Head Inside Mental Health
Todd Weatherly, Therapeutic Consultant and mental health professional hosts #Head-Inside Mental Health featuring conversations about mental health and substance use treatment with experts from across the country sharing their thoughts and insights on the world of behavioral health care.
Head Inside Mental Health
Exploring the Neuroscience of Attachment with Dr. Norm Thibault
Join us as we explore the complex landscape of adoptive families, particularly those who face the unique challenges that come with raising adolescents with severe attachment issues with Dr. Norm Thibault, a leading expert in adoption and attachment. Dr. Thibault is the founding owner of shares groundbreaking insights from scientists like Dr. Nim Tottenham and Dr. John Balin, revealing how early developmental factors can shape a child's life well before they've taken their first breath.
Parents of adopted children often find themselves on an emotional journey, reconciling their expectations with their current reality. Our discussion touches on controversial topics like the "primal wound" and challenges the notion that adoption is inherently traumatic. We also venture into the enigmatic world of epigenetics, using historical examples to illustrate how prenatal conditions influence future behaviors. With references to polyvagal theory, we emphasize the power of creating safe, nurturing environments to help reverse these effects, advocating for trauma treatments that prioritize nonverbal communication and healing.
Finally, we tackle the significant hurdles within the DSM-5 when diagnosing and treating complex developmental trauma in adopted children. Dr. Thibault underscores the urgent need for systemic changes in insurance practices to ensure mental health care is accessible and effective. We also confront the profound theme of loneliness, exploring the innate human desire for connection and the metaphorical journey some undertake to find their true "home." This episode is a heartfelt exploration of the intricacies of adoption, attachment, and the search for belonging in a world that often feels disconnected.
Hello folks, welcome back to Mental Health Matters. On WPVM 1037, the voice of Asheville Independent and Commercial Free Radio, I'm Todd Weatherly, your host, therapeutic consultant and behavioral health professional. With me today, I'm thankful to say, is another Carolina boy.
Speaker 2:Yes, sir.
Speaker 1:Dr Norm Tebow is the founding owner and chief executive officer of Three Point Center residential treatment center exclusive to adopted adolescents. Dr Thiebaud is the recipient of the 2017 Bilardi Humanitarian Award of the American Adoption Congress and is the former two-term president of the Utah Association of Marriage and Family Therapy. Now I'll say that Three Point Center not only has a program in Utah, but right here in the south, just outside of Raleigh, north Carolina. Dr Thibault is a clinical fellow of the American Association for Marriage and Family Therapy and is an AAMFT-approved supervisor. He is a certified clinical trainer of attachment and trauma-focused family therapy. He's been taught extensively by Dr John Gottman and has presented polyvagal theory for adoptive families with Dr Stephen Porges, and he is completing his second term as president of the board of directors of the Association for Training and Trauma and the Attachment of Children training and trauma and the attachment of children the A-T-T-A-C-H dot org.
Speaker 1:Norm utilized all of these skills and he needed everyone, I'm sure, to marry the girl of his dream, meg. Together, they have five children and two granddaughters. How does that feel? And being a grandparent like? How does that feel, norm?
Speaker 2:No, you know what, todd? I love it. I'm telling you, they were over at the house last night and goodness it's just they just fill you up. There's some fantastic neuroscience studies now on the relationship with grandchildren and how our mirror neurons get in sync with them. And just fills you up. It's beautiful.
Speaker 1:Yeah, it's good, it's good to witness. Well, you know, norm, thank you and welcome to the show. You get introduced often as the prestigious Dr Tybo, but you know, I'm really grateful just to know you as Norm, as a decent guy that knows something about Carolinas back in the 80s.
Speaker 2:Can I get an? Amen brother, Can I get an?
Speaker 1:amen, yes, and I tell you, you know we hit this topic a little bit.
