filter I guess is kind of what you’re pushing it all through and it doesn’t and I think in that sense it makes it pretty exclusionary because it will reinforce things like shame so if you have a lot of trauma if you have a lot of depression if you have a lot of PTSD if you have um I think if you have a lot of underlying mental health it’s I don’t know how effective it is without additional interventions and yeah but it’s a it does serve its purpose and it has a place and these aren’t pure models of care yeah heart reduction is considered a model of care yeah but of course that also uses these components as well um and our production can be so many things it absolutely is yeah just yeah so I think I purely separating them all out there’s they’re all kind of Venn diagrams they all kind of overlap each other anyways yeah it feels like reductive it yeah bio psychosocial is kind of the the new sort of Paradigm but it can be reduced into these or these right you know AAA uh you know disease model and so forth reduced into the biocycle absolutely they all have components but the biopsychosocial model doesn’t seem to have the edges or the the feeling of restrictions around the level of care like an ability to see past something into something like hey I think you know the existential moment here matters right you know in that type of way or the um the room to shift from spirituality into a term like existential right so that maybe people can better hear what you know the approach might be for them if they have become in a way you know Dev to the concept of spirituality you know before entering treatment yeah absolutely yeah it’s a I I you know the biopsychosocial model really for me anyways um takes away the pressure to I try to identify why like it doesn’t it’s there’s no one answer why we do anything it’s everything the reason why am I who I am because of everything that’s happened to me up until this moment like I cannot go back and find that one time that has that has really um defined a behavior that is that I’ve reinforced on my own for however long it’s and when you don’t have to focus on the why you as much or at least you’re not looking for causation you it gives you the freedom to explore all of the other variables that are out there it allows you to see things on a much more macro level rather than just saying I’m just going to take the disease piece and we’re just going to do the disease piece and I’m going to do this really well again that’s taking somebody and putting them in a box in a Vortex where there’s no other things around it and it’s not all work opioid addiction can be resolved through Suboxone yeah exactly you know mat right and there’s an incredible harm reduction value to it it saves many lives in the process but it doesn’t always objectively work for each independent subjective experience around why a person uses drugs or alcohol in the first place a common thing that I’ve talked about in past episodes around that is like an example is you know there’s a difference between subjectively speaking a person who takes an opiate for the first time to get high versus like you know a dad skating down the driveway with his daughter Falls breaks his knee gets into a hospital takes an opioid to resolve the pain and then in the process becomes addicted right there’s two existentially different and subjective experiences for which one pill cannot account for both situations in all instances and in the end like is that really what we want to explore over 45 days to me a more interesting question yeah it’s like okay so who are you right now and uh who do you want to be when you in the future you know like those are pretty good questions to ask somebody that give you actual directional goals right you’re not you’re really looking at right now and saying all right this no matter how I got here I’m here and I’m unhappy and I need to change it’s like cool what do you want to change into like where are you going from now uh where do you want to end up where is this path gonna start gonna lead to and then you can actually nail down a plan you can start working through things and while you’re working through that plan then you start to do that exploration you develop that Insight you start to see and do those deep Dives clinically that allow you to sort of see how maybe you’ve framed the world or created narratives or um or just sort of Taken uh maybe an approach that is maladaptive that you thought was actually really healthy so it’s um it just to me it also makes for like a much more interesting uh treatment episode rather than like all right well let’s talk about that how you went to that party that one time and now you’re you know now you’re homeless yeah because that’s yeah yeah you went to that one Rave and we it all went downhill from there it’s like that doesn’t make any sense so yeah absolutely and it speaks to like you know many people go to the Rave and many people will try the Ecstasy and many people will walk away and not do it again and some people will move forward and form a habit around it you know as well too and I think that there’s and you know to your point earlier around like this isn’t a necessarily a thing that you’re living with it’s always going to follow you throughout the rest of your life because we know you know we’re talking about it at the um at the winter Symposium recently in the Psychedelic panel that we had put on you know that um you know to the point I think I want to make is like we’ve we’re forming behaviors over a long period of time and we can go okay I want to change these behaviors and move into this direction but post-treatment we might be resolving behaviors that are decades yeah you know impregnated in the brain right and our responses to the world and so the challenge becomes on the other side of that um figuring out a path forward not just with this great thought of wanting to change but how I’m going to actually do that in real time oh the how yeah your favorite the how component yeah and it’s his favorite too and I think this is also where it bleeds into like you know some treatment websites say well 73 of all of our patients go on to get a job after treatment it’s like is that the outcome that is desired it’s an important outcome within a capitalistic you know you know society that we live in and it’s something we appreciate when a person ties their boots in the morning and goes out and gets a job but at the same time that doesn’t really resolve anything we’re talking about other than something like okay that’s one Behavior change they’re holding a job but if you’re white knuckling it and that moment just holding the job and you got all these stressors going on like how miserable yeah technically being a drug dealer is a job so I think that’s it
