Chuck LaFLange (00:02.825)
Hello everybody, watchers, listeners, supporters of all kinds. Welcome to another episode of the Weekend Ramble on the Ashes To Awesome podcast. I'm your host Chuck LaFlange checking in from Krabi, Thailand, halfway around the world in Calgary is my good friend and cohost Dr. Lisa. How are you doing today? Dr. Lisa.

Lisa (00:19.049)
I'm good. I'm glad it's Saturday. I'm on call tomorrow. So I'm gonna milk this day off. And yeah, I'm good. Glad to be here.

Chuck LaFLange (00:29.757)
Awesome. How's the weather doing out there? Are we a little better now? A little warmer than last week? Is it?

Lisa (00:34.073)
warming up just literally today. Like even yesterday, it was minus 30 something again. So gross. I think this afternoon, it's supposed to be like minus 3. I know, it's so bad. It's been.

Chuck LaFLange (00:39.638)
Oh.

mike miller (00:47.538)
It's warming up to minus three.

Chuck LaFLange (00:47.659)
I see our returning guest Mike Miller, who's also in Krabi Thailand with me, well in virtual studio, none of us still, but laughing, as you say, 30 below, like that is more than halfway to boiling point away from us, right? Like that's, like, that's a lot of degrees, right? How you doing today, Mike?

Lisa (00:50.177)
Yeah.

mike miller (01:11.75)
I'm well, I mean, today being 1.22 in the morning. No, I'm good, I'm actually very upbeat and hopeful and had a lot of good stuff happen in the past few days work-wise and stuff. So yeah, I'm good, happy to be here.

Chuck LaFLange (01:29.633)
That's great. That's great, that's great. And just for full disclosure, it is plus 27 degrees here in Krabi, Thailand. So at 1.22 in the morning, I might add. Yeah, it's gonna be a hot one tomorrow, right? You can hate on it, that's okay, because it's not gonna make me hate on it, that's for sure, yeah. Yeah.

Lisa (01:41.388)
Hehehehehe

Lisa (01:45.113)
I want to like say bad words or raise certain fingers or something like that, but I'll refrain.

mike miller (01:55.204)
But it's human, so you should feel sorry for us.

Chuck LaFLange (01:57.617)
Yes, absolutely. Right. A friend of mine, my friend of mine in Saskatchewan was made a post that he said, he said, Oh, I said my starter went I had to replace it in the Walmart parking lot. I'm just like, Oh, it's like minus 35. I was like, man, I had to drive like five minutes in the heat to go put like fuel in my scooter. Pretty much the same thing. Right. I might have got some of the comments and gestures you're talking about.

Lisa (01:57.99)
Oh yeah, right.

Lisa (02:22.053)
listening to an episode...

Lisa (02:26.569)
I was listening to an episode this week, I can't remember what one it was, but you were like talking about how like when you go outside like it's so hot that it like hurts your skin or something and I was just like rolling my eyes in my car. I was like whatever.

Chuck LaFLange (02:38.67)
Which is a direct steal from a meme from when I was in Saskatchewan that I posted. It's like, why do I live somewhere where the air hurts my face? Right. So that was about the winter in Saskatchewan. So kind of same thing here though. Right. Same thing. It was, well, the yoga instructor at Yatra, Carrie, she's, Carrie said to me once, it's actually cooler if I ride with a sleeves on.

Lisa (02:55.085)
Same, same, but different.

Chuck LaFLange (03:04.425)
because the sun doesn't hit your damn skin, right? So she's like, it's actually easier for, like it's easier on you, it's like cooler if you have sleeves. I was like, wow, I totally see what she means now. 100% I see what she means, right? To actually be cooler to have a long sleeve on. Yeah, yeah, right. Anyway, anyway, anyway. Listen, last week, I, oh. Ah.

Lisa (03:18.293)
Hehehehehe

Lisa (03:27.305)
you by the way? I was thinking about this you always like introduce us and ask how we are. How are you?

Chuck LaFLange (03:33.661)
I'm well today. It's been a rough week. You know, and I can kind of speak to it a little bit, I guess, because it very much doesn't involve Mike, especially, it's relevant. I posted up on social media and very vaguely touched based on what was happening. Of course, you guys both know, being friends of mine, about the power imbalance. I don't know if you had a chance to read that post or not, but it was a lengthy one. I know you did, Mike, because I saw you react to it. I experienced a power imbalance.

mike miller (03:38.361)
Thanks for watching!

mike miller (04:02.423)
Hmm

Chuck LaFLange (04:03.397)
over the course of the last months. And it's been really hard, really, really hard. This month it finally came to a head. I feel like I was gaslit into reacting and my reaction got the desired effect that this person, what I feel is a desired effect. And it really, because Mike has talked so much about power imbalance with me in direct, about the situation.

it really got me to thinking and doing a lot of introspection on, first the people who are inactive addiction and the multitudes of this power differential that they have to face every single day, all day, every single day. And if it can affect me who is well into my recovery, I mean, I'm not long-term recovered, it's only been a year and change. Oh, look, it's the 21st, so yeah, I guess it's been 14 months today? 14 months today.

If it can affect me the way that it has, and it very much has, right? Like I have been very, like it's been a rough time. How does somebody without the tools that I've been given, right, and just before I got to Thailand, nevermind, you know, with everything that I was, the tools that I was given at Yatra Center, how does somebody even like, and I know how, because I guess I was there at a point, but I'm sorry I'm rattling here.

mike miller (05:05.166)
Excellent.

Chuck LaFLange (05:33.333)
Realistically, I was on the other side of that power balance for most of my active addiction, right? I was the dealer. I was the guy that exploited people's lack of power with me for a long time in many, many ways. And then me being me, because, well, look, I've got something to hyper-focus on. I really took it back to before all of that, it just in my professional life, not even before, because it really hasn't been a before in my adult life of addiction.

But in the times when I was high functioning and I wouldn't really consider myself, you know, problem, problematic with addiction at the time, but in my professional life and my relationships and my holy shit, right? And like, we do this so much, all of us do this so much. And not because we're bad people or nefarious characters and, or evil or any of the, it's just, it happens. And it happens outside of our awareness. And like, wow, we gotta be careful, right? We just have to be.

mike miller (06:28.738)
I'm out.

Chuck LaFLange (06:29.841)
And Mike, I see you nodding away there, and I know you've got something to say on this topic, because you're kind of the one that's opened my eyes to the whole thing.

mike miller (06:38.71)
I mean, every relationship has a power imbalance, right? I mean, if you, I don't know how many people here wanna go read a nice heavy book by Michel Foucault or something like that, but you know, like.

It just exists, it just does. There's always a power imbalance. And then I think that what happens is, you know, for people in the position that I'm in or that Lisa is in, like we have to be acutely aware of that power imbalance and to not exploit it and to ethically act correct. But in most people in the world, I don't even know that they would frame it as knowing that there's a power imbalance, except for that.

it's really frustrating when you feel powerless, right? And then like you watch people like freaking out or lashing out, they go to like a social services office and they have this person behind the desk who's like.

putting barriers in front of them before they can get some form of relief because their security and safety relies on getting that. And then they freak out and break up the office or do whatever they do. That's a response to that power imbalance and feeling powerless, right? Yeah, it's woven into every relationship. And that's as I've been taught and I've read and I see it happen all the time. Some people exploit it and some people are really careful not to.

Lisa (07:56.477)
I mean, I see this a lot in my role in the emergency department, you know, where people are brought in, they're certified, they're, you know, like, they're forced to take medication sometimes. And yes, very much having to walk that line of making sure they're safe, making sure we're safe. But I, you know, I try to be mindful.

Chuck LaFLange (07:56.729)
Yeah.

Lisa (08:25.181)
I can't say I know what it's like. I haven't been certified. I haven't been put in a room and had the door locked on me and not allowed to leave. I don't know what that feels like, but I make a hard effort to try to put myself in those shoes and imagine what that must feel like.

Chuck LaFLange (08:43.073)
Well, for anybody listening that...

mike miller (08:45.405)
I've been locked in a room. I haven't been certified, but I've been locked in a room, not allowed to be let out. And I'll tell you how it feels. It sucks.

Chuck LaFLange (08:52.461)
It's awful, right? I said it in the post. If you wanna know how it feels, it's fight, flight, or freeze is what it is, right? It's the exact same thing as fight, flight, or freeze. So whether that's been in a car situation or like in the jungle as you've traveled, whatever, right? You've had that, you felt that, right? That's what it is to somebody, right? Over an extended period of time is awful, right? It's absolutely awful.

Lisa (08:53.373)
Yeah. And it's scary, like, because I feel like the thing that I

mike miller (08:54.83)
It's terrible.

Lisa (09:04.801)
Yep.

Chuck LaFLange (09:18.717)
And the two of you I've been quite frank with and honest in how it's affected me, but it really has affected me like in a really like in a hard way. Right. So anyway, just continue Lisa.

Lisa (09:32.985)
And I think one of the things that I know I personally try to do, and it doesn't change the power imbalance, but is to name what you imagine the person must be feeling. I, you know, I imagine this must feel really scary, you know. I imagine you must feel really helpless. And then the reassurance of, you know,

We're trying to make sure you're safe. We're trying to make sure we're safe. We want to work with you. But I think that if you can name it, like when you are the person on the side of this that is in the power role is to at least name it for them. Don't force them to name it, you do it. You acknowledge what you think that they might be going through. And I will see people's fight or flight.

you know, reaction really settle down very quickly when you do that.

Chuck LaFLange (10:34.869)
That makes sense. But you're validating, right? Yeah.

mike miller (10:35.652)
They're going to feel understood. And you know, I know we're in.

Well, we're in the third of this little series that we're doing, right? And at the beginning of each one of the previous two, based on my knowledge of the power imbalance between us in certain situations, like we've named it, like that we had a preexisting relationship through the podcast before you came to treatment, and that even though...

my center sponsors your podcast. We don't expect certain things to happen. You know, we just name it for the for the audience to be aware of that there's no exploitation or anything like that, because I think it's important to just get that stuff out in the open. And I'll just name it to some people and say like, yeah, like there is a power imbalance in this room. Sometimes like, you know, if I have a client in my center, like ultimately, I can ask them to leave or whatever other things might be happening.

And, you know, I think people are coming to me and I'm in the position where I'm supposed to be a professional at the top of my game and the assumption is like they're not exactly where they want to be in their life, which is why they're seeking me out. So like just in that there's a power imbalance, right? So yeah, I think that it's important to just be aware of it.