Speaker 1:You and I have worked together a little bit with a mutual client who, I'm grateful to say, just came out of your program and is doing exceptionally well these days, now a young adult herself. And this is a family that struggled with the topic I think you and I want to hit on. You know they were often quite distraught at the fact that, you know you got a child. They were adopted at birth, they were loving parents, they provided her with everything from nutrients to resources to education, everything that a growing child would need to be what we would say you know, well adapted and able to go out in the world. But came away, despite all of that, with lots of attachment challenges, lots of behavioral health challenges, you know, getting kicked out of school, getting in fights, doing all the kind of outwardly expressive behaviors and even and we're we're also talking about a child that even in treatment, went to multiple treatment programs and got kicked out of a couple, you know, assaulted staff. You know like she had, she had a history and came into your program and I think that one of the things that you were able to address with his family is that one of the things that you were able to address with his family is, you know why, why, why is she rejecting our love.
Speaker 1:You know what is it about. What is it about having had her and being an adoptive child from an environment and, of course, her particular situation. There's a brother involved. They were not, didn't get co-adopted, um, and so you know, there are elements of separation that can still occur in those scenarios. But just adopted from birth and still with all these kind of you know, specific to adoptees attachment disorder and attachment symptomology challenges that wreak havoc on this family system, like you say, we don't talk about this enough and I think lots of people want to know. The big question is why, why does that happen and where does it come from and what can we do about it? So I'm more than interested to hear your answer to some of that question at least.
Speaker 2:Thanks, todd, and let me just say what a delight it is for me to visit with you and to be on your show and to partner with you in helping kids. You are so well-respected and I am so grateful for this opportunity. From the bottom of my heart, thank you for allowing me to visit with you.
Speaker 1:Pleasure's mine Again. Carolina boys got to stick together.
Speaker 2:So you ask a great question, and it's a common question we get, which is you know, for example, my child was adopted at birth. Why might they afford food? Why might they be so reactive? And they've had everything they need. One of the things that we're learning through wonderful research from some colleagues like Dr Tim Nimtottenham, who is the director of the Neuroaffective Psych Lab at Columbia University, or Dr John Balin, who is a psychologist and author in neuroscience the research that we're getting speaks to the idea that our pre-birth environment plays a much larger role in the expression of our DNA than we ever thought. And so what does that mean?
Speaker 2:You know, when I was in graduate school and I won't say how long ago it was, todd, but when I was in graduate school you know, we talked about neural development and sensitive periods, right, and the sensitive period for neural development and attachment, which we thought about three months prior to birth to about age five.
Speaker 2:By the time I graduated, someone had said three months prior to birth to age four. Well, a couple of years ago I was at the Congress of Attachment and Trauma in Manhattan and they brought in leading researchers all over the world to discuss this. Some are positing that that sensitive period begins as early as five weeks post-conception, when you're first learning that you're pregnant, when you first miss a period up to about 20 to 24 months post-birth. Now, it's a sensitive period, which means optimally, things happen during that period of time Doesn't mean they have to, but what we're learning about epigenetics is that very sensitive period of time plays a significant role in the way that our DNA is expressed. And so you know, we know, that mom and dad come together, have a baby, dna is set, but the way it is expressed excuse me that is influenced by the environment that the birth mother carries the baby in, carries the fetus in.
Speaker 1:And, if I may, because I'm what you might call an armchair expert on epigenetics, which means I read a lot but don't participate. So you know, just for the audience out there, and because I think the world might not have a clear definition. They hear epigenetics and they confuse it with genetics. It's like, well, as you know, genetics is you've got this vast amount of material that's stored in your genetic code. Why does your grandmother have green eyes but you came out with blue eyes? Well, epigenetics is the thing that's the picker. It's like what part of the code am I going to read?
Speaker 1:And the thing that we're learning, that that you know the addictions the addictions treatment world can echo in the same way that you're echoing it here is that you know environmental influences and chemicals and substances and you know, and the availability, the availability of nutrients and resources in the whole nine yards that are occurring while a baby is in the womb are having an impact on the picker, the epigenetics, the thing that says, hey, what part of the code am I going to read? You can have a real impact on that thing in the womb environment. And continues, there's even evidence to suggest that you can have an impact on the epigenetics of an individual, even when they're in adulthood, and that sort of thing, which is that we won't go down the rabbit hole in the science that's being done about that stuff. But this is really fascinating to me and explains a lot of this question. In terms of treatment, though, what is it like? You're going to get this kid and maybe you know something about their, their, the womb environment in which they were, you know, birth?
