"This ain't no Psych Op" with Joseph Reichmann, Psy.D.

Joseph F. Reichmann, Psy.D. is a clinical psychologist currently residing in Southeast Pennsylvania. He earned his doctorate in psychology from Marywood University. He was commissioned into the Navy in 2014 in order to complete his predoctoral internship at Walter Reed National Military Medical Center. He completed his postdoctoral training and served an additional three years at Naval Medical Center Portsmouth (NMCP). During his time at NMCP he worked in the outpatient behavioral health clinic and was a part-time embedded psychologist for Submarine Squadron 6, at Naval Station, Norfolk. Dr. Reichmann was eventually selected to be the assistant department head of the military’s largest substance abuse treatment facility and served in that position for two years. After completing his service contract, Dr. Reichmann went on to pursue a career with the Veterans Affairs. He currently works at one of the VA Medical Centers outside of Philadelphia where he manages a program designed to treatment veterans who are diagnosed with a severe mental illness. Dr. Reichmann also does part-time work conducting assessment and selection for the military. His clinical interests include: Substance-Related and Addictive Disorders, Serious Mental Illness, and Insomnia. His personal interests include: spending time with family (wife, son, daughter & two doodles), weightlifting and cycling, snowboarding, Philadelphia (Eagles – go birds!),

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Chapters

• 0:00 Introduction to Dr. Joseph F. Reichman.
• 3:24 Growing up in Long Island, New york.
• 7:15 How could I have been so blind to the situation?
• 12:02 A tainted view of the school.
• 15:28 How did you feel about yourself as a teenager?
• 21:39 Getting sober in Scranton
• 29:21 The self-centeredness of brain development.
• 31:39 How to get into the field of psychology?
• 37:30 How did you decide where to pursue your career?
• 44:02 The first application of his Psy.D.
• 49:41 What am I looking for in responsible use?
• 55:05 The role of psychologists in the military.
• 1:01:00 Working for the VA
• 1:03:58 Severe mental illness vs Moderate mental illness.
• 1:10:05 People’s surprise about the severity of addiction.
• 1:16:01 How would you describe addiction and trauma?
• 1:21:58 Exercise meditation and meditation.
• 1:27:58 Closing Remarks.

Transcript

Joe Van Wie  0:02  
Hello and thanks again for listening to another episode of all better. I'm your host, Joe van wie G. Today's guest is Dr. Joseph F. Reichman. Dr. Reichman is a clinical psychologist currently residing in Southeast Pennsylvania. his doctorate in psychology from Marywood University, commissioned into the Navy in 2014. In order to complete his pre doctoral internship at Walter Reed National Military Medical Center, he went on to complete his postdoctoral training and serve an additional three years at the Naval Medical Center Portsmouth during this time at an M CP, he worked in the outpatient behavioral health clinic and was a part time embedded psychologist for the submarine squadron six at Naval Station norful. Dr. Reichman was eventually selected to be the assistant department head of the military's largest substance abuse treatment facility and served in that position for two years. After completing his service contract, Dr. Reichman went on to pursue a career with the Veterans Affairs. He currently works at one of the VA Medical Centers outside of Philadelphia, where he manages a program designed treatment for veterans who are diagnosed with severe mental illness. Dr. Reichman also does part time work conducting an Assessment and Selection military. His clinical interests include substance related and addictive disorders, serious mental illness, and insomnia. His personal interests include spending time with his family wife, son, daughter, who doodles, weightlifting, and cycling, snowboarding, and Philadelphia Eagles, Gilbert's extra food, tattoos and travel. I've known Joe for quite some time. It was great to catch up. There are some audio issues, but I think they're worth producing. Because we have a very interesting discussion about the Navy's history with substance use disorder. Let's meet Joe.

That was our lead in with Dr. Joseph reichlin. Thanks for coming on, Joe.

Dr. Reichmann  2:39  
Yeah, thanks for having me. You know, I'd seen you post so many people before me and I was just I was waiting for you to ask is what really happened? And then he finally did and I was like, it's he must have not realized it was me and forgotten.

