Trapped to Triumphant: Justin McMillen on Breaking Addiction & Finding Purpose in Recovery

Addiction in many ways is a poor relationship with pain. If a person's mind is constantly evading the problem instead of facing it as a challenge, psychological resilience is really maybe the aim for people of this particular type. But how do we get people to be psychologically resilient where they're actually pushing forward and into the trouble to conquer it rather than hiding or evading or avoiding it altogether? Justin McMillan is the founder and CEO of Treehouse Recovery, a drug and alcohol addiction treatment center. Dr. Amen, Tana, and Justin discuss how treehouse recovery started and the real issue behind addiction. We're not supposed to be living the way we live. There's a mismatch going on between how we're built and how we currently live. Addiction is clearly not one thing. Giving them the same treatment is just irrational because it's like giving everybody with chest pain or fever the same treatment. You're not finding out why. Hi, this is Dr. Daniel Amen. I am so thrilled to talk about our brand new course, Brain Thrive, for preschoolers through grade one. In this course, we're going to teach kids to love their brain, to know that it's amazing, to know that it controls everything they do and everything they are, is if they learn to love and care for their brains, everything in their life will be better. Welcome. Change your brain every day. We have a very special guest with us today, Justin McMillan. I met Justin in Washington, D.C. when I spoke at an event with Patrick Kennedy. we should have met long ago. Our friend Earl Henslin introduced us. And Justin is the founder and CEO of Treehouse Academy and Research Institute and the co-founder of Treehouse Recovery, organizations he built with his brother Clayton to advance a new way of understanding and treating addiction. For Justin, the work is deeply personal and spiritual. Justin is relentlessly driven to advance the mission of Treehouse to save as many lives as possible by transforming how addiction is thought about, talked about, understood, and treated around the world. Let's just start with your story. Why do you care? about this. Why do you do this? I just want to say Treehouse, you actually have five treatment centers, Southern California. We're in Nashville. We're in North Carolina, in Wilmington. We're in Denver, Colorado, and we're in Portland, Oregon. And then we're here in Southern California. Well, we're so excited to have you here. Yeah. Thank you. We're very excited to be here. I'm very grateful for this opportunity. I'm a huge fan of everything you do. Thank you. And so being able to sit across from you is a big deal for me. So thank you. Yeah, very much. So tell us the story. The story of Treehouse's origins or? Why you do this. Why you're so passionate. What's your passion? I think both Tana and I think we could do such a better job with addiction. Yes. And that you're actually doing it. And what's different about Justin's program is they go for six months because 30 days really doesn't change anybody. No. And I think that's why you get so many frequent flyers and repeat and then people giving up. Yeah. Yeah. I mean, there's a lot to what we do and how we do it. I think the why, it's personal for me. It's from the time I was very young, I've always gravitated towards people who are in pain. And that led me to some problems, I think personally, because I tended to surround myself with people who were going through hard times and found myself going through hard times with them. But over time, I learned that that's part of what I'm built for, meaning that I'm absolutely here to end as much unnecessary suffering as I possibly can before I die. So that's crystal clear to me at this point. I don't think I could verbalize that until maybe a few years ago. But between that and raising my children and having my family, those are the two things that wake me up every day. And my family is, so Treehouse is a family business and it's more than just me. It's my brother as well. My parents are involved. My brother and I are co-owners, but our other brother works for us. Everybody sort of gave up their careers and all came together to do this. And, and we're, we're all kind of built that way. My mother was a special ed teacher. She's got a heart of gold. Like that's just how she is. And we were raised in a house where you just do everything you possibly can to help people who are struggling. And that's just what you do. And, you know, it's interesting years later when my brother went to Scotland, he came home and he brought our family crest and I'm going to screw up the Latin on it, but it's something to the effect of, I learned to take care of the distress because I too have been under stress or something like that. Yeah. So it goes deep. Yeah. That's our McMellan. That's my last name, but it's, it seems to be hardwired into us. So, um, so like I said, I was always, you know, I was the kid that was, you know, I was always high performing, but maybe at risk because I was around people who were struggling and I always found myself in those positions. and then I guess in some ways I resigned myself to thinking maybe I was one of them, right? Well, then you realize there's no such thing as an other, that humans are humans and that we're all in pain in different ways and me having to come to an understanding of my own struggle allowed me to see and be clear about the struggle of others. So that was the beginning. as far as I'll go with that I'm gonna keep it simple but that was the beginning and then of course that creates a fuel or a fire in a person right you want to I feel compelled constantly in fact it's a visceral thing for me when I see people hurting themselves it's a very deep seated feeling in my stomach I can't stand watching it and I think to myself you have to stop there's got to you know you have to understand there's another way And so that propels me forward. That wakes me up every day. So then how that leads to treatment. Well, there's another part of your story. He invested in property, if I understand this right, and started putting homeless people. At one point in time, I designed a building. And this was 2008. And I thought that my future was supposed to be architecture. And I designed a seven-unit common interest development, which is just a fancy way to say a big contract. loft complex with rooftop gardens. And it was written up in some magazines. It never got built because the economy crashed in 2008. And I was there as the sweat equity contributor. So there was investors and a lot