The Brain Behind Addiction: Inside A Transformational Care Model-Where Hope Meets Science with Dr. Amber Deckard, Psy.D.

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Welcome to the Let's Talk Brain
Health podcast, a public health

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educational initiative of the
virtual Brain Health Center.

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I'm your host, Doctor Crystal
Color, and I'm so glad you're

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here.
On this podcast, I sit down with

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incredible guests to explore all
things brain health and

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Wellness.
Together, we'll talk about how

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to care for your total brain
health, mind, body, and spirit

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while sharing the latest brain
Health Science practical tips

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and strategies you can use
everyday.

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By prioritizing your brain
health, you're taking an

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important step towards living a
happier, healthier life.

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So let's dive in and welcome
today's guest.

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Today we're talking about
addiction through a new lens,

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the brain First approach.
My guest, Doctor Amber Deckard,

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leads Karen's Neuropsychological
Services and its cutting edge

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Neurocognitive assessment
program, bringing over a decade

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of hands on neuropsychology
experience to the evaluation and

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treatment of cognitive,
psychological and substance use

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disorders. the US Marine Corps
veteran turned leader, Doctor

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Deckard combines military honed
experience discipline with

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clinical insight to guide a
multidisciplinary team focused

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on evidence based
neurorestorative care.

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Her expertise includes the
assessment of brain injuries,

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pharmacology, chronic pain,
dementia, ADHD and Co occurring

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psychiatric conditions.
Before joining Karen, Dr.

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Deckard founded a concierge
neuropsychology practice and

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served as director of Training
and clinical supervisor across

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multiple memory and Wellness
centers.

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She holds a Doctor of Clinical
Psychology with a specialization

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in neuropsychology from Nova
Southeastern University, where

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she now serves as an adjunct
professor.

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Her leadership is rooted in
clear communication, rigorous

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standards, and a belief that
resilience and collaboration.

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Dr. Meaningful Recovery.
Doctor Deckard, welcome to

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today's podcast.
Is there anything else about

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your background that you'd like
to share with our audience

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today?
Thank you for having me.

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I would say maybe just to add
what drew me to neuropsychology

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was the power of the connection
between brain, behavior and

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emotional health.
During my time working with

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patients who struggled with an
array of concerns from trauma

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and addiction, I started seeing
a pattern where people weren't

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failing treatment.
Their brains needed healing

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first.
When that clicked, everything

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changed for me.
I'm so grateful you shared that

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because one of the things I
think is so important on this

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podcast is it's not only our
expertise that our guests bring,

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but it's the part that their
brains in their hearts seem to

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bring them into the spaces in
the communities that they serve.

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So I'm grateful that you've
shared that for us today,

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especially if we're going to
drive into the topic of

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addiction as a brain based
disorder.

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And I thought one of the best
ways to really start this

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conversation is just to combat
one of the most common myths

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surrounding this space that I
hear people have always come to

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our virtual brain Health Center
about as they're trying to

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better understand addiction very
broadly of any type.

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It can be from dopamine
addiction to substance use to

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why we're still relying on
caffeine in the mornings.

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This whole idea that it's just a
lack of willpower or people are

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lazy.
What does the latest brain

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science actually tell us about
addiction as a brain based

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disorder?
Yes I agree.

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So addiction is a brain based
disorder and it's not a moral

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failing.
Substances physically change the

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brain and whatever that
substance is as you mentioned

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dopamine addiction or gambling
and addiction to gaming,

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addiction to any type of
substance from alcohol to

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fentanyl.
It does physically change the

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brain, especially in the areas
that are responsible for reward

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and motivation and memory and
decision making and

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self-control.
Think of those as the primary

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networks.
The primary I call the CEO,

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right, the executor of the
brain.

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Those substances change that
that part of the brain.

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And then to me it's really
important to say how do we

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expect somebody to engage in
life or remember something or

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engage meaningfully in
treatment.

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So we expect them to attend
groups or individual sessions

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and learn the information and
encode it and consolidate it.

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And then how do we expect them
to retain it and recall it and

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apply it if their brain is not
functioning properly?

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So we know that the brain is
changing.

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We know that there are
significant impacts, but yet in

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many arenas, we continue to
think that this is primarily a

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moral failing, that it's a
choice, that it's lack of

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intelligence.
And what we really want to

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change this to is this is about
how the brain regulates impulse

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control, makes decisions and how
it thinks.

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So it is the primary organ to
focus on is the brain.

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Treat it and then we can treat
the substance use disorder, the

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mental health disorder and the
whole person.

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It's a shift in a conversation
for a lot of us to think about

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that, not just the person that
may be coming in with the

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concern, but for those in their
immediate support network.

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How do you think that
conversation changes or shifts

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when families start to
understand addiction through

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that ledge?
Does that start to shift the

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change in the recovery journey
for everyone involved?

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Yes, I think that the shift in
the recovery journey is

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significant for the family
system and the relationships.

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We know that substance use
impacts marital partner

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relationships, parent child
relationships, sibling

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relationships, social
relationships, workplace

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relationships.
So allowing these individuals

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and more than just saying this
is a shift in the understanding

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of it being a brain based
disorder.

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But when we talk about treating
a whole person, saying we're

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able to work with the family
system, we're not just doing

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individual or group therapy,
right?

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But focusing on the family
system and their network of

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relationships allow them to also
tell their side of the story and

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work through their experiences
and bring them back together.

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But also understanding that how
maybe they view their family

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member of maybe they stole from
them, maybe they were extremely

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hurt, maybe there's generational
trauma, whatever that is saying,

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how do we heal the family system
and help them also understand

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that we want to treat the brain
that this is not something that

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they are making a choice to
purposefully hurt their family

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member.
Even though in the moment it may

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seem like that, it may feel like
it, it may look like it, but

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helping them all come to the
realization that there is an

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underlying cause for this
underlying source that needs to

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be addressed first.
I think so much has changed in

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the field of neuroscience and
neuropsychological assessment,

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especially now that we can see
images of the brain.

