Episode Transcript
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Joe Van Wie (00:01):
Hello and thanks
again for listening to another
episode of All Better.
I'm your host, joe Van Wee.
Today's guest is Louis DeSanto.
Louis is the Regional ResourceDirector of Pennsylvania for the
Karen Foundation.
We speak a little bit aboutKaren's history today, which is
(00:22):
one of the oldest and mostcredible treatment providers in
substance use disorder in theworld.
Lou is the Regional ResourceDirector for Philadelphia, bucks
, montgomery Counties and theScranton-Wilkes-Barre area.
In this role, he's a resourcefor individuals, families and
clinical professionals in needof substance use disorder mental
(00:44):
health treatment resources.
He's always available to answerquestions, provide information
and guide people into treatmentand the thoroughness of the
treatment process.
He has an in-depth knowledgeabout Karen's programs and
services, as well as otherresources, allowing him to
create a continuum of care foreach patient's specific needs.
(01:07):
As a Karen alumnus, lewis useshis lived experience to offer
empathetic and passionateassistance to those who need
help.
Prior to coming to Karen in2023, lewis served in a similar
role as outreach specialist foranother treatment center.
Before that, he was thedirector of a new business
(01:27):
development for a retail energyprovider, a position he held for
five years.
He has a bachelor's of arts incommunications from Shippensburg
University, pennsylvania.
Today, we discuss a lot oftopics with Lou.
Most interesting is scanningthe brain.
Most interesting is scanningthe brain and in mental health
(01:49):
services, say, if you even had abroken bone or any other
medical condition, you could getan image and associate data to
that image.
You don't find that too commonin mental health services.
Karen is changing that and wediscussed some other topics but
that in the most interest, let'smeet Lou.
(02:09):
Well, that's it.
That's enough countingBeautiful Lou.
Thanks for coming by.
Yeah, thanks for having me, louDeSanto.
Lou, where are you from?
Louis DeSanto (02:31):
I'm from Delaware
County, pennsylvania, and born
and raised there and, if you'reasking work-wise, I work at
Karen Treatment Centerscurrently.
Joe Van Wie (02:42):
Karen Treatment
Center.
So what?
What does?
How would you define Karen inthe field of treatment?
For someone who didn't knowwhat Karen is, it's a.
It's kind of an institution,one of the first um and the
namesake of Richard Karen.
Um, how do you make your kindof pitch?
Or what story do you stay to tolet someone who's not familiar
(03:06):
with karen or family, how do youtell that story?
Louis DeSanto (03:10):
yeah, um, there's
a lot of history, a lot of
history behind karen, almost 70years or close to that.
Started as chitchat farm whenit first originated with dick
and katherine karen, and when itstarted dick karen was writing
(03:34):
a letter he called chitchatbefore the grapevine.
Then he would type up on histypewriter and mail out to all
the members of aa and he'd goaround and pick up local
alcoholics and they'd come bythe house and eventually his
wife Catherine learned thatthese wives keep calling me and
they're asking for their ownhelp.
(03:55):
And so you know, when theystarted really getting into it,
they decided that the family isjust as important as the patient
.
The patient is the family justas important as the patient.
Patient is the family and thefamily is the patient and being
able to treat the whole systemrather than just the patient.
So as it as it grew, and Karentoday.
(04:17):
I think one of the main thingsthat stands out to me about
Karen is the connection and ouralumni base.
I would put Karen's alumni upagainst most universities
honestly in terms ofphilanthropy and just overall
(04:42):
involvement, wanting to giveback.
We do this really cool thing.
You know each region has theira dedicated alumni coordinator.
So let's take Philly, forexample, where I'm from.
Keith Rogers goes up to campusa couple of times a week and
he'll meet with every patientthat's discharging back to the
greater Philadelphia area.
When he meets them he'll askyou know where are you heading,
(05:06):
what are your plans, whatfellowship are you interested in
?
And there's a number of alumniI'm one of them.
We've given Keith permission togive out my phone number.
Yeah, and so if he meets a guythat's you know, local to me and
they're he's interested in AA,they have my phone number.
He says call Louis.
(05:26):
He'll take you to a couplemeetings, introduce you to some
folks and he'll give at leastthree numbers to each individual
.
So immediately when youdischarge from treatment you're
going to meet someone who wentthrough the same treatment
process you went through.
That gets it, that knows whatKaren is, and that gets you
plugged in.
And I think Karen does thatamazingly.
(05:49):
And we know that the longeryou're involved, the more you
stay connected, the betterchance you have at recovery.
So I was a patient before Iever worked at Karen and I got
plugged in as soon as I cameback from Florida and it's made
my recovery that much stronger.
Joe Van Wie (06:04):
Well, there's a
lot to unpack.
Um, we got family dimensions ofaddiction, that the trend and
the approach was set by Richard,karen and this, the chit chat
letter, and how they were goingto approach treatment, which
evolves totally to this alumnibase that rivals an Ivy League.
