In this episode we are joined by Dr. Ashley Johnson, DO to discuss depression and improving mental health with neuromodulation.

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empathy is knowing your own darkness

without that connection you don’t have

anything what’s the opposite of

addiction just freedom

hello and welcome to another episode of

finding peeks i’m jason friesma your

host this week joining me

is uh peaks recovery center’s chief

medical officer

dr ashley johnson and peaks chief

clinical officer

jason friesman

chief operations officer

yeah all right straight to the blooper

reel here we go um

but anyway uh

we are here to continue a conversation

with dr johnson um

and kind of the innovative approaches

she is taking in her in her practice and

and uh where i kind of want to start is

i know last week you introduced a

metaphor around a frayed rope and so if

you could maybe do a quick summary of

that in case some people are tuning into

this episode that didn’t watch the last

one and then uh and we’ll kind of go

from there okay sure

uh so last week we had we just talked

about it’s a

helpful analogy

kind of to to summarize the effect of

ketamine really all of the

neuromodulatory

treatments that was kind of the word

that we’ve lumped these treatments into

so basically just meaning we modulate

nerves

meaning we change nerves

or improve them is the hope and so

the analogy of the frayed rope

uh

helps people understand

that uh if it’s like taking a rope like

a hemp rope that’s got a lot of fibers

uh kind of braided together and twisted

together and

so

when you take something rough like a

brick maybe maybe even like a razor

blade or something and you rub it across

it it just frays the rope

in that area

and

we liken that to untreated mental health

conditions

to include chronic pain

uh and substance use disorders and so

when all of those conditions

kind of go untreated for years in most

cases um

it’s it’s like it’s fraying the ropes of

our brain so the ropes are are

synonymous with nerves so nerves are

typically long and um they’re just

elongated and like a rope is and so

when all these

kind of neurotransmitters and hormones

are

are dysregulated in our body over time

that’s usually how the ptsd or the major

depression is manifesting internally

it’s fraying the ropes of your brain and

so when we

what we found is that we have to

intervene in that process in order to

stop that process of just

destruction to the nerves

we have

over time found many different types of

treatments that work

to stop that process but then go a step

further and do what we call neuro

regeneration so meaning it helps rebuild

the nerves but it also helps

like clinton mentioned is like the the

medications the therapies

the tms

is like pouring wax on the nerve and so

it’s almost like it’s trying to help

heal it

um

not so much like a band-aid

but

to where it takes it a step further and

actually neuro regenerates and it

smooths out that rope

in a sense

and while they all of these treatments

that we talked about

ketamine infusion spravato which is s

ketamine nasal spray transcranial

magnetic stimulation which is tms

psychotherapy that targets all these

different disorders

all of them are kind of working in the

same way and also to include psychiatric

medications

in that they’re stopping the assaultive

process on our brains and then they’re

helping us to move forward and

regenerate

okay

and i wanted to talk just for a minute

specifically about tms i had the

privilege of helping you i think

hone in your machine and you put a cap

on me

and turn the dial up to 11 out of 10 and

give me a little

shot of magnets

but i’d love for you to explain it in a

way that isn’t uh so colloquial

and yeah

it’s a good way yeah we’ll understand

that yeah so um maybe we should get a

clip for this podcast absolutely yeah

[Laughter]

so what we do with uh

the machine that i use in my clinic

is

manufactured by brainsway and so

i mentioned that not to advertise for

them necessarily but because they have

patented their type of device where they

utilize a helmet so they are the only

tms

device manufacturer that utilizes a

helmet to deliver these

magnetic pulses essentially into

the brain and different areas of the

brain that correspond with some

different conditions that people suffer

from

and

all of the other types of devices out

there are what we call figure eight

devices for the most part those are all

the ones that are

on the market primarily and are fda

approved for major depressive disorder

treatment

and actually more specifically treatment

resistant major depressive disorder or

trd treatment resistant depression so

that’s kind of the new

um or terminology emerging terminology

right that that that will become

standard or is becoming standard and so

um

with

tms when it’s administered through

a helmet

we have you come and sit in a chair much

like the one you’re sitting in it’s got

a straight back

it’s not reclined

but we place the helmet we deliver a few

pulses

to to try to locate different areas of

your brain and specifically

the area

of the motor cortex which is the outer

layer of the brain is what cortex is

and motor refers to muscle and so

when we find that motor cortex by

delivering a few pulses here and there

it will

we’ll focus on

for major depression having your fingers

twitch like that and then we know okay

look we found the motor cortex if we can

get your fingers to twitch it doesn’t

hurt

unless you turn it up yeah

and the goal is to treat at the lowest

intensity possible

just

for my own

clarification the process of finding the

cortex or the motor cortex is that the

brain mapping piece that you talk about

yes is that what that’s referring to

exactly thank you that that is the term

for

the first session that you

you attend for to start tms is

essentially the intake

um and so it’s where we are learning the

most about your brain specifically

because everyone’s brain is very

different and has

nuances as to where maybe

neurons are crossing and that kind of

thing and so we have to do kind of like

a test sure

to

identify where your specific

in the case of major depression your

specific left prefrontal cortex is

and so that is what we are looking for

so that when we

place the helmet then for the treatment

session

um that is where

the it’s about right here on your brain

uh that’s where the left prefrontal

cortex is and so this helmet is is

guiding all of these magnetic forces

right here into the left prefrontal

cortex and so

that will

pulse

thousands of pulses over about a

kind of the standard for how long it

takes to go through a tms session

for major depression we now have a very

accessible um

improved

time frame that we can administer the

same treatment

with about the same efficacy meaning

this this you get the same effect pretty

much from it in three minutes

so we’ve now come over time from

week

for six weeks

to now three minutes a day

um and so that’s that’s been pretty

groundbreaking as well that’s called the

theta burst

and you may see that on websites and

such for different clinics that

administer tms they’ll call it theta

burst stimulation and uh

tbs is the way that it’s being

abbreviated now so all of this

terminology is just emerging and

becoming standard so

um

but that that frees people up a great

deal in their lives because as you can

imagine six weeks of coming into a

clinic five days a week

can be pretty cumbersome for your life

if you’re trying to work try to raise

your family trying to go to school

that kind of thing and so now that we

have a three minute

treatment session

that has

made it a little more accessible for

people so with tms the beauty of it

is that you can still go back to work

sure back to school in the same day go

back home you can drive yourself

there are no restrictions in that regard

for the most part unless you have some

very obvious

side effects which is extremely rare

so as far as being invasive it would be

would it be considered a non-invasive

considered non-invasive exactly

and the fda has approved tms now for

first was for

treatment resistant depression

trd

and

and then was ocd

with

a few select devices not all devices are

approved

to treat ocd

the brainsway device with the helmet is

approved for that specifically

and it that’s somewhat important for

people to understand because that way if

they do suffer from debilitating ocd and

they need to get tms for it

because medications are notorious for

not

um fully treating ocd

they need to look for a clinic that has

the ocd specific

tms device

they’re not all the same

and so

that that’s one way that you can look

for that

um

well i think that’s important to

identify that not all tms is the same

that not all tms devices are the same

and that um different devices will be

more efficacious for different diagnoses

and

so it’s a it’s a really i think that we

start using state you know

tms and it becomes a sort of generalized

idea or concept but the reality is that

tms is a really diverse within it within

the treatment itself is really diverse

in approach and

yeah so i think that’s really

interesting it is absolutely and there’s

more

you know every year it seems like

there’s more

uh movement and what type of devices are

coming onto the market

to treat different conditions like

migraines right now there’s

a tms like device

delivers the same type of magnetic

pulses but you hold it up behind your

head

to treat basically to abort a migraine

interesting um just with a few pulses

and you can have it at home and so you

can see that you know there’s this whole

spectrum and evolution of tms that i

think we’ll see quickly come out um as

they’re doing more studies on it how to

maybe deliver different protocols

through the day and that kind of thing

kind of like the evolution of the

computer right it starts off and it

takes up this entire room right now and

and now it’s right here on this table

exactly over time yeah exactly it’s

really interesting

so it

i find this to be so interesting and i

and it’s an emerging field and then i’m

a

counselor so i uh

my knowledge of it is very limited um

other than you know what i can read

online and everything but i i did wonder

just from your perspective i i had found

um an article talking about ketamine

um and it studied people who just got

ketamine and then people who received

ketamine and therapy and then people

received just therapy and then people

who received neither and far and away

the most efficacious

intervention

um

for depression was the was the ketamine

and therapy piece and and how do you how

do you see those

how do you see these new modalities uh

that you’re talking about um

modulating modalities i can’t remember

what the term was but uh neuromuscular

modulation yeah the neuromodulation uh

interventions how do you see that

being enhanced by clinical interventions

from from a counseling perspective

so right now i think we are very early

in this process

the protocols are still being developed

and refined

through

you know our major institutions right

now

as far as ketamine assisted therapy

goes

there are

lots of therapists out there who are

working hard at helping develop these

protocols

and and i think the reason you’re

hearing so much about it is because

they’re seeing such

improved outcomes especially in ptsd

um

and while i i don’t know that

it they’re going to be you know

complicated protocols that we’ll find i

think what we see is

is we’re really applying our principles

of therapy and the various different

modalities

um cognitive behavioral therapy

prolonged exposure um

to basically while someone’s under the

influence of ketamine

that that kind of opens up

their mind sure so that you can help

rework the memories

and

uh i’ve seen it quite a bit to where

i’ve even attempted it myself and

as a psychiatrist and in my office where

someone is is really going through the

ketamine infusion

really for more the nerve repair aspect

of it

and because we know it has a very rapid

immediate anti-depressant effect

but you can see

how pliable their mind becomes

interesting while they’re going through

the infusion and so you actually feel

especially a seasoned therapist

you actually feel a lot of confidence

that

wow we’ve got some amazing access yeah

some real space

memories yes their pain their um

you know how they’ve been experiencing

their grief um to where you can start

applying if you’ve you know in most

cases been able to build some rapport

with this patient by gathering their

history their

psychosocial history specifically

understanding diagnostically why do they

suffer from what they suffer from so

that you can then if you are present

while they’re going through the ketamine

infusion you can then intervene

in the discussion with them

they are way you know for the most part

i think

most patients that i’ve treated in this

realm

they are very willing to discuss

and as long as they feel safe that

you’re there

occasionally you know they’ll they’ll

feel like some weird dissociative

effects because it’s a dissociative

anesthetic but there are ways to kind of

comfort someone help give them tips on

you know just kind of put your hand on

the seat

sometimes they’ll feel like maybe the

bottom the floor is falling out from

under them not quickly but it’s kind of

like an odd

sensation that they might feel um

but there’s there’s some very good ways

that you can address that while you’re

talking with them

constantly reassuring them that you’re

with them who you are

um

where they are

and how much they’re they’re being

supported and that it’s a safe place to

discuss their yeah their trauma

basically it’s so interesting to think

about dissociation i mean when we talk

about it in clinical terms and generally

speaking i mean

it’s not a positive or a um it’s a

firming word or

experience for people but to think to to

use a dissociate a level of dissociation

that it makes that kind of unlocks all

of these doors that otherwise could take

i don’t know years to unlock i mean we

work uh i mean therapists can work for

months and months and months to try to

get act like you said sort of this this

access to the mind and in the way that

um

what what seems that ketamine gives us

almost instant access to through this

kind of dissociative moment associative

properties

and the another beautiful part of it is

that ketamine is so short acting

that you recover ex very quickly right

so what we typically do is we’ll have

someone

complete the infusion within about 40

minutes

and then they have about 20 minutes of

recovery time and then they’re usually

able to walk out the door

uh they can’t drive sure but

they’re able to usually safely go home

with with someone um whom they trust

um get through the evening sleep it off

and then uh the goal is to see the

antidepressant effect continue sure or

maybe in in the case of ptsd maybe see

the edge come off of the hyper vigilance

the avoidance behaviors and all of those

uh hallmark symptoms that you typically

see with ptsd maybe the intrusive

memories aren’t as intense as well so

absolutely it’s really exciting to see

that happen i have also seen it with ocd

to where people are

they feel free to become more productive

like in their job

they are less obsessing about you know

whatever it is that that they’re

obsessive about whether it’s body image

um

whether it’s it’s about you know i’m i’m

not doing this right

that kind of thing and then the

compulsions that usually follow

oftentimes we’ll just ease off

that’s pretty amazing do you have any

indication if people can remember

the experience like if

somebody does a therapeutic intervention

during the infusion or right after do

they remember it

they do some okay

i um

i think most patients that i’ve treated

with ketamine

remember most of the time okay that

they’re in the room

i actually noticed though that the parts

that they don’t remember

are insignificant

and actually good because it was the

times where maybe they felt like

where am i you know i don’t sure i don’t

know what’s going on here am i outside

of my body i mean that can be common

maybe they see the walls start to wave

that’s that’s common too

they don’t remember that typically

speaking and if you can comfort them

through it and reassure them that this

is normal let’s keep going they’re

usually um going to do fine

interesting

and then

where do you see this all headed we were

talking before the show that

um

all of your training experience with

with this modality has been since

you got out of med school so you’ve had

to teach yourself or access whatever

resources were out there to learn this

stuff but

where’s this headed i mean i think about

um psilocybin or um

lsd micro dosing these are kind of some

popular things right now i mean

psilocybin isn’t

uh criminalized in denver anymore and

and so i know people are kind of drawn

to that or where

yeah where do you see this emerging

with other

i think there is a uh

a rush to regulate now that makes sense

and

that’s what i am seeing i’m hearing

about reading about i know they’re

studying psilocybin in boulder

um

[Laughter]

