Untangling Addiction | Dr. Marcus De Carvalho

0:00 Hey guys, welcome back to another episode of the Disciplemakers podcast. In today's episode, Bobby Harrington, our founder, hosts a discipleship.org webinar with Renew Network guest, Dr. Marcus Carvello, a board-certified psychiatrist specializing in addiction. And they're going to discuss his book, Untangling Addiction. Listen, you don't want to miss it. Let's take a listen. My name is Bobby Harrington and I have a very special guest that I'll talk to you about in just a second. This webinar is being provided by discipleship.org and discipleship.org champions Jesus' method of disciple making. In fact, we not only champion it, but we try to promote it. Fan Jesus-style disciple making into flames or pour gasoline on

1:01 it wherever we find it. Because we believe that by focusing on Jesus' method of disciple making, we're actually providing that which is best to help people to be who God wants them to be. Disciple making includes reaching people who are lost and who do not know Jesus. And it also includes helping those who do know Jesus to grow up and live and be transformed into the image of Christ. We're doing this webinar tonight in partnership with Renew Network. Renew Network champions Jesus' teaching for disciple making. And I have as our special guest, Dr. Marcus D.

1:48 Carvello, who has a very unique distinction. He's a psychiatrist who believes in Jesus, which is actually a rare thing. And what makes him even rarer yet is he's a psychiatrist who believes in Jesus, who has dedicated his life to making disciples. So, Dr. Marcus, let me draw you in. If you would bring a greeting to us and tell us just a little bit about your background and in particular, your passion for disciple making. Bobby, thank you so much for having me.

2:27 I'm really grateful to be able to be here and be able to share my life and my expertise with everybody who signed in. Essentially, I am a medical doctor, board certified with the American Board of Psychiatry and Neurology. And my specialty is psychiatry as well as addiction. You know, while I was in medical school in the 90s, I had decided to leave medical school and go into the full-time ministry. And I actually led a church that was focused on making disciples.

3:03 And while I was there leading the church, I started to realize that my passion was to share in other people's suffering, to utilize empathy in order to help people have full functional lives through discipleship and through the scriptures. And I realized, you know, God did have a deeper plan for me regarding my educational background. And I decided to leave the ministry and go back to medical school and focus on psychiatry and addiction. And really that foundation came from my work while in the ministry because I met so many people who were suffering and who were stuck. And I thought that God, you know, really had this incredible plan for me and I wanted to use it and give back to people who want to make disciples, who want to

3:49 pour on other people. And we're here today. It's so great to have you with us. And I'm so grateful that you not only care about people, but care enough that you're combining two things that are often difficult to combine, as I've described, and that is a Jesus-style disciple making and psychiatry. Well, Marcus, let's jump right in if we can. Your book that just was released this week on discipleship.org is called Untangling Addiction. In fact, I think we have a picture of it. If I can get Jason in the background to pull up the picture of Untangling Addiction. If you're joining with us on the webinar or possibly listening to our podcast, we would encourage you to go to discipleship.org and there you'll be able to download Untangling

4:45 Addiction. And so we're going to be coming out of this book in our conversation today. Help us to understand if you could, Marcus, how does a person develop addictions? Like, let's start right at square one. How does a person develop an addiction? What happens is that depending on your life, say your development or your genetics, and you navigate through life and there is suffering there. Okay. And you come across a substance that releases a chemical called dopamine and you continue to use this substance.

5:27 Dopamine will lay down new neural networks in the brain that make your brain believe it needs that substance or even behavior like pornography to survive. So as I mentioned in the book, we evolved as human beings to experience pleasure out of things that keep us alive, food and sleep. And God designed us that way. He knew that in order for us to repeat behavior, we would need a sense of reward. But now when you take in chemicals like alcohol, nicotine, or you've used certain things like pornography or even gamble, they release more dopamine than those basic things for survival. And you lay down new neural networks that get intertwined with those same survival neural networks. And then your brain believes you need these things to

6:13 survive. So now when you're dealing with stress or anxiety, that's going to be your go-to. And you start to do these patterns over and over again and reinforce even more neural networks in the brain. Okay. Hey, Dr. Marcus, let me just get you to pause there for a second, because basically I can see a lot of people going, what did he just say about all these neural networks and everything? And somehow he threw in evolution in there. So let me just clarify some things. First off, I know that you believe that God made the world and God created us as human beings. You're talking about in the development of human beings. I don't want to put words in your mouth, but you believe God created everything. This atheistic evolution