Chuck LaFLange (11:55.757)
Yep.

Chuck LaFLange (12:00.249)
Yeah. It most certainly is, and Mike, it was those conversations with you and I about that specifically that really started to open my eyes to it, and then of course how, you know, this current situation, right? And I said, and I said, you're weeping, and I was. Like I was just like, holy shit, man, you know? Partially because of my own, but that hyper-empathetic side of me that is just like, my God, right? The people I've affected, the people that are still being affected.

One of the things I talked about, and I tried so hard to word it properly, and you probably know where I'm going with this, was the families of people who are suffering an addiction, and the power and balance there. So, and I kinda wanna qualify that. What I said was, for anybody that didn't read that, I guess I could pull it up and quote it, but I won't bother, I'll just do it verbatim. The people who suffer an addiction also face this power and balance with their families.

mike miller (12:39.222)
Hmm. Yeah.

Chuck LaFLange (12:57.045)
Whether they're trying to get money for dope, whether they're trying to get money for food, whether they're trying to, whatever, right? When it goes into treatment, when they're actually looking for healthy things, right? Yeah, right? All of these things. And that's not to say that a family should be second guessing. I mean, I think everybody should always second guess everything they do, but specifically, I don't mean to in any way, shape or form suggest that people's boundaries are a problem or that it's not okay.

mike miller (13:04.65)
or just housing or...

Chuck LaFLange (13:24.353)
However, to the person who is experiencing that power imbalance, it doesn't matter what it is. It's just one more example of them being hyped up and worried and in this fight, flight or freeze mode, right? What it takes to, go ahead. No, no, go ahead. Okay.

mike miller (13:40.31)
But I think part of that, sorry, go ahead. No, you go ahead. I interrupted.

Chuck LaFLange (13:51.769)
Fucking Canadians, right? Uh, what's that about? Um, it's, I know for instance, there's somebody in my family who if I have to ask for help, it takes me weeks to put together a message. Certainly days, often weeks, to put together a message to ask this person for help. I typically now I just don't because I know where it's going to come.

mike miller (13:56.418)
Sorry, eh?

Chuck LaFLange (14:21.493)
But it's the same thing. It's okay, there's a power imbalance here, obviously, right, misciparity, whatever. All the reasons in the world that I should be able to ask and in my mind I should be able to get that, but it doesn't work out that way. But like, it got me thinking about that too. It's like, wow, it takes me days to put together a message asking for this, right? And the feeling that you get from that is just awful, right? It's a horrible, shitty feeling, right? But, yeah.

mike miller (14:48.81)
I think it very much depends on obviously the context of that stuff. You know, you had said earlier, like, you don't want to tell any family members that boundaries aren't OK or anything. But I think you can also have a healthy boundary while naming the power imbalance and being like, I'm not doing this thing to punish you. I'm doing this thing to protect me and you ultimately. Right. And you can just name it like, yeah, I realize you're coming to me for help and that I have this choice and I'm going to make the choice I'm going to make.

You can do that without wielding the power like a cudgel.

Lisa (15:22.225)
Mm-hmm.

Chuck LaFLange (15:22.561)
Fair enough, fair enough, right? Fair enough. Okay. Unless either one of you has any more you wanna touch on with that one, we can kinda move forward into the episode. I just, you asked how I was doing, it was very relevant, and it's something that I like to talk about anyway now. So go ahead, Lisa. Yeah, you did the deep breath there.

mike miller (15:23.692)
Ahem.

Lisa (15:41.821)
I was just going to share this one story. I think I've shared it on the podcast before. But you know how like you have these like, these events that like really stand out to you, you know, in your life. This is one for me. And it's interesting because I feel like to an outsider, it might sound like this somewhat minor insignificant event. But I often

say that like one of the things that I think about a lot as a psychiatrist, I have like medical students, I have residents who work with me. And one of the things that I've thought about for 10 years is how do I translate to students who don't have experience with addiction in themselves or a loved one? How do I pass on the knowledge that I think I have earned as my brother's sister?

that is not something I learned from a book. And what I mean by that is when I see somebody in the emergency department and they're skinny and they're unkept and their clothes are dirty and they're spitting at people and they're hitting the walls, I look at them and I'm like, who are you really? Because this is not who you are. I'm staring at your disease, which is what I believe it is.

I am staring at addiction. This is addiction. And I am always like, who are you really? The reason I do that is because I know who my brother is. And I know what he has looked like and behaved like in the depths of his addiction. And they are two completely incongruent things. There's no alignment there whatsoever.

Chuck LaFLange (17:19.699)
Mm-hmm.

Lisa (17:34.765)
So it's like, how do you take someone who's a learner, who is seeing a person at their worst and make them truly believe that that's not who they are? That is addiction. That's what you're looking at right now. So I'm always thinking like, how do you teach that to people? Unless they have seen somebody go from here to here, how do you make them realize that

that it changes somebody's behaviour and appearances and all of that so much. But so my brother had reached out to me years ago, and maybe 10 years ago. And at the time he was doing pretty well, he was on Suboxone. He was having to drive from Grand Prairie to Red Deer.

mike miller (18:24.078)
Thank you.

Lisa (18:31.833)
to see a doctor who would prescribe him Suboxone because there was nobody in Grand Prairie who would prescribe it.

Chuck LaFLange (18:38.685)
And for context, that's what a four or five hour drive, something like that, six hour drive, maybe.

Lisa (18:45.877)
Yeah, I would say five, six hours probably. And this doctor had kind of said to him like, okay, like I'll do this with these conditions, like basically don't fuck up, you fuck up, you're gone. And he had experienced this at times where he would get kicked out of programs. And so he had developed this trauma response and this fear.

Chuck LaFLange (18:49.065)
Yeah, yeah.

Lisa (19:13.965)
to people taking away something that was his life depended on. So he was working in the oil field at the time and he was told he was getting moved from one rig to another rig. And it involved an entire change in his shift and his scheduling. So he now needed to go see this doctor who had made it very clear, if you do anything suspicious, if you do anything that makes me think you're diverting, whatever it is, you're out.

So anyways, my brother who rarely asks for my help. I mean, I talk about how I'm always willing to help my brother. My brother does not call me up regularly asking for my help. And he called me up and said, can you come to this appointment with me? And I was like, very confused. And I'm like, okay, like I'll drive from Calgary, I'll meet you in Red Deer, we'll go see this doctor. And I was just kind of like, what is this about? Basically, he wanted me there for backup.

that the reason he was asking for this shift in his prescription and his carries and he needed the, you know, his pickup date changed and all this kind of stuff was legitimate. And so I went to the appointment. I didn't actually end up saying anything, but he wanted me to come with him. Like I actually went into the appointment with him and sat there while he spoke to this doctor. And I will never forget this.

I remember watching my brother as he was talking, and this, like, this fear, and almost in a pleading sort of way, overcompensating, overexplaining, overjustifying. And I know that these reasons were valid and real and legitimate. I just remember thinking, This is the saddest thing I have ever watched.

Like why, like you're terrified that this doctor is not going to help you.

Lisa (21:19.229)
and it blew my mind. And again, it's one of those experiences that I feel like.

Chuck LaFLange (21:21.415)
Yep. It's a perfect example. Perfect.

Lisa (21:27.297)
You know, and it's like, this is where I've said before, you know, my dad asked me once, Are you becoming a doctor to save your brother? And I've said to my dad, I believe my brother is my brother, because I am meant to do this work. And he has gifted me an experience and knowledge that no textbook would ever give me. And watching him have that conversation that day is one of a number, but one of the most monumental moments I've had as his sister.

who is a physician, to just stop and go, holy shit.

Chuck LaFLange (22:02.905)
Right.

Lisa (22:02.933)
We are failing people. Like our job is to help and a patient should not come to us terrified that we're going to pull the help or refuse to help. It's terrible. So that.

mike miller (22:17.782)
based on some probably moral judgment as opposed to a medical judgment. And the fact that your brother recognized that not only does he not have any power, but that you would have more power than him if he needed you for backup, because that's how powerless he was and how desperate. Like I can feel the desperation that you're describing in your brother, because I've felt that before, right? Yeah, and we are failing people as a system.

Chuck LaFLange (22:17.855)
Mm-hmm.

Chuck LaFLange (22:37.322)
Right?

Lisa (22:41.407)
Yeah.

Lisa (22:46.793)
Yeah. And I think, you know, this was a conversation I had about two weeks ago, where because of my privilege, you know, my brother's living in a different area, needed a doctor, I was able to find somebody who would see him and had the opportunity to speak to this doctor and to give some collateral and some background history. And one of the things I said to her

mike miller (22:47.714)
for sure.

Lisa (23:13.845)
And I've never actually, well, maybe I've touched on it, but I have not had in-depth conversations with my brother about this. But I believe that he has incredible medical system trauma from things that he has gone through with the healthcare system in the last 20 something years. There was a case where to get on suboxone, a clinic up in Edmonton refused to give him a prescription or caries for a month.

mike miller (23:25.692)
Sure.

Lisa (23:42.965)
So he again left Grand Prairie with a three-month-old baby, a seven-year-old son who he had to pull out of school, and him and his wife had to stay in an Edmonton hotel for a month because they refused to give him a prescription until he proved to them that he was not going to abuse his suboxone. You know, like the...

Chuck LaFLange (24:05.015)
Wow.

mike miller (24:09.739)
I've never had that with my asthma inhalers.

Lisa (24:12.865)
Yeah, exactly. Right? Yeah. Or I would say, even beyond asthma inhalers, what about, you know, again, the choice thing, right? It's like asthma, okay, but like what about if we compare it to diabetes, type two diabetes, you know, diabetes that you probably have because of a series of many years of lifestyle choices that led you to have diabetes.

Chuck LaFLange (24:13.918)
Ah, right, you know. Well said, well said.

mike miller (24:18.002)
When you talk about that doctor...

Lisa (24:42.625)
So do you go into your doctor to get your metformin prescription and do they sit there and go, well, did you eat chocolate in the last month? Not sure I'm gonna give you your metformin. Hell no.

mike miller (24:53.078)
That's it's the moral model in action, right? It's the stigmatization. It's the othering of people with addiction, right? And just the oppression, it's all gross. And when you're talking about the doctor too, and like your brother's desperation, like I've seen, and you know, Chuck was talking about when he had the power as the dealer and stuff, and I was that for a long time too. Like I've been that guy who could have.

pulled the rug out from under someone who was gonna be really sick if they didn't get what I had. And so that doctor was like a dope dealer. Like essentially, like it's like legal and all that, but it's like he's using discretion rather than medical interventions, right? And based on his own biases and moral judgments.

