I welcome back Dr. McAuliffe to talk about his work within Sauk County and beyond to help people that have been caught in the dark web of opiate addiction. As a physician he is acutely aware of the toll addictions take on people's lives and how difficult it is to recover. We discuss in depth the nature of addictions and how to help pull someone you love and care for out of this condition. His insights and explanations of how we are "wired" and how addiction corrupts that wiring is both illuminating and challenging. At the core of it all is his compassion and kindness for those people that he treats in addiction recovery. He understands the devastation it causes and seeks to be a lifeline to those that will grab what he can offer.
When he was 11 years old, McAuliffe knew he wanted to be a doctor. He was always nurturing his many pets. Today, you can see his compassion in the empowering respect he has for patients. "The patient should be in control of his healthcare-not the physician," he says. As medical director of Sauk Prairie Memorial Hospital, McAuliffe also helps with administrative concerns in healthcare, which impacts patients directly. "It has always been my passion to do everything I can to make a difference. I have no plans to retire; it's a privilege to help people," he says.
"It's not where you are in the process of change that matters. It's the direction that you're looking that counts. Take one step at a time, and recognize your small successes," says McAuliffe.
Announcer: 0:04
Welcome to frame of reference informed intelligent conversations about the issues and challenges facing everyone in today's world, in depth interviews with salt counties, leaders and professionals to help you expand in and form your frame of reference, brought to you by the max FM digital network. Now, here's your host, Rauel LaBreche.
Rauel LaBreche:
0:26
Welcome to another edition of frame of reference, the only podcast Yep, I'm back to saying that here we are in the third season. But I am back to saying we are the only podcast in Sauk. County, Wisconsin, that talks with the leaders in this community in trying to cover issues that are global in their impact. And that's not to try to sound like we're big deal. Although if I were Ron Burgundy, I would say you know, kind of a big deal. It's more to say we're trying to make this into a podcast that is worth listening to, regardless of where we're at. And the way that I do that is by inviting guests that I personally know, to be experts and knowledgeable and just compassionate people in general that can see a lot of what's going on in the big news media, and reflect upon it in ways that are meaningful to most of us. So the guest I have today is somebody that meets those criteria in spades, as we used to say, is a dear man, dear doctor, a great friend, he's somebody you want to know, if you ever do move in this community, you want to make sure you look up Dr. John McAuliffe, and get into a conversation with him about something that will be fascinating. I guarantee you, John, thanks so much for being here again. Raul. Thank you. You're You're way too kind. Well, the last time we talked, I was okay. But you were talking about delivering grandbabies or something? And I said, well, that must make you not today over 424 hours. And my wife kicked me for that one. So just now and no, we, she was like, Oh, my God, I can't say that. I'm like, Oh, he knows me well enough. Now to know that that's just wrong. So that's right. You try to find reality, you're never gonna win. Well, no. And if we make things extreme right data that what is doesn't seem so bad. So yeah. Anyway, thanks again. I appreciate it. And we those of you that listen to this podcast know that Dr. McAuliffe and I have had several really, I think, interesting conversations about COVID. And, and about addictions in general, and some of the work that he's done with the opioid task force here in our area. But today, we're, we're, we're going to try to focus on that part on addictions. John and I talked off, off recording, or off site a bit about, what else could we explore together and it just hits strikes me that there have been a lot of comparisons between what we're enduring as a general populace with COVID in terms of what has happened to us collectively, and in that smaller subset of what happens in addictions, that is parallel, in some ways, very similar to that. So maybe in exploring the one will understand the other a little better. But I can guarantee you, it'll be an interesting conversation. So I know I'm gonna learn something. So that's that's always a good thing. So but we have to start out as we do with every episode with talking a little bit about my favorite things, and I'm gonna try to really think outside the wall here because Jon's been on the show enough times now that I've gone through all my kind of basic favorite things, and I've got to get out into lala land. Okay, so bear with me, John. I hope this isn't too weird of a question. Some of these that are gonna come up. They're just kind of off the top of my head. But first one out is favorite movie.
Dr John McAuliffe:
3:41
Oh, favorite movie? Huh? I'm not a movie goer.