Speaker 1:carried yeah carried, carried and eventually birthed. And you probably see a lot of folks that you know. Mom gives birth, adoption happens at that time, sometimes it happens after, but at the very least the mother and the child, the birth mother and the child, for the, for the, you know incubation period, the pregnancy period, they're in charge of that environment. And you know the other things that impact the chemistry of a person is are you experiencing psychiatric symptoms? Are you experiencing high levels of anxiety? Are you experiencing high levels of stress? These are all chemicals, you know, neurochemicals, that are having an impact on the baby's environment.
Speaker 1:And when you get a kid, how much do you? You know they're going to be presenting, but by the time they get to you, they're presenting with behaviors and things that you you can see from the standpoint of having a clinical profile might do an assessment. How do you start working with a child? You know the environment is epigenetic or it's it's prior to the parents being involved. How do you work with a child on those behaviors to help shift how they address and see the world? And then families, because I know that family work is a huge piece of what you do work with families to kind of come together on creating something that is new and different and adaptive to the world they're going to go into. How does that work start and how do you do it?
Speaker 2:You know, a part of it is getting a real, as much as possible accurate, assessment of the background. Todd, you know we really have to understand the layers and complexities that we're dealing with and, as you mentioned, a lot of it's work with the adoptive parents, because there's a few different layers and a few different variables that we want to really understand. One is the sense of loss that our adoptive families have dealt with. It's been said that one trait that distinguishes all adoptive families from every other is the threat of loss. There's not an adoptive family who hasn't suffered loss at some level, be they the adoptive parents or the adopted child, and so understanding loss and how they grieve that loss and how they're managing that loss. In addition, understanding the adoptive parents' attachment style themselves, because we know that their attachment style is going to inform and influence the way that they parent an adopted child.
Speaker 2:For the kids that you and I work with, you know most adoptions are quote-unquote successful. The majority of adoptions turn out very, very well and most adopted kids are cognitively, emotionally and physically caught up to their peer group within two years post adoption. But for the kids that you and I work with who have suffered some level of developmental trauma, either pre-birth or pre-verbal or post-birth. Those challenges can be enormous, and so understanding that adoptive parents, their anxieties, their attachment insecurities, their unresolved traumas, can be really activated by parenting these kids.
Speaker 1:Like mirrors, those kids.
Speaker 2:Yeah, yeah, and a neurobiological. We don't say what we don't say unconscious level anymore, because it sounds too Freudian, right? So now we say neural at a neurobiological level, parasympathetic level, yeah exactly, exactly.
Speaker 2:So. So understanding those parts of it that that you know these parents need a lot of support, because we know adoptive parents have typically have higher education status than non-adoptive parents, but they also have higher anxiety levels than non-adoptive parents and so being there as a support to them, adoptive parents get judged so often by others who don't understand the challenges that they're dealing with, and so there's shame, there's inner shame, there's a lot of layers to it that we have to examine and we have to be there for those adoptive parents. I say for those parents. If they're dealing with developmental trauma and real, significant challenges, there's three bridges they have to cross and we have to support them in crossing. The first is they are not the child I thought they were going to be. The second is I don't get to be the type of parent I thought I was going to get to be. And the third is this is not the experience I thought it was going to be, and really being honest in those moments and really taking a look at what we're dealing with is absolutely crucial in the work we do with these wonderful, wonderful parents who, you know, kind of feel let down at times, feel insecure themselves. One other thing I would say about that, if I might.
Speaker 2:Nancy Verrier published a book some years ago called the Primal Wound, and Nancy is a wonderful clinician and she's so kind and generous.