7:00 is not how we got there, correct? Absolutely. Okay. Now, I think we also have a diagram. Is this the time to show the diagram that explains what you were just talking about? Yeah. Okay. There it is. By the way, those listening, we have a diagram. On the far left-hand side, it looks like there's a little bit of rain, then a little bit more, then a little bit more. Finally, there's a lot of rain. Now, that's not what it is. So Dr. Marcus, will you tell us the diagram we're looking at? Yeah. So in the book, we have this image there. This basically shows that through continued repetitive behaviors, your brain will start to make new neural networks. So on the left there, those little squiggly lines, those are actual nerves in the brain. Those are actual

7:50 neurons. As you repeat certain behaviors, when you repeat those behaviors, if they release dopamine, which make you feel good, like you get that euphoria, those neural networks will start to grow. They will start to branch out as we move from left to right. What you see on the right there is this huge cascade of neural networks. What is hidden in there? In those neural networks are all the lies that you've had to create to live a double life in order to have this addiction, the hiding, the stealing. Everything is in there. It's not just the chemical. It's the emotions.

8:27 It's the feelings. So your brain starts to develop new neurons. We have neurons that look just like this for food, for sleep. The brain has those things to keep us alive and to survive. But then you introduce an addictive substance or an addictive behavior, and these neural networks now get intertwined with those survival networks, and your brain believes it needs those things to survive, like food and sleep. That's where the brain gets stuck, and that's how people get hijacked. The brain goes to those substances rather than food or sleep to survive.

9:04 When you get addicted to a substance like nicotine or heroin or even pornography, you're willing to sacrifice food, sleep to get that thing because the brain is going to demand more dopamine. Okay. Hey, Jason, if you could put that diagram back up. Here's what I hear you saying. If we look at this diagram to the left, there's not as much neural activity. Am I describing that correctly, Marcus? Yeah. Okay. Then as you move to the right, there's actually more neural activity or activity in the neurons, because what's happened is that you've gotten used to this, whatever it is that's giving you pleasure, and it's creating more pleasure.

9:51 It's almost like your mind or your physiologically, your intellectual capacities, and I may not be saying that right, so correct me, but it's almost like they develop these tracks that make it really easy to keep staying in those tracks. Am I saying that right? The example we use in the book about riding a bicycle. When you're a young child, your parents give you a tricycle, and you start riding that, and you're developing new neural networks just to ride it. Then you get a five-speed, a 10-speed. By the time you're a teenager, we've moved from left to right in these neural networks here, and your brain can turn left, turn right. It sees depth perception. It's got all the good feelings associated with riding that bike,

10:36 and you will never forget how to ride that bike. You can go 20 years down the road and jump on a bike without riding one, and you will never forget it. It's not muscle memory. It's neuroplasticity, and that's the same thing with addiction. Your brain will always remember. Okay, so tie this in, if you would. Let's say that I go to the dentist, and I get a prescription for a painkiller. How does that lead? By the way, I have a good friend whose son went in, had dental work, and I don't remember how many drugs they gave him.

11:17 It wasn't very much. The next thing I know, this guy who's a really godly person is addicted to drugs. He's selling and buying and doing all this crazy illegal activity, and then he ends up in jail. I would have never thought it about the guy. How does that happen? That's a very common story. When you go to the dentist and you get these opioids, you take a pain pill. They're called opioids. When you take one, it does exactly the same thing as eating a meal. It releases a certain amount of dopamine, but a thousand times more dopamine than, say, a basic meal would. When that dopamine is released for that opioid, the brain lays down these neural networks for that opioid. Now, if the doctor prescribes that opioid for you three

12:08 times a day, and he says, take this three times a day, and take it two weeks to a month, that's all you need for your brain to develop those neural networks that we just showed you there, that now your brain believes it needs that opioid to survive, like food and sleep. When you wake up in the morning, your brain is going to demand that opioid with your coffee or with your meal.

12:31 Then what happens is this. Say you stop taking that opioid. Say you run out of that prescription that doctor gave you. It's just like you run out of food. Go a day. Go two days. Go three days without food. What is your body going to do? It's going to go into a withdrawal-like state. You're going to dream about food. You're going to do everything you can to get food, because your body knows it needs it to survive. It does the same thing with that opioid. It's that quick that somebody can be addicted to it. I've heard that story several times, where the doctor cuts off the patient. He overprescribed the patient. Then the patient now is on the street looking for these things on the street, just because he just wants to feel

13:07 normal again, because the brain is demanding something it believes that's a part of him, and there he is stuck. Wow. It can happen just like that. It can happen just like that. The problem is that we're seeing in the United States with this opioid epidemic is that there are people selling these pills on the street. These pills can be laced with something called fentanyl, which is 100 times more powerful than morphine. You could take just one tablet, and basically it turns off your ability to breathe when you sleep, and you pass away. That's why we're seeing so many people die on the streets. It's very tragic.

