Beyond Diagnosis: Unveiling Trauma's Narrative

hello there fearfully and wonderfully made human welcome to another episode of the holistic counselor podcast where I Diana s rice from through the valley therapy guide you through an intersection of a personal and professional trail trail where I hope you will find useful information and and encouragement as you navigate your own journey toward your Mountaintop today I am super excited to introduce to you a unique nationally certified mental health counselor with over 30 years of clinical

experience Dr George Wallace Barnhill has served as a Clinical Director of drug and alcohol programs as well as an intensive trauma program for women he has conducted research on stress and safety in anesthesia and surgery while serving as an assistant professor in anesthesia and surgery at Jackson Memorial Hospital in Miami Florida he has taught graduate classes at Nova Southeastern University in the center of psychological studies and Palm Beach State College Dr Barnhill's comprehensive nonpol path I

always get messed up in that word nonpathological can you say it pathological thank you non-pathological approach helps patients achieve success by helping them understand the connections between emotions behaviors thoughts and perceptions so they can achieve a more rational and positive sense of self all right folks before Dr B and I get into it gather around because I've got a story that'll give you some Goosebumps I call it a supernatural God story I was kneed deep in

a tough case back in August feeling like I was hitting a wall but refusing to throw in the towel I just couldn't bring myself to send this client back to a system that had let her down time and time again so every single day I poured my heart out in prayer while researching online about the latest on did and Trauma watching video after video now fast forward to September 29th I almost turned down an invite to

a tiny networking event but something call it the Holy Spirit or a gut feeling pushed me to go and man am I glad I did Big shout out to Victoria and Phil at dude breath counseling for that one sitting at that table surrounded by strangers I took a leap of vulnerability and asked if anyone knew a specialist in did it felt like an eternity before a fellow therapist spoke up mentioning Dr Barnhill you won't believe it

turns out he was my professor back in 2002 the one who wowed us with real life footage of did clients and taught me the ropes on this complex diagnosis I was floored thankful and without skipping a beat I shot him an email the next day boom he responds and we reconnect since then he's been my Gandalf my mentor sitting in on his session and soaking up every bit of wisdom he throws my way and here's the

kicker this divine intervention didn't just help me but the client he now he's now working with is thriving like never before it's like fate synchronicity at its finest Dr Barnhill might not realize it but he is a true godsend and this whole experience well to me it's nothing short of miraculous so let's welcome Dr Barnhill hi Dr B hello can you tell us a little bit about your personal story in terms what led you to be

in the profession that you are in today and what is did and what do you mean by non- pathology well that's a lot um thank you for the wonderful introduction it's quite surprising and meaningful uh to hear you make those kind comments and it's certainly helpful to be able to connect with someone who uh is on the journey that I was on for many years uh starting back in the late 80s uh before D was did

it was actually multiple personality disorder which of course is a misnomer because uh did patients are not uh multiple personalities they're actually less than one one and that's the reality of it because dissociation means that you are fragmented the degree to which you are fragmented psychologically emotionally uh determines the degree of the diagnosis so did like because that's a new name for it what's it actually dissociative identity disorder really gets to the Crux of uh the

the problem with the diagnosis which is it is a um uh identity disorder okay uh the patient actually is unclear and the symptoms that they manifest which predominantly are memory okay identity confusion and Consciousness and there are 10 15 20 30 different diagnoses that fall or symptoms that fall under that large you know category right and the problem with many therapists regardless of how well trained is if you don't know what to look for you're actually

not going to see or hear or recognize the symptoms so and I remember learning about this 20 something years ago and uh what I'm seeing and hearing and what you've taught me is that a lot of the this this diagnosis do you feel like it's under represented or confused to with other diagnosis well it is because first of all very rarely do patients present to you with these diagnosis they present to you with a borderline bipolar

add um um and other diagnoses like anxiety and depression right and when and and these diagnoses basically can almost be made by anyone we've all experienced depression and anxiety so when we we hear the symptoms from our patients it's not hard to recognize and then we find out if they meet to criteria and they say oh patients depressed the problem is that they may be dissociative okay well how do you know right the patient's not going

to throw those symptoms out because they don't even know that they're dissociative symptoms right so it's it's the one diagnosis or category of diagnoses including PTSD where it's up to the therapist to move forward uh because you have reason to suspect that there may be more to ask for uh everyone with did has depression and anxiety so what yeah but that's not the terminal diagnosis okay and what I tried to teach my uh students for many

many many years is to get the terminal diagnosis so how would you do that like say there's an intern or someone that's new in the field and they didn't you know because in college you don't learn all these right it's experience and so you're thrown into Community Mental Health and here you are and like even with the clients I had it took a while it took a while for me to realize oh this is exactly because