(06:25):
There's almost a status thatcomes with recovery, with care.
I don't mean to be strange, butthere's a social aspect to this
, especially in the recoveryculture and community.
But I think where we couldstart is the idea of families
(06:50):
being approached seems just sointuitive and it might not be
historically and I think youcould see families say we don't
know what's wrong with our sonor our daughter.
They've caught some geneticillness that's now associated
with an opioid or an alcohol andthis just isn't fully true or
(07:10):
flushed out or even meaningfulin that regard, as when you
compare it to treating a familydimension, even generationally,
this is what seems to be themost profound factor in
addiction.
Is environmental communication,coping.
It's complex.
We could even say it's on aspectrum now of severity that
(07:34):
doesn't have to involve, say,violence, severe neglect.
It could be just heightenedcortisol in a long pregnancy
that was stressful could nowincrease the chances of someone
having this.
How does Karen still take thatapproach today?
And how do you present that tofamilies?
Is it ever delicate that theyfeel that they're defending
(07:57):
something like you know?
No, that's the problem with ourson.
It's not all of us.
How do you navigate thatdelicately without offending
someone's good senses?
Yeah, that's a.
It's not all of us.
How do you navigate thatdelicately without offending
someone's good senses?
Louis DeSanto (08:06):
Yeah, that's a
it's a really great question and
there's something important totalk about, because every family
is unique and and every familyI'll speak for myself and you
know I thought my family wascrazy and no one's like us and
then you start talking about itand other people are talking
(08:26):
about it and we're all morealike than we seem, but but
still, every family is uniqueand they will have their own
experiences with recovery andtheir loved one will have their
own experience.
So I think, when there'spatients who you know maybe this
isn't their first try, maybethis isn't their first treatment
(08:47):
center, their first shot atrecovery, those families tend to
you know they can be a littlemore hands off.
You guys take them.
I don't know what to do anymoreand what I try to do, you know,
in those situations is let thefamily know that that they're
not alone.
And, yes, we're going to takeyour loved one and we're going
(09:08):
to treat your loved one and lovethem until they can love
themselves.
But you deserve to be loved tooand you deserve to love
yourself too and you deserve tounderstand what your loved one's
going through.
And I think that's the biggestpoint that I try to get across
to families is.
We want to help you understandwhat your loved one's going
through.
Amidst all this chaos that hasoccurred over the past years, or
(09:31):
however long it's been, you'vebeen so caught up in it.
What have you done for yourselfand really try to explain to
them that you know when ourtherapists reach out to family
members, it's not just an updateto say, hey, lewis is doing
great here, it's, lewis is doinggreat here.
And what are you doing foryourself today?
(09:53):
What have you done?
And we have a great familytherapy team that focuses more
so on the family than they dothe identified patient, and I
think once I start explainingthat, they realize that they can
play an active part in thiswhole thing.
They listen a little more andthey get enthused about that.
Joe Van Wie (10:13):
Yeah, it's
apparent.
And why it's apparent and whatI mean by that is when I've seen
people that have left yourprogramming, karen, any age from
19 to even late 20s or 30s it'sapparent that there is a
different result happening,distinctly from what you just
(10:35):
described working with families,an isolated treatment of just
the person, even though you knowmost social work's always in
this lane and this culture ofempowering the patient.
That's it.
They're up to it To take thatapproach.
I think you're really doing adisservice, irregardless of the
(10:56):
family.
If you're, if you're making, ifthere's this approach, that's
non-separation that you're fromyour environment, you're from
your culture, you're from yourfamily and you're not treating
that as a whole system, I thinkthe probabilities of success go
down.
I'm not saying it's a failure,but you're increasing the
probability of success becauseof this is what you're treating.
(11:17):
You're treating a sociologicalproblem, not only a
psychological.
So where is this person from?
Not only a psychological, sowhere is this person from?
You see it in your approach ofhow engaged families are.
I just I guess I see where itgets complex that there's so
many dimensions to this is thatyou're talking about someone
that rose out of a family.
(11:38):
You're a result of your family,that you have to always be on
guard and cautious of of ofrestraining people, that there's
nothing to blame.
Like this is almost an emergentevent addiction.
It emerged and there's there'sno profound or meaningful
(11:58):
position to say.
We finally found what to blame.
Oh, this, this will make senseof it all.
So, once that's kind ofdiminished, that that game of
blaming, you see, the lastcomplexity I I feel is seeing a
person become more, more of afree agent of their future.
And where does a parent?
(12:20):
That seems where where thingsget real delicate, okay, where
does this person become fullyresponsible for their future,
even if it's not going toconverge with what a family
wants, and can they still haverecovery?
I guess that that's really hardto navigate.
Do you see that thecomplexities in that like?
Louis DeSanto (12:40):
when does?
Joe Van Wie (12:41):
when does a 19 to
24 year old become autonomous?
And I don't know.
That's gotta be, that's gottabe hard.