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And I know I can always speak
from my personal experience of

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someone that has had family
members with addiction.

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It's when I first saw brain
imaging scans of what addiction

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can look like in the brain that
I then began to better

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understand their behavior or a
repeated behavior or why they

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may have had this cyclic
behavior and was unable to get

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out of the loop.
Because I finally then could

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understand what was better
happening because I could see

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the imaging.
I could see the areas of the

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brain that were impacted and was
then better able to understand

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the behavior, at least for
myself, and navigating that in

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my own journey, what I was
learning and studying.

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Because now the pictures were
worse, a lot more to, I think,

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link this behavior to the
imaging and now this treatment

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plan that an individual was
going to be going through.

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And now you leave Karen's
neurocognitive assessment

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program, which uses advanced
tools like QEG and PET scan.

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So what kind of insights do
these tools uncover that

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standard assessments often miss?
That's a great question.

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That's a big part of this when
we link the two together, the

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brain being the primary organ of
focus.

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And then why do these cognitive
assessments matter?

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And you spoke beautifully about
what, when I first see the image

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and I'm like, oh, now this makes
sense.

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I can link all of this together.
One of the areas that I tend to

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focus on when I'm giving a talk
or just generally speaking to

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patients is when you think about
imagery.

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And many times you'll see a
treatment centers or especially

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in the field of psychology or
behavioral cell help, you'll see

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a tree use.
And we understand the root

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system and the overall
connections and the electrical

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systems in a tree.
But the one of the images that I

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use as a part of this program is
an upside down body in a tree.

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And thinking of the broad
canopy, the beautiful canopy as

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all of those things that we
touched on, right?

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Family systems, relationships,
mood, emotions, behaviors, all

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of the things that everybody
overtly sees, right?

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And we attribute that to a moral
failing.

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And then the trunk of the tree
be more of that human

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physiological body and taking
into account all of the things

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that impact the physiological
symptom or the physiological

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system secondary to substance
use, trauma, depression,

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anxiety, and then bringing it
down to the base where this

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body's upside down is now the
brain.

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And I use that as the root
system to really say when you

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think about a tree system, the
canopy can be far spread and

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beautiful, but the root system
is always significantly wider.

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The root system spans broader
than the canopy for a tree.

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Understanding that the overall
root system of addiction, of

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mental health, saying what came
first, What do we focus on as a

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part of that?
When we spoke a few moments ago

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about the reward system, right?
Understanding that with

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substance use in the reward
system, every day can feel flat

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or unpredictable.
Feeling out of control that

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something is driving you, that
you need something even when

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willpower wise you don't want
this substance, but your brain

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is telling you that you need it
or you have to have it to be

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able to function, to feel
better, to feel less anxious, to

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feel maybe less flat.
Understanding the frontal lobe,

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understanding executive
functioning and how somebody

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plans and organizes and how they
struggle to resist impulses.

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Do you just give into your
impulses or is your executive

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functioning piece of your brain
functioning below expectation

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and therefore you really
struggle to resist the impulses

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even though morally you don't
want to?

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You don't want to engage in this
behavior, but yet here we are

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time and time again.
Emotional regulation, mood

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swings, irritability, anxiety
and saying I don't want to be

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anxious, I don't want to feel
this way, but yet I'm back in

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the same loop and I can't get
out of my own way.

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It really allows us to
understand the brain when we're

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using FDG, PET, QEG,
neuropsychological assessment

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and a full history and physical.
We understand the whole body,

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the whole person.
The history and physical gives

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us that collateral piece to
understand where some of these

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things stem from.
We understand if the importance

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of let's say significant alcohol
use and there's a thiamine

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deficiency, then the thiamine
deficiency is going to impact

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both physical body and the
brain.

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And how do we treat that?
If there's imbalance cortisol

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levels, how does that impact the
brain?

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And how do we go about
understanding the impacts to the

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patient and their anxiety and
their regulation?

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It also tells us, as far as the
FGG PET goes, it tells us blood

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flow and it while FGG PET
primarily looks at glucose

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uptake as a part of that.
When you're looking at the

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imaging, usually we can see
where the uptake is flowing in

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the brain.
If there's a reduction in that

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area, it also aligns with
reduced blood flow.

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We want to understand if the
brain is not getting healthy

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oxygenated blood flow to certain
areas with the QEG, we want to

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understand electrical activity,
is it fast wave activity, is a

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slow wave activity.
So basically is your brain

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processing information, the
connections, are they too slow?

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Is it too fast?
And then switching that into how

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do we tie that all together
functionally?

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So if we see let's say in the
temporal lobe on a FDG PET scan,

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we can see those reduced blood
flow.

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And on the QE e.g, we can see
some of that cortical

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involvement that may be
impacting a language area on the

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temporal lobe in a memory area.
And then on functional testing,

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we see that their auditory and
visual memory is below

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expectation and they struggle to
produce some words.

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We are able to tie all of that
together and show there's

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multiple pieces of the brain
impacted by their substance use.

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And then the next step is how do
we target our treatment to help

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them heal the part of their
brain that is impacting their

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functioning the most, so they
can engage meaningfully in

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treatment and therefore with the
goal of sustained recovery in

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the long term?
Wow.

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I think if we didn't know how
interconnected the mind and the

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body were for a level of detail,
when you can go into one place

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that will really take the time
to look at that and to put the

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pieces of the puzzle together
through tests and then figure it

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out.
Would you mind telling us more

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that about how once you have
those results and that

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personalized data, because this
is unique to every individual,

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as we always say, like one brain
is so unique to its patterns.

