A recent study has found that repetitive Transcranial Magnetic Stimulation (rTMS) is effective in treating depression. The results showed that the majority of patients experienced a significant reduction in symptoms, with some even achieving complete remission.

Are you interested in Group Therapy? We are starting a new group on Wednesdays at 5PM beginning on September 13th. Groups offer a safe space for sharing ideas, helping others who are going through similar struggles and can promote social skills and group accountability. Call or text Ascend at 330-754-4844.

The combination of TMS (Transcranial Magnetic Stimulation) treatments and Ketamine Infusions is gaining national attention as a powerful way to alleviate Treatment Resistant Depression. For more information or to schedule an assessment call or text us at 330-754-4844.

Yoga and Addiction

Therapist, Yogi, and Reiki Master Lisa Shaefer, LSW, LICDC-CS, RYT-200 from Carve Your Own Path, here in Copley, discusses yoga and addiction with nurse anesthetist Nick Angelis, MSN, CRNA. There’s a continuum in mental health between simple movement and posh inpatient rehab retreat facilities. As we continue to delve deep into spiritual topics on Ascend Health Show at the Wadsworth Community Television studio, common threads emerge. You’ll recall our last guest, Sonic Shaman, today’s energy practitioner, or, for our next show, a Christian trauma counselor from our friends at Renew Counseling Ministries. Transcript below.

Nick:
Hello and welcome to the Ascend Health Show. I’m your host, Nick Angelis. I’m one of the owners of Ascend Health Center and I’m a nurse anesthetist. And today we have Lisa Shaefer who is with Carve Your Own Path. She’s a therapist. She’s a licensed independent chemical dependency counselor. She is a Reiki master and she’s a Yogi. Welcome to the show.
Lisa:
Thank you, Nick. Thanks for having me here.
Nick:
Did I say all the things you said?
Lisa:
All the things perfectly? Yes.
Nick:
But I should have written those down. But that’s fine. That’s okay. So we’re going to talk about yoga and addiction, which don’t really have much to do with each other, but we’ll try to make it fit and do some Segways and analogies and transitions and see how it goes. But starting with a topic of addiction, there’s a troubled teen industry that we’re both familiar with. It’s probably billions of dollars in the US. Hey, my kid’s acting up. Here’s some money. Fix them. So why can’t we just send troubled people to rehab centers and call it a day? Because I mean, they call my clinic all the time telling me, hey, if anybody needs to go to Florida or to remote places in Ohio, just send them in. We’ll fix them. So why yoga?
Lisa:
So that’s a really interesting question and I will do my very best to interweave and show how they’re very connected because what we know about the research right now is that addiction comes from disconnect. So when we are looking for connection, we want to bring in the family, we want to bring in parents and bring about that connection for everybody. And then with the individual, we want them to connect to their intuition and not have to feel as though they need to seek outside of themselves to find comfort, to find peace, even to find connection.
Nick:
That makes sense. So it’s more of empowering. I know when we first started our clinic I had the idea that we would almost be an E.R. for mental health and we still can be that for pain where if a patient’s have a flare up of fibromyalgia, they’ll call and schedule an appointment and we’ll do a ketamine infusion. But then I quickly realized that for mental health it doesn’t work that way. It can’t be like, Hey, this is a bad day. Can I come in and get fixed that I mean, it sounds great from like a business standpoint. We were talking before the show about how insurance works, where the whole system is meant to keep patients coming back and back. And each time we build our insurance and this is never ending promise of incremental improvement until their benefits run out or something. But instead with yoga, you’re saying it’s something that the patient themselves can control. It’s an inward thing.
Lisa:
Yeah. And I think bringing up medication medication is appropriate at times and some people absolutely need medication to help manage whatever their symptomology is. However, if you have a person who’s depressed and they’re continuing to do behaviors that keep them in that depressed state, they can take as much Wellbutrin or what other medication that they’re taking. And it’s only going to offer so much relief. Whereas when we go inward and we look at what are those triggers or we look at what are the things that I’m not doing for self care. So, you know, halts hungry, angry, lonely, tired is very known within the addiction world of, you know, I’m checking these things off to make sure, you know, what am I not giving my body that it needs? And so have you had water today? And, you know, maybe it’s your dehydrated or maybe you haven’t eaten and, you know, maybe you’re tired because you didn’t sleep well the night before. And you know, goodness sakes, if we have at least three of those things of, you know, then we’re feeling disconnected from ourselves and from other people especially. Right. And, you know, those famous SNick:er commercials, right, where it was like you’re acting kind of out of sorts. So, you know, eat something. But, you know, doing those basic things again, honoring your intuition and honoring, you know, know what your body needs and doing the things that aren’t always the easy fixes or aren’t always the easiest thing to do, especially when we talk about like setting boundaries with people and setting boundaries with that impulse control.