Joe Van Wie  2:53  
It's called a crescendo. Yeah, good music like right. Also counts. The space of silence in between, and that silence was momentum to your show.

Dr. Reichmann  3:05  
That's what I figured, you know, I saw you had some lawyers on and I was like, You know what, he's just waiting for the build up and then he's gonna retire after this. That's gonna be good.

Joe Van Wie  3:12  
This is all what designed to get it's funny. It's the first formal time I called you Dr. Joe. Reichman. And I like saying it, but when I met you, originally, what would you have been? 1718 I was 18 1818. Yeah. And you haven't changed or age you must be taking some Tom Cruise cocktail in the evenings because you got some good genes. Joe what uh, tell me a little bit about growing up where you from?

Dr. Reichmann  3:55  
From from New York but not not the New York I grew up in Long Island New York. Pretty normal family situation for the most part I had an older brother who was handicapped so I guess that made it a little less than normal but but yeah, you know middle class family stay at home mom my dad worked and went tip before we met and before getting sent to a boarding school for bad kids. I went to the regular high school and had I'd say you know relatively quote unquote normal life pretty privileged life I would say didn't have to like want for anything.

Joe Van Wie  4:36  
Did you see it as privileged then that wouldn't be like a term you would use to describe your own life? Maybe no, no

Dr. Reichmann  4:42  
your time you know, I was but I never needed anything and especially the more experience I got, you know, life experience and meeting others. I was fortunate I had college paid for I didn't have to work through college. You know, I didn't have to my my town. It's Self was pretty diverse, but it was still a pretty upper class town like people that immigrated from the country. Some of my friends was one of my close friends was from Brazil. But then you had people like the owner of Arizona iced tea that had a house in my town. So it was very, very diverse. They're all in all a relatively like middle class ish and uptown. And there was no like, I never, I never had to, I never needed anything. Like everything I had was provided for me. I didn't, I worked. My parents wanted me to work. And I worked in high school just for responsibility. It wasn't like I need to work to buy my own clothes. Yeah. And so looking back, I was like, Well, I had everything that I ever needed.

Joe Van Wie  5:41  
Yeah, it's it's interesting to describe that and it's key because a lot of people end up wondering what how do I have alcoholism? There's no negligence, I'm pointing to directly. No socio economic stress that makes all of my life variables harder. Right. It's pressure cooker. Out of curiosity, I, I guess I would want to ask at any time did that. Did you have friends that came from you said diverse, but is there a lower socio economic friends? Did you ever feel strange about your position of privilege? Did you ever before 18 encounter a friend that was having a totally different life? And you saw that there's different worlds happening here in this neighborhood?

Dr. Reichmann  6:27  
I'll be honest, I was pretty ignorant to it. I mean, looking back now and reflecting on it, and knowing what I know now. I was like, how could I have been so blind to that? But I mean, absolutely. I remember specifically a situation where I had taken my brother's car, I was 15. So not even old enough to legally have a permit. And when joy riding with one of my friends who happen to be you know, he was an immigrant from Brazil. And he was in the country illegally. And he, we I crashed into the gas pump when I was going to pull, like fill up. So notice I like knocked it off. And the police can sell your jewelry, right? It sounds like Lethal Weapon. It was all good until I had to get gas. It was all fun and games. And he's like, Dude, I gotta go. I have to get out. Like, it's very difficult if you're going to leave me. And then so it guilted him into staying. And it's like that could have had a really negative impact on his family, you know, versus me. I just had to pay for the pay for the pump. And that was it. Like that was just replaced to replace the politics of the car.

Joe Van Wie  7:40  
There's no texture for you even consider what that would have meant, though, at age two, right? Yes, no,

Dr. Reichmann  7:46  
absolutely. I mean, I was again, I just had no idea. And you know, now especially with my career, like my, my part of my job is to try and see things from other people's perspective. I was, you know, I was just ignorant. I had no idea of what it could have been like for this kid. And even now reflecting on it. I still like I think, a lot of go.