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And that of course would also
change over time as well.

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And when you start to see those,
how do you see that in outcomes

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once you start to take your more
personalized Taylor approach for

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someone?
Can you walk us through that?

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Sure.
But once individuals have gone

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through, and I like that you
said that an individualized

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assessment process, once they go
through the assessment piece and

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we have all of the objective
data, we sit down together and

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we review next steps and
recommendations and that looks

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different for every individual.
If I can just use an example, if

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we have an individual who has a
history of substance use, but

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they also have a significant
history of borderline

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personality disorder, for
example, and that shows up on

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their objective testing that
their trajectory forward or

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their recommendations would
include some of those same

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things.
Some individual therapy, group

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therapy, family therapy, support
groups, but they also include

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specialized treatment.
So we may recommend them

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specifically for dialectic
behavioral therapy or DBT,

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right, to say we want to focus
on something that may serve as a

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barrier to your treatment, which
is the borderline personality

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symptoms and characteristics.
We may also have individuals

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whose primary symptom
presentation is severe cognitive

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impairment.
If that is the individualized

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case, then what we're going to
do is focus on neuro restorative

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care that would still engage in
individual sessions and group

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sessions, but we may focus more
so on helping restore their

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brain with brain training.
I'm sure you've heard of it.

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The brainhq.com is an excellent
resource for brain

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rehabilitation.
We may recommend hyperbaric

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oxygen therapy, which kind of
ties when you think about the

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FGG PET.
So we're saying we're seeing

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areas of the brain that are
under perfused or hypo perfused.

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So we may recommend hyperbaric
oxygen therapy to help reperfuse

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the brain.
A good way to think of that is

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for your listeners, especially
if we told everybody while

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they're listening for the
remainder of the podcast to sit

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on their hand and continue
sitting on it until the end,

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it's going to go down.
And if we told them to sit on it

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for probably another couple
weeks or so, it might fall off.

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We need healthy oxygenated blood
flow to tissue in order for it

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to regenerate.
Overall goal is knowing that

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neuroplasticity in the brain or
the ability for the brain to

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create, work around networks and
heal itself and neurogenesis,

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the creation of new neurons in
the brain that the goal is to

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00:16:50,680 --> 00:16:53,920
help understand that is
happening naturally.

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00:16:54,000 --> 00:16:58,200
So the natural recovery, the
cone of spontaneous recovery is

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going to occur, but how can we
help maybe speed up that

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timeline so that they can engage
more meaningfully in the

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therapeutic process?
And in doing so, it would be

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00:17:08,480 --> 00:17:11,839
hyperbaric oxygen therapy, but
also have options for spiritual

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00:17:11,839 --> 00:17:16,200
fitness, nutritional counseling,
physical fitness, the overall

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things that we know when we
treat the whole person and the

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whole body.
The goal is every single piece

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00:17:21,319 --> 00:17:23,880
of that where we can see that
there is a deficit.

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00:17:24,200 --> 00:17:27,680
We want to help them get to a
better level of functioning both

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cognitively, mentally,
neurologically and physically to

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00:17:32,560 --> 00:17:37,000
help improve their chances of
recovery through increased

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00:17:37,000 --> 00:17:41,040
neurogenesis.
So it's a true interdisciplinary

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00:17:41,160 --> 00:17:45,560
holistic approach to self-care
that's very individualized to

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00:17:45,560 --> 00:17:47,480
where they are.
And it seems you give them

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00:17:47,480 --> 00:17:51,600
recommendations as well as they
have a role in the process as

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well as to where their goals are
and where they're aiming to go

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00:17:54,640 --> 00:17:57,120
to as well as where they're
prioritizing.

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00:17:57,120 --> 00:18:00,400
It seems like at this moment in
time, what may be important for

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00:18:00,680 --> 00:18:03,640
where they're striving to be?
Because you've leaned into the

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whole point.
As neuroscience shows, this

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brain has this incredible
capacity and ability to heal,

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and we can do it through
multiple modalities.

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And you feel eloquently
highlighted all these different

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00:18:15,560 --> 00:18:20,080
areas where we can have supports
really through a biopsychosocial

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00:18:20,080 --> 00:18:22,680
approach.
It can be biology, it can be

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00:18:22,680 --> 00:18:26,000
through spirituality, it can be
through our social supports and

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00:18:26,000 --> 00:18:28,720
our networks.
And yet when we seem to tap into

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00:18:28,720 --> 00:18:34,000
all those multiple dimensions of
our Wellness and well-being, we

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00:18:34,000 --> 00:18:37,160
really can better support
ourselves as well as the mental

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00:18:37,160 --> 00:18:39,680
health that we are striving to
support.

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00:18:39,680 --> 00:18:42,200
And you really encapsulated all
that well.

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00:18:42,520 --> 00:18:46,120
And your response.
How do you best understand that

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00:18:46,120 --> 00:18:48,920
for people with their outcomes
and their support and recovery?

325
00:18:48,920 --> 00:18:53,200
Do you find one modality works
really well because you seem to

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00:18:53,280 --> 00:18:57,680
have this multi faceted approach
and do you seem that's the best

327
00:18:57,680 --> 00:19:00,520
approach from what you seem to
run at your center?

328
00:19:00,520 --> 00:19:03,040
Is this holistic approaching
care?

