Patrick: Welcome to the Spiritual River Podcast Episode Number 3. Todayís guest is Jacques de Broekert. Jacques is the program director at the Natural Horizons Wellness Center and he also runs a private practice treating everything from drug addiction to eating disorders to phobias. And heís also a personal trainer as well. So Jacques letís dive right in here and Iíll ask you the first question. Can you just tell us a little bit about your approach to addiction and how you try to help struggling alcoholics and drug addicts, what your techniques are, how they might be different from traditional stuff like Alcoholics Anonymous?
Jacques: Well, thanks for having me. I guess the first thing that I would say in response to that is that addiction have a lot of different forms. We have everything from substance to behavior addiction and whether itís food or drugs, gambling, whatever, theyíre all very different in how they kind of manifest themselves but the main reason that they occur, I find, is predominantly because of trauma. Most addicts I deal with when they talk about their addiction and you go through their history, thereís trauma. Some form of trauma. There are five forms of trauma and itís physical abuse, sexual abuse, emotional abuse, verbal abuse, and abandonment. And one of those has been a factor in their life when they were a child, most likely. And that changed the way that they kind of process emotion. So the approach that I have has changed over the years. Initially, when I started this work back 12-13 years ago was to use the model of cognitive behavior therapy as an approach in individual therapy sessions that I would conduct. In groups, as well, you kind of try to orient towards that cognitive behavioral component. From that, there was also a behavior therapy that kind of sprung from that, which is a variation of cognitive behavioral therapy. However, over the years, as a practitioner, what I have found is because of that trauma experience, as a therapist Ė the individual Ė emotionally connective therapy really is way more effective. They have a hard time understanding their emotions. They have a hard time dealing with their emotions. And as a practitioner, what I try to do is connect in with that emotion. And being present and being emotionally connected to the client, itís a lot harder for the therapist. Itís very taxing on them. You tend to take on a lot of that emotional experience that they have experienced in their lives but at the same time, they feel very isolated in that experience. So my approach is now shifted to the emotionally connective psychodynamic type approach. Weíre not trying to find a solution. Weíre not trying to have the person become more aware of their behaviors and their thoughts. Itís really guiding into that trauma. And so my approach now has included things like EMDR, prolonged exposure therapy, the emotionally connective thing to really link with them. And I think that it really doesnít make any difference if itís drugs, alcohol, food, or behavior. Thatís an important component so my techniques and my style have evolved over time and I think the research kind of shows that thereís a more positive outcome through that. On the other side Ė Iím sorry, go ahead.
Patrick: I was just going to say that itís interesting that you mentioned this emotional component because when I was in long term treatment myself for alcoholism and drug addiction, the therapist Ė I was living in a long term treatment center with 11 other guys and the therapist was pushing us to sort of Ė she has had this emotional component and she wanted us to get down to the root of our feelings. Not our opinions, not our surface level opinions, but the real feelings underneath, and it was so hard for 12 guys to do this, to really open up and connect with those feelings. But it was amazing that we didnít see how it was going to help us. We didnít see how itís going to help us not pick up a drink. But really, in the end, thatís where all this huge growth came for these 12 men that I was part of, is being able to look at our feelings and understand them and process them and talk about them without covering it up with anger and lashing out at people and so on. So thatís interesting that it kind of where your work led you.
