“My mind works just like yours. It’s just that yours is on steroids.” Eric Schmidt from New Roads Behavioral Health talks borderline personality disorders, substance abuse disorders and pursuing new and effective treatments like dialectical behavioral therapy (DBT). Enjoy.
The Illuminate Recovery Podcast is about Mental Health, Mental Illness, and Addiction Recovery. Shining light on ways to cope, manage, and inspire. Beyond the self care we discuss, you may need the help of a licensed professional. Curt Neider and Shelley Mangum are a part of Illuminate Billing Advocates (illuminatebilling.com). They are committed to helping better the industry and adding value to the lives of listeners by sharing tools, insights, and success stories of those who are working on their mental health.
Transcript (no grammar): welcome to the illuminate recovery podcast we shed light on mental health issues mental illness and addiction recovery ways to cope manage and inspire beyond the self-care we will discuss you may need the help of a licensed professional my name is kurt neider i'm a husband father entrepreneur a handyman and a student of life i avoid conflict i deflect with humor and i'm fascinated by the human experience and i'm shelley mangum i am a clinical mental health counselor and my favorite role of all times is grandma i am a seeker of truth and i feel like life should be approached with tremendous curiosity i ask the dumb questions i fill in the gaps the illuminate recovery podcast is brought to you by illuminate billing advocates make billing and collection simple with leader in substance abuse and mental health billing services verification and analysis of benefits pre-authorizations utilization management accurate claim submission and management denial and appeal management and leading reporting improve your practices cash flow and your ability to help your clients with eliminate billing advocates today kurt and i are privileged to talk with eric schmidt eric schmidt has been in the industry a long time he he runs new roads treatment center eric has worked in behavioral health field for more than 20 years he served primarily in key executive level positions for community-based behavioral health care and substance abuse treatment organizations eric boasts both a master's of science in social work and a master's of business administration besides his business and administrative success eric has a as a licensed mental health therapist personally provides a variety of clinical services such as individual group and family treatment diagnostic assessments and psychosocial assessments utilizing a range of techniques and theoretical designs eric i know you've been in this industry a long time and i really appreciate you taking the time to visit with us today well thanks for having me um your your reputation precedes you i've heard about you in the industry i've heard some of the work that you've done and and how incredible um that has been at changing people's lives and i wondered if maybe you could share a little bit of of how you ended up in substance abuse and mental health okay yeah i'd be happy to um it was it's it's a bit of a funny story because i i did not at all intend to do this i wanted to be a doctor uh i grew up with really horrible asthma and that really affected my childhood affected what i could do affected my what kind of activity i could have and i just kind of fell in love with medicine and and my goal was to be a pulmonologist just because i was really familiar to me and and i think that's pretty natural between my freshman and sophomore year my dad and i had a series of disagreements which led to me having to pay for a good portion of my education and i wanted to find some place that i could work at night this is in fort collins colorado at csu and i wanted to find a place i could work at night and i've heard from a friend oh there's this this youth treatment center and you could get a night shift job there and and so i did i got this night shift job there it was pretty active even at night so i didn't get as much homework done as i was originally hoping to and i was in my between my junior and senior year and i was applying to medical schools and i'd gotten into some and the psychiatrists that worked there and then another social worker clinical social worker took me to lunch and just said we think we think that you really haven't a talent for that and at this point i've been promoted kind of not really always understanding why like they took me off put me on swings and then all of a sudden i went i went full time and i actually was made more money at that point it took me to get getting into my 30s to make as much money as i made when i was 21 because i was working for the government at that time and um and i really listened to them and so i applied to social society programs and social work schools kind of followed what was going to be least expensive for me honestly so i went back to texas where i'm from i went to ut which which is was an incredible clinical experience and they have a really good clinical track there they also have a dual master's and jd program so i was in with some really high caliber students who are pursuing some really high educational aspirations and just every step of the way i was working with pretty profoundly affected subs uh people with mental health issues and almost all of them had substance use disorders and so i i pursued my msw and the only thing that i did out that was not consistent with substance use treatment was i got a job working at um at hospice so i'd actually done my my half of my second year internship at hospice and then they hired me i primarily worked with people who had aids and and this was early 90s and so at that point these people were dying which is why they're at hospice and