Step
#
13
Suboxone Enhanced,
Empowerment Training
Mondays, Tuesdays, Wednesdays, 3 PM;
Thursdays, 3:30 PM; Saturdays, 11 AM
2300 S. Broad St Philadelphia, PA 19148
(215) 285-0832
Sponsored by the
National Association
Substance Abuse Prevention and
Treatment
Presented by Alan L. Summers, MD, Ph.D.
1|Page
Table of Constants
Preface
Author’s background.
Reason for writing this book.
Future of Psychiatry.
Acknowledgments
Stephen Stall Milton H. Erikson. Warren Hampe.
Laurence Konigsburg.
Linda Rappaport.
Staff, present and former patients. Marilynn Jacquer
Summers.
Chapter I -- Introduction
Introduction to Systems Theory.
Freud’s Theory Revisited.
Chapter II – New Horizons
CT Scans & Cortical Thinning.
Theory
NeuroCybernetics.
EEG.
Volterra’s Equations.
PET Scan Data.
Stall’s Neuroreceptor
Chapter III – Etiology of Addictive Disease
Role of Early Life Trauma. Damage to Neuroreceptor System.
Socioeconominic Factors. Genetic Factors.
Cortical Damage.
Chapter IV – Basic Concepts
Subliminal Flashbacks. Attribution. Unpardonable Guilt & Core Myth.
Principle of Discordance. Relapse Cycle & Meta Cycle. Driver Mechanism
Unconscious Driver Mechanism. Transactional Analysis,
Chapter V – Neurocyberntics – Cognitive Level.
Part I
Core Myth. Trigger. Reality View, Victim Tape. Subliminal Flashback. Core
Pain. Problem Attitude. Life Script & Script Crash. Hang-ups, Basic Operating
Position. Something to Prove. Operational Fallacies.
Part II -- Psychomap
Chapter VI -- Counterfeit Realities
Part I -- Elements
Attribution. Sibling Rivalry. Identification with the Aggressor.
Flashback Relay System. Cognitive Lacuna
Deflection.
Part II – Versions
2|Page
Surrealism Sad o-masochism Street Addict. Unknown Legend. Death Trip.
Sexual Regression Thrill Seeking Insensate Romanticism Spiritualism
Mission
Chapter VII – Mapping of the Neurorecptor System
Adrenergic
Cholinergic
Chapter VII -- Neurodynamics
Volterra’s Equations
Chapter VIII – Concomitants
Opiate Addiction. Panic Disorder. Intermittent Explosive Disorder. PTSD.
Major Depression. Borderline Personality Disorder. Obsessive- Compulsive
Disorder
Chapter IX -- Treatment
Part I -- Neurological
Least Harm vs. Traditional Approach
Part II -- Psychological
Least Harm vs. Traditional Approach
…
Part III --
Hypno-meditation.
Part IV –
Psych-educational Process (PEP)
Part V -- Tools
Concern Sheet
Preautherizations Tracking Log. Telephone Call Tracking Log
Twitter & Email Tutorial Program.
Psychomap Inventory. Internet
Applications & Social Media
Chapter X – Legal Aspect
Regulatory
Malingering & Dealing.
Politicization
DEA.
Chapter XI – Research & Future Directions
Game Changer Multivariable Analysis.
Cocaine Addiction
treatment of ADHD. CT PET Scan. EEG.
Non-stimulant
Covers
Front
Back
3|Page
Preface
Author’s background.
Reason for writing this book.
Future of Psychiatry.
Acknowledgments
Stephen Stall Milton H. Erikson. Warren Hampe.
Laurence Konigsburg.
Linda Rappaport.
Staff, present and former patients. Marilynn Jacquer
Summers.
Chapter I -- Introduction
Introduction to Systems Theory.
Freud’s Theory Revisited.
Chapter II – New Horizons
CT Scans & Cortical Thinning.
Theory
NeuroCybernetics.
EEG.
Volterra’s Equations.
PET Scan Data.
Stall’s Neuroreceptor
Chapter III – Etiology of Addictive Disease
Role of Early Life Trauma. Damage to Neuroreceptor System.
Socioeconominic Factors. Genetic Factors.
Cortical Damage.