unbrand

but i also was just reading this week

how

you know all the ivy league schools the

major medical institutions

there

are quickly trying to form a psychedelic

psycho

psychedelic psychiatry residency or

fellowship basically so that

like i went through a general adult

psychiatry residency right that’s four

years um well there’s many different

ways that you can then sub-specialize in

child and adolescent psychiatry sleep

medicine

or um

you know geriatric psychiatry those kind

of

um

specializations and now they’re trying

to add

psychedelics like interesting psychiatry

i still have to think about how to say

it yeah that is going to be tough

yes um so that because you can feel it’s

like this wave coming off

all of this uh momentum

to

kind of like the gold rush of

trying to find out how do we do this

safely right

because like we were talking about

before it

most of these treatments all really kind

of emerged around the same time or at

least

re-emerged lsd is a

absolutely

you know decades ago they were studying

it

um

it just didn’t quite go anywhere um

and now i think ketamine is being lumped

into the psychedelics and

interesting so i think it’s been kind of

it’s you know as far as i have seen it

it’s been kind of the trailblazer here

and so now psilocybin follows and lsd

and

mdma

exactly started in the 80s really so

exactly and so i don’t know maybe we

have more resources now to study it more

thoroughly

and safely that’s my hope um is why when

it seems like

i mean most of those drugs were

scheduled on drugs were they sure no

medical use and so

i mean you’d be punished way more for

having mushrooms than say heroin which

is a schedule two i believe if i

remember right but like i just find it

really interesting

they’re likely that war on drugs and

scheduling the drugs in that way uh

create that

um despair or put so many barriers to

researching this because it was

basically saying social stigma and on

its own i mean i think that it’s you

know there was

uh what we don’t understand we tend to

stigmatize right and then what we

stigmatize we tend to make it legal so

right now and then hopefully in the end

that regulation or over regulation maybe

of it stigmatization

as well we can find the balance

and i think for instance with ketamine i

think that’s you know it’s a schedule

too yeah yeah and uh

i think

necessarily so sure um in that it does

help keep it controlled

um

you know in in most cases except in like

this like we were talking about the

online companies that maybe it’s it’s

just easier to access oral ketamine

with some access to maybe an online

therapist as well so

seemingly that that is fairly

unregulated it’s just difficult to tell

and

also as we talked about

you know i’ve had i’ve worked with many

patients who have

felt as if that was such an unregulated

approach

to utilizing ketamine

that they actually suffered from it in

that

it kind of got them on a anxiety mood

roller coaster and that they would they

were taking ketamine as needed

which many drugs are prescribed that way

uh but the effect that they got from the

ketamine

was not what they anticipated right yeah

we’re not looking at full efficacy in

that in that manner so exactly

yeah i think it’s i’m it’s interesting

that all of these sort of new uh

approaches kind of surfaced around the

same time right like we see this sort of

like i don’t know as the second maybe

third wave of psychiatric intervention

approaches especially to mental health

um

and i’m curious what you’re i’m just

kind of from my own curiosity what what

do you think propagated that you know

like what do you think kind of initiated

or sort of started moving us into this

direction into this new wave of

psychiatry or this next wave of

psychiatry

i think uh

i think we just got tired of

or maybe stagnant’s a better word sure

of the medications

not

achieving more than

you know maybe 30 percent efficacy uh in

treating the vast majority of these

disorders that we’ve talked about

um

[Music]

and so

you know as

necessity is the mother of invention

right and so

uh i think

necessity can be equated to people

suffering really is that is what’s

driven us to keep looking is

you know i think we always had these

clues

uh in the neurologic

realm

of how the brain was working and

overlapping with

the psychiatric

conditions

so neurologic and psychiatric processes

very much overlap to include pain

and

in substance use

that

the fields have kind of converged some

and so that’s where i think tms is a

great example of that

and that’s been in development since

insurances to start covering it so right

on time yeah there we go

well i would like to

uh come out on this show as a former

employee of a big pharma company i used

to sell pharmaceuticals

and i think part of my answer to your

question is like pharmaceutical

companies

want people on medications they take

every day for the next two years

when i hear about these treatment

episodes of

tms or ketamine it’s very short and so

there isn’t

a ton of money to make for big pharma

and these are medications that aren’t

really regulated by big pharma at least

right now until they come up with

different formulations like spravata but

like i think

i think it’s interesting that uh

i i feel like psychiatry is moving away

from its reliance on big pharma and kind

of carving their own path now that’s my

weird that’s my

outsiders and as a psychiatrist that’s

very freeing yeah i’m sure

up until the last few years i i mean i

have felt like i am completely dependent

on

finding a medication that can help in

some way

and that almost no matter what whoever

comes to me

is expecting to be prescribed something

and so it’s nice to now be able to offer

different treatments that

they don’t feel like they will they have

to be reliant on it

now it doesn’t it it doesn’t necessarily

change

the trajectory for some people who have

chronic conditions they may have to stay

on their medications the rest of their

lives

but they may not have to

uh be only partially treated right

partially improved and that’s what the

vast majority of people i think have had

to suffer through

up until we’ve started finding these new

newer treatments

well when we talk about disrupting an

industry right at peaks and i think that

this is it’s great to see psychiatry as

a field have these sort of avenues of

disruption where we do get to see

innovation come forward and we and we

recognize that suffering has not gone

away nor will it ever but we can do a

better job as far as addressing it

especially

the

levels and types of suffering that are

debilitating for people and chronic and

really um really disrupt their lives in

a way that is um

really uh tragic

yeah and unmanageable for sure

i i have one more unscripted question i

might have more uh

um do you see a lane for cannabis in

this and if not why not because like we

we’re here in colorado

i mean we could probably see some

dispensaries from where we sit like i

is there a lane for cannabis because

that’s all the popular thing right is

and we also treat cannabis use disorder

yeah as part of our yeah in our clinics

and certainly at some levels it

exacerbates a lot of mental health

issues but i’m wondering if there’s a

lane for it as a medicine too i’m

curious

i think there will be okay i think we’re

trying to get there

uh again it’s kind of like this just

ever-evolving process to regulate sure

the dosing of thc

um

you know now we understand a little bit

more about cbd and

how it’s not psychoactive and that kind

of thing and it can treat some of the

things that marijuana in particular we

were relying on to try to treat um like

insomnia or pain or

even ptsd which there are no

you know if you if you rely on the fda

to put out these indications

cannabis is not approved for anything

sure

by the fda

and i i am passionate about letting

people know it’s absolutely not

indicated for ptsd for major depression

for really any psychiatric

uh condition

but the word on the street is that it is

and you can act you know you can find

justification pretty much anywhere

online um

if you want for literally anything right

and so there is a lot to be found out

there

of

um

people and companies and institutions

trying to justify it but none of it has

ever been

proven safe

and effective to treat those specific

conditions

because guaranteed the va would be

you know

advocating for that for ptsd if it were

if the studies were there and the

evidence was there that it was well

treated that way

and so i think

cannabis in particular

is going to

follow a different path because we know

so much about it and its side effects

now whether or not people believe the

side effects

because of this legalization process i

think maybe it can cloud that

somewhat is that that gives people a

false sense of security is that oh well

it’s legal it must be safe

it’s kind of like with alcohol right is

yeah it’s legal

but it’s not safe yeah absolutely um

and it depends on the level of use when

do you start using it

and actually now that i’m saying this

out loud it’s kind of

very similar to the trajectory of

alcohol use in someone’s life if they

start as a child

drinking alcohol that it’s probably

indicative of the problems they’re going

to have later in life

or as a teenager

we know that if if you start drinking

regularly at age 15

or earlier

you have a much much higher risk of

developing alcoholism or alcohol use

disorder

you know within the next decade of your

life pretty much and

similarities could be discussed about

cannabis in that

uh we know that

if you start using cannabis in your

teens

adolescents in general and regularly you

have about a 15

percent chance of

developing schizophrenia from it

meaning permanent psychosis it never

goes away

and it could be a low level of it

i’ve seen it in many people where they

just kind of carry around a low level of

paranoia

they just constantly have to do reality

checking and

[Music]

but it is disruptive in their life and

so usually you can go back and you can

take a history to find that they started

using cannabis very early in life

usually in early high school or middle

school and

and just continued from there and so

and if you have an underlying genetic

predisposition for a psychotic disorder

or a mood disorder like bipolar you are

a much higher risk of just opening that

box

through cannabis use

and a lot of people just don’t realize

that they don’t understand it

we’ve also found

some very good evidence that

people who have used cannabis off and on

since adolescence

if they

continue to use it in their

later decades of life

starting in their 40s 50s and 60s

if they’re using it consistently then

even if they’ve taken a break from it

like in their 20s and 30s potentially

and then they go back to regular use of

cannabis the cognitive decline is

very significant

and in that age group specifically and

um whereas

if someone who has never touched

cannabis

or rarely

up until their

they have a much less

they have a lesser chance of having that

significant of a cognitive decline

uh

in those age groups so

there’s just there is a lot to consider

there’s so many caveats to to that

question it sounds like yeah yeah there

are

the difference of course with alcohol is

like alcohol is a licorice you get it

from the liquor store

these dispensaries put you know little

green crosses and act like

yeah there’s a medical

reason and justification that it’s

somehow

um

safe or approved or whatever and i think

that that’s

i mean unlike the other

medications we were talking about

earlier and interventions like tms

marijuana is much more ready shoot aim

we’re like we’ve already shot it now

we’re trying to aim it

right uh probably the wrong order there

um

so i

we are at it out of time and i just hit

my mic um

i really i really appreciate you coming

in and joining us i this i think is a

really exciting

direction that we’re headed and and i

think um you know having been in this

field a long time and like i said even

worked in the pharmaceutical field it is

refreshing to think about something

other than

um you know a lifetime of a medication

cocktail that constantly needs

adjustment and all that but if there

could be things that either augment the

medications or even can help people come

off of them or whatever to to treat

mental health illness i think that’d be

great so

with that we will sign off um

thank you all for tuning in i i hope you

enjoyed the discussion i certainly did

please follow us on facebook and

we have a tick tock account which is

weird and then

[Laughter]

and then

instagram and all those other things but

uh

thank you and

—

In this episode we are joined by Dr. Ashley Johnson, DO to discuss depression and the progression of modern treatment.