most of what i did was working with their families to help the family come to some degree of acceptance often in the final hours that their son was homosexual and could they find some way to forgive forgive this and accept this and maybe even realize that this is this was god's work too and um find some way to to let him pass with some peace but everything else i did was pretty pretty related to substance use disorder during those those two years of my master's program well that's um that's kind of a heavy heavy job to work in hospice with aids patients who are dying and their families in i'm assuming were you in texas then yeah i was in austin and and these family i mean in the 90s that was still you know homosexuality is still their struggles around the stigma and all of that and and i'm not going to go in the whole lbgtq community and all of that but there's there's a lot of work we've done and a lot of work to be done tell me about the spiritual or religious environment in texas where you were working there to give a little bit of context yeah well you know texas is a conservative state and it remains conservative um i i grew up there and you know i grew up primarily i grew up interestingly catholic and i went to catholic schools but everybody else around me was southern baptist all of the rest of my family was southern baptist and so too were most of the people that i worked with in when i was working at hospice so i i had a sense because when i was with my grandparents and i was with my grandparents a lot i went to the church at a baptist church and so i would go mass two times a week and baptist church on the weekend so i felt like i had things really covered you know [Laughter] so i really understood and and had some compassion for where they were coming from and their beliefs and and in some cases how they how they had come to some rigidity about how their son should be living and at the time of and and and that's and i can really accept that and understand that and and validate that and work with them to come to to come to some degree of acceptance despite the rigidity of those of those beliefs to let their sun pass and and over and over again what i actually saw was that the sun wouldn't pass they just kind of hang on and i think the most dramatic case i was actually working with a with a family and a father worked for the boy scouts of america uh and just a really conservative thinker and and some of my most beloved people in my life are conservative thinkers so i'm not saying anything negative about that and he just was really struggling and and i and i realized that and and his son who i had known and worked with for several months at this point and and his son's uh lover uh partner at the time and i i i mean this was so profound but i just i just really realized and just felt that i needed to come from a place of where he would be coming from which is what would god what would god have me do and i and i said hey i know how my loved ones who are baptists would feel about this and i also know that they would want to minister they would want to minister to this person who maybe doesn't think or believe or live the same way you do ministry is still really important it's important to your son and he's clearly holding on for your forgiveness and acceptance and i was able to work with that dad i mean it was just so profound and lovely at the time and he went into his to his son and and the son was was unconscious at first and actually became lucid for a short period of time i mean it was really miraculous so again this is early in my career so i'm just saying this stuff works you know this therapy really has some healing potential to it and i and he and he uh became lucid and talked to his dad and his his sisters and brothers and his mom and they left to go get a body and he died he passed that was just such an amazing thing to see i still remember sitting they had a swing and i still remember sitting on that swing with his dad talking about talking about that yeah like it was yesterday ah well and and what a profound place to start your career in in hospice which is some of the most it is such a beautiful experience to watch somebody pass and to be there to support them and hold a space for them and my questions are going about five different directions but i'm curious how much how much work did you have to do to come to a place of peace yourself because here you've got this really strong baptist background catholic background did you have to shift your thinking some before you could help those families shift theirs well i was i would i hate to say utter a perpetual state of confusion but uh the people i i love the most were were typically in disagreement about what happens next and how you get to what happens next so you know i i don't know that i had some strong truth this is how it is but i i do say i had just such a wonderful advisor at ut his name is dr ron bennu i don't know if he's still with us and he just really loved what the work that i was doing over at project transitions which is where what they called the when people could no longer be cared for at the home they would have this beautiful home they could go to pass and he he introduced me to some writings and some studies that had come out of the naropa institute which is a buddhist institute and it was kind of my i had taken aikido so i knew a little bit about it but this was the first time to really practice mindfulness and how you're calm could be infectious and i remember reading this this uh article that had been published out of it called uh on the care of a dying patient and one of the things that they said is that we have a responsibility in that moment to be a placid lake for the people that are there emotionally struggling and and people are losing a loved one