Chuck LaFLange (25:34.333)
Yeah, and to the person experiencing that power imbalance, it's the same goddamn thing. 100% it's the same thing, right? Ah, Jesus. Yeah, yeah, right, to the person experiencing it. So, oh dear, and I think, talk about medical trauma. I mean, I've shared my experience in the past. In the interest of time, I'm not gonna go into great detail, but I went in with an abscess from injecting, and I was treated like a subhuman being.

mike miller (25:44.261)
Yeah, for sure. It would feel like it. Absolutely.

Chuck LaFLange (26:02.621)
100%. I was put in a room with a steel door, and it was like, uh-uh, you know, closing that fucking door, right? That's gonna bring up a whole new trauma for me, right? Because I've done that, right? But it is, that's a very real thing, and perhaps an episode to be done on medical trauma. They said, now that you're talking about that, I think that would be a great, great episode to do, right?

Lisa (26:03.818)
Mm. Yeah.

Mm-hmm.

Lisa (26:11.855)
Mm-hmm.

Mm-hmm.

Lisa (26:20.662)
Mm-hmm.

mike miller (26:22.106)
Well, there's a segue here because...

Today we were going to talk about EMDR, and I have used EMDR surprisingly, a surprising amount of times for people that have been traumatized by the medical system. Absolutely. Not necessarily in situations just like this, but in lots of different ways, right? Because yeah, you don't feel safe. It can be very invasive to your body. It can be invasive, like having to justify.

Lisa (26:39.737)
Mm-hmm.

Chuck LaFLange (26:40.334)
Right?

mike miller (26:53.278)
like why you want certain things to be done or whatever. Yeah, and it's, I was surprised how many, how many clients I've had come and say, like, the system has failed me in these ways and made me feel these certain things and people that are terrified now of doctors, of dentists, and all kinds of different things.

Lisa (27:12.213)
Mm hmm. And it's interesting because I feel like there is like a hierarchy with physicians no matter what like it doesn't matter what you have, you know, there's I think it's better than it was 50 years ago, I think, but maybe I'm biased. You know, like, I feel like back then, you know, the doctor always wore the white coat. And it was like everybody had to call them doctor and the doctor knew all things and the doctor was not wrong. I don't think it's quite

Chuck LaFLange (27:12.417)
Kidding. No kidding, right?

Lisa (27:41.901)
the same, you know, like most of the people I work with, like we don't wear white coats. Why? Because it just adds to that power differential. But I still have nurses who refuse to call me by my first name. And I'm like, you don't need to call me doctor. Like you and I are colleagues, like you can just call me Lisa, and they will not do it. So there is that hierarchy. But I think, you know, when you are someone suffering an addiction,

Wow, do I think that's pronounced? You know, I think it is magnified big time.

mike miller (28:13.07)
pressure.

Chuck LaFLange (28:13.089)
big time.

Chuck LaFLange (28:17.409)
Big time, big time.

mike miller (28:17.91)
Yeah, absolutely. I would agree with that. I've been, you know, sorry, go ahead.

Lisa (28:20.382)
Yeah.

Chuck LaFLange (28:25.08)
Go ahead.

mike miller (28:27.542)
No, just to say I've been sort of the situation that you were talking about, Chuck, is like walking into a clinic and feeling dirty and less than just because of my substance use disorder at the time, right? That it was active and just knowing that, you know...

there's like signs, like we don't keep drugs here. And like, you know, it's just like the stigma is just baked right into the system when it comes to addiction. And I think most people that have any kind of, I mean, I've said this lots of times before, I don't even like the word addiction. Because it's like so stigmatized, but if you're living with that, everywhere you go, you feel.

that if you're going into a restaurant, if you go into a 7-eleven or something and people are keeping their eyes on you and like, you know, it's just like constantly that stigmatization and feeling less than and when you're coming up, like if a 7-eleven employee can make me feel less than and they don't really have a lot of power over me, what can a doctor do? Right? What can police do? What can, you know,

Chuck LaFLange (29:30.922)
Right.

Yep, yep, yep. 100%, yep. Yes.

Lisa (29:38.965)
I mean, I have a question. I know we want to talk about EMDR. So this will be my last question about this. But as people who have that lived experience, who are in recovery, who have done trauma work, who are trauma trained therapists, like what do you, like if there are physicians, if there are healthcare professionals, if there are pharmacists like listening to this.

Like, what would you say? Like, what are things, and again, I know it's a broad question and we could talk about it forever, but like, what are things like, or pieces of advice that you would give that you think would help to decrease, because we're not gonna eliminate it, but would help to decrease that sense of that power differential that I think negatively impacts people in recovery seeking help or reaching out for help?

Chuck LaFLange (30:30.765)
I think you answered this question already earlier, Lisa. Right? Name it. Own it. Right? I think you did. Go ahead, Mike.

mike miller (30:31.903)
I mean, it's a...

Lisa (30:37.753)
Maybe.

mike miller (30:38.69)
Yeah. I also think like.

For a medical professional, I think, like if you could illustrate for them the difference, like, you know, and I love it, and I've used it for years too, the diabetes, you know, it's like this is caused through behaviors, you know what I mean? There might be some predisposition or whatever, but you know, lifestyle choices and behaviors that have you in this situation with this illness, does a doctor treat them any different? So then, you know, maybe if you could illustrate to them, like, do you do that in any kind of way?

But I also think like, the doctors take a Hippocratic oath and they should do no harm and they should like be, you know, patient centered and like, leave your biases at the door and just see the person as a human being and that they're struggling with something. And I mean, it's easy for me to say that, but like bring empathy to your work because I think, you know, whenever I hear you speak, Lisa, that's what I hear that you do.

right? And I know I try very hard to do that myself. And the thing about addiction is it, you know, comes with a ton of really shit behaviors, right? So it's easy to be like quite judgmental and get on that moral sort of model of it that like, addicts are bad people and stuff, but, but they're not right? And yeah, I don't know, like,

Lisa (31:57.386)
Mm-hmm.

mike miller (32:04.242)
If people are working with addiction and don't have that, maybe my advice would be like, get a different job or work in a different area of medicine, right? Like go, I mean, I remember when I did some work for the College of Physicians and Surgeons in BC, training prescribers and pharmacists around methadone. This was probably like 18 years ago or something like that. And.

Lisa (32:10.164)
Yes.

mike miller (32:32.326)
I got to role play as an addict. And I had a whole scenario behind me and I got to come in and yeah, they're like, do you think you can do that? I'm like, yeah, I think I can probably do that. And so with my scenario, what was happening is this doctor should have cut off my caries, right? Because I had tested positive and blah, blah.

Chuck LaFLange (32:37.8)
I got this.

mike miller (32:54.95)
That's the scenario that I was given to play up. And by the end of it, like, you know, and this is in front of a room full of doctors. Dr. Sobi was the one that got me in there running it. It was amazing. And the doctor said, like, can you give this woman some feedback? And I said, you know, and this is me, like, a couple of years clean.

Lisa (33:03.661)
Mm-hmm.

mike miller (33:17.642)
working at like a 12 step recovery house, a little bit of education at that point, but not very much, not very much experience and everything. And I was, you know, here's the power imbalance. I was like, I can't, I literally said, I can't tell her. And he said, no, you have to tell her, tell her what you think. And I said, like, if this is how you're gonna treat people, you're in the wrong job. Like this is like, you just gave me, not only let me keep my caries, but increased my dose of methadone when I tested positive for cocaine.

Like, why would you increase the, you know, I was like, you just don't understand it. And it wasn't about the stigma or anything. It was just that she didn't get it. And I think that maybe some people should specialize in other areas or get more education about it. You know, I think, I think at that time, uh, Paul told me that going through medical school, like how long do you go and do fellowships and placements and like all the, like, like 10 years to be able to be a doctor.

Lisa (33:59.577)
Mm-hmm.

mike miller (34:14.386)
And he told me it was like an hour and a half on addictions in that 10 years or some like crazy little amount. And I was like, Oh my God, like I know infinitely more about addiction than most doctors and that's just from living it. Right. Um, so I think like, if you're going to work with it, you should probably learn about it. Could you imagine like some me go like a doctor who's like a GP all of a sudden like doing, you know, neural

surgery or something on someone like it's like that's not your specialty you should probably learn about it before you get your hands in there and Maybe that's the advice I would give is like learn about it or get out of it I don't think it should be part of gp work

Lisa (34:42.669)
Mm-hmm.

Lisa (34:49.657)
Mm-hmm. Yeah.

Chuck LaFLange (34:49.937)
to use the fallback, learning about diabetes for an hour and a half and then telling me about my, you know what I mean, right? Right? I went to themailclinic.com. Yeah, right? Listen, we do need to segue, and Mike, you had a beautiful segue there, then we took and we turned it into a ramble, but you had a beautiful segue into the EMDR. You kinda did, you kinda did, but that's okay, I'm not gonna shame you for it, right?

mike miller (34:57.538)
Yeah. And then just shaming you for the choices you've made.

Lisa (35:02.805)
Hahaha

Lisa (35:11.565)
ruined it.

Chuck LaFLange (35:16.545)
This is like, hey, I have hosts, you have co-hosts, like this is the only power balance I will ever have, right? So I'm gonna exploit the shit out of this right now, okay? All right? Ha ha ha.

Lisa (35:17.945)
Hehehehe

mike miller (35:26.146)
Take the reins.

Lisa (35:27.637)
Yeah.

Chuck LaFLange (35:30.341)
Listen, this is the third part of the series. Whether it's the final part, I don't know, but it's the third part in this series on trauma. In our first episode, guys, if you go back and listen to it, it's episode 207. It was about internal family systems therapy, as Mike practices that at the Otter Treatment Center. And in the second episode, episode 209.

mike miller (35:31.566)
It's the ramble. Lee said, I will go on forever.

Chuck LaFLange (35:56.649)
was about cognitive behavior therapy as Mike practices that are modality. And we're gonna say what, I'll say it, the best for last, at least my favorite of the processes that happened there because it was so profound, the EMDR, the eye movement desensitization reprocessing therapy. I'll speak to my quick experience here, Mike, and we have a laugh about this, we have multiple times.