I took you know did assessment after assessment and I'm I'm nonpathological as well and so can you explain what that means well actually I think you suggested to me that it took probably a year before you felt pretty comfortable that your patient had dissociative symptoms much less may have been did and uh of course you can be dissociative with dissociative symptoms including having alars without being did right okay yes so here's here's the um situation too

altars right yes we end up having you seeing a client and you're seeing these multiple personalities and these altars and I think what happens with a lot of clinicians they're seeing this and they're overwhelmed and they really don't know how to treat them in a respectable manner well the problem is they're not seeing them okay or or at least they're not aware that they're seeing them ah you see uh and many uh particularly newly licensed therapist

look the Master's programs particularly uh educate you about dissocial disorders there there's no no master's program that I know of that actually teaches you experientially how to actually treat someone so even if you're pretty good at diagnosing that's a far difference than okay now I can treat it you can read how to do brain surgery but you really can't do it so uh the experience is missing and unfortunately um even though all therapist whether they be

psychiatrists or psychologists or mental health counselors or other trained psychotherapists um don't get the experience they go to a treatment center and they usually uh get their experience through through a drug and alcohol treatment program maybe a psychiatric facility or a drug um eating disorder clinic right or Community Mental Health like a a Henderson clinic or something like that exactly and actually at Henderson mental health you certainly get a plethora of diagnosis uh but it's unlikely

that you'll get specifically trained in how to diagnose dissociative disorders much less did and at a treatment center for drug and alcohol there's there's no way that you're going to you're going to mostly DN learn educational uh group process to to work with the patients who are there for addiction or alcoholism and the same with eating disorders um it's totally focused on the eating disorder and my hypothesis for 35 years has been that neither uh alcoholism

or addiction or eating disorders is is actually a disease and um I think it's a symptom and the real problem lies behind why the person has these issues in the first place because the symptoms are almost always historical right and if you track the symptoms back to when they began then you can start looking at the circum ances under which the person start having difficulties with drugs or alcohol or eating or something else right so so

tell me okay so say that I am a client that comes to your office for the first time right and i' I've already have gone through the system like a drug and treatment center or a community mental health and they've given me like two or three different diagnosises and I'm on you know four different medications and I come to you what would be the first thing you would do well actually the first thing I would do

is exactly the same thing that every licensed clinician out there should do okay which is to listen because every therapist out there thinks they know what to do because if you've been in the system you came to me with perhaps diagnoses more than one yeah as well as perhaps medications right well I never ever accept a patients diagnosis that they bring in to me oh that's a little controversial no no it's not controversial if I have

to go to court right and I have to justify that a patient of mine has a specific diagnosis I darn well sure want to make sure that I've diagnosed the patient on my assessment and evaluation not on someone else's assessment and and evaluation true regardless of who they are and probably I don't know eight or nine times out of 10 I may well agree okay with the previous clinician I'm not saying they're wrong right uh but

I'm saying I want to make sure that I do agree and why do I agree but if I have any reasons to suspect particularly if you come in and you're been diagnosed with ADHD and uh bipolar perhaps borderline right I'm going to say well why don't we just scrap that for now and let you and I decide what's going on which will immediately put the patient at ease there's two things that every clinician must do in

the first session okay you have to determine whether the patient is psychotic right and you have to find out if they're suicidal exactly we all know that right that's our mission that's why we have a license we have a license for basically three reasons which we can do legally and other people who aren't licensed cannot do at least legally I mean anybody can diagnose you but that doesn't mean it's valid right so what we're licensed to

do is a clinical assessment and evaluation a diagnosis yes and a treatment plan right and then we are licensed to provide treatment which is called Psychotherapy okay so that's the lane that I'm in and that's what I do right I don't do alcohol treatment I don't do um eating disorder treatment if someone comes to me who's in recovery and you come start talking to me about your drug problem I'll say you need to take that back

to your treatment team I don't talk about that okay if you have an eating disorder the last thing I want to do is talk about how you're weighing out your food right because in my mind that's a symptom of the real problem when did you start having an eating problem okay oh Dr bar I guess I was about 12 years old duh I wonder what was going on let's check it out okay and a borderline diagnosis