329
00:19:03,920 --> 00:19:06,600
Yes, we know that certain things
work better going back to we

330
00:19:06,640 --> 00:19:09,720
know that CBT works better for
borderline personality disorder

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00:19:09,720 --> 00:19:13,640
than let's say CBT.
However, what we've really

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00:19:13,640 --> 00:19:16,760
realized is that this
comprehensive approach and

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00:19:16,760 --> 00:19:20,640
having it all in one space
really running into when we hear

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00:19:20,640 --> 00:19:23,680
patients feedback about I've
been doing this for years, I've

335
00:19:23,680 --> 00:19:26,880
been in and out of treatment for
years or I've been seeing a

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00:19:26,880 --> 00:19:31,080
therapist for years or I have
this doctor over here.

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00:19:31,080 --> 00:19:35,480
But I was recommended to go see
XY and Z specialist and I can't

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00:19:35,480 --> 00:19:37,680
get into them for six months or
nine months.

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00:19:37,680 --> 00:19:40,520
Or I had an appointment but it
was cancelled and now it's six

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00:19:40,520 --> 00:19:43,160
months later.
We noticed that when it's all in

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00:19:43,160 --> 00:19:46,480
one place and it's accessible to
the patients to engage in

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00:19:46,480 --> 00:19:49,160
simultaneously, we're not
reinventing the wheel.

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00:19:49,280 --> 00:19:53,200
We know that nutritional
counseling in of itself is

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00:19:53,200 --> 00:19:55,880
important.
We know that spiritual Wellness

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00:19:55,880 --> 00:19:58,040
is important.
And we know that individuals

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00:19:58,040 --> 00:20:02,320
that have this faith base have a
stronger chance of recovery.

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00:20:02,400 --> 00:20:05,280
And we know that the physical
piece and getting the body back

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00:20:05,280 --> 00:20:08,720
in shape is important.
And when you're not engaging in

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00:20:08,720 --> 00:20:11,120
physical fitness, there's a
higher risk for calling the

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00:20:11,120 --> 00:20:13,560
decline.
What we're simply doing is

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00:20:13,560 --> 00:20:16,560
taking all of these pieces that
have been.

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00:20:17,000 --> 00:20:20,480
Researched and are backed
scientifically and in

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00:20:20,480 --> 00:20:24,240
neuroscience and saying let's
put them all in one place.

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00:20:24,520 --> 00:20:29,800
One model of care and at the
basis of this model of care is

355
00:20:30,320 --> 00:20:34,400
instead of being subjective,
someone come in and say I feel

356
00:20:34,400 --> 00:20:38,680
anxious or I feel down or I'm
having trouble thinking.

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00:20:39,160 --> 00:20:44,800
The basis of this model is
objective assessment, numbers

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00:20:44,800 --> 00:20:50,280
based, scientifically based
findings, and then making an

359
00:20:50,280 --> 00:20:53,480
individualized treatment plan
that encapsulates the entire

360
00:20:53,480 --> 00:20:56,360
body and everything that we
already know that works per

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00:20:56,360 --> 00:20:58,800
person.
So I can't say that there's one

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00:20:58,800 --> 00:21:01,960
thing that I know works better
than the other, but when I know

363
00:21:01,960 --> 00:21:04,960
that all of these things have
been proven to work in history

364
00:21:05,360 --> 00:21:08,840
and we put them all into one
place simultaneously to give the

365
00:21:08,840 --> 00:21:12,240
most comprehensive care package,
that's where we're seeing the

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00:21:12,240 --> 00:21:15,040
significant impact to
individuals, both mental health

367
00:21:15,440 --> 00:21:18,760
side and also substance use
disorder treatment side.

368
00:21:19,680 --> 00:21:22,120
I'm so glad you shared that
because it trends with

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00:21:22,160 --> 00:21:23,720
everything we see in brain
health.

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00:21:23,720 --> 00:21:26,240
It's multimodal lifestyle
interventions.

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00:21:26,240 --> 00:21:28,560
That's where the science goes.
And it's very hard to

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00:21:28,560 --> 00:21:32,840
disentangle once we say we've
given you nutritional education

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00:21:32,840 --> 00:21:35,040
and physical exercise at these
intervals.

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00:21:35,040 --> 00:21:37,920
And of course, they include the
brain training with Brain HQ as

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00:21:37,920 --> 00:21:39,640
well.
And those interventions as well

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00:21:39,640 --> 00:21:43,080
as it's very hard to break them
apart and say it's been 1

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00:21:43,080 --> 00:21:45,960
leading factor and everything
seems to come, come back to this

378
00:21:45,960 --> 00:21:48,760
multimodal intervention and
support.

379
00:21:48,760 --> 00:21:51,640
And I look back to even when I
did my doctoral training on

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00:21:51,640 --> 00:21:55,080
integrated care is it matters in
one location.

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00:21:55,080 --> 00:21:57,880
And we know these referral drop
off rates, I believe at that

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00:21:57,880 --> 00:22:01,760
time to behavioral health
providers was well over 70 or

383
00:22:01,760 --> 00:22:05,440
80% is the amount of people who
will not follow up.

384
00:22:05,440 --> 00:22:08,120
And then by the time they make
the appointment at the higher

385
00:22:08,120 --> 00:22:10,960
percentage after that, that they
even show up to the first

386
00:22:10,960 --> 00:22:14,120
appointment is abysmal.
So it's like the idea that we do

387
00:22:14,120 --> 00:22:17,240
need these integrated care
centers where these

388
00:22:17,240 --> 00:22:20,920
multidisciplinary providers are
all in one spot is the best

389
00:22:21,280 --> 00:22:24,920
chance of success and likelihood
for people to get a

390
00:22:24,920 --> 00:22:27,240
comprehensive integrated care
approach.

391
00:22:27,280 --> 00:22:31,040
So I'm so grateful you took the
time to walk us through all the

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00:22:31,040 --> 00:22:34,160
modalities of your program and
what it is you are doing.