empathy is knowing your own darkness

without that connection you don’t have

anything what’s the opposite of

addiction just freedom

well hello everyone uh welcome back to

another

episode of finding peaks my name is

brandon burns chief executive officer

for peaks recovery centers joined today

by our chief medical officer

dr ashley johnson and our chief

operating officer mr clinton nicholson

everybody uh

welcome back everybody who’s joining us

today as we spoke about on the last time

i hosted we were going to invite dr

ashley johnson in to

talk about a variety of issues

surrounding patient care in the

direction of depressive major depressive

disorders

we’re going to do what we can to stick

true to depression as the topic today

but if you know how this show works if

you catch us going out in different

directions

you already know how it works and for

those who are new this is how it works

so

um so here we are today uh on top of

this uh not just our chief medical

officer and i think i just want to

highlight you know really what that

means for you know peaks recovery

centers you

came into peaks and showed us a variety

of different ways about how to improve

patient care not only did you introduce

um and and bring onboard detox services

for us so that we could do a continuum

of care through peaks recovery centers

but you were really

the anchor and the flagship for us

developing integrated care whatsoever

making mental health primary

a significant feature of programming and

creating that inclusion as well as us

having to kind of punch through the door

of medication-assisted treatment and

move through those kind of attitudes at

the time so

she’s done an incredible amount of work

on behalf of peaks recovery centers that

we are super grateful for

at the same time as well too

she’s branched out and created uh

colorado recovery solutions uh for which

she’s the ceo and founder of as well too

and we’ll get into more of what those

services um include uh in that regard

but a lot of fantastic things happening

um that you’re a part of and i think uh

for the viewers out there as well too um

you all know me my job here is wanting

to disrupt an industry and i think uh dr

ashley johnson here i’m just gonna go to

dr j because that’s what we call her at

the office dr j here um is a big part of

this disruption and i think in a really

beautiful and vibrant way and so we’re

going to tackle

uh these topics today and get right into

it so

um through your vision at colorado

recovery recovery

recovery solutions um what do you see as

needing to be disrupted from an industry

perspective and i’m sure that’s a loaded

question and maybe there’s a lot to

dive into there but i think maybe at

just a high level in a general sense

what are you seeing

through the lens of psychiatry

that is not working for which you

wish to change moving

forward i think what i what i see most

and what drives me the most is what a

lot of other

psychiatrists are seeing too

is it’s just this exciting kind of

emerging field

of

neuroplasticity

and neuromodulation

and so that is what really drives uh

this kind of

changing the path of our approach um

so for for decades it was just

medication we had to wait for the next

new medic

new

mechanism really to come out

especially with depression

which is one of the most debilitating

mental health conditions and

so we’ve just gone through probably

every decade since the

we had a new mechanism of action come

out and then it wasn’t until the

ssris

hit the market that

in probably around 1990 or so

was prozac it came out first and then

zoloft was soon to follow

and they are amazingly still the

standard

first line medication

however

what we have also found out over the

last three decades

is that you can’t expect full remission

of symptoms especially with depression

and ssris are

first line medication for many different

psychiatric disorders

ptsd

ocd

generalized anxiety so all of those are

really kind of top of the list

that we see

especially when you come into peaks and

you know because we have

now this primary mental health

i guess kind of track

it’s not only treating

someone who has a primary substance use

disorder but

we have to think differently about it

and so because depression is probably

the most common

mental health condition

we are going to see a vast majority of

primary mental health patients who come

to peaks for stabilization

have major depressive disorder

and so

it just makes sense that we look at the

next

the next best treatment past medications

and

that has now emerged as tms

or transcranial magnetic stimulation and

i’m glad you said it because i was like

how do i say tms

don’t mess it up brandon but you have

the language so that’s perfect

it took a lot of practice

to get that one down

and then i just went back to calling it

tms

so

it’s a safe place for me too

so

i look at the this

emerging field of

uh really neuromodulation as kind of

really two different emerging categories

and one is tms

and one is ketamine and

there’s a couple different forms of

ketamine now available

first it was just your basic

generic ketamine that was first used um

for anesthesia

and it’s a it’s a very short acting

anesthetic dissociative anesthetic and

um and so for again decades we were

using it and then just incidentally

found that it had an extremely potent

antidepressant effect and so

then

practitioners started noticing this and

and said well why why not just go ahead

and let’s refine this

medication

and

and give access to the psychiatric

disorders really people who are

suffering where we haven’t made a whole

lot of

improvement again since the ssris came

out and then

that was primarily for depression where

we saw people really just coming back

into their own

after a ketamine

i guess dosing and then over time we

also found that through

understanding the bioavailability of

ketamine

is that infusion

is the best way for people to get

the best effect and the most exposure

throughout their body

from ketamine

and so that’s why

for the most part

if you want a an extremely effective

version of ketamine therapy you want to

do infusion and so infusion

uh i guess if you said

infusion versus spravato which is the

nasal spray that’s still that just came

out a couple years ago

and is still on patent of course

is much more difficult to

access that medication

um

but the bioavailability of sprovato as a

nasal spray

is it’s it’s actually s ketamine

um which is just a slight change in the

chemical makeup

of it and

different from

your just

basic ketamine

ketamine is 100 bioavailable

through infusion

whereas s ketamine or sprovato

is 50

bioavailable through nasal spray

and so that you can kind of

associate the differences in its effect

based on that bioavailability

so because

when you deliver that drug through

the nasal passages

it has to go through many different

stages of processing through the body

where

it actually degrades it

whereas infusion can bypass many of

those kind of filters in your body

to where you get much more effect from

it so

um

you brought up if you don’t interrupt if

you brought up two really interesting

concepts that i think are worth kind of

mentioning again which uh the idea of

neuromodulation and neuroplasticity and

i’m wondering if you could speak to that

a little bit just for the audience so

that they recognize because that those

concepts like you’ve mentioned really

have sort of changed our approach and

kind of our understanding of what

uh the ability or capacity for

long-lasting change and recovery

actually really looks like in somebody’s

day-to-day life um so i’m wondering if

you could speak to that from the

psychiatric standpoint what the

importance of that concept of

neuroplasticity and neuro modulation

really is

yeah absolutely

so

really

it’s not so much that that concept is

new from medications however it seems

new because

these treatments that i’ve mentioned and

as well as even better understanding

about

psychotherapy or talk therapy

as well as

your traditional oral medications

like we mentioned the ssris

all of those actually have

an effect on your neuroplasticity if

done

correctly

right uh it’s just some are more

effective at it than others so that’s

where tms

and ketamine come in

is that they really kind of showed up on

the stage here

as

having a neuromodulatory effect on the

brain

that could cause a faster healing

process basically we were seeing the

effects faster

than if you did long-term psychotherapy

even cbt

that’s time limited if you did you know

by the book 12 sessions

in 12 weeks and then you did occasional

follow-ups for cbt

you could see the effects

similar effects

if you did six infusions of ketamine

uh

in two weeks

and so

if now what we’re finding is that the

the neuromodulatory effect is so much

more improved if you have a ketamine

infusion

or even spravato

or even oral ketamine while you’re doing

therapy right so now we’ve combined it

all and

while there are lots of therapists out

there doing that i don’t think we quite

know yet um the impact of this and how

positive it’s going to be

and just so much more effective that’s

what’s so exciting to me about it

especially

absolutely for treatment resistant

depression

but especially for ptsd

in that regard

yeah i think that you know brandon spoke

to you um really sort of creating this

interdisciplinary culture at peaks and

establishing that through a really

robust medical program but the it’s the

integration and sort of the

collaboration of the clinical world and

the medical world that where we really

start to see that where we can have the

most efficacy as far as change in and

sort of taking advantage of that the

sort of neuromodulatory effects of

treatment and it’s

what makes this very exciting these

types of collaborations and the fact

that there’s this is new

to a degree you know at least the

concepts may have been around a while

but our understanding of them has

improved our ability to approach them in

a more in a fresh more um innovative

fashion is also really improved and then

when you bring the two worlds together

you get this sort of um

exponential impact which we’re just now

starting to really to kind of explore

and see what how that works and how that

engages and really does improve the

treatment of clients and just quality of

care in general so it’s pretty um it’s

it’s an interesting and fun time to be a

neuro nerd basically it is it is yeah it

really is absolutely and for me i mean i

think the brain is the is the new

frontier it’s the final frontier as far

as our understanding of of everything

about us as individuals and how we work

and how we function and so bringing in

these kind of new um and uh or or kind

of more innovative approaches to

treatment is really exciting

it is yeah absolutely and and you gave

um and i’m curious for because i’m

hearing neuromodulation and

neuroplasticity and you know at the end

of the day how how we might be able to

simplify it through you know a metaphor

and what that healing mechanism actually

looks like and you gave uh

a beautiful presentation and training

opportunity for staff a few weeks ago as

well too around the subject and you um

in describing the neuropathway and what

was happening i think you brought up the

metaphor of a rope and it being frayed

and

if that still is applicable here and has

context i would certainly love for you

to re-review that metaphor on behalf of

the viewers um so that we can bring

these con these

big encyclopedia style terms into you

know something that’s a little bit more

palatable yes try to get it down to less

than five syllables

in the word uh

but

so i love the that metaphor of uh

if you were to kind of take your

you know a piece of the brain and kind

of smush it and you would see all the

different nerves or even throughout your

body um

and in neurons which are kind of long

and like a rope and so

what we had talked about was that

if you take a big rope um like you might

see it at some

port somewhere around ships and things

um and and you just kind of take

something rough like a brick or or

whatnot and you just rub it on the rope

really hard like a hemp rope and

you’ll start to see the fibers start

fraying right and so those frayed fibers

on this rope really represent what your

neurons

can look like if you have suffered from

an untreated mental health condition for

quite some time like years

so

absolutely major depression generalized

anxiety

and ptsd and ocd all fit into that

category they can all really when

they’re untreated and they go on for

years

they actually are assaulting the brain

in different areas of the brain

through the different hormone cycles

that are being released the

neurotransmitters are

dysregulated and that kind of thing so

like all the chemicals and such that are

swirling around the brain

they are so disregulated that they’re

actually assaulting the brain and so

they will

those conditions can over time kind of

almost shrink parts of your brain

uh again if it’s untreated and so that’s

why it is so important to

intervene early in these processes if we

can you know

assign the diagnosis figure it out

through someone’s history

and then we can come back to what we

described as this rope

and by applying even the medications we

talked about the ssris

or

the psychotherapy

tms

and ketamine

when all of those are applied

appropriately

those frayed fibers from the rope

are kind of like smoothed out it’s

almost like you are

pouring

a substance that kind of clears that

rope off of the yes like a like a wax is

a good

good uh analogy as well so then once you

go and you pour the wax on the rope you

can’t feel those fibers anymore and

that’s really what your nerves

will then look like as they are healing

if you were to look at them under the

microscope

once you have undergone some of these

treatments right and especially if you

achieve full remission meaning all of

your symptoms go away

and you kind of return to full

functioning in your life

i mean the english major me just loves

the metaphor so yeah yeah yeah

absolutely

and

and as a philosophy major was always

told not to use metaphors i think i

think it’s a great metaphor

in that in that regard as well too um so

there’s oh there’s so many different

branches we could fire off from here uh

on but i think flat out speaking

somebody comes in with a major

depressive disorder before we were um as

a medicalized system or through the lens

of psychiatris a psychiatry really

looking at uh these opportunities it was

just medication right and when it was

just medication or assuming medication

moving forward

um you know there’s a reason in which we

kind of want to move away from it and

that reason to me seems to be that there

isn’t a great uh deal there isn’t a

significant probability that all

individuals will get well under

medication that at some point it feels

like we’re throwing darts in the dark in

that regard so

before diving more into these you know

unique value propositions that you’ve

created and brought into colorado

springs and certainly supported peaks

patients through

colorado recovery solutions what is the

efficacy of medications in the direction

of

major depressive disorders at this time

what we can expect is about 30 percent

of

individuals that try

any one of these first-line medications

so

ssris which again is prozac zoloft

lexapro those are the common ones that

people are prescribed

maybe 30 of those people who are

prescribed those meds will get 30

improvement in their symptoms of

depression

and then it continues down the line

if if

prozac zoloft lex pro if it doesn’t work

standard of care is that you would then

either try a different ssri or you would

switch classes of medications and that

typically in our

traditional psychiatric

prescribing world would mean that you

would go to an snri usually

is most common and so that would be your

effexor which is venlafaxin or cymbalta

which is duloxetine um

you might somewhere in there try

wilbutrin which is its own unique

mechanism it’s a stimulating

antidepressant and so

if you have anxiety you don’t typically

want to use wellbutrin

but it can be a potent antidepressant in

and of itself

and so

generally speaking you would go down

that

kind of algorithm of decision making if

someone doesn’t respond at any one level

of that or any treatment there and so

every time you fail a medication

generally means that you have less of a

chance of getting better with a new

medication

it’s still worth a try generally

speaking because medications

oral medications meaning by mouth

are

the side effect profile with ssris and

snris

again are all those i just mentioned uh

they

the side effect profile is very low

generally speaking

um

at least in regards to if you are

weighing the risks and benefits of do i

go on continuing to suffer from

depression

or do i try a new medication

the benefit does outweigh the risk

of the side effects or even

the fact that it may not work

so then um

so that’s that’s really the cycle we’ve

been on for

we didn’t talk about this prior to

coming on here so uh feel free to just

say we didn’t talk about this we’re not

talking about it but it reminds me of

like when i i think this is how tylenol

works right let’s say i have a headache

right because of dehydration i’m not

aware that i need to drink water but i

have a headache so

in american culture one of those quick

external strategies isn’t to explore hey

am i did i drink enough water today it’s

like no i have a headache advil you know

or thailand all night prescribe that for

myself over the counter in the moment i

give it to myself um it’s not clear to

me that when i take it that i’ve

actually resolved the core issue that

the medication is in fact

at least in the way that i’m perceiving

it right now is just distracting me from

the fact that i still have this ongoing

headache because i have not drank enough

water

and if that’s true about how those work

at least in those moments as a

distracting feature how much

do those medications when they’re

working are

are they working in a similar way of

where they’re not actually smoothing out

the rope in the way that you know

ketamine infusion and tms is actually

doing um is it more of a distracting

feature and it’s still frayed or in time

is it actually smoothing out that rope

if all that

yes that’s a that’s a great question so

the way i would look at it is

and what i tell my patients is

when we’re starting an ssri or an

antidepressant in general is that this

is a

is not just a patch

it is a neuro regenerative

medication

and it if you take it consistently which

is every day for the most part with all

of these medications you have to take it

every day you have to allow your

body to to reach a steady state of the

level of the drug

and then allow it to remain at a steady

state level for weeks before you will

get the optimal effect

on your depression or anxiety and

during that process

it is actually stopping the assaultive

process on your brain’s nerve so it’s

like taking that brick

or whatever it was this razor blade that

that whatever was scraping across this

rope and fraying it it’s like it’s

removing that from the process it’s

putting it’s stopping it but it may it

may not be

at least not in the immediate sense it’s

not

pouring the wax over the rope to smooth

it out that takes probably at least a

year or more

of you taking the medication

consistently

really doing consistent psychotherapy

so there’s no modulation neuromodulation

taking place it’s just

giving it’s taking the brick away and

then allowing the rope to stay there the

distracting feature of the medication is

that i no longer experience the fraying

the major depression and that sort of

thing but in time

uh because we have these natural uh

cellular you know remodulation that’ll

take place independent of all these

things in the background it’s slowly

healing itself now whereas

uh

under the new lens of like ketamine

infusion for example it’s an immediate

remodul remodulating of the the the

neuron there right

yes uh it still requires uh repetition

of the infusion

but

uh

and then it still may require boosters

of the infusion

uh over

you know the

the following year or so

um

but it’s quicker and so like with the

medications the oral medications

it’s like taking

if you’re gonna pour wax over the rope

right it’s like taking a candle a tiny

little candle that’s burning

and you do like one drop

yeah and it

i mean if you had a rope like as big as

this room

that would probably you know could

easily take a long time yeah a couple

years easily

inconsistent therapy and medication to

achieve the healing that you might

achieve

uh through tms or ketamine and so with

ket well tms actually

is right now we think that

you can

[Music]