Speaker 2:There's been recent research by some wonderful and just stellar researchers. Some colleagues Dave Brzezinski, who is probably I would say he's denied this but I say he's probably studied adopted children in treatment more than anybody but David Brzezinski, megan Gunnar at the University of Minnesota and Jesus Palacios, who's out of the University of Seville in Spain they did a foundational research on meta-analysis on adopting kids and treatment, and they found there was no support for a primal wound, that adoption in and of itself is not traumatic unless that child has been with a caregiver long enough to form a secure attachment prior to adoption. So you know there's a lot of layers there as we work with adoptive families and try to, you know, understand the complexities that have gone into. Why is my child acting this way? If I can touch on the epigenetic piece again, there's two research studies that I love that kind of really explain pretty clearly how epigenetics can inform the way our kids are responding today. The first one is and you're probably familiar with it, todd, during World War II, the Dutch hunger winter.
Speaker 2:And that was toward the closing months of World War II, when the Nazis had blockaded the Netherlands, and so there were people starving and there were some brilliant researchers who decided to understand and study women who were pregnant during the blockade, so during a famine, but who gave birth after the Allies had liberated Holland.
Speaker 2:So these kids were carried in a famine but born right after the famine ended, and in studying those kids they have statistically significantly higher levels of heart disease, obesity and other caloric-related issues.
Speaker 2:The theory is that in utero their DNA was expressed in such a way to prepare them to survive in a famine, so that every calorie count. And when you're not born in a famine and your body digests food differently, then it's going to process it differently and people like you and I give it a diagnosis. Now another more recent study that goes along the same principle there were approximately 1,700 women in the New York metro area diagnosed with PTSD as a result of the 9-11 terrorist attacks. Studying their children, who are turning 23 this year, those kids have statistically significantly elevated levels of PTSD and anxiety, even though they were not born at the time of the attacks. And when you take a look at it, the theory is that their DNA was expressed in utero to prepare them to survive in a hostile environment, because you and I know nobody wants PTSD and anxiety. But from an evolutionary perspective it keeps us alive right.
Speaker 2:But when you're not born in a hostile environment and you have those traits, then again we give it a diagnosis PTSD and anxiety when, in the context in which it was developed, having your head on a swivel, not relaxing, being hypervigilant and hyper alert would keep you alive.
Speaker 1:Yeah.
Speaker 2:So they were prepared to survive in a hostile environment, but weren't born in a hostile environment.
Speaker 1:Which creates maladaptive behaviors in a in a right.
Speaker 2:Exactly, exactly, which is what we see from many of the adopted kids that we work with. They're not bad kids at all, but their limbic system and their amygdala, everything is on hyper alert, prepared to react to keep them alive because of what they experienced.
Speaker 2:Rebirth Exactly Right alert prepared to react, to keep them alive because of what they experienced rebirth Exactly Right. And so if you take that and then you combine it with what we know about polyvagal theory, the idea of safety is so crucial to helping these kids right. In order to form a relationship with them, they have to feel safe. And in order to feel safe we've got to dampen that amygdala, dampen that limbic system, so they're not quite so reactive, so that they can kind of relax into our influence and start trusting us. Because what we know is if it's epigenetic, it's influenced by the environment. That means epigenetic effects are likely reversible based on the environment. Epigenetic effects are likely reversible based on the environment, environmental enrichment at the right time.
Speaker 1:Well, and you see, there are a lot of aspects of this in adult care, especially as it pertains to PTSD and other things and something I think and I'd love to hear your thoughts about this have really advised the sophisticated trauma treatment approach that we have, um, because you know it used to be. It's like well, they suffer, let's say it's ptsd, so there's this, this, they, they called it a can of worms, I call it trauma trunk. Um. And you know, if you, if you walk in on a person who, like you know, who, doesn't experience safety as a result of the neurobiology that's going on, for whatever reason, and you try to go in trying to address trauma, well, what's the traumatic issue? Let's go address this issue. Let's go dig it up. The chances are incredibly good. What you're going to do is re-traumatize that person, not address the trauma issues that are coming up as a result of a specific event.