is exactly what it means it's a borderline between what neurosis and a real diagnosis so why don't we find out right and how do you find out uh first of all I think particularly with Border Lines now that you ask and the research that I've read and any of you can look this up about 87% of borderline patients are dissociative wow now how would you know that if you're a clinician you need to ask the questions

the the basic problem with newer clinicians who don't have experience is they're afraid to ask the questions in the initial clinical assessment and evaluation right if you have any reason to suspect that the patient may well have some history of abuse you have every reason to begin to ask questions right if the patient says no Then move on but most therapists don't even ask because their their anxiety goes up right and they would much rather you

go get on some medication wow and then they could relax oh you see okay so uh particularly with borderlines that the new therapist particularly if it's a psychiatrist almost immediately changes their medication which infuriates a patient right but my initial job with anyone who may well be borderline or at least have those symptoms uh is to put them in control of their medication okay why don't you tell me what works for you and I'll call your

psychiatrist okay well that's I mean some of them I would say some clients I've come across don't know how to advocate for themselves right well the problem now the real you can't put it on the patient the problem is we in the mental health profession are not confronting these people with symptoms because you're not familiar with them okay so I think any therapist who's inter and any of you that say you're not working with traumatized patients

you're blowing smoke because all of you are you're just not recognizing it look out look at the percentages of patients that have major depression or severe anxiety and tell me they're not um suffering from stress SL trauma right uh I've asked patients a very significant question to begin the process what was your first memory okay what do you mean Dr barill what's your first memory I know it's kind of a stupid question but when your what's

your F you mean in my life yeah well I I've had patients tell me their first memory wasn't until they were a teenager yeah true or 10 11 12 I had one lady tell me she didn't remember anything before the age of 16 now as a therapist if that unless the person is organically has an organic medical problem right or they're they're so physic you know they really have a physical problem then there's no other at

least you have reason to suspect to say wow I mean the first patient I diagnosed with MPD back in 1988 said she had a perfect childhood and how'd you find out she didn't well I began to ask questions about her childhood because she had no memory for most of it wow and that's why people won't like this either perhaps but that's why my cognitive behavioral therapy is very minimally effective with working with trauma right because the

conscious your conscious memory is a defense and it protects you from knowing just like a dissociative patient is protected from knowing that they have parts or altars inside that have been abused okay so the patient has no memory sometimes right I mean that makes sense and ouch cuz I'm a CBT therapist well if it's for the proper diagnosis of perfectly the same as having coping mechanisms I'm coping mechanisms like affirmations and mindfulness and cognitive behavior therapy

and exercise doesn't it works minimally and it only works temporarily but it does not deal with trauma so what does work with trauma real trauma therapy which in my estimation is less about the trauma okay and more well uh about well everyone says or many people try to get the patient to keep it in the past and to let it go well it's almost idiotic to think that someone sitting in front of you who's 20 to

55 years old you don't think if they could have Let It Go they wouldn't have already done it true so it's punitive for you to verbally as a patient to say why can't you just let it go I'm going to help you I'll give you some medication and we'll help you to repress it by doing affirmations every day by looking in the mirror and telling you you're handsome or beautiful or smart okay that's like taking an

aspirin for a migraine okay it just doesn't work and after they've been through three or four therapists right and many different medications and they're desperate then they'll go to a trauma therapist and if they come to me I'll say well I don't do coping mechanisms and they say thank God you know okay so in other words the trauma needs to be addressed however I don't treat the trauma okay what do I treat yeah what do you

do I because the trauma is already over okay right anywhere from three years ago to 30 years ago right the trauma is already completed so the logic Al among lay people is that somehow or other you should just keep it repressed because you can't do anything with or or the sematic movement of it that's what that's a thing another thing but I'm not interested in I am but I'm not interested in directly cope helping the person

to deal with the trauma itself okay what am I what I'm interested in is the effect that it still has on you okay right which is almost always emotional slatic so how do you so I'll say to a person um uh uh have you ever felt this way before let's say it's extreme anxiety and panic and fear yes and obviously they'll say yes and I'll say how long have you felt that way oh Dr barnham my

whole life and I'll say well that's actually not true you really weren't born that way okay did you have this last year yeah when you got married yeah when you graduated from college yeah yeah did you have these symptoms when you were in high school oh yeah oh now I remember okay tell me oh you were 12 years old U your parents got a divorce ah how did that affect you oh I just moved on and

