The Brain Fix: How Understanding Neuroscience Enhances Treatment Compliance

Ralph E. Carson, PhD, RD

The Brain Fix explains the symptomology and behaviors of an addiction using a neuroscientific model to point out particular circuits, nuclei, and neurotransmitters involved in the disease process. It is a unique approach to break through denial and contribute to a higher level of adherence to treatment by formulating a viable explaination for a complicated condition. Employing a user-friendly visual brain atlas, the patient is provided a sense of empowerment to achieve a greater measure of control over his or her life. Recently published scientific research on serotonin, brain plasticity, nerve cell regeneration and the neorcortex provides encouragement and connection to the patients and their families who perceive recovery as an extensive, confusing and often helpless ordeal. New and improved brain imaging techniques (fMRI, SPECT, MRS, CT, PET, and EEG) over the last decade have opened up new opportunities to provide insight into what recovery is and how therapy, nutrition and drugs can catalyze the recovery process. The Brain Fix helps put treatment into perspective and action because one can actually visualize the addiction as an imbalance of interconnecting circuits that trigger distorted thinking and feelings around drugs and behavior, which otherwise would be abstract concepts beyond their imagination and reach. The illustration provides a backdrop on which tradition treatments (CBT, IPT, trauma resolution, 12-step, and antidepressants) as well as novel techniques (EDMR, positive psychology, meditation) can be explained, supported and connected. Finally, this concrete neuroscientific explaination enhances long term recovery by incorporating support for why more than weight gain, refeeding, and abstinence from inappropriate behaviors are necessary to prevent future relapse.

Many times it is hard to communicate with addicts struggling with various negative complaints, just how wellness methods play out in the healing process. With the onslaught of new brain imaging techniques (PET scans, fMRI, EEGs) and new brain pathway discoveries in the field of neurochemistry, there is fortunately a window of opportunity to begin to allow anyone to visualize what is taking place in their bodies as lifestyle changes are practiced. This lends additional credibility to the therapist-patient connection and may accelerate the healing process. It has long been recognized that the body will not respond to what the brain does not understand. The times we heal most efficiently are when we know the cause of our symptoms. By owning an understanding of the healing process, our body is allowed to heal itself and the catalyst for healing are wellness techniques of exercise, nutrition, meditation and behavioral change.

Ralph Carson, R.D. B.S., B.H.S., Ph.D., is a nationally recognized clinical nutritionist and exercise physiologist. Dr. Carson is a frequently requested speaker on a variety of nutritional topics for medical groups, pharmaceutical companies, universities, athletic training camps and corporations. He has a successful clinical practice as well as being a faculty member of the University of Alabama at Huntsville for over 20 years. Dr. Carson is also a nutritional advisor to numerous university athletic departments including the University of Tennessee National Basketball Champion Lady Volunteers. Dr. Carson received his B.S. from Duke University, his B.H.S. in pathology (Cum Laude) from Duke University Medical School, and his Ph.D. in nutrition (Phi Kappa Phi) from Auburn University. Dr. Carson currently manages Oprah Winfrey’s web page on eating disorders and is the consultant for Pine Grove’s eating disorder program, The Women’s Center.

Visit http://www.pinegrovetreatment.com/ or call 1-888-574-HOPE (4673) for more information.

What is Next Step?

Next Step is a 48-bed extended community setting especially designed to aid men in regaining their freedom from the disease of chemical dependency. Next Step provides an alternative to traditional inpatient treatment programs in an environment that is both clinical and cost-effective.

Next Step employs a variety of 12-step based programs for each phase of treatment and with an interdisciplinary staff of physicians, nurses, counselors, clinical assistants, social workers, and certified addictionologist the Next Step program provides patients with a full continuum of care.

The treatment program includes:

- Comprehensive Psychological/Psychiatric Evaluation and Testing
- 12-step support groups
- AA Big Book Studies
- Gender-Specific Groups
- Individual and Group Therapy
- Family Program
- REACH (experiential therapy)
- Expressive therapy
- Recreation therapy
- Nutrition Services
- Lectures and Films
- Dual diagnosis
- Aftercare program
- Intervention
- Exercise/Fitness

Visit http://www.pinegrovetreatment.com/ or call 1-888-574-HOPE (4673) for more information.