probably achieve

double the effectiveness of medication

with a six week actually about more like

eight week trial

of treatment with tms

so speaking of the time frame that it

takes you know because it

we have a 45-day residential program in

which medications are first line of

defense we usually start those

immediately however

seeing the efficacy of those take effect

is going to take weeks sometimes um and

we only have six of them right so we

start the medication right away the

clinical interventions start right away

the psychotherapy the sort of

traditional

intervention strategy happens right off

the bat but we know that’s going to take

time and that really that is the healing

mechanism at that point it’s

so

we have a shortened model we have a

shortened amount of time and now we have

these

new interventions or more

interventions that have become more

accessible

is it appropriate then to start

ketamine or start tms right off the bat

in order to kind of almost as a jump

start to that process does that make

sense from a medical perspective

it does and uh i i don’t think of it as

well if if you look at

our our detox

model of care right where it fits in the

continuum of care for substance use

disorder treatment

it’s the first week of treatment about

right so it’s it’s removing the

substance

helping keep someone comfortable

until they can kind of get back

to somewhat of their baseline right

they’re still going to need to go

through a few weeks of stabilization in

the residential program

but having removed

this the substance that was also

assaulting the brain

is stopping that process

and then we’re kind of in the clear is

how we look at it medically cleared

basically to then apply these other

treatments that are more rapid in their

effect

while someone is

you know participating in the group

therapy the individual therapy

especially at peaks and the the model of

care that we have there

it’s

we also can start the the oral

medication at that time too because

ketamine

s ketamine or sprovato tms they all work

as augmenters of the oral medication as

well as the psychotherapy

right and so

instead of let’s say we have someone who

comes to us with treatment resistant

depression and suicidal ideations which

is pretty common

in order for them to really

be able to bypass going to the hospital

for that to stabilize

these new treatments especially ketamine

can help stabilize someone like that so

that they can continue in the program

and then with repeated administrations

of the infusion or sprovato

it actually is helping propel them into

healing

and so it does work

really seamlessly together and should at

least now our systems may not our

financial systems and such i was going

to might not help us with that a little

disruptive for a second because knowing

what we know about the efficacy of these

treatment interventions and strategies

the access to them is is does not

necessarily align with what our

treatment trajectory would look like

specifically within this timeline the

sort of chronological timeline we want

people in right away and insurance

companies are not necessarily allowing

that and i’m just curious want to be

curious with everybody

why that is and what we can do within

our industry and as disruptors of this

industry to try to change that

through um

sort of collaboration with

organizations like yours and companies

like yours like crs so as a psychiatrist

what do you think is our best strategy

to make

to make these changes and make them

known

so

i’m uh

i’m i’m someone who

my first approach is to just comply

with whatever they tell me to do

in order to get my hands on the

treatment or be able to give access to

my patients as i just do what they tell

me to do and

so

that’s what i’m doing right now and kind

of have and just now

have fulfilled many of these

requirements

from insurance companies from the fda

which you know a lot of those kind of

things from the fda and what

what’s bravado is controlled by is

called a rims program so that stands for

risk evaluation and mitigation strategy

and so that’s overseen by the fda the

dea

um

and jansen who created spravato and so

uh

we

in order to

provide spervato to any given person

with major treatment resistant major

depression

and or acute suicidal ideations we have

to comply with their program

in order for the drug to be safely

administered and not diverted basically

into the community

and

so

that’s one approach

[Laughter]

[Music]

we encourage that approach yeah sure

right yes uh safety first absolutely

absolutely

truly believe that yeah

and so uh

but then come the insurance companies uh

is so how do you comply with everything

they want you to because they all have

different standards

despite what different interpretations

of the studies the literature about

these different treatments and so they

impose on us

all their different criteria or i look

at it as

what’s that agenda

yes the almighty dollar

is always looming in there somewhere so

so in my approach i learned their game i

i learn

basically how do you give access to

these treatments in their most effective

manner

according to

the evidence that we have for them

and then how do you advocate to the

insurance companies

on the behalf of your patients so that

when when they’re denied which all of

these ketamine infusion aside

it is not covered by any insurance

because

many different reasons it’s generic it’s

been around forever

there’s no patent for a company to

really take it and advertise it to

all these different companies and such

but

that is really if you think about it

while ketamine infusion is invasive in

that it’s an iv

um

effect probably

potentially

versus bravado

should suggest in our culture that you

know we should be

supporting this treatment really and

trying to get

this one

out because it’s affordable more

affordable at least

than spervato so

but

insurance has embraced sprivado

they they cover that

but we have to

of course go through this prior

authorization

form for everything that i’ve mentioned

tms bravado even med management

at its basic level we have to go through

these um

at least

you know

figuring out the benefits and such and

the millions of different plans and such

and

but it’s it’s in the times when you you

spend a lot of time with the patient

filling out the prior authorization you

submit it

um you think it’s a

slam dunk of a case this person has just

been suffering for years

from treatment resistant depression

you’ve justified all that through all

the med trials that they’ve gone through

through the duration of their major

depressive episode and then um

it’s possible through some technicality

that’s written in the insurance um

policy about tms or academy or spravato

that they’ll say oh wait no we don’t

agree with

that you know

the overlap of when you tried lexapro

was one month outside of what you

documented as the current episode of

depression and so

so we don’t count that as a medication

trial

and

you know i think you have to really get

up

up to speed on

all of the literature so that you can

really you have to kind of go into a

debate

with the other physician on the other

line who is saying no this doesn’t

qualify i’m going to go ahead and deny

this and you can just barely keep them

from hanging the phone up on you

and then

if if you do

get your point across with them

they still say without any kind of basis

for it sorry

we’re just not going to approve this

today you need to either go to an appeal

or resubmit it or sorry you’re just out

of luck so it’s

that takes hours out of your day

and the whole time that the patient is

still suffering absolutely and the risk

is mounting absolutely for how

debilitated they may be from their

depression

if they’re suicidal yeah you know what

may happen and these are people who are

not in the hospital that we’re trying to

help keep them out of the hospital um

which ultimately saves insurance

companies money so there’s this element

of irony to it all and the thing is

yeah and i i think i just i i’d like to

talk about it because this is the world

in which we live right this is the

access to care

that is um

we we have these new and amazing uh

intervention strategies at our disposal

but not necessarily always accessible

and that is um and that’s frustrating

and i think it’s valuable to talk about

it yeah oh a hundred percent and it and

from uh you know you know my

frustrations of course and all the

episodes i’ve done around treatment

centers websites hope and save and all

these words have behind it a great deal

of complexity to actually

bring the individual forward to which

now they start feeling hopeful and um

this is such a wonderful discussion but

for the sake of time for sure because

the kids on the social media only have

so much attention span i think they’ve

all walked away now

with the rope analogy so i think we got

that much across in this moment i just

wanted to uh before i before i uh take

us home and uh out of this room uh at

least for this time until you come back

with uh jason friesma uh in the

following week um

what is

how long does it take is it neuro uptake

i forget the language of when you

take an ssri say you know it’s zoloft or

lexapro whatever the case might be how

long does that actually take before the

individual for the 30 that it may work

for how long does it take for them to

actually start experiencing that is it

immediate is it weeks what can what does

that look like

we generally just

tell people to

expect

you know at least four to six weeks

before you get the max effect of the

dose that you are currently taking

you might feel some effect in the first

week or two

it’s

very possible but

it’s not going to be the full effect

and then at four to six weeks

you

if you don’t have full remission of your

depression at that time you always want

to look at what a net would the next

higher dose be

uh

indicated here and usually it is usually

you just go on up if you haven’t had

side effects to the to the drug

and if you have had side effects and

they’re still going on

the standard of care is that you have to

wait that out so you can’t go up on the

dose

unless you’re just willing to accept

that those side effects may get worse

and then you have to wait it out again

it can be

become a very

strenuous laborious process for any one

person who’s suffering from depression

or extreme anxiety even to

have to wait that out and then

if it doesn’t work on the first

go-around to have to do it again

and then give up if that that one

doesn’t

work

um do have augmenting strategies we can

try sometimes that does help it kind of

take control a little bit better

or take effect

not all levels of medicine and at least

practitioners are comfortable doing the

augmentation strategies with different

medications but

so again access to care

then becomes another risk

with medications

and so uh and then access to care

in regards to tms and and spravato

is so much more difficult

to achieve

then then your risks just continue to

mount and the suffering continues to

mount really

um

and the vast majority of people

don’t have

you know money flowing out of them to

just kind of yeah pay out of pocket for

any one of these treatments

and and for instance bravado

if you paid out of pocket for that could

be

fifteen hundred dollars in

administration

and so you could have

you know it

easily

i’m calculating in my head what may be

the average of someone how many

administrations someone might have

uh to actually stabilize on sprovato

you know at least eight in the first

few weeks and so

who can afford that yeah

absolutely

they’re already paying for their health

insurance right so they can barely

afford that and then it doesn’t um

oftentimes cover it so yeah it’s a it’s

a dilemma yeah

yeah well it i i think that uh so one of

the things that i just want to challenge

viewers on especially in relationship to

addiction treatment centers you know

even mental health primary centers when

you get to all of our brilliant websites

we are stating we treat things like dual

diagnosis and dual diagnosis as a

category could be i have a major

depressive episode taking place right

now and yeah i was smoking pot six

months ago or you know maybe engaged in

some other you know abuse around drugs

and alcohol but this is the primary

issue of concern and

our admissions lines are always so

passionate to bring people in to be the

opportunity to be the treatment episode

that provides these services

but i think for me and the caution to

the wind here is is that if our only

shot at this is to you know dole out

medications ssris or otherwise that we

have a fairly limited opportunity to

actually treat what we say we can treat

at the end of the day and that really

resonates with me and calls upon

treatment providers

watching this aware of this information

all around the country

to proactively

move in the direction of the creation of

these advanced services and on top of

that

or these services through colorado

recovery solutions that dr aj has

brought to

the community here in colorado springs

and certainly been supportive of our

patient demographic coming through

finding peaks

uh that

uh there needs to be these alternatives

and that

uh what we can also hear out of this

discussion is like there is a whole

insurance side of thing in payment

platform and a fragmentation that is uh

right for disruption in this regard in a

really big way because it is in the way

of okay now we know meds aren’t going to

work or it’s going to take four to six

weeks but the person’s suffering right

now and how do we get ahead of that in

this moment so i think it calls upon all

of us to do a better job to lean into

these types of

resources and where we’re going so kind

of to you know recapitulate what’s going

on it seems like the problem within

psychiatry at least in the past has been

kind of just waiting for the

pharmaceutical industry to create

something for us and then to get behind

it and then hopefully there’s enough

money behind it for the insurers to come

in and say okay we’ll provide this

and that um

we can’t wait anymore mental health and

depression and anxiety especially over

the last two years are just skyrocketing

exponentially among

american citizens and certainly around

the world and so we’re in the need of

new solutions and through platforms

such as colorado recovery solutions that

dr

jay here has created on behalf of this

community and is working with peaks

recovery centers to

defragment our situation seems like the

new opportunities and where this is

headed for which we should all be

excited about

but slightly discouraged by um

the

amount of time it may take to actually

get all of this to come together so

at the end of the day

thank you so much for coming on and

talking about this with us it’s a really

important topic especially around

depression ptsd

generalized anxiety there are solutions

that are out there and available to the

community and through treatment centers

like

peaks but at the end of the day

the situation is extraordinary and it

calls upon all of us to do better and to

have these discussions and to

represent what the limitations are so

that people can appreciate why these

solutions exist and where we’re headed

as an industry so

on that note

as always signing off here at peaks find

us on finding peaks at peaksrecovery.com

dr uh johnson here is going to be on uh

next week’s finding peaks episode as

well so if there’s more questions

thoughts ideas that you want to ask in

her direction uh please let us know

about that so we can address that at

that time certainly won’t be the only

episode i think there’s a we could go on

for weeks about this uh these topics in

general uh as you all know chris burns

is doing awesome fun videos on the tick

tock follow the peaks recovery tick tock

page so you can hear loud screams of

recovery and energy here

a little bit different than the

discussions that i’m generally having uh

again the facebooks the twitters

you kids all know what’s going on out

there thanks for being with us and being

patient as we describe

these uh technical and detailed uh

issues that are going on especially

around depression and until next time

In this episode we are joined by a family that holds a special place in our hearts to remember and celebrate Krystle’s story.