I feel like it’s more of an under the table thing but yeah yeah that’s an interest that metric doesn’t make sense uh without context right that’s like taking that one thing and we’re gonna say hey we’ll measure all success based on this one if you can do this one thing that we killed it yeah we nailed it and maybe you just have like a really robust indeed portal and that’s actually you’re the best part of your program I don’t know yeah and and one other conflict that I wanted to add to it just for the viewers out there and part of that panel discussion too and not just carrying out behaviors but that there is this strange um moment between after the age of like I think it’s December between 24 and 26 and the samsa data where 50 of users who prior to the age of 26 would have received per the DSM-5 uh substance use disorder it would meet criteria for a substance use disorder but for some reason after the age of 26 50 of them drop off and are no longer uh qualified in that sense lack better words within the DSM-5 for having a continued substance use disorder so we have real data out there that somehow people form these behaviors and then somehow it just falls off and they stop doing them at the end of the day and to the job point I think that accelerates people’s attention why I want to become this engineer I want to do this type of thing and so there are things that can change behaviors quite naturally and organically within our society that don’t also require treatment but also alludes to the fact that if we’re just going to Anchor into something like the disease model we’re losing 50 percent of that suddenly and why is that happening right and I so so I think those types of data sets reinforce the biopsycho you know social approach that maybe this person is continuing to use maybe after the age of 26 because it’s more than just the biology that’s taking place or some symptomology that’s pushing it Forward right yeah and you know as you’re talking about all this in the job measurement it isn’t like I feel like there’s so many behaviors that change as a result of doing good work of doing good bio psychosocial work it’s like people will just become happier and they will get a job they’ll want to be productive in that sort of thing and and it isn’t about like it just it’s just so much more than just getting people to be compliant with behavior changes specifically yeah because that’s no Freedom at all right that’s no it’s no relief at all to just figure out what behaviors are going to make other people happy and then do that I think for me one of the best indicators has always been you really start to see self-respect come back there’s a value people start to recognize that they have value again and once you start on that pass it’s uh I think I think you’re in a good place I think because you have a lot of that’s a a lot of Runway there because you can start to give yourself Grace you can start to give the world Grace you can start to really focus on all of a sudden your journey you’re worthy of it again and before I think that self-worth when when we meet people those first two weeks it doesn’t really exist people feel pretty worthless and that is a very very hard place to exist in Period and and we’ve talked about it too I think you know the great challenge is that we can make this a safe place in time for all the struggles we go through between us and the clients at the end of the day there is this natural like you guys care and I get that and I’m grateful to be here right but so we’re creating a safe place we’re building trust with the individual they have to go back into the unsafety of the world and this is where the social aspects come in because you know around a job you know we have you know clients come in I don’t want to be a burger flipper like who told you that’s the value of that job right as a society as a social aspect of this and what I’m getting at maybe all jobs are fairly valuable right and the individuals that are behind the counter taking our you know McDonald’s orders all that sort of stuff we as a society say well that’s not like kind of a job right and it doesn’t allow for that type of safety and they immersion back into it because now this is a thing I have to get through to get to that next thing that I can actually feel value and needed within at the end of the day but I think you know I’m gonna have to wax too philosophical about this but I’ve been in a taco you know Bell drive-through and like don’t totally love myself after going through the process but I do love some of the food or whatever but the experience of it matters if that person on the intercom gets on and goes what are you here for today man I’m gonna get you the best breed we’ve ever had and some excitement around that for all the viewers out there who’ve experienced kind of a drive-through atmosphere like that you’re like [ __ ] I actually feel really good right now you know in this moment and I’m connecting with somebody and they’ve made that Journey better and for that reason their job matters right and so I don’t get too political about it but in the social aspect of things this is what younger and uh these past guests that have been on Peaks celebrity and so forth and even ourselves at Peaks are talking about is that we