13:44 Actually, there's a good question as we begin here. I do want to get into this understanding of the chemical basis or the biochemical basis of these addictions, and then how discipleship and following Jesus can actually be a way of overcoming them. Let's stay with understanding it first. Perry writes, what's the difference between muscle memory and neuroplasticity?

14:15 That's a great question. For many, many years, people used to use the term muscle memory. Let's give the example of a golfer. I love golf. My son plays junior golf. Right now, he is learning how to swing a golf club the proper way. As he hits that golf ball, every time he hits it, and he hits it well, and he's learning how to swing that club well, his brain is releasing tons of dopamine over and over. He's hitting golf balls every single day.

14:45 What ends up happening is that there are neurons being laid down, not just for the feeling of hitting a golf ball and the good time, but for how your muscles have to move while striking that golf ball properly. As you continue to do it, and continue to do it, those neurons are laid down in the brain with the exact memory of how to move your body, of how to shift your weight, of how to curve the ball. Muscle does not have memory. Muscle has neurons that fire onto that muscle from your brain, from the cerebral cortex. Those neuroplastic changes that are occurring in my small son are going to be with him forever. Say if my son plays high school golf, and then he decides, I'm not going to swing a golf club for 15 years. He goes out with some friends,

15:34 and he swings a golf club. His friends are going to look at him, and he's going to hit that ball amazing. Is that muscle memory? No. That is neuroplastic changes that never go away in the brain. Wow. Okay. We can come back to this, but one of the things I'm hearing from you, then, is the expression with alcoholics that one drink's too many, and a thousand's not enough. How they can just go right back to an alcoholic lifestyle after 15 years of sobriety. Is that what we're talking about? Absolutely. I've had patients who have had 20 years of sobriety. Anybody who has 20 years will tell you that tomorrow, I can relapse at any moment. They say that. Why?

16:23 Because they are humble to the fact that they are vulnerable forever. They understand that the neural networks in the brain that were laid down at a certain time will never go away. The brain will always believe it needs that alcohol to survive. That's why people who are in recovery, who do well in recovery, work on their recovery daily. The daily thing. The reason is this, Bobby, is that, remember, the neural networks that are laid down for addiction are laid down in your survival mechanism, in the survival area of the brain. If you wake up tomorrow, and you have a cup of coffee, if you have a meal, you are strengthening all the areas of your brain that are responsible for your survival, but it's also activating neurons that have been laid down there

17:09 for alcohol. Just like that person who wakes up in the morning, who starts his day, who has 20 years sobriety, he knows where is he going first thing in the morning? To an AA meeting, where he's going to get on his knees that morning and pray to God, God, keep me sober today. It is going to be in front of him. He's humble to that. There's tremendous humility in that. The reason why AA works so well, too, and we'll probably get to this, is the relationship factor. I know we want to talk more about that in regards to discipleship. The thing is that people will be vulnerable forever to the things that they are addicted to. Now, is there a genetic factor in some people becoming more, some people more likely to become alcoholics because of genetic factors,

17:56 some pornography? Talk to us about that. We've known for a long time, with alcohol, we have isolated those genes for alcohol. What's really new now is that we are starting to isolate the genes for dopamine with regards to opioids. There are people who don't make enough dopamine to actually feel pleasure out of basic things in their day-to-day. They go through life with this depressed state. Imagine the young boy who's depressed. He's not really social at school, and he may have one of these genetic predispositions. He goes to the dentist. That dentist gives him an opioid for his wisdom teeth, and he suddenly feels normal. That person genetically was more at risk to develop an addiction to opioids. We even have screening

18:46 tests for these people now to make sure that, hey, would this person be at risk to develop an addiction to opioids? Yes, definitely from a genetic standpoint, there's a huge predisposition to that as well. Just before we leave that, Marcus, is there any way that a person can know if they have a genetic predisposition to some of these things? Because my friend described his son getting hooked on pain medicine and how it wrecked his life. It's like, whoa, if they'd have ever known that, they would have avoided even taking anything more than Tylenol-3. Absolutely. You can definitely get genetic testing, but I would say it's as simple as this. If you know if anybody has struggled with addiction in your family,

19:34 you can ask your parents, siblings, cousins. If anybody ever did have an addiction issue in their family, more than likely, they are genetically loaded with genes that can predispose them to addiction. You could go even further and get even more testing done if you'd like, but that's all you really need. It's just like when we look at a woman with breast cancer.

19:59 If somebody has breast cancer in the family, without a doubt, your siblings, everybody should get tested that's biologically related to that person to prevent a death. Yeah, I've heard it before. The children of alcoholics are really advised with the potential that they too would become alcoholics and to therefore really be careful about getting drunk and things like that at an early age where you're just like, I can't. I'm not that kind of person.