Speaker 1:And so you it's not something that you can hit head on, as they say, like it's something you've got to be careful about. You've got a lot of use of nonverbal strategies. You've got to, you've got to help that person learn how to regulate first, before they can process anything that's that's anywhere close, anywhere close to triggering material. And so you know, just and with kids, of course, I think for parents who have adopted a child who has these symptoms or has, you know, had that in utero environment and came out and starts to and is on edge and has their head on a swivel and has high anxiety and is is fearful for their life, even though they're not in a situation that would require them to be that their, their, their amygdala has taken over. Um, it's very hard for them to even set what I would call regular limits. It's like you know this it only makes sense that you would put away your dishes after you're asked, or you don't make sense that you would clean your room or all these other things, and this person decides that it's not important that they clean their room, and being asked to do something is a threat to their life.
Speaker 1:And then you get all these behaviors that come out and the parents are just dumbfounded, first of all, as to what to do with this, and they don't know what to do. Eventually, they'll either find somebody like me and I send them to you, or they'll find somebody like you who knows how to work with their child and teach them. Let's work on safety first, then let's train some behaviors, Then maybe we can address some of these other issues. But even that is a much longer term kind of thing. What message would you give to a family that has you know? If somebody happened to be listening to this podcast, I think there's a lot of great information here already. What message do you have for families that are struggling with all of this?
Speaker 2:Well, and there's a few different things that I might say.
Speaker 2:One is the self-care piece, because these kids have to be able to borrow serenity, and you can't let someone borrow your own serenity and you can't.
Speaker 2:You can't let someone borrow your own serenity if you don't have it. And our parents, our parents, have to be able to find find that serenity I mean truly so they can, they can share it with their children. There is a there's a good portion of the research that says that one of the significant variables for the successful outcomes of these kids is a parental capacity to manage their own dysregulation when their kids are not managing their regulation, and so a parent's ability to stay centered, to stay calm when it's hitting the fan with their kids is really, really important. And the only way, the only way Todd that adoptive parents can do that is if they have a good support network, because it's a Herculean task we ask, we're asking parents to to take okay, so so a little background, right. Being from North Carolina, dad was a Marine for 36 years, right, when I got out of line when I got out of line, I knew it was coming right.
Speaker 2:I knew I needed to stay in line if I didn't want to get whooping.
Speaker 2:Okay, well, that doesn't work for these kids. That cause and effect, very simple response doesn't work for these kids. And you can take all the toys away. You can take everything away. Traditional parenting does not work for complex developmental trauma. Therapeutic parenting is what we've got to do, which is a real shift, because it feels like we're just coddling kids and we're letting them get away with stuff. The goal in therapeutic parenting is not compliance. Compliance is not to get them to behave. Our goal has to be and this is our goal at three points neurodevelopmental attachment-based healing, which means we're focused on healing that, that neural substrate between the midbrain and the lower prefrontal cortex, so that they're operating and communicating. Our parents, oftentimes adoptive parents, struggle with. Why do I have to keep repeating myself over and over again at this child? Well, the reality is, their capacity to retain information, to listen and learn really is greatly reduced if they've had some kind of complex trauma prior to birth.
Speaker 1:It never passes the threshold of the reactive amygdala. It never goes into the brain.
Speaker 2:Exactly so. There's no capacity for cause and effect thinking. But because they look their age, we assume that they're their age, when in fact, cognitively and emotionally, they're so much younger, so much younger, and so it's. It's a real challenge for for professionals and parents working with these kids to really kind of go. This isn't a choice they're making. The behavior makes sense in the context when it was originally developed.
Speaker 1:Right.
Speaker 2:And that's what we've got to put it in Um so so, living in an environment, and that's what we've got to put it in.
Speaker 1:They're living in an environment you can't see Exactly.
Speaker 2:Exactly, and so for these parents it's a Herculean task, and so we say you've got to have a support network, you've got to take care of yourself and educate yourself on what's behind this, because for most of these kids, these behaviors were in place before they took their first breath.