Rauel LaBreche:
3:48
Favorite type of movie. Maybe? Or if you're going to watch
Dr John McAuliffe:
3:53
my fifth, of course, my favorite thing to watch the Olympics. Okay. And anything that has to do with running? I guess I'm, I'm interested. So Chariots of Fire. Would that be? Yeah, that was Yeah. Yeah. Okay. The music was great. very jealous. Yeah, exactly. So did you think they did a good job of capturing that runners? I think they did. And, you know, if you correlate that even to what's going on today, I mean, all sports are really a reflection of our society in a lot of ways and that they bring forth you know, the human spirit. And I think that movie really did capture the human spirit, just as athletics do and just as, you know, war and discrimination and all these other things. It's all about how do we as a society, how does our spirit it can't be dampened? You know, we have to we have to continue to have courage to to question things and then the courage to act on things that sport does that in manifest that and I thought that movie brought that way back. Yeah, that correct courage that he has
Rauel LaBreche:
5:00
to stand up for his convictions, right? And do it in a way that that's not disrespectful. He's just No, this is my line. I won't crossover. Right. Right. And that that was that took a lot of hotspot I guess he would say in some circles, right?
Dr John McAuliffe:
5:15
Yep. And I think it also manifests what we're going to even talk some more about today, is that as what do we focus, we need to focus on what we have in common. And rather than differences, differences are meaningless and superficial. So I think sport, does that. Okay.
Rauel LaBreche:
5:34
Favorite tree?
Dr John McAuliffe:
5:36
They've achieved maple,
Rauel LaBreche:
5:37
Maple. Why maple.
Dr John McAuliffe:
5:40
Just how it changes how it evolves? is both probably one of the more colorful trees. And it's like I say it just manifests that. That change is always aspiring. And plus, I have three or four of them outside my window. Yeah, I don't know if I asked you this one or not earlier. But favorite animal? Do you have a favorite animal? Oh, I have a dog. In lab. Oh.
Rauel LaBreche:
6:13
White lab?
Dr John McAuliffe:
6:15
yellow lab? yellow lab? Yeah. Okay. You have to go with that. And there again, I think, you know, just not to be too anecdotal here. But to just, you know, we should all treat each other just like the lab treats. You know, every time you come home? Yeah, it's unconditional. Yeah, you know, and always there. So, as long as you treat them, they're okay. Why I think of our dogs that honestly, through COVID, one of the most healthy things I've had in my life is my relationship with my dogs. I'm not only by walking them daily, and just getting out and making sure they exercise but that unconditional love that you talk about when you can come home and feel so completely. Oh my gosh, this is the most wonderful thing that has happened to me all day long as you're coming home. It's really hard to walk away from that. In fact, it's one of the few things that I really, really get incensed about is somebody that's mean to a dog. I just that that's really hard for me to not be like, Yeah, you know, yeah, there's probably some pathology there and some history that has led to that kind of pathology. Yeah. But even even like in Alzheimer's, you know, just even a stuffed animal. If you give them that they can, they can hold that. And you can just sort of see a different mindset starting to evolve with that the comfort that happens from it, they're connected in some way to something. Yeah. I'd have to turn to another anecdote. I was reading Walgreens not too long ago. And this older couple came in with obviously a black lab in training for some sort of sensitivity training for whatever. And I didn't realize that you're supposed to really make sure that a dog in that phase is focused on you and you alone that they don't get sidetracked by me. I could not resist going to that document. And the guy was like, No, don't do that. So I'm like, oh, so and then his wife was really kind of overtraining him. And it's really important. And I'm like, How are you supposed to resist that? That face that, you know? But yeah, I'm, I'm I would not be a good trainer that way. How about favorite? This gonna be really weird, a favorite bug?
Rauel LaBreche:
8:24
Or most interesting one that you're most
Dr John McAuliffe:
8:27
to say my, excuse me? Monarch butterfly. Okay. Yeah.
Rauel LaBreche:
8:31
My wife would join you in that. And the this the the way the monarchs. What is their migration path is particularly
Dr John McAuliffe:
8:38
interesting, isn't it? Pretty amazing. Right? Right. How they
Rauel LaBreche:
8:42
flock there isn't a place like Mexico or something where they all kind of gathered together. Right. So which is fascinating. I like bees, too. I don't know if Bees fascinate me in terms of how they're kind of a central thing to just our whole ecosystem and the the health of our plants, the health of our crops. It's a really fascinating thing to me.
Dr John McAuliffe:
9:02
Even if you look at the physics of a bumblebee, there's no way it shouldn't be able to fly.
Rauel LaBreche:
9:10
It still does. Yeah, you just
Dr John McAuliffe:
9:12
kind of wandering defies physics. Okay.
Rauel LaBreche:
9:15
And when I see friends I think you know, if you don't think God has a sense of humor, look at the platypus. You know, I mean, it was at all about right. So how about do you have a favorite? I'm assuming you've traveled a bit. Do you have a favorite city that you've ever visited or fifth favorite place you've ever visited?