So my first one, and I'll just lay out how it happened as I remember it, my first one, my first session with EMDR, you had asked me to write down the names of some events, not a description, not anything of the sort, just the names. And I could have called it Orange, but we just needed something to refer to it, right? A title. For me, it was an event where I'd taken hostage, and I knew I was going to, and this is way more information than I gave Mike in the session.

mike miller (36:35.374)
Thanks for watching!

mike miller (36:44.086)
titles.

Chuck LaFLange (36:56.517)
I knew I was going to die half a dozen times that night. It was absolutely horrifying, terrifying, and has affected me and kept me a prisoner in my mind and even my home for a long time.

mike miller (37:11.628)
your body.

Chuck LaFLange (37:13.381)
It most certainly my body. All I had to do was give it a name. Okay, so I think I called it the hostage, is that what I said? I think that's what it was. After a 20 minute session of EMDR, I looked at Mike and I went, fuck you. I was just completely taken back by how much better I felt thinking about it.

mike miller (37:23.542)
I think so, yeah.

Chuck LaFLange (37:39.941)
It wasn't gone, the memory wasn't gone, and that's not the promise made. And I don't know if a promise is the right word anyway, but it was certainly, the memory was still there, but I was able to talk about it. I'm able to, like just now, there's no way, six months ago I have this conversation the way I have right now, there's no way. Right? Jesus, there's just no way, right? So, and now if I get emotional about it, it's about the relief, it's not about, because it was so profound to me.

Mike, I really do want to talk about EMDR. And like I said, and I'll call it the best for last, God damn, I will. I think it's interesting how it all meshes in together. So, it is, it is. And we've talked about it on the show before, but we've never talked about it in a way that I experienced it. So now we've got some real context to go into it. So, what's EMDR, Mike?

mike miller (38:17.602)
Yeah, well, it's my favorite.

mike miller (38:23.074)
Yeah.

mike miller (38:30.158)
Yeah, well, I mean, there's a... Well, I could talk about it forever, because there's like a lot of different aspects of it that are sort of important to talk about. So, you know, Francine Shapiro was this as legend has it. And it's true, but I might get some of the details of it off because it's been sort of verbally passed along. She's a psychologist. She's...

also does research and stuff. So she's walking, she's having a shit day. So she goes home after work and she's walking her dogs and she's in the park and she finds her eyes kind of going back and forth and she's soothing herself and she's going like, Oh, I wonder what that's about because she's a psychologist. And because she's a researcher, she gets very curious about what's going on. And she's dealing with very complex clients, trauma clients. So this is in 1987. Um, there was no re like the understanding of trauma back then was a lot less.

effective treatments for trauma, a lot less. So she just started sort of like working with her clients and being like, if I'm moving my eyes and it's giving me, it's soothing me, like maybe I could get some relief from, or for my clients from what they're dealing with. And so I'm sure that there's like a lot of different iterations of what she did. When she first came up with it, it was called EMD. There was no R, which is reprocessing. That wasn't part of the process, but.

So she started practicing and essentially like, she needed to write, like in order to write and be published in any kind of like medical journals or psychological journals, she had to have a theory about why it was working. Because she was getting good results. Like people were getting the results that you were just saying. And what we know now, the evidence shows us that EMDR will do basically three things. It will make memories.

Lisa (40:09.965)
Mm.

mike miller (40:21.178)
harder to recall. So like usually if they're traumatic memories, it's like, it's almost like they're stored in short-term memory, not in long-term. So they get quite intrusive and they come back at us like flashbacks, nightmares, intrusive thoughts like around memories. And so they become harder to recall. So they're not as intrusive. They're less vivid. So like the colors and textures and smells and sounds and that kind of stuff gets desensitized and less disturbing. So you don't

When we talk about disturbance in EMDR, we always call it suds, subjective units of disturbance from zero to 10. Zero is calm, neutral, no disturbance. 10 is the most you can imagine. When we talk about disturbance, a lot of times with clients, I'll do like a little experiment, if you will, and I'll sit with a client and I'll say, okay, so if I was to say to you, yes, what do you feel in your body? And most people go.

nothing, I don't really feel anything. And I go, and I don't even have to do it. But I say, if I was to raise my voice and lean in and go, no, what would you, and so many people go, oh, that thing in my chest. Like, oh, that's the disturbance, right? Because say we're doing a memory on a hostage taking, we're not making that, we're not erasing the memory. We're not making it a happy memory.

What we're doing is we're desensitizing it and making it less intrusive so that when you want to think about it You can go back and think about it But that won't come with that gut punch kind of feeling and you'll have an appropriate Emotional response which will be like that was sad or that was scary, but I'm not living it right now Our hippocampus, you know, and I'm not a neuroscientist, but this is what I was taught by a neuroscientist and it's probably pretty simplistic but when

When you used to take photographs with film cameras and you take it into like a photo mat and then you'd get the photos back, on the back they would have like a timestamp on it, a digital like in red timestamp. And the way I was taught is that when your memories are being stored, they're supposed to have timestamps on them. Like this is when it happened and this is what it ended, but traumatic memories don't get that last timestamp. So like you don't, your brain doesn't know.

Lisa (42:36.985)
Thanks for watching!

mike miller (42:39.638)
that memory is over, which is why we keep reliving these traumatic events and why we get nightmares and flashbacks and intrusive thoughts. So EMDR as a process is called adaptive information processing. And for lack of a better word, we're attaching those memories to adaptive information that we have now and storing them away in long term. And I'll talk about like what that means adaptive information. So say,

I was taken hostage. I'll just use that if I can use that as the example, kind of continuously through this. I'm gonna have a negative belief about myself based on that memory. Whenever we have a traumatic memory or processing it with EMDR. So this is the thing, Chuck said he didn't tell me all that stuff. We don't. EMDR is very strict protocol. We go, what's the target memory? Hostage shaking. What image represents the most disturbing part of that memory? And he just tells me the image.

with all the vivid sensory stuff, what sounds go with it, what smells, all that. What's the negative belief that goes with that image about you today? Or what words go best with that image that describe your negative belief about yourself today? So I would say it would be something like I'm not safe, right?

mike miller (43:56.31)
but actually you are safe. The adaptive information is I'm safe. But when I think about that memory, it's like, I don't feel safe. It doesn't feel true that I'm safe. I want to believe that I'm safe. So when we do the EMDR, the eye movements or any other kind of what we call bilateral stimulation, which was what Francine Shapiro's theory of how it works was, it's like we attach that memory to this new information, which is like,

Oh, actually, I am safe. So we desensitize it so it doesn't feel the gut punch. So the EM stands for eye movement, desensitization, less vivid, harder to recall, less disturbing. And then the reprocessing is I get a new understanding or belief about that memory. So if I'm abandoned when I'm five years old, then I have this belief about that is like, I'm not lovable. Then as an adult, I'm 53 years old. I go, well, actually, people do love me.

And when I think about that memory now, I can actually believe that when as before I couldn't, right? So that's the R part of it. So I'm gonna go back. She needed to have a theory about why it worked. And so she came up with bilateral stimulation. You're stimulating both hemispheres of the brains through moving your eyes and following the therapist's fingers. And she published it. And a lot of people went, oh my God, that sounds amazing. And I'm gonna try to work on.

with my clients on their stuff using that. And a lot of people went, that sounds insane because we're talking 1987 when the prevailing way of doing therapy was talk therapy, right? So at that point, some people tried to kind of prove that it would work with their clients and some people tried to prove that it wouldn't work. And so they just kept.

Chuck LaFLange (45:34.345)
I'm going to hit stop, I think. You still there, Lisa?

Lisa (45:40.917)
Yeah, I'm still here.

Chuck LaFLange (45:43.497)
Yeah, I'll hit stop. Who knows, right? Yeah.

Lisa (45:43.885)
Wonder if Mike knows he's not. Is he just still going?

mike miller (45:48.886)
doing it and replicating her results. So she kept getting good results and the theory was what was making it work was the bilateral stimulation, stimulating both hemispheres of the brain. That make sense?

mike miller (46:02.735)
you guys.

mike miller (00:02.91)
So going back to Francine Shapiro's theory, she had to have a theory to get published about how it was working because she got good results. Other people were probably in need of this great tool, but she had to theorize how it was working, why it was working. She knew it was working, but she didn't know exactly why. So she came up with bilateral stimulation, stimulating both hemispheres of the brain.

And that's connecting the memories to the adaptive information and desensitizing and doing all the things that I've kind of rambled on about. Now, a lot of people read her papers on it and were, this sounds amazing and started doing the work with their clients and replicating her results. And a lot of people, I think were probably like, this sounds like crazy because it's 1987 and what we do is talk therapy.

Chuck LaFLange (00:57.997)
Voodoo, yeah.

Lisa (00:58.703)
Thank you.

mike miller (01:01.686)
and psychoanalysis and we don't do this like waving our fingers in people's faces while they're not talking about the memory, like literally intentionally not talking about the memory. And yet they kept replicating a result. So like EMDR has one of the biggest bodies of evidence for psychotherapies showing that it works. Later on, there was a British guy.

Chuck LaFLange (01:01.726)
Yeah.

Chuck LaFLange (01:08.925)
Hahaha

mike miller (01:28.078)
who happened to be in the United States, and he became a fan of college football, excuse me, and he was listening to a game driving along, and he was visualizing what was happening in the game, and his driving got really erratic. And then he stopped listening to it, and his driving got smooth, and he came up with what's called the working memory theory, which is like, you have long-term memory, which is vast, and can have millions of bits of information in it.

And then you have like this working memory where you can only hold a few things at the same time. You know, if you think about when you're driving along looking at like a house address, you like turn down the music. Or if you're like counting and someone next year is going like 6, 13, 24, like you lose it a bit. Like you're, you can't do all of this stuff at the same time. So some EMDR therapists theorized that, well, that's actually why the memories are getting desensitized. It's because you're taxing your working memory.

through memory taxing tasks, one of which is following the fingers with the eyes while thinking of an image and noticing what's happening in your body. And that what's happening is your brain can't do all of that stuff. So something has to give and what gives is the vividness of this memory. Now, we know it works. There's so much evidence that it works. And these are these two sort of prevailing theories about why it works.

Lisa (02:29.899)
Mmm.

mike miller (02:52.578)
So in my work, what I do is because I'm a belt and suspenders kind of guy, I do both. So I will do bilateral stimulation and I will add other memory taxing tasks, including like tapping a very simple rhythm, spelling words, forwards and backwards, humming, like there's lots of different things that we can do. Um, there's different forms of bilateral stimulation. So you can like tap, it's called a butterfly hug, lots of different ways to do it. Um, but the end result is, uh, generally speaking.