20:30 I mean, getting drunk is a sin, but just even more so to stay away from that type of thing. All right. Well, let's assume then, Marcus, that we have somebody who's addicted. Actually, if we can, can we take a minute on pornography? Sure. Because I know you've also taught a lot about this with pornography. It's a similar version of neuroplasticity leading to this rewiring of the brain around pornography.

20:59 And I've heard numbers recently as 70% of men of one degree to another are struggling now with a pornography addiction. I've actually even read even higher than 70% actually in the 80s. One of the things about pornography is this, is that when we look at the amount of dopamine that's released, say when you use an opioid or cocaine or alcohol, we see dopamine release at very high levels and we see these spikes and then it drops off pretty quickly. The thing about pornography that's different is that the viewing of pornography can actually increase the dopamine levels to just as high as those addictive drugs, but the dopamine will linger for about five hours at that high level and no drug does that, only pornography. So let me give you the example.

21:51 Imagine the man, he's at home and his wife tells him, honey, I'm going out shopping. She leaves and then he goes on the internet and he views something. He watches it and boom, there's the dopamine surge. It goes up high and she comes back within 45 minutes. And there he is now with that dopamine still in his system that's laid down for that pornography. He's going to have to lie to her. He's going to have to behave in a certain way. He's going to have to live a double life at that moment in order to navigate through that situation. That creates neuroplastic changes that are responsible for all of that fantasy, all of that double life, one foot in reality, one foot in fantasy. And that's the problem with

22:33 pornography is that it destroys the fabric of families. It destroys the fabric of the intimacy that somebody could be having with a real spiritual relationship because they're viewing this stuff online, which is all fantasy. So without a doubt, we talk about the opioid epidemic. We talk about all these other things. Pornography is a massive epidemic in our country. Actually, the pornography industry is targeting young teenage girls as an untapped resource to make movies specific for these young girls because it's out there in our schools. People are talking about it. Young kids, they watch this pornography like it's nothing because parents may not be watching what they're seeing on social media or watching what they're viewing in their computers.

23:16 The average age of a teen or the average age of a child that accidentally comes across pornography is nine years of age. Parents often ask me, what do I do to prevent that? It's not preventable. I mean, we're on our laptops. We're on our iPads. We use this for school. It's going to come in front of your child. The thing is, you've got to be involved in that child's life. You've got to be engaged. You've got to know what they're watching in order to help them navigate through it when they see it because it's going to come. Okay. Wow. Okay. So we see how the brain then develops this addictive pattern with the neural pathways in our brains. How do we help people with these problems? How do we help them? And here's your key word is to

24:04 untangle addiction. That's a great question. So oftentimes when I talk to people about this, initially they feel like, wow, there seems like there's no hope. I mean, if we're going to be vulnerable forever to these addictions, how do I overcome? Well, like I said, you will be vulnerable forever. And the majority of people who come across an addiction in their lives can maintain their sobriety. But the hope lies in the frontal lobe of the brain, in an area of the brain that's responsive for rational thinking, for your values. The reward area, the survival area is impulsive. It's about getting what you want quickly to survive. But the frontal lobe of the brain is responsible for making good decisions. People that signed on tonight with us, they want to know, they want answers. They're

24:52 making rational decisions and that lies in the frontal lobe. So what do we do? We use neuroplasticity that the same thing we spoke about that can create an addiction. We use neuroplasticity to lay down new neural networks in the frontal lobe that are responsible for healthy lifestyle skills. We teach them the scriptures. What are your values in the scriptures? What do you stand for? What do you want people to remember you by? When you come face to face with Jesus, what is going to be your value-based system, the judgment from right or wrong? All that lies in the frontal lobe. When I became a Christian, it wasn't an impulsive decision.

25:30 It was a rational decision. Can I count the cost to do this? That doesn't lie in the amygdala and the brain reward pathway. That lies in the front of your brain. So the hope lies in the front of your brain and it ultimately comes down to discipleship, Bobby. It comes down to learning the scriptures. Somebody teaching you how with a relationship with Jesus, you can overcome and what those teachings are. So Marcus, I think you're describing in part right now, mindfulness. Is that correct? In other words, spiritual mindfulness of developing the ability to create these different neural pathways of relying on God, following what scripture says.

26:14 Am I describing it correctly? Absolutely. So in order to navigate through temptation and feeling, you've got to be able to make room for those feelings. And the only way that you can make room for those feelings and not be fused to them and jump into them is to be mindful of them. But that's not enough, Bobby. In order to be able to be mindful of these feelings and not jump into them and seek relief, you have to have a value-based system.