Dr John McAuliffe:
9:32
I actually I don't travel too much. I would like to trip probably travel more but I just work a fair amount. But yeah, I sort of a favorite city. I like St. Louis. Okay. If you know just the archway and everything it just says, brings back sort of, you know, adventure and frontier ism and just a lot of history of our country. You know, When I was first being founded insurance, it sort of captivates that part of my spirit,
Rauel LaBreche:
10:06
I think gateway to the west. Right? So, yeah, there's some fascinating stories aren't there about how people congregated there as sort of the last stop of civilization before heading out
Dr John McAuliffe:
10:16
for anything that sort of relates to Mississippi River? I think is, is also the other thing that is really what our country really is, is sort of the bedrock of our country. Okay, no.
Rauel LaBreche:
10:29
And, um, last question in this realm, and it's one I've asked you before, but even if you answer the same way as you have, like, it's a good metaphor for our listeners, but a favorite memory that you have from childhood, or something youth, when you think about you think how formative it was, or how it just always kind of puts you back into a good center place.
Dr John McAuliffe:
10:55
Oh, that, you know, favorite memory Boy, that is? I would have to as much as I, you know, I have to sort of chuckle to myself, because I really, at times tried to avoid it, really. And that was with my dad, when he'd asked me to go with him ride, deliver chickens. And he would ask me to do that. And I would pretend to that I wasn't feeling well, sci fi or whatever. And he would always he would have not in a chicken. Oh, yeah, he didn't have a way of, you know, getting me to, I guess, maybe feel a little guilty about not going so I would always go but those those were the things I remember that were very endearing, manufacture get emotional, even now thinking about that.
Rauel LaBreche:
11:46
Isn't it interesting to it? I would imagine there's some research or perhaps some MRI studies that have been done of how those ordinary things as we get older, those kind of, you know, things that were regular become more and more significant as we get older.
Dr John McAuliffe:
12:03
Oh, definitely. I mean, that's a, you know, our brains are forming then and so are our memories, you know, first we have our thoughts, and then our thoughts lead to feelings or emotions, and then that leads to actions. And, and so it's just, you know, it's how you grew up. And just sort of, you know, having people like your parents there that you, you realize that the that's, that's who you are, that's your essence, essentially. And that, that becomes more and more powerful. I think the older you get.
Rauel LaBreche:
12:41
I've been doing some training, here at Macfarlanes, on the origins and the nature of mental health issues, and particularly as it relates to the ag community, because we have some unique stressors and in the ag community, and but one of the things we talked about is what mental health is not what mental illness is not. And there's a statement in there talks about the result of being poor, and environment, the environment making us ill. And I always, whenever I come to that part, I think, I wonder, what part does environment play what part does, you know, poor health play in, you know, just not having good nutrition or whatnot? What part does that play in growing up in a environment where there's abuse or whatever going on, that has to have some part of what happens to us
Dr John McAuliffe:
13:41
an enormous part, you know, you know, the whole, you know, nurture versus nature kind of issue. And, you know, the ACE score, and that's, that's, that's what we use in addiction. Oftentimes, when people are, you know, they grew up with bipolar disease, or, or anger issues, and all kinds of different emotional psychiatric issues. Usually, you find some indication of childhood trauma, unfortunately. And that oftentimes is what you have to deal with in our brain is then gets wired that way. And so how do we, you know, how we treat that as one way but how we self medicate, it is another way and that, you know, people don't want to be constantly under a threat. They want to have some consistency and some stability. And they're again, you know, you asked about their memory, and I just my folks just showed up. I mean, they were there all the time. That, you know, at least that's my recall of that. And I just wish, I wish we had more of that sense in our society that we had each other's back we were there. We are there for each other, rather than trying to find the differences and separate and get polarized
Rauel LaBreche:
14:59
which is Bray leads me to in the past, we have talked about this. And I don't want that to be the the overriding topic this time we we've structured this to not have that be. But can you give us a just kind of a brief update or status report on how we're doing locally, Wisconsin nationally with the COVID problem with a pandemic? And where are we at now, and we're recording this at the end of October, and almost November. So the stats are changing, right? We appear to be in a lower trough portion. Any indications of where we're going to go from here?
Dr John McAuliffe:
15:35
I think we're going to keep going down. Okay. I think we're approaching again, the herd immunity, which we had talked about to all our other things, and I think we're probably at the at maybe 85% herd immunity, okay. And that's really where it's going to make a difference. And I think we're going to evolve, you know, from a pandemic into an endemic kind of situation where we're Coronavirus will always be with us to some in some degree. And so we'll adjust to that be with continued vaccine vaccination or masking or whatever, I don't go ballistic on that. But, you know, to whatever it's going to take, but I do definitely think we have turned the corner. And looking looking definitely forward to that. And, you know, again, that's the reason for the mandate, because people weren't getting vaccinated, and now the vaccination rate has gone up. And it's made a difference. But, you know, there are two ways to get herd immunity, and that is to get to disease, number one, or to get vaccinated. And so, again, vaccination is by far and away the best way, because the natural disease factor of that is a third of the people who have the natural disease will get the so called Long hollers syndrome, which is not a good thing to have. It's neurological issues, it can be cardiovascular issues can be all kinds of different things that can go on pretty indefinite, you know, even six months to a year, etc.