Joe Van Wie  8:07  
Yeah. Well, we all emerge for ignorance, right? It's it's better to emerge from ignorance than have bad software, where you're just assure of what you're seeing. So, you took a different path from this neighborhood that started to at least people were pointing to that this is not You're not following norms, there's distress, and you got sent to a school as kind of a proactive way to deal with this. Your family doesn't seem like they were hiding from some distress you were causing, right?

Dr. Reichmann  8:45  
No, yeah. They I think part of it was economic decisions like they were going to send me to a wilderness program. I'm sure you've heard of those, right? Yep.

Joe Van Wie  8:56  
Yeah, I've been to one. Okay. There we go.

Dr. Reichmann  9:00  
They said, Oh, well, that's three months. And we could get the same amount. You know, we get more bang for the buck we could send to a school for a year and pay the same tuition. So let's do that. Yeah.

Joe Van Wie  9:11  
What was the name of that school? Or was it he was here in northeastern PA?

Dr. Reichmann  9:16  
It was it was in Hancock, New York. It was, oh, this is different. Okay. It was it was called The Family Foundation school. And then it actually they'd gotten a lot of bad publicity, because people that had left started this foundation, but the truth about the Family School, and so then they changed their name to Allenwood Academy, and then they eventually shut down.

Joe Van Wie  9:38  
Yeah. And there was an article of faith based school, was that a faith based school?

Dr. Reichmann  9:47  
I wouldn't say they advertise it as such, but it there was definitely a component of that. Absolutely. But essentially, you had to follow the religion of whatever your parents prescribed. And so My parents were Roman Catholics. So I had to go like Catholic services and it was kind of very much forced on you.

Joe Van Wie  10:07  
Wow, that's intense. Yeah. And this this experience you're having, can you point to any other friends that you grew up with in your neighborhood that are having this experience?

Dr. Reichmann  10:17  
Actually, yeah, one of my one of my buddies, and he was we're still we're still in contact today. He, he got in a lot of trouble as well. And he's been sober. Not sober as long as me but but no, but he's been sober, like, you know, double digit years and is doing quite well became an LCSW. And actually works in New York and like, helps inner city kids.

Joe Van Wie  10:45  
What would you do if you had to go back and think like, what do you think's happening to Why do you think this was happening to feel punitive? Did it feel like something you needed to resolve? Or did you feel like a victim of misunderstanding now having to go to school like this for a year, because of what you're considering your behavior?

Dr. Reichmann  11:05  
Yeah, I was, I was there 22 months, it was a full it was there. So I was there senior year, and then super senior year, they kept me an extra year, not for grades, but they were like, you're not ready to grow. Graduate the program. Academically I was. I think at the time, I thought it was really punitive. It's interesting, except I do a lot of like, when I drive to work, I end up doing a lot of reflection on this still, for a number of reasons. And it's interesting, because the school I think, changed my life. Like, I don't think I would be here sitting with you today, if it weren't for the school. I also think the school did a lot wrong stuff that I still like think about today. I'm like, oh, yeah, I have a tainted view of things. And I don't think it's an accurate view, because of my 22 months at the school and kind of being forced to do things a certain way and think certain ways about things and feel guilty for doing things. So I think the school didn't necessarily accurately portray itself to parents. You know, parents saw kids carrying like buckets of rocks, filling in potholes and doing that, you know, I don't know, if they were, you know, sitting in the corner eating off their laps like, I don't know, if that was clearly portrayed to the fan parents. So still, knowing what I know, now, I still think there's a layer of parents potentially, like, I don't think my parents knew how to handle me. And I mean, we're both parents now. Like, I don't have all the answers for how my kids act, even just, I mean, the oldest one is only going to be three, but still, like, I don't have the answers to everything. Like we get the manual of when they do this, you go to page seven, you know, second part of that. But I think also part of it, as I mentioned earlier, my brother being handicapped, they didn't like get that. Oh, the older one makes his mistakes. And we learned from it, and then apply it to the younger one. So I was the first one creating this problem. Plus, since he had this, you know, handicap, there was this concern or this disability, that there was a concern about? Am I going to do something to then make myself disabled? So there was this almost over protection?

