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Chapter 1: What is the main topic discussed in this episode?
It was only a few versions ago that women having a job was a disorder. Shut up. No, I'm not shutting up. I missed it. Yeah, OK. And it's like a bunch of white dudes get together in a room and say, here is what everything is. No.
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Today's guest is one of those rare people who actually understands what's going on under the hood, not just emotionally, but neurologically. Dr. Daniel High is a clinical neuropsychologist, founder of the Neuro Assessment Center, the guy people go to when everything else has failed. Dr. Daniel High, how are you doing? I am so excited to be here. Thank you for having me.
Well, thanks for joining us today.
Where'd you come from? Encino? Yes, that's where my office is. I really wanted to prep myself for you. But it is actually really true that I do see the cases where people don't seem like they have any hope left.
Good. Let's get right into it. Sure. You call what you do neurocognitive therapy. Break that down for the audience. In plain English, what are you actually doing to people's brains?
Neurocognitive therapy is holistic in a sense that it works both on what's happening neurologically and emotionally. So basically you'll come in, I'll do an assessment on you. Then you'll do actual treatment and we'll do cognitive like rehab. And then after that, I show you and I graph your results in terms of the improvements that you've actually had.
So instead of actually just coming in and saying we're going to talk about our feelings, it's a little deeper than that. And I like to show like evidence.
demonstrating the results so through the testing through the testing and through real life so it's ecological which means my lens is based on what's happening in real life not on tests i'm also not traditional in that sense for that clinical information of what's happening in the client's life is way more important to me than what's happening on the test okay let's move on you're blending neuropsychology mindfulness attachment therapy
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Chapter 2: What is neurocognitive therapy and how does it work?
Yeah, no. I put myself in uncomfortable positions. They put themselves in uncomfortable positions. Why shouldn't I? There it is.
Good for you. You've got people out there saying functional medicine is BS. What do you have to say to that?
I think it can be BS. I think anything can be BS. As we talked about earlier, it's the trust that you have with your provider that determines the symptom relief.
Well, let me just go in there because I am a huge believer in functional medicine. Good. I think what you mean is, and you do functional medicine. So it can't be BS. What's BS about it is there are so few psychologists, therapists, psychiatrists that actually have the ability to help anybody. So when they try to do something, OK, it's not top notch.
Yes, it's really it's quality determined is really what you're.
Yeah. Let's be real. Most therapists barely understand trauma, let alone the brain. What do you see them missing every single day?
I think a lot of people haven't done their work, like your own personal work, and they don't look in the mirror. I think having your own therapist as a therapist is crucial. I think consulting with other people is crucial. I've been in therapy since I was four. I'm still in therapy. Being aware of myself, knowing my limitations and understanding what I can't do is important.
And I think that that's really the differentiation there is really knowing those differences and also understanding that maybe you're projecting your trauma on someone else. Maybe this time you don't know.
Maybe you need to look a little deeper into what you can know and maybe you shouldn't write someone off right away or maybe that person just doesn't want to help themselves and maybe you just need to accept that.
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Chapter 3: What role does the therapeutic alliance play in treatment?
That's fine. But
you know i am the chairman of a healthcare corporation so i'm not completely devoid of talent and if you would have checked pre-drug use what my capacity would have been i'd be homeless yes i think that you're you have to use the proper norms and the clinical history is at play if someone has like reading issues you certainly wouldn't use that to determine their capacity so to speak excellent what would you use
You'd use a clinical interview. You'd use basically some people use the TOEFL. The TOEFL is a test that basically asks you about your childhood and asks you about where you grew up. It asks you about what your parents did or didn't. And I'll be candid about- That's good, by the way. Yeah, the limitations of neuropsychology. Call that again? The TOEFL. The TOEFL? Mm-hmm.
That's the free- Are they only available from like October through November? They're available all the time, but I do love white truffle. But no, it's not as good as actual- Is black truffle even truffle? Not to me, but I'm a snob. Right, okay, go on. I do think that being able to determine someone's premorbid intelligence is a grandiose task.
I think that you can't really tell what someone really does or what their intelligence is just through testing, which is why I go out of my way to look at advanced norms and look at people's families' histories and things of that nature as well. And I do know the limitations within that, definitely. Nice, nice.
Okay, that horse shit thing might have been a little harsh. No, it's chill. Okay. Push me. Can the brain actually heal or are we just learning to live with the damage better?
Both. Some of the brain actually can rewire. Through the neuroplasticity? Some say it's through neuroplasticity. Some call it a higher power. Some things we just don't know. But yes, I do believe that there are ways for the brain to not just heal, but get better. And there's also ways for it to just stay stunted for where it's at. And it's case by case dependent.
I certainly think that there are some people who just... You have to accept that that's where they're at. And keep them and stabilize them there so that they don't atrophy. Harm reduction. It's all about understanding what someone's limitations are ethically. Absolutely.
Okay. What does ethics have to do with it?
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Chapter 4: How does exposure therapy differ from traditional methods?
90% of the people don't get to transcend. And the reason they don't get to transcend is because they didn't do the work in order to transcend. It's something that you've got to work on. For example, I've got therapists back in the day. I found out that one or two of them didn't have their own therapist. And I told them they had a week to get their own therapist or they were gone.
Because you can't give something away that you don't have. Okay? Same type of thing.