Rauel LaBreche:
17:12
I know we talked about this issue. months ago, if not more than a year ago, about there, there weren't enough data points at that point in time to know whether or not getting the illness would provide the same level or close to the same level of immunity as the vaccination does that. If we found out more about that, do we have more conclusive evidence now?
Dr John McAuliffe:
17:33
Right? He right, it's probably about a third of what the strength of the vaccine initially for the first two months probably comparable, but then after that, it drops down by a six month period is about a third of what we get from the vaccine. And, again, that that data is still is evolving somewhat, you know, as we get because immunity from the vaccine is even different from the first one to the second one now to the booster. Right. And or the third vaccine, right? So I think, I think COVID is gonna end up being a three shot thing for the most part, and kind of the, from the third shot. I think that's going to really last significant period of I think, even more than a year perhaps. But Will
Rauel LaBreche:
18:15
there be an ongoing then do you think like, just like a flu shot, people will go in and get their COVID shot as well?
Dr John McAuliffe:
18:21
I don't think it's going to be an annual thing, quite honestly, I think it's, I think it's going to probably be like a three shot
Rauel LaBreche:
18:27
thing. And then your system is covered for what about what the variance? Is there potential there that see there?
Dr John McAuliffe:
18:32
Again, that all depends upon maintaining herd immunity. And so the more herd immunity we have, the less capability there is for the virus to replicate. So they're less capability to mutate. Okay. So
Rauel LaBreche:
18:45
I know there was some question to you, we had a conversation that was just aired to Macfarlanes employees, and a couple of questions have come up about the monoclonal antibody treatment, and how advantageous that can be that if you do have a breakthrough infection with which in some circles, it seems like the breakthrough infections are happening at more alarming rate than you would think it was at am I miss reading some of that data? No,
Dr John McAuliffe:
19:09
I don't think you're Miss reading it. But I think it's a reflection again of the immunization status of that population.
Rauel LaBreche:
19:16
Is there any indication that the there are, there are some strands that are more effective at breaking through the vaccination so that even if you are vaccinated, that perhaps those people are taking more chances? And they should and as such ended up contracting the illness as a result of?
Dr John McAuliffe:
19:35
Oh, absolutely, yeah. The more the more you ignore, you know, masking, distancing. You're putting yourself at more risk. There's no question about that.
Rauel LaBreche:
19:47
So you have to maintain that healthy mindset as throughout all
Dr John McAuliffe:
19:51
it's it's straightforward. The more things you have going in your favor, the better and the vaccine doesn't make you exempt from doing them. those things.
Rauel LaBreche:
20:01
Well, good news, though the marathon is maybe wrapping up.
Dr John McAuliffe:
20:04
Yeah, I think we can. We're sort of well, wrapping up is may be a little bit of an overstatement. But I think we can see the finish line probably about a half mile away, okay, you're still tired. You're very tired, you're
Rauel LaBreche:
20:20
still wondering, what did I get myself into?
Dr John McAuliffe:
20:23
You are saying the marathon prayer that is, oh, God, if you bet lift these legs up, I'll make sure they get that.
Rauel LaBreche:
20:31
That makes sense. I just saw it make me think when you said we're tired, what was the read a columnist talk about the thing, which was a John Carpenter movie back in the 80s. And it was wonderful, because he said, you know, it was just totally ripped apart at the time it came off, because it was during the Reagan era, era. And people just didn't get the message. But there's a line in there that he quoted that he used as the title of the article, and it was, we're tired, and we just don't trust anyone. And it's an actual line from the movie, because of the way the thing works. It's able to take on the look and whatever of a person and then use that look and what to disarm a person and overtake them. So I thought he made some really interesting parallels about how at that time, we weren't able to see the, the significance of that message. And yet today, it's playing itself out in so many ways.
Dr John McAuliffe:
21:29
And, again, it's all and we may talk about this a little bit later, but it's about the wiring in the brain. And we have in our brain was called a default network. And if we're stressed, we default to that we don't go to our higher, more cognitive regions of our brain, we default to our more reactionary parts of our brain.