i'm sure most of people who are really listening to this would know it's a confused confusing emotional time in some ways you're so glad that this person's no longer suffering and you're super sad they're not with you and what i saw too is that some of the most healing moments and and the relationship were in those last few months or even hours and so that has to create this just an emotional attention and so i loved that he had given me that that feedback and and and really kind of set my my path towards learning about and improving my own mindfulness practice really started then very very cool story and i mean i think back on when i when i did my internship back at a halfway house right and how pivotal that was it changed the whole way i looked at the world because here i come from a fairly sheltered environment and had not ever seen or heard stories i mean you might hear them in the news these horrific stories but here's woman after woman after woman coming and sitting down and saying you know things like um you know i'm going to introduce you to my alter ego or my my you know uh my my ultra personality who's a four-year-old and her name is sodomy and i'm like what oh my heck and some of those kind of stories and so i'm listening here tell it you know you telling this and thinking this must have really started to um direct or uh you know lend to the the change that was happening for you as you were growing as a therapist it definitely did and i think there was a lot of convergence in those few years not only when i was in graduate school but in my post-grad training which i did with a with a just a wonderful clinician named carl nichols and i had learned this and i was learning psychodynamic practice i also was working at a place called austin family house which is for women and children and i was also working at a hospital psych hospital and it was it was those places that that really got me interested in borderline personality disorder because i had people on my caseload and i could not with all that i was learning about psychodynamic theory i was not getting the behavioral correction and then the other thing that happened was i just noticed that the people in on my teams were there was they were pretty pejorative often about people with substance use disorder they were really pejorative about people who had borderline personality disorder there was this community permission to make fun of them give up on them you know say pretty hurtful things to them or about them and i kind of got mad and i said i i i i know there is a better way to deal with this and and i had gone to the evolution of psychotherapy conference and seen marshall and hand speak and then i said oh my gosh there is something that we could do about this and so i just devoted my as much as possible um devoted from then until now which is probably 25 years from then until now to being better at working with those those people that have these chronic conditions like bpd and substance use disorder and psychotic disorders and and you often all three well and as you talk about that i i mean i've seen people that struggle with mental illness that seems to at times take over their life and they make decisions that they wouldn't normally make and they do things in a way that is not their culture it's not what they came from it's not what was modeled for them and you like why why are you hurting yourself like this why are you going out and putting yourself in dangerous way and feeling compelled to do that um and instead of you know throwing up your hands and going there's nothing i can do you went to look for answers to help them yeah yeah i was really like i said i kind of got mad about it you know just i don't really like that there was i think it's still there hopefully not as much i just didn't like how our field was treating that group of people particularly the people with bpd yeah it's it's tough so when you do dialectical behavioral treatment and it sounds like you focused a lot of your energy there that there is that that can translate into different places in your practice and different types of mental illness in very effective ways am i reading into that oh no there's there's a multitude of of disorders and populations that benefit from from dbt and it's being studied and adapted all around the world um marshall linehan's not as involved and and then and as it's being uh the there's her the marshall linehan adherent way and then people in in uh germany won't have ever met her you know they might have seen a video and so i think that there's been some freedom with with that south america there's you know most of the studies on dvd right now are outside of the united states so these are these are not necessarily disciples and what and what's wonderful about that is they're saying why can't we adapt to this population i think we can i think we can change the workbook for them in fact my team just had a wonderful training over the past couple weeks with somebody who wrote a book on using the skills the dbt skills for people with psychotic disorders like how do you what skills do you use for someone hearing voices what strategies are are there you cannot argue with them they're not hearing this book you cannot tell them that that's not real or true because it sure is for them so what adaptations can we do and and you know i just love the wonderful creativity that we're seeing especially now in adapting dbt to a variety of populations instead of just bpd and incidentally originally she wasn't even thinking of it for bpd she just she was thinking of it for people who had chronic who were chronically suicidal and self-harmed and and then it kind of as she was studying it people around her were saying this it sounds like somebody with bpd and of course we now know she had a history of