Jacques: What youíve just said is a key part of the issue too is the gender issue. Men are a challenge to treat because theyíre so Ė theyíre taught from birth to stop crying, suck it up, that kind of mentality, what youíre describing. So itís very difficult for men to feel anything other than happy or angry. Those are the two emotions weíre allowed socially and so it is hard and we tend to be kind of linear thinkers to feel that, well, whatís the problem? Letís find the solution and move on and get to the next problem and emotions are difficult for us. I can see how that would be wrong with 12 men talking about their emotions. Thatís a tough one. Thatís the case with all addictions across the board, whether its Ė I have some clients who were males who have issues with eating and are either bulimic or compulsive eaters. And that is the problem. Itís the emotional component to the addiction. And because of that, the treatment that we do, like for example at Natural Horizons, we focus on the idea of multi-faceted treatment. We now know, and the literature is showing this, that the AA model of sit in a group, do your groups, and then maybe go to individual counseling, and abstain, doesnít work. My thinking is that, nobody gets sober in AA. AA maintains sobriety and can support it but youíre not going to get sober in AA. So going to a meeting once or twice a week, youíre not going to get sober. You may be able to abstain for periods of time but youíre not going to get sober. What we do know that works are the other things that are acupuncture, massage, exercise, medication, art therapy, all the ancillary stuff thatís outside group worked. Thatís what actually works, when you integrate that into the process. So youíre saying a lot of trends and residential programs, for example, were those who are included. And itís very effective, getting the connection between the body and the mind, and the body and the spirit. And that worked thatís kind in that way. Itís way more effective than just groups and individuals and a certain way for the next group.
Patrick: Right. That kind of goes into the next question here that I wanted to ask you about as far as the ancillary stuff that you worked with a number of different clients and I know you got a good idea of what strategies worked best. And I realize that individual needs are going to differ but what do you see is being more powerful for recovery overall? Physical exercise, faith-based programs, what are those ancillary things kind of makes the biggest difference for you and do you think that people, sometimes, theyíre hurting themselves because theyíre not using one of those strategies or that theyíre not open to it and itís hurting their chances at recovery?
Jacques: It does hurt their chances tremendously. Anybody who has struggled with addiction, theyíre disconnected from, kind of, reality, in a way. Letís talk about exercise first. Thereís a guy who has written a book a number of years ago called the Polly Vagle† TheoryĒ. Steven Torte, he is a medical doctor. And his idea is that the limbic system and the torsal nervous system kind of functions as a separate part of the nervous system but it actually has the ability to process emotion. Even though itís just your heart, your lungs, and your skin, and your muscles, that kind of thing, as opposed to your brain. And that we do respond, and the vaguest nerve, as an example, there is a response that happens through emotion, whether itís fear, anger, excitation, in some way, the vaguest nerve reacts. And then our body reacts and then our minds starts reacting as a secondary thing. When youíre startled by a loud noise your vaguest nerve gets activated immediately and your brain hasnít had time even to think about what that noise is yet. And so the vaguest nerve is ahead of that. And that there is a connection between the body and the mind, the body and Ė not the brain, but the mind, because thereís a difference between the brain and the mind. The brain is that grey matter, the mind is the thinking part. And so thereís a connection between the body and the mind. When we feel anxious, we feel depressed. We feel angry, you have cortisol, you have adrenaline that starts pumping, our body is reacting to it. And so a lot of time people just donít pay attention to that. They donít realize there is that connection. So physical exercise. Physical exercise helps because it enables the body to function. We get some hormone releases that go on and that can also, when weíre having that point of excitation, we can get that flush of adrenaline cortisol out of our body through exercise. Chronic tension. Chronic anxiety. Itís a real, real trigger for addicts. Itís an uneasy feeling. They donít like it and they medicate it. So you can use things that are positive ways to medicate that they perhaps have not engaged in, like exercise. And it helps release stress, combats depression. Itís very effective for them, if not the most effective thing. And so the negative emotional part of our life can be effectively treated through exercise. And thereís a lot of data out there now, research showing that. Thatís an important part. When we treat addicts, in my private practice, as a personal trainer again, I canít help but go there.† But also in Horizons, that is a component, a requirement. You have to exercise, where you go to a personal trainer, you go to a gym, or whatever. Faith-based. Your faith. What do you believe? What can guide you? The 12-step process is based on that. But you have to believe that thereís something thatís stronger than you are at your point of weakness. I am an addict, step 1. I need to rely on a higher power to bring me back to sanity, thatís the next step. So your faith is what you believe. And again thatís an emotional thing. So again weíre back to that same emotional connectivity thing. Do you believe that you can get better? Do you believe that thereís something that can help you? And the faith-based component, no matter what your religion can be very effective in your treatment. And thereís certainly a lot of Christian programs available for everything from eating to heroin. And I do have a broad span of religious faith scene in my private practice from Muslims to Jews to Christians to atheists. Iíve got some Seiks, itís a pretty broad range. For addiction, if you can turn toward your faith, it allows you to have that understanding of a higher power. I must find something that can help me because Iím weak. Iím weak right now and I need something that I can rely on. So thatís an important thing and I think that when people tend to ignore that, when they ignore their faith or they ignore the concept of a higher power, it can be a bit of a challenge working with them. That can undermine their efforts. So again, recovery is a multi-faceted thing. Itís not a single Ė thereís not single thing you do for recovery.