393
00:22:34,400 --> 00:22:37,320
I want to ask for you to
highlight one more aspect for us

394
00:22:37,320 --> 00:22:40,720
because I do think it's unique
in the aspect of what you are

395
00:22:40,720 --> 00:22:44,560
doing there because it is
becoming a bit more mainstream,

396
00:22:44,560 --> 00:22:47,040
especially under this brain
health arm and with the work

397
00:22:47,040 --> 00:22:50,000
you're doing there is, if you
wouldn't, telling us a bit more

398
00:22:50,000 --> 00:22:53,480
about neurofeedback and those
types of similar therapies I

399
00:22:53,480 --> 00:22:56,960
think are becoming more common
or it's one that people are

400
00:22:57,280 --> 00:23:02,120
actively seeking out as I think
some of it depends on maybe the

401
00:23:02,120 --> 00:23:04,920
diagnosis someone may have and
if it's billable and

402
00:23:04,920 --> 00:23:08,080
reimbursable through insurance.
But this seems to also be one

403
00:23:08,080 --> 00:23:12,960
that people are more akin to
paying possibly out of pocket as

404
00:23:12,960 --> 00:23:16,240
well as we're seeing more
science behind this space.

405
00:23:16,240 --> 00:23:20,080
So how does it help the brain
rebuild or rewire itself?

406
00:23:20,080 --> 00:23:22,640
Or what would you like people to
know about it success that

407
00:23:22,640 --> 00:23:25,200
you're seeing in your
programming as well in terms of

408
00:23:25,200 --> 00:23:28,240
using neurofeedback?
Neurofeedback.

409
00:23:28,400 --> 00:23:35,360
Is best described as real time
EEG training so real time brain

410
00:23:35,360 --> 00:23:41,200
training, electrical brain
training used to optimize and

411
00:23:41,280 --> 00:23:44,520
kind of rewire brain waves or
brain wave patterns.

412
00:23:44,800 --> 00:23:49,400
We've seen it enhance attention,
mood regulation, executive

413
00:23:49,400 --> 00:23:52,240
functioning.
It's also had some impacts on

414
00:23:52,600 --> 00:23:58,160
sleep and overall improved sense
of energy, less fatigue feeling.

415
00:23:58,600 --> 00:24:02,400
It is popular.
It's one of the neurotherapies

416
00:24:02,400 --> 00:24:06,320
that we use and I would say in
the civilian world, it's one of

417
00:24:06,320 --> 00:24:08,120
the more affordable
neurotherapy.

418
00:24:08,120 --> 00:24:10,040
So you're correct.
It's going to be leaned on a bit

419
00:24:10,040 --> 00:24:13,840
heavier maybe than transcranial
magnetic stimulation or more

420
00:24:13,840 --> 00:24:16,280
than hyperbaric oxygen therapy.
And it's well known.

421
00:24:17,000 --> 00:24:20,920
A colleague of mine here at
Karen, I'll use his terminology.

422
00:24:20,920 --> 00:24:24,280
He likes to say that
neurofeedback is physical

423
00:24:24,280 --> 00:24:28,560
therapy for the brain.
Basically, if you broke your

424
00:24:28,560 --> 00:24:33,040
knee and then in recovery you
were told, OK, we're going to

425
00:24:33,680 --> 00:24:36,440
assign you 12 weeks of physical
therapy.

426
00:24:36,800 --> 00:24:39,440
You wouldn't think twice about
going to your physical therapy

427
00:24:39,440 --> 00:24:42,520
appointment and being put
through maybe some rigorous

428
00:24:42,520 --> 00:24:45,640
training that maybe is a little
bit uncomfortable at times, but

429
00:24:45,640 --> 00:24:49,400
it pushes you to improve your
functioning so that you can

430
00:24:49,400 --> 00:24:52,080
ambulate independently and
return to your baseline.

431
00:24:52,760 --> 00:24:55,560
Neurotherapy or neurofeedback is
no different.

432
00:24:55,640 --> 00:24:57,840
It is training the brain.
I would say maybe the difference

433
00:24:57,840 --> 00:25:02,120
is it's not uncomfortable, it's
not painful, but basically it's

434
00:25:02,120 --> 00:25:06,640
focusing on the brain and the
central nervous system to help

435
00:25:07,120 --> 00:25:11,680
manifest change in the neural
activity as the goal to

436
00:25:12,200 --> 00:25:16,880
stimulate you with the feedback
to return you back to an

437
00:25:16,880 --> 00:25:20,240
improved level of functioning
and get you closer to your

438
00:25:20,240 --> 00:25:22,200
baseline.
And that's that takes us back

439
00:25:22,200 --> 00:25:25,360
that baseline matters.
So that's why the brain mapping

440
00:25:25,360 --> 00:25:29,400
or the QEG and the FTG pad and
the neuro psych testing are

441
00:25:29,400 --> 00:25:33,480
important so that we understand
the baseline, so that we have an

442
00:25:33,480 --> 00:25:37,960
objective data-driven comparison
for pre and post.