Nick:
Well, that makes sense because that’s something I’ve had to tell my patients. Hey, there’s a few ways that we can help you. I doubt any of them are easy and I doubt any of them are instantaneous. And usually if it is instantaneous, it also doesn’t last long because, you know, one of the things we do at ketamine infusions and there’s cases where a patient has one infusion and everything changes and that’s actually when we’re the most like, no, actually you really need to follow this up with therapy because a whole identity change when you have all these subconscious behaviors that sometimes try to protect your brain from trauma like this is something that we have to explore, not just, okay, I’m better. Thank you, Jesus. Let’s go. Because speaking of the whole So last night I went. Of this church meeting. It’s like a marriage conference. And they’re talking about. There’s a Bible verse that says Let not the sun go down on your anger. And they’re like, Nope. That’s true. But sometimes you’re not going to solve it late at night when you’re tired and angry and in the morning usually it’s like, well, that wasn’t as big of a deal. So even with the drinking water, like you can’t get into trouble while you’re just stopping to drink water, you know, you can’t text someone something you shouldn’t while you’re also drinking because you’ll get water on your phone and it’s just going to be a mess.
Lisa:
Yeah. And I think, you know, looking at unfortunately, our culture, which is that, you know, keeping up with the Joneses, you know, that that drives this addictive nature and the need for immediate gratification. Well, there is zero mindfulness in any of that. So if I’m always planning for the next thing, I’m not sitting here tapping into my body using my five senses, you know, seeing the things that are around me, hearing the things that are within the scope of my environment, you know, what can I smell? How does how do the clothes on my body feel? You know, we get up every day and I’m sure you probably had some thoughts about the outfit that you chose to wear today. But, you know, do we pick things with intention, You know, because we like the way that it feels against our skin or it’s a comfort item. You know, one of the things that I love about working from home is I have my therapy blanket over my legs, you know, so that I can kind of wrap up when I’m chilly and, you know, regulate my own temperature in those moments. And so, again, like, what are the intentions and how do we tap into our five senses? And yoga is the perfect place for that to happen in and on your mat. Okay.
Nick:
That makes sense. So in some ways, is it almost like a healthy regression to childhood? So my three year old niece, she’ll she used to just cry and scream like toddlers do. But my brother and sister in law are very wise and they taught her like, stop for a minute, think of what you need so she’ll get tired and then she’ll be blankie and so she’ll get her blankie and she’ll start playing with it. And then she’ll think I can see her like mind working, like, do I need something else? And so c b and I’ll give her a pacifier and then she’s fine. Yeah. So I’m like, Oh, I need to do this.
Lisa:
Yeah. And and I think that’s a really great example as well because at a very early age she’s being taught how to identify her feelings, how to identify what she needs as being told You don’t have anything to cry about. You know, you can’t cry because you’re a boy or you’re out in public and kind of making a mess at Target because that’s the Barbie or the toy that you want. And now you’re having a meltdown about why you can’t have what you want.
Nick:
Yeah, well, that’s really good. So we should distribute blankets to everyone after this. Yeah. Is it so is it more the philosophy of yoga or the movement that you think helps the most? I mean, I know it’s all intertwined. Yeah.
Lisa:
It is all intertwined. And I and I don’t think that I could pick out one or the other because when we’re looking at trauma and how it’s stored in the body, then when we are in movement, we’re releasing those stored synapses, those stored memories and so that we can release it. And that’s not to say that like, for example, somebody who does then have an autoimmune disorder like fibromyalgia, which they’ll have flare ups and you know, it’s again kind of having that intuition of what helps my body. And then when I do have these increase in symptoms, what can I do that’s going to give me the most relief?