Louis DeSanto (12:50):
It certainly is,
and the one thing that Karen's
therapists are really greatabout is they will do family
work with both parties when thetime is appropriate.
Yeah, you know, they certainlydon't want to rush into anything
(13:13):
and maybe do more harm thangood, but I think it really
comes down to education.
So we have a family educationprogram that every family has
access to when they have a lovedone with Karen, and it's a
(13:36):
two-day program and the firstfull day of that it's just
psychoeducation.
We're learning about the diseaseof addiction and all of the
things that come with it, andthat's a really eyeopening
moment for families.
As you kind of hinted at, likeokay, this emerged from
somewhere and here's how ourfamily of origin operates,
(13:59):
here's how we've always operated, and you can see, it starts to
something, starts to click intheir mind, like, uh, maybe I
had a little more to do withthis than I may have thought.
And I think once a family isopen-minded, once they're
educated, they can really becomea partner and an active
participant in their loved one'srecovery, rather than try to
(14:22):
run the show or the patient tryto run the show and finding that
happy medium and settingboundaries.
Boundaries are super importantso, and both parties need them.
And so you know, I think itcomes down to open-mindedness
and education, and if you haveboth of those things, you're
going to be set up for success,at least from the beginning
(14:46):
those things.
Joe Van Wie (14:47):
You're going to be
set up for success, at least
from the beginning.
Yeah, yeah, it's amazing.
So, karen, maybe if I couldstep back for a second.
And in total, it's what?
70 years old yeah and how manypeople does it staff now would
you?
Would you say?
we have around 700 700 employees, 70 years, one of the leaders
in addiction treatment.
How has this been maintained?
(15:07):
Like why do you think Karen isnot only just relevant, is still
a leader in credibility, beingtrusted and somehow able to
scoop up all the leadingprofessionals in clinical work
and inpatient treatment?
How does something like if youhad to take a look back?
(15:30):
How does something like thisjust happen and be maintained?
Louis DeSanto (15:35):
So one of the
major points I'll make is that
when I started professionally atKaren and I had meet and greets
across campuses with manydifferent professionals, it was
uncommon to hear I've been herefor a year, I've been here two
years.
It was much more common to hearI've been here 10, 20, 25, 30
(15:57):
years, which is amazing.
And I think that that happensbecause Karen has never strayed
away from the original ideasthat Dick and Catherine Karen
had about treating the patientand treating the family and
treating the unit together, evenwhen one of the biggest shifts
(16:18):
was maybe about six, seven yearsago.
Before I was working at Karen,we started taking insurance on
our Warnersville campus.
Prior to that, it was a fullyself-paid program.
When we did that, theprogramming didn't change.
We just increased access to theprogramming we were already
providing.
So I think Karen does a greatjob of just staying true to what
(16:43):
they know works.
Just staying true to what theyknow works, and with that comes
an amazing community of workingprofessionals that every
employee has a voice.
Every employee can go intoanyone in leadership's office
and say, hey, I have this ideaor hey, I've been seeing this
come up a lot recently.
(17:03):
Maybe we should have a groupabout this, a webinar about this
, and I think the fact thateveryone's voice is heard and
we're all working together tofight this disease is what keeps
employees there.
It's what keeps alumni engagedand just sticking with the
mission of recovery for life,and we haven't strayed away from
(17:26):
that, karen hasn't strayed awayfrom that to date, and and
that's what just makes it such amagical place- yeah, that's
basic physics.
Joe Van Wie (17:36):
A simple idea
could create many complex things
, but the core is still.
It started with a simple ideaof programs work that way and
that's you know we, and we triedto mirror that ourselves Even
down to our logo.
It was a fractal Very simplething Could just keep repeating
itself into kind of a complexity.
Karen, what if someone feltthey didn't have the resources
(18:06):
to send a loved one, family,their child there?
How do you guys approach that?
Louis DeSanto (18:13):
Sure.
So we've operated as anonprofit for all of these 70
years.
With that being said, Imentioned our alumni being
amazing in terms of philanthropy.
So we have a large pool ofdonations that our admissions
team can access.
So if a patient doesn't haveinsurance, that works with us.
(18:33):
Or maybe they do have insurancebut they have a high co-pay and
deductible Even for anythingout of pocket.
We do have a financialassistance process that our
admissions team is great atworking with the families on,
and they fill out someinformation and can get back to
the family of if they'reeligible for this assistance and
how much it may be.
(18:54):
We do that for a number offamilies every day.
We want to be as accessible aswe can and and we are actively
working with many differentpayers and insurance companies
to get as many in-networkcontracts as we can, so we never
(19:14):
have to turn a person away andif, for some reason, you know we
have to.
That's why people like me andsome of my colleagues in
business development andadmissions are there to work
with our partners to make surethat they get to a place that's
appropriate Patients get to aplace that's appropriate for
them, but our goal right now isto increase access.
Joe Van Wie (19:38):
Yeah, and access
where your main campus is
Warnersville correct, correct,and there's two other offerings
in Florida.
How would you describe all thelocations?
