The Chris Voss Show - The Chris Voss Show Podcast – David M. Ockert, Ph.D., Founder and Executive Director of the Parallax Center

Episode Date: February 15, 2023

David M. Ockert, Ph.D., Founder and Executive Director of the Parallax Center Parallaxcenter.com

You wanted the best. You've got the best podcast, the hottest podcast in the world. The Chris Voss Show, the preeminent podcast with guests so smart you may experience serious brain bleed. The CEOs, authors, thought leaders, visionaries, and motivators. Get ready, get ready, strap yourself in. Keep your hands, arms, and legs inside the vehicle at all times because you're about to go on a monster education roller coaster with your brain. Now, here's your host, Chris Voss. Hi, folks. Chris Voss here from thechrisvossshow.com, thechrisvossshow.com. Welcome to the big show, my friends and family. We certainly appreciate you guys tuning in today. As always, here's the plugs.

Take care of the show to your family, friends, and relatives. YouTube.com, Fortuness Chris Voss. Goodreads.com, Fortuness Chris Voss. And LinkedIn and all the big things we do over there on the LinkedIn side of things. There's a lot of stuff that's over there. There's like a newsletter and everything else. Anyway, guys, today we have David M. Orkert, Ph.D., who is the founder and executive director of the Parallax Center on the show with us today.

And he's based in New York City. Established in 1984, the Parallax Center is a private New York State licensed outpatient detoxification and chemical dependency treatment facility. Dr. Ockert has developed methodologies for outpatient detoxification and stabilization from all drugs of abuse. Welcome to the show, David. How are you? Thank you very much. I'm fine.

It's very nice to be here. And what an introduction you have. Yes, well, we try and do well. But you've got a great bio, so that helps. So, give us your dot com or wherever you want people to find you, David, on the internet. It's the simple old one. It's New York, NY

Parallax, P-A-R-A-L-L-A-X at AOL.com. There you go. The older age group. There you go. Estab group dot com i think established in 1984 i was great i graduated high school in 1986 so uh you're a young man maybe you started when you were a baby uh so uh what what got you into this field what what motivated you to want to get in the field of working with people? I actually came to New York in a 66 Volkswagen as a contractor.

I did this in 1973, and the economy crashed shortly after. When the economy crashes, nobody hires contractors. So I was walking by the new school one day. I had a bachelor's in psychology and I walked in and they gave me a smoking cessation clinic job. So I started at a smoking cessation clinic. It was behaviorally oriented, meaning it was really a talk therapy. It wasn't well developed, wasn't well rounded. And so I started to work there and I started to add vitamins and exercise and get biology involved. And I improved outcome. Then I started to get people involved in the person's life, like family and friends.

That improved outcome. From there, I wound up, and so I rounded out the treatment to include biological as well as psychosocial issues. And following that, I started to work at Center of Alcohol Studies at Rutgers. This was sort of an important transition because this is back when people were either alcoholic, opiate dependent, and poly substance wasn't really a big thing at the time, but it had begun to be a big thing. And so kids were going, getting drunk, going into their parents' medicine cabinets, taking medication. And now we had polysubstance issues, which we were in charge of studying at Center of Alcohol Studies at Rutgers.

Oh, wow. So that was a very interesting transition. Following Rutgers, I went ahead and I finished my Ph.D. at Columbia, which was really a good thing. And I was fortunate enough to get an NIMH research fellowship. They call it a full ride. They actually, bless you, they paid for it. And I went there for four years and three months and got a PhD. when I think about patients and what is absolutely necessary for them to be successful in a treatment and this is a very difficult treatment and it is treatable

is they need the commitment they need the commitment to abstinence. And that's a very hard thing to achieve. And it's very hard to maintain it over time because moods tend to change. People stop using alcohol, opiates. Their mood's not good. They usually experience depression and anxiety. Talk therapy will be useful and helpful, but probably won't work quickly enough following acute withdrawal. And this is where Parallax has started to, many years ago, 30 years ago, integrate medication into treatment strategies. When people stop using a substance, opiates, alcohol, any of the above, they typically don't sleep. And so the first thing we try to do

is establish a normal sleep-wake cycle so now we're starting to work on the biological aspects remember this is not a choice this is an illness this is a disease and it really is out of control and people don't know what to do about it. But one of the things that we found very useful in addition to our talk therapy, which is both individual and depression, or other states that are emotionally difficult and usually drive them back to drugs because they want relief. Yeah. And so what we try to do is make them comfortable with psychotropic medication, medication targeted at depression and anxiety and sleep to try and reestablish a level of comfort.