Patrick: Right. Well, I think itís interesting that your Ė Natural Horizons Center, that you require that they exercise because when I got sober for about the first two years I basically ignored that piece,† and I didnít Ė Nobody could convince it was important because I was basically doing the AA path and finding the spiritual path and focusing on faith-based recovery and I didnít see how physical exercise could be relevant. I didnít see how it could help me and people told me, oh yeah, it will make you feel better. It will help with depression and I kind of said, yeah, yeah, but I didnít really believe it, I guess. I didnít act on that advice until about until two years and something just clicked and I started exercising everyday and it just made a huge difference and it was just like this light bulb went on and it was like, oh my gosh, how could I have missed out on this. It helps so much and itís so hard to describe to other people the benefit that theyíre going to get from physical exercise. I think thatís really Ė itís a tough salve.
Jacques: Well, when I was doing my clinical rotations through psych hospitals, psych clinics, if somebody was chronically depressed you can medicate them but we would get them up and just have them walk up and down the hall one time and you could see them almost like a wilted plant just come to life just walking, just as basic as that. You can imagine if you just integrated daily exercise for 30 minutes even or four times a week. The change is amazing in your outlook. Our body is provided with joints to move so we should use them.
Patrick: Yeah, yeah. Absolutely. Okay, moving on, when someone has multiple problems, how do you start finding the strategy for helping that person? Say they have an addiction, an eating disorder, and some severe emotional issues. Where do you start in a case like that? How do you get started?
Jacques: Well let me just Ė Itís an interesting question because I have yet to meet an addict who doesnít have multiple problems. Not just the drama that they create because of their addiction because thatís what addicts do. They create drama and thereís a lot of drama in their lives but there is actually a connection with those multiple issues and the comorbidity rate with addiction itís just, itís absolute. I mean itís just absolute. But the littlest things, they fall down and into their knee and three months later theyíre on disability and theyíre not working and theyíve got Ė itís like it just snowballs. Whereas the average person, who wasnít an addict, they fell down, hurt their knee, they go to a doctor there but they walk around with the crutches for a few weeks maybe, and then theyíre fine. But the addict brain draws them into that drama and draws them into that Ė So I donít know, is that the lack of the ability to cope? Or is that part of the way they function? Or both. Are they depressed? Yeah, theyíre probably depressed. Theyíre most likely always anxious. They have chronic anxiety, most likely. Are there other things? My thinking is, the drink Ė letís say alcohol. The drinking is not the problem. The problem is the problem. So letís work on the problem. And the problem is, you have mild depression and you have a history of Ė thereís a disease that you had when you were younger. You had, I donít know, asthma or something. Well, thatís a factor. So multiple problems, are they diagnosable? Yeah, most likely. So thatís the thing I look for is whatís the problem? Okay, youíre presenting youíre a heroin addict. Okay, I get it. So tell me about your back injury that you suffered in that car accident 10 years ago or 20 years ago. Or you were in the hospital when you were a child for six months because you had suffered a severe fall and you broke your hip. Tell me about that. Tell me about the problems you have with that. Because thatís really Ė thereís the real treatment. Addictionís not the problem. The problem is the problem.
Patrick: Hmm, interesting. Okay. So how do you see your work evolving and where do you think things are headed in the next 5 to 10 years when it comes to helping people? And do you think medication will play a role in that in the future?