Chapter IV – Basic Concepts
Subliminal Flashbacks. Attribution. Unpardonable Guilt & Core Myth.
Principle of Discordance. Relapse Cycle & Meta Cycle. Driver Mechanism
Unconscious Driver Mechanism. Transactional Analysis,
Chapter V – Neurocyberntics – Cognitive Level.
Part I
Core Myth. Trigger. Reality View, Victim Tape. Subliminal Flashback. Core
Pain. Problem Attitude. Life Script & Script Crash. Hang-ups, Basic Operating
Position. Something to Prove. Operational Fallacies.
Part II -- Psychomap
Chapter VI -- Counterfeit Realities
Part I -- Elements
Attribution. Sibling Rivalry. Identification with the Aggressor.
Flashback Relay System. Cognitive Lacuni
Deflection.
Part II – Versions
Surrealism Sad o-masochism Street Addict. Unknown Legend. Death Trip.
Sexual Regression Thrill Seeking Insensate Romanticism Spiritualism
Mission
4|Page
Chapter VII – Mapping of the Neurorecptor System
Adrenergic
Cholinergic
Chapter VII -- Neurodynamics
Volterra’s Equations
Chapter VIII – Concomitants
Opiate Addiction. Panic Disorder. Intermittent Explosive Disorder. PTSD.
Major Depression. Borderline Personality Disorder. Obsessive- Compulsive
Disorder
Chapter IX -- Treatment
Part I -- Neurological
Least Harm vs. Traditional Approach
Part II -- Psychological
Least Harm vs. Traditional Approach
…
Part III --
Hypno-meditation.
Part IV –
Psych-educational Process (PEP)
Part V -- Tools
Concern Sheet
Preautherizations Tracking Log. Telephone Call Tracking Log
Twitter & Email Tutorial Program.
Psychomap Inventory. Internet
Applications & Social Media
Chapter X – Legal Aspect
Regulatory
Malingering & Dealing.
Politicization
DEA.
Chapter XI – Research & Future Directions
Game Changer Multivariable Analysis.
Cocaine Addiction
treatment of ADHD. CT PET Scan. EEG.
Non-stimulant
Covers
Front
Back
5|Page
6|Page
7|Page
Table of Constants
Preface
Author’s background.
Reason for writing this book.
Future of Psychiatry.
Acknowledgments
Stephen Stall Milton H. Erikson. Warren Hampe.
Laurence Konigsburg.
Linda Rappaport.
Staff, present patients and graduates. Marilynn Jacquer
Summers.
Chapter I -- Introduction
Introduction to Systems Theory.
Freud’s Theory Revisited.
Chapter II – New Horizons
CT Scans & Cortical Thinning.
Theory
Neuropsychomechanics.
EEG.
PET Scan Data.
Volterra’s Equations.
Stall’s Neuroreceptor
Chapter III – Etiology of Addictive Disease
Role of Early Life Trauma. Damage to Neuroreceptor System.
Socioeconominic Factors. Genetic Factors.
Cortical Damage.
Chapter IV – Basic Concepts
Subliminal Flashbacks. Attribution. Unpardonable Guilt & Core Myth.
Principle of Discordance. Relapse Cycle & Meta Cycle. Driver Mechanism
Unconscious Driver Mechanism. Transactional Analysis,
Chapter V – Neuropsychomechanics – Cognitive Level.
Part I
Core Myth. Trigger. Reality View, Victim Tape. Subliminal Flashback. Core
Pain. Problem Attitude. Life Script & Script Crash. Hang-ups, Basic Operating
Position. Something to Prove. Operational Fallacies.
Part II -- Psychomapping
Chapter VI -- Counterfeit Realities
Part I -- Elements
Attribution. Sibling Rivalry. Identification with the Aggressor.
Flashback Relay System. Cognitive Lacuna
Deflection.
Part II – Versions
8|Page
Surrealism Sad o-masochism Street Addict. Unknown Legend. Death Trip.
Sexual Regression Thrill Seeking Insensate Romanticism Spiritualism
Mission
Chapter VII – Mapping of the Neurorecptor System
Adrenergic
Cholinergic
Chapter VII -- Neurodynamics
Volterra’s Equations
Chapter VIII – Concomitants
Opiate Addiction. Panic Disorder. Intermittent Explosive Disorder. PTSD.