Rauel LaBreche:
21:49
We will talk about that after we take a quick break here to hear a word from our sponsors that helped make this podcast possible. So don't go anywhere. My guest today is Dr. John McAuliffe, where we've been talking about a lot of things we're going to move into talking about how our brain really deals with and becomes addicted. You know what that does to us both on a physiological level and social logical level on the psychological level, we try to take that apart and see if there are some meaningful things so that we can all not only be aware of looking for sensitive all those good things that bring people together instead of drive them apart. And we're gonna be doing it right here. 99 Seven Max FM's digital network and frame of reference he didn't need it now have no fear. The problem solvers are here rented at Macfarlanes in Sauk. City, we've got everything to help make your party is success tables, tents, tablecloths, treat machines, you name it, something on that honey duelist getting put off, we can help with everything from edgers to excavators, floors, trimmers, generators, lifts, it's all here under one 200,000 square foot roof at Macfarlanes. In Sauk. City, your complete rental center one block south of highway 12 at 780. Carolina's street where service is a family tradition. And we're back here on Prime reference on 99 Seven Max FM's digital network. My guest today is Dr. John McAuliffe. If you live in the area, he's a man that doesn't need any introduction. But if you're listening from France, like we have some listeners or Germany or San Jose, California, I will only introduce him as a doctor that's been in this area for 44 years. My room serve as Vietnam, real medical doctor as a doctor then full doctor. Okay, so were you like a mash Doctor kind of doctor? No,
Dr John McAuliffe:
23:39
we were at I stationed at Fort Benning, Georgia. So we got all the returning or the returnees from Vietnam. Okay.
Rauel LaBreche:
23:47
So these are the people that have been patched up and now needed long term care.
Dr John McAuliffe:
23:52
Okay. Yeah. A lot of psychosocial issues. A lot of substance use disorders. Yeah. Okay.
Rauel LaBreche:
23:58
So I say all that with the anticipation that all of you will be thinking now even more, so. He sounds like a good guy. So take this into account. Remember this as we talk about some of these issues now going forward? Right. Before we went on break, we talked about a bit of how our brains are wired to basically be in two different modes, if you will. And it's it's appears that for a significant number, if not the majority of us COVID has tended to push or seems to be more apparently pushing, pulling whatever, people into that more base functionality. Is that a fair assessment?
Dr John McAuliffe:
24:41
I think so. Yeah. Okay. And that that base base
Rauel LaBreche:
24:46
mode of operation is that's a what we would think of as lower brain function. So now,
Dr John McAuliffe:
24:52
in our brains are it's the more primitive part of our brain for sure. And it's probably the first where our brains are have originated in its third of the survival part of our brain. It's referred to in other ways as a reptilian brain, because it is just reacting to whatever sort of threat there is whatever tropism there is in the environment, and it's just acting and reacting, sticking its tongue out trying to sense, you know, what's out there. And then reacting to that.
Rauel LaBreche:
25:25
So if we look at a brain diagram was that the portion of the brain called the amygdala is that the amygdala
Dr John McAuliffe:
25:31
is just a little bit above that portion, as it goes into the second part of our brain. And the amygdala is sort of like the fire alarm part of our brain, because it's situated just behind our eyes. Okay. And so behind our eyes, that's where our nose is, that's where a lot of our sensory organs come into. So it's sensing even our thoughts for that matter. It's sort of that's the clearinghouse of that, is this a threat? Or isn't this a threat? That's what it's asking. Okay, and it's sorting that out really fast? And oftentimes, that is, if it's a threat or not, is often boils down to is this familiar? Or is this unfamiliar? And so if it's unfamiliar, it's a potential threat. Okay. And so that's, it's like, first impressions, I'm going to kind of go there, because I think that would fit into this. So we are all making first impressions of everybody you make me I make it a view. And we do that in a split second. And that's our amygdala that's doing that. And it does two things. Number one, it's sorts for trust. Because trust means warmth, okay? And number two, it then sorts for competence, because competence equals power. So if you think of just a rodent sticking their head up out of a hole, and looking around, the first thing, they said, Is this warm out here? Can I trust this environment? If it says no, boom, it's gonna go right down the hole. Okay. No further discussion. The other half is sticking up. And they're done that yeah, sticks his head up out of the hole and say, Oh, this isn't this is all right. But I'm not really too sure about it. And then this, this competence is there, this is a powerful thing. I'm gonna bring my head down even quicker, because chances are, I wouldn't survive, I be eaten by whatever. But if I sense it as warm, and I sense it as not a threat, I'm going to go out, I'm going to start searching for food basically. Rather, and, but always being aware that I don't want to become the food. And that's, you know, that's, that's our primitive. Have you ready for a lunch? Or be lunch? Right? That's it? Yeah. So we're sorting out and, and that that sort of circuitry is in our brain, and that's well instilled. And that's what you see in our society is still reacting at that level, actually.