If we can get them comfortable, they will move along with us. Okay. But again, it all goes back to whether or not they truly are making a commitment to abstinence and maintaining abstinence over time. And it's a very hard job. This is not an easy job. Yeah. I have a lot of people that are friends of mine who struggle with addiction. You know, they've had to, you know, they're constantly, you know,

every day is a battle for them to stay sober. And many of them have been doing it for decades and years, and sometimes they fall off the horse. And it's definitely a challenge. You know, I've had people that I've loved that have had addiction problems, either alcohol or other issues. What's been kind of interesting is a lot of people we have on the show and a lot of the discussions we've had with authors over the years and brilliant doctors like yourself is it's amazing how much childhood trauma and or some sort of trauma plays into sometimes withdrawals or addiction i'm sorry what's that you said some sort of uh some sort of

addictions uh you know some sort of trauma will affect them having some sort of addiction later in life and a lot of times they're medicating that trauma. That's right. And this could be a short-term event or it could be trauma over a long period of life. And you guys seem to kind of give a balanced approach, it seems, to everything, where you try and get all the other aspects of the life kind of maintained. You mentioned diet, sleeping, you know, a lot of these things, if you don't sleep eight hours a day, if I don't sleep eight hours a day,

there's some murdering that might take place. I'm just kidding. I've got to get my sleep. And it seems like you guys tend to balance people out more on their whole sort of what's going on in their life. When you think of the whole picture, you have to think, yeah,

we have a psychological element that's a talk therapy element. We have a group therapy element, which is a social. But we also have a biological. Remember, these are drugs impacting your brain, and your brain is highly sensitive. And so now your chemistry has changed. And we have to get your chemistry to recover. And to do that, we have to get through periods that have emotionally difficult or trying times where you don't feel good. And so medication can make the difference.

You need the individual. You need the group. You need to change behavior. But you also need to modify the biology. The definition of parallax, parallax is the definition of binocular vision. If you look from one eye, you have no perspective. Everything's flat. You have to look from more than one angle in order to attain perspective, in order to get it and know what to do.

And so parallax means you must look from more than one angle, biological, psychological, and social, and intervene in all three. And most people don't do that. Most people do individual and group. Some people do groups only. But without the third element, the biology, outcomes suffer. We know through National Institute of Drug Abuse that most therapies that are effective have some element of medication during their career. And so it's not forever, but temporarily to get through very difficult times may be quite useful. Yeah, I like the balance element of it where you can balance everything out and help people. I mean, you probably find people don't fall off the wagon, as they say,

quite as much if they can learn to balance out their lives. I mean, there's probably, you know, between diet and sleep, I mean, this is one of the two most important things I've learned over the years is my diet is really important, what I'm eating, how I feel is directly impacted by what I eat, and different things I come into contact with. These things are essential. And it's hard to get somebody to eat differently. If you get to sleep, they replenish brain hormones at night. They may not stop going to McDonald's during the day. Yeah.

You got to avoid doing that. But it's not always the case. You know, diet was one of the most important things that I learned. I used to abuse alcohol where I used to drink it fairly heavily for about 20 years. I didn't have an addiction to it, but I was definitely using it as a crutch. And then I started to lose weight. I got my diet into place. I got my sleep order into place.

And, you know, one day I just quit drinking booze. I just got tired of it. You started to feel better. Yeah yeah i started to feel better and and i started you know when you started doing the diet thing and learning to eat better i started listening to my body and my body was like hey man we really don't like this drinking thing it dehydrates you and makes you feel awful and then i started to feel that for three days my body would be dehydrated and i would drag and i I'd be like, this isn't fun. I have a couple hours of fun on Friday night and I pay for it for three days.

That's right. And probably age was a factor as well. But it just came to a point where I'm just like, okay, well, I'm just not doing this anymore. I just don't want to do it. Yeah, you're right. You're not living. Yeah, and so listening to my body and and now i'm just so happy i tell all my friends and the one thing i didn't know is alcohol was impacting my testosterone levels and as you get

older that's important as well so uh i think it's interesting how you guys approach it in so many different aspects so that people can uh make their lives better and stuff. Uh, what other sort of things do you, services do you offer, uh, for people that need help? Um, one, we're very supportive. A lot of people have come here and burned many of their bridges and don't really have a support network and they rely on us to help support them during this period. One of the things we can do that helps is bring their family and friends in. If we bring their family and friends in, their outcomes are better.