chronic suicidality and self-harm and hospitalization uh it's interesting to hear where some of these thoughts ideas came from from her own history well it's so interesting that so often even like yourself who wants to go in and be a pulmonary medical doctor because you have asthma right she's like i gotta figure out how to heal myself and and then she put herself to work in finding solutions right finding things that work yeah they make some of the best the best teachers yeah and i you know i'm i'm not i i do not think i have bpd but i do remember when i was when i when i was younger and with my sickness it was real i was really aware of the pain that that caused in people around me you know the worry and the pain and i remember having these thoughts like i somehow need to protect those people from myself from me how do i do that and i remember one of my very first clients with bpd i was sitting across she was a exotic dancer and you know i i don't know that she was yet addicted but she was on her way with cocaine and she said to me i just caused so much pain i need to figure out how to protect people from myself and i thought well i can really understand that i can really understand that i do find it so interesting that you know we might look at ourselves and go our journey so much different than someone that deals with addiction or someone that deals with a serious mental illness but it's not the journey and the challenges they might be on a different place in the spectrum but those core beliefs of eminent enough and you know am i too much for people those are seem to be pretty similar and i see you shaking your head going yeah that's so true yeah i'm not good enough story yeah we all have that right i don't think anybody's immune it just shows up differently in our lives i tell that to my clients with bpd and when i'm training i always say my mind works just like yours it's just yours is on steroids yeah it's true story yeah i want to ask you a question you know i've been listening to some of daniel siegel's work and he's talking about attachment and attachment's been you know has brought some really great research and knowledge base to how we address people how do you i don't know compare is the word i'm going to use how do you compare that to dbt i don't think it compares but do you see one just having different applications or do they tie together oh my gosh no they're they're they are completely interwoven because if you think of one of the primary diagnostic criteria for borderline personality disorders it's frantic efforts to avoid real or imagined abandonment and how why how in the world does someone be become afraid to be abandoned it's because they have a really fuzzy attachment process and and and we know now we can kind of go back and look at their early childhood and part of the reason they have is that these really sensitive brains interacting to a more or less with a more or less invalidating environment and if you're really sensitive it can be a really good environment most of us would thrive but yet they are dealing with kind of attachment trauma all of the time i tell i tell the story if you think about a regular if you think about most of us who've had kids know that that that three-year-old is gonna dart away from us and run around the corner and we're gonna hear them giggling and laughing because they feel really secure they have object constancy they feel really secure that we're going to be coming back come around the corner and find them that's what makes it fun and thrilling but if you have somebody with with with who is has already started to experience attachment disruption and a lot and and um then they're going to run around the corner too and they're going to get over there and it's going to be thrilling for a minute and then that fear is going to come up this is three years old and then they're good and then what you're gonna do i'm afraid i don't know that he's gonna come for me and i'm gonna grab this gallon of glass gallon of milk and i'm gonna smash it on the ground then everybody comes and that behavior but now that this attachment fear this abandonment fear um that the the way to mitigate that is to do something sensational in your environment and that's how people would just start to develop bpd those behaviors that we associate with bpd so so much of it is about this attack this this this kind of yo-yo attachment style that they interacted with yeah that's powerful and it's a powerful insight to to see somebody who's putting themselves in really harmful situations but they are crying for attention it's really this i need to connect with somebody or i'm going to die and it doesn't matter if it's painful or hurtful or dangerous i still have to do it that's a tough one yeah and so how do behaviors have served the purpose at one point or another and i i have a client that just i did a telephone consultation on sunday who's still she's in her 20s and she's still dealing with oh my gosh this push pull so she was in a really horrific relationship and thank god she is out of it and now she's in a really good relationship and that scares her a lot more than that believe it or not in the horrific relationship that that was palatable to her for some reason but this one you know she she and her text was can you please call me i just want to run away i just he's such a wonderful man and i just want to run away and it's because she's accumulated all these she does have some big tea traumas but she also has he's accumulated all these kind of traumatic invalidations and so she's it's when she's there relating to him it's just it's just a complex set of emotions and thoughts for her and who wouldn't want to flee yeah well and she's he's accepting her and loving her and holding a space for her and it's not traumatic and