[Music]
hey everybody and welcome to another
amazing episode of finding peaks so
grateful to be here on this beautiful
winter day 2022. um to my right we have
our trusty steed i don’t know i always
call you that i don’t know either it
just feels like a prize
you’re always here and you’re consistent
jason friesma our chief clinical officer
and we have our lovely guests over here
we have brooke
as well as stephanie who are the family
of um crystal perez who came through our
program back in 2016 and we are here
today
in an effort to just celebrate crystal
and celebrate her cause and celebrate
her loving energy her connecting spirit
and as we just talked about her
tremendous fight with her mental health
but before we kind of get into the weeds
with some of that stuff i’d love to talk
about
brooke as well as stephanie they’ve put
together and mom
have put together a non-profit and so i
want to just let them have the stage a
little bit talk a little bit about this
non-profit and how they’re raising
awareness for addiction and mental
health through their beautiful cause so
i’ll turn it over to you brooke yeah
thank you um so we started my family and
i started the nonprofit kk fearless
after the loss of crystal my sister and
my brother kevin as well
to an overdose and so
we’re just it’s our way of honoring them
of keeping their legacy alive and we
hope to raise money and give to local
rehabs all around colorado to create a
music room where their residents can use
music as a tool to help them on their
road to recovery
that is awesome now was was music
something that crystal was passionate
about yeah so we chose music because of
crystal and kevin who they were
super musically talented you might know
this as well but uh she she had the
tattoos
yeah yeah we all did all three of us did
okay
but and i’m not musically talented
that was them
but i do love music and so yeah it was
just kind of that was how we
we knew initially we wanted to give to
rehabs um but we weren’t really sure and
then and then we found like our niche
where we’re like oh we can incorporate
music and that also honors them because
they were so talented and
loved music and loved to play music um
so that’s where we get the music piece
from that’s so awesome we get so many
artists on our side of things
and sometimes you know artists i’ve
found is certainly in family systems
sometimes they have a tough way of
expressing themselves exactly and giving
them that opportunity to really express
it through music through art whatever it
might be it’s just such a phenomenally
connected outlet
um
where do you show up in that cause
stephanie
yeah so i am
married into the family with brooke so
we’re cousins but not blood related and
so obviously through that connection
with the family and knowing crystal and
kevin for the past almost 14 years since
i’ve been a part of the family
but personally like most of us
also know many addicts
have lost friends to addiction
know a lot of people that are still
struggling i have close family members
that are also addicts and so i um
i think at first
they
you know going through crystal and kevin
i hadn’t opened up about like my
connection to addiction with brooke as
you know both sisters
um in a relationship and so
that has been
um
an area for us to be strengthened by
like our relationship to
just be able to talk about it in a space
where we both know what we’re going
through understand each other understand
each other help support um
and so
yeah my just
knowing addiction knowing the challenge
being close is like family members to
to the cause is really what sparked us
to
start just wanting to do something we
didn’t know what it was going to look
like but we just wanted to do something
yeah i just i really really honor that
action-oriented step you know i
unfortunately talked to a lot of
families of ones that have lost loved
ones and in every family’s like what can
i do what can i do how do i do it
you all are doing it it’s a pretty
magical thing i’m sure they’d be looking
down and be like those are my people
let’s go you know
jason what was your relationship
potentially with
crystal and i want to talk about kevin
too here in a little bit just because i
didn’t get to meet kevin um so we’re
going to give him some time here too but
what was your relationship crystal’s
going to get more time probably because
we knew her
um
i mean
obviously
uh she was a client in our program and
it was back when our program was a lot
longer you know now we’re a 45 day
program with with iop on the back end of
it but um
you know
i don’t know if this is the time to talk
about it but like i i can remember like
crystal i think came to our program like
right before we went on a hut trip
um
like maybe the day before maybe two days
literally right before and
um i i swear i told her this later like
i thought she had like the coolest
glasses because i couldn’t see the arms
oh yeah but then she didn’t have enough
glasses
yeah yeah your glasses were broken i’m
like oh like how is that
[Laughter]
and the one thing that immediately stuck
out i mean that trip was amazing to be
with her but she was
tough as nails that one um like
she literally
uh
was going through withdrawals you know
in the middle of nowhere and complained
zero times
she just needed to be by the fire which
makes sense yeah checks out um
but immediately uh
you know there was just something about
her like there was
there’s this essence to crystal that was
so
um engaging and so
um
i know she just brought a life uh and
when you were talking about music brooke
like
i don’t remember what the event was i i
i’m pretty sure one of the other clients
had to go to the hospital for some
reason and it’s back when
like our whole house would
travel as a pack so everybody went to
the hospital and there’s a piano in
there and she just sat down and like
blew everybody’s hair back with what she
could do on the piano and um
everything she taught herself
yeah which makes sense um
and
i just always remember wanting her to
like express more and more of herself
and like she would like do it and then i
think she would not feel embarrassed or
ashamed or i don’t know what or like
self-conscious maybe
um
i don’t know but there was always just
something uh that i just really
that just profoundly touched me about
her and and
her path um
uh and then obviously with logan too and
like walking through that and there’s
just a lot of
um there’s so much life and then so much
pain inside of that young woman um
it just was uh
she was easy to like and easy to invest
a lot of time and energy into trying to
walk with her
on her path
yeah
thank you for that jason um i want to
talk before we jump into it um kevin
um i didn’t get the opportunity to meet
kevin tell us a little bit about kevin
yeah kevin um
he
was just as musically talented as her um
he they both i feel like
um had this like energy that just drew
people to them they were always um loved
and liked by so many people they were
the popular people all the time
everywhere they went
kevin struggled with his addiction
probably for just as long as crystal
so probably over a decade
and
he the last year of his life he was
diagnosed schizophrenic
and went through that with his
medication and everything like that
and then
he yeah i mean
i don’t i don’t know what else to say
about him i don’t really want to speak
to his addiction but
um yeah he just was a very loving
kinding human being so talented he drew
that picture he’s artistically talented
musically talented yeah and what year
did he pass
he just passed in 2020 november mm-hmm
yeah it sounds like you know mental
health
um and i love what you said there is
like we don’t need to go into the
addiction
because it actually is it’s mental
health yeah and people are struggling
with mental health today and um you know
us here at peaks we’re doing it putting
our best foot forward to bridge that gap
um because it is that unnecessary shame
spotlight that gets shined oh he’s a
substance a user it’s different it’s not
different
and we talked about that pretty candidly
before the episode so
sounds like a phenomenal human yeah i
would have loved to admit i don’t know
yeah so he’s great yeah he played a
bunch of instruments uh he mostly played
guitar uh he was really good at playing
guitar
um crystal was the one that was
guitar and piano and violin
and any of them sing
no no neither i think i’m the i’m i’m
the one i just haven’t started that yet
here we go
lead singer of the non-profits of her
voice there’s potential
why don’t you just sing a little
foursome oh yeah
let’s just jump right into the people we
actually have two women in programming
right now that are literally after the
commencement upon my last two groups
they got a guitar out and they sang a
song that they wrote at peaks wow
so yeah i wanted to get into some
questions about crystal and just kind of
pick your brain a little bit because i
want to make sure that
we’re telling her story in the right way
i want to make sure that the energy that
we’re putting out into this world
fits
and so as her family and really as maybe
one of her closest people in her life
um
how should we be telling crystal’s story
i don’t know i mean that’s a great
question i would tell her story in the
way that you knew her um
because that’s how i tell my story i
don’t go off of what people tell me
about her i go off of what i how i knew
her and who she was to me and that’s how
i think you guys should share that
because um i love like meeting people
who knew her and them telling me stories
and like you guys telling me stories
about her hike and her sledding and like
that’s your guys’s stories that you have
of her and i hope you continue to share
those because that keeps her alive
um and i’ll continue to share everything
that i know about her and the great
memories i have of her
yeah that’s that’s that’s really
beautiful and
i appreciate you saying that it
it can be really difficult at times as
we talked about before the show to
really carry that message on
in a really infectious way and i always
feel
geez i kind of feel a little bit guilty
because the only thing i know of your
sister is
absolutely perfect
you know it’s i i get to watch her come
in hopeless and i get to see hope come
alive and that’s the last i remember of
her
and so
the way that i want to tell her story
moving out there is just in that way is
i saw someone come in a fighters fighter
and fought a great fight um and
experienced significant happiness and
recovery
and that’s how i remember yeah and
that’s what i love to hear i love to
hear different perspectives of how you
guys knew her and connected with her in
different ways
how would you tell her story stephanie
from what you know
i mean
what comes to mind is just
her intensity for love like
whenever she was around anyone it was
like
she was just so present right like
and i never remember i mean we all have
like phones and stuff but i just always
remember her being like so present and
like
whatever whatever we were doing it was
like playing games at the table like we
played games and puzzles and stuff it
was just like she was always just so
there and just wanted to connect and
just
genuinely loved being around these
people that
she cared for
that she was safe with
that made her laugh like she was like i
just keep going back to her laugh like
you can’t um
yeah she she made her presence known by
the joy that she like filled the room
with
yeah i don’t think you can speak about
her unless you bring up her laughs yeah
yeah
yeah i was just saying you yeah everyone
knows her laugh i mean she would
she would make fun of you and you’d
still be laughing with her
because her laugh was so infectious but
you didn’t care yeah
it’s weird i hear a little of her
laughter yeah yeah i do i hear myself in
it a little bit too yeah when i laugh at
certain times it’s usually like when i’m
around people that knew her which is
really kind of cool uh and then some
pictures i noticed i’m like oh my gosh i
look like christian
well your mom even talks about when you
were growing up like baby pictures and
stuff you were like the same like people
didn’t know like wait which daughter is
which
i was i was at the parking meter out
there and i saw you and i was like i got
lit up with chills like oh yeah brooke
yeah wow
yeah yeah i get that a lot from
stephanie when we had crystals um we did
we celebrate her birthday every year
and stephanie came and she was just
staring at me and was like it is uncanny
like how much you look like her and it
freaks me out to stare at you right now
i get that a lot
and it’s really cool how you all have
stayed pretty well connected we were
talking a little bit before the show of
some of our other peaks alumni that were
here with crystal
it’s really cool that you all have been
able to stay in touch with them a little
bit and um yeah it’s really cool that
they have supported us through this and
have reached out to you guys to have you
know it’s it’s really a cool tight-knit
community i think yeah yeah
jason how about for you i mean what
i know that crystal
um positively impacted you in a number
of ways i mean i train with jason in the
morning in the gym too so we’ve been
talking about this a lot leading up to
this and um i just know she holds a
special place in your heart personally
and professionally
yeah i think
you know interestingly like it’s
you know like when we started serenity
peaks and invited women into you know
there’s a men’s program and then and
then we start serenity peaks and really
you know crystal was in that kind of
first cohort of young women that came
into our program and um
and with it being a new program and and
um
a new kind of adventure i guess for me
and i think for us chris i think
um
it just created these really special
bonds like with that first
group of people and and i do think of
that hot trip that we went on like i i
mean i will never forget that and
um and i mean i i do have so many
pictures in my phone of of what we were
doing and the hikes and
this silly beanie that crystal was
wearing is like red i think in white
but just a smile and and like
um
so i think there’s a there was a piece
of crystal too that just signified just
a really
fun part of
my career too like selfishly that just
like there’s an intersectionality there
of like this is
fun and like um
[Music]
and i think during that time too we you
know chris you and i would
not joke but like just be in amazement
of like
how
um how different the women’s program was
from the men’s program and how
just the depth of pain and trauma that
came in versus
the men not that they don’t have their
own problems but like
with what the young women walked in with
um
it felt really heavy and so i do think
we we invested i invested a lot of time
into
really kind of wanting to make sure
peaks did well but then of course as a
result of that like just really getting
to know
um
just that whole group that that that
you’ve been mentioning and um
yeah and then uh just yeah crystal like
she just
she was in it man and like uh
and
when i think about her too like she
definitely was kind of the life of the
party in a way but not like i’ve been
around people who are like the party and
they’re really forcing it or like it’s
about them yeah
um in her it was just yeah it was just
how it was her setting
and um
and like she was just always in for it
was just always a yes like we’re going
to play this game cool
uh yes
let’s do that or
we did
we did a charades on that hud trip and
like we had just funny things of like
riding in the van or
the best chris burns oh my god yeah
that’s great
and she just was in for that even though
she felt
terrible in in that um
that sledding video that we had that i
if you remember that like i mean it
she just did it all out and like she
went over that jump and her glasses one
arm glasses go flying everywhere
they may have had two arms at that time
i can’t remember but like it was uh um
yeah it i and i remember
i don’t mean for this to sound morbid
but like i remember thinking that you
know with these with this group two of
like
you know
unfortunately you know i’ve done this
long enough i’m like not everybody makes
it out of this
like i remember it broke my heart at the
time and then
you know unfortunately not everybody
made it out of them
and that
hurts and sucks
and um
yeah
i don’t know that that gets me yeah
um
she was such an amazing
i don’t know is i guess i think we’re
carrying her forward in a lot of ways
and and like i said that
that that picture of her sits on my desk
like right like i just have a spot for
it and i’ve moved that desk
dozens of times now i think but like
it’s always the first thing to put back
up because it’s just a reminder um you
know and
we’ve in the last year peaks have have
said that we are here to save lives
um and i want that reminder that like
this is what saving lives really does
mean um and
because it is a life and death battle
and not everybody gets out of it alive
yeah
it’s cool to hear
such a personal connection
coming from
i mean i see you guys as like you guys
work for with the rehab right and
being on the family side of it like we
hear
some stuff what happens you know while
in recovery while in different programs
but to sometimes it feels
like you know addiction is such a big
thing
and
addicts are just numbers you know and so
to hear that there’s actually like a
memory and connection tied and like it’s
you know wasn’t just passing through
your program is just another number
is really encouraging from a family
perspective that it’s like you know
there is there is so much more than just
the step by step and cranking through a
system type thing and so
that’s cool yeah yeah because i think
yeah not everywhere right right but i do
think
um
yeah i think
how we’ve chosen to run peaks to and and
this comes from chris and how he started
it is like we
we don’t have to be three steps removed
from our from the people we’re helping
like
we’re all just people yeah doing the
best we can and
crystal was doing the best she could and
um
yeah that
and we didn’t have to create some sort
of barrier to say hey we can’t be in
alignment with people who are just doing
the best they can and
um
we have to be there with them yeah
yeah you guys bring up an absolutely
great point as well and we touched on it
a little bit before the show is just
disrupting an industry too really