Nick:
Right now that makes sense because we do a lot of pain management since I’m a nurse anesthetist and it’s difficult because, you know, our medical director is a psychiatrist, my nurse practitioners is trained in psychiatry. So we think, well, how are we going to do this if this is just a pain problem and there’s no mental health related? But what we found is probably about 75% of those patients actually don’t treat their pain. I’ll start with a ketamine infusion, which is a lot like EMDR, where it forces you to see trauma. It rips away any facade that you have in your life and then a lot of anxiety and depression will manifest. And we realize, no, we need to work on this, that if we can prevent you from catastrophizing your pain, if you know how to react to it and your whole body doesn’t go on red alert, as soon as you feel a twinge of pain, then you’re actually much better off. And obviously the treatments also shorter and a little bit easier if we’re giving smaller dosages than if we’re like, no, we must destroy every fiber of pain in your body. And so I’ve had patients where like, you know what, this hasn’t helped my pain, but I’m actually good. Like my anxiety that I didn’t even know I had is better. My depression is better. So let me work on this and then I’ll let you know if I need to come back to deal with the pain.
Lisa:
Yeah. And I think. That kind of recognizing the bittersweet in that that we’re all going to experience pain physically, pain emotionally and how do we walk through that? Because even people who are recovering opiate addicts who have a very low tolerance for pain afterwards, like how do you cope with that when you stub your toe and it feels like you really broke your foot? And I don’t want to diminish that experience from someone, but how do we talk ourselves through that experience so that it doesn’t become a trigger to old behaviors?
Nick:
Right. And that is something that works for everyone because I’ve done some talks with churches about do you need Jesus or Xanax, which is a really fascinating tangent that we won’t quite go down today. But a lot of times that’s the feeling of like, this hurts so bad, what can I do? Or this is so overwhelming and it is easy to reach out for a pill or reach out for a substance, especially if your brain already has an ingrained that, okay, here’s a stimulation, here’s a way I deal with it. But what you’re saying is if you have a philosophy of let me understand these feelings and deal with them and just sit with them for a minute, then you’re less likely to just react and immediately try to take the pain away regardless of the consequence.
Lisa:
Yeah, because cravings and triggers pass, you know, they don’t last a long time if we don’t feed into the thought processes that are part of that, right? So that’s where you know, DBT, CBT, EMDR, those kinds of therapeutic modalities can kind of come in and help redesign the way that we think about our experiences and then how that trauma kind of comes back up when we are triggered.
Nick:
So at Carve your own path, how do you make that decision? Because I know you guys have a lot of different modalities. That’s why we like to work together. But and part of this is what you were saying about even the patients, they have to realize, okay, there is going to be some work involved. So how do you go down that path of, okay, let’s start with CBT or you really need to work on this trauma through EMDR. And for some of our viewers, they’re like, Well, that’s a lot of acronyms I’ve never heard before. So maybe a little bit more basic of like, how do you start?
Lisa:
Yeah, it’s you know, we have our profiles online. We’re on mental health match Psychology Today. And so, you know, someone who’s choosing a therapy can kind of read and see what we’re about. They can visit our website and then, you know, through our consultation, you know, I try to tell and encourage people that, you know, they’re coming to me as a resource not to be the expert on their life. And that’s something that I’ve held very true ever since I’ve started. You know, being a therapist is that no one can be an expert on your life but you. And so that’s really where the empowerment comes in and meeting people where they are just because they’ve called and they’ve made the appointment and done the assessment doesn’t always necessarily mean that they’re really ready to kind of dig in deep to do the work too. And so it’s kind of really just chipping and peeling away those layers of defense mechanisms that have kept them safe but continue to keep them sick.
Nick:
That makes a lot of sense because we’ll do the TMS or sometimes a SPRAVATO or ketamine for addiction. But in many cases we tell the patient like, no, this is a deep problem and we need to chip away at this slowly instead of starting this medication right away. Let’s do some therapy, get more of an insight into what’s going on because unless the patients themselves can really figure out what am I feeling and how can I explain this to someone, it’s almost like we’re veterinarians trying to like, okay, the cat me out that way, so this must be the problem and we have to treat it that way. And especially with complex disorders, it can get very confusing very quickly that way.
Lisa:
Yeah. And I’ll share an example with you. I had a person who had as many of my clients do some pretty significant trauma history and had decided to go on a journey in the car and did not expect to encounter some like bad weather. And so in this experience where they had no control, they needed to get to their destination. They were feeling anxiety and some triggers of their PTSD coming up. And through our sessions they had been practicing tapping. And so per their reports, you know, they said, Well, I tried that tapping thing that you told me about and it didn’t work. And here’s what I say to that is that you didn’t increase your anxiety. You actually were so focused on tapping that you weren’t being triggered by the environment. And so while it didn’t make it a zero because you were still kind of fighting the bear in that moment, it did. Work because you didn’t get worse. It didn’t escalate to a full blown panic attack. And so when we’re talking to a lot of people who are in early recovery, again, getting them to identify that the quick fixes aren’t there, like we have to meditate consistently. It doesn’t have to be hours and hours and hours at a time. But if we do five minutes a day every day, the neuropathways in our brain change over time and it gets easier and easier. So maybe you do want to do it longer and longer because you find the peace of the relief to be so much more comforting than the chaos of the triggers and the trauma.