Pine Grove Behavioral Health and Addiction Services in Hattiesburg, Mississippi is known as one of the nation’s most comprehensive treatment campuses. For over twenty five years Pine Grove has offered a continuum of services ranging from outpatient to inpatient and residential treatment for adults, children and adolescents suffering from psychiatric and addictive diseases. Specialized services include the treatment of addictions, eating disorders, and professionals struggling with interpersonal difficulties. The Pine Grove Mission is to be a leader in healing and changing lives by providing the highest quality behavioral health services.

The Disease Model

Once upon a time, all mental disorders, including eating disorders, gambling addiction, drug and alcohol addiction and sexual addiction (along with everything else in the compulsive spectrum) were thought of as wickedness, weakness, or both. Now we use what is called “the disease model” to talk about these things because (thank goodness) we know a lot more than we used to about them. We know that all addictions are compulsions and vice versa, which gives rise to the saying, popular in all the best recovery circles, “An addiction is an addiction is an addiction.”

From the standpoint of recovery, the specific substance or activity is less important than the recognition of the fact that someone who is suffering with this terrible problem feels driven, absolutely compelled to do, ingest, or focus on something that hurts her in body, mind, and spirit, wrecks her relationships, and keeps her from wholeness and wellness in life. As a well regarded researcher in the field, Dr. Doug Talbott, says, “The compulsion IS the disease.”

The scientific evidence for this position is mounting in all areas of research—clinical work with patients, family history studies, newer brain imaging techniques, and psychological research into what is called “addiction interaction.” The compulsion really is the disease. As one woman put it to me once, “I overeat and throw up just like my dad used to drink. It’s so out of control and I can’t make anybody see I need help just like he did.”

The difficulty in the medical sciences often lies in translating research evidence into clinical practice. Someone has to lead the way, and we all tend to resist change. At Pine Grove Women’s Center, however, we are committed to bringing you the most up to date, comprehensive care possible, using what has worked in the past to set a framework for making full use of the advances in the here and now.

Visit http://www.pinegrovetreatment.com/ or call 1-888-574-HOPE (4673) for more information.

Sexual Addiction Screening

Sexual addiction is characterized by compulsive sexual thoughts and acts. Like all addictions, the addict usually has to intensify the addictive behavior to achieve the same results.

If you have concerns about sexual behaviors then ask yourself these questions:

- Have you had difficulty resisting impulses to engage in sexual behaviors?
- Have you tried to stop, control, or reduce these behaviors?
- Have you thought of killing yourself because of your sexual behaviors?
- Have you experienced legal consequences due to your sexual behaviors?
- Do you spend large amounts of time trying to get or recover from sex?
- Do you feel anxious or irritable if unable to engage in sexual behaviors?
- Do you worry that others will find out about your sexual activities?
- Do you often find yourself preoccupied with sexual thoughts?
- Do you feel that your sexual behavior is not normal?
- Are you experiencing family problems as a result of your behaviors?

If you are concerned about your sexual behaviors or attitudes, or even a friend or family members, consider professional help.

Pine Grove’s Gentle Path is a program for those suffering from sexual addiction, relationship addiction and sexual anorexia. It is under the direction of Patrick Carnes, Ph.D., C.A.S., world-renowned speaker, and author on addiction. Dr. Carnes’ 30-task-model serves as the basic curriculum for treatment.

For over twenty five years Pine Grove has offered a continuum of services ranging from outpatient to inpatient and residential treatment for adults, children and adolescents suffering from psychiatric and addictive diseases. The Pine Grove Mission is to be a leader in healing and changing lives by providing the highest quality behavioral health services.

Visit http://www.pinegrovetreatment.com/ or call 1-888-574-HOPE (4673) for more information.

Warning Signs of Suicide

Suicide is a devastating act that almost always seems to friends and family members like a bolt from the blue. But people often give clues that they are thinking of suicide. Recognizing the warning signs of suicide could result in a life being saved.

Giving away cherished possession, making a will and being preoccupied with death are red flags for impending suicide. Furthermore, the old saying that people who talk about suicide don’t do it is simply not true. Often such talk is a cry for help before it’s too late.

Another warning sign of suicide is depression. Any of these changes could indicate depression:

- Feelings of hopelessness or helplessness
- Changes in eating or sleeping patterns
- Poor performance at work or school
- Poor concentration
- Withdrawal

Anyone who is depressed or has been depressed is at risk for suicide. Other risk factors include:

- Alcohol and drug use
- History of physical or sexual abuse
- Death of a friend or family member
- Previous suicide attempt
- End of a relationship

If you suspect someone is considering suicide, take the warning signs seriously! Don’t assume it will blow over. Share your concerns with someone who is a position to take charge or contact your local health professional.