ensuring that the people that you know
are treating our vote most vulnerable
have the resources to do so
and if they don’t have the resources to
do so it can end up causing more harm
and so that’s been something that our
ceo my brother brandon burns has been
tried and true on over the last year
he’s like we are disrupting this
industry this is crap the way people are
being treated to your point as numbers
and things of that nature i mean i i
find no greater joy than getting on an
introduction call and say i can’t wait
to i can’t wait to have a smoothie with
your loved one you’re like what
yeah i’m the founder like that’s my
thing
i just drink smoothies with people in
early recovery and celebrate they’re
like wow
because it does matter different yeah
because we’ve never had more than 12
beds in our women’s program it’s always
been very intimate and very very cool
let’s say never we had 16 for about two
weeks
never
then we learned way too many yeah
so let me ask you brooke
what would you say that one of the
greatest things
that you carry with you today that
crystal left behind
one of the greatest things that maybe
you got from her
throughout your guys is close connection
that’s a great question i i think i
think it’s hard to pinpoint just one
thing
i carry a lot of both of them with me
and i think like i was saying to jason
that sometimes
i i can hear myself or i can hear her in
me
um and i think that’s a gift really like
i i find joy
in that sometimes i i may look at like
her in pictures or sometimes i may laugh
like her
um i think is really cool but i think
that’s probably one of the things is
like it’s it’s her laugh
it’s
being able to like still hear her laugh
in me which is really weird
just laugh just to hear yeah
that’s cool
yeah it’s it’s weird it’s trippy um but
and i i have like lots of dreams about
them i feel like they come to me you
know which is really weird but
yeah i mean i still feel like they’re
with me everywhere i go it’s
um i haven’t really separated myself
from them i guess
yeah what about the connection with
fearless
and like the way she lived fearlessly
because we’ve talked about that a lot is
like
we strive for that and like yeah she
just
she
she had a lot of shame i know
that was
really hard for her
because she was also gay
and i know that that was hard for her to
talk to other people about um so it’s
not only like you’re gay but you’re also
an addict and so you look down like
doubly you know it’s like
double marginalized because of that um
and so
she but like you guys were saying like
anywhere she was just the life of the
party anywhere she went
um and
it was more so like behind closed doors
i feel like is when
she had that shame and stuff with her
but i think when she was out in front of
other people people saw this confidence
in her and this sort of like fearless
component to her
and so the whole fearless aspect that we
have incorporated is like the ring she
wore said fearless but it’s also how she
acted you know and how people saw her
did you have a question
i have a lot of questions
[Laughter]
um
so
i mean what a gift to kind of carry your
siblings
around like that and have them visit you
and your dreams and all that yeah
my question too is like what’s the
weight of that
yeah
um
the the dreams it’s it’s heavy
uh because that crystal and i always
talked about our dreams um just how
vivid they were and we would go to the
bookstore every you know every week and
read dream books and it was something
that like we connected and bonded with
um and so it’s yeah the dreams are hard
um especially after the the deaths they
were really hard but now it’s like
now they’re like really you know they’re
they’re like good dreams now you know
and so it’s kind of
refreshing in a way but
i don’t think anything else is as heavy
as that
i don’t know
i love what you brought up too is
that’s exactly my experience with
crystal is
even though we knew obviously through
working with her that
that shame lived inside it was never in
the center of the room
yeah it was something that fortunately
or unfortunately
she dealt with a little bit more
independently
you know
i think that’s a
great point she always was kind of this
happy joyous
kind of persona and it attracted the
people around her and wanted people to
get closer to her you know i remember
her graduation that must have been maybe
the coolest graduation of our first you
know first couple cohorts of clients
that have come in yeah i mean it was
just jam-packed in there i remember yeah
sitting on the floor
you know it is interesting because like
i remember as you were talking about her
shane it’s weird to talk to you because
like it just keeps
flooding
um but like her her shame was also like
some of the most sacred space like i
think some of
my my best conversations with her were
about the things that you just kind of
brought up and
and that burden she carried which
that’s when you felt the heaviness that
she was carrying around yeah and
and i just remember you know my own
reaction to that too
was just almost feeling desperate to
help her
unburden herself with some of that
because um
almost wanting her to see her as
everybody else saw right because i think
sometimes she missed that
i
i feel bad
sometimes and guilt is kind of sits in
me because it’s like i i had this whole
like tough love approach
and a lot of the times when she would
tell me she didn’t want to do something
she was self-conscious or she
shame or whatever and it was like and i
didn’t understand i was just like what
do you mean like just who cares like
you’re beautiful
who cares what what anyone else you know
and it’s um it’s just kind of like naive
for me to to even think or say that to
someone who you know when i can’t even
relate to that
um and i see now in retrospect but
yeah that’s unfortunate yeah how could
you have known though i mean
i talk about it all the time i’m a new
dad
so i was reading the dad to be book in
like where’s my mental health section
there’s nothing there so we all show up
and to jason’s point i think we do the
absolute best that we can do
yeah you only know what you know yeah
but when jason brought that up about
crystal and the shame is i have
experienced that and it was heavy
um and there was a piece of her that’s
like i just
somehow someway want you to be able to
see the way that the world views you
because it’s
spectacular right you know and that’s
that’s the age-old journey of recovery
with young people who’ve experienced a
tremendous amount of shame and pain is
like can we get them to see what we see
before it’s too late right you know
and i think that’s what i that’s a
something i plan to do with this
non-profit is to be an advocate for
those people who are feeling that way
because i know how crystal and kevin
felt that way and
i
i wan i know what it looks like and i
know how it makes them feel and i want
like everyone to know that i’m an
advocate for you you know it’s like i
you can come to me and you don’t have to
be afraid to tell me that you’re using
right now or whatever the case may be
and i’m not going to look down on you
and i’m not going to judge you because i
saw it firsthand
and so i think that’s kind of what i
want to bring with this non-profit as
well as just being an advocate for those
who are suffering and in all this pain
and the shame and just break that stigma
yeah
right really i love the the niche that
you guys have thought about too of
creating um a musical space because i do
think um
it’s easy
you know for us to meet people like
doing sporting things or like physical
activities and yeah
all kinds of things but it does leave
like a segment of people
wrestling and get sober that
need to engage with the arts and like i
think we do try to include arts in what
we do but
um that specific musical space um i
think that’s a powerful uh gift i think
to give people um
and and we’ve certainly you know over
the last you know five and six years or
whatever like we’ve had certainly people
come through that like we have a
i mean not the best keyboard in the
world
maybe we can hook you up with it yeah
right
yeah it’s not i think it’s just fun to
watch people who really get it yeah you
can sit down
and also that’s a vulnerable space too
because i think uh
you know to exhibit your talents like
that um you can feel really well
vulnerable and really uh
scared it is it is like
i remember crystal would only let it out
a little bit here and there like little
pieces and then
it was of course amazing when she would
but
it was very incriminal yeah i think
that’s how they
expressed themselves crystal and kevin
both i saw that because they
had a hard time kevin i mean wore his
heart on his sleeve really like he was
really open and transparent with you but
crystal was much harder to crack and i
think
the music helped
her a lot with that and expressing it
and i know from
experience her and i just listening to
music was like our way of bonding and
like talking to ourselves yeah just
through lyrics
but yeah i think the music part i hope
will help a lot but i’m really glad that
we incorporated that into it for sure
yeah that’s really really cool
i love it it just creates vulnerability
i don’t know what it is about music
she’s like man i’m gonna sink into that
right you know i can remember being a
new professional and
that was the music therapist and i have
no idea how i got that must have been
music it must have been an
therapy i’m like done man i like music
and i like therapy so
let’s put them together but i remember
sitting in there and i had no idea what
i was doing i just had a big heart to
help people but i remember there was
this guy in there who
passed away was one of my friends his
name was yaya
and he would never talk in group
but he’d say hey can i play song
and you he would just belt and you’d
move to tears because he would just you
could heal everything he’s trying to
express
in that one song right and you’re just
like oh
just so moving yeah so i love love what
you’re doing and i think that um longer
term we’d love to get a music program
going here at peaks i think it’d be
exceptional because there’s nothing
greater than sitting around and just
watching
these amazingly giftedly talented people
in recovery jam out
it’s like the coolest thing ever well we
experienced just a small bit of it at
our first drop-off and so we’ve you know
from raising money to getting
instruments to dropping off at recovery
center
just pulling up we hear all this music
happening you know like they’re already
playing and tinkering and it was like
they’ve had the instruments for 30
minutes and they’re like already
creating songs together and it was just
like this like organic thing that it was
just by the instruments being there like
something was happening right like
nothing that we did like it was just the
music was there and then
they just like lit up and we just sat
there and watched them just jam out and
just organically just like play together
they’ve implemented a um a music theory
program into their rehab and so if you
didn’t know music before here’s an
opportunity to learn music and now we
have the instruments to do it and they
have a church band now brook went to go
listen to the church band so they now
have a band in their weekly
sessions and so that was a really good
experience to go see them and do that
and people after the session would come
up to me and like thank me um was yeah
so powerful and just like you have no
idea how much this has helped me and
like i’ve never played an instrument
before and i picked up the the bass and
love it and it’s helped me so much for
this recovery yeah um was and he’d only
been there for a few weeks and so that
was really
powerful it’s really cool to hear that
you can feel that in that video too yeah
and just hearing that you know some of
the guys that got on there and just said
simply what this is doing for him
yeah wow like we hadn’t known them for
more than 30 minutes and they’re
bringing up their past with their you
know trauma with their parents and like
all this stuff and it’s just like
holding this guitar in your hand for 10
minutes and suddenly you’re just feeling
free that vulnerable space we talked
about right like i now trust you to have
this conversation and this is opening up
so much for me to be able to talk and
we have grand plans about the future of
opening a storefront space a physical
space that can be sort of like this
drop-in jam session that is like a space
to just like
you know you don’t need to have a guitar
but you can come and play ours or
private rooms where are you know they’re
a handful of people that want to just
start maybe creating a band or just like
have something to do you know like we
like you mentioned sports there’s you
know 24 7 you know
recovery like gym workout spaces and
like you know what if you want an art
space to come and just do the art thing
and tap into that side of you but you
don’t have a space to do it that’s sort
of the grand vision yeah or the money
right like just come hang out with
like-minded people and we’ll have a
stage if you want to put on a show like
let’s put on a show like we’ll give you
an audience and so that’s the grand plan
is to create a community and we know
there’s so many
aspects you know recovery isn’t just one
thing
but if this could be the one thing that
helps you know that coke that healthy
outlet that coping mechanism that one
thing that like
you can
lean on and get you
to that next step whatever that looks
like
that’s you know worth it in itself for
you know and that is like you know
crystal and kevin will live on through
each one of those moments so that is a
really cool thing actually phoenix
multi-sport yeah yeah does it for sports
right it’s like all you got 24 hours
sober you come in come home yeah
you bring up a great point and we’re
gonna wrap up here shortly but um
touching our passion every day
and a lot of our artists too i had a
female in our women’s program just
graduated
she’s on itunes i mean so gifted and i
sat down there and i said that was the
most amazing song i’ve ever heard played
in front of me
and she goes
yeah my mom told me how to do something
a bit more reasonable and i’m like oh
right and so what what i think our
artists are told or at least they’re led
to believe throughout their lives that
that’s that’s when when you want to get
serious come over here
you know and so that i think they’re
they tell themselves a narrative like i
can’t do this i can’t be
i’m pushing the the
the energy today that says we should
touch our passion every day if you’re an
artist we paint if you’re a singer we
sing if you play guitar we play guitar
yeah because no matter what we do in
this world in the name of recovery we’ll
be fulfilled
so i love that cause i’ve loved having
you all on here um i want to talk about
something really quick that i’d like to
do for
you and your family and most certainly
in crystal’s name
um
i don’t know if i told you but we’re
getting ready to build a 13 000 square
foot state-of-the-art treatment program
right up here in north colorado springs
wow we have the real estate we’ve been
fighting for it for the last two years
annexing it rezoning it so
congratulations thank you we are
breaking ground um this month wow and
our treatment team would like to
dedicate a portion of that building to
crystal
wow
a
corner we want to call it crystal’s
corner
in an area where people can go and they
can play music oh man that’s amazing we
can carry on crystal’s name um forever
wow yeah that’s amazing thank you
you’re welcome
thank you
and i am hopeful that that starts coming
here
i’m hopeful that that starts
the ball rolling for a music therapy
program
that we’d love to start with well you’re
a music therapist
i’m gonna be heading up the charts
but i am just as i told you before the
show i’ve just been we’ve been thinking
about ways how do we let these beautiful
faces live on and
crystal’s face is going to live on a
peak’s recovery forever and we’ll go on
and tell her story and we’d also like
for you all to come out each year and
talk to our team and talk to our clients
about how much this matters to you
so we’re gonna let that beautiful face
live on
certainly on our side of things and it
is our promise and our commitment to you
all that will continue to disrupt this
industry and continue to have the
personal touches in our program that
connect people to things that really
matter
so that is our commitment
thank you thank you all so much for
coming on it’s been so nice having you
on thank you for driving down in this
horrible weather
thank you jason for accompanying me on
this show it’s been really special to
connect with you all in here um
yeah i’m really grateful
it was actually fun to sit and talk to
her and talk about it and talk to you
guys yeah it was great
yeah
well it just reaffirms i mean
nothing about addiction for anyone is
easy right there’s so many different
layers but
the fact that
the efforts the talk the discussions
like the stigma the shame all of that
just
there is a reason for
continuing to have the conversation and
i mean we
we’ve been up and down with like where
we’re going with this non-profit ever
since crystal passed away and
as soon as it hit it hit and like this
is just a perfect example that like
when you follow your passion right when
you like
see a gap you feel a gap and like it’s
coming from a place of just you know
this can work and that there is that
need and there’s people
that um appreciate that that it’s all
worth it
so we’re grateful for you for
having continuing to have the
conversation and the dialogue and
um seeing
seeing crystal and kevin and everyone
else that you come in contact with as
people and doing the best that they can
yeah
thank you all so much for coming on and
sharing this vulnerable piece but i
think it’s just a really important piece
we’ll let that memory live on in a
really infectious enthusiastic and
relentless way because that’s what
crystal left for me was this relentless
approach
to the work yeah so
thank you all
and that’ll do it everybody uh thank you
all for uh coming on tuning in please
find us on all of your podcasts
instagram facebook
anything else tick tock tick-tock i am
the brand ambassador please tune in to
the tick tock it’s a good time
um but until next time um thank you so
much for joining us today uh we miss you
crystal and we love you peace
[Music]