Joe Van Wie  13:27  
disability as a result of an accident?

Dr. Reichmann  13:31  
Well, no, well, he was born with a heart issue. And then he had surgery and there was a botched surgery that he which resulted in brain damage. And he had cerebral palsy and this, this congenital heart issue. But so but it wasn't an actual, like accident or anything like, you know, he did something. But so I think there's a concern of, oh, I'm going to do something that would cause that. Yeah, so I think that it was overprotectiveness, but also just a word that was a dynamic, along with maybe parents not knowing how to handle, you know, a kid that's acting this way.

Joe Van Wie  14:11  
Along with caring while the care is being needed for your brother to Yeah, and also,

Dr. Reichmann  14:16  
you know, I there was a layer of me just being an asshole like that, too, you know? So you have like, all that dynamic at play, and, oh, well, here's a school that could probably manage him because, you know, we were not we can't we don't feel like we're doing

Joe Van Wie  14:32  
well, how would you describe with all of that? How you bound it to an addiction? Like what relief came when did an addiction arise out of this?

Dr. Reichmann  14:43  
It I there was always that layer of like insecurity you know, it was like I never felt like I fit in. Whether it be with women or girls at the time with even just with the guys I was friends with. And so it gave me that like, oh, I have one on one up. You know, I'm, there's a typical cliche thing never is a square peg in a round hole. But when I got drunk especially it was like, Oh, I have a round peg in a round hole now. I'm one up.

Joe Van Wie  15:14  
It's like, it's a medication initially, it seems like wow, that's profound. Yeah.

Dr. Reichmann  15:20  
And it gave us a look forward to it was you know it was. So it was

Joe Van Wie  15:26  
body feels like Bondi trill

Dr. Reichmann  15:29  
Yeah, it was. I mean it, you know, in some ways it yeah it was it was the medication it made me feel, you know, normal or like again like one of everybody else so in that time I was free.

Joe Van Wie  15:44  
Yeah. What age was that? You think that were you recognize this is something you that is has value this is helping?

Dr. Reichmann  15:53  
I mean, I would say I started in when I was 14 and like, it was pretty instant. Yeah, I can't see the first time I got messed up. I don't even remember it and not because I like blacked out. I just I don't actually remember where the incident I really don't. But I know I all I do remember is like I enjoyed it. I was like, let's do that again, tomorrow with like, let's make it happen as soon as possible. And then last time, I got introduced to actually like getting drunk at school. I was like, this is even better schools like fun now.

Joe Van Wie  16:25  
Yeah, it's when did that when did the addiction or alcohol itself become the visible problem, like what it was like, oh, that's Joe's problem. He's drinking too much.

Dr. Reichmann  16:39  
Probably after, like a year, it didn't really take long, because that became like, that was the thing. Like it was just, oh, the and I was I was I mean, I was still living with my parents, I was trying to hide it. I was never one of these people that was like drinking every day. Because I mean, that would be pretty hard. 1516 years old doing that under your parents roof. It's possible, but it would be pretty hard, especially with caring parents that were home. And, and so but it was like, it was as low as long as I could get to this day. It's good. Like, okay, and this, you know, let's get to the weekend, or, Oh, it's a break. So even more so at that. But that's just what became life was like

Joe Van Wie  17:18  
you, there's a ritual, you're waiting for it. It's on a clock. So you're ruminating throughout the week, when you can be yourself again, right?

Dr. Reichmann  17:29  
Or just even feel, you know, feel like happy and not feel if you will not not overthink. And so it was which again, I think it's a different dynamic being, you know, 15 years old under your parents roof, you know, I mean, if I at that age, like lived alone, it would be it would be bad. Okay. I mean,

Joe Van Wie  17:49  
yeah, yeah, I would say, I think about it, how much you're describing me. I don't think I don't know if we've ever talked directly of about our adolescence or teenage years, I had similar experiences in schools like that military that like boot camp style thing you were describing, and the way you described, yeah, you're here today, because of it, they might not have done everything the right way. It definitely would be a you know, any moral approach today, if not, criminal or unethical, but it's like the drill sergeant mentality, there is value. That was all that was being offered. And it worked somehow made the best of it. Right. And there was, so I don't think I ever I don't remember you speaking to that. I forgot the details of that. But we had a lot in common there.