it's not loud and and and negative and you know and so that's got to be uncomfortable when that's what you're used to and that's how you're used to connecting with people yeah yeah yeah i think i cut you off earlier i'm so i'm sorry about that oh no you're you're fine we'll just kind of kick back and forth here okay okay so so you've learned so much and and now you're at what tell me what's between new roads and and um some of the other programs that you did so you did um the so i was at saint francis uh down in new mexico and then i came for and then i when i moved here which was um 20 20 21 years ago now i moved here i worked for utah county division of substance abuse and um and then i ran odyssey house so i moved out of house and i was director of odyssey house and now i've been at new roads for 12 years and the gift the gift of new roads has been that i can i can really provide the services that i've wanted to provide my whole career my wife actually says i i didn't remember this but i did when she prompted me she said on the night that i met you i was asking kind of what your goals were what you wanted to do and and i said i want to start a program for people who for women who are suicidal and cut on themselves so i was pretty young to i think i was 25 at that time so it's been it's really been a passion of mine i'm curious how do you move from you know texas and new mexico to utah that's that's a pretty good jump oh yeah well um i i followed my wife to utah when we when we were married i we lived in new mexico and and there's some there's some wonderful things about northern new mexico and then there's some there's a reason breaking bad was based there it's a violent violent place and we had some murders very close to our home and um she said you know i really we just had a little baby she said i just would feel more comfortable raising them in a place that i know and i'm familiar with and we'd lost a friend of ours had been murdered he was a defense attorney he had been shot and killed literally on the courthouse steps and you know there have been some violent attempts towards me and so she just she said you know i just i don't want to do this anymore i'm going home and i hope you come with me she wasn't asking for permission she's like i'm out of here i'm not knowing this anymore the decision was made yeah that's fantastic she's from utah then yeah she grew up in cottonwood heights oh nice nice so you've been here for a long time yep 2000 moved here in 2001. so talk a little bit about new roads and what you're able to do there with these it isn't just women no we have a program for men too okay yeah yeah talk about what you do talk about your women's program and your men's program and and why because i i can hear your passion and what you do and why you're doing it talk about how you're able to change people's lives yeah uh well i the women's program is specializes in treating people who have bpd i think most of our clients if not all have bpd i think we do have a few clients that maybe have a more of a severe persistent mental illness right right now like schizophrenia the men's program is particularly set up particularly for people with spmi severe persistent mental illness and and really where most of our clients there are early in their disease and but they have not gotten to the point where they can navigate through the system to get into disability and then avail themselves of the of the state-funded programs so they're still on their parents insurance so those are the two populations that we work with which is ex is expensive i'm for one i mean because i have to have case managers full-time psychiatry specialized medical medical programming it's expensive but i i just i just love that we do it and i love that we're a solution i just had uh lunch with two wonderful people from pepe on and one of the things they said is we're just so glad you're there because there we get those clients pretty regularly and we we don't always know how how profound their illness is and then we get find out how it is and we know exactly where to go and uh and i really i really i'm glad to be able to provide to provide that to the community to do that requires just a lot of training required to work with that puppy both of those populations just require a lot of training i mean that's some of the hardest and most difficult mental illness to address because it's persistent it's it's like they carry it with them and even after they get a lot of healing it's not like it goes away they just have to learn to manage it and it becomes very difficult so so even somebody that's got some schizophrenic you know behaviors and patterns and symptoms that would seem you know some would say you know we really can't help them we can medicate them and hope they stay on their medication but i don't hear you saying that i hear you coming up with different solutions yeah yeah well one the medication is wonderful now compared to when i first started a long-acting injectable so i've that has really been life-saving for so many people there are there are other things too there's uh cbt for psychosis and um you know like the dbt adaptations for psychosis and just just to give you an example one of the things that there's a skill in dbt called fit the facts and one of the things that we have been taught to do is when a voice or there's a command hallucination we can say does that fit the facts and we're not saying that's wrong that's that's not there that's not accurate that's not true that voice isn't you know you're just hearing things we're just saying well the voice is trying to do that does that fit the facts i mean and here's my brain tells me to like an example that somebody gave me recently that i really loved is that they would wake up to thinking that they heard