Today we discuss the reasons why we continue to implement gender specific care and the benefits and hardships we face while doing so.

[Music]

hello everybody

welcome to

another special episode of finding peeks

i am brandon burns chief executive

officer of peaks recovery centers chief

clinical officer

guru

clinical officiant

part-time uber

driver clint nicholson chief operating

officer

part-time lyft driver

we actually share yeah we share a car

yeah

they fight all the time about it

he steals his uber sticker he steals his

lip sticker

here we are here we are you’re a coke

guy i’m a pepsi guy i mean yeah yeah

it’s all about the bumper sticker yeah

kidding and jokes aside folks of course

we’re just trying to liven it up a

little bit here be a little bit more uh

intentional about drawing you in to talk

about some serious topics that we want

to speak to the world about

here at finding

peaks

as an episode as me as the host i’m just

going to continue to talk more about it

that i am invested in this concept of

disrupting an industry through our

company culture and our vision and with

that hopeful that uh the folks on the

other side of these cameras and the

social medias uh and so forth the ones

emailing us fervently at finding peaks

at peaksrecovery.com

do it

thoughts ideas questions bring it

forward

hopefully to give you information for

which

if you are pursuing treatment services

whether it’s substance use disorder or

mental health primary uh in that regard

that at the end of the day the

information that we’re giving you

empowers you to seek treatment uh to

find the programs that appropriate for

you and your loved one and to identify

where

treatment centers may fall short and

actually delivering those services to

your loved ones so today we are going to

talk about

kind of societal norms and culture and

how that influences substance use

disorder

and mental health

uh for those out there who are like why

is he using substance use disorder and

not the word addiction is because our

prior episode

we really sort of went after that word

and got a little passionate about it and

i don’t want to use the word for fear

that

he will he will give me a good punch in

the face so trying to move away from it

it’s familiar

it’s a figurative punch in the face

figurative punches totally he can’t do

that it’s an hr issue you are my boss um

so cultural norms our experience is it’s

something that we see with an addiction

treatment it does influence behaviors it

does cause

trauma

for individuals within society i was

talking um

a pretty uh famous

marketing uh

platform in our industry without using

their name i was recently talking about

for example how uh during election

season right after election season

addiction treatment experience or

addiction treatment centers and mental

health centers experience an increase in

call volume related to the results of

elections in that regard so

something about elections is stirring

the pot of

substance use disorder and mental health

in that regard it’s interesting i don’t

have much more to expand or gain

insights into that but that is curious

there is something about

the world we live in

the society we live in that causes

people to experience

um suffering in those processes to the

degree that they’ll reach out to centers

like ours

to address what’s going on uh maybe the

hangover post-election maybe just the

anxiety about who just took power and

what that means for the individual

but really to open this up i’m going to

take a general direction towards you

know the benefits in disrupting an

industry

or taking a look at what it means to

disrupt an industry whether you know

co-ed facilities or gender specific care

is going to be really important

especially given the fact that when we

talk about male versus you know female

that we’re not really culturally

nurturing

um

these binary terms alone that it is much

greater than just those terms by

themselves but from our lens within

treatment you know it’s kind of at a

high level what are we seeing on the

therapist side giving your guys’s

talents in being therapist

that

you know whether it’s trauma or drive

something that’s driving

the substance use disorder or disrupting

them from an anxious depressive state

what are we seeing kind of through the

lens of our

patients

that

you are seeing where culture is actually

playing an influence on how they feel

about who they are

i feel like there’s so much to unpack in

what you just said truthfully

um and i i appreciate you mentioning

that obviously gender specific care is

automatically binary uh

and we and we can do things variable

things uh

to try to bridge that gap but but it’s a

binary decision i just want to

acknowledge that and

however that being said

you know having spent a lot of time on

both of our campuses our men’s campus

and our women’s campus

the the culture that whether or not it’s

from well it’s certainly from society

but the culture of both of our campuses

are very different i um

you guys have probably visited both our

campuses i assume yeah done the tour

that once i’ve done the tour um online i

did it to work yeah but i do think um

you know like at the

just in general like during groups that

are at our men’s campus we talk

clinically about

um

really helping men truthfully like it’s

an excavating process of like helping

men

gain insight into themselves and um

maybe even allowing themselves to

release some

difficult emotions that they haven’t

been able to release

and

the women’s house tends to be a lot

about containment where the women have a

lot more access it seems like

to be expressive and being open and are

a lot more in touch with their trauma

um

and it’s about kind of helping them

kind of make sense of it and then also

contain it um

and

combining these cultures in a primary

care setting

um i i think would be a lot like trying

to combine water and oil is that that’s

not a thing right you can’t do that very

well they don’t even do it just not well

yeah you can do it but they don’t they

don’t mix very well um

and i think uh i think that’s why

that’s the appeal i think of of a gender

specific program is that um

it’s just having that ability like it’s

just a different skill set if i’m just

gonna be totally honest with you and i

think

um and we see it too clinically like we

have clinicians that are drawn to work

more with the men and clinicians that

are drawn to work more with the women

because

um just of their their skill set and

approach uh

fits better in one side or the other and

not good or bad but just simply a fact

is what i notice

i think that you said something really

important um

like

i do think that there is uh the level of

care is actually important when you talk

about gender specific treatment um when

you’re doing the residential sort of

stabilization model

uh safety is is vital towards because

what we’re again trying to do is help

people access vulnerability and so in

order to establish safety uh i think

what i’ve recognized over the years and

i think what we see in our programming

is that gender specific programs

actually do foster a sense of safety

that

maybe a

co-ed program would actually create

barriers to

and so by providing these sort of

gender-specific

approaches we allow people to be able to

explore

in a way that is um

helps them actually kind of bypass

the uh

the shame and expectations and

um

that that the sort of like binary model

actually imposes on people um

now i think as you sort of progress

through your treatment

the integration of men and women

actually becomes really important and i

think it becomes uh really helpful and

really beneficial because in the end we

don’t live in these sort of like

vortexes you know we we live together um

with one another and so being able to

sort of uh kind of re-establish and help

people develop that sense of safety

within a coed environment is also really

important so

yeah in

into that point uh

and i think it’s worth mentioning to the

viewers that you know challenge me of

course go to the google

search engines whatever and you know and

ask google you know in relation to

addiction how

google the data and you’ll see that

women and men experience addiction for

example differently than one another

generally you’ll see that men are using

higher quantities of the drugs and

they’re using it more often where

women are generally using

less quantities and less often in that

regard but both experiencing

frustrations around that addiction and

of course that’s not going to be true

across the board

but when we think about you know

stabilization and vulnerability coming

into a setting if we’re

if our experiences are different

on one side of the equation coming into

another experience i think in ways that

makes us vulnerable to the people that

we’re around in a in a pretty

significant way but with those you know

touches of differences for people

entering treatment i think it’s

interesting from a residential

standpoint you know

that

it feels good and first and foremost to

break it up and move them apart but

that’s interesting to think of course

that well at some point there has to be

this integration um maybe interesting is

the wrong word because it is the world

we live in uh in that regard but the

world that we live in prior to coming to

p you know to a place like peaks uh is

scary and we’ve been mistreated in a

variety of different ways and we have

different experiences within that you

know maybe it’s trauma uh maybe it’s

mental health maybe it’s a female in the

way her dad treated her versus a male in

the way that his dad treated him and out

of those experiences it seems best to

create that separation so that that

vulnerability and the ability to bring

that forward

can thrive but also where where do we

where do you guys think we have blinders

on in this moment because we operate a

gender specific you know uh

culture of course and i think those

experiences for us are uh really

important but

um challenging you guys to think about

maybe in a gender specific setting maybe

it’s around the binary language of just

men and women where we’re not really

seeing that being fully efficacious

i mean i think

i’m not sure it’s a blinder like or

maybe it is like i’m aware of the

blinder that like

creating gender specific program it

serves

a significant portion of the population

but it doesn’t serve another part of the

population i think that’s very much true

um

and then i do think like another course

correction we’ve had i think just in the

last month or two is

we kind of had a lot of our residential

staff

matched the gender of the program they

were working in

and it

and it wasn’t the best idea necessarily

i think it it’s helpful to have

um well boundaried healthy people

of both genders interacting with our

clients and and we had kind of began to

isolate our programs into very specific

camps almost from a staff perspective

and um

and i’ve run plenty of uh programs in

our

plenty of groups and individual sessions

in our women’s program and there is

there is some uh i think there is some

power to having like a a healthy well

boundaried um

compassionate person

providing some care in that women’s

program and then at the same time like

you know we have a lot of really

successful uh

staff members that are women working in

our men’s program that provide an

element of care and compassion and

concern

that um that has been really help

helpful i think

i don’t know what other blind spots do

you think we have i mean i i do think

that when we

you know anytime you sort of like

separate out um

into categories or groups you you are

reinforcing some of the stereotypes that

go along with those so they’re

in in a way that we um

having gender-specific programming does

further entrench some of those

uh kind of variables and i would say um

kind of

beliefs about self and experiences of

shame and victimization i think it kind

of can reinforce that sometimes rather

than

helping to break that up which is

i mean we live in

a diverse world you know like we are

like

gender is a spectrum you know everything

is a freaking spectrum really and to

when when we

reinforce that the world is black and

white we we miss all of the gray and in

the ends i mean the gray is where we

heal and so

i think that it’s uh

i believe pretty firmly in gender

specific programming to a point but i

think that it has its limits like there

is a ceiling that you hit at which point

uh it’s kind of run its course and now

it’s time to fully engage with the world

around you you know these these sort of

like um

i don’t know kind of like

self-manifested little worlds that we

try to live in and i think that and

maybe that’s hark that kind of goes back

to the election

era right like i think that we do we get

we kind of

find our own little cloister of our own

little beliefs and our own little circle

of people that feel and believe the same

thing that we do and when that gets

disrupted it is

extremely um imbalancing yeah but

um

in the end that’s what we’re trying to

learn how to do is to to balance and

stay still in chaos rather than try to

avoid or ignore it

yeah and and you know and and to catch

it really in terms of you know to bring

outside societal norms in you know

america has had many discussions about

it and about non-binary bathrooms in

that regard and that somebody who

identifies

as a female

for example with male genitalia wants to

use the female bathroom and there’s a

lot of tension about that within society

but at the same time we’ve had

individuals come in who are

male per their genitalia in that regard

transitioning into

womanhood and going through that

experience and we’ve

placed those individuals into our

women’s program at time and

out of that once it’s become aware

through the whispers of culture a parent