I think being transcended, as you put it, also requires a certain level of respect and maintenance. I do know that, heaven forbid, you don't maintain routines that brought you there that you can fall back. Absolutely. And that's what I mean by never fully recovered, in my opinion. I think that it's something that you can get to, but I do think you need to maintain it.
Well, you need a healthy lifestyle, right? So when I wake up in the morning and I roll out of the rack and I do my prayers and I get quiet for five minutes... I get in the shower, I come out, I work out. Don't worry, I don't get sweaty because I don't do it hard enough. And I take my medication, I give myself my shot, and I have my coffee and go to work. Now, that's my routine in the morning.
It's been my routine now for 15 years. At least.
Can you imagine what would happen if you didn't have that routine for a year? Yeah, I'd go insane because if you don't move your body, you get sick. And that's my point is that you always have to work at it. And I think that's something that people get to have to know. You don't just get somewhere and now you're fine, right? Look, you're in great shape, aren't you? You're in great shape.
For 59, I'm not pissed. Well, just for a human, you're in great shape. That requires maintenance. If you don't maintain that, it's going to go away. Right. And that's the point. There is a gray area here. There's color. It's not just recovered and not recovered. There's something more here. There's a process. Good. Okay.
We're saying the same thing. We are. Different ways. Beautiful. Well, that's how people learn, right? They hear it in different ways and they get clarity. Clarity is power and then they can use it, can actually be applied. Do you ever get pushback from other doctors like, who does this guy think he is? What's he doing?
Yes, I do. You're an example. I like to stay partially employed and contracted. I do what I think is best. Wait, you work for yourself. I do work for myself.
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Chapter 5: What are the implications of functional medicine in therapy?
exhausted all of your remedies and you would have had the conversation with them. But I'm just assuming that doctors, a lot of them have got complexes, right?
Yes. And I try to put mine in check all day, every day. I look in the mirror and I try to make sure it's not my baggage. But at the end of the day, yes, I've gotten there and I have taken people that I have been with me for years out of treatments to different places that I thought were better for them because the team wasn't aligned in a collaborative approach. That's right.
That's exactly right. The client is my boss and that's how I do it.
But you have a therapeutic alliance with your client. Absolutely, I do. So, due to the fact that you are the psychologist and he's got medical doctors or whatever the hell he's got, right? You're the psychologist, you're the one with the therapeutic alliance, you're going to get what you want.
i want an egalitarian approach where the client learns to trust themselves and i don't tell them what to do with their own life i don't want them dependent on me i want them to leave me eventually and come back later and if they need maintenance work with me that's fine but that's where it ends i am not an enabler and i will never be that therapist that's a grandmother that's sitting there petting someone who's stuck in the same circle their whole life
What are the five pillars, the five things you build every person around when you're rebuilding a life? And that's a horrible question. You don't have to have five pillars. You could have two or three or whatever it is. Yeah.
Five pillars or two or three. I think one. I think I have to look at, first of all, where they came from and what it is that they want in order to build a proper foundation. To me, that means a strong support system, A. No support system, forget it.
Well, don't you create the support system?
I try.
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Chapter 6: How can understanding premorbid intelligence aid recovery?
was only a few versions ago that women having a job was a disorder shut up no i'm not shutting up i missed it yeah okay and okay it's like a bunch of white dudes get together in a room and say here's what everything is no it's for insurance it's diagnostics are meant to guide clinicians but What if our obsession with diagnosis is what's stopping us from getting better?
And I'm a glorified diagnostician, but I try to practice functionality first. What does this mean functionally? And I'll share a small story if you permit me to. I would love you to. I started out in the field, 18, studying music, musician, state run home, adolescent kids. I met a kid and we built a very strong attachment. At that time, he was 11. He was nonverbal, no eye contact.
He had diapers and I learned how to change his diapers. His hands were pretty bruised because he, you know, self-injury. He was hitting himself. They told me he would never talk. They told me that he just was what he was. And I just worked with what I got. I sang to him. I changed his diapers. I helped prepare his food. And... How old were you? 18. And...
we got to a point where one day as I was changing his diapers, I blew up the rubber gloves into balloons. And he took these gloves and he started hitting them. So it became a ritual where every day I changed his diaper and every day he would take the glove and hit them. Now, fast forward a year later, bruises are gone, fine, he's hitting these gloves.
They're telling me that this home is closing and I have to say bye to this kid. Now you have to remember I'm so unevolved at this point. It was a very, very delicate time for me. I was attached to this kid. I didn't know how to say bye. I went to go make him a balloon. as a parting gift one final time. There were none left.
I broke down, you know, snotty 18 year old kid with like a Jufro looking, you know, completely unprofessional. He took my hand. You know, which that on his own was special because he doesn't touch people. He took my hand. He took me to his closet. He looked at me and he said, OK. He talked. He said, OK, for the first time. And then he opened up his closet.
There were like 300 freaking balloons in that closet. He kept every single one. He gave me one. That moment, like that made my, I was like, I'm addicted. I want to do this for the rest of my life. That's how I got started. I love that.
I love that. What's the one thing you believe about the human brain that most of your colleagues would roll their eyes at? Don't worry. I get that all the time. Okay.
I believe that there are senses that we're unaware of. I believe that intuition is greater than you know. I do believe in a higher power. I don't believe that everything is science. I believe there's some things you just don't know. And I do believe that there are things that some people are able to do that some people aren't. I don't think I don't think science explains everything.
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