their phone other phone hadn't gone off so we all have this this these these propensity to have these i i hate to say hallucinations but that's really what they are we all do it to some extent or another and these people that people that have schizophrenia it's high it's just it's affects them in a lot and and far a far greater magnitude than it affects us we can still say i can still challenge my thoughts you know i have impulses too and they're not always appropriate to act on and they're maybe never appropriate to act on and same with your voices your voices are telling you to do something does that fit the facts is that is that's consistent with who you want to be or how you want to show up in this moment so we can use those same sort of skills with clients with schizophrenia and they can help them build a better and your voice is telling you not to brush your teeth have you ever been around somebody who doesn't brush their teeth i don't like it i don't like it either so even though voices tell you do that does that fit the facts is that consistent with how you want to be and most of them especially after they're medicated will really respond well to that just to give you an example well it does it happens to all of us irrational thinking and and those patterns they may not be to the same degree and the same severity but we do we all experience it we all have to go i'm not my thoughts you know my thoughts are there but that doesn't mean they belong to me or that they're right or they're wrong or whatever they're just thoughts and i have to choose what to do with them right and so we take away the power of of the thoughts that pop into our head when we can do that i love that i was talking to somebody the other day and we were talking about homelessness and i imagine that there's a certain percentage of the population you deal with that either has been homeless or has a propensity and this idea that you know and i'll tell you the story just briefly is that there was a couple of guys that in different situations that had gone through substance abuse treatment had done all of the work had gotten jobs gotten apartments and we're in the process of you know being contributing members of society and a year or year and a half later come back and go this is too much i can't take it i'm going back to the streets i don't want to do this and i imagine that's something that you run up against talk about that dynamic a little bit and how you address that and and how you think about that yeah yeah and and i can even even clients on my uh caseload um have i i i'm thinking of two or three in particular that would hit these sort of limits of kind of conducting themselves well in in polite society and then just kind of need to take off and um and sometimes to some pretty pretty uh extensively they would they would do this and i'm thinking of one client who even would would leave for periods of time and be on the streets of prostitute and um and then i get her back i in fact i remember i was talking to one of my dbt friends uh her name is linda dmf about this client because i've been in her life on and off for several years and i said linda one of i remember i was talking about another client a long time ago and i remember what you told me it's always messy so i just kind of there there's an old there's an old commercial remember i don't remember what what uh what hotel it was for but they'd say we'll leave the light on for you you know and i would just that's what i would say i'll leave the light on for you i'm here i'm here and yeah and how many does that answer your question yeah sort of i mean it's just a curiosity i don't know if it was a question as much as just what does that look like and what have you seen is are there are there people who really prefer to live on the streets and and not not live a conventional lifestyle and is and how do we think about that as you know white entitled people i i hear that there are people who prefer to live to live that way and be hobos i don't know them i mean most of the time that my clients are saying i'm done i'm heading back to the streets or at least for a little while it's because they're they're disregulated and distressed and they just don't feel like it's what they're doing is working and and and and then even if it is i think of this one gentleman even though it was working it just took so much energy and so just kind of constantly thinking about what skills i need to be using here and that he i'm done and then he'd go live by the river and then i'd see him again three or four months later so i guess that sucks too so you know so i haven't met the people that really want to what i mean is that people are distressed and just don't feel like they're functioning or they feel judged or they feel you know it's too much and that somehow the streets make sense the problem is is that you come back with new traumas almost always and that's the sad part about it and so what you're seeing is it's really more like you said a dysregulation they're up against something a trigger or whatever that is and it feels insurmountable for them and i'm going to go back to what's familiar which we all know that right we all do that um very interesting but you'll see them messy messy i like that word they'll come into treatment they'll go out of treatment they'll come into treatment and and then what's the long term do they finally get to a stable place where they can function what happens yeah most people do that's that's been my experience and i and i and i've really had to change my thinking from leaving treatment as to say well that's a treatment failure to say well this is part of the process i mean there's one person who many people will know so i'm definitely not going to use their name but i worked with them for almost 10 years