Speaker 1:Oftentimes it's not about you, it's about what needed to happen, but then in utero, yeah, I think we're seeing a lot of that in general, with just the new generations of kids, you know, adolescents and young adults, whether adopted or not. We're you know, we have the pandemic, we have all these other periods of time that are having an impact, and what I'm telling you, norm, is that you need to open a program that's not just for adolescent, adopted adolescents.
Speaker 2:Yeah, I think you're right. We are seeing it across the spectrum, aren't we? And the impacts, the ripple effects of post-COVID, the shutdown and everything else. It's going to be a tsunami, I think, unfortunately, on the impact of these kids.
Speaker 1:Yeah, I couldn't agree more. I think that one of the things I've been discussing with not just families but other professionals of late and that came up, I was recently at Silver Hill for a conference and they were talking about education and everything else Knowing resources that exist out there is one of the greatest challenges, and even when you know about them, navigating the one it's. You know, our treatment and mental health world is not a user-friendly environment. What is it it you're doing with your families to help grow this kind of consciousness around, not only the kind of care you're trying, the kind of parenting you're referring to, but also kind of the kind of care that Three Point Center is able to provide? Like, what do you, are you seeing it being a little more on the stage, both nationally and internationally, and that sort of thing? What's, what's going on in the field that gives you hope, I guess, is my question.
Speaker 2:Well, great question. A couple of things. One is because people are becoming more aware of it. There's so much frustration. You know, and as you know, todd, you know, in NATSAP, the National Association of Therapeutic Schools and Programs, I've spent time in Capitol Hill working with senators and members of Congress to educate them that, look, these parents, these families need help. They really do. One of the challenges and I'm going to geek out and get a little technical here, but one of the challenges we have is in the Diagnostic and Statistical Manual of Mental Disorders, and do you know what that is? Many of your listeners may be aware of it.
Speaker 1:The DSM? Yes, we are familiar.
Speaker 2:The DSM. You know the fifth edition. You know most of us, as mental health professionals around the world, use the DSM but it's woefully inadequate to conceptualize the experience of adopted children with complex developmental trauma. Because we get all the diagnoses right we get ADHD, we get oppositional, defiant or conduct disorder. Uh, intermittent disruptive mood repulite yeah exactly and and you know transparency I contributed to the DSM five. You'll find my name in the book, but I'll be the first to say it does not do any service to adopted children.
Speaker 1:It does not do any service to adopted children, bessel van der Kolk, who you know is just wrote, keeps the score Right no-transcript, which does a much better job of conceptualizing what these kids experience.
Speaker 2:It's different than PTSD and it's pretty simple to understand why. Because PTSD is described, you know it hasn't changed much since it was battle fatigue in World War. I right, it's about an event that challenges your safety and your sense of self, whereas complex developmental trauma is a chronic. The person who's supposed to be taking care of you not taking care of you trauma and it rewires the circuitry of the brain. So PTSD doesn't do a good job of it. Adhd doesn't, because they're hypervigilant it's not that they're lazy and don't want to focus.
Speaker 2:Exactly, exactly. So all that to say, more and more people are becoming aware that we need this diagnosis in the DSM, the next iteration, because if it is, then we'll teach it in graduate school, and as long as it's not in there, we're not talking about it in graduate school. I wasn't talking about any of these things. And secondly, insurance companies will then have to take a look at it.
Speaker 1:Yeah, I was going to say there's a elephant in the room there with the diagnostic code, right?
Speaker 2:Yeah, and if we are talking about complex developmental trauma, then we're talking about neurological healing which takes longer than simple behavioral changes. Right, yeah? And insurance companies. My own opinion, this is just norm. But my own opinions on insurance companies don't want to look at that, because now we're talking about really long-term stuff.
Speaker 1:Well.
Speaker 2:Because we're talking about rewiring the circuitry of the brain.