Lisa (03:19.939)
Hmm.

mike miller (03:22.422)
I get people, I mean, minus the fuck you part, I get a lot of what Chuck tells me, which is that it doesn't bother me as much anymore. A lot of times what I'll get people saying is it feels farther away. Like when I look at it, it's harder to bring it up and it feels farther away. Or they'll say it's blurrier or it's like there's like a sheer.

curtain in front of it, like lots of different ways to describe like that it just isn't so in their face all the time. So when I first got trained in EMDR about eight years ago, I went to Hong Kong to get trained in it. And the place I worked for was sending me and I was a super skeptic. Like I am just absolutely a skeptic of anything that I can't like touch or, you know, I was like, you know, I'd been a counselor and a top therapist for like

Lisa (03:51.695)
Mm-hmm.

Lisa (04:08.527)
Thank you.

mike miller (04:15.874)
10 years at that point and I was like, this sounds like a bunch of garbage, but free trip to Hong Kong, sign me up, right? I'm in. And a couple of guys from work went there with me and a woman from work that was already in Hong Kong, we all met there and had a great little time. And we worked with each other. And not, I mean, us all that attended, not me and the guys I was at work with, but this was my experience on Day One as a super skeptic. And it's a very strict protocol.

Lisa (04:20.717)
Yes.

mike miller (04:45.534)
So I'm going off a piece of paper and I'm like, okay, am I supposed to like move my fingers now? Is this how I do it? Really clunky, like it didn't flow and I didn't know what I was doing. Real neophyte EMDR therapist, no idea what I'm doing. And the woman that I was working with, she was having a struggle because her boyfriend was wanting to ask her like, we should get married.

but it was like a gut punch to her because a memory that she had was her last fiancee, she walked into their apartment and he was cheating on the sofa with somebody. And that was the image she had in her mind. The belief was, I'm not lovable. And I'm going, how do I do this? She was like quite distressed by it. Within 20 minutes.

She said it didn't bother her anymore. The image wasn't so vivid. She went up to her room. The next day she came back down. And I asked her, I checked in, because EMDR is eight phases. The eight phases are evaluation. So you always come back after and go, how are you after the last session? How's that memory? And she said, I felt so good. And I talked to my boyfriend and we're gonna get married. And that was like, I didn't know what I was doing. And that took 20 minutes.

Lisa (06:08.387)
Hehehe

mike miller (06:12.702)
And my first experience as the client was someone else who also didn't know what they were doing. He said, you know, okay, so, so what's the image, blah, blah. And I had an image from when I was 15 years old at the time I was like 45. So this is like a 30 year old memory. And how, how disturbing is it? I said like five out of 10. And he asked me, what do you know this now? Cause that's EMDR language. You know, what do you notice? And I said, what I noticed was the thought in my head. I said, this isn't going to work.

And he said, what EMDR therapists? Like, okay, just go with that. Meaning just notice that's what you're thinking is. And he just went again, what do you notice now? And I said, yeah, this might work for other people. Definitely not gonna work for me. And he went, okay, go with that. What do you notice now? And I went, oh, I feel like I have this big grapefruit in my throat, like all of a sudden I was getting physical sensations. What do you notice now? And just kept going, kept going. He wasn't asking me about the memory or doing any of that stuff. And I'm in my head, I'm kind of going like, this is crazy, but.

I really am noticing some stuff in my body. Within half an hour, that memory didn't bother me anymore. Um, I had a different belief about myself in relation to that memory. And to this day, eight years later, that memory doesn't bother me anymore. And it's like really changed a lot of, uh, the impact of what that memory had on relationships at work and stuff like that. That is like what I saw my value as it worked. A lot of that stuff changed.

And this is someone who, day one, didn't know what they were doing, had just been trained. Um, so at that point I was like, okay, I've gone from a skeptic to a believer within like two days of training. I was like, okay, this is happening. One of my colleagues had just been in the, uh, earthquakes in Nepal. And he was, um, having a struggle being in a, in a higher up building that we were in, like we were in a library building and he saw the trainer after, and I don't know exactly what happened.

between them because I wasn't there. But the next day he seemed to be quite fine. And so I was like, okay, so I've seen some pretty profound things really quickly with this therapy. And so, you know, I became a big believer. And when Chuck said, you know, save the best one for last, it transformed my practice at that point. I was like, I love EMDR. I'm gonna focus on trauma because all the people that I met at, this is at a rehab center where I worked. All the people that I met had some form of underlying trauma.

mike miller (08:37.582)
or negative beliefs about themselves. Because as we talked about last week, you can use the MDR in so many different protocols, including to desensitize negative beliefs or memories that support negative beliefs you have about yourself.

Chuck LaFLange (08:52.212)
So that is where, well, that's interesting there. Actually, yeah, let's do your question source because they're gonna be about EMDR and I wanna talk about some other stuff. So yes, please do, yeah.

mike miller (08:54.414)
I have way more, I can go on and on. You guys gotta jump in, it's just me talking.

Lisa (09:01.295)
question.

Lisa (09:11.431)
So I am not trained in EMDR or ART. We do have a psychiatrist who's trained in ART. So again, different, but I think similar in many ways. And I find in the day hospital that I work in, so much trauma, like, you know, either childhood stuff that's driven personality development or acute traumas or whatever.

And so I'll have her come in and I'm kind of like, you Mike, like I hear about it and I'm just like, it sounds kind of wild, but I'll consult with her to see patients to do this trauma work and I'll see them after a session. And it's just like, like.

Lisa (10:01.959)
like there's not another modality of therapy where I see such an acute change after so little time, after so few sessions, you know, and I'll see people who are like on antidepressants and benzos and they're tremulous and they're like so traumatized and it like I'll never forget this one guy and this trauma was like 20 years old and he was like a non-functional human being who couldn't leave

get him to day hospital. One session of this sort of trauma work. And he came in, he's like, I'm good. I was like, what? Like, are you for real? Like, you're like, is this for real? And it's for real. And I like, I'm the same. Like I see it over and over and over and like see the effect.

And yeah, so I do think it's like mind blowing work. And like we said, like even with theories, like I don't think we fully get how this is doing, what it's doing, but it's doing it. And so let's just run with it, right? Question for you, like with the belief piece, some of them I feel like I can like, I can think, okay, I can imagine what the belief might be. Like, you know, I'm not safe in the example that you've been using.

mike miller (11:04.834)
Yep.

mike miller (11:10.517)
Mm.

Lisa (11:18.327)
What about like, what are the common beliefs that you hear from people whose trauma is related to witnessing something? And I can see again how it could be well, an I'm not safe thing. But what about when

mike miller (11:26.145)
Mm.

mike miller (11:31.438)
powerless. So there's different, and I could send it to you. So I have like a little prompt, like if you looked up, if you Googled common positive and negative cognitions for EMDR, it's online. And so they'll have them and it comes in different sort of headings of like responsibility, control, power. So it's like, I should have done something, right?

Lisa (11:33.103)
Okay, yeah.

Lisa (11:36.759)
Mm.

mike miller (12:01.95)
you know, I'm not good enough, like, you know, if it's witnessed, it would depend, obviously, on the context of that. But I think there's going to be some stuff helpless, powerless.

Lisa (12:10.607)
Because I'm thinking of a case that I have right now, and she actually just had her intake to do trauma therapy with the psychiatrist yesterday. And the session itself will happen next week, but her trauma was walking in on her sister who had suicided, and her sister was deceased when she found her. And no one would question that that's clearly incredibly traumatizing.

but I had not really thought about like, what's her belief about herself in that? But I suspect it's probably in that powerless realm. Cause I don't, yeah, yeah.

mike miller (12:48.002)
I should have done something, something like that, a lot of people, survivor guilt stuff, like possibly that stuff, right? But what I do is a lot of the times, I will bring out that prompt sheet and I'll say, look, I want you to pay attention to kind of what's happening in your body, holding that image, because we always go with one image, the most disturbing part. I'm gonna read down this and let me know what resonates, like what feels like that, right?

And I would just go down it and some of them don't feel even like, you know one of the ones that's on there is You know, like I'm not lovable like that might not resonate if you if with this client that you're talking about but definitely I would think some of the stuff about control and the power stuff like You know then Yeah, so it's not my you know, it's my fault. I'm a bad sister You know

Lisa (13:36.447)
the guilt.

mike miller (13:44.766)
I've let her down. I always let people down like, you know, there's those aren't necessarily on the list like that but you can definitely like find a way into that stuff and then After they have the negative belief we go. Well, what's the preferred pause? What's the belief you'd prefer to have right? So let's say you know in the example if I've been taken hostage and my belief is I'm not safe When I think about that image that feels true. I'm not safe. Well, what would I like to feel true?

Well, I'd like it to feel true that I am safe. How true does that feel on a scale of one to seven? One being false, seven being true. Well, it feels false because they can't both feel true. I'm unsafe and I'm safe. So that becomes a treatment goal. We want to, we're going to change that belief from I'm unsafe to I am safe. And it's funny because like a lot of times by the time you desensitize it and it's connecting to adaptive information.

I don't even have to ask how true does it feel like, well, I know I'm safe now. I wasn't safe then, but I am safe now. I get that. And that takes no prompting and no more. We do some eye movements if that doesn't feel completely true, but a lot of times it just feels true once you've done the reprocessing, or the desensitizing.

Lisa (15:00.475)
Because when you're exploring that belief, is it the belief when you think about the memory or are you focused on the belief that they have there in the moment sitting with you?

mike miller (15:13.41)
So it's a strict protocol and it's worded quite specifically. And it says, what words go best with that image that describe your negative belief about yourself now? So first person, present tense, a lot of I am, whatever it might be, but it matches that image. It feels true with that image, right?

Lisa (15:34.532)
Mm-hmm.

mike miller (15:39.37)
Some people will be like, well, I know I'm safe now. So, okay, so it's not, I'm not safe, you know, and then we go through and we try to find the right negative cognition. And we always, sometimes that can take quite a bit of time. It's kind of like finding a core belief in the CVT stuff. Like it can be, you gotta find the right one. And it's pretty powerful stuff when that stuff shifts.

Chuck LaFLange (16:02.119)
Mm.

Lisa (16:02.347)
And like, I was just gonna say too, that is what I hear. Cause like they go and they do the ART as an add-on to the work that they're doing with me. And so I get to see them like pre-ART, I get to see them post-ART and.