can’t guarantee the safety but from a social aspect you never know who you’re talking to whether it’s a restaurant at a bank you know somebody might be really going through something in their life and how we treat them helps them move forward in their own process and journey and so this social aspect is probably one of the deepest lacunas of how do you fix that to support the individual once they get outside of here uh you know in that regard in other aspects of it as well too you know a family system that’s drinking now they’re out it’s Thanksgiving or whatever and oh I’ll just have a water like now we’re treating people differently and that’s awkward and that feels shameful and that the atmosphere is changing because I’m a part of it and so anyways that I just wanted to highlight as some of these social factors that are quite challenging for a person to transition into and I think that um one of the one of the things that you that you maybe think about is this idea of placing our value externally outside of ourselves like I am valuable because I have a good job I am valuable because I am normal like everybody else I am and uh because I fit in so having your value be basically decided upon things that you can’t control as one of the most empowering tools you can give somebody is the ability to actually just be able to you decide your value like it’s internal you carry it with you wherever you go that way no matter if you are you know performing brain surgery or or um you know giving you your Mexican pizza in the Taco Bell drive-through your value doesn’t change because it’s you’re carrying it you decide you you hold on to that it’s not something that’s ever outside of you it’s always something that’s inside of you and again and I think that’s when the the sort of spiritual existential component of the biopsychosocial model biopsychosocial spiritual slash existential model um becomes really powerful because you don’t and it gives people some it allows them to navigate really tough situations especially if they’re going back into the same environment it’s it’s a it gives you a little um it’s just a little something in your back pocket that allows you to be able to recalibrate when if you get a little bit frazzled so so to to take the viewers out here I think you know so let’s talk about because at Peaks we have an integrated model of care right where we nurture both as substance use disorders and mental health disorders at the same time within the same model but we’re also tacking on a lot of this you know biopsychosocial implementation throughout the duration of treatment so how how effective is this you know really and why and why are we trying to do so many things within such a limited you know time frame clinical officer yeah yeah curriculum guy yeah curriculum guy
to take your question like I think um this biopsychosocial model of care like it doesn’t say for addiction use or for depression like um implicit in this model is just this treatment of suffering that we have been talking about here at Peaks and um somebody who’s depressed needs just as much social support as somebody who is four months sober or four weeks sober from alcohol use um and again people depressed uh their bodies can become deconditioned due to lack of exercise and that sort of thing just as much as somebody who can’t get off the couch because they are drinking so much so um so really you know I think we we’ve designed a curriculum and continue to work to to perfect it not just in the clinical ones but you know from the approaches of all our departments to treat people um through this way through this lens and treat them as humans and to address the needs that brought them there and the behaviors or lack of behaviors lack of support and that sort of thing that brought them into our program and so um we we’ve talked about this I think the distinct the distinction between alcohol use disorder and other psychological uh diagnoses is artificial and it is based upon the history of our industry and also prejudices and so the alignment of the treatment of that um probably would be how all this would have started if that wasn’t the case that’s my response to your question damn Jason yeah that was really good actually yeah I was yeah okay and I just made it up
I mean people are complex right like we’re Dynamic we are um yeah this is wild like what we’re doing right now like life is insane it’s really really really crazy and I think that we just acknowledge that you know by acknowledging it you start to regain a sense of control you know change is really hard like it just is hard and ultimately um that’s what people are seeking so you give them all the tools that you possibly can some of them will stick some of them won’t but in the process you are also to Jason’s Point acknowledging them as like a valued worthy whole human being in this wild crazy world of ours yeah and um I don’t know there’s something very uh it just feels good to be able to see people as people you know it takes a lot of judgment away and allows you to kind of cut through the the BS and really get to the heart of things yeah but in the the challenges within it right like the biological right like if you’re not feeling well you can’t move into movement and movement is so important in our historical timeline as human beings to uh Wellness experiencing sunlight experiencing walks going out and doing something like a project like getting water for the tribe like these types of things have real internal value but if you’re suffering within a treatment episode you can’t access it you know some people come in and say something like well you know uh I’m here and I I only you know I need to work on my nutritional value that’s true and I guess what I’m pointing at here is the difficulties in approaching these Services because it’s difficult to contain everybody’s biopsychosocial elements you know within any given treatment episode and I think all treatment centers do what they can to address it but you know to have sort of the new