Speaker 1:Well, and I think that you probably agree with the statement, I think neuroscience is the treatment science of the future and not to dismiss good therapy and good medication management when necessary and all these other pieces. But I want to hear what you think about this. I was at Silver Hill and it was a big discussion and their CEO was like you know, you'll never get insurance companies to sign on because the average subscriber never stays a member with their insurance from one to two years. So interesting, and in order for there to be this incentivized health dynamic and be in behavioral health and I would say, in medical care in general, you have to you know a person who is going into treatment. What we know is that you're looking at two years worth of care. You're looking at, you're looking at two years worth of care You're looking at two years worth of.
Speaker 1:You know there's a residential level of care and there's, you know, a variety of levels of clinical care that exists past residential and then even support when a person goes back into the home or an independent environment or what have you. So you know, I tell families all the time you're looking at one to two years worth of various levels of care. And the point that I made to this group I said, look, they're going to save money. The point made back was that well, they won't save. The company itself won't save money because they're subscribers. They only last for two years.
Speaker 1:I said, yeah, but if you can get them all to sign on at the same time, the savings can be held across the board. So while maybe this company's subscriber may not save, by the time they switch, that person's going to go into another care environment or another you know subscriber membership environment where they no longer need the same level of care because they got adequate care the first time. If everybody does it at the same time, you'll get this mass effect where the care does not cost as much. Therapeutic care can be effective because we know we know how to do good treatment. Good treatment exists, but largely only exists for people who can pay for it so expensive it so expensive.
Speaker 1:It's very, is it, though? I mean, you know my point to that. When people say it's very expensive, it's like well, yeah, for an average family, an out-of-pocket expense of anywhere from $18,000 to $40,000 a month could be an out-of-pocket residential care expense. But if you went into the hospital for a heart attack or any other major illness let's say you had a diabetic attack or you had severe liver disease or kidney disease or you had any of these other things and all of a sudden an insurance company is responsible for caring for it, you'll pay that money for sure to handle any of these major medical conditions. I would say that behavioral health conditions are no different than the severity that you apply to any major medical condition and, by and large, if you talk about what I would call appropriate levels of care, what we're doing we're doing fairly economically when you think about it.
Speaker 2:You know, in that context, what you're saying makes perfect sense, todd, it really does, and you're absolutely correct.
Speaker 1:You know, I only get people on the show that are going to agree with me.
Speaker 2:So, uh, yeah, no Carolina boys again. There you go, that's right Well.
Speaker 1:Norm, I man, I tell you we, I tell you we could sit here and talk about this for quite some time. I'm so grateful that you agreed to join me in my ramblings on the show. The information that you provided for us is just going to be valuable. I'm going to play it several times just so I can dig out all the resources. I'm going to play it several times just so I can dig out all the resources. But I'm grateful for you as a person, as a Carolinian, but most importantly, as a resource for families out there struggling with these challenges. Thank you so much for founding the Three Points Center and being involved in the work that you're in. It's a pleasure and an honor to have you on the show.
Speaker 2:Well, thank you, todd. The pleasure is truly all mine and I appreciate the work you do and the esteem you hold in the field. Thank you.
Speaker 1:Well, I'll look forward to being with you again here pretty soon. This has been Mental Health Matters on WPVM 103.7, the Voice of Asheville. We'll see you next time. I feel so lonely and lost in here. I need to find my way. Thank you, bye. Outro Music. I need to leave. I found the other day I need to leave. I found the other day I need to leave. I found the other day.
Speaker 2:I need to leave. I found the other day I need to leave. I found the other day I need to leave. I found the other day I need to leave. I found the other day I need to leave. I found the Indian. I found the Indian. I found the Indian. I found the Indian. I found the Indian. I found the Indian. I found the Indian. I found the Indian. I found the Indian. I found the Indian. I found the Indian. I found the Indian. I found the Indian. I found the Indian. Thank you, I'm so lonely and lost in here, bye. I feel so lonely and lost in here. I need to find my way home. I feel so lonely and lost in here. I need to find my way home.
Speaker 1:Find my way home.