Dr. Reichmann  18:44  
Yeah. And, and I think you know, when you tell your story today, especially when you're like, you feel like you don't have as low of a bottom as everybody, you know. Yeah. Not that I lie. But like, Let's go really into let's get let me give you some story. So I get my street cred. And now I'm like, I got now and especially now, that was I've been sober, so much like, I mean,

Joe Van Wie  19:09  
how long is it though? So I

Dr. Reichmann  19:11  
was trying to do the math, because what threw me off is my wife like two years ago, or not this past anniversary, but the year before, she wished me a happy anniversary, and she wrote like, she gave me an extra year of sobriety, which I was like, you don't even know how long I've been sober. And so now, I'm thrown off, but I got sober. July 7 2006.

Joe Van Wie  19:37  
Wow. Yeah. 10 plus 414 plus 216 years. 17. six

Unknown Speaker  19:45  
years, seven years. Yeah.

Dr. Reichmann  19:48  
I mean, I guess I'm like, not sober enough. Because I don't know the exact year age but like, and it used to be like, Oh, I could off the bat. But now it's like, I think I was even talking to my wife about this. How I remember assignments in college would have to get describe yourself in three words or five words. And one of the first words was always like alcohol. Yeah, exactly. And it was just and not that in a bad way, but it's like, that was just who I will. I'm sober. Like, that was a big thing. And now it's just, my life is so full around it, that it's just, it's just such it's just a component of my life.

Joe Van Wie  20:21  
Yeah, and that takes a little time to define him. Right? Yeah, it was such a defining thing, especially when you feel saved from an addiction. It's hard to consider yourself in any other lens for a while. But something happened. You got sober in Scranton, you grew up in Long Island, you come to Scranton, which is a jarring culture shocks, your introduction to these cultures through a 12 step program. So you meet a cast of characters.

Dr. Reichmann  20:55  
You know, it's funny, I just looked at 17 years, I pulled my Instagram post that I did 17 years ago. But yeah, it's funny, because I think it would have been, it would definitely be a culture shock to me today. But having gone from such strict rules, to then, you know, the barn doors weren't open because I lived in that transitional living program. Yeah, if

Joe Van Wie  21:22  
you and James, James, I love

Dr. Reichmann  21:27  
I think that will ease the shock of just like, Oh, I'm out. I'm free. You know, like, the freedom because it was overwhelming. I mean, I literally I remember feeling guilty driving a graduate from boarding school finally going home after 22 months. And I was listening to Eminem in the car with my brother. And oh, I shouldn't be doing this because we weren't alone that was considered negative music. And so that was something that you know, and so Scranton wasn't it was it was kind of an oasis Believe it or not, because oh, I can I can walk down the street by myself and go by a Dr. Pepper at Turkey Hill if I want, you know,

Joe Van Wie  22:07  
culture are going to indulge in culture this afternoon.

Unknown Speaker  22:13  
Turkey Hill

Joe Van Wie  22:15  
with the with the pagans are listening to the radio live. You know what I remember I met you in the midst of that, and I met a lot of guys, they're great guys. But there was a fundamentalism that was just you guys. I could see were being Washington. It was tired. I'm not saying it's bad. I'm just saying it was it seemed intense from my views, was a little older than you guys. I was like, Man, you guys are all wonderful. But it was a little fundamental and fanatical, you were really rigid. You were doing every one of us was doing well. But it was a rigid approach.

Dr. Reichmann  22:51  
Well, and it was rigid, because that's what was required to live there. And yeah, one way someone described it was it was, you know, this pendulum and we were living on such so one end of the pendulum, that it's like, well, we need to swing completely the other way. 180 degrees, then, you know, kind of balance in the middle left, you know, the 90 degrees,

Joe Van Wie  23:09  
or whatever. Yeah.