nutritional salad bar we’ll call it of like this is how you’re going to eat this and you’re going to do I mean people are coming in Peaks they haven’t eaten sometimes in days you know let alone sleep and that type of thing so getting them biologically attuned nutritionally is like we’re just you know it’s like just eat first you know and then we’ll discover something like that um but if hunger is the real rooted need and I’m not in a psychological position to entertain microbes and macronutrients right then talking about it is going to be ineffective right at the end of the day so and I think this is where it gets more into that sort of holistic attitude of like you know approaching somebody in one context just is not going to work for the entire group and I think that’s what makes substance use or the treatment of substance use disorders and mental health disorders so complex at the end of the day because we have all of these resources right at Peaks recovery but you can’t just give it to all of them because they’re not only going to receive it in the same way and it’s the problem with or to be charitable to the other models right you know whether it’s 12 steps you know moral choice you know disease model or whatever these become restrictive ways of approaching treatment right because you’re taking an individual and you’re stating okay this condition is true because this model is true and so you’re moving somebody through it as a care but it’s restrictive because it’s missing the potential for all the other opportunities for why the person’s suffering right well and I think that speaks to the importance of individualized care you know like by meeting people where they are and not trying to push them through an algorithm you know it’s like oh you are this model go this way do these things and then you’ll be fine but actually recognizing that literally every single individual’s treatment is going to be different period you know but there are some there are some components and there’s some uh I don’t know there’s an arc to it right like you come in and I think the first the one thing that connects all of our treatment is just that it’s connection you start off with these like human connections and the first one is just the nurse saying hey are you hungry you know and then going and getting them food first one’s admissions actually oh yeah that’s yeah hey are you scared that’s basically what they’re asking yeah um do you do you want to not be scared anymore yeah and you get these sort of invitations to engage with the world in a way that you haven’t been able to in a long time and then you’re cared for you’re nurtured and by the end by the time you’re leaving you are actually just cooking food for the people there you know like you’re cooking for your housemates on a Sunday so you see this Evolution and then there’s all of the millions of things that happen in between there but there is a I think a a pretty consistent Arc that is built off of you know it’s like we said the the opposite of suffering is connection and so I think that that becomes a really crucial component as well yeah and you know maybe taking it out here you know we were talking about it at the office where we did the episode today it a person leaves treatment and says I feel good I feel great and they go back into the same environment um is one way to look at it another thing I’ve talked about a lot or we’ve drawn attention to is like well that place didn’t work for me because they didn’t work on the trauma the things what I’m curious is about is what we can leave the viewers with if if those are rooted internal things that are not being operated on I mean that’s why case management exists right we talked about the complexity of the biopsychosocial that if it takes two to three weeks just to work through the psychological associations of I know I have access to something that can help me you guys just took that away you know right off the rip and I’m debating between my how I feel physically and what I know can work for me psychologically and at the same time I gotta wait for these extra psoriasis and our eyes all these medications to kick in right we spend a lot of time negotiating the biological no wonder we didn’t work on the trauma right because we had to move through these phases of treatment so what can we share with the family systems and taking this out that when they hear this from their loved one how what can we do to encourage the best path forward because we’re we’re not going to go back into a treatment episode so you know you relapse you know in the process you didn’t work on the trauma that you believe is the cause of your uh suffering here and then you go back into treatment but again we’re in the same resistance of biopsychological because you were doing drugs for the last six months right and so how do we charitably get out of this kind of loop that it feels like right and what can we do to encourage families or Empower family systems probably more appropriately as they navigate some of these Loops that happen because statistically speaking especially for sud and this is not to you know promote relapse by any occurrences but the general averages are between two to four times but maybe we can have some sort of you know instead of this Loop take relapses to lapses and contain or maintain I should say sort of a directional approach to it so how do we how do we Empower family systems to keep leaning into the process without thinking none of this works so I’ll I’d like to answer that question first I think I think it’s a shift of mentality right when when somebody is in AAA and they get a chip and it says I have three years sober and then they go out and they have two drinks and they have to go to their next meeting and turn that ship in if you know and and get a new what they call Desire chip and they’re back at square one or Square zero actually and um that mentality says that that person failed it erased the the four years or whatever of recovery that they got and they are