Sure, what level of care arethey?
Louis DeSanto (19:54):
So Wernersville
is the original site.
A lot of our clinical buildingis built around the house that
Dick and Catherine lived in.
Oh, they lived there.
Joe Van Wie (20:05):
Yes, I never
understood, so that was their
home.
Louis DeSanto (20:09):
It was their home
.
Wow, so it was their home.
And then there's a largerbuilding behind the original
clinical building.
That was a hotel that theyacquired and that was the first
property they purchased to treatpatients behind their home.
And we've just expanded on allof that original structure.
Joe Van Wie (20:30):
And for anyone
who's not, I mean you could look
up further information aboutRichard Karen he.
He is the man that gotinsurance companies and
advocated for them to pay forthis as medical treatment.
He's it was the first timeaddiction was a treatable
disease and noted as a disorderNot only in the American medical
(20:52):
association.
Later on, dsm five for APA, hespearheaded all of that.
Louis DeSanto (21:02):
You, just you
know you struggle for words
because just such a champion ofrecovery and from helping the
next alcoholic and helping thefamilies, just you know whatever
he could do, he did.
Joe Van Wie (21:19):
We have a short
history, say, as a recovery
community of culture.
Both of us understand that it'sabout 120 years.
If we want to say modernhistory, um, from 12 steps to
great psychologists, greatsociologists, he is in the top
five.
I I would venture to say thathis contribution to culture and
(21:42):
american life in treatingaddiction you know we're talking
about a nation that has 75million illegal drug users, 22
million people in some form ofrecovery.
That's a short history and itmust be.
It feels prestigious.
I know for my friends that workat Karen, to work there because
you're doing really meaningfulwork with a meaningful history.
(22:04):
Is that still felt all overWarnersville when, when you're
down there?
Louis DeSanto (22:09):
It's such a
privilege to work for Karen.
I'm a Karen alumni from 2019.
When I I did 90 days oftreatment in Florida, I came
home I was working a familybusiness for another two years
and I reached out to thecontacts that I had made at
Karen as an alumni and just saidyou know, hey, what do I have
(22:32):
to do to be a part of this andit?
I had no experience in thisindustry other than being an
alcoholic and um.
But instead of just saying, youknow, kick rocks, no, keep
being an alumni but never goingto work here, they helped me
understand what skills I neededto gain and what experience I
(22:53):
needed, referred me to somegreat people to get that
experience and when I was ready,I applied for a job and they
took me back and I.
It is just such a privilege,not only to work for the
organization that saved my lifeand saved my family's life, but
to see it grow and to seeincreased access and to see
(23:17):
patients on this side now gothrough the full continuum and
come out on the other side.
I mean, every day is a blessingand it's amazing and and I know
many of my colleagues feel thatway, which is why they choose
to stay at Karen for 10, 20, 30years.
Joe Van Wie (23:36):
And is that common
Uh?
Many of the staff clinicianssupport uh on that campus,
florida or Warnersville.
Are they alumni?
Louis DeSanto (23:47):
I don't know the
exact percentage of people, um,
I do know that there's a bunch.
It's not uncommon.
It's not uncommon, um, and Ithink industry-wide right, you
go through some of the stuff asa active addict or alcoholic and
it's a lot of people's pathonce they go back to school to
to want help the next people.
(24:08):
So, whether they do itprofessionally, they become a
therapist or take their businessskills and business acumen and
help in another aspect.
I think that's common acrossthe industry, but alumni coming
back and working at Karen is notuncommon and it helps me serve
our patients and families better.
(24:28):
And it helps me serve ourpatients and families better.
I'll just speak for myself andsay that, knowing and being 100%
confident in what I'mrecommending, because I lived it
is a game changer.
Joe Van Wie (24:41):
Staying on that
topic of alumni how many events
and how do you engage alumnievents and how do you engage
alumni?
What's what's the event of theyear and how do you keep
communication and a dialoguegoing with the alumni that are
across the country?
Louis DeSanto (24:55):
so there's a lot
of events, um, some of them in
person, some of them virtual.
There's a handful of things.
One of the biggest events is atthe end of June.
We have our Karen reunion onthe PA campus, which is a
weekend long.
(25:15):
We always say family, friends,loved ones of Karen are welcome
and they all stay there.
People stay locally locally Ifthey're from you know, out out
of the area, not close toPennsylvania.
If they're close, people willdrive up.
I know my family will drive upfor three days and it is just
(25:41):
full of love and fellowship andand connection and whether you
went to the Florida location,the PA location or any of our
regional sites, you're welcomeand you know that's a very large
kind of Karen-wide event.
In addition to that, each regionevery year has a gala.
The Philadelphia gala is at theKimmel Center in November, dc,
(26:04):
florida.
Everyone has their own gala torecognize partners in recovery,
to recognize alumni.
They also serve as fundraisersfor our nonprofit.
And on top of that, each regionhas fellowship meetings weekly.
So I'll stick with Philadelphia.