26:45 And value-based systems lie in the frontal lobe. Where do your values come from? So say that gentleman whose wife left the house and he was tempted to watch pornography. If he had no value-based system or something that he's been turning to every day in prayer, maybe reading the scriptures, he would just impulsively turn to that reward. But if he has a value-based system that he's been working on every single day, that now has created new neural networks in the frontal lobe, he can be mindful of these feelings that he has, not turn to them, but turn to his values and focus on them. Do you follow what I'm saying?

27:27 Yeah, I am. And that's, if you can help us, that's called mindfulness. Is that right? Absolutely. And that's kind of a big thing today. Can you talk to us a little bit about that? The type of mindfulness that I teach is something called acceptance and commitment therapy. Now, what is acceptance and commitment therapy? We accept our past. We accept the fact that it may have been hard and there may have been sexual or physical trauma there. We accept an unknown future. We don't know what tomorrow is going to lie, the stresses and the anxieties of it.

28:03 But we live in the moment. We are mindful of the moment. So when something comes our way that's overwhelming, it could be as simple as you go to the mailbox and there comes your tax bill. How am I going to pay for this? How am I going to take care of my kids? All those fears and worries. And you may have learned through the course of your life that a glass of wine at that moment will suppress all those feelings, and you want to run back in the house and have that glass of wine.

28:27 Well, if you get those feelings and you feel them, but you have a value-based system that you've been working on spiritually, the scriptures, it could be AA. Instead of being fused to those feelings and wanting release so bad, you can be mindful of them. You can actually make room for them. You can use a technique that's simple as I notice I'm having a feeling of fear, but my values say I want to step into this. I'm going to go to God in prayer in this, and I want to be able to navigate through this. I don't want to turn to drinking an entire bottle of wine in order to deal with this tonight so I can go to bed and not have all these worries and fears when I'm trying to go to sleep. So that's how we utilize mindfulness in order to navigate through feelings. When we

29:11 talk about Jesus in the Garden of Gethsemane in Matthew 27, we're talking about our creator who at a moment in time said basically, quote-unquote, I'm feeling sorrow to the point of death. Jesus wanted relief at that moment. He's our God. He was our creator. Even he needed relief. He was fearful of what was to come, and it was almost as if he couldn't even see straight.

29:34 He went to his father asking if there was another way, but what did he do? He stepped into his life. He was mindful of what he had to do. He went to God in prayer, and he focused on his values of what he had to do. When Judas showed up there, he didn't tell the disciples that were there with him, grab your swords, let's fight them, or let's run. He said, let's go to them. Here comes my betrayer. He was focused on a value-based system, and it's all over the scriptures that without a set of values that we can use in our frontal lobe where rational thinking takes place, we will just basically do what impulsively we have desires to do. Even Paul said in Romans, he basically said, do not conform to the patterns of this world. He knew that if you just conform

30:19 to the patterns, you're just going to follow them, but he spoke about being transformed by the renewing of your mind. He understood that with a sense of mindfulness and a sense of values, the power of Jesus can be displayed to everybody. It was clear to him. Dr. Marcus, what's the difference between that and white-knuckled sobriety where the idea of you're holding on as tight as you can. I'm not going to do it. I'm not going to do it. The idea with white-knuckled sobriety is you know that person's not going to make it because there's not enough willpower. Often when I speak at church conferences or at different conferences, people will come to me and they'll share their white-knuckle experience.

31:05 Usually, it's in the context that it didn't last for very long. I tried to white-knuckle it, and it did give me a few months, but it just didn't work out. They actually fall even deeper than that. In reality, Bobby, true sobriety is through transformation. It's through transformation through relationships, through working with somebody else who understands what's going on in your brain, who can be there for you and help guide you. White-knuckling it, sometimes some people have to go through that. It's just like in spirituality. When you want to share with somebody about Jesus and they just don't want to hear it, you got to let them go for a while to just let life humble them. In addiction, it's the same thing. Okay. Let's say I'm watching this

31:55 discussion and I have a loved one, or maybe the person watching has an addiction themselves. How do we find recovery? What I would say is that I would love for people to be able to reach out to us or connect with us so that we can help them. I think things like healthy lifestyle habits that you could find through mindfulness can definitely help them. Without a doubt, the ultimate foundation, I believe, is with a true deep relationship with Jesus and relationships with other people who are actually maintaining that spirituality and sobriety at the same time. Places like Celebrate Recovery. I know at Harpeth Church, they have a phenomenal Celebrate Recovery. Here in Jacksonville, where I'm located, there's some excellent Celebrate Recoveries. Those programs are based

32:50 on relationships. I've never met an individual who has been able to maintain their relationships, sobriety alone. I've never met anybody in addiction that's been able to do it by themselves. It's through deeply forged relationships with other people who are doing it on a day-to-day. I just want to punctuate that point that you're making right now. In your book, Untangling Addiction, you state this, and it's so important, is that as a psychiatrist, you have not seen people able to maintain sobriety from whatever the addiction is without an ongoing relationship with other people who are working on and practicing recovery themselves. Am I saying that right?