Visit http://www.pinegrovetreatment.com/ or call 1-888-574-HOPE (4673) for more information.

How to Avoid Burnout

Burnout is a stress condition brought on by being involved in an intense situation for a long period of time without adequate rest and recreation. Most often thought of in relation to a job, burnout can also occur in other situations, such as being a primary caregiver to small children or a sick elderly person. It is the result of feeling overworked and unappreciated. Learn how to avoid burnout by knowing your own limits, taking care of yourself, and listening to the ideas of others.

Sometimes we can control a situation that has the potential for burnout by recognizing it at the outset. In fact, certain jobs, such as air traffic control, are known for their high incidence of burnout, as are jobs which involve caring for the very ill or in which a great many hours of overtime are demanded.

Some people thrive on stressful environments, but if you are the type of person who can’t help but get involved to the detriment of your own need, you might reconsider the situation and choose not to participate. Knowing yourself well enough to avoid situations of potential burnout can be a health strategy for you.

Share your feelings about the situation with others in the same or similar situation; listen to what they have to say about strategies they use to cope or talk with someone from outside the situation. You might find that communicating with others about your own situation is a positive step away from stress and burnout and a positive step toward greater health.

Visit http://www.pinegrovetreatment.com/ or call 1-888-574-HOPE (4673) for more information.

The Brain Fix: Healing the Damaged Brain through Integrated Recovery

Ralph E. Carson, PhD, RD

Recovery from any addiction is often a very difficult, challenging and drawn out process. Long before any constructive therapeutic work can commence, the individual needs to break through their denial and admit there is a problem. Even after one accepts their behavior is inappropriate, they continue to resist getting the necessary treatment. There is a feeling their addiction is not that severe and it will go away if they just persevere and abstain from their drug or behavior of choice. If they do commit to treatment, too many times it’s all about adhering to only what they think recovery looks like and what they perceive as efficacious care. There are some whom may eventually fully understand recovery intellectually, but too many times think head knowledge is all that is needed and then the healing process is complete. If the addict never connects with the final stage of recovery, which is emotional commitment and total surrender, the potential for long-term (permanent, if you will) recovery will never manifest. Unfortunately, most addicts will either find themselves relapsing, cross addicting, or fighting their cravings tooth and nail for the rest of their lives.

Words like surrender; spiritual; higher power; feelings, hope, intimacy and other abstract therapeutic terms sometimes are meaningless phrases that the addicts learn to repeat in therapy sessions or support groups. These concepts are part of a world that they cannot fully comprehend, but they feel that they must put up a good front, move the process along, and get on with their lives. Being able to grasp these abstract concepts is frustrating to addicts who pride themselves as being intelligent, but many miss the point because they think that just giving lip service to the process will guarantee recovery.

Most will agree that the primary organ that is injured during stress and addiction is the brain. Except for antibiotics and chemotherapy, no medication or therapy by itself cures a disease. Truly drugs and therapy are necessary as a catalyst for healing, mitigating symptoms, preventing diseases and progression, reducing risk and making the process of healing more likely to occur. But in every other instance, the body heals itself. Something physical is happening in brain during this recovery process that can be observed as a change.

Nerve cells are destroyed, dendrites (nerve connections) are rerouted, neurotransmitters are depleted and nerve coatings (myelin) are diminished during the years of abuse stemming from stress, trauma, addiction and poor nutrition. The first thing that has to happen is to cease completely the further destruction of brain tissue, which necessitates total and complete abstinence. This obviously means no cross addictions whether chemical (to include caffeine and nicotine) or process (food, gambling, sex, etc). The healing process of regeneration, repair and replenishment necessitates a stimulation, which is provided by therapy, 12- step, meditation, medication (i.e. SSRI – antidepressants) and exercise. This entire stimulus for healing is for naught without proper nutrition to provide the necessary nutrients and raw materials (omega – 3 fatty acids and protein), energy (low glycemic load carbohydrates) and protection (vitamins, minerals, antioxidants and phytonutrients). Yet effective healing takes place during stages III and IV sleep and there must be a program of sleep hygiene in place to insure that periods of appropriate sleep are achieved.

Thanks to the innovations in brain imaging, scientist can actually look into the brain and begin to see what is going on in addiction and recovery. Though relatively in its infancy, neurochemistry offers the potential to connect how therapy produces recovery. It also offers a window to those who fight understanding how abstinence, 12-steps, therapy, nutrition, exercise, drugs, sleep and all the modalities used in a treatment program contribute to recovery.