Nick:
Right. So instead of being continually stimulated, even if you think, well, this is lame or this isn’t working or this is boring, that’s still a very healthy thing for your brain to feel. Yeah. There’s a study that said that today’s teens have as have anxiety levels as high as what they saw in asylums a few generations ago. But part of that is because we expect that we can control our lives because so much today compared to generations ago, you can control like I was at Cedar Point last week and I didn’t have my phone and I was trying to find my family and I was like, this is I don’t get upset easily or it takes a lot to rattle me. And I wasn’t angry or worried, but I was like, Huh, This reminds me of back in the day when I was a kid and you didn’t have a cell phone. You just have to like look around and find the people you came with. But even that experience was like, I haven’t felt this for a while where like, I just don’t know where the people are that I came with. Yeah. So we think we have life under control and then all of a sudden there’s a crack in our perfect sphere of how life is supposed to be and we just go to pieces.
Lisa:
It’s funny that you say that because I actually was lost as a little kid at Cedar Point at age eight where I definitely did not have cell phones at that point in time. So like I did what I was taught to go to the lost and found and got reconnected with my family. And so yeah, we have lived through these experiences where we haven’t had everything at the tip of our fingers and we don’t need to always have everything at the tip of our fingers because there are systems in place that will offer support, right?
Nick:
Yeah, that’s a good point. I mean, I probably would have just gone and ridden the scrambler a couple of times, but you’re probably a better kid than I was. I also had wandered off a lot. But this isn’t supposed to be my own personal therapy session, So yeah, we’ll get back on topic.
Lisa:
But you know, and I think that that’s something to kind of bring about. Is that something that small would be very unraveling for a lot of the people that we treat and that we see come into our agencies because they weren’t taught like your niece, how to identify feelings and self-soothe. And I think that that’s the biggest thing because the people that I see boredom and lack of productivity means they can’t rest. They can’t restore because they’re so worried about those thought processes that kind of come in when they have those down moments where to let the thought go. And you know, this idea that meditation and even yoga means that I’ve cleared all of the cobwebs, all the thoughts, I have zero thoughts. And that’s not the intention. The intention is to honor it, acknowledge it, maybe kind of be curious about where that comes from and let it go.
Nick:
So I had a patient yesterday who was talking about inner restlessness and he was like, Well, the problem is I’ll start to exercise, but then I’ll get really tired. Like my nervous system is so wired that I can’t get rid of it by exercising, but it’s always with me. So something like yoga or meditation might be helpful in that case.
Lisa:
Yeah. And one of the things and I don’t know if you’ve seen this as well, one of the newer pieces of trauma research that’s showing is that when people do like high intensity workouts because our nervous system doesn’t know the difference, well, is this trauma or is this just me being excited? Right. It reacts the same way. And so again, for some of those people, this calm down, this slow down effect is more appropriate to get them to tap into their parasympathetic nervous system, right?
Nick:
Yeah. There’s a lot of our patients we can call it anxiety or depression or fibromyalgia, but for some of them the root cause is just a nervous system mismatch where the parasympathetic nervous system that’s supposed to let you do rest and eat and digest and the sympathetic which is supposed to go out and you have a spear and you stab a saber tooth tiger is it’s a little bit to my knowledge earlier of like being like a kid again, but it’s almost like a prehistoric thing where this makes a lot of sense. If you have an acute stress and your brain is really excited and then it deals with the issue and it’s gone. But not in today’s world where it’s like, okay, I still have to pay the mortgage this month. And it’s a. Chronic stress that there isn’t really a relief from.
Lisa:
Yeah. And you know, when we are devoting at least 40 hours of our work life to outside of the home for many people, even for even for people who do get to work at home, you’re committed to doing something during that time. And you know by the time you come home and eat and and find connection with the people that you live with or the people in your community, you know, that can be mundane for some people because they don’t find the gratitude out of those experiences and look for the nuances of change within each of those experiences. Right.