Rauel LaBreche:
28:02
So we taught a we talked a bit before about the the fatigue of all of this too, right. I mean, we're Please God, let me get my feet up. And I promise I'll get them back down. Right. So the fatigue of the onslaught of information, the onslaught of conflicting information that we've been enduring? And, to me, it seems absolutely foolish to not be surprised that we're more polarized. You know, to me, it seems like the polarization has been a completely understandable and reasonable reaction to the craziness of this de loop information in it's like, that's how we're, that's a self preservation mechanism kicking in, right? I can't think about it anymore. I can't be I'm so tired of all of this, right? How many times do we hear that. And
Dr John McAuliffe:
28:54
so what then happens is our brain, we get habituated to that. In other words, that the more that circuitry is fired, the more it learns to get fired. And the more it defaults to that, and so we don't, then 80% of our lives, our daily activities is our habits. And they're not, you know, thought out and structured. And logically, we don't do stuff, we do things out of habit. And it's the same thing with our thoughts. And so this is we get that reactive. And that's, that's the challenge and throughout our society is how do we down regulate that reactivity? And start to say, Okay, let's have a discussion. Let's have a dialogue. And how do we back away from that? And again, that's, that's a learning process. And that's what we want our kids to do. That's what we want our whole society to do is to realize and function at a whole different level and not at a habitual level.
Rauel LaBreche:
29:55
So how do you break that what are there specific techniques are there many vacations are their, you know, you know, just new, how do we form a new habit and I've read some stuff on forming a new habit. And it's actually pretty difficult. I mean, you have to get something that you can maintain. And it takes a significant amount of time to just the habit of walking, you know, getting some exercise to Billy really build that the habit of eating better, you know, we talk about I have to do that I have to do that. And people start out with all kinds of steam, and then four days into it, it all falls apart, and then the habit becomes See, I knew it would happen again. Right.
Dr John McAuliffe:
30:31
So this brings us to the whole issue of addiction. Okay. And so, by definition, addiction is a chronic disease of the brain that involves the circuitry of the brain. And that dysfunction then accounts for all the maladaptive behavior and the psychosocial issues and everything else. But it's about the circuitry in our brain. And that refers to, you know, we talked a little bit about the reptilian or the reactive kind of part of our brain, the other circuitry that's in our brain is the reward system. And that's where that's where our habits get come into the picture. Because the only way to change a habit is to really have a new habit that has a greater reward. So, like what foods we eat, that can be a habit, you know what I mean? We get habituated because glucose, that's how it reacts to our brain. And the reward system is we take something into our mouths say food, and that goes to a certain area of our brain called the nucleus accumbens. And what the nucleus accumbens does it releases dopamine. Dopamine is a neurotransmitter for to make us feel it makes us feel betters the transmitter of joy, basically.
Rauel LaBreche:
31:52
So when you have ice cream that just pours out in space that just comes out in loads. Yeah, okay. Yeah, no wonder and so much ice cream. And then when
Dr John McAuliffe:
31:59
you start Yep. And then when you start with a drug, you know, so we can also do it psycho socially. I mean, we can go out and we can work. And we can practice and we can achieve our goal. And we get some dopamine release for that. And so we keep those habits willpower is, is sort of a figment of our imagination in what people have
Rauel LaBreche:
32:23
here that your willpower is squat.
Dr John McAuliffe:
32:28
Well, it might be alright, for about two months. But then after two months, people who say they have a lot of willpower? No, they have the habit. Yeah. And they've done it often enough. So their brain is now wired that way. And that's their habit. Okay? So then it really boils down to how much dopamine can be released. Okay, so you're eating your ice cream, you say, that's a one out of 10. Okay, well, you start taking say, I don't have to go out and work and perform and do this to feel better. I can just smoke some weed or I can just take a substance. You know, marijuana is probably like a two or three from that. Okay, well, now you start talking heroin, you know, and now you're talking eight 910. Okay. And that's why we see people, you know, you have a 5050 chance of developing the disease of addiction, every time you use heroin. Okay. So now the people who use other substances, say marijuana, or even heroin, and they know in their higher centers, that Oh, this isn't a good idea, but you know, I'm still gonna do it, my friends are doing our whatever, all kinds of other things that doesn't make me feel better. They don't have the disease of addiction, they're still experimenting with that, okay. But then there's a delta foskey, that's another little protein in our nucleus accumbens. And studies in rats have shown that once that builds up to a critical level, a switch trips, and now they develop the disease of addiction, okay? Not before that, okay. Before then we were just experimenting, we got this under control, we think we're sort of playing with something that we're not sure about. But then once that gets triggered, we have the disease of addiction. Three things happen in our brain, once we have the disease of addiction is number one, we start using drugs, not for the euphoria. In other words, not because of the hit we get from the dopamine, but we use it to avoid the dysphoria. In other words, the pain of where we're at the alienation, the isolation, the shame, that's what we see in addiction. Those are powerful, powerful things. So
Rauel LaBreche:
34:42
we've made a bed that we're now forced to sleep in, and we are aware that we're actually sleeping in a really, really lousy bed. And at that point, then, it seems to me then that the the the the thing we have to somehow combat is the despair, of being in a relatively hopeless place.