Chuck LaFLange (16:10.504)
Sorry, that's the second time you've referenced ART. Lisa, that's the second time you've referenced ART. So what are we talking about there?

Lisa (16:16.435)
Oh, sorry. It's um.

Lisa (16:22.623)
Accelerated resolution therapy. I had a moment there, I was like, what is it again? Accelerated resolution therapy. So like, I don't want us to derail off the EMDR, but they're very similar, right? And so it's just, I say ART because the lady that's trained in the clinic that I'm in, she's not trained in EMDR, she's trained in ART, but very similar, right? Yeah, and what I find...

Chuck LaFLange (16:26.168)
Okay, okay.

Chuck LaFLange (16:45.364)
Okay, okay, okay.

mike miller (16:45.494)
Yeah, there's some similarities for sure.

Lisa (16:50.435)
the same is that when I see them after the messaging, and again, like what Mike is saying is what they'll say to me is, well, like I still remember, like I still have the memory, right? Like we're not going in and like wiping people's memories out there, like I still remember it. But now when I talk about it, I don't get like a physical reaction in my body. I don't start to psychologically feel scared and anxious and distressed.

They'll tell me like suddenly places I was avoiding, like I couldn't walk through that door of the hospital because it's somehow linked to the trauma. Well, I walked through that door the other day and I was like, hmm, like I'm here and I feel okay. So very sort of.

mike miller (17:35.55)
I had someone who had electrocuted themselves in the backyard of their home and ended up becoming disfigured by it and thought they were going to die and all that kind of stuff. We did a half hour EMDR session with a plan to do more. I contacted them maybe three days after the session and just said, hey, how's it going, blah, blah.

Oh, I went home and went in there and everything's fine. Like literally couldn't go in the backyard, bought the house and was like heartbroken that they couldn't go into their own backyard that was their forever home and all that stuff. Half an hour later, boom, walked in. Oh yeah, I forgot to call you. Everything's fine now. Like, oh, okay. And I'll tell you, I have these moments where I'm like, really? Like really?

I sit down with someone and we're talking about childhood sexual abuse stuff, not talking about it, sorry, we're processing it. The end of the hour, that disturbance level has gone from 10 to zero and their belief about themselves has gone from feeling completely false to feeling completely true, whatever that belief is. That's a memory that's been around for decades.

Chuck LaFLange (18:31.992)
I'm sorry.

mike miller (18:57.586)
It doesn't, we're not erasing the memories. That's actually really important to point out too. A lot of people, if what they're processing is the loss of a loved one, they feel, or maybe a part of them feels, like they will be betraying that loved one, or they're afraid that they're going to like forget about them if they process the memory. And so I quite often liken it to like a logjam.

Lisa (19:20.754)
Mm-hmm.

mike miller (19:25.706)
When they think about that loved one, they always think about the loss. Like that's the first thing that pops into their mind is the loss. And then when we do the processing, it's like a log jam in a river. And as we process, it like opens up and all this other stuff comes through. So now when they think about them, they think about like all these amazing, good, happy memories that they haven't had access to because the loss was front and center blocking that river. And I've seen that happen a lot. So during the processing, what do you notice now?

Lisa (19:50.959)
Mm-hmm.

mike miller (19:55.686)
I thought about this time with them that was like really amazing when we were like kids or whatever. Oh, okay Go with that. We just go again. What do you notice now? And all of a sudden like all these positive memories are coming up That they didn't have access to at the beginning because anytime they thought of that person they had this debilitating like Sadness and grief and just like, you know, again, I always say the word gut punch But people understand what that means I think and that's you know, so now not only are you not Forgetting them you're not betraying their memory

Lisa (20:01.638)
Thank you.

mike miller (20:25.046)
but you're actually getting access to like way more of the good memories about why you feel that loss in the first place, because you're so close to these people, right?

Chuck LaFLange (20:33.672)
So Mike, I have to ask if, oh, okay. I'm gonna ask about this one real quick, Lisa, if you don't mind. Well, if you do mind, I'm gonna ask, but. It's, hey, it's like, I get it rarely, right? So anyway, longevity of the effectiveness.

Lisa (20:34.094)
Mm-hmm. Because, yeah, how do you deal like,

Lisa (20:41.111)
Sorry.

Chuck LaFLange (20:59.512)
I'm sure there's papers written and I'm sure there's all sorts of evidence to back it up. In your experience and with the evidence available, how is that? How is the longevity of the effectiveness of this?

mike miller (21:13.646)
enduring. You know, like I say, my very first experience with someone who'd never done it before the first day that I did it, like as a client, that memory was 30 years old, eight years later, doesn't bother me. My experience. So this is the eight phase. Everyone thinks EMDR is literally just the fourth phase, which is this. I mean, anyone who knows about EMDR, I get clients coming in and they go, I want to do EMDR. And they think it's just this.

Chuck LaFLange (21:20.818)
Yeah.

mike miller (21:41.57)
The eighth phase is always the reevaluation, where you go back and say, okay, that memory that we worked on, you said it was at zero, how's it at now? I'll tell people, think about it in between sessions. If it's obviously disturbing, because I always go like, it's our brain and our brains are very complex. Anything could happen kind of, but in the eight years or so that I've been doing EMDR, I've never had someone come back and say that memories that we've processed have become more disturbing later.

But what can happen is when we're dealing with complex PTSD, people might have multiple memories around, say for example, like this family member. And if you process one, like it might not feel disturbing at the end of the session, but that family member isn't going to all of a sudden feel safe. You've got more stuff you have to process. So complex PTSD can take a longer time because it's, you know, there's quite often

a lot more frequency and over a longer time span. So, you know, it's complex, right? One off like PTSD, like if someone was in a plane crash, like that stuff in my experience, we can like clear that up like really quick. Criterion A symptoms, nightmares, flashbacks, intrusive thoughts, that stuff goes away like really, really fast. And I don't have people come back and tell me that it's sort of undone itself, right?

And so, yeah, that's my experience. I mean, there might be papers written to the contrary, but I don't know that people would be writing those papers, but it's not been my experience. And I don't know anyone in any of the EMDR circles that I circulate in that report.

Chuck LaFLange (23:22.644)
Okay, great answer.

Lisa (23:22.735)
Mm-hmm.

mike miller (23:23.766)
I think it's just, you don't want to be naive enough to think that everything is straightforward and you have to be quite aware that if it's, if we're dealing with CPTSD, then it's going to be more complex and it's going to take more time.

Chuck LaFLange (23:37.945)
Fair enough. Lisa, what were you gonna ask?

Lisa (23:44.819)
What was I going to ask? Oh yeah, how do you, like again, I'm thinking about this particular patient right now, but one of the things, you know, her and I in one of our sessions explored this trauma and she does have symptoms that are in keeping right now with active PTSD related to finding her sister deceased.

And so then, you know, for me, the next question is, do you want to do a RT? Right? Is that something you're interested in? Do you want to explore it? And she did. And then she said to me, you know, what you kind of touched on about sort of that, that guilt that can kind of come along with healing herself and what she sort of described for me, so this, this sister had, you know, intentionally

planned out for many weeks from information, she'd kind of piece together. She had left a suicide note, she had left suicide videos, like saying goodbye to people. And what my patient said to me is, she was suffering, and so I should suffer and feel pain around her loss. Like there was that thing of, I'm doing my sister a disservice.

if I release the suffering that comes from finding her after her suicide. And so, no, yeah, you go, you know exactly where I'm kind of going with that. But.

mike miller (25:10.414)
Yeah. So, so we would, sorry, go ahead. Um, yeah, we call that a blocking belief. So there's three things that will kind of impede the processing of EMDR. So if we're going along and someone's stuck, it's like, well, I feel like I should still be upset about this. Okay. Notice that. And you go again, what do you notice now? Yeah. I, if I'm not still upset and I'm.

betraying her memory or whatever the language might be. At that point, we kind of figure out there's a blocking belief of I should still be suffering. And then we do cognitive interweaves, which is basically interjecting almost like disputes from CBT or educational things. There's different interweaves that we do, the 200 interweave, et cetera, et cetera. Sometimes,

The other things that will get in the way other than a blocking belief is a feeder memory. So that wouldn't be suitable in this or wouldn't fit in this. But say I've had six car crashes and we start processing car crash number one. And as we're processing the person says, Oh yeah, I was thinking about car crash number three and I go, okay, notice that. We go again. What do you notice now? Yeah. Car crash number three. I'm like, okay, notice that. What do you notice now? And they go, yeah, car crash number three. I go, okay, we're going to park car crash. Number one.

We got to process car crash number three. We're in this memory network, but it's sort of taking over. So we would go to that one. Once that one's done, we'll go back to car crash number one. That's just about like target sequence planning about like we've just picked the wrong one to start with, not through any, you know, we just, we didn't know. And so we've started with that one. Now we'll go to this one and then we'll go back. The third thing that can get in the way of processing or can impede it is parts. If a part of me...

is resistant to healing because it holds a belief of this. Or if a part of me is scared to do the work, or then we use some IFS and at the end of the day, maybe just ask that part to step back for an hour and it can come back and protect that person at the end of the hour. Or we find a way to sort of deal with that part. Yeah, things can kind of happen sometimes where you have to finesse it, if you will, right? But there's...

mike miller (27:32.426)
different ways to do that. One of the interweaves that I use, it's actually a set of four interweaves that I learned from a guy named Ad de Jong in the Netherlands, is say the memory was from, I was 16 years old and it's me and my sister. I would say, if you from today could walk back into that memory, what do you need to say to your sister?

I want you to visualize that while you follow my fingers. And then the next one is, what would you need to physically do with that person? And then what do you need to go back and say to yourself? And what do you need to do physically with yourself? A lot of the time, if it's a perpetrator, it'd be like telling them off, like protecting yourself like you couldn't back then. If it was this loss, it might be like saying things that didn't get to be said.

Lisa (28:21.56)
Hmm.

mike miller (28:27.114)
the physical stuff might be like hugging them with a perpetrator might be like throwing them off the balcony, like, you know, it depends on who it is. And the stuff with themselves, a lot of the times it's like they're reassuring, like you got this, you're gonna be okay. And the physical stuff they do with themselves a lot is take them out of there. And a lot of the like, you know, visualize taking them out of there into a safe place. And then at the end of those four interweaves, I go, okay, let's go back to the first image and then we start going again and that will move something in there.

Lisa (28:44.149)
Mm.

mike miller (28:57.035)
So there's like lots of different ways that we can kind of work around this stuff.