Major Depression. Borderline Personality Disorder. Obsessive- Compulsive
Disorder
Chapter IX -- Treatment
Part I -- Neurological
Least Harm vs. Traditional Approach
Part II -- Psychological
Least Harm vs. Traditional Approach
…
Part III --
Hypno-meditation.
Part IV –
Psych-educational Process (PEP)
Part V -- Tools
Concern Sheet
Preautherizations Tracking Log. Telephone Call Tracking Log
Twitter & Email Tutorial Program.
Psychomap Inventory. Internet
Applications & Social Media
Chapter X – Legal Aspect
Regulatory
Malingering & Dealing.
Chapter X – Practical Considerations
Office Protocol Contacts
Politicization
DEA.
Internet Psychiatry
Chapter XI – Research & Future Directions
Game Changer Multivariable Analysis.
Cocaine Addiction
treatment of ADHD. CT PET Scan. EEG.
Non-stimulant
Covers
Front
Back
9|Page
10 | P a g e
Preface
Author’s background.
Reason for writing this book.
Future of Psychiatry.
Acknowledgments
Stephen Stall Milton H. Erikson. Warren Hampe.
Laurence Konigsburg.
Linda Rappaport.
Staff, present and former patients. Marilynn Jacquer
Summers.
Chapter I -- Introduction
Appendix II -- Origin of the 13th Step Method
Dr. Summers began his professional career as an electrical engineer, graduating the University of Pennsylvania’s
Moore School in 1965. He spent the next five years employed by the Harrison Department of Surgical research,
University of Pennsylvania, designing and building an apologues computer to measure blood flow through the
heart. At the same time he completed a Master’s Degree in Biomedical Engineering, also at the Moore School.
This background in engineering science, mainly a training in Mathematical Physics, would come in later
when he became interested in psychiatry which also dealt with abstract concepts, particularly Freud’s
theory of the unconscious mind.
One other important aspects of an engineering training is that one is taught to think in terms of things
happening as a result of interactions between components of a multidimensional system – again an
abstraction, but this time one which deals with a highly complex processes with many interacting
components.
In adding the theory of systems into the equation with the unconscious mind, it became possible to
develop a systems theory for the human psyche. This, then, became the basis of a new model for
psychodynamics in a mathematical language known, mainly, to engineers and physicists.
At the hub of this system is the core myth, an erroneous idea developed in early childhood, usually the
result of a major emotional trauma. The core myth eventuated in a 12 – element system including:
fallacies, hang-ups, game changers, defense mechanisms such as ‘needing to prove something’, life
script, victim tapes, cover story, live view, subliminal flashbacks to the early life trauma with a resulting
blast of core pain emanating from the trauma.
Later, teaching Crisis Intervention to Philadelphia police and to students at Temple University, he observed that his
students (in learning to think in terms of a new language) were performing a form of self-therapy. This self-therapy
phenomenon gradually evolved into Step #13, a novel treatment of addictive diseases.
Dr. Summers continues to evolve his model to the point where he has been able to develop new
strategies for the treatment of panic and rage attacks. Panic attacks, in his model, are caused by
subliminal flashbacks occurring after a sufficiently strong trigger, bring to the fore the core pain
emanating, by way of the flashback, from the early-life trauma. Confused as to where the blast of
emotion is coming from, and feeling out of control, the person panics.
11 | P a g e
The rage attack is simply an oncoming panic attack that is deflected by confronting the individual or
situation that triggered the flashback. Aside from panic and rage attacks, opiate dependent individuals
will resort to taking illicit substance to control
Dr. Summers gradually refined his theory during his residency in psychiatry at Temple University Hospital. There,
he began to think in terms of neuro-receptors that form a complex system of interacting bundles of nerve fibers.
When he became involved in the treatment of opiate addiction using Suboxone, he began to see, not only the
opiate receptor involved in the etiology of addictive behavior, but also the GABA receptor involved with the
addicts panic attacks.
Since, he found, that close to 100% of his patients had panic attacks, and 50% with rage attacks. The GABA
receptor was, in his analysis, also dysfunctional in the brain of the addict.