Nick:
So what is the first step then in meditating? And again, I have a lot of fascinating guests on the show all the time, so I have a Pentecostal background. So for me there’s plenty of Psalms about meditating on the Lord, clearing your mind, focusing on Him, Eastern mysticism. There’s a lot of other ideas of how exactly we clear our minds. But for everyone the faith process is one has to be genuine. I mean, that’s something that I’m sure you’ve noticed in your work. And I’ve noticed in mine that a spiritual facade or a let’s just add some generic spirituality, add the word holistic and a few other buzzwords and then you’re set like that’s it just doesn’t work even a little bit. So what’s like the first step to kind of clear your mind or center yourself? Yeah.
Lisa:
I love that question. And the thing that I’ve learned from my meditation teacher is that you should be comfortable when you meditate because again, it’s going to let us open up and kind of give and receive in that process. So a lot of people think that they have to be very stoic and sitting in a very stiff and rigid form and you really don’t like my favorite way to meditate is laying down on the ground with a bunch of bolsters and pillows and blankets around me where I’m very much tucked in and have this relaxation around me. One minute a day is all that you really need to start that journey. It’s ten breaths, okay? Five If you’re able to hold and exhale a little bit longer, which some people, because of, you know, disorders, they might not be able to, but being able to inhale and exhale and extending the exhale longer than the inhale again taps into the parasympathetic nervous system. So we’re getting that down regulation in those moments. So set your timer on your phone or whatever device that you’re working with and just breathe for one minute and see how you feel.
Nick:
And that makes a lot of sense because what I was saying about different religious beliefs, it’s that same thing with comfort. If you’re like, I kind of feel like this isn’t what I believe or like it’s not going to work because then you’re because I’ve seen people who’ve done that like devout Christians going to like an acupuncturist and they’re like, Well, I really don’t believe in this, but nothing else has helped. I was like, Well, you have to be in the right mindset before you try anything like you have to be in. I think the the young kids these days would say you have to vibe with it. I just made myself sound a lot older than I am.
Lisa:
Well, and I think it goes back to what you were saying at the beginning of the episode is that, you know, we look to medical interventions as a way to heal when we are really the vessels to heal ourselves. And we can do that through breath, through movement and sometimes with the help of medication. But if we start with ourselves, a lot of people would be very surprised at the power that they have to heal.
Nick:
Right? Well, that makes sense because I tell patients like, Well, I can do a lot of this for you, but you’re going to have to see my face all the time. Or you can do a lot of this work and my patients are doing the best. They’ll come in maybe once a month for Spravato, which is the nasal spray ketamine, or they’ll come in every two months and it’s enough to check in, make sure everything’s fine. But then they’re doing the rest of the work and it’s a really good balance where it’s completely in their control. It’s not, Oh no, I really have to go back there or it’s that time of the week where I have to go for my appointment. But getting there again it is. But the other question I would have is what about active addiction? Because those are cases where it’s not, okay, just do some yoga and you’ll be fine. That’s when we have to use all of our resources. But how do we prevent that from becoming too much over so focused it becomes this okay, Every single feeling I feel I have to report it. I have to talk to my therapist, I have to do all this work and then they get exhausted and relapse.
Lisa:
Yeah, I think that that’s where having an opportunity to be vulnerable is really critical because in active addiction, that’s. Trauma and any person who has lived in active addiction, that’s a whole trauma cycle that doesn’t even count as what got you to that point. Right. And so we’re talking about all of these little T’s and these big T’s that we need to look at and address. Why do we say yes to using substances as opposed to no? Because your typical person can manage throughout the day without turning to a substance to down regulate. And that’s not to say that we all don’t have our own vices. Right? And so then where is that moderation factor in that? And you know, at least in our culture, we have this abstinence only ideal and maybe that works for some people and maybe that’s not the case for other people. Maybe they can find a way to moderate at least alcohol use where in other European countries, you know, they when you get down to the root of why why you’re picking up alcohol as a way to cope, maybe that’s not the way that you cope anymore and so you can do things differently.
Nick:
Absolutely. That’s great. So if anyone wants to reach you, how do they do that? If they need to schedule an appointment or just see all everything that you all offer over there.
Lisa:
So you’re going to go to carve your carve my path.org and you can schedule online for Reiki sessions and sign up for our yoga classes and you can send an informational email requesting information about yoga Reiki. We also offer art therapy with Jenna and we have all three of us have a different view of holistic services. Great.
Nick:
And then for us it’s Ascend health Center.com We have psychiatry therapy. We offer transcranial magnetic stimulation Spravato ketamine. But like we were just saying, sometimes you need some high tech solution and sometimes you just need to breathe and pay attention to it. So thanks for joining us today.
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