Dr. Reichmann  23:11  
I like that. And it's, it's good, but it's also not necessarily real life, you know? Yeah. Like, I remember graduating from the school thinking I was going to walk around campus, like holding a rosary bead, like with my coat up like a monk like that was going to be socially acceptable walking around a college and I was going to meet people that way, you know, and nothing wrong with that. But if you're in a monastery, yeah, you're fit right in. But if you're just working on a college campus, we're good. You're just That's it. But that was what the school made it seem like yeah, that's the acceptable thing to do. And then you get to the real world. And it's like, oh, this is not how people operate necessarily. And so figuring out your way, in the, you know, the real AAA what A is really like, and, and so that that was definitely a challenge.

Joe Van Wie  24:01  
Yeah. Yeah, good friends. So you had a lot of good friends and Scranton, so I don't know if you would describe it. It's a pretty forgiving culture and a testing ground, you're from Long Island, you got to go through that experience. So that transition happens here. You're leaving the fundamental rigid approach to this is the approach I'm taking a life to have a wholesome, fulfilling life, right? It's got some virtue. How did it safely transition where you felt like you were gonna apply yourself more into a, I guess for lack of a better terms a secular world? Or having new interests and not feel guilty about them? You seem to have done it really well. How did that happen?

Dr. Reichmann  24:46  
I think the biggest thing was I always stayed connected with AAA like I always I created such a strong support group, which I will say that that transitional living program kind of really set me up for one because you had one built then. But then also, you're building, you have the safety net there. But so I had at least one kind of given to me. And then it allowed me to develop my own. And I just I stayed connected like I made, I made sobriety, the priority. And that was, again, that will say, privileged because I didn't have to like work to go to school. So it wasn't like I was trying to balance school sobriety, a family, a kid, it was just, yeah, go to meetings and go to classes like that was what I had to do. And fortunately, scrap offered enough variety that that was accomplishable.

Joe Van Wie  25:36  
And so you go to school, just one question what what started to draw your interest to study academically? undergrad?

Dr. Reichmann  25:43  
I knew from elementary school that I wanted to be a psychologist. And really, yeah, because I saw psychologist in elementary school after getting bullied. And I was like, I'm gonna be a feeling stalker from legitime. From elementary school.

Joe Van Wie  25:58  
Holy God, I, Joe, I'd never heard just say that. And I've spent some, like, if you really make a measurement, I've probably spent hours and hours within the context of a recovery community. And I valued you like it felt there's an age difference, a little difference. I'd like to say, I valued you as a peer. And I would listen to you because I saw your experience in Scranton, and I just always valued your conversation style what you would be talking about. I didn't know, I knew you were studying psychology, but I didn't know you knew that. That's like that's like Napoleonic like, you know, you're gonna take over Europe.

Dr. Reichmann  26:40  
Yeah. Yeah. Right, like, drinking and other activities got in the way of, you know, that made that a challenge, right? Because it's like, Well, okay, I have this goal, but I'm not doing anything to get to the goal. But I knew from elementary school, like that's what I'm going to do. And it was, that's, like, you know, I even in regular before I got sent to boarding school, in high school, I took like, the, whatever psychology classes they had, I took it before, I was supposed to start my senior year, I was signed up for like, a college psychology course. So I was like, Yeah, this is the route I'm gonna go.

Joe Van Wie  27:17  
And it all rose from the first impact you had with a school psychologist.

Dr. Reichmann  27:23  
No, just a traditional out, you know, outpatient psychologists that I saw, I'll push that my, my mom had like, gone to like a support group with them back when? When my brother was in the hospital. And so I guess she still had the name. She's like, Oh, she's a child psychologist, you can see. And so I saw her in elementary school. And I was like, Oh, she makes me feel better. This is what I want to do. Wow. The first grade.

Joe Van Wie  27:51  
Fourth grade, you're seeing, do you think what made you feel good? What did it feel like? The first person was listening, active, like an active listener to a fourth grader? Like what? Connected?