Where Suboxone was a medication that targeted the opiate receptor, he soon found that a benzodiazepine such as
Klonopin was instrumental in the treatment of opiate addiction. Not only were Klonopin and Suboxone,
concomitantly helpful to these patients, but that one medication boosted the effects of the other if both were
given above the usual dose range.
At this point, his treatment of addiction posed a dilemma; his use of these medications at the dosage
rage where they were found to be most effective, was diametrically opposite to the thinking of most, if
not all of the medical community. He knew that he had to make a decision, either conform to
conventional thinking or risk consequences at the hands of Medical Board, and even criminal justice
institutions. His choice, based on the outstanding reports coming from his patients, he was determined
to move forward,
This past May, Dr. Summers spoke at the Annual Meeting of the American Psychiatric Society, for the third time,
where he was received with interest and encouragement. He continues to work on his systems theory of
psychodynamics, and is moving toward an explanation as to what is happing, neurologically and psychologically,
when a woman can walk out of a prison after three years, determined to begin a new life, and suffers a relapse the
same evening. This then, has resulted a new endeavor, developing a Systems Theory of the ‘Game Changer’.
Neuropsychomechanics
A new formulation, utilizing Systems Theory, is in the process of development, unifying psychoanalytic theory, the
action of neuroreceptors, MRI data, and behavior. Psychiatric entities that are characterized by cyclic events (e.g.,
Bipolar Disorder, Addiction, Substance, Sado-masochism, Marital Dysfunction, Criminal Behavior) may be better
understood using this approach, and a more precise use of medications to treat these entities may be developed.
Hypothetical Considerations
There are a number of way to depict psychological events. The
most familiar being the DSM – 5 in which symptom
constellations are formulated into diagnostic categories; from
there, the provider refers to textbook accounts as to how these
diagnostic categories should be treated. If the psychiatric entity is
treatment refractory, the psychiatric literature may provide
alternative approaches.
For this new approach, symptomology is translated into (1)
neurorecptor dysfunction, (2) history of emotional trauma of both
12 | P a g e
the patient and his primary support system, (3) cultural factors,
(4) genetic factors, and (5) cognitive impairments, (4) other
personality factors, and MRI data which shows damage in
specific areas relating to early life trauma.
Volterra’s Equations
This approach is made possible by virtue of a non-linear calculus,
originating from Volterra’s Equations, This calculus describes the
result of two conflicting populations, for example perona fish
enclosed in a body of water with minnows. The minnows live
exclusively on algae; and the perona’s live exclusively on
minnows. Volterra’s equations predict the two populations will
cycle at regular intervals, but that there will be long quiescent
periods in which neither fish scarcely make an appearance.
Systems Theory Representation of Dysfunctional Marriage
The Failing Marriage is a film that depicts a young married
couple, Carolyn and Charley, are enmeshed in argument
regarding bringing Nicky, Carolyn’s sister, home to live with the
couple for a time. Charlie is adamantly opposed to the plan, and
Carolyn, secretly, doesn’t want Nicky to live with them either, but
sets Charley up as the bad guy, so that she doesn’t have to feel
guilty. During the argument, Carolyn assumes the role of Nicky’s
protector, but takes the position of controller with Charley. When
Carolyn can’t make any headway as a controller, she switches to
martyr. Charlie, on the other hand, starts off as a dictator, but
when Carolyn switches to martyr, Charlie then counters in the
Bully position.
Systems Theory has been successful in describing the dynamic
depicted in the film, The Failing Marriage. In order to conform
the dynamics of the interaction with Volterra’s equations, a
‘missing link’ had to be accounted for. What was needed, in order
to make the mathematics describe the dynamics was an
unexpected factor that was responsible that would account for
Carolyn making the switch from Controller to Martyr. What
made most sense was the introduction of a new entity,
discordance. As it turns out, that Carolyn finds herself in a fightvs. flight double bind: if she fights, she is intimidated by Charlie
and disrupts her relationship with him. On the other hand, if she
moved into a flight response, she feels disloyal to her sister, and
humiliated by having to back down to Charlie. This double bind,
then, turns out to be an unexpected, although significant factor in
the dynamics of the interaction.
.
Personality Map
be tracked, and new focuses of treatment can be identified and
worked on.