Lisa (29:00.815)
Mm-hmm. Love it.

Chuck LaFLange (29:04.436)
So much there, so much.

mike miller (29:04.462)
It's very cool. I am never at a loss for being happy with the outcomes that people report. And that's all, I mean, that's why we do what we do is to get good outcomes, right? And to increase the positive outcomes of my work. I will also say this, there are different protocols to EMDR. What I've been describing is called standard protocol, but we've got a bunch of addictions protocols. So like we can desensitize, instead of desensitizing a painful traumatic past,

Lisa (29:15.011)
Mm-hmm.

mike miller (29:34.038)
we can desensitize euphoric feelings around drugs. So we can go back to first use and desensitize that. We can also desensitize triggers and cravings, and we can do what we call a flash forward, and we can go forward and desensitize fears. So yeah, with the, it's called, so there's one protocol that's called DETUR, which is desensitizing triggers and urges. There's ones that called maladaptive,

positive affect. So it's like desensitizing the euphoric feelings for the drugs so that people get less triggered by it. So like it's, yeah, there's tons of stuff. The flash forward is like, if you have an irrational fear of something, or maybe it's rational fear, but if you have a fear of something like I have to go home from treatment and I'm going to have to engage with my parents and they're going to scream at me and all this kind of stuff. And it's like, okay, so we can actually desensitize the fear of that. And then we

it, we, um, install resources that you can take with you into that situation. Like there's, there's so many applications of EMDR, including what we talked about last time, which is desensitizing memories that support core beliefs that are negative. Um, and that's one of the things I could

So the second phase of EMDR is like client preparation. So we do a history taking, then we do client preparation, which includes education, all the stuff I'm talking about today. And we also do like grounding and resourcing and stuff. So there's a lot of like mindfulness, the yoga, the Tai Chi, the samples, like all the stuff that we do at the center. When people are like, I wanna do EMDR, and it's like, you've been doing EMDR this whole time, you're just doing phase two.

You just don't know it because you think this is EMDR, but it's actually, you have to be prepared to walk into this work. Right. Um, so it all kind of goes part and parcel with the rest of the stuff that we're doing. Yeah. It's, I love EMDR. It's very cool.

Lisa (31:19.811)
Right.

Chuck LaFLange (31:19.901)
Ha ha ha.

Lisa (31:25.578)
Mm-hmm.

Chuck LaFLange (31:33.259)
It makes you kind of...

Lisa (31:33.707)
Yeah, like I think too, one of the things I'm learning from listening to you is that I think as well, like, I have this very narrow view on what EMDR is capable of, right? And I think last week I mentioned that, like, I was like, wow, the idea of doing EMDR to work around these negative core beliefs, like, you know,

it just opens it up. And then now hearing you specifically talk about being able to use EMDR. And yes, we talk often about how a lot of people who suffer with addiction, you know, do have traumas in their past. And for a lot of people, the reason they're using substances is to try to cope with these traumas that haven't been addressed or haven't been worked through with something like EMDR.

But then the add-on that you can work around the euphoric memories from first use or things around urges and cravings and triggers and desensitizing those. Like, that's huge!

mike miller (32:39.039)
and we use it with motivational interviewing to increase their motivation. Like how much do you want to make the change? And we use eye movements to move that along too, to get them more motivated and stuff. So, yeah.

Chuck LaFLange (32:55.262)
It's funny. Just before I left, before.

Lisa (32:55.583)
I'm gonna do Ryan, I'm gonna bounce. I'm gonna bounce.

mike miller (32:55.899)
to 2024, Lisa. We're doing a different, so I train.

Chuck LaFLange (33:05.317)
Go ahead. Okay, I'll speak to it

mike miller (33:06.987)
I was just going to say just to Lisa about the addiction stuff. I have a psychologist friend in Australia that's an EMDR practitioner, trainer, consultant. I sort of ride shotgun with her and we train psychologists around Australia in addictions protocols. We do it, we've probably done it four times together and we do it a couple of times a year, I think.

mike miller (33:34.802)
either do the trauma but don't know anything about addiction or they do addiction and they don't see the tie into the EMDR or the trauma. So like we just bring them together. We, yeah, we've trained probably 80 psychologists in Australia in EMDR protocols for addiction. So yeah, it's very cool. The more that people know, because nobody knows about it. That's the crazy thing about it. Cause nobody knows about it.

Lisa (33:51.695)
amazing.

Chuck LaFLange (33:56.22)
That is crazy, that is crazy, right? Just right at the end of my time at the center, yeah, that's okay, right at the end of my time at the center, I sort of remember casually, you're like, well, we're gonna have to address the smoking thing with some EMDR, and ever since, and I've just been like, fuck, I missed that, right? I never did do that. So one of these days, I'm gonna take the drive out there, and we're gonna sit down, we're gonna do one of those sessions, and you can put it on my tab, I guess, I don't know, right?

Lisa (33:57.527)
Yeah.

mike miller (33:59.99)
gives me a little niche too, so that's all right.

mike miller (34:23.949)
All right, we can do that. Well, then you can report back to Lisa what it's like. I'll give you one example about the desensitizing the triggers. So I had a client from Canada come to the center and he was, this is a bit graphic and I apologize, but it's sort of important to the story. He is a crack user and when he would use it, he would use cigarette ash for the filter, right? To put in the pipe. So here he is at the center.

Chuck LaFLange (34:24.168)
So. Ha ha ha.

Yeah.

mike miller (34:54.518)
excuse me, not using, but smoking. And so every time he smokes, he's seeing the ash and he's getting triggered, right? How strong is the trigger? Oh, it's like eight out of 10. Like I'm feeling it, you know.

Chuck LaFLange (35:01.932)
Oh yeah, 100%. I remember that. Yeah, that's 20 years ago before Brillo, right? That's what we did. So yeah, right, yeah, 100%. Yeah, yeah, yeah.

mike miller (35:11.582)
Yeah, exactly. Yeah. So he's getting triggered multiple times a day. Right. We sit down. Yeah, well, and, you know, like, with no intention of using or anything, but he's definitely feeling uncomfortable. We do one session to desensitize that trigger. And he was there for I think seven more weeks. And all the way through, I keep doing

Chuck LaFLange (35:19.74)
by himself, nonetheless, right? Oh, geez, yeah. Triggering himself, yeah. Yeah.

mike miller (35:41.226)
the phase eight, the reevaluation, I kept coming back and be like, how are you doing with that trigger? How are you doing with that trigger? And I remember because, you know, it's got the negative beliefs attached to it. The positive belief at the end of the session was like, something along the lines of like, this is dirty, this is gross, I'm better than that, I don't wanna do it. My kid deserves better, my family deserves better. All this kind of stuff was coming up as we were processing. For the next seven or eight weeks, he was like, yeah, it's like, I don't, it doesn't bother me at all.

And that's just one session around one trigger. Now that being said, as we know, people can have lots of triggers, people, places, things, all the stuff, right? Times of day, et cetera. We can work on desensitizing all that. I am a firm believer. I have one client I've worked with at the MBR and parts work for like the past almost four years. And there's like, see each other. At the beginning we saw each other a lot and now we see each other less. And there's just...

Chuck LaFLange (36:08.592)
No kidding.

Chuck LaFLange (36:19.453)
Yeah.

mike miller (36:36.362)
always stuff to work on and EMDR is our method that we use and he loves it.

Lisa (36:41.209)
And do you need to be physically together to do EMDR? Can you do EMDR virtually?

mike miller (36:44.51)
No, no. Yeah, evidence shows that it's virtually the same outcome. So I think personally, like, if you're in a room with someone, obviously, you can get the connection because therapeutic alliance is going to be the biggest predictor of a good outcome of therapy. But for the actual mechanics of it, like I have a website that I use, and I send a link to you, and it's just got a ball.

All you have is a ball on the screen and I control how fast it moves and at what pace and how frequent and all that kind of stuff. Um, and you know, so we use zoom or Skype or WhatsApp video call or whatever it is and have this open and we use the ball. And, um, that's what I did all through the pandemic and got amazing results with people.

Chuck LaFLange (37:32.904)
That's crazy, that's crazy. I mean, it's no secret that you're a sponsor to the show and it's no secret that I kind of scream Yatra from the rooftops, but while we got you on here, if somebody is interested in either attending Yatra or getting some online therapy, and I think that's obviously the more attainable thing for a lot of people because Thailand's not exactly close to a big part of our market. So how do they go about doing that?

mike miller (37:33.494)
back in the COVID times. Yeah.

mike miller (38:00.584)
story.

mike miller (38:03.866)
They email us is the easiest way. I mean, there's buttons like call to action buttons on the website, like, you know, contact us here, contact us there. That gets through. So hello at YatraCenter.com, admissions at YatraCenter.com or mike at YatraCenter.com. Center C-E-N-T-R-E as Chuck likes to say.

Chuck LaFLange (38:05.585)
Yeah.

Chuck LaFLange (38:23.84)
R-E. That's just kind of part of my little chant now, isn't it? Yeah.

mike miller (38:27.25)
Yeah. Um, but any email us, I mean, one thing like, yeah, I think when we say Yatra center, like people might envision like the closest, because we're residential treatment, the closest thing they have in their mind about us would be like, like a rehab kind of, we're a boutique center, we max out at eight clients. And, you know, because my little saying is, we're a clinic run by a clinician, we're not a business run by a businessman.

I'm not profit motivated. I'm not like desperate to fill those beds. I would rather have four people that need to be there and want to do the kind of work and work well together, you know, in a safe, cohesive community than have it full of eight people so I can make more money and have the community disrupted. So you know, it's, it's small. So when people contact us, like quite frequently, they're getting like

me or the admissions guy whose name is Shane. And like we're not some big organization that you have to wade through all the red tape to get ahold of us. Like you send an email, we'll get back to you like really quick and it'll be one of us that are frontline people.

Chuck LaFLange (39:39.94)
Yeah, yeah, right, right. And I do, of course, we were talking about this pre-recording, I do get the phone calls, I do get the messages about it now, and more and more as the platform continues to grow. And that said, the conversation I had with somebody today, and thank you for reaching out, was from our last episode, this is kind of funny, it's from our last episode, she messaged me thinking it was you.

And when I started talking, I was like, no, no. Like, no, I'm the host of the show and I was lucky enough to experience, you know, the Atra Center and all of that to offer. I was just like, oh, okay, well that's even better. Right, so she's like, because now I know, like I'm talking to somebody who's experienced it. So it was great to, and to anybody that is listening, if you want to reach out, by all means, reach out through any of the social medias, atra I can speak to my experience.