33:37 Absolutely, without a doubt. The foundation of AA, of NA, of Overeaters Anonymous, of all of them, the foundation is based on relationships. Why? Only through relationships. When that area of your brain lies to you and tells you, you need that alcohol, you need that pornography, you need these things, you've overcome, you're doing better, you're not going to slip back in, only through a relationship can somebody tell you, hey, careful, you're slipping. I can see the change. I see you going back. It's only through that, only through relationships that are transparent, vulnerable, only through relationships with another person who understands what's going on in your brain.

34:27 Because I've worked with tons of people that, I had this one patient, I said to him, so how's your sobriety going? And he said, well, I've been going to AA, and I think it's going okay. And I'm like, what does your wife think about AA? And he goes, oh my, I would never tell my wife that I go to AA. I'm like, she doesn't know that you go to AA? And he said, no, I don't want her to know about that. And I told him, I'm like, so you've lied about your addiction, and now you're lying about your sobriety. He wanted to keep his sobriety and his past concealed, and you cannot do that. It has to be exposed. We have to be okay with, look, I was a slave to this thing, but now my relationships, everybody that knows me, they know that this is who I am, and I'm open and

35:14 exposed. In Proverbs 20, verse five, it says, the purpose of a man's heart are deep waters, but it is a man of understanding that draws them out. That relationship is a reciprocal relationship. Somebody who is sponsoring you in Celebrate Recovery needs you. They need you to maintain their sobriety, just like you need them. And so it has to be completely exposed and transparent.

35:38 Okay, so what I hear you describing is Alcoholics Anonymous or Celebrate Recovery, which is the Christian version. I believe you can go on the website, Celebrate Recovery, probably celebraterecovery.com, and find churches that are hosting these gatherings. Tell us a little bit about it, where a lot of people will say, well, for Christians, shouldn't just good Christian relationships be enough? Why would we need AA or something like that to help us overcome addictions? Well, because, I mean, in order for somebody who's struggling on a day-to-day with things like alcohol or pornography, and somebody who has developed all those neuroplastic changes in their brain, who understands that there is a war, there's

36:33 a battle going on in their head every single day, there is no way that somebody who doesn't struggle with that addiction is going to be able to be empathetic and understanding of what they're going through. It's just impossible. And so we need that relationship in order to be able to do that. So like at Celebrate Recovery, you have people there who are dealing with food addiction, sex addiction, alcohol addiction, and discipling relationships can be forged there, and you can have somebody walk you through that process to get you to that place. That's really good, because what you're describing, and it's really the subtitle of your book, it's how discipling relationships are essential. Even the basic description is where you said, I haven't seen

37:23 somebody recover from an addiction unless they were in relationship with somebody else who's recovering from an addiction. That's relational discipleship right there. And what you're saying is that for people who develop these addictions, walking with other people who are dealing with the real world issues of overcoming these addictions through relationships, through the habits of the 12 steps. And really, one of the ways I've always described the 12 steps for people is they're just spiritual disciplines. They're spiritual disciplines or habits organized in such a way in the context of relationships to help people to develop habits and patterns where they can be mindful and rely on God and the Spirit of God. Absolutely. What you just described, Bobby,

38:15 is a set of values. Why are the 12 steps so important to somebody who's maintaining sobriety? Because it is their value-based system. When somebody is struggling with having a drink, and they're having those feelings like we talked about, the first thing that they're going to go through to is their steps. They are ingrained in their heart. They're ingrained in their mind.

38:39 And their truths, that's the thing. That is the difference. Feeling and emotion is feeling and emotion. It is not truth. Values from the scriptures or from the steps are based on truths. In Celebrate Recovery, they're biblical truths. You know, I was reading through the AA book not long ago, and my wife looked at it, and she looked at the steps with me. She had never looked at the 12 steps before, and she said, wow, I mean, everybody should live by these.

39:08 And that's not, you know, I mean, these are the steps from AA. People don't hear that. They're biblical truths, you know? And if you did live with them, they're a great set of values to live by, okay? The other thing is that one of the reasons why I talk about these relationships is that it teaches obedience. In Matthew 28, Jesus sets out our purpose for us.