In order for the personality map to be maximally by useful, it
needs to have the linkages between personality factors defined by
a rule system consistent with the mathematics (i.e., Volterra’s
equations) for which we can find solutions.
MRI Data
The entire soma, point for point, is mapped on the central gurus,
parietal lobe. It is intriguing to think that it may be possible, at
some future time, to discover a personality map on the cerebral
cortex. There is significant evidence that certain elements of the
psyche are mapped on the cortex For example there are areas of
damage on the hippocampus in patients who have suffered early –
life sexual abuse, and damaged areas on the left temporal lobe in
patients who have suffered early-life emotional abuse. This data
alone, suggests a neuronal basis for panic attacks eliminating
from the hippocampal area, and rage attacks emanating from the
left temporal lobe. Future studies, including PET scan data
conceivably contribute to a replica of the personality map
transposed onto the cerebral cortex. As information to this effect
is gleaned, it could be included into Systems Theory and utilized
for diagnostic and treatment purposes.
PTSD / Receptor Disease Model of Psychiatric Entities
Presently, the standard of care is to collect a history and physical,
together with a mental status examination, and ascertain a
diagnosis via the DSM-5. The treatment recommendation then is
sought from an appropriate discussion from an appropriate
textbook or journal article. In the future, rather than arrive at a
DSM-5 diagnosis based PE, H&P, but an analysis of receptor
activity based on similar data, PET & MRI data,
endocrineological testing, psychological testing, and multifactor
analysis based on computer models.
Treatment, then, would be aimed at ameliorating receptor
dysfunction, and psychotherapy aimed at dysfunctional thought
process, education, and assisting the patient deal with issues
relating to PTSD.
Thus there may, at some time in the future, be a major shift in
thinking; one that focuses on PTSD and receptor dysfunction, but
syndromes that result from a dysfunctional system of many
elements.
Related Discussions
While Systems Theory can be helpful in describing interpersonal
dynamics, the construction of a personality map can afford an
opportunity to track interpsychic events that are responsible for
symptomology evident in Major Depression, PTSD, Anxiety
Disorder, Addiction, and Personality Disorders. Furthermore, as
treatment progresses, the personality factors that are remedied can
Concomitant Benzodiazepines. Particularly regarding the use of
benzodiazepines in the treatment of opiate addiction, there is a
strong bias against using a habituating drug as a part of the
treatment regimen. If the objective becomes harm reduction,
however, and the focus on rectifying a dysfunctional system of
neuroreceptors, one may see that benzodiazepines can play a
13 | P a g e
pivotal role in a population of persons who are afflicted with rage
attacks and panic attacks.
constructs that are derived from such. We have already seen that,
in using mathematical modeling, that the investigator is force to
look for dynamic entities that may not be immediately obvious
Panic Disorder and Intermittent Explosive Disorder, both of
which are concomitant illnesses in opiate addiction, leave the
patient particularly vulnerable to relapse. With the current
philosophy being absence from all substances, medical or
otherwise, as the goal of treatment, it is no surprise that the
recovery rate for individuals who see misguided absence from all
chemicals at about 5%. From the point of view of opiate addiction
based on an underlying PTSD and receptor disease dysfunction,
one would no more subject the patient to abstinence from a
medication so effectuations as Suboxone, than one would subject
a type II diabetic to a regimen with a goal of abstinence from
insulin.
Subliminal Flashbacks. Systems Theory, based on PTSD as the
foundation of panic disorder introduces a new element in the
etiology of this ailment, the subliminal flashback. The individual,
according to this model, has suffered a devastating early life
trauma that, for the most part is suppressed. Given an appropriate
trigger, a partial flashback takes place, bombarding the individual
with an overpowering blast of emotion without any obvious
source (since the flashback itself is subliminal). The individual
imagines he is suffering a catastrophic heart attack and panics.
Once the individual is educated, and finally convinced or the
flashback hypothesis, his panic attacks generally abate, an
eventually disappear.
Intermittent Explosive Disorder. Systems Theory also provides
an explanation for rage attacks as the psyche’s attempt to deflect
the panic attack by misinterpretation the individual who triggered
the flashback as perpetrating a deliberate act of aggression. This
justifies retribution on the part of the afflicted individual who then
feels justified in launching a vicious counter attack.