Lisa (40:08.248)
Hehehe

Chuck LaFLange (40:31.012)
I'm very careful not to speak to knowing anything about any of the therapies. I just kind of, you know, one of the things that I do is bastardize things that really smart people teach me and tell me, so I try really hard not to get into what is what, and especially costs, any of that stuff. I can't speak to that. The only thing I can speak to is my experience at Yashra, and I'm more than happy to share that with people if you message, right? It's, yeah, like I say, I shout it from the rooftops.

mike miller (40:56.978)
I would say that you're, you answering those things is actually more valuable than if I did because people would see it's my business. Of course I want you to come in. I'll tell you whatever I want to tell you. You know, like I can be seen as doing that and, but you can't, you have no upside to it. There's not, if you, if someone contacts you and you send me a client, I'm not paying you money or like none of that shit's happening. Um, you know, so I, when I would have clients.

Chuck LaFLange (41:14.916)
No.

Chuck LaFLange (41:20.812)
No, nothing of the sort, right? Yeah.

mike miller (41:25.226)
When I would have clients in care and they'd be talking about extending their stay, I would say, don't talk to me about extending your stay, like if you should or not, like talk to someone who's extended their stay and let that person give you some feedback on whether it's a good idea or not, because I won't be seen to be upselling people or a salesman. But if anyone's interested in cost, I'll just say this, anyone who is listening to this, if you don't live in a developing nation, our prices will be

less than anything that you'd get in your own country. And I promise you that they won't be able to provide all of the things that we provide for the same price because the cost, our overheads are so much less here than they would be anywhere else. We don't have a hospital on site. I don't have like...

you know, a bunch of psychiatrists and doctors walking around. We don't have that. That's, you know, there's a, there's different levels of care. So we have therapists and we have support workers and, um, you know, we don't have a medical team, but we have people that are trauma informed and we do what we do and there's like holistic practitioners, somatic, uh, therapists. Um, and you wouldn't be able to get that for the price that we can offer it in, in your own country.

Chuck LaFLange (42:44.836)
Of course, my only experience with treatment is yatra. So I can't speak to, I can definitely say that everything that he's saying right now is very true.

mike miller (42:46.052)
I would say, you know, and I can give you specific numbers, but I don't want to.

Lisa (42:53.747)
I'm literally sitting here right now texting.

Chuck LaFLange (42:58.728)
Go ahead.

Lisa (42:58.799)
I'm like texting people and I'm like, oh my God, you need to watch this episode. Like the use of EMDR specifically around addiction, euphoria and triggers. And I'm just like, oh my God, like this is amazing. This is amazing. Like I...

Chuck LaFLange (43:02.652)
haha

mike miller (43:04.626)
Hahaha.

mike miller (43:16.882)
Yeah, I'll send you some. I can send you some literature on it, Lisa. Yeah.

Chuck LaFLange (43:17.95)
Time to get some training, Lisa. Yes, right.

Lisa (43:22.387)
Yeah, yeah, please do. And I'll send some people to you. That's where I'm at. And you're not paying me, I'm very clear. But because that's like a huge thing is it's like, yes, like I think that it's often, you know, trauma like old sexual abuse, old things like that, that will precipitate somebody into the life of addiction.

Chuck LaFLange (43:27.848)
Ha ha ha.

mike miller (43:29.006)
Please do. That's true, yeah.

Lisa (43:46.647)
But once you're in the life of addiction, especially if you're talking about being 20 years into the life of addiction, then yes, you know, dealing with, and I don't like the word dealing with, but you know, working through that childhood trauma, addressing, thank you. Like, yes, like I obviously support that, but I think that just living in addiction for so long, it's hard to break free from those chains.

Chuck LaFLange (43:58.192)
Addressing.

Lisa (44:16.631)
because there are so many triggers and you become so used to being in that euphoric state that it's just difficult to go back to feeling, real feelings or living a life without feeling that euphoria anymore, you know? That I'm just like, phew.

mike miller (44:37.559)
And I don't want to turn this into an ad for us, but just to say like, we're pretty remote where our location is. We're like 30 minutes outside of a town, on the seaside, like it's an inlet with a mangrove forest and stuff. Like there's nothing there. Like, so as far as triggers, you're out of your environment, you're away from family, you're away from like the people you use with, you're away from the places that you'd score and you'd have a pretty hard time.

Chuck LaFLange (45:04.861)
paradise.

mike miller (45:05.998)
finding like you've, I mean, I know that, I know that drug addicts can be quite resourceful, like as I was a resourceful drug addict, but you know, there's barriers built into it that aren't built into doing treatment at home either. Right. The only thing we don't do is we don't do detoxes, but I've had people, you know, come to us with like a week or two weeks clean and have good outcomes, um, as long as they're medically stabilized and actually motivated. So that, you know, we do obviously comprehensive assessment to make sure that they're adequately motivated to do it. Um,

Lisa (45:12.78)
Hehehe.

mike miller (45:37.971)
and we jump in with that EMDR really quick. I'm a huge believer in it. And I always tell people, we treat addiction through the lens of trauma, but one of the ways that we do that is with the EMDR, with addiction specific protocols.

Chuck LaFLange (45:54.304)
Yeah, it's truly amazing. We can talk about this offline, but I'm definitely gonna invite you back for kind of a fourth wrap all this up into one. Because it's just like, we've already gone to for an hour and a half now. Yeah, nah, no, it's compelling stuff. I don't see at any point where I wanna edit any of this out, right? I do wanna move into the final segment of the show, and that's the Daily Gratitude, just for sake of time.

mike miller (46:06.006)
Yeah, you're probably gonna have to edit this one way down.

Chuck LaFLange (46:22.7)
And we can talk offline about when to do a fourth, because I think a fourth is definitely called for. So let's have that conversation. So yeah, that brings us to my favorite part of the show. That is the Daily Gratitudes. And in the interest of chivalry, we'll start with you, Dr. Lisa, what you got for us today.

Lisa (46:44.815)
Well, I mean, I'm sitting here looking at the windows, so I'm gonna start by saying I'm grateful that it is not minus 47 anymore. Yeah, and the interruption earlier, my little one swims on Saturday mornings, and then she goes to a climbing center and does climbing in the middle of the day.

Chuck LaFLange (46:52.116)
I'm going to go ahead and turn it off.

Lisa (47:09.811)
And this afternoon she's having a playdate. And so she was very concerned that I was not around to fix her hair. And so she showed up here to get her hair fixed. And so, you know, I know, so cute. But yeah, just, you know, grateful for my family, you know, grateful that I've got this healthy little girl, grateful that I have a husband who takes her to all these things and lets me spend my Saturday mornings here.

Chuck LaFLange (47:16.572)
Ha ha

Lisa (47:37.089)
and drives her over here for 60 seconds so I can fix her ponytail. And yeah, I'm pretty lucky.

Chuck LaFLange (47:45.364)
That's awesome. That's absolutely awesome. Mike, what you got for some gratitudes?

mike miller (47:46.345)
Beautiful.

mike miller (47:53.674)
I'm going to be like a bit of a broken record from probably the previous weeks, you know, because we've transitioned from Phuket to Krabi and we're renovating and stuff. And I just got to say like, my wife is an absolute superstar who goes so far above and beyond and her work ethic is unreal. But just obviously because she's Thai and the workers that we get like, you know, contractors and stuff to do.

all the construction and renovations and stuff. Our tie, like, I need her to be the one, but she's also like, you know, she's got an art degree. So she's got an eye for all the details. And so she's just like been so on top of working with these contractors and getting our new space up to speed so that our clients can come in and feel safe and they can relax there. You know, so she's really taken the lead.

much more so than me. And I just, you know, tonight I was telling her how proud I was of her and the work she's doing. Now, that being said, I'm also grateful to all the other staff that have, you know, because when we didn't have clients in care, like your job isn't painting, but that's the job I have for you right now. Right. So my staff have been like painting and doing like gardening and you know, like all kinds of just different renovation stuff. And so, you know, everyone's really stepped up, you know, and again.

The staff moved from Phuket to Krabi and gave up like, you know, one of my staff members has been there for years, right? And came with us and it's like, I don't know how you put words to how grateful you feel that people believe in something that you're doing enough that they would uproot and follow you to a place and help to make it, you know, and the fact that they're saying like, no, us investing this effort in doing it is like, makes it better for us and the clients will feel that. And I'm just like,

sitting back, kind of watching it and being like blown away by it. So yeah, a lot of gratitude for just the support and people in my life, primarily Chu, who's my wife.

Chuck LaFLange (49:57.736)
Of course, of course. And before I give you my gratitude, I can speak to that there, that kind of family, let's just all get it done thing. It's amazing. It is, it's truly a family atmosphere. It's something that I hadn't experienced for a 40 day stretch in many, many years. So like, wow, it was really, really cool to be a part of that. So yeah.

I am thankful today, Sunny, my dog, always, hey, he just like, he lights up my life, just day in and day out. I even put a poem out, which is probably the most vulnerable thing. Of all the s*!t I have done on this podcast and being on social media, posting a poem I wrote is like by far the most vulnerable thing I've done, but I'm just like, this dog, he's just everything to me, right? He just, yeah, so I'm very thankful to him.

I'm thankful for this series. I'm really glad that we're getting it done. We have more to do and I'm so thankful for both of you to give up your time very, very much. So I'm thankful to each and every person who continues to like, comment, share, subscribe, do the things, hit the buttons down at the bottom. Because every time you do any one of these things, you're getting me a little bit closer to living my best life. My best life is to make a living spreading the message. The message is this. If you're in active addiction right now, today could be that day. Today could be the day that you start a lifelong Yatra.

Reach out to a friend, reach out to a family member, call into detox, go to church, do whatever it is you gotta do to get that journey started, because it is so much better than the alternate. And if you have a loved one who's suffering an addiction right now, you should take the time to listen to us. If you could just take one more minute out of your day and text that person, let them know they're loved. Use the words.

Lisa (51:41.406)
You are loved loved.

mike miller (51:41.598)
You are loved.

Chuck LaFLange (51:45.288)
That little glimmer of hope just might be the thing that brings it back.

Chuck LaFLange (51:52.333)
Beautiful. Fuck that, we just knocked that out of the park. That was really.

mike miller (51:55.822)
The delay miss.

trauma series

212- TRAUMA THERAPY PART 3