Jacques: I think we are at a change point because we had a couple of things that had occurred over the last 12-13-14 years that have really significantly changed addiction treatment, on both sides of usage as well as treatment. To give you an idea, on the usage side, weíve had the introduction of homemade drugs, drugs cooked up in labs at colleges or in peopleís homes, synthetic drugs. Weíve people in there seeking out ways to get high, have latched on to the things that I grew up in the 60ís we wouldnít applaud of. Bath salts, marigold seeds. Weíve got all kinds of synthetic marijuana out now. And so people are using drugs that didnít exist and the biggest culprit† of all, unfortunately, comes from my side of the fence, on the clinical side, with doctors who are overprescribing the opioid pain medications. Now itís a thing that they were never meant to treat. The strong opioid drugs were meant to be applied and used with people who were suffering from cancer as a way to medicate the pain. Well, now weíre doling it out for everything from my stomach ache† to, hey, I have a soft tissue neck injury here, can you give me some hydrocodone? And it really only takes about 30 days of usage of the opioid use† before you really are not really high risk for addiction. Hyperalopecia kicks in, your pain receptors are kind of on overload and now youíre hypersensitive to the pain so you need to increase that dosage and before you know it, 60 days later, youíve got somebody whoís on 60-80 milligrams of hydrocodone everyday. Like 500 milligrams of hydrocodone. And itís just insanity. So educating physicians on proper usage of pain medications and I think youíre saying a legislation coming down now whether starting to pay attention to that. But use of drugs that didnít exist creates a situation for us as clinicians where we have to figure out how to treat that. How do we even know what it is? So then on the other side you have the issue of treating and how do we treat? The exciting thing thatís happening is weíre actually starting to look at the research on whatís effective and what isnít. So everything form neural feedback, EMDR, hypnotherapy, transcranial TMS for magnetic stimulus in the brain. Thereís so many exciting things that are out there that are not necessarily drug treatments but are the ancillary clinical treatments that are so– So weíre really making some strides. Unfortunately, weíre trying to keep pace change in the community with the drug usage and we have legislative change like, for example, the legalization of marijuana. People that treat addiction are just, a lot of them is just completely outraged that thereís no understanding of what that causes. Well, itís not a big deal kind of thinking but with things like marijuana — Itís an exciting time to be involved in addiction treatment. I think thereís a lot of new techniques and things coming out and unfortunately thereís a lot of new drugs making their appearance in the world. The old days of heroin, uppers, downers, alcohol, and that was it. Those were long gone, unfortunately.
Patrick: Okay, great. Can you give us an example of an amazing transformation that you witnessed with one of your clients and all this how theyíve been more than won by just something that you found to be really special and kind of what role your therapy played in that transformation?
Jacques: Well, Iím a little bit of a different type of practitioner. I donít really Ė I do things a little differently. When Iím treating somebody I donít see them Ė I donít have a Ė because weíre not a residential program and weíre not government run. We donít have a treatment protocol that follows the ďnormal treatmentĒ of groups therapy and give a couple of ancillary things, something like antabuse or suboxone as the primary treatment. So what I do is being the emotionally connected therapist. I strive for that. And so I start to live with that person emotionally. And so the transformation — part of the most amazing transformation I saw was I had a client who would come to me and had severe alcohol addiction. A younger person, in their 20s, and they went through a couple of different treatment, residential treatment programs, and failed at them miserably, and was just out using and had given — had forfeited their life. They were no longer working and had lost basically everything that theyíd normally would be involved in their life. It was interesting because the client had not experienced any kind of a connection emotionally with the therapist or anybody else in treatment. They were just going through the standard residential protocol and when I started working with that client I would ask questions about their lives. I would try to found out, what are you feeling? Whatís going on? Your relationships. What do you think about these things? Slowly, over time, it caught, and this client started to connect in with their own emotions. And itís frightening to do that. I was working with them multiple times a week, individually, for a good while, and we would explore emotions. We would explore feelings and weíd sit and laugh and weíd sit and cry and it was just Ė itís a painful, horrible process to go through but thatís life. The idea of hiding from the emotional content of life for this client was very difficult. Within a matter of three or four months, the drinking had started to subside. They were drinking the entire time and thatís part of outpatient treatment but the drinking had stopped and this client started to abstain and then started to engage. I had them going to all kinds of exercise classes and I had them bring in proof that theyíve done it. And you see this person just completely come to life through this emotional process and in understanding thatís how to deal with the things that were the traumatic things in their life. And so a year later, we were done. This client had been engaged, had gone from abstinence to sobriety and were starting to understand sobriety and starting to understand how to — had enough time. And that treatment model was focused on the first 36 to 90 days and somehow youíre sober after that doesnít really Ė itís not true. Addiction recovery and sobriety happened in the last two months of the year, after month 11 and 12 and sometimes 13. Thatís when sobriety starts to kick in and what I saw with this client was just truly amazing that the emotional part of their life had started to heal through this constant focus on emotional connectivity and complete recovery. Itís been a couple of years now that theyíve got their lives back. They got their work and are happy. I think this personís even possibly involved in a relationship. I havenít seen this client for quite some time. Complete change from where they were. And thatís the reward for us, is that complete change.