of people lost money. And after they lost money, I went into a pretty dark place personally. I felt deeply responsible for all of that happening, even And though, I mean, at the time, in hindsight, obviously I wasn't responsible for 2008. But the project got approved and all the tentative track map, everything was done. And I pulled off a really difficult feat, which was to design something without having a degree or an education in architecture at all. But once the economy fell apart, the properties were going to be taken by the bank. And so the people that had invested stopped paying the mortgage. I was living on the property. and that led to a whole bunch of homeless people living on the properties as well. And through a series of events, I ended up with all the houses filled with homeless people, the bank's going to take them, and not the people, but the houses. And I ended up pulling a lot of people off the street and then some miracles happened and some people came along and helped me to buy the houses. And that led me to, there was no sober living idea. It was just pulling people off the street. But of course, most people on the street are on drugs. And so, um, so over time, uh, there were more houses added to the equation and going back to 2009, late 2009, I think we've pulled more homeless people off the street and helped them get work than anyone else in the Southern California, Orange County area. Um, but that wasn't, that wasn't where it stopped. So me being around all these people that were struggling, my brother saw me and he was like, you are happier than I've ever seen you. And, uh, a lot of it was because of the miracle about the houses being able to be bought out of foreclosure and all this stuff happening. It was just unbelievable. Um, and so when, when good things happen, I think you kind of double down, like, okay, do whatever you got to do to make sure that, uh, that you don't, you do right by this opportunity. Right. I mean, I was kind of raised, you get an opportunity. It's what you do with it that makes you who you are. And so it was just head down and go forward. So my brother says, I want to come work with you. And he's an engineer and he's working for the largest, one of the largest construction companies in the, in the U S Q it. Uh, and he's building, you know, expanding, you know, freeways and doing all this stuff. I said, you don't want to work with me. I'm, I'm, this is not the kind of work you would like to do. And he was like, what if we do treatment? And I remember very clearly I said, well, treatment doesn't work. It's all BS. Like you can't, there's no such thing as effective substance use disorder treatment. That's not, you know, I said, in fact, I said the treatment centers end up kicking people out and they end up on my doorstep and, you know, we have to house them for free and help them get jobs. Like treatment doesn't work. And he said, well, if you could do it your way, what would you do? And saying that to a guy like me is like, uh, that's like a, I don't know. That's, that's just, you're opening a can of worms. Um, that's just the way I'm built. And so I obsessively started diving into what I would do. And through that, I, because I didn't understand what was happening inside treatment centers, what started as ignorance became my greatest competitive, our greatest competitive advantage, because I didn't understand what was normal. I just knew it didn't work. And so I started with a simple biopsych social assessment. It makes sense, right? You look at biology's role in addiction and psychology's role and the social dimension of addiction. So all that made sense. But then I thought, well, okay, how do you treat these things? Well, so you look at how do you treat biology's role in addiction, and the whole field is just you give drug addicts more drugs. And I was like, this is crazy. Suboxone. Yeah, let's suboxone. And I'm not anti-psychiatry or anti-special. I would never. It's okay. I am. Well, you're changing the game. Let's see. The only medical specialty that never looks at the organ and treats that give you medication based on symptom clusters with no biological. Now, I'm not a fan. Yeah. I love being a psychiatrist, but clearly not a fan. Well, I think people – It could be better. I think the idea is that changing brain chemistry is vital. But do you need to use drugs to do it? That's the big question, right? Head-to-head against antidepressants. Yeah. Walking like you're late for 45 minutes four times a week is equally effective. Well, and saffron. Things like saffron. Yeah. So I'm so glad I asked you about the homeless thing because that's the origin. So that's sort of how you got started. And then your brother is like, well, how would you – It chose me. This isn't what I wanted. I mean, I love it, but this is definitely not – How would you design it? Then you're like, well, let's think about it, biopsychosocial. But being serious about biopsychosocial. And not doing it the traditional way that wasn't working. And we would just add spiritual, as you would, meaning and purpose. Why the heck do you care? Right. And it's deeply personal for you. Yes. Um, okay. Keep going. Okay. So, so yeah. So biology, you know, you're like, if you have a, if a, a drug addict showed up at our doorstep because they were putting stuff in their body to change the way they think and feel. And so if you, if you give an, an, an addict or an alcoholic an option to take more drugs to change the way they think and feel, they're going to say yes a hundred percent of the time. So this is a problem. There's a paradox here. And at first I was pretty dogmatic about it. I was like, we can't, you know, we should not be using drugs to treat drug addicts. Like that was, of course that changed. Um, but that was the first thing. It's like, okay, so this is what, how we treat biology's role in addiction is we give drug addicts more drugs, you know, psychiatry, uh, uh, psychotropics and other medications. And this is kind of before Suboxone really came online Hard methadone was around for sure Um and then psychology well there plenty of psychological interventions There clinical interventions all day long So that made sense I get that And then the social side how do you treat the social issues? There's nothing. And this is a huge problem because humans were built for bonding. We're supposed to bond. I mean, we bond with our children. In fact, the way that we formed bonds was how we got here as a species. If we didn't have tight bonds with other people, we died. Right. And so this, this idea of needing to form attachments is so essential. And you can