I did this and I did that but that's when the person started having the anxiet anxiety okay and of course they're usually lost in the shuffle when the family's going through something you know psychologically emotionally traumatizing like like a separation and or a divorce now it's not outright straightforward life-threatening but to the child it can feel that way and you do not have or you it's not required that you were in a real war to get

PTSD right so young people at any age can have symptoms of PTSD right complex PT or childhood pts child PTSD and it it doesn't heal it doesn't go away if it's not addressed the the person him or herself obviously learns to cope by rationalizing and minimizing pretending it's the same everybody else has my Situation's No Better or Worse that's what I did I thought everybody dealt with the things that I did and the lady I was

telling you about the first patient I diagnosed who thought she had a perfect uh childhood I said um I hate to ask you this because it was the first time I directly was focused on all the research and treatment programs I had gone to and medical conferences and visiting trauma therapists in in Texas in Washington DC and in Philadelphia all the people who are writing the books about dissociative disorders so I said she finally she said

Dr Brill just asked me and I said you don't hear voices do you and she said oh yeah doesn't everybody wow that was her normal and so I said how come you never told anybody nobody ever asked right so we as therapist must begin to ask if it's not medical doctors rule out diagnosis all the time right why do we think we have the answer just because the patient presented with seven of the depressive symptoms to

qualify the patient for major depressive disorder it's probably accurate but what if there's more right well nobody goes any far farther they just start treating you for major depressive disorder they start using cognitive behavioral therapy and you know I spoke at the University of Pennsylvania and um who's the CBT guy who's that who is that guy I don't know that was so long ago oh back Aaron Beck well so many different modalities out there that you

have to memorize to pass the test I mean he's fantastic and I I met him and met his interns and when I was with the University of uh Miami medical school at Jackson Memorial Hospital so um and it works okay but it doesn't work for trauma so what if you're depressed patient is also coping with associative symptoms and you're not aware of it and you keep going back to all the cognitive features and the person can't

do it and then the the therapists get frustrated and then of course they say maybe you need more medication right and of course that's the that's the that's what Pharmaceuticals are doing to us right now if you're if you're ression medication isn't working ah we have an answer we have another one that we can add to it we make things okay then you see the person skipping down the street everything's fine now because I'm going to

double the amount of medication yes it's ludicrous yeah I mean it nothing against medication medication has its place we know that it's the last resort I that's Crystal Clear it's like the last resort not the first thing to jump on just I mean unless you want to just manage symptoms for the rest of your life right but most people that go into therapy actually want to get to the root cause of what is ailing their po

mind exactly and and that's why I think we need to listen and pay attention and if you have reasons to suspect right that there's something else going on that is connected to or related to any kind of traumatic experience the patient's not going to bring it forward and of course there are some scales which I'm sure you're aware of we may not talk about them today but we use depression scales and anxiety scal there's even a

disassociative um the dis um assessment that I know I used before I even I mean I think I I did every assessment possible before I finally said yes this client has did well the first one if you're suspicious any therapist is suspicious should use the ace it's and that's the um adverse childhood experience childhood experience scale and then if if the person has positive responses and you say wow maybe I should try the uh PTSD scale

there's a national scale the patient can fill it out you can evaluate it and then if you're more suspicious and you start getting more information and the patient begins to open up a bit and you say hey I may be on to something you use the dissociative evaluation scale which goes through the the primary symptoms of dissociation which have to do with memory identity and Consciousness when you start the patient starts opening up you know that

you really have something right and and so so when I was with you watching you do your thing I mean that right there how did you know how to do that and is that are you able to teach that to an intern or a therapist who's interested in really knowing how to because to me like every client is a unique thumbprint right there's no one client that's like any others and we must every patient that I've

treated since 1988 and began to get into the dissociative area treating dissociative symptoms as well as did initially multi-personality disorder every single one is different every patient has a different internal system right that is usually made up of a minimum of 17 to 20 30 40 50 60 70 80 different altars and one of the main things you need to do is to help the patient to stop creating more altars okay that's critical that's that was

like something I didn't know even though I read and I was researching it's like I guess when I was in the midst of it I was trying to just find that textbook you know because that's like okay I want to help my client I know that she's suffering and I want to learn more and more and so I'm like oh my gosh I think I even like contact someone in England the cad Clinic the the first

thing I do when I discover that I may have a dissociative patient much less did uh is that I make my mind a complete blank and I throw out any or cognitive thoughts that I might have of exactly what I should do because we are powerless and that's the feeling that most therapists have when they work with dissociative patients is they feel powerless well guess what you are you must Engage The Client the client must take