Character Disorder. Systems Theory results in a depiction of a
personality mapping process which has, at its hub, an entity
dubbed the core myth. The core myth is a negative belief one
holds regarding his self-worth; the bulk of his conscious energy is
then spend disguising the negative inference, or overtly denying
it. The outcome of a psyche obsessed with reconciling with this
erroneous belief is essentially a character disorder. The treatment
of character disorders based on the core myth is what has been
called a cybernetic analysis in which the individual teases apart
the elements that reinforce the core myth and then utilizes a
dialectic, cognitive behavioral approach to break away the
structures that support the central element, the core myth.
Conclusion
It is not likely that there will be abrupt chances in psychiatric
practice in the near future. What could be accomplished in the
near-term is a teaching machine that simulates certain entities,
and a new language based on Systems Theory and the visual
14 | P a g e
1 Incorporating PET scan data into Psychoanalytic theory, using Network Theory in Order to Devise a Treatment Strategy for Psychiatric
Illness, Alan L. Summers, MD, PhD. American Psychiatric Association Annual Meeting – New York. May 5th, 2004.
2 Harm Reduction Approach and the Concomitant Use of Benzodiazepines in the Treatment of Opiate Addiction. Alan L. Summers, MD,
Ph.D. Unpublished.
3 PTSD / Neurorecptor Disease Mode in the Treatment of addictive Disease. Alan L. Summers, MD, Ph.D. Unpublished.
4 Treatment of Panic Disorder as a Variant of Post-traumatic Stress Disorder. Alan L. Summers, MD, Ph.D. Unpublished.
5 Cybernetic Analysis. Alan L. Summers, MD, Ph.D. Unpublished.
6 Step #13 – The Future of Addiction Treatment. Alan L. Summers, MD, Ph.D. Unfinished.
7 of Diagnosis and Treatment of Psychiatric Illness Utilizing Systems Theory. Alan L. Summers, MD, Ph.D. Unpublished,
Volterra’s Equations.
Freud’s Theory Revisited.
Chapter II – New Horizons
Presented by Alan L. Summers, MD, PhD to the American Psychiatric Association Annual
Meeting - New York. May 5th 2014
INCORPORATING PET SCAN DATA INTO PSYCHOANALYTIC THEORY,
USING NETWORK THEORY IN ORDER TO DEVISE A TREATMENT
STRATEGY FOR PSYCHIATRIC ILLNESS – ABSTRACT g - New York. Presentation:
May 5th 2014
Addiction is a consequence of both a Post-traumatic Stress Disorder and Brain Receptor Disease.
Treatment, then, must cover both the psychological and neurological dimensions.
A trauma, usually occurring early in life, results in a negative self-view which dramatically impairs
the individual’s ability to function at the workplace and in relationships. This negative self-view is referred
to as the ‘core myth’. Examples of core myths are: “Underneath it all I am …a failure …worthless …bad
and evil …never able to control of my world …don’t belong …unlovable …doomed.” An individual, of
course, may have more than one core myth. Treatment, then, is aimed and disempowering the core
myth.
Having subjected oneself to large doses opiates and other chemicals over a period of years result in
damage to cortical structures, including brain receptors. Not only are opiate receptors disregulated, there
is also a disruption of receptors that include GABA (anxiety), serotonin (depression), NMDA (memory),
dopamine (attention), noradrenaline (initiative), oxytocin (bonding), and others.
Along with psychotherapy, treatment then, must include a medication regimen that reregulates
affected receptors.
15 | P a g e
Systems Theory
Psychiatry of the future may incorporate mathematical models, utilizing Systems Theory (ST) in the
diagnosis and treatment of disease entities. PET scan data of individuals suffering from PTSD revealed hyper
metabolic foci in both prefrontal lobe and hippocampus. These foci suggested a linkage to abnormalities in
behavior and cognition. I.e., (1) abnormalities in impulse control were associated with the focus in the prefrontal
lobe and (2) abnormalities in memory function were associated with focus in the hippocampus. This conjecture,
was then incorporated into psychoanalytic theory. The subsequent Systems model resulted in a successful
treatment strategy utilizing CBT in a group therapy setting.