look at any person who struggles with addiction and you can, and I'm not a one size fits all, it's all attachment, but that's a huge piece of it. Because if we don't have people to attach with or attach to, or we're maladapted, we don't know how to, and we ingest a mind altering substance that produces the same neurochemical response, then we find ourselves deeply attached to a bottle, right? This is why you see a man in a gutter holding a bottle like it's a baby, because you have a deep and personal relationship with this drug that's fulfilling that need. And so I'm like, well, what are the social ways we treat addiction? There's none. Group therapy is not social. That's not teaching someone to be social. So all of that sort of happened. Then I was like, okay, well, what are you aiming for? And all these things were big lessons around medical everything, right? Because I've learned so much in the last 13, 14 years, you have to be aiming for something. You cannot in life, you cannot get to any place unless you're aiming for it. You won't hit a target you're not aiming for. And what I learned was that there was no clear aims for anything. Like, what do you mean? So treat biology, what are we trying to get to? What's the idea? You don't just treat biology, you have to be aiming for something. And sobriety is not enough because- Right. So 28 days of not consuming something shouldn't be the target. Yeah. So what is biological? So instead of saying treating biology, it's what are we trying to do with biology? Well, let's optimize biology. Okay, that's a weird way to say it. So what does optimal biology look like? Well, then you could say, well, maybe there's a way in which a human being can move and eat and physiologically interact with the world that is optimal. And then where would you find that? Well, maybe if you look through an evolutionary lens, you just say, how have we lived for most of human history? And how much movement should we have? What should we be eating? And so I think a lot of the answers as far as what to aim for in biology came from looking at humans through an evolutionary lens. And I'm not saying I'm this evolutionary guy, but it's how have we lived for most of human history? And we can assume that what didn't work died off and what worked didn't. So you can look at that. And so we started saying, okay, let's aim for something biologically. Let's look for a basic level of fitness that's similar to our ancestors. Let's look for circadian rhythms that are similar to our ancestors. Let's get people back to their basic- Eating normal food. Eating normal food, whole food. Yeah, whole food, right? It's not that complicated, that it's bringing people back to, it's sort of rehumanizing people, right? Because we were built for a different environment than we live in today. We're not supposed to be living the way we live. We are because we're here. But the reality is the environment that we live in today is not best suited for our genetics. There's a mismatch going on between how we're built and how we currently live. So biology, it's like, let's aim for something. Let's declare what we're aiming for and let's shoot for that so we actually have something to aim for in treatment. And then psychology, okay, what do you aim for psychologically? This is interesting. What is psychologically healthy? That's a big one. There's no normal. No, there is no normal. And this is where, but there could be an optimal way for people that struggle with addiction to think. Because addiction in many ways is a poor relationship with pain. and resilience, right? And so if a person's mind is constantly evading, you know, the problem instead of facing it as a challenge, that's an issue. And you see this, this is constant in people in addiction, in the psychology of addiction, right? Is I don't want to have to face this. And so I'm going to hide from it. And so psychological resilience is really maybe the aim for people of this particular type, right? So how do we get people to be more psychologically resilient where they're actually pushing forward and into the trouble to conquer it rather than hiding or evading or avoiding it altogether. So psychological health, strength-based psychology, psychological resilience, that's the main focus. Socially. So what's the best way to be socially? What's social health look like? Well, we establish deep social bonds. That's what we're looking for. So what does that mean? That means that you and I, so I grew up, you know, I'm from a farm, North Dakota, right? Grew up on a farm till I was, you know, eight. I mean, before we moved, but my family's all farmers. And if you know farmers, the whole world is independence, right? You've got to know how to fix your own stuff. You don't depend on anyone. That's how I was raised. You know, you, you, you got your family, but you, you don't want to depend on the world. Well, the great American dream of independence, which is beautiful, but it also has put us in a position where we feel like we don't, we shouldn't have to depend on each other. We are so grateful you are listening to this podcast. You know, virtually everything I've learned, I've learned from our patients. I've learned from the brain imaging work we do at Amen Clinics. We now have 11 clinics and have over 10,000 patient visits a month. We want to serve you. If you're struggling with anxiety, depression, concussion, ADD, temper, relationship issues, it could be your brain. And I always say, how do you know unless you look? That's what we do. But we do way more than brain scans. We look at your brain and then we give you a plan to make your brain, your mind, your relationships, even your deepest sense of meaning and purpose better. Go to AmenClinics.com or call us. This is a problem because we're hardwired to depend on each other. For example, you bring something to the table. If we're in a tribe together, us three, we each have our thing, right? You bring something to the table. I bring my thing. You bring your thing. we put them together and we share these things. And then our relationship is based on, yeah. And this is where purpose comes from too. Like purpose is really, at the end of the day, it all comes back to serving something, right? And it's hardwired into our survival. I have to have my thing. You have to have your thing. And we all have to share, right? This idea. So, and it could be our personality types. It could be lots of things. It doesn't just have to be that you weave baskets and I kill antelope. It can be that we each bring something to the table that's important. So in order to bond with somebody and establish a deep