Patrick: Right. Thatís great. So based on that, what is your advice to someone who was struggling with addiction or other serious life problems right now? Whatís the next step they can take in order to get help and what would your advice be to a person whoís struggling?
Jacques: Itís really difficult. If somebody actually is motivated enough and perhaps are listening to this, if theyíre motivated enough to take any steps, if they have an inkling that they want some help, you got to find the right kind of help. And I think one of the best things that you can do is, and I know this kind of goes against what Iíve said previously on its face but Ė just go to a meeting. Go to a meeting. Go to an AA meeting. Go to an NA meeting. Just sit there. And do it three or four or five times and just sit there. You donít have to say anything but just sit there. And the first few times youíre going to go, youíre going to realize Iím not of these people. Theyíre addicts, Iím not an addict. This is not Ė their stories are horrible. Thatís not me.
Jacques: And then on the third or fourth visit, youíre going to realize, wow, that is me. That guy just told my story. Itís the idea that youíre an addict. Thatís the thing that people chase against that idea, that theyíre an addict. They donít want to admit that. They donít want to think that. Iím not urinating on myself, living in a shopping cart, out of a shopping cart, thatís not me. But addiction has many faces. And then the other thing is that the driver for a lot of that push away from the idea what addiction is about, that Iím not an addict, is the big A, and thatís arrogance. Arrogance drives a lot of the addictís idea. That drives a lot of their behavior, particularly the men. Arrogance is the big shield and they donít like that idea that theyíre arrogant but you have something youíre struggling with. Itís a disease of the brain, of the mind, and arrogance is going to tell you that you donít have Ė I donít have an addiction. Itís the disease that says you donít have a disease. For me, as a clinician, find somebody you can connect with, that you can bond with, that you trust. Go find somebody. If you can go find somebody that can help you and kind of guide you through the process that you trust, a ďhigher powerĒ for you that you can lean on. Whether itís somebody whoís in recovery or a counselor, somebody. And if you donít find it the first time, go back, find somebody else. Keep trying but donít give up. But itís that idea of, oh man, Iím an addict. Thatís a hard one to get over.
Patrick: So the flipside to that question is, letís say thereís somebody whoís already in recovery and theyíve already taken those steps and theyíve gotten their life back, so to speak but they feel like theyíve kind of lost their way and theyíre becoming complacent. What would your advice be to someone in that situation?
Jacques: Well, when you think complacent, what are we talking about? Are we talking about theyíve had an accident and theyíve caught themselves using a couple of times or they Ė
Patrick: Well, no, they havenít necessarily relapsed yet but theyíre kind of headed in that direction. Theyíre no longer engaging. Theyíre no longer doing the things that they were doing when they turned their life around. Theyíve kind of slipped into a comfortable pattern and maybe theyíre no longer going to counseling or therapy. Maybe theyíre no longer going to meetings. So they havenít picked up yet. They havenít taken a drink yet or they havenít relapsed to whatever their problem may be but theyíre headed in that direction and they kind of slowly realized that they donít know how to pull themselves out of that, that funk, so to speak.