443
00:25:37,960 --> 00:25:42,400
So after neurofeedback we can
test again and say yes, we

444
00:25:42,400 --> 00:25:46,120
achieved this level of
improvement, not just

445
00:25:46,160 --> 00:25:49,320
subjectively, I guess I feel
better, but we can actually see

446
00:25:49,440 --> 00:25:52,880
domains of the brain showing
standard deviations of

447
00:25:52,880 --> 00:25:55,800
improvement.
And thinking about some of those

448
00:25:55,800 --> 00:25:59,600
improvements, and I know this
may be a broad question to ask,

449
00:25:59,920 --> 00:26:04,400
are there any early signs that
the brain is beginning to heal

450
00:26:04,400 --> 00:26:08,280
even before maybe some of the
behavior catches up that people

451
00:26:08,280 --> 00:26:13,200
may want to make note of?
Objectively, I couldn't say

452
00:26:13,360 --> 00:26:18,000
anything regarding earlier signs
simply because of when we're

453
00:26:18,000 --> 00:26:20,720
testing and retesting and
there's a pretty big stand in

454
00:26:20,720 --> 00:26:24,880
between that.
But subjectively, as far as our

455
00:26:24,880 --> 00:26:28,880
patients have reported, they
have reported an array of

456
00:26:28,880 --> 00:26:33,040
things, again, individualized.
We recently had a veteran that

457
00:26:33,040 --> 00:26:36,840
reported before we could see it
objectively on paper that

458
00:26:36,840 --> 00:26:41,400
reported feeling more energized,
feeling more positive, reported

459
00:26:41,480 --> 00:26:45,520
reduced depression, the
symptoms, reduced anxiety,

460
00:26:45,640 --> 00:26:48,120
increased ability to focus and
concentrate.

461
00:26:48,560 --> 00:26:52,880
We weren't able to see that
objectively until about the

462
00:26:52,880 --> 00:26:57,600
month and a half the two-month
mark out on objective data.

463
00:26:57,800 --> 00:27:02,200
But those reports came in, I
want to say about two weeks

464
00:27:02,680 --> 00:27:07,160
after engaging in hyperbaric and
also with neurofeedback.

465
00:27:07,880 --> 00:27:10,520
I appreciate you sharing that.
I think this is always the one

466
00:27:10,520 --> 00:27:12,720
that's the balance.
Because even with health tech

467
00:27:12,720 --> 00:27:16,600
data coming online and so many
of us having these wearables or

468
00:27:16,800 --> 00:27:19,560
we're tracking things that still
some of the times you wake up

469
00:27:19,560 --> 00:27:22,280
and you're like your sleep's
telling you we're slept great

470
00:27:22,280 --> 00:27:26,000
that night and you're thinking I
do not because I know how I have

471
00:27:26,000 --> 00:27:28,280
felt.
And so it's this balance of the

472
00:27:28,800 --> 00:27:32,600
data we're using and we want
good data that's indicating

473
00:27:32,600 --> 00:27:34,920
this.
But also having this balance of

474
00:27:34,920 --> 00:27:38,040
real world use and then having
it in the clinical setting.

475
00:27:38,040 --> 00:27:41,280
But still being able to say if
these things are working for us

476
00:27:41,280 --> 00:27:43,760
still subjectively and it's
good, that's still enough

477
00:27:43,760 --> 00:27:46,560
motivation to keep going on the
right path.

478
00:27:46,560 --> 00:27:49,320
And it's finding that balance.
And I think we've had authors

479
00:27:49,320 --> 00:27:53,280
write how many books about this
around behavior change, and it's

480
00:27:53,280 --> 00:27:57,320
just enough to help us know when
we're trying on this path of I

481
00:27:57,320 --> 00:27:59,920
think lifestyles changes.
They always joke, it's not going

482
00:27:59,920 --> 00:28:03,240
to be the one salad that's going
to overhaul your healthy diet.

483
00:28:03,240 --> 00:28:06,200
But where is enough of these
intervals that just let us know

484
00:28:06,200 --> 00:28:08,280
we're on the insights for these
right path?

485
00:28:08,360 --> 00:28:11,880
Because this holistic brain
healthy lifestyle that ideally

486
00:28:11,880 --> 00:28:14,960
is a lot of what your whole
program is looking at is it

487
00:28:14,960 --> 00:28:17,800
takes a long time for these
change, but where we can

488
00:28:17,800 --> 00:28:22,360
acknowledge these small things
along the way is always helpful

489
00:28:22,840 --> 00:28:25,120
for us.
And it seems like we have

490
00:28:25,120 --> 00:28:28,240
covered a lot of ground in a
short amount of time.

491
00:28:28,240 --> 00:28:31,800
So I want to make sure as we're
winding down that we have

492
00:28:31,800 --> 00:28:34,440
covered the topic that we have
set out today.

493
00:28:34,520 --> 00:28:37,040
Is there anything that we may
have missed that might have been

494
00:28:37,040 --> 00:28:41,880
a misconception or something you
want to set straight around the

495
00:28:41,880 --> 00:28:46,560
conversation about brain health
and recovery that you think the

496
00:28:46,560 --> 00:28:49,840
science should be emphasized in
today's conversation?

497
00:28:50,720 --> 00:28:54,000
I think maybe 2 points that only
based on some of the questions

498
00:28:54,000 --> 00:28:57,960
that we get with this model, we
recognize that there are

499
00:28:58,120 --> 00:29:03,400
multiple mechanisms and pieces
to this model and we don't have

500
00:29:03,400 --> 00:29:06,800
the answer yet to say, OK, but
what is the most significant

501
00:29:06,800 --> 00:29:11,560
mechanism of change?
That's because we are in the

502
00:29:11,560 --> 00:29:16,120
field of treating patients.
We are not solely researchers.

503
00:29:16,440 --> 00:29:21,760
In the near future, yes, our
goal is to move into a research

504
00:29:21,760 --> 00:29:24,080
study separate from what we're
doing as far as treating

505
00:29:24,080 --> 00:29:26,440
patients.
That would also have a control

506
00:29:26,440 --> 00:29:29,280
groups that we could maybe begin
to understand and maybe answer

507
00:29:29,280 --> 00:29:31,600
that question.
Between all of these mechanisms,

508
00:29:31,600 --> 00:29:33,320
what is the greatest mechanism
of change?

509
00:29:33,840 --> 00:29:37,520
We're not there yet, but I think
there's a powerful case to at

510
00:29:37,520 --> 00:29:39,720
least acknowledge where we have
done some separately.