social bond, a person has to understand what they bring to the table and what they need from others. They have to be able to clearly communicate that and they have to learn how to attach and communicate and interact with other people in a way that's healthy. And when you do that and you get psychology right and you get the biological side right, targeting brain health, which I hope we talk about a lot here today, you get those three things right in concert, and then the system of a human becomes healthier, and then the symptom of addiction disappears. Yeah. So how does that translate into the program at Treehouse? I mean, one of the things I like, for what seems like the same cost as a 30-day program, it's six months. Yeah. And how do you put each of these in action? Sure. So we run, we think of the treatment environment as an ecosystem rather than, you know, because we work in different states, every state has kind of their own formula for what they do. So you think residential treatment in California is, you know, you have, you live in a house with a bunch of people. If you do this, you say the same thing and it's inpatient in North Carolina and that's a commercial building where you're locked up for 30 days. We think ecosystem. So an ecosystem includes all places that a person would go during the day, including where they sleep and eat, how they interact with other people. Even in Orange County or California, it's the beach. It's the whole ecosystem. So we want to manage the entire ecosystem. Of that ecosystem, 11 hours a day. So we'll talk about California. 11 hours a day, the people are spent on our campus. They live away from the campus, but we also have a relationship with where they live. They live in what we call team houses, and they live in groups of 12. And the 12 people come together and they all come to the campus for 11 hours a day. And the 11 hours a day mirrors a work day. So it starts, they're there before 6 a.m. The first part of the day, and you'll love this with being a brain doctor, first part of the day, actually they come over on their bicycles typically. And this is funny because we'll have like former DOJ attorneys and stuff riding a bike, right? But it's important. That morning, they ride with their team and they come to the campus. So they're getting sunlight in their eyes. The sun's coming up and they're experiencing something, just a nice, brisk movement in the morning. They show up, they prepare in the morning. And then the first four hours of the day in the morning is all spent doing physical things. So physical things, it's either going to be teamwork-based exercises, and I can go into that in a second. They come from Naval Special Warfare. Do a bunch of work with Department of Defense. Yeah. Yeah. And then every day they're doing a 90-minute functional fitness training. And when I say this stuff, people think, oh, this is for athletes only. That's not the case. We've treated amputees. We've treated people in wheelchairs. We've treated people that are 350 pounds. It's functional for wherever they're at. Exactly. We meet them where they're at. But the idea is you need to have a relationship with movement. And we do it in the morning on purpose and by design because we're setting up the brain. we want to get all the chemistry in the brain ready to be able to learn. So the idea is we're elevating BDNF, we're bringing IGF-1 up, and we're preparing the sort of chemistry set in the brain to be more capable of learning everything afterwards. So the first thing that they do that's not physical in the morning, and by the way, all the physical sessions are either teamwork based stuff that's run by clinicians. So this isn't like go to the gym membership kind of a thing. This is like sessions that are intended to be coordinated movements that target brain health, trying to get people healthy and strong. I think he invited me to go to the beach to like go on a boat or something. That sounds so fun. I would love. That sounds so fun. I would love so much to get you on the boat. She would love this. Both of you. It would be great. We could film it. We could make a whole thing of it. It would be amazing. That would be so fun. It would be amazing. And the guys would take amazing care of you. Like there's so much love in the environment that we're in and you can feel it when you show up. But the boats, the boats is incredible. So one of the things where this came from is kind of a cool story. So in early 2000, through just mutual connections, I started hanging out with some guys from the SEAL teams and from down south. And one of them I became really close with, his name's Neil. And so as I was developing the program, I was thinking, all right, how do I establish targets, right? I thought, who's the most deeply socially connected person I've ever met. I was like, let's this, the seals that I've met, they're like, they don't even know each other. And they act like they've known each other forever when they get together, their brothers, right? The military guys. So I reached out to Neil. I think he was bodyguarding for Paul Allen or something at the time we met in the orange circle at Felix's, you know, that place. I don't think it's still there, but it was so good. Um, and we sat down and I was like, I have this program and I want to create it. And I wanted to want everyone to be as close as the seal teams. And He started laughing at me. He's like, that's never going to happen. And, uh, and I was like, well, what would you do if you, if you could, if you could do it? Like, how would you do it? And he goes, well, you've got to have guys living together. They've got to be so close that they're attached to the hip. They've got to be competing against each other, but also wanting each other to win. A little struggle. Yeah. It's got to be struggle. And, and they've got to be focused on, um, they're, they're constantly obsessing over improvement and through that they're developing connections. I was like, this sounds like a sports team, which I'm not, I swam, but I never did like team sports and stuff like that. And, uh, and then he pulls out his phone and he shows me an exercise called, um, uh, surf portage, um, rock portage, which is taking an inflatable rubber boats and paddling them through the surf. And these guys are all wearing these red life vests and they do this down South. And he's like, this is how we establish whether somebody is a good team player or not. And I was like, my brain just started going crazy because I thought this is amazing. I imagine as a clinician, like if you, after you scan someone's brain, if you could take them out