finds out or something and seems to be

you know dysregulated at some level in

the same way that culture is out there

you know so for me i you know went

around and i always found myself in the

marketing stance of like oh we’re gender

specific and that’s really great and

then people would say well what if they

are non-binary in that regard and what

are you guys doing about that

and how does that blur these norms of

you know gender specific care at the end

of the day and we’ve also done it the

other way women

or or individuals with female genitalia

identifying as male and making that

transition who went into our men’s

program as well too and

um and then tension occurs throughout

that as an experience but uh i think

those are you know the types of things

that are playing roles within this that

for which you know treatment centers

such as ours mental health treatment

centers and so forth integrated care all

have to be accounting for in real time

because these individuals uh across the

board in the spectrum are all suffering

in their own you know unique way uh in

that regard so

so having a gender-specific camp is you

know good to a degree but at the same

time uh really requires um an ability to

be

more relational and you know less

transactional from those those terms

absolutely yeah it’s complicated yeah

and you have to allow it to be

complicated i think if you try to keep

it simple

um

it’ll fail what do you guys think is the

biggest like concern men and women early

stages of recovery in the same room

group room together what do you think is

the the the sort of liability there for

which this industry might fear most you

know within those moments

i mean there’s the obvious

things of people struggling

people

who are maybe having some difficulty or

haven’t regulated their impulses in a

long time

providing them

an opportunity

um

to become distracted by either uh

trying to attract people of the opposite

sex but don’t get me wrong it happens um

even in gender specific programs so i’m

not

that right

that isn’t the only reason by any

stretch of the imagination but just

having sat in in i don’t know countless

men’s and women’s groups it is

men when they’re in groups with other

men they do share about their shame in a

different way or they share about their

stories are they sure about their

struggles in a different way than if

women are introduced to the room and

it’s the same with the women like i i do

think

um for a period of time i think that’s

just really important and i think even

you know even in the aftercare setting

um you know i don’t think it’s

necessarily a bad idea for people to

still attend um gender-specific either

groups or support groups or just have a

friend group that’s gender-specific

where they can talk about these things

without kind of some of that other

distraction but i mean it’s the same

reason why we you know in some ways we

don’t

uh

intentionally try to trigger people or

tempt them with things or or have

liquor bottles laying around like

there’s no value in that creating that

safety is just to me about removing a

lot of

um

a lot of temptations maybe for people to

that

so they can just really dial in and

focus on themselves and and

having done this in both settings i can

just tell you the the

depth and the quality and the safety

um in in the group setting certainly is

just different when it’s gender specific

it’s it’s

for sure for a period of time to your

point well and i think i mean

to your point jason like whether you

like it or not um

trauma is typically experienced through

a gender a gendered lens you know i

think that

a lot of

um of the traumas that we see that we

address are actually gender specific or

gender impacted i guess maybe would be a

more appropriate way of saying it so

when you are

bringing people especially who are sort

of like early in this process who are

just starting to access these feelings

who are processing shame who are

experiencing vulnerability who are still

working on establishing a sense of felt

and internal safety bringing those two

worlds together can be um cataclysmic to

a certain degree so it just has to be

done very mindfully

and um they are

there are

certain ways to approach it and um

i think that there are also ways in

which you can talk about it directly you

know to to not try to avoid it actually

but to really engage in it and and speak

to the fact that you know um

the way that men and women i think

experience uh being a victim in our

culture is really different

and um i think that there’s a lot of

really interesting dialogue to be had

around that

um so that would be like just an example

of one way that you can kind of open

that door but in the end you’ve got um

you know

when you when you’re bringing these

traumas together you always have to be

really careful

yeah it in

this is just the the kind of i’m going

to go out on a limb here and trying to

describe something that

is just coming to mind as we have this

uh conversation but uh you know in

consumerism for example in america like

there there are there’s specialization

of services there is you know peaks

recovery is an addiction treatment

center to resolve you know in it you

know mental health issues and uh

substance use disorder and then there’s

the the doctor to help you know manage

pain and then there is the restaurant

that specializes in serving food that

you can’t necessarily cook yourself or

whatever the case might be

what i’m getting at here is that

oftentimes we experience things that we

need as an internal frustration hungry

externalize it go to a restaurant i’m

got an addiction externalize it i go to

this place can’t sleep externalize it

get on these meds

as an experience at the end of the day

and so for me

in the seven and a half years or so now

that i’ve been doing this and just you

know witnessing this within addiction

treatment cultures and uh integrated

care as well too is this immediate

externalization to create that internal

wellness and the individuals that we

treat and serve are so disrupted

generally speaking when you take the one

externalization feature drugs and

alcohol away from them or the

environments which it was more

comfortable to be depressed in or

anxious in or those sorts of things now

they’re in these new environments and

we’ve talked about it before it becomes

about the pillows and the couches and

you guys tvs are only 70 inches and it

should be 85 and you know

couching the silliness aside from it it

feels like in a in a in a co-ed facility

we start wanting to feel internally well

and

because culturally speaking of course

we’re

largely a heterosexual population

there’s a significant potential for

conflict there in the externalization of

i don’t feel well in here they’ve just

taken this i mean i can’t think of a

greater dopamine kick on the other side

of losing all that dopamine kick from

drugs and alcohol that sex as an

opportunity provides now it doesn’t

as you guys are pointing out discourage

externalization and gender specific

cultures because

people can be sexual in multiple ways

than just being heterosexual in that

regard i think the world has taught us

that

in a big way as we have more and more of

these conversations and bring it to

light but

it seems to be that conflict that is

most uh

as an experienced dire within thinking

about whether to cross that bridge into

a coed facility

and if we’re not disrupting that then it

leaves this major external

externalization and distraction in front

of us and if i’m motivated by that i’m

not going to talk about how you know my

dad smacked me around maybe culture has

taught me to be strong and big and now i

see wounded you know female on the other

side as a male heterosexual and i think

oh i’m just going to be tough man and

i’m going to save and now i’m being you

know maybe codependent all these sort of

features out of it and i think that’s

the rub

that um

to the core of this that we’re not

thinking about in terms of business

models but it’s a cheaper business model

in our industry to invite the model in

to have them all on one site and yeah

they’re housed together here and here

but we’re running groups in the middle

here and then we have two or four you

know staff members at night time trying

to keep all the kids apart and in

between but the reality is with

intentionality and once that external

external hook takes place it’s nearly

impossible to do productive work um

am i wrong am i no i don’t think you’re

wrong at all and i do think

i think people

i mean you’re mentioning substance use

like when when people are struggling

with substance use

issues

they

uh

yeah

um

but i will say it is it’s challenge like

they’re used to feeling an uncomfortable

feeling and i have to do something about

it and that something provides immediate

relief from it

and so

when somebody is four days sober that

impulse doesn’t go away like i’m feeling

uncomfortable i need to do something

about it

call the craving right

um

but okay now i don’t have access to my

what i would prefer to do so i’m going

to access a variety of other things and

sex is a really powerful one to your

point

you know eating issues like we’re not

going to set up like a gambling parlor

in a rehab either because that would be

appealing too like if i could go get

lost

in the gambling way provide the rush and

all of that but

but i do think like that’s part of this

early process and stabilization is

saying okay you have these feelings that

feel intense and overwhelming but can

you recognize that

they don’t last forever in fact they

don’t last very long at all if you kind

of let them what lasts a long time is

ruminating about them and telling

yourself i have to do something about

this rather than just like

letting it come through and being

mindful about it um

so providing gender-specific care to me

takes away one very dramatic thing that

people can

do often times or would be drawn to do

and there’s an intensity too that like

okay

people are sharing things that maybe

they haven’t talked to anybody about and

and it’s being well received it gets

really easy to conflate

um empathy with love right like if

people are understanding what you’re

saying it’s easy to feel like oh my god

this is the most important person in my

life that i met

yesterday right right so i don’t know

that’s where i see it yeah

yeah i mean

i agree i think

that

really

i guess for me treatment

and recovery is

the process of sort of reconnecting to

self

and you’re talking about externalization

right um

we there’s there’s still that tendency

early on to to believe that you’re

that your answers and your connections

lie outside of you and i think that you

can create environments like a co-ed

program especially at that like early

residential stabilization period

in which you start to reinforce that or

at least i don’t know it’s almost like

you’re kind of setting people up you’re

tempting fate really at that point and

when in reality what

you really need to be doing is getting

people to go inside go inwards right

and anything that you can do early on in

the process of treatment whether it’s

for

substance dependence or mental health

is help people reconnect to themselves

because they people come in completely

detached you know they i’ve most people

come in can just completely lost and i

mean that’s why

identity and purpose is one of our our

primary program weeks you know that’s

one of our intensives because people

have completely lost that sense of self

so

um and i think that anything that we can

do as a program anything that we can do

as therapists

to

help people

remain

focused on what’s going on inside as

opposed to outside

the better

the job that we’re doing essentially

that makes sense

to me yeah to me hopefully the viewers

uh in this regard and i think we’ll just

we’ll take it out from there this is a

uh

this is a topic that is uh interesting

and it’s uh it’s got tones of

combativeness in it uh the way that

culture probably experiences addiction

and what it is and how addiction

treatment centers substance use disorder

centers integrated care mental health

should be

behaving in this world

but there are internal conflicts within

our industry and the services that we

provide each and every day and these are

things that whether co-ed or gender

specific facility that we have to be

thinking about in real time and how are

we going to disrupt that and you know in

our experience i think i would prefer to

be generous if it feels like you we do

away with a lot by separating that out

from the very beginning but if we’re not

thinking thoughtfully about these things

and the business model is just to push

them all in one room and think like

here’s the group therapy go but yeah

they sleep in separate places that’s

just not being thoughtful about how this

works

at the end of the day because

individuals who are receiving our

services are hollow within and looking

for

largely anything to fill that space in

that void within

and sometimes these

simple you know primitive features of

our existence are the things that they

will quickly move to fill those in and

it’s just something to be mindful of so

over the next few weeks uh jason

friesman i and clinton as well too will

be joined by dr ashley johnson uh our

president chief medical officer at peaks

recovery and we’re going to be talking

about major dis major depressive

disorder

in a variety of different ways how it

connects with or

more innovative care how that connects

with treatment

the limitations of medication management

in that regard the complexity of what

takes place within treatment episodes

around this um

so uh for my next hosting position i’ll

be joined by clinton and dr aj as we

call her at the office and jason will

have another person and dr aj i suppose