Wednesday evening there's aphiladelphia area alumni
(26:29):
fellowship meeting which youit's not for a specific
fellowship program, any andeveryone is welcome.
Uh, three, three weeks a month.
It's virtual on zoom.
One week a month we gettogether at the k Philadelphia
office and patients are welcomefrom day one and there are
(26:52):
individuals who attend thatmeeting that just got out of
Karen yesterday and there'sindividuals that got out of
Karen 15 years ago.
Joe Van Wie (27:00):
And that's special
.
That's a lot of organization,that's a lot of data to keep.
So many years of data,pre-database, pre-salesforce, a
lot of archives.
Yeah, when you say regions,when you're describing regions,
who designates these regions?
Are you describing regions ofyour own outreach, internal
(27:22):
outreach, designations of aregion?
Is that a map of what?
The Eastern Seaboard, thecountry?
Louis DeSanto (27:28):
Really just
looking at the country.
So Northeast, southeast, that'swhat we traditionally know.
Our big regions where we havean active office are
Philadelphia, new York, atlanta,delray Beach, florida,
arlington, virginia, dc and then, right by, warnersville,
(27:50):
wyomissing also has a regionaloffice.
Joe Van Wie (27:52):
Yeah, I wanted to
note that because I think that
would be surprising for certainfamilies if it's their first
go-around at confronting thisdisorder in their family, or
alarm that this may be the firsttime it's occurred in their
family.
Are they always kind ofastonished at the size and scope
of Karen?
(28:13):
Do you still see surprises inthis?
Louis DeSanto (28:16):
I do.
I was surprised myself when Iwas a patient.
I went straight to Florida fromjust outside of Philadelphia
and I got down there and a bunchof guys were like, oh, did you
come from PA?
I was like there's one inPennsylvania, what?
Joe Van Wie (28:30):
region.
Are you from?
Louis DeSanto (28:32):
Um, so yeah, it's
.
It's surprising, I think, to alot of folks and it just adds to
why people love and respectwhat Karen does.
Uh, cause we want to beeverywhere and support every
patient that's coming throughthe doors, no matter where
they're from, and for some, I'msure of it that there's families
(28:54):
out there that don't know thewealth of knowledge and
resources that we have to offerthem.
But it's everywhere and there'salumni everywhere and there's
someone to connect with.
Joe Van Wie (29:07):
It's a basic law
to me that good things enlarge,
they can enlarge and theyenlarge well.
The size and scope is atestament to the approach, the
advocacy, that simple,fundamental kind of mission that
you described not only treataddiction but treat the family
(29:33):
has made this all happen,especially from such a dynamic
founder.
What does the future look likefor Karen?
What things are changing and Iguess I could just add this
question there to guide the nextkind of segment I want to talk
about there, to guide the nextkind of segment I'd want to talk
about what.
(29:55):
What have you been wrong aboutin approaching your own
treatment that you still see isastonishing for other people,
like this revelation oh, Ithought recovery was this, or I
thought the problem substanceuse disorder was this, and it's
almost like a rebel revelationthat you could, you know, be apt
to describe as an awakening,spiritual awakening.
Some of that's just provided bystraight information that the
paradigm I'm living in was sofalse it's so impossible to
(30:18):
share with truth.
This is what you could point toas a spiritual awakening, not
something supernatural.
You could say holy shit, I'mcompletely wrong about
everything.
I think is me.
Yeah, absolutely.
How are you seeing?
How do you see that stillrelevant there and how are you
adding to that, Karen, thishappening to a wider base of
(30:40):
people?
Sure, so, If you're sufferingfrom a substance use disorder or
your addiction is bringing yourlife to a standstill, call
1-888-HELP-120.
That's 1-888-HELP-120.
(31:01):
This hotline is available 24hours a day, 7 days a week.
Use evidence-based practice,crisis intervention and
trauma-informed therapy to helpyou get to the treatment you
need.
End addiction now at1-888-HELP-120.
(31:25):
1-888-h88.
Help 120.
Louis DeSanto (31:33):
Personally, I
mean one of the biggest things.
I was 26 when I went to Karenand got sober and I thought my
life was over no more fun, nomore Eagles games, no more
anything I like to do.
And that couldn't be furtherfrom the truth, and that has to
do with being in Florida, havinga local alumni base in Florida
(31:58):
that volunteers to pick uppatients and take me to their
house and watch the Eagles gamewith them, so I can be with
other guys from Philly and takeme golfing and take me to local
AA meetings to see that my lifewas only just beginning.
Where's Karen going?
I'm really excited about whereKaren is going and that's
(32:19):
another reason why I'm soblessed to work for Karen, and
what I think Karen does great ofis holding on to Dick and Karen
, catherine Karen's originalmission, but also being
innovative for the future.
And something that we're reallyworking on and studying right
now is is the brain.
(32:40):
Addiction is a brain disease.
If you have a heart attack, yougo to a cardiologist.
If you tear your ACL, you go toan orthopedic surgeon.