They have better outcomes. They're more likely to be successful. They need to be supported in their attempts at abstinence. And to fight them on it doesn't usually help. Supporting them usually does. And so it's really important to support their movements towards abstinence. Yeah, I'm sure it makes all the difference. I mean, what if they have family issues?

Maybe that's the reason they're drinking or tuning out with drugs is they have conflict in their family. Do you have to address that when you do the family thing? Absolutely. When family is involved, outcomes are better. When family is supportive, outcomes are better, meaning they tend not to relapse as much or tend not to use or maintain abstinence. Is it because it kind of helps create a support system? I found that when I was losing weight and trying to stay on my diet,

an accountability group really helped. When I wrote my book, accountability group really helped. I probably wouldn't have the book without them. Having that accountability and kind of a community that supports you and goes, hey, do this, having that accountability and kind of a community that supports you and goes, hey, you know, do this, do that. Yeah. The basis of all 12-step communities is to try and have a supportive group that's doing what you are trying to do.

Yeah, yeah. It's really useful. And then you guys create individual plans for people based upon their needs. I think that's kind of interesting, too. You don't have a one-size-fits-all. Everybody is different, Chris. Your brain chemistry is different than mine. My effect with alcohol and your effect are different.

So because everybody's different, you've got to individualize treatment to deal with the issues that they are grappling with. And then there's a – go ahead. I'm sorry. Go ahead. There's this thing on your website that talks about understanding substance abuse disorders. How can people identify if they have a problem or if there's a problem in someone they love? You know, when I first encountered an alcoholic girlfriend, I had no idea. I mean, I knew what alcoholism was on a basic standard. But because she was a weakened alcoholic, I didn't understand how, I didn't understand what was going on.

And she was hiding it from me, too, as well. So I didn't understand why I was meeting Dr. Jekyll and Mr. Hyde, you know, when she would drink. What are some different tips you can give to people to identify, you know, if they're out there listening, does my loved one have a problem or maybe do I have a problem? Let's talk about that a little bit so people can maybe identify if there's an issue with themselves.

When people, you know, the characteristics are when you get up in the morning, how do you feel? If you feel bad and you take a drink, you've got a problem because it stops you from going through withdrawal, right? Yes. Hangover in the morning is a withdrawal. And so, you know, you say you have one night and then you have three bad days that's very characteristic of an alcohol binge drinker frankly um alcohol one drink of alcohol trains your attitude towards anything driving a car you know doing dangerous things um one of the things that people don't really understand is this is a

disease. This is not a choice. And a disease takes you away from everything that you know to be healthy and good. And that's part of what the chemistry reality is. How can you feel good if you don't have enough dopamine? Dopamine is one of the neurotransmitters that gives you pleasure. You know, we wonder why opiates are so addictive. You know, we know that it ameliorates pain. But we also know that it floods the body with dopamine following administration and that reward is so strong you know 20 times 30 times more than a normal reward would be

in your brain for eating a good meal or having sex um and that's very hard to turn down. And it becomes what you look for. You know, you're not going to get it by eating a meal all of a sudden. Your brain reward system is trying to help you perpetuate the species. You know, production, eating properly, getting food, et cetera, all are reinforced by your brain. But if that reinforcement goes to 20 or 30 times normal because it's a chemical, bless you, then that's hard to fight against. And it's likely to be the behavior that you pursue. And I imagine you've treated a lot of different patients over the years. Thousands. Literally thousands of patients over the years.

And I imagine opioids have been a big issue for you guys to treat opioid addiction in the last 10, 20 years. Alcohol is probably the broadest problem. Really? Opiates are a crisis because of the high death rate. We'll call it accidental overdose, for lack of a better word, with fentanyl. So it has become a crisis beyond what most other crises are because of the rate of death. We know we lost 100,000 patients this year to overdose, and we don't know if it was accidental or purposeful or what, but 100,000 people is a lot of people.

And I mean, there's fentanyl, too, that's really become a huge problem with a lot of overdoses taking place. You mean in general, the criminal involvement? Yeah, with fentanyl and, you know, some of it being presented, you know, it's mixed with heroin and different things. It's a problem because you can make it in a laboratory. Opiates are typically a broad class of medication, all resembling heroin. Yeah. The thing is, is you don't have to get it from a poppy. You don't have to grow it. You don't have to cure it.

You don't have to dry it. You don't have to process it. You make it in a laboratory. It's cheap and dangerous, life-threatening obviously and so this is why it is out there so much because it's really not part of that illegal drug distribution system that starts with the poppy in the east this is a laboratory anywhere in the world. And so that's why it's so pervasive at this moment. Yep. It's interesting how challenging it is and the fentanyl problem in America.