39:31 When somebody goes to AA or Celebrate Recovery, and they have been lost for so long in their addiction, and they come to a place where their purpose is laid out for them, and somebody teaches them obedience to the scriptures and to their purpose to go out and help other people who are struggling the way they were, to help other people who are lost in darkness, whether it's addiction or let's just call it sin. It's about helping these people obey. That's what these relationships that are forged in Celebrate Recovery in AA are. It's about helping them to obey a set of values, whether it's the scriptures, whether it's the 12 steps, or whether it's the steps in Celebrate Recovery. The parallel to discipleship in addiction, I mean, it's really not even a

40:19 parallel. It's just sin, essentially. That's why discipleship, and when I talk about, I've never met anybody maintain their sobriety without a relationship with somebody who's maintaining it as well. I've never met anybody spiritually maintain their relationship with Jesus and make it and go through it without a relationship with somebody else who's doing this thing as well. I mean, if you have a relationship with somebody else who's not doing it, they just don't understand that set of values. They just don't get it.

40:48 That's why the parallels to discipleship are just solid. I really feel with this book and really lining out really what Jesus taught his disciples, teaching them to obey, giving them a sense of purpose really helps people maintain their sobriety. That's basically the drive home of the book is that through this relationship, you can actually maintain your sobriety.

41:15 Okay. We have just a little bit of time left, Dr. Marcus. Let me ask you one of these questions that's in our Q&A box. Someone asks, what about someone whose addiction was driven by depression and anxiety? That's a great question. We talked a little bit, Bobby, about the genetic predisposition to addiction, but really when we look at addiction, we look at three spheres. We look at the genetics, we look at the development, and we look at their life today. Developmentally, what happened in their development? Was there sexual trauma, physical trauma? Were they brought up in the foster care system? Did they have a chemical imbalance where they developed depression or anxiety or bipolar disorder? Along the way in their lives, they've

42:04 come across an addictive substance like alcohol. Because of their bipolar or their depression, they learned how to drink and it just settled their emotional feeling. Alcohol or anything addictive in nature actually turns off an area in your brain that's responsible for you to be emotionally aware so you don't have to feel. It's not a treatment. It's just a band-aid. You don't have to feel anything. Over the course of time, when you're young and you're feeling so much pain from your past or from a chemical imbalance and you come across this thing, it gives you a sense of normalcy. A lot of people, they turn to these things and they get stuck. Then they carry this into their adulthood. This is the only thing they know in order to deal with the depression or the

42:47 anxiety that they've had for a long time. In psychiatry, we call that a dual diagnosis where they have a mental health issue and an addiction issue at the same time. That definitely can happen as well. Through some of the teachings and things that we've written out in our book and what we're going to be teaching actually at the discipleship conference, you can still overcome with the utilization of things like mindfulness, of acceptance and commitment therapy. Also working with a good psychiatrist, somebody who's willing to spend the time with you to tease out your past, not just give you some medication, but really understand what is the underlying etiology.

43:22 What is the underlying reason you struggle with addiction or you're struggling with a mental health issue? That's the way you can put a good treatment plan together for that person to overcome. Okay, good. That was a great question. Talk to us a little bit about untanglingaddiction.com, this ministry that you're wanting to offer.

43:45 Absolutely. My dream as a disciple and as a physician is really to utilize my expertise and the opportunities that God has given me. Untangleaddiction.com is a website that we'll be launching in January, full force with podcasts, webinars, live videos, educational materials, eBooks like the one that we're presenting now to give education and awareness to our community.

44:14 My goal is to help people become unstuck. When I use the word untangle addiction, that knot that's tangled up, you can loosen it and lighten it. It'll never go away just like those neuroplastic changes, but once you loosen it, you can live with it and you can navigate through it. That's the goal of Untangle Addiction is to help people navigate through the vulnerability they're going to carry forever. What we're doing right now is we are building it. We are creating our content videos so that in January, we're going to launch it full force and start presenting it nationwide.

44:47 That's good. Just staying with the theme of getting people help when they're trapped in addictions. Let's say that I'm somebody and I'm in a church in, I don't know, Nowhereville, Illinois, and I'm watching this and I want to get help. What's my first step? Really, your first step is to reach out to somebody locally, whether it's addiction or a psychiatric issue. I would contact a mental health professional. I would get understanding and awareness to what's going on. Do you have a chemical predisposition to your depression or anxiety or your addiction? Should you get counseling? I would reach out and get those questions answered first. I would also really try to grow spiritually. I would look locally

45:38 for a church, somebody who believes in discipleship, where you can develop relationships with other people. Hopefully, they have a Celebrate Recovery program there where you could start to develop relationships. The best thing about Celebrate Recovery is when you show up there, you're going to meet people who have been there, who know the resources, who know who to go to. That opens up so many doors for you. I would also tell you to visit my website, HealthyMindMD.com.