If you're an addict, you shouldtake a look at your brain.
You go to the brainwash.
Yeah, and we've been doing somereally sophisticated work with
(33:01):
the brain as far as brain scansand different labs.
We can run with our docs downin Florida.
That we've been doing for quitesome time as part of our
program.
What we've done recently ispackage all of those things
together and we call it theneurocognitive assessment, which
can be anywhere from five toten days, where you can come in
(33:27):
without an SUD diagnosis,without mental health, really no
strings attached.
Okay, you say I want to take alook at my brain health and my
performance.
We're going to do a QEEG brainscan, okay, and you will receive
(33:47):
this very colorful report thatshows the activity in your brain
.
Joe Van Wie (33:51):
That gives a
electric, magnetic kind of
scanned visual of every regionof the brain correct.
Louis DeSanto (33:57):
It is a
non-invasive yep.
You kind of put the shower captype deal on and and look at a
tv and have you done it?
I've done it.
Oh wild, it's amazing, and soyou.
So you're, you do that right.
And then you're going to meetwith a psychologist and just do
a general talk, psychologicalassessment while you're you're
(34:19):
under that, you're being scanned, you're, are you?
Doing it separate, separate.
So this, in addition to beingso, you're going to get your
scan.
That, that's part one.
Joe Van Wie (34:28):
Well, let's let me
just isolate part one.
You put the cap on and you'regetting a map, a reading of
activity, of where it'shappening, and it's on a scale
of what's normal and what isn'tof activity for most of the
population that had this.
What exercise?
(34:48):
What is happening during thescan?
Are there any cognitiveexercises or tasks being
approached, or is it just astraight mapping of a set time
of the brain?
Louis DeSanto (35:00):
So there's two
parts of that.
One is with your eyes open, oneis with your eyes closed.
Okay, when your eyes are closed, that's it.
Your eyes are closed.
You have the cap on are closed,that's it.
Your eyes are closed, you havethe cap on.
For a set amount of time Eyesare open.
I do believe that you'relooking at something on the
television, but there is no task.
Joe Van Wie (35:22):
You're not doing
any tasks or exercises.
Louis DeSanto (35:24):
You're not asked
to complete anything.
You're really asked to relax asmuch as possible.
Joe Van Wie (35:29):
I'm not a
neurologist but that is
substantial.
So, eyes closed, it's reallyinteresting to look at these
maps of, say, someone who'ssuffering from anxiety,
generalized addiction, trauma,that their occipital lobe is
(35:51):
where vision is located, thecortex.
It would go back there and showactivity, that you have a
visual field.
Now, with your eyes closed, ifthat stays and remains active,
it's curious to see how activeis that.
Is this rumination, resentment,what is this presentation of
the activity still looking like?
(36:11):
It's seen visuals.
I'd be curious to have a longdiscussion on that.
That always fascinates me, butfor some people, when their eyes
close, is the amygdala beingactivated, and most I would.
You know I don't know what theportion of the metric is.
We both know how high anxietyis a comorbidity or it might be
(36:33):
what addiction could be treatingthis measure of never feeling
safe, never feeling attached topeople.
You are leading the way of, notonly in mental health and
behavioral health, especially inaddiction, that you can now
have a metric from ourtechnology to say let's look at
this like a broken leg, andthat's simplicity.
(36:54):
I don't mean to oversimplify it, but there's very few
psychiatrists I could go to inthis country and say I have a
problem with my brain, thequality of my life's
dissatisfying.
I think it's my thinking.
All right, let's talk about itmore.
No, scan my brain.
Louis DeSanto (37:08):
Yeah Well, and
what's interesting about that is
, you know, you'd be in theadvanced portion of the
population to even go and say,hey, there's something wrong
with my brain.
Most individuals are justsomething's wrong, I don't know
what, and they don't even thinkabout their brain.
And as a general population,even as an industry, we just
(37:29):
starting, yeah, to look at thebrain science and how we can
improve that to help thepatients.
So the scans, part one, yep,part two.
What's part two?
Part two you're going to bewith a psychologist and run
through a battery of assessments.
Dr kranz, our doctor down inflor in Florida, is much better
(37:50):
at explaining the medicalterminology for this.
Maybe we can get him on someday.
Joe Van Wie (37:54):
Lou, are you going
to help me?
Louis DeSanto (37:56):
I'll help you out
with that.
So you're doing an R-band.
You're doing things that Ibelieve are similar to what you
might see in an IQ test Okay,believe are similar to what you
might see in an IQ test.
You're looking at pictures andmemory, recall and language and
spelling and things like this.
(38:16):
And then the doc's just goingto ask you questions and they're
going to ask you about aninterview, history, growing up,
traumas, things like this.
They're going to take notes thewhole time.
They're going to get the scoresof those assessments.
We're going to do blood workwith some specific biomarkers
(38:41):
that can indicate differentareas of the brain to look at
and you're going to put all ofthis together and all of our
docs, the neurologist, thepsychologist, psychiatrist
everyone's going to get togetherand look at these results
comprehensively.