and watch them behave socially, put them under mild stress, nothing dangerous, but just enough stress to see how they responded, you would get so much information as a clinician to be able to build their treatment plan, to understand their maladaptive behaviors, where they're going right or left. And so I was like, this is not only an amazing assessment tool, but an amazing tool to provide real time changes on the spot to be able to say, Hey, this is how you're communicating, or this is what you do when you're under stress, or this is how you, you know, push people away from you. Yeah. So, so we developed action-based induction therapy, which is basically like an experiential therapy run by clinicians. Um, and it's crazy. We get people from Iowa who've never seen the ocean and they come out and do this and it's mind blowing to watch what happens. So I just went off on a tangent. Action-based induction. Yeah. We're inducing the first Part of the day is... Monday, Wednesday, Friday is that. Yeah. Yeah. And then what? Tuesday and Thursday is yoga but we targeting autonomic nervous system function which I could go on and on Parasympathetic Yeah Yeah Which is a huge thing This is the bridge between the way we experience the world in our body and then how we think right And our feelings And so that got to be any treatment So teaching them to regulate themselves rather than need a substance to regulate them. Which is so dysregulated when they come in. I mean, there's not a single person that comes in that's autonomic nervous system isn't just totally haywire. They're going from crazy, you know, arousal to stress or staying stuck at Arosa. Yeah. So we, we do that through yoga, breath work, meditation. We also have thermal therapy. So we use sauna and ice baths. Yeah. So that's how we address autonomic nervous system. So whether it's Monday, Wednesday, Monday through Friday, it's one of those things in the morning. It's either the boats or this yoga type practice and breath work and meditation. After that, there's a break and then they do 90 minutes of functional fitness where it's in a gym and we have more targeting you know so it's physical stuff and then more physical stuff but the beginning physical stuff is much more teamwork based or autonomic nervous system focused then they have a break they eat and then they go into uh addiction education which is like a college level type class from 12 to 1 and they're learning everything that they i mean we could learn more and hopefully we can you and i can talk because there's a whole program yes just perfect we could for this yes You will love it. Yeah. There's so much we're nerding out. They will love it. When we got together, it was like two hours. We were just this close, just nonstop talking. So there's so much we could do. So 12 to 1 is that. And then they break off. And this is the first time they're not with their team. Now they're going to one-on-ones. And they do four one-on-ones a week. Two of them are narrative therapy. It's a writing program that was developed for Treehouse by a mentor of mine. And the other one is just traditional psychotherapy, two sessions a week. and then they do process group from 4 to 5 and then at 5, that's the end of the 11 hour day and they go home and eat and then at 90 days they do a leadership training class or a course which is a month I teach it most of the time I still teach even though my whole staff's like you gotta stop because I'm so busy I'm always in DC going back and forth it's like it recharges I love it so much I still see patients yeah, you have to I don't even see 40 patients a week anymore You know, I love this story and it's amazing to me. I love your passion for this, your heart for this. As someone who has a lot of addiction. It's his brain. It's not his heart. His heart doesn't feel. As someone who has a lot of addiction in my family, the world needs people. I think when you've grown up with a lot of addiction in your family, you go one of two ways. Well, one of three ways. You get very involved in the addiction and you go that direction. You have a heart for it or you completely withdraw from it. I mean, I completely withdrew from it and it was my survival. Of course. So to hear you and I'm just like, wow, I mean, this is amazing. Well, thank you. What you have done and what you have created. What's so cool is we're just getting started. There's so much. The most important thing, it's effective. Yeah. Yeah. So just talk about some of the outcomes that you have seen. So going back 13 years, so we started doing, we started gathering data in 2016, in 17, the end of 2016. And all this is practitioner research, so it's internal. We're gathering it ourselves. There's tons of challenges with gathering data, but I won't talk about all that because it's just going to keep it simple. when it comes to program completion for six months, conservatively 85% of the people make it through six months. That's conservative. I would say the number varies center to center and it varies over time. But if you go 13 years, it's probably 85%. I think if you went the last two years, it's probably 90%. That means nobody's leaving early against medical advice. They're finishing it out. Relapse is almost zero. Really? Yeah. Well, in treatment. Okay. I'm going to stratify all this out. Post-treatment, now we only have 13 years to go back, but we think about approximately 65%, and it gets hard because you're dealing with self-reporting, but 65% are never touching or using another drug again. Interesting, that's huge. Yes, it's massive. I mean, the numbers most people talk about is 10%. Yeah, 10% to three years. That's like the most commonly quoted statistic. And then we see about 10% is relapsing, but they're not, they're not, they wouldn't qualify to go back to treatment. So this is somebody who's like, I'm going to go try to see if I can do this. And then with their tail between their legs, they're like, I'm not built for this anymore. I've just, I'm not meant for it. They don't go off the rails. They don't lose their job. They don't, but there's, there's that moment. Then there's another 20%, which is like 10% to 15% who needs treatment again. And then there's a 10% mark that we don't know why, but that's the part that we can't help. So I have a question about that. Those are the ones for sure we should speak. And I have a question about that too. Those are the ones that haunt me. But it seems to me like a big part of what you're doing as I'm listening is changing their identity from an addict to someone who's kind of a badass. who's like very different in their physiology and in their