responsibility for what's going on inside and they will do it if you can connect with them and if they know that you will not leave them so you're talking about abandonment uh exactly okay so it's critical that you establish a Therapeutic Alliance gee where have I heard that before I mean that's one of the Cardinal things that you do regardless of the patient if you have an established the Therapeutic Alliance they're going to be seeing somebody

else in about three weeks right and I think that might be the frustration too if you're under if you're a therapist who's like working with insurance companies or in the community mental health um where you just don't you know you here you have six six sessions or 12 sessions and then that's that and and you're you know you have to hurry up and take as many as you can and like what do you what how do

you encourage anyone or interns in in in the mental health field well I remember uh when I first started working with the multi personality disorder literally two or three or four times a month because I was treating four 14 15 multi-personality disorder patients a week wow for 3 years and uh I would get calls from hospitals all the time because they were taken into the hospital for doing strange and unusual things and families or friends or

somebody didn't know what was going on because a altar came out that was homicidal or suicidal or cutting cutting is a significant symptom uh and um they wouldn't know what to do with the patient I would run to the hospital and try to stabilize them because they were terrified and usually it's a 12 or 13 or 14y old male alter who's trying to protect whoever the person is usually a woman not always and uh you know

you have to be able to respond and I'm getting to a point that um it's it's critical it's critical that you're willing to acknowledge what's going on and that you feel immobilized and that you need the patient's cooperation the patient in front of you must be willing to finally face Their Fear MH okay because it's fear that protects and keeps the altars from coming forward because they keep all these secrets so and I think that could

be overwhelming say for a client you know like all of a sudden you're seeing this human being in front of you and I I've seen it like they they change like eye color I mean there's just it's yeah their whole chemistry their whole biology is changing right in front of you and then they could become this three-year-old child and in a heartbeat and how do you encourage a therapist to continue to work with clients like this

without giving up that right there because it's probably one of the few diagnoses in all of the DSM that's treatable what the symptoms go away when the patient is integrated they no longer have the diagnosis true I I mean with what with what other diagnoses can you do that um I'm waiting uh yeah I guess that's what I'm talking about non-pathological it's not a disease they're not crazy okay they're dissociative right I but I guess I

think it's those that don't understand this um well not understanding doesn't mean it's not true true it's just a complexity of like because we're in the field so when we see somebody we know how to treat it but I think it's the stigma I'm trying to get at how do we break that stigma you say you're in the field the truth is let's say you're in a football field you're in one corner of the football field

you're not looking at the whole playing field right as licensed clinicians we're responsible for all the diagnosis that are that are in the dsm5 right so it's in the dsm5 so if you don't know about it and you think you're not going to treat it and you're only going to treat what you call the the worried well the worried well H you're you're you're kidding yourself you really are and you're not you're not doing what it

is that you're licensed to do and you certainly don't need a license if you don't want to do that so so how do I how do we encourage those that are coming up right especially with this like I said I'm trying to help people break the stigma and not be in fear either even if you're a mental health counsel or not like someone listening to this and going oh yeah my uncle you know right wrestles with

this or whatever how do we get it to a place where they can understand it better without just going straight to the oh my gosh they're crazy look at them talking to you know whatever or the fear there is a Fear Factor and especially I come from the faith-based community some some people just automatically think these are you know oh my gosh that's the devil and I'm like uh no you got to understand the whole picture

people well that's unfortunately and forgive me but that's the easy way out really I mean it's it's always easy to say well that's the devil uh even if you actually believe in the devil that's an easy way out because you're giving up all your power wow and you don't have to give up your power you are not powerless with this diagnosis you're powerless if you think that the system is going to take care of you wow

you may need help mhm but if you find somebody that can actually help you not only can you decrease minimize or comp a patient who's completely integrated joined Blended bonded and all the parts inside all the situations for them have been resolved all the traumas have been uncovered then the person is a whole person so how long do you feel like a person would with the did like can you give them some words of wisdom or

hope if they feel like they're they might be wrestling with this well if they're ready to face their fears and stop doing what doesn't work get to a pat get to a therapist who can actually treat trauma but where do you find one well there I guess you go on to the uh psychology sites and find uh like Psychology today yeah and and find therapists that treat trauma now unfortunately many of them particularly those who who