So I'll give you my.
(39:03):
I went through this when I was apatient and my experience with
it was I did this maybe halfwaythrough a month, month and a
half into my 90 day stay.
So I'm sober, I'm detoxed, I'mhaving the thoughts of am I
actually an alcoholic?
(39:23):
Do I really need to be here?
These things right, I'd neverbeen to therapy before.
And then I sit down with theteam and we're going through my
report and they say do you seeall this red in your brain scan?
That's a decrease in alpha, andalpha correlates to anxiety and
(39:44):
depression, and if you havedecreased alpha, you're probably
anxious and depressed.
Also, you told Dr A about beingbullied in second grade and
your parents getting divorced.
We think those two havesomething to do together.
Wow, I'm not kidding you.
I sat there and said wow, isthat what I'm supposed to talk
about in group?
Joe Van Wie (40:04):
Lou, this isn't
most people's experience with
approaching addiction, and youknow that well.
Yeah, that is real work.
Louis DeSanto (40:15):
Real.
Joe Van Wie (40:16):
That is real help.
Louis DeSanto (40:18):
It is and you
know I am blessed that that was
my first and, you know, knock onwood last experience with
treatment.
So it's what I know.
But the more I've come to learnand study different treatment
centers and providers, I knowthat not everyone is doing this
yet and it just helps.
You know I could have sat therefor 90 days trying to figure
(40:42):
out what I talked about.
What should I talk about ingroup?
Why am I an alcoholic?
Joe Van Wie (40:46):
All of these
things and that report told me
it finished your you knowhistorically, maybe you could
call it a first step, which isthis more of an existential kind
of meeting with other people?
Do I have this same condition?
Other people described it to meand this is what's parallel to
the discussion we're having.
A human being has no intuitiveaccess that he has a brain, for
(41:11):
most of history being the lastweek we could look at brains, in
the in the context of, you know, just modern civilization.
I won't even go far back asevolution and I look at brains.
You know, atomically therecould be a problem with a
structure, which is kind of rare, or there could be, you know,
(41:33):
an insurgency of something, alesion, a cancer, a mutation.
Um, the environment had someeffect.
All right, let's put that allaside.
I have no access that.
I have a brain.
I think on my experience, thisis this is a weird thing to do.
Now, the technology thetechnology you were specific to
tell us could take a map of thebrain.
We have EEGs, fmlris.
(41:56):
This proved to you in fiveminutes you didn't have an
argument left that you hadsubstance use disorder.
That's awesome, that is juststraight awesome.
And to think now that you canuse this evidence-based approach
really excites me, because Ididn't have that when I first
(42:21):
got into treatment.
It was a sales pitch and I'mgoing back and forth disputing
it.
I desperately need help, but mycritical mind was compromised
by my own anxieties so Icouldn't even I wasn't
approachable Like you.
Put a map of my brain in frontof me and you tell me
something's happening.
That's.
There's a scary thing thatcould happen to someone there?
(42:42):
Where is will?
Where's your agency?
What am I calling me If it'sjust this soft, strange tissue I
have no access to controlling.
Um, that's where I think thingsget really interesting on the
back half of like beingexistential cognitive therapy,
that that will and volitionarises through agency.
(43:04):
I might not be controlling this, but I could be aware of it.
Louis DeSanto (43:07):
That's a
different game and you guys are
you guys are killing it and andthere's, like you know, a couple
things with that that I'll add.
I mean one is it can also bevalidating, you know, yeah,
knowing knowing I'm here, I'mhere for a reason.
I know I have a substanceproblem.
Okay, maybe this is why, andmaybe that did have, maybe these
(43:33):
things from childhood did havea greater impact on me than I
gave him credit for.
So it's validating in a sense.
So now let's get to work,because I feel validated, that I
quote deserve to be here, right, and in addition to that, it
gives the docs and anyonethereafter that's treating you a
(43:53):
roadmap.
Yeah, you're going to know whatmodalities, what therapies,
what exercises are going to workfor an individual, based on
this scan and based on thebattery of psychological testing
that went through For me.
After that, now I had to starttalking about childhood a little
(44:15):
more, a little, some of thosethings that I put in the back of
my mind and buried way deepdown that, ah, they didn't
affect me.
Now I had to talk about them.
So, guess what?
You're on your way to traumagroup.
You're on your way to angermanagement group, and now my
treatment is very individualizedand very evidence-based and
(44:36):
specific to my history, which isreally unique.
Joe Van Wie (44:44):
That is promising
and I look forward to the field
going faster with that,especially now overlapped with
AI and how AI can developpatterns, which is a little
frightening, but I'll leave thatin its own caveat for now.
We could talk about that forhours, but I guess, to be poetic
and summarize, richard Caronstarted with a simple,
(45:07):
fundamental approach the familyand things built upon that.
Now, 70 years later, you have700 employees, the largest
alumni association I wouldattach or associate to any
treatment center.