Therefore, by employing a model of recovery as the healing brain, the patient can assign purpose; meaning and hope to the recovery process and it may for the first time begin to make sense. The healing brain model helps explains the symptomology, heredity and behaviors of all addictions using a neuroscientific model to point out particular circuits, nuclei, and neurotransmitters involved in the disease process. It is a unique approach to break through denial and contribute to a higher level of adherence to treatment by formulating a viable explaination for a complicated condition. Employing a user-friendly visual brain atlas, the patient is provided a sense of empowerment to achieve a greater measure of control over his or her life. Recently published scientific research on serotonin, brain plasticity, nerve cell regeneration and the neorcortex provides encouragement and connection to the patients and their families who perceive recovery as an extensive, confusing and often helpless ordeal. New and improved brain imaging techniques (fMRI, SPECT, MRS, CT, PET, and EEG) over the last decade have opened up new opportunities to provide insight into what recovery is and how therapy, nutrition and drugs can catalyze the recovery process. The “Healing Brain” helps put treatment into perspective and action because one can actually visualize the addiction and stress as an imbalance of interconnecting circuits that trigger distorted thinking and feelings around cravings and behaviors, which otherwise would be abstract concepts beyond their imagination and reach. The illustration provides a backdrop on which tradition treatments (CBT, IPT, trauma resolution, 12-step, and antidepressants) as well as novel techniques (EDMR, positive psychology, meditation) can be explained, supported and connected. Finally, this concrete neuroscientific explaination enhances long term recovery by incorporating support for why more than abstinence from inappropriate behaviors and head knowledge are necessary to prevent future relapse.

Affective neuroscience is the study of how emotions are generated by the brain. Brain imaging (fMRI and PET scans) explores pockets of the brain where emotions develop and provide a detailed neural schematic. By mapping how the brain generates and processes emotion, it may unfold ways people might use the power of their own minds to overcome the crippling impact of depression and addiction and may even improve their physical health as well. Many research projects have been done on negative types of emotion such as depression, stress and trauma. On the other hand, research on positive types of emotion has not been studied as much. As of late, studies on happiness are now getting more attention. People are in control of reaching ultimate happiness by following three components: pleasure, engagement and meaning. There are numerous parallels between spirituality, 12- step models and authentic happiness that may influence a restructuring of our brain and hence provide healing.

Much like nutrition and strength training are interdependent while building muscles, what we eat has a significant influence on how the brain heals during recovery. The brain only has so much reserve. The combination of abuse (addiction/eating disorders) and neglect (poor eating habits) takes an even further toll on mental function. Fortunately, the brain is malleable and with proper nutrients: nerves are regenerated, proper circuitry is restored, neurotransmitters are replaced and optimal brain functioning is possible. New research has revealed how to design a food plan that maximizes the healing of the brain and expedites recovery.

Healing takes place during stages III and IV. Even though people think they are getting proper sleep, many addicts fail to achieve these stages. The environment, the therapy, genetics and past history play a part in achieving proper sleep, and a complete program will intervene to make this final component not just an interesting concept, but a reality.

The healing brain model therefore is really echoing what has been taking place in good treatment programs for decades. The Model does dictate that therapist change their methods of treatment or philosophies. The healing brain model is merely an effective vehical that integrates all aspects of healing and enlist the emotional participation of the patient for more efficient, complete, and perhaps faster recovery.

Ralph Carson, R.D. B.S., B.H.S., Ph.D., is a nationally recognized clinical nutritionist and exercise physiologist. Dr. Carson is a frequently requested speaker on a variety of nutritional topics for medical groups, pharmaceutical companies, universities, athletic training camps and corporations. He has a successful clinical practice as well as being a faculty member of the University of Alabama at Huntsville for over 20 years. Dr. Carson is also a nutritional advisor to numerous university athletic departments including the University of Tennessee National Basketball Champion Lady Volunteers. Dr. Carson received his B.S. from Duke University, his B.H.S. in pathology (Cum Laude) from Duke University Medical School, and his Ph.D. in nutrition (Phi Kappa Phi) from Auburn University. Dr. Carson currently manages Oprah Winfrey’s web page on eating disorders and is the consultant for Pine Grove’s eating disorder program, The Women’s Center.

Visit http://www.pinegrovetreatment.com/ or call 1-888-574-HOPE (4673) for more information.