511
00:29:39,720 --> 00:29:42,560
We've seen significant
improvement with neurofeedback

512
00:29:42,560 --> 00:29:44,880
alone.
We've also seen a significant

513
00:29:44,880 --> 00:29:48,080
improvement with hyperbaric
oxygen therapy alone.

514
00:29:48,480 --> 00:29:50,560
There's a brief case study, if
you don't mind me just

515
00:29:50,840 --> 00:29:56,520
mentioning that of a 21 year old
with traumatic brain injury and

516
00:29:56,720 --> 00:30:01,600
overdose secondary to fentanyl.
That individual had severe

517
00:30:01,600 --> 00:30:06,960
cognitive impairment, severe the
daily dysfunction, the ability

518
00:30:06,960 --> 00:30:11,280
of fine motor skills, reading
level was below 4th grade, the

519
00:30:11,280 --> 00:30:13,960
ability to ambulate.
We had urinary incontinence,

520
00:30:13,960 --> 00:30:16,840
fecal incontinence, so very
severe presentation.

521
00:30:17,520 --> 00:30:20,120
We understood when we speak
about it being individualized,

522
00:30:20,120 --> 00:30:23,640
we understood that person could
not go through an in depth

523
00:30:23,640 --> 00:30:26,360
assessment.
That person could not go into

524
00:30:26,440 --> 00:30:28,640
individual therapy or group
therapy.

525
00:30:28,640 --> 00:30:32,160
At this point we had to work on
Neuro Restorative care 1st.

526
00:30:32,720 --> 00:30:36,320
So that individual received 20
sessions of hyperbaric oxygen

527
00:30:36,320 --> 00:30:41,360
therapy at 1.5 atmospheric
pressures and then we did a post

528
00:30:41,360 --> 00:30:45,000
test before moving into the next
steps in decision making for

529
00:30:45,000 --> 00:30:47,640
where they would go and what
that would look like for their

530
00:30:47,640 --> 00:30:51,800
care.
And that individual showed on an

531
00:30:51,800 --> 00:30:54,440
FDG PET scan.
So again located that reduced

532
00:30:54,760 --> 00:31:00,120
perfusion in the brain.
They were -4 and -5 standard

533
00:31:00,120 --> 00:31:03,400
deviations below where they
should be for their age.

534
00:31:03,640 --> 00:31:08,600
Severe hypoperfusion.
Once we repeated the FTG PET

535
00:31:08,600 --> 00:31:12,360
scan after 20 sessions of
hyperbaric, their brain was

536
00:31:12,760 --> 00:31:15,800
there's only one area that was
broadly normal, but the rest of

537
00:31:15,800 --> 00:31:18,360
their brain was reperfused and
normal.

538
00:31:18,600 --> 00:31:22,040
Meaning we're getting healthy
oxygenated blood, increasing the

539
00:31:22,040 --> 00:31:24,560
chance of neurogenesis,
improving functioning.

540
00:31:24,920 --> 00:31:29,240
That individual after was able
to engage in the testing, was

541
00:31:29,240 --> 00:31:34,120
able to engage in a therapy
setting and following our last

542
00:31:34,120 --> 00:31:38,120
follow up with that individual
was still substance free and was

543
00:31:38,200 --> 00:31:41,680
holding a part time job.
Yes, our goal is to understand

544
00:31:41,680 --> 00:31:44,920
all the mechanisms separately,
but right now what we do know is

545
00:31:44,920 --> 00:31:49,320
working or is the comprehensive
multimodal approach.

546
00:31:49,720 --> 00:31:54,480
And I would say is the last take
away is mental health, substance

547
00:31:54,480 --> 00:31:59,520
use, Co occurring disorders that
the brain is at the center of

548
00:31:59,520 --> 00:32:03,120
everything, your mood, your
decisions, your relationships,

549
00:32:03,320 --> 00:32:07,600
your motivation.
In short, our goal is to have

550
00:32:08,280 --> 00:32:14,000
mainstream media and insurance
networks understand that brain

551
00:32:14,000 --> 00:32:19,480
health is treating the brain is
healthcare, it is a healthcare

552
00:32:19,480 --> 00:32:23,640
model, and that brain health is
mental health and that it should

553
00:32:23,640 --> 00:32:29,800
be treated no differently than a
physical injury to a part of the

554
00:32:29,800 --> 00:32:32,720
body or cancer.
It should be treated as a

555
00:32:32,720 --> 00:32:36,560
healthcare modality.
I think anyone tuning in

556
00:32:36,560 --> 00:32:39,480
understands why you're here
today as an expert on our

557
00:32:39,480 --> 00:32:42,920
podcast diving more into this
topic with us.

558
00:32:43,240 --> 00:32:46,000
This is my favorite time of the
podcast where I get to pick your

559
00:32:46,000 --> 00:32:50,240
brilliant brain for some
actionable takeaways for us.

560
00:32:50,560 --> 00:32:52,720
I'm going to ask a bit of a
personal question though.

561
00:32:52,720 --> 00:32:56,240
As an expert in behavioral
health and psychological care,

562
00:32:56,520 --> 00:33:00,880
what is your one non negotiable
for your personal brain care?

563
00:33:01,920 --> 00:33:08,560
Part of brain care maybe turns a
bit existential and I am a water

564
00:33:08,560 --> 00:33:13,840
baby.
For me my non negotiable is time

565
00:33:13,840 --> 00:33:19,960
in nature especially open water
shark swimming I.

566
00:33:20,360 --> 00:33:22,800
Say that's a new one for us on
the podcast.

567
00:33:23,520 --> 00:33:26,120
I love open water shark
swimming.