back just like somebody who is on their very first day of ever trying to get off of the drug and that mentality still permeates and in in kind of a medical type model like people with you know chronic illnesses like diabetes and that sort of thing it’s common for them to have spikes in their blood sugar at times and for their meds to stop working a little bit so they have to go get Hospital intervention for a little while and to kind of re-regulate and get get on the appropriate meds or or maybe um try a different program or new technology or whatever and that’s perfectly normal in the medical setting and it isn’t judged it isn’t like none of the other diabetes treatment worked it worked for a period of time served its purpose and now it just needs some refinement and so I’m not I’m not trying to downplay what a relapse does and what a lapse does and how devastating that can be but I’m also saying that it’s compounded by it wipes everything out and people just start from square one that the truth is somewhere between those two things right yeah because then you’re battling the idea of failure and the shame and the guilt and all of the things that have probably been at least to some degree motivating the behaviors that you’re trying to avoid yeah so giving um I think giving families a lot of Grace more than anything teaching them how to give themselves Grace um I don’t know I think working on the fear is really important and being very honest like you just have to be you know I’m a pragmatic guy I’m a realist and um it’s so interesting how much of our thinking is magical and so actually having like breaking that down and doing it in a way that is really compassionate and really actually normalizing it’s like this is going to be hard but it’s also okay that it’s hard like it should it don’t run away from the difficulty because then you’re actually running back into the problem so yeah and and for me I you know just for the viewers out there anybody watching this like consider what it is in your life to have a behavioral change right take anything like going to the gym in the New Year I’m going to lose weight this year like whatever those challenges are gyms fill up for January and then the memberships go away for the rest of the year right as a process I just got done running a marathon as you guys know a few weeks ago and it’s it’s imperative it’s crucial that you rest on the other side of that and let your body heal I mean it’s an intense activity and it does really mess up your body in a variety of different ways and in that regard though just sitting there knowing I can’t run because I got calf cramps and that type of thing was so challenging to sit still in that moment and just let my body heal and I’m talking about something that’s rather benign you know compared to a you know a 10-year addiction you know or something of that nature but at the same time it’s so challenging to change these behaviors and that feels like a positive behavior right you’re running you’re taking care of yourself in your body but at the same time I experience the real difficulty of just eating still and like avoiding going outside for a quick mile you know in that regard when we become conditioned in these things it is difficult to let go of the prior aspect no matter how important or healthy it is to change moving forward right and so if we’re all being charitable to Behavior change for ourselves and our own lives whatever that is how we show up in our relationships how we show up for you know our kids how we show up at work and professionalism and all these types of things uh and and causing us to change in the process and noticing how difficult that is I think we can be more charitable as a society to how difficult these processes are especially for you know individuals with psychological diagnoses like sud and mental health you know primary disorders so um in that regard keep loving on people people absolutely uh and uh and anything you guys want to add to that no I think that’s no that was great all right yeah okay yeah and Jason checked his watch I was like did you get a uh do you want to have some chats do you want to let us know what’s going on no yeah yeah my wrist has been ringing a little bit too so yeah yeah wow we just push it down yeah at work their watches ring differently than that’s for sure and with that folks uh I hope you enjoyed this episode of biopsychosocial stressors please take into account everything we’ve been talking about the complexities for what informs treatment how an individual moves through treatment and what it takes on the other side of a treatment episode to really discover something like a cure to discover Wellness in the process and this is going to look entirely different for each individual and if we go into this with a more you know sort of open heart open mind mentality I think we can discover in the process a better way to treat all of these individuals who are suffering not conscious individuals who arrive at Peaks but commonly speaking in the world we all have challenges and the better we show up for people I think the better outcome overall so enough with my politics uh it’s another great episode of Finding Peaks Brandon versus Chief Executive Officer for Peaks recovery centers taking this out finding Peaks at peaksrecovery.com Coopers I know is going to put some I’m missing it’s like information at findingpeaks.com something like that your thoughts questions ideas uh for these episodes we’re listening to you the viewers so continue to ask those questions this episode came about today from all of your thoughtful visits to our website and this biopsychosocial page in particular and on top of that we got the tick tocks we got the Facebooks the Instagrams all those types of things that can be a negative world to live in social media but on our social media it’s all positive we’re just talking about recovery and trying to get people well at the end of the day so with that thanks for joining us for episode 6922. we’ll see you next week