Jacques: Sure. Well, letís use two examples. One, with food. Letís take food. You canít stop eating. Itís the only drug that you canít stop dealing. Everything else you can abstain from and not die. Food, you canít. So youíre constantly using a potential triggering element. Thereís something. Now we have drugs of choice within food well, maybe, chocolate chips or something that are those drugs of choice. So you stay away from those and eat healthy foods that donít trigger you, youíre fine. But what are the things that people who have Ė because that eating is an issue, itís an ongoing issue, is thereís always a risk that they could end up being exposed because they go to somebodyís house and thereís their drug of choice on a table in there and everybodyís having some but I canít and combine that with, actually, Iím really depressed right now. Iím feeling really anxious. I want that piece of pie or whatever it is. So when that happens, you have to go back to what works for you and this also applies to other drugs and alcohol, whatever. What is it that works for you? How did you get sober? What did you use? What process did you use? Who did you talk to? Go back to that person. Go back to that process. And for me, my doorís always open with clients and I have clients who I have worked with for 10-12-13 years. I wonít hear from them for five years and then suddenly they call me. I think Iím having some issues. I say, come on in. When can you get here? Can you get here in the next hour, the next day? How much at risk you are right now? Come on in. Donít be afraid to go back to the basics, what worked. And Iím not a firm believer of ďonce an addict always an addictĒ. I think that there are some people that can overcome their addiction. Theyíre no longer even at risk but there are a lot of people, I donít say majority of people, theyíre always at risk. And so go back to what worked and seek it out. Find out Ė if you had a counselor that youíve worked with for a year or two or three, or whatever. I havenít seen them for a while. Pick up the phone. See if you can find them. And if not that person then find somebody thatís like that person and then maybe re-engage in that process of what keeps you sober. Rework your sobriety, so to speak. For drugs and alcohol, itís a little bit different because youíre not exposed to it all the time. You donít have to use it, unlike food. But again itís about getting back to the process, what worked for you. And letís start doing it again. Go back to it. Itís not your Ė itís not a failing that youíre feeling bad. Itís not a failing that youíre starting to have some urges, starting to think about it. See more often the guy who just died from heroin overdose. That was the issue. I mean, he was perhaps re-engaging in some kind of drug that was prescribed for him and he started to have some at risk thoughts and he didnít seek out help. So that happens. But when you have that, go back to the process that worked for you. Thatís your grounding. Thatís where it starts.
Patrick: Okay, back to the basics. Thatís powerful advice. So I want to thank you, Jacques for doing this interview and sharing your experience and wisdom with us. It was really helpful. Letís let people know where they can find you. Youíre at wellspringmindbody.com and also at nhwellnesscenters.com. Thatís the New Horizons, is it?
Jacques: Natural Horizons Wellness Centers.
Patrick: Natural Horizons Wellness Centers, okay, nhwellnesscenters.com.
Patrick: So, itís where they can find you?
Jacques: Yeah, and when they go to the Natural Horizons website, we have a whole section on addiction and our treatment program. And we do a variety of different services. We are moving towards doing suboxone treatment with a titration plan in that protocol. Weíre trying not make it just a maintenance program because I donít know that thatís really helpful. But then we also treat Ė we have a variety of things that we offer there, weíre multispecialty. So it runs a gamut from acupuncture, massage, chiropractic care, IV, nutritional infusion, suboxone treatment. So itís a pretty broad spectrum. Itís a great treatment protocol that weíve got and I think itís very effective. And then in my private practice that, again itís just a private practice, I donít have access to that level of treatment but Ė So either one of those and you can just contact and get all the information you need from the websites and contact us through the websites or we have Ė we also do phone counsels for quick consultancy to help you figure out what programs would work for you and if ours is one of those.
Patrick: Great. Excellent. Alright, well, thank you again, Jacques. This has been really helpful and I appreciate you taking the time to share with us today so thank you for that.
Jacques: Yeah, thanks for having me. I really appreciate it.