Dr. Reichmann  28:02  
Yeah, you know, I never thought about it that way, Joe, but yeah, I mean, it was it was my time. And again, looking back, I get why my parents, one, you have two kids, you got to divide the time. But also my brother required more time, because he had a disability. So he got more attention. He needed it. But I think you know, as a kid, you don't understand that you don't get Oh, mommy daddy or giving Nick more attention than you think, Oh, they just liked him more. And, you know, we're going to his physical therapy appointments and his, and I'm just kind of going along with it. And so it was, you know, you didn't know. And when I was in therapy, that was Joe's time, I got the attention sheet, you know, part of his playing. And it's like, Oh, I thought about that way until now. But yeah,

Joe Van Wie  28:50  
I'm thinking about it more. I'm a dad, now you got a head start on me. Just the self centeredness of brain development. Like there is nothing beyond like my daughter, like she's, that's her point of view. Yeah. And it's freakish. I'm 40. And I'm reading like, a basic lifespan development book a couple years ago. And I'm reading and I'm putting them in context. So looking back at myself, I had this weird habit at 16. And some of the experiences you had, I'd look back and judge myself from the lens of an 18 year olds mind, I never kind of clicked the dial that my brain was not that sophisticated. Like, it's, it's hard. So I'm reading this book, and I'm reading it. I'm like, I've never looked at myself accurately. Like in this course of how a brain develops, right? When you started reading psychology, books and seeing things that are happening to people against their will, that are stemming from the brain anatomy, or changing the will or cognition of someone, like how did you view that it seems so freaky like where Here's a person's will or agency, would that draw you into psychology after having this background?

Dr. Reichmann  30:08  
See, I'll be honest in undergrad like you don't actually get that deep into it yet. So don't be a weirdo like you don't it's because really undergrad is giving you just like an overview. It's not until you get to grad school, you already like take it, they'll be committed, you're in a doctoral program, or at least a master's program. But in undergrad, you I mean, maybe you learn a little bit, but you don't go that as in depth until you get to grad school. Did you have like, I gotta get through this to just get to the next level.

Joe Van Wie  30:47  
Yeah, you've always been deep consideration thinker. I remember even conversations from a decade ago. So you have to laboriously get through undergrad to go where you really want to start asking questions and probing how do you fit into the world of psychology? Hey, it's

Unknown Speaker  31:03  
be Jonathan Edwards, again. You know, the editor, producer, and all that kind of good stuff. This is the part where Joe's internet cuts out. And that's why the following parts of the episode are a little disjointed for a couple seconds, but a they get right back into it.

Unknown Speaker  31:24  
I don't know what happened.

Dr. Reichmann  31:27  
Now all this talk about Mike, my internet better have a good connection. And

Unknown Speaker  31:31  
then Yeah, mine shut down here. It's rebooting. I'm not getting up speed that's fast enough to use it.

Unknown Speaker  31:40  
Oh, and not only did the internet cut out, but joven wheeze recording got kind of sketchy. It's a little muffled. I'll see what I can do to fix it.

Unknown Speaker  31:50  
So I can piece that back to a quick at it and just interrupt and say, you know, we had a little interference.

Unknown Speaker  31:58  
Alright, sorry to interrupt. Again, to be clear, when Joe says he will do a quick fix in the edit. What he means is that, John, that's me, we'll do the quick fix in the edit. And he will forget to tell me that anything happened at all? And I'll figure it out. Alright, as last time, I'm going to interrupt.

Unknown Speaker  32:19  
So by the time you're, you know, through undergraduates are you looking at as it's something in the way to get into the classes, you really feel you would be involved in psychology?

Dr. Reichmann  32:33  
Yeah, and unfortunately, I think one of my growth edges is, you know, I get to destination focus rather than the journey. Yeah, but it was kind of like, get the doctorate, get the doctor to get put up the shingle, and like, do what you really want to do and help people. So it was, it was kind of like, okay, I got to get through all this training to get to that point. So undergrad, you don't actually get much, you have to do a little internship, but nothing, nothing too intensive. So it's not really until grad school till your real training takes off.