568
00:33:26,520 --> 00:33:30,960
There is something about being
in that environment that is so

569
00:33:30,960 --> 00:33:35,640
much greater than you, that is
unpredictable, that allows me to

570
00:33:35,640 --> 00:33:40,680
feel gratitude and grounding at
the same time.

571
00:33:41,320 --> 00:33:43,840
I get that it can be scary for a
lot of people.

572
00:33:44,080 --> 00:33:47,080
And even in those moments of
being able to recognize an

573
00:33:47,520 --> 00:33:51,200
ability to control the fear and
appreciate your surroundings in

574
00:33:51,200 --> 00:33:54,800
the midst of that, I think it
ties together all of the

575
00:33:54,800 --> 00:33:59,560
emotions and the cognitive
demands to be able to control

576
00:33:59,560 --> 00:34:02,760
your heart rate and your
breathing in those moments and

577
00:34:02,760 --> 00:34:04,960
just experience a sense of
gratitude.

578
00:34:05,800 --> 00:34:09,440
You explained that so lovely, so
thank you so much for sharing

579
00:34:09,440 --> 00:34:11,920
the way you take care of your
brilliant Brandy.

580
00:34:12,320 --> 00:34:15,639
How can our listeners learn more
about you and follow your work?

581
00:34:16,159 --> 00:34:19,320
If the listeners want to find
out more about the

582
00:34:19,320 --> 00:34:22,440
neurocognitive assessment
program, but a bit more about

583
00:34:22,760 --> 00:34:26,360
the work we're doing here or
some of my backgrounds, they can

584
00:34:26,360 --> 00:34:30,880
go on our website, karen.org.
And we are primarily the NAP

585
00:34:30,880 --> 00:34:33,520
program or neurocognitive
assistant program is located in

586
00:34:33,520 --> 00:34:35,840
Florida.
So if they look at what the

587
00:34:35,840 --> 00:34:38,719
Florida offerings are, they'll
be able to find my background

588
00:34:38,719 --> 00:34:43,880
there along with details for the
program and they can also reach

589
00:34:43,880 --> 00:34:46,000
out.
My contact information is on the

590
00:34:46,000 --> 00:34:47,880
website if they have follow up
questions.

591
00:34:48,600 --> 00:34:51,000
And thank you for making
yourself available to our

592
00:34:51,000 --> 00:34:54,480
listeners for questions, for
follow up, and for those

593
00:34:54,520 --> 00:34:58,720
listening who may be in recovery
or supporting someone through

594
00:34:58,720 --> 00:35:02,760
it, what message of hope would
you want them to take away from

595
00:35:02,760 --> 00:35:08,280
today's conversation?
The strongest message of hope is

596
00:35:08,720 --> 00:35:13,960
that the brain can heal with the
right support, just like any

597
00:35:13,960 --> 00:35:20,560
other organ, and that your loved
one and their struggles can make

598
00:35:20,640 --> 00:35:27,320
AU turn to be patient with them.
To understand that this is not a

599
00:35:27,320 --> 00:35:31,720
conscious choice that they are
making and that there is help

600
00:35:31,760 --> 00:35:35,600
there for them to heal their
brain and get them to a place of

601
00:35:36,120 --> 00:35:39,160
sustained recovery and to get
them back to a point of

602
00:35:39,160 --> 00:35:41,960
functioning where they can be
that loved one.

603
00:35:41,960 --> 00:35:46,560
They could be the father,
sister, brother, mother that you

604
00:35:46,560 --> 00:35:49,320
either imagined they could be or
that they once were.

605
00:35:50,120 --> 00:35:52,160
That sentiment is worth
repeating.

606
00:35:52,680 --> 00:35:55,920
The brain can heal.
Viewing addiction through a

607
00:35:55,920 --> 00:36:00,240
neurobiological lens opens new
possibilities for recovery,

608
00:36:00,520 --> 00:36:02,680
compassion, and lifelong brain
health.

609
00:36:03,240 --> 00:36:06,760
Doctor Amber Deckard, thank you
so much for letting me pick your

610
00:36:06,760 --> 00:36:09,600
brilliant brain on the Let's
Talk Brain Health Podcast.

611
00:36:10,280 --> 00:36:14,000
Thank you for investing your
time and energy into your

612
00:36:14,000 --> 00:36:17,480
personal brain care by listening
to today's episode of the Let's

613
00:36:17,480 --> 00:36:20,920
Talk Brain Health Podcast.
I hope our conversation gave you

614
00:36:20,920 --> 00:36:24,680
fresh insights, a bit of
infiration, or practical steps

615
00:36:24,680 --> 00:36:27,920
that you can take on your own
personal brain care journey.

616
00:36:28,360 --> 00:36:31,240
If you enjoyed today's
conversation, I'd like to ask

617
00:36:31,240 --> 00:36:34,080
you to please share this episode
with someone who could benefit

618
00:36:34,080 --> 00:36:36,600
from it or consider leaving us a
review.

619
00:36:37,080 --> 00:36:40,360
If you have questions or a topic
in brain health you'd like me to

620
00:36:40,360 --> 00:36:44,280
explore, please e-mail me
anytime at podcast at

621
00:36:44,280 --> 00:36:48,000
virtualbrainhealthcenter.com.
I'd love to hear from you.

622
00:36:48,280 --> 00:36:52,280
We have so many more exciting
topics ahead, and I can't wait

623
00:36:52,280 --> 00:36:55,280
to continue this lifelong
journey of better brain health

624
00:36:55,280 --> 00:36:58,560
together with you and our
growing virtual community.

625
00:36:59,000 --> 00:37:02,080
Until next time, remember to
give your brain the care it

626
00:37:02,080 --> 00:37:05,280
deserves and make your brain
health a priority.