And this started from a simpleidea.
You saw a map of your brain.
This starts with a simple idea.
(45:30):
Brains just seem to always likewhat I'm just in, this constant
concrete state of being Lou orJoe.
No, the brain started somewhereand it started with simple
stuff, and that simple stuffcould just be disconnection.
Let's go back and take a lookat it for meaningful treatment.
I'm not saying everyone has toyou and I both know recovery
could happen without many ways,sure, but I think for people who
(45:55):
are going to, we're going toneed sober in recovery with the
future we're facing.
We need more alcoholics andaddicts because they have big
hearts.
They have creative minds.
We need them in the game forthe future, Just as a species.
We need these people a part ofcommunity.
They will increase our survivalthe way they think and connect
(46:17):
with people, and you guys areleading it in the most
scientific, thoughtful, I don'tknow precise way.
I don't know where else this ishappening.
Louis DeSanto (46:28):
And we want
everyone to join us.
We want this.
You know you sound like the tojoin us.
We want this.
You know you sound like theMoonies now.
Joe Van Wie (46:33):
We want everyone,
everyone.
Louis DeSanto (46:36):
You know, our
docs and our leadership is
traveling to differentconferences, specifically with
payers, because right now,insurance companies aren't
recognizing this assessment as anecessity and we need to change
that and we need to.
The world needs individuals tohave access to this and you know
(47:04):
we're at the beginning andwe're happy to be, but we don't
want to be the only ones.
You know, we want to spreadwhat we've learned, what our
docs have researched, and makethis accessible to everyone.
Again, regardless of if youhave a diagnosis, if you have
history or you know, maybe youare just a high functioning
(47:25):
executive, business person andyou're curious about your mental
wellbeing.
Yeah, sure, as you should be.
You go to your doctor and get acheckup, a physical, every year
, right?
Joe Van Wie (47:37):
Yeah.
Louis DeSanto (47:38):
Check on your
brain and you can repeat it.
I'm interested.
So I did mine almost five yearsago now and I'm interested to
get it done again and see what'schanged.
Joe Van Wie (47:49):
I bet you have
less stimulation in your
amygdala.
Yeah, with short circuits rightto like, the temporal lobe
can't get to the frontal lobefor activity, with rumination
thoughts, unresolved issues ofjust feeling safe, I think every
alcoholic I meet.
I have to rely onself-reporting and then actions
(48:11):
and observed behavior and thentake a full picture and this is
a great basic clinical approach.
Now coupled with a roadmap ofsomeone's brain who has an
internal, maybe a mixture ofinternal and external
motivations for recovery whichhelps you could see where
there's a disconnect fromreporting versus.
(48:33):
Well, this is what's happeninghere.
You, you, you can have moredirect work, you won't waste
time and I think it's moreeffective it serves the client
and the patient for for real,real, distinct help.
Louis DeSanto (48:48):
Yeah, yeah, let's
maximize, you know, as
clinicians, maximize the time wehave with the patients by
looking at the playbook.
You're going to receive theplaybook and it's, it's
fascinating, it's fascinatingstuff.
Joe Van Wie (49:07):
Lou, is there
anything I didn't ask you that I
should have?
Well then, would you come back?
Louis DeSanto (49:12):
I would gladly
come back.
I love that you're doing this.
I just want to say that I thinkit is so important for people
like me, when I was 26 years old, to hear that you know in
podcast or in any type of media,that one recovery is possible
(49:36):
to there's a lot of resources.
And three you get sober, youget to do cool stuff like go on
podcast and this is my firsttime on a podcast.
Joe Van Wie (49:46):
Really Congrats,
man.
Louis DeSanto (49:47):
Yeah, so thank
you for having me, and just it's
so exciting to to share what welearn.
You know I'm a member ofAlcoholics Anonymous.
You got to give it away, right?
Yeah, we're looking to giveaway, we're looking to give it
(50:12):
to other providers, we'relooking to give it to families,
to patients, and just askingthat people be open-minded and
start thinking about addictionas a brain disease, as we would
any other medical illness.
Joe Van Wie (50:26):
That's it, man.
That's the future, all new.
Thanks again.
Thanks for having me.
If you want to stick around,we've got some pizza.
Can's the future, althoughthanks again.
Thanks for having me.
If you want to stick around,we've got some pizza.
Louis DeSanto (50:34):
Can't say no to
pizza, right.
Joe Van Wie (50:36):
You're in me, but
now baby, all right, thank you,
thank you.
I'd like to thank you forlistening to another episode of
All Better To find us onallbetterfm or listen to us on
Apple Podcasts, spotify, googlePodcasts, stitcher, iheartradio
(51:00):
and Alexa.
Special thanks to our producer,john Edwards, and engineering
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Please like or subscribe to uson YouTube, facebook, instagram
or Twitter and, if you're not,on social media, you're awesome.
Looking forward to seeing youagain.
(51:22):
And remember, just becauseyou're sober doesn't mean you're
right.