psychology. And because if you don't change your identity, nothing's going to change, right? I know in my own family with lots of addicts, I don't change the word, lots of addiction. Thank you. Right? I appreciate that. Like I said, I turned hard the other way. I think a lot of exposure therapy kept me away from it. but one thing that always frustrated me was the language they use. And I'm like, why can't you hear it? I didn't understand. Like there's a lot of victim language. There's a lot of inability to take responsibility. Oh man. And so when I'm listening to you, I'm like, wow. I mean, it's not just about the exercise. What I'm hearing is identity change. Yes. You're so on. You cannot change if you don't change your identity. You can't. And you cannot ever stay well if you believe that the world is happening to you. Yes. We teach extreme ownership. Yes. And we call it living a cause and extreme ownership. And the idea is how can you make as many things in your life your fault as possible? Then you have control, right? So it's like, you know, someone stole my backpack out of my car. You could find a lot of people who would feel really bad at you for that, you know, for that happening. Or you could say, what did I do wrong here? Well, I left my backpack in my car. I parked under a broken street light and my window was partly down. Now I control the situation. We pound this. We literally teach this concept. So my favorite word in the world is responsibility. I love it. And I learned it. And it's not only for when things are your fault. Sometimes things aren't your fault, but it doesn't have to be about blame. It can be about your ability to respond. Yes. And so when I learned that, because I felt very sorry for myself, I had cancer. And when I learned this, that it doesn't have to be my fault, but I can still take responsibility, it's changed my life. And you will find that this characteristic in so many people who are successful in the world, and to take it, this identity thing is so interesting. So originally there was a hunch that I had, we had, and then it became supported by science and now we're really running with it, which is that addiction in many ways is caused by a genetic predisposition, but not how we're taught to believe. There are certainly ways that the liver metabolizes opiates in one way or another or alcohol. That's true and the research around that's good. However, there's also ways that our genes code for how our dopaminergic system works and how our brain works. And we're not all built the same. Okay, so what does that mean? Well, if you consider that these genes, these traits, didn't get bred out of the gene pool for a reason, so why do they exist? Why is it that 20% to 30% of the population has less density of dopamine neurons? How would that have been an advantage through human history? Well, those people are never satisfied. they're constantly looking for more. Now this can be one of two ways. You can either turn in somebody into somebody like Dr. Amen with the warrior gene perhaps, or I do have the warrior gene. There you go. Or you can end up being somebody who's novelty seeking, never satisfied. And with the wrong environmental conditions become addicted. Now why this matters is because there are genes that drive this forward, but they're not addict genes. They're genes that either make you into the highest performer or the worst self-destructor. The same coin with two sides. And so why? Yeah, because you have people in the same family. Yes. That's the thing. Yes. You look at families and you'll always find the ones who become addicted and then you'll find the ones who are like, what the hell is the matter with you? Right. And they have the same similar traits. It's just expressing itself in two different ways. So thinking of identity. That's like the most exciting thing about all of this. Do you put 12 steps in the program or not? Yes. Well, okay, I come from a 12-step background, and it's pretty clearly stated that we shouldn't be charging money for 12-step. So there's a lot of treatment centers that do. I'm not going to say whether it's good or bad. People can make their own decisions about that. But billing insurance and treating somebody and using a big book and then billing insurance for it seems to me to be maybe not the best move. But it starts with, I'm an alcoholic. It starts with identity. Yeah. Which I worked with Rick Warren for a long time. Okay. And he has Celebrate Recovery. And he's like, no, we're not starting with an identity of illness. We're starting with I am a child of God. With infinite value. I have some patients who 12 steps saved their life. But when you look at the research, it's not good. Yeah. It's not good. And I wrote a book, Your Brain is Always Listening. And I just decided to rewrite the 12 steps from a neuroscientist perspective. And step one isn't I'm in trouble. That's the step one in the 12 steps is my life is out of control. step one for me is what do you want what are your goals and step two is your behavior getting you what you want so you're sort of like creating an opportunity for somebody to analyze what's going on around them versus identity right yeah and i love the idea of an alter ego or what you're doing with like just really like ingraining in them that there's someone different about starting This is a hard one because I have seen people that we tried to treat, the 10% that were really struggling or what appeared to be the 10% end up finding what they needed with AA. I've seen it's hard. AA is so accessible to so many people that it's hard for me to say. I used to have a lot of opinions and people knew them around AA. I struggle with the idea of saying that I was powerless. Right. Yeah. It felt like, okay, all right, Dr. Amen, I'm going to prepare you to go to war. You're going to fight the hardest war of your life. But before we start, I want you to say that the enemy is something that you're powerless over, right? Like that's, there was a lot of problems with that in my head. I've become a little bit more open about it and it's not political. It's not, I mean, political. It's not, um, cause I don't, I'm afraid of pissing people off. I don't, I'm not afraid of pissing people off. Um, it's really just that it's not, uh, I'm focused on trying to treat the whole person as at a system level. AA is really the best that it can be outside of that available for the public broadly. Um, and, and I, until something better comes along, like it's so essential because so many people don't have options to go to places like, yeah, I think that's a great way to say it. It's, I don't know. I don't