Panic & Rage Attacks
Systems Theory has been most helpful in promoting the understanding and treatment of panic and rage
attacks. Both panic and rage attacks are seen as a manifestation of a sub-clinical Post-traumatic Stress Disorder;
where trauma, usually, occurred in early life. Given a sufficiently intense trigger, a partial flashback takes place in
which only the emotions of the early-life trauma are re-experienced. There is no memory of the trauma at the
time, nor is there an awareness of the fact that a flashback is occurring. For this reason, the phenomenon is
referred to as a 'subliminal flashback'. In the case of the panic attack, the emotion comes in as a sudden blast,
seemingly from 'out of the blue'. The individual experiences an inordinate sense of loss of control, and generally
believes he is about to die. In the case of the rage attack, the individual launches an attack in the individual who
triggers the flashback, thereby deflecting the incoming emotional blast, and regaining the illusion of control.
Treatment for both of these conditions include medication, insight oriented therapy, and operant conditioning
such that the afflicted individual trains in the response to a trigger."
Conclusion
Systems Theory presents a way of interlinking brain scan data with psychoanalytic theory, and evolving a
mathematical model that will suggest the use of specific medications in accordance with their neuro receptor
affinity. The model also has the capacity of incorporating observed behavior and the results of psych testing. This
may be the first serious attempt to evolve psychotherapy in the direction of a new science, Neuro Psychiatric
Engineering.
CT Scans & Cortical Thinning.
Theory
EEG.
PET Scan Data.
Chapter III – Etiology of Addictive Disease
Stall’s Neuroreceptor
Role of Early Life Trauma. Damage to Neuroreceptor System.
Damage. Socioeconominic Factors. Genetic Factors.
Chapter IV – Basic Concepts
Cortical
Subliminal Flashbacks. Attribution. Principle of Discordance. Relapse
Cycle & Meta Cycle. Driver Mechanism Unconscious Driver Mechanism.
16
Transactional Analysis. Unpardonable Guilt & Core Myth – Equilibrium by
Failure
Chapter V – Neurocyberntics –
Part I-- Cognitive Level.
Psychomap -- Core Myth. Trigger. Reality View, Victim Tape. Subliminal
Flashback. Core Pain. Problem Attitude. Life Script & Script Crash.
Hang-ups, Basic Operating Position. Something to Prove. Operational
Fallacies.
Part II -- Neuronal Level.
Chapter VI -- Counterfeit Realities
Part I -- Elements
Attribution. Sibling Rivalry. Identification with the Aggressor.
Deflection. Flashback Relay System. Cognitive Lacuna
Part II – Versions
Surrealism Sad o-masochism Street Addict. Unknown Legend. Death
Trip. Sexual Regression Thrill Seeking Insensate Romanticism
Spiritualism Mission
17
Chapter VII – Mapping of the Neurorecptor System
Adrenergic
Cholinergic
Chapter VII -- Neurodynamics
Volterra’s Equations
Chapter VIII – Concomitants
Opiate Addiction. Panic Disorder. Intermittent Explosive Disorder. PTSD.
Major Depression. Borderline Personality Disorder. Obsessive- Compulsive
Disorder
Chapter IX -- Treatment
Part I -- Neurological
Least Harm vs. Traditional Approach
Part II -- Psychological
Least Harm vs. Traditional Approach
Part III -Part IV –
Hypno-meditation.
Psych-educational Process (PEP)
Part V -Tools
Concern Sheet
Preautherizations Tracking Log. Telephone Call Tracking
Log Twitter & Email Tutorial Program.
Psychomap Inventory. Internet
Applications & Social Media
18
Chapter X – Legal Aspect
Regulatory
Malingering & Dealing.
Politicization
DEA.
Chapter XI – Practical Considerations
Office Protocol
OFFICE PROCEEDURE PROTICAL
Russell – Take numbers at door of group room as patients come in, and take seat in group room.
Make sure they get number on post-it, as well. and also put number on urine paper and concern
sheet. Even if they come in after group starts, a new number sheet is started, beginning at 100.
They are given concern sheet at front desk as well as post it. They can give urines while waiting
for group to end, and hand in money.
Before Group Ends; Process stragglers who come in with urines, concern sheets, prescription
templates; write number (all numbers will be over 100, at this point) on all sheets. Collect
money, staple to concern sheet. Have them wait in office area until group ends, if too many
people are waiting, send them outside and have them come back after group ends.