before he finally could kind of um get into the life that he really wanted can kind of and then and stay clean and sober he's clean and silver four years now i think a little over four years but it took years to ten years and i and i think about that always when i start when i when i see someone's left and i think oh gosh a failure i'm like well no i just need to be not think of that as a failure but this is a step on their journey and and and in so doing and being that way i'm a lot safer to come back to and hopefully my team does that as well that's incredible and i mean it as a as a therapist or a counselor it can sometimes feel like a failure on your part right and that you've got to do some of your own work of you know we can't take ownership of people's choices and their free will that's part of the journey of they get to pick and then when they don't like what they pick they come back and have a safe place so i love the way you approach that and talk about that it's very neutral it's very non-shaming it's very well you made a choice and now maybe you want to make a different one let's see what we can do right yeah yeah and and sometimes i i mean we're always balancing that dialectic of of accepting that they did this and look and wishing that they'd done something different and also saying we did a really good job and maybe there were some things that i could have done better i mean i love when people have come back and said you know what last time we didn't do this and this let's try this let's try it a little different what do you think about that well and i love that you bring that up i was just thinking they have such incredible stories and so much to teach us um you know and everybody does i think everybody has this incredible story and and these people that struggle with schizophrenia or bpt or any serious mental illness they have something to teach us and when we can sit down and look at them as an authority or an expert on something there's a lot to be gained as well as what we can offer them yeah i i uh i call it the uh marshall linehan says this so i i she doesn't use the analogy but i call it the the pretty woman ending syndrome because he said she says how does the story end well he saves her and then what about her well she saves him right back it's the same with our clients we're we're changing them and they're changing they're changing us too yeah hopefully for the better hopefully yeah that's the goal right but it's messy it might get ugly before it gets better yeah almost always does oh that's incredible um so eric we could talk for hours and hours and these stories are i always love the stories right because these are real people living real lives doing the best that they can and we're just here to see if we can't help and support them and so i love the work that you do and i love what you bring to the table what's in the future for you and for new roads well yeah i get i get asked that question a lot and i don't know if i'm just i'm in my 50s and i'm emanating what's next you know um the truth is is that i i'm not sure you know one of the things i always tell my clients is don't don't make a change unless you're moving to something you know we want to get out of the habit of just fleeing and i you know i it's things are wonderful in many ways because i i'm i'm doing uh trainings all around the country now i just offered to to the folks over at uh papillon to teach them how to set up a a consultation team which i think which is just wonderful for for clinicians and for clinician retention and you you know so i'm helping the people at nero's and we're and we're helping the people outside of you know helping the community provide by providing um more attainable re financially attainable dbt treatment so a lot of my trainings are in the southeast and it's pretty common for someone to be in one of my training and say i haven't had training four years because my my organization can't afford it and then what will happen is somebody wonderful like tulane university will say i'll host you and they'll charge this person hey i'm gonna charge a hundred bucks for a training that would normally cost three thousand you know so um so it's been wonderful to to make this this magnificent treatment accessible to to others and so i think what i've really been devoting myself to is what's next in terms of training my team uh we've you know there's some some trauma therapies that i'd like them to learn i'm in a process right now of learning i'm in the university of pennsylvania prolonged exposure therapy train the trainer so you can so i'll be certified probably next month or two and then and then the next step is to become a certified trainer which which is takes a little more time and so it'd be nice to be able to have all my team uh because that's it really is one of the best maybe the best treatment for big t traumas that are just hooked in and holding on you know as soon as pe that's what the data is kind of telling us and i have about seven of my therapists who have blessed their hearts have have devoted themselves to becoming dbt certified clinicians so right now i'm one of four in the state of utah and there's so there's not that many of us and and it'll be a wonderfully proud moment kind of dad moment i don't i hope that doesn't come across as narcissistic dad moment if i have six or seven people that work for me most of the dvt certified people in the state will be at new roads i mean i will be very very proud of them at that point so those are kind of things we're working on we're looking at maybe a couple other programs maybe a small program for people who maybe just for because of their wealth and their status aren't fit won't fit in quite as well at the at our residential center which is no frills in fact i got i actually have