People have addiction problems. Maybe they're on heroin or some other drug, and they take it, and it's mixed with fentanyl and they die. They overdose because it's so powerful. It's too strong. It's actually too strong. You saw those kids in a dorm at a college. They all got it from the same person.

They all died. Jesus. And so, I mean, the best thing to do is, what's the best thing to do if you think that you or yourself, you're out there listening, or someone you love has an addiction? What are the best steps to take and do to try and look into getting help? If you're on the outside, the best thing to do is to go to an Al-Anon meeting. Uh-huh. thing to do is to go to an al-anon meeting al-anon is a juxtaposition to aa in that it will talk to people who have problems with people that have substance abuse disorders it will give you ideas of how to deal with it how to talk about it what to do, because you can push somebody away.

And so I would literally go and get more education and find out what people are saying or how they say it to approach somebody and not scare them off, frankly. Nice. And so that's my initial suggestion is get more education and try to understand what's appropriate and not appropriate in terms of your intervention as a friend as a as a family member yeah because it can be it can be challenging you can lose you can use loved ones and other people who uh who are uh you know they push you away because you approach them or have an intervention. I used to watch that show Intervention from time to time.

It was always interesting, some of the results and the challenges that people go through. But I like your approach to where you guys have an all-around approach to the whole life of a person? Because usually that's somewhere in that whole life of the person is where maybe the bleed-out is coming from, where they're medicating with alcohol or other drugs. You know, you need a multidisciplinary approach. You need a physician. You need a therapist. You need a group therapist.

You actually need to approach this from multiple angles simultaneously. You can't treat chemical dependency and not treat depression and anxiety. You must do it simultaneously so that you can help manage somebody's moods. And this is especially true with acute withdrawal and post-acute withdrawal. Right after withdrawal is over, your chemistry is not in balance and needs to be reestablished. And like you said, diet would make a difference. Sleep makes a difference. All of these things make a difference.

Healthy living style makes a difference. Definitely, definitely. Balancing your life and me getting healthier made a difference where I was like, I'm really tired of alcohol and it's not as fun as I think it was. And you really start listing your body, especially with diet. I mean, I just started listing my body. I went kind of vegan-ese for a while. I started exercising. And I just realized the toll that that was taking

on my body, my health, my state of mind. I constantly kind of felt fogged over a little bit, especially with the hangover element of it. I just started, my body started talking to me going, hey man, we feel like shit for three days after you drink. It's not fun. One or

two hours of fun is not worth three days of grab. That's really what you have to recognize. And you have to be able to do something about it and recognize the changes that you've changed. And that you're feeling better. You can get up and go to the gym. That's a really important feature. Exactly.

Because you don't feel like going to the gym if you're dehydrated and your body's beat up and everything else. So I like how you guys approach it from so many different angles. Anything more we need to know about your company and how you guys do things? Inpatient treatment, there are plenty of good places that do inpatient treatment. And they work hard and they help patients. The trouble is, is once you leave that inpatient facility, there's something else you must learn. You must learn how not to use in the environment you live in. And that means the dealer down the street or upstairs or wherever it is, you have to figure out you're not moving. You have to figure out how to conduct your life in a way where you can be in the world and not use. And so even though inpatient may be necessary for some people, useful for other people. Outpatient is useful for everybody because they've got to learn how not to use in that environment with the people around them, with the access to alcohol and all other drugs that we know you have access to.

And this is very, very important. Definitely. It's essential to do outpatient treatment. It's not the only treatment, but you must finish off with outpatient treatment. Yeah, it makes all the difference in the world in being able to achieve what you're trying to achieve. Because if you don't do the things, then you're not going to do well. So anything more you want to tease out to us about what you guys do and how you do it before we go? Yeah, our number is 212-779-9207.

You can talk to somebody. They will talk to you specifically about what issues you're dealing with and how we might be able to help you. There you go. There you go. And give us the.com one more time, if you would. I'm sorry? Give us your website. Y, parallax, P-A-R-A-L-L-A-X, center, inc, at AOL.com.

There you go. There you go. Be sure to check out the website, folks, and all that good stuff. It's been great, David, to have you on and give us your insightful experience. I appreciate the time. There you go. Thanks, Manas, for tuning in. Go to YouTube.com, Forge.Goodreads.com, and YouTube.com, Forge.ChrisFoss, and all of our places on LinkedIn.

Thanks for tuning in. Be good to each other. Stay safe. We'll see you guys next time. Thank you.