Dr John McAuliffe:
35:06
But when we have when we're in that hopeless place, and we're the addict, the only way out is more drug is to use again, we will lie, we will cheat, we will do anything to get that drug. And so how powerful is that? If I were to ask you to take a breath in and let it out, take another breath in and let it out. Now stop breathing. Don't take a breath. Don't take a breath. Don't take a breath. While my telling you not to take a breath as Mike my children, you don't use heroin roll, don't use heroin. You are gonna take that breath. I guarantee it. You can breathe wrong. You're okay. No.
Rauel LaBreche:
35:45
You told me not to breathe. Breathing. Yeah, not until I pass out. What do you hear?
Dr John McAuliffe:
35:50
So? Yeah, sorry. So that's, but that's how strong that is. That's no exaggeration.
Rauel LaBreche:
35:57
I mean, they look like cigarettes, too. I mean, they have that. I mean, I remember talking with friends who are like, they don't get poor people that are still buying cigarettes. And I'm like, you don't get addiction, you don't get how powerful the addiction of anything that cigarette is. And you also don't get how for a person that is still smoking, even though they're costing a what $8 A pack or something ridiculous, that that's still like one of the things that they have that shows that they have some value is that they're worth the $8 that they have to buy. Right? So there's there's some of that psychological stuff going on an addiction as well. Oh, absolutely.
Dr John McAuliffe:
36:31
So it's not so they become addicted to the nicotine, okay. And so there's that and that that's the physiological cycle. That's a physiological, it's not a psycho physiological addiction, and you still have that, that that's what you're alluding to. So we oftentimes treated with a nicotine patch or some other nicotine substitutes. So they still have that. But then there's the psychosocial part of it, that cigarette becomes their best friend, you know, you take away that cigarette, and you've taken away a lot of their support, because they know if they're under stress, for whatever reason, they can light up and now that cigarette and the world is there connecting differently than reception is different. And same thing with other addictions. And against that's the wiring that's in our brain. That's the reinforcement. That's the dopamine. That's the reward system.
Rauel LaBreche:
37:22
So why don't we just take dopamine pills? I mean, we certainly could synthesize that, what would stop us from doing that? And just say, Okay, we're gonna sell you now, diva dopamine, you know, diva, dopamine will make you feel like a diva all the time, you know, whatever.
Dr John McAuliffe:
37:37
Because, number one, we don't have that drug. And yet, we do have that drug. And that's why they take everything else. So just take dopamine, that's why would I take dopamine, when I can use heroin in it can be under my doorstep, just with a phone under my, you know, front door with a phone call? It's there. And I know the same and they learn it. I mean, they learn that when they're in pain, when they're suffering psychologically, emotionally, they can rely on that they can't always rely on you or me or anybody else. But in the know that,
Rauel LaBreche:
38:10
can we form a habit? I wonder this with like the pandemic, and the polarization of people in terms of you know, Trump, anti Trump Biden, anti Biden, the amount of anger that that has triggered in certain circles in a lot of places. And I think it's that anger, can we become addicted to the chemicals that are produced when we're angry about something too, and look for ways to feed that hatred? Because it seems like there, there are folks that just want to be angry. He is really, really want and no one's gonna stop them. So anything that will trigger that anger, they're all over
Dr John McAuliffe:
38:46
it? That's right. You know, yeah. Yeah. So, you know, if you look at your hierarchy of emotions, okay, first you have anxiety, and then you have depression. And then you have shame, okay. And so it's often better to be angry, than to have the depression and the shame because there's some energy and anger, you know, at least they're feeling competent. When you start to get down to the shame level, you are now feeling no good. I am not worth anything. And that's hell. That is hell. And that's, they don't want to go there. Our brains don't want to go there. So we have that first circuitry, the reptilian circuitry that's sensing a danger in our environment, and it's going there, okay, so that that's how they perceive it's like, if you were driving down the road and a deer jumped out at you. I mean, we could be having the most wonderful conversation in the world, but you're gonna slam your brakes on your heart's gonna be gone. And that when they're in that mode, that's what they're constantly doing that they're constantly coming out. That's their life at this point when they get wired like that.