know. It's, it's better than the alternative. You can dig into each piece of it if you want to. I mean, I certainly... Yeah, maybe another one. Well, I love your model. It fits so well with our brand health model. In so many ways. I do want to say one thing about A. I think one of the metrics I've seen for people staying well that struggle with substances, and you see it every time, is when people start to get enough peace with their past they start looking at the world around them and they notice things and they're like everything's happening exactly as it should and this is this this is sort of like like aa the acknowledgement of a higher power in a person's life i think is probably the most powerful part of it because this idea that i'm not completely at the wheel that there's something greater than me that i can rely on that i think is okay like i'm not i'm powerless but something else greater than me has that's okay. But to say that I have no control over anything is that to me feels. Yeah. Yeah. Yeah. I agree. I agree. But I think that, that, that piece is incredible. And I think the community, uh, where it's challenging is if you go to an AA meeting and you hear people say this happens all the time they speak about it When I drink I end up in a hotel with prostitutes and I So they saying the present tense They do Yeah And it crazy to hear it It like you I noticed that stuff In fact, I noticed it's like language matters when I used to, or exactly. If somebody is talking that way and you'll hear this repeat narrative and you're like, this is like something that's just sitting right at the edge about ready to fall at any moment, which is taught, which is like one moment from relapse, you know, it's just one, one drink away and you're gone. But I also know people like our secretary, who's an amazing guy, who's relied on A for 40 years, and he's done really well with it, or Russell Brand. Also, he's got a relationship. I don't want to diminish it if it works for someone. But AA is a psychosocial, spiritual program. There's no biology in it, which is why I felt the need to rewrite the 12 steps. Step three is get your brain healthy. Yeah. And the question always, is this good for my brain or bad for me? Right? We're building a national brain health revolution around that one question. I love it. Is what I'm doing now good for my brain or bad for it? And does it make the world better? So in that is biopsychosocial spiritual because does it make the world better? which means it's not just about me. It's about generations of me. And why would I ever do anything that damages my brain unless I was just not that smart? Because clearly alcohol, marijuana, cocaine, methamphetamines, they are bad for your brain, right? I mean, that's what I do. I look at people's brains. and I have so many great stories like Jonathan Cain, the band member of Journey, who wrote most of their iconic songs, drinking two bottles of wine a day for decades, saw a scan and stopped because I could show him he was headed for Alzheimer's disease. Here's your brain. Here's a healthy brain. Here's yours. Here's yours. If you do what I say and here's yours, if I don't, don't. If you don't, which one do you want? And then made a poster and he put it on his tour bus so that, I mean, it's just so powerful. But if you add that to the bonding, to the exercise, to the education, it just, they reinforce each other. Hardware, software. Well, you bring up such an important point, doctor, because like I said, aiming for something if you tell someone oh you just need a healthier brain but you don't if you show them look what you've done look what you're doing and then you have something to aim for right like i want this to be that people need that you have to have a target if you're not aiming for something you'll never hit it you're helping people establish targets it's what you're doing for the innovators like you are what inspire guys like me to keep pushing forward despite all the slings and arrows and craziness of putting yourself out there. I know it's a sacrifice to put yourself out in front. What do they say? Pioneers get the arrows and settlers get the lands. One of my favorite speeches is the man in the arena. Yeah. Oh my goodness, sorry. You're fine. But that's, yeah, I think it's incredible. I think it's so incredible that people who want the status quo continue to complain about people that are putting themselves out there and pushing for change. It's insane. And it's happening all over the place. It's happening right now with our current political system. It's like specifically HHS. I don't know about the other side of things, but it's like people are trying and that matters, right? There's a new program from CMS, Center for Medicare and Medicaid Services called Maha elevate where they're actually looking for innovative programs to deal with chronic disease. I love that. At least they're kind. Yeah. So much. I'm so hopeful. And, you know, if you disrupt an industry, people hate you. Machiavelli, 15th century, said there is nothing more dangerous than trying to upset, a system that's in place that's making a lot of money. But yet, if you know you have something that works, there's no choice. There's just no choice. You can't look yourself in the mirror if you don't do it. I mean, if the goal is money, then you conform. If the goal is making a difference, you don't conform. You do what you know works. What I'm excited about for Treehouse recovery is the data you have. You're smart enough. Most treatment centers don't do outcome studies. We've done an outcome study on every one of our patients since 2011. So we have the best published outcomes of anyone in psychiatry that we know about. And we sort of get to cheat. We look at your brain before we go about trying to change it. But is it cheating or is it just Smarter. It's just smarter. It's so obvious too. I don't know why anyone even would debate that. That's crazy. But, you know, and the people who call me bad names, it's like, you know, I'm one of seven. And I have five sisters. So I got called lots of bad names. He came well-trained and fully housebroken. Yeah. No, I get it. But how can people learn more about your work? And if they have somebody they care about who needs help, or if you're listening and you need help, how can they get connected more with Treehouse Recovery? You can Google us at treehouserecovery.com. That's the easiest way. We have a YouTube channel with hundreds of videos that have a ton around addiction education. People use them for resources. They're used in VAs to teach classes and all kinds of things. So there's a