use EMDR will say they're trauma therapist and they can treat trauma but EMDR is essentially for single event trauma and for phobias okay it's not for chronic uh complex and PTSD or uh multiplicity or did okay and um the therapist who the only skill they have is MDR uh are going to run into problems because I've used it many times I I use it myself but there are times when the patient says Dr bro this isn't

working right and then now what are you going to do yeah and I remember this one patient I had when I was not a patient she was a student in my class at Nova and we were doing group therapy like we did with your class and um uh uh she wanted me to evaluate something with her in her life she was a single mother with a couple children and she remembered a trauma and she wanted me

to use EMDR to get rid of it yeah and I did and 20 minutes later she had no significant trauma feelings related to that experience uh and I said well let's make sure let's just go through it one more time and all of a sudden she regressed to the age of seven wow right in front of us sitting in class and she said it was dark and she was somewhere at night on the street sitting on

the curb all by herself terrified okay and to this day I can still remember her saying to me you better not leave me now if all you know is EMDR you're dead in the water so what would you do at that moment if you are a therapist who like has this one skill only or like with in a client this happens to a client what do you suggest they do well I suggest well in that situation

if you don't know what to do you're call Dr Barnhill my Gandalf well you need you need more than that I mean I to be honest with you I spent 10 years doing this on my own okay traveling to visit Richard K and Colin Ross and these are all the icons who've written all the books in in 80s and '90s and early 2000s they ran the international Society for dissociative disorders they gave conferences I presented a

paper at the dissociative conference in U uh Orlando back in like 1992 or something like that okay and these were the people I I learned from I went to uh Texas with Colin Ross and spent two weeks watching him work with dissociated patients uh Richard kft was at the University of Pennsylvania in Philadelphia I hounded him for three days until he let me go on rounds with him and Richard Lowenstein came down from I think NIH

or someplace in Bethesda Maryland and I worked with him for a weekend I had all these people on speed dial okay so that when I had a dissociative patient in front of me and I got stuck I would call them on the phone and they would help me deal with it so after 10 years you know I was able to experience many of the things that are kind of pitfalls that any therapist would go through that

you have to learn how to how to modulate so do you are you able or do you have some kind of training for us well I would I would definitely suggest initially that you read trauma and Recovery okay by Judith Herman I'll put that in the show notes okay MD PhD and uh and I would read uh the body keeps the score by Bessel Vander number one yes I still have my notes from the first lecture

of his I went to in in 1986 I think when he first started w doing research with uh Judith Herman okay I would certainly read um uh H cier and stress okay a Canadian endrocrinologist all right I would read uh bulby yes attachment theory yes that's where all this comes from and uh I would learn how to trust yourself more uh your education in and of itself does not help you to treat dissociative patients but I

don't think you should do it unless you have the educ nor do I think you should do it if you're not licensed so that's the good news the bad news is you're naked and afraid yeah for sure but that doesn't mean you shouldn't do it that's true that doesn't mean you shouldn't and your patients need you and uh did is as common as psychosis oh that's approximately 1% of the mental health population so if you think

you're going to be in therapy and treat a random patients who come to you for a period of years years I guarantee you you're going to run across these patients and you're going to miss the opportunity to treat them yeah I I I understand that completely like I've seen it and I and I just in my personal experience as a as a therapist it's just when you when you have a patient client like this you know

I I didn't want to throw anyone back into a system that that totally traumatized them even more on top of the trauma they already had no exactly and so that right there I'm thinking like maybe if you are in Florida that they can contact you and you can give them like come D Gandalf or something like that well the thing is the the other thing is I've I've found out that this can be done online I

I never believed that it was possible but the past year or year and a half I've been treating dissociative patients online from other states in the United States and to my Happ it's actually working it's still not the same as having the patient come to you in your office uh but if the patient is motivated and they're willing to face their fears uh then it can work okay well listen I mean I know I can sit

here and talk to you forever but um we're going to have to start closing this episode out and maybe I'll have Dr Barnhill back or we we might be starting something together in the future I'm not sure huh Dr I certainly I hope so yes he also has a book called the jukebox of life it's his Memoir and uh it's a very interesting read I don't know I guess I am on video so here we are

and um I will put that in the show notes as well so before I totally close it out is there one or two sentence you would like to say to the audience uh basically I think what I would say is if you're ready to help your patients to stop doing what doesn't work and I suggest you look into trauma period much less did yes and I just did an episode on cptsd and Aces only honestly and

uh I think that's coming out well soon look for it all right so as I close out another episode remember sweet listener to trust in the Lord guard your heart and renew your mind bye oh