After Group Ends: Front office is cleared- everyone goes into group room. Guard continues to
give out numbers as stragglers come in, but no further paperwork will be done; they will be sent
into group room. All people who come in after group starts, get numbers beginning with 101.
After Group Ends, Front Desk calls in patients 1 – 10 who are to come into front office
only if their paperwork needs to be completed; only these patients are permitted in front
office; guard makes sure of this, but stragglers will continue to come in front door, they are
assigned numbers as they come in and are sent into group room without processing.
Once 1 – 10 are processed, person at front desk, front desk will now see 11 – 20, etc, only if
their paperwork needs to be completed . Front desk will not begin working unless everyone is
seated (It will take about 10 min before the uncooperative patients catch on that they are holding
everyone up). Do not get involved in yelling, or reprimanding patients. If patients who are seated
are yelling at uncooperative patients, then this is not allowed either and no paperwork will be
processed while patients are yelling at other patients.
Patients are permitted to stand, only if they are in line to use the bathrooml
Collection of Money: stapled to concern sheet along with receipt copy; patient is given receipt
(receipts won’t start until next week). Concern sheets are put in number order, and are numbered
and put together with prescriptions that are also numbered. Paper work is put in pile in number
order.
Labs: are either gotten by FAX, gotten off the Internet, or have been delivered already and can
be found in boxes in file room. They are given numbers, or ae re-numbered and put together with
other paperwork which is accumulated and kept in number order.
New Hard Copy Files: will gradually be re-made. Old number will be crossed off, and new
number will be written on front of folder, and put with other paperwork, which is kept in number
order. Once old files are returned, these may be renumbered, and put with other paperwork from
patient. Do not put new paperwork in old file.
Patients who have preauth problems will fill out a preauth sheet when they are being
processed at the front desk, put number on preauth sheet, and hand it in to front desk, to be put in
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file in number order, Peter, or person doing preauths will collect pile of preauth complaint sheets,
enters group room, waits until people are seated and quiet, and ask for person who has lowest
number on preauth complaint sheet (to come with him into his office).
Once he has done this person’s preauth while they watch, he calls the next person in, and so
forth. Peter will be given assistant who will log in information into preath log.
Peter will look up preauth problems on Big Messages and process them once he has finished
with patients who are present. .Assistant will log in, preauth log, text or call back patients to let
them know what’s happening.
Peter will go t current preauth log, list patients in order of upcoming preauth dates. Copy preauth
dates from column, and copy them into present date, select all the patients with upcoming
preauths, and paste them at the end of the current preauth log, all put in in RED font. This is now
the new preauth list, and preauths can be done ahead of time.
Usher- Copy each prescription after it is signed by doctor. Make sure number is on prescription
and doctor has filled out number of tablets correctly.
Trained to do Pre-authorizations: Star, Bonnie, Crystal, are to be trained by Jannet, including
filling out preauth log. If Peter cannot finish preauths before end of working day, or it looks like
he won’t be able to, back up staff will compete preauths. Once the backup system is in place,
Peter will log in preauths, or will continue to have his assistant log in preauths.
Telephone Calls. Will be forwarded to Big Messages, logged in on telephone log, and caller will
be texed regarding what is being done. We may have one person assigned to call back patients. If
staff is available, we will take incoming calls in office during office hours, but make sure that if a
call comes in while staff is on phone, the call will go to voicemail. Make sure all voicemail calls
have been listened to, logged in and voicemail cleared before staff leaves for the day.
ALL PATIENT / STAFF ISSUES WILL BE RESOLVED WITH Dr. S PRESENT. Staff
will not attempt to resolve issues with patients that are not fully cooperative, argumentative,
hostile, or inappropriate. Staff will not discharge patients, reprimand patients, close door to
arriving patients, or refuse to accept new patient without the approval of Dr. S.
Telepsychiatry
Contacts
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Sylvia Mathews Burwell 877 696 6775 hotline; correspondence 202 690 6392. Email
sylvia.burwell@hhs.gov
Chapter XI – Research & Future Directions
Game Changer Multivariable Analysis.
Cocaine Addiction
stimulant treatment of ADHD. CT PET Scan. EEG.
Covers
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Preface
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