somebody that texted that i was talking to last night wanting to come in and they're and i know who they are we all know who they are and i just said i want you to really vet us because we are not fancy i would love to have you but we are not fancy so yeah you'll get great dbt but you're not going to have a chauffeur you know so that's got to be hard to ask somebody to change their lifestyle to come and get treatment right and so yeah and maybe we we change the lifestyle environment for them yeah yeah i'm thinking i'm thinking about that um i i have a dear friend i don't think i'm gonna breach confidentiality because i don't think there's any way anybody would know who this is but i have a dear friend who is robert downey jr sponsor and i've not met rob robert downey jr but my friend tells me that one of the things that was a breakthrough for him is when he was disallowed to go to a fancy program when the judge said no you're going to uh walden house that's where you're going and and he said it was really what he needed is and so sometimes i think maybe i'm on the wrong path and let's help him have him adapt to to some you know so i don't know i'm batting it around that's one of the things i'm thinking of doing that's incredible and i'm i appreciate your thoughts around the trauma therapy approach because there's a lot of a lot of them competing for you know we're the best and this is you know the emdr kind of changed the environment for a long time and then there's a ct and there's cbt you know tpp and db and there's all sorts of different trauma approaches but what you're seeing is the extended exposure is showing as one of the most effective for those so for ptsd and for traumas that just are not so i'm not saying this this is what the this is what the the studies are showing so if you've got if you have a if you have ptsd so you've been traumatized enough that you've actually developed full ptsd so we have traumatic invalidations which people nicknamed small t traumas and we have these big t traumas and we've now developed ptsd so the the data is really clear that if you have a stubborn trauma it's just not responding to mdr um that pe is indicated at that point and i think part of it is just you spend soul and pe you're spending there's not a lot of processing you're doing imaginable exposure over and over and over again around that same trauma and doing in vivo in life exposure as well so i think i think that part of the reason is you just you habituate because you're spending so much time on this one trauma instead of kind of processing through a series of events i i am not putting emdr down i think it's wonderful we use it but those stubborn ones seems like pe is what what you need and and the truth is my goal is so my my staff's already trained in dbtpe i just want to be a trainer so they're also trained in four different trauma therapies so this way we can kind of have enough informs um collaborative discussion with our clients which ones we think might i'm training them all so which one do you think would really be beneficial for you that's powerful because those are their tools they're just tools to help people process what's going on in their system right um do you so i'm curious with extended exposure with pt pt is it um are you that window of tolerance are you working to help them have tolerance for it or you're just exposing i mean i'm sure it's not simple yeah yeah well and so in dbt we we always one of the reasons that that's always in stage two as we want them to be able to regulate well enough to get through exposure whatever exposure we're gonna do and um and so uh the pe that that edna foam created out of she's the university of pennsylvania she actually created it in israel but it's the most well studied at this point and um the the being exposed we want to make sure that our clients are skilled enough to make it through so so um we we have to and neuros be particularly careful because these are people who are already um emotional like emotionally sensitive people so we want to make sure that they've had 90 days without self-harm that they've maybe had a year without drinking or using you know we will have some things that we'll want to make sure that we have in place before we begin exposure so because then we're going to say you know let's talk over and over and over again for 40 minutes about the worst thing that's ever happened to you and they want to do it again next week you know so thank you so much that's what i want something i've been avoiding for my entire life and you want to talk about it over and over and over yeah it really works yeah and i don't know i don't want to bore everybody this is super exciting stuff for me and so i could pick your brain for a long time um and i appreciate you sharing your wisdom and being so again passionate to help this these people that can't they just not in a position to help themselves they need someone that really understands what's going on and how to help them so i appreciate the work you're doing oh thank you and i imagine that uh there's gonna be people that listen to this and and really get just how informed you are and how much you understand and are able to help people they're going to want to get a hold of you what's the best way for them to do that um i think the best way would be just to send me an email it's eric eric nrbh.com i try to be really accessible to people yeah that's awesome i love that and and i find that you know some people will give you their email address or some people give you their phone number and you know when somebody's giving you something where you can contact them directly they're pretty serious about helping people so oh thank you eric thanks so much i sure appreciate your time sure thing well thank you for having me it's been an honor