good educational library. Um, every one of the States. So there's treehouse recovery TN that's in Tennessee. There's treehouse recovery NC in North Carolina. Uh, treehouse recovery is the one here in Southern California and treehouse recovery PDX in Portland. Um, and then, uh, CO Colorado treehouse recovery, Colorado, but you just Google us. We're, we're visible. Um, and then call and we've got amazing people that even if a person, uh, every person that answers the phone at treehouse is trained that even if a person doesn't end up at Treehouse, we guide them to wherever they need to go. And we don't stop until they find a place. We know everybody. We connect people to care all the time. So we'll help. Yeah. And we got, yeah, we're here completely. One of the things I want to mention about data is we recently partnered with DNA Hive. And the Hive was built for the FDA. And it was built by a dear friend of mine, Dr. Vahan Simonian. And what it does is it's one of the largest databases of genetic information in the world. All of the pharmaceutical companies have to use the hive to run through and do analysis. So we're now plugged into the hive so we can do multifactorial analysis in ways that nobody else can do. And it can port data from everything from imaging to blood to clinical notes. and it can find correlations using AI in ways that have never been possible, you know, four years ago, at least in the open market. So we partnered with Hive and then now, which I'm hoping we get to work on in the future, is the Comprehensive Addiction Research Network, which is bringing personalized medicine to the substance use disorder treatment space. And so what that looks like is Dr. Simonian, who I'm working with at the Hive, were going to be co-PIs on this study. It'll be three years long. He worked heavily on bringing personalized medicine to cancer treatment and through that reduced cancer death rates by 30%. He's not the only guy. There were several people, but he was one of the key players in it. And so the idea is to bring that to substance use disorder treatment. But in order to do it, we have to bring in as much data as possible and analyze it and look at what are the strongest signals about what's effective. And then the goal in the future after three years study and then five years out would be when someone comes in to go to treatment, you do extensive data collection on them, genetics, blood, even gut biome, everything. You put all that into this backbone of the hive and it spits out the ultimate treatment plan based on all of what's been gathered over time across all the other treatment centers that are part of the Comprehensive Addiction Research Network. So the more information it gets, the better it gets, and it's constantly improving. So we get away from this one-size-fits-all treatment approach to personalized medicine for substance use disorder treatment. I love that. Yeah. I wrote a book, goodness, I think it's 15 years ago with David Smith, who founded the Haight-Ashbury Free Clinic. He's considered the father of addiction medicine in the U.S., and it's called Unchain Your Brain, Breaking the Addictions That Steal Your Life. And based on our imaging work, what we discovered was ADD is not one thing. It's seven different things. That being overweight is not one thing. It's five different things. Stop putting everybody in the same program. And that addiction is clearly not one thing. They're impulsive addicts. They're compulsive addicts. They're sad addicts. They're anxious addicts. They're head trauma addicts. and giving them the same treatment is just irrational because it's like giving everybody with chest pain or fever the same treatment. You're not finding out why. Right. And I love that you've been doing that. You've been doing that with the brain, but I also loved that I heard you say that you assess them as well for your program to figure out like what is this person's communication style? What is this person's style for interacting? Because you can't treat them the same if they're not the same. Exactly. Yeah, there's so many cool things that are happening. I mean, the wearable side of things too, and this is the last thing I'll say. So I'm really into Aura rings and wearables. We're going to include Aura. So we just did a NIH. We made the pay line and all that for NIH. We're just waiting for the mess to get untangled in NIH right now. But what we're doing is we're using Oura rings and we're putting them on all of our patients and we're looking at the phase one is going to be just during treatment. And we're looking at anybody who starts to, so I said people don't leave early, but people definitely want to leave and then stay. So we're looking for that period of time before someone's contemplating leaving and we're teasing out the data. And the goal is to find, to develop an algorithm that can predict relapse before it happens. That's so interesting. So now the future is, yeah, you're wearing a ring if you're in recovery. And through your phone, it'll say, hey, you're moving towards relapse based on data. The more data you put into it, the more we're likely to know whether people are more or less – So likely heart rate variability will be a predictor of relapse. On stands, it's low frontal lobe activity will be a predictor. There's already published studies on that. But yeah, the future is so interesting. And exciting. All right. We have to wrap. We're going to have you back. Hi, I'm Dr. Daniel Lehman. I've experienced firsthand the powerful impact that proper supplementation can have on your brain, your body, and your mind. That's why I founded BrainMD. Our formulas are scientifically created from decades of clinical research designed to help you think clearer, feel better, and improve every aspect of your health. Whether it's Brain and Body Power Max, the same formula I used in the world's largest study of NFL players to optimize brain performance, to Happy Saffron, to boost mood and memory, and Pro Brain Biotics Max to improve the gut-brain connection. BrainMD delivers the highest quality science-backed solutions to help you think and feel better. Tan and I take many of our products every day. And as a special offer, just for our listeners, you can save 20% on your next order. Visit brainmd.com and use the code podcast20. With a better brain, always comes a better life. Treehouse Recovery, Justin McMillan. You can go to treehouserecovery.com to learn more. And I'm excited about the research we're talking about doing together. I am too. Thank you so much. Leave us a comment, question, review, subscribe. Change your brain every day in a good way.