Rauel LaBreche:
39:56
So breaking that circuit
Dr John McAuliffe:
39:59
how hard. Yeah, hard, but that's what you want to do is okay, so how do we, and that's really what therapy is all about? How do we down regulate that?
Rauel LaBreche:
40:09
So I'm going to say, given where we're at and our timing, we're gonna make people wait a week to hear how you do do that. So we've identified and do you think we've identified the problem? The the root cause of what's going on? That is? Or is there something else we should talk about briefly that would kind of encapsulate this polarization process and the, the addiction to certain kinds of wiring and thinking about things.
Dr John McAuliffe:
40:33
Yeah, it's important to understand the profound nature of the circuitry in our brain, and how much we have to, as you pointed out to get that under control, that's the key key thing. And it's
Rauel LaBreche:
40:45
his understanding it you think, is that key to a foundational capability of changing?
Dr John McAuliffe:
40:52
I think it goes even beyond that, you know, because if I were to just tell you show you how profound this is, if I were to say, okay, you know how to ride a bike, right, right. Okay. So if I were to say, Okay, so that's, that's circuitry. So if I were to tell you, Okay, now, unlearn, riding a bike?
Rauel LaBreche:
41:13
Well, I could wait a long time, and maybe I got
Dr John McAuliffe:
41:18
a question, why would I want to learn writing? So that you first has to go through that? So awareness, it's bad for him? Is it bad for me to ride a bike? So first, you have to come to that realization, you know, what kind of question is that? How do I So again, there's a learning readiness to everything is my point. And it's like learning to walk you can do all you want with a child before year and a half to get them to walk and or at a year, and stuff gonna happen. But then all of a sudden, certain things happen. And as myelination is the maturation of that central nervous system that has to take place. And that's about what we refer to as learning readiness, and for some way, then for this circuitry to change us and for us to be motivated in that regard. Something has to change.
Rauel LaBreche:
42:08
So in some ways, you're looking for a better habit. And absolutely, getting people to
Dr John McAuliffe:
42:12
the crux of a better habit is a higher reward. Okay. And when it comes to drugs, that's tough, because there aren't many other rewards that will relieve pain, and add pleasure.
Rauel LaBreche:
42:26
And in some cases, it seems like the perceived relief, the belief in that perception is what drives us to keep pushing. Absolutely. Keep pushing to know I'm not going to change my bias here because I believe that this politician's answer is what will make everything better.
Dr John McAuliffe:
42:47
Yep. Right. In all the environment around that belief. Yeah. Folks, my
Rauel LaBreche:
42:53
guest today is Dr. John McAuliffe. We've been talking just getting into addiction and the nature of it what is going on our brains that allows it to occur and become so deeply embedded in our life? We're going to take a break and come back next week and talk about how you how you get around it, how you change it, how do you make some progress? Because I would be willing to bet dollars to doughnuts as we used to say that virtually everyone virtually everyone has some kind of addiction to something and you may recognize it, you know, it might be cake. I am just addicted to cake. I personally am addicted to potato chips, any kind of potato chip especially Boy, those cattle ones all my Lord. If I have chips near me, I'm going to eat them and I'm probably gonna eat all of them. You know, just That's my thing, you know? So how do I get away from chips and maybe transfer into carrots we're going to talk about that next week here on frame of reference, so don't go anywhere. I'll be right back. Where are closing thoughts on 90 minutes up Max FM and frame of reference.
Unknown:
44:00
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Rauel LaBreche:
44:29
But diction is defined as a compulsive, chronic physiological or psychological need for a habit forming substance, behavior or activity, having harmful physical, psychological or social effects and typically causing well defined symptoms such as anxiety, irritability, tremors, or nausea upon withdrawal or abstinence. Given that definition, do you see why I believe Everyone has some sort of addiction. You know, some addictions are seen as socially positive, and yet are still harmful, being addicted to gossiping and the need to habitually bought into other people's business, being addicted to angry fits of rage in response to relatively benign circumstances, not to make light of addiction, but at what point do habits and excuses for those habits become an addiction for which we should seek help? Should our frame of reference simply be to ask the question? Am I controlling it? Or is it controlling me? Join us next week as Dr. McAuliffe and I talk even more about the physiological roots of addiction and how to rewire our circuits for a better connection to ourselves and those around us. And don't forget, if you have suggestions or questions, visit us at www for sohc.com Stay well
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