46:06 On that website, outside of Untangle Addiction, this is my professional website, HealthyMindMD.com. I have tons of videos there, education, things that we're doing, resources in order to guide you. Ultimately, UntangleAddiction.com is going to be our main website. In the interim, I would tell you to go there, HealthyMindMD.com to give you some resources. That's good. One of the questions that came up in the chat box or the Q&A box is a really natural one. That is, and I know you've heard this many times before, but why does it seem that the church doesn't feel comfortable handling these issues? A lot of times, people say, it's like my church, they don't want to deal with this. That's a really great question.

47:01 It's actually one of the main reasons I left the ministry to do what I do. I think that as we grow as a church, we are going to have more and more people who are members of our church that are not necessarily ministry staff, but have a set of expertise. At my church, the leadership really welcomes what my knowledge and what I know. They invite me to preach. They come to me for counsel.

47:26 They ask me questions. I think what happens is that sometimes when a lot is left on the lead minister or the evangelist, things like addiction, it can be overwhelming. What I would encourage is ministers around the world, around the country, that if you have people who are experts in your membership, encourage them to lead a ministry, encourage them to take on some of this load.

47:47 We're all in this together. We're disciples. We have to take care of each other. If there isn't a Celebrate Recovery program in your church, start one. If you are an expert in the field there, a psychiatrist or a physician, start one. That's what I encourage people to do. In my church here, nobody was doing it. What an opportunity for me to just do this. I know that this is what I'm passionate about, and this is what I want to do. If I was a member of a church that didn't have something already ongoing, I would get to the leadership and say, you know what? Let me start it.

48:19 I'll start it. I would encourage you to do that type of thing, to help your ministry leaders, because sometimes they just need that help from the membership. It's such a big need. Dr. Marcus, your book on untangling addictions, and then an other book that we had about a year ago called Beyond Accountability by Nate Larkin, which is again around addiction type issues.

48:45 These two have been the fastest downloaded books at discipleship.org. Yours in the first 24 hours, coming pretty close to 1,000 copies. His was very similar. There's a lot of need out there, but I think people feel like they're not sure where to go to get help. They're thinking that the church can't really help them, and so they're struggling. Just to build on that, Bobby, I wouldn't look at it as, hey, the church can't help me. I would set your mind on Jesus, pray about it, fast about it, go to the scriptures, really think deeply and reflect, because Jesus, without a doubt, can help you. When we look at Mark 9, and I talk about this in the book briefly, when we look at Mark 9, Jesus was walking through the town with his disciples, and his disciples

49:40 came to him, and they said, Jesus, there's a man, and his son is convulsing. We need you to come there and save this boy. He goes to the boy, and he goes to the father, and he says, how long has he been this way? The father looks at Jesus and says, he's been like this since birth. Please, can you help him? Jesus looks at the father and says, only if you believe. The father says, and I'll get a little emotional about this story, but the father says, I do believe, but help me overcome my unbelief. He wanted to believe. He really wanted to be able to be like, yes, he can change, but the evidence of this boy's life, his entire life, this is all the father saw.

50:20 How is he going to believe that anything is going to change? The thing is that Jesus is trying to teach us that, yeah, on your own, you are not capable of overcoming your addiction. On your own, you are not capable of having a spiritual life, but with me, you can. That is the thing. Sometimes we separate that with our churches, and we rely on our leadership to solve these problems, and it pulls us away from really relying on Jesus. I would say, strengthen your relationship with Jesus. Go deep in the scriptures. Pray about it, and he will give those answers.

50:54 Boy, that's good. Well, boy, this time, the time really flew by very fast. There's so many other things we could say. I'm going to leave it to you, if you would, to give us a last word, a word of encouragement, and then our time together will come to an end. So really, my focus tonight really was to be able to bring more awareness and education, and really help those who are out there right now looking for answers.

51:26 Please utilize the book. Utilize the resources in there. Reach out to me, if you can. Go to healthymindmd.com. Also, pray for our website, untangleaddiction.com. I really feel that that's going to have a huge impact in our country today. There are several epidemics going on, the opioid epidemic, the pornography epidemic. There's a huge need out there. There's a spiritual battle. So I just encourage you, please, anything you find in that book that may help you, reach out to me. I'd love to answer questions. If you're at the conference, please come up to me, talk to me. I'd love to be able to spend time with you and answer any questions you may have. Oh, that's great. Well, thank you so much for being with us.

52:14 Thank you guys so much for tuning into this episode of the DiscipleMakers podcast. Please check us out next time for more great content. And in the meantime, come check us out as well at www.discipleship.org.