Unknown Speaker  33:11  
How do you get a doctorate without that kind of, I always think, you know, a balanced life, you approach things, you enjoy the journey, not the destination, and, but the work and effort that goes in that I've seen my friends, you or other people with Psy D PhD, you kind of have to have that attitude to break through, right? Is there another way?

Dr. Reichmann  33:37  
I mean, they could have been more of a balance. And I think, you know, some people like my my doctoral program was a five year program. So, but some people have to take an extra year and make it a six year program or whatever it is. And, you know, when you're in it, that sounds like the worst thing in the world. In the grand scheme. It's, it's an extra year to give you more training for something you're going to do the rest of your life. So it's just it's such a pressure cooker that you're kind of you're stuck, you know, we're not stuck, but you're so focused on okay, at least I would say I was so focused on like, I just gotta get my doctorate. I gotta get the training, do what I got to do so that I could get licensed and and be done with this phase of life.

Unknown Speaker  34:24  
You do that work? And where is your interest drawn? By the time? You're now a licensed psychologist? You're in the Navy.

Dr. Reichmann  34:37  
Correct? Correct. But what

Unknown Speaker  34:39  
happened? Let's go back I did you get in? Did you join the Navy? When did so?

Dr. Reichmann  34:46  
It was so in order to get your doctorate in psychology you have to do a year long internship of training you already you do local, what we call practicums or externships. You know, I was at a state hospital. was at the federal prison. I was. So you do those they're part time. But your final phase of training is a year long your fifth year of the doctoral program is a year long, full time internship. And it could be a number of sites, it could be vas, it could be at state psych hospitals, it could be at university counseling centers, community practices, you know, there's so many different options out there different types of settings. Hazelden has when I actually interviewed at Hazelden in

Unknown Speaker  35:33  
Minnesota, Minnesota, yeah, yeah.

Dr. Reichmann  35:38  
And the Navy offers one. And so you, I, one of the reasons I applied to be honest, was, it was obvious, it was one of the highest paying internships in the country, it actually paid a real nice starting salary compared to other ones for more stipends, you actually got an intimate salary. I also knew it would set me up for the future because you did a year of internship. And then you you had to serve for another three years after that. So you had it job for essentially four years minimum. And I also thought being a veteran that opens up doors usually. And the a lot of these internships have hundreds of applicants apply. And of their 100 applicants, they might interview 10% of them. And then you know, they might only offer 10% of those people a position. So for example, my wife, who is also a psychology, we've entered our doctoral program, she applied to one site that has like over 300 applicants, somebody who had 500, and then they interview however many and they took, I think,

Unknown Speaker  36:51  
four. Wow, do you enjoy? Do you enjoy competition, and that pensive will throw that like, it's almost feels like throwing darts at a wall, like that's 500 people for choosing you, you love competition? Academics.

Dr. Reichmann  37:08  
That was her site, and it was the top of the class. So she had four points. She was legit graduated tower. I on the other hand, the Navy had put a list of 50 applicants for 10 spots. Okay. All right. So

Unknown Speaker  37:23  
we had

Unknown Speaker  37:25  
a very different very different ratio there a Oh, win to win. Yeah.

Dr. Reichmann  37:30  
So I thought, well, it's it's a higher likelihood of getting it, it'll open up more doors, it's guaranteed employment. As long as you know, as long as you do your job in the Navy, you could stay likely stay for you know, close to do 20 years and retire. So, and also, a student from my program had done the Navy internship the year before me, and he did well. So that put kind of my school my school's name on their radar. Oh, this individual did well. Here's this guy from Marywood. They must have good training. Let's give him let's give him an interview. Yeah, let's you know, and so. So I ended up matching with my first choice, which was at Walter Reed, or now it's called ash, Walter Reed National Military Medical Center, which is in Bethesda, Maryland, where the President goes for their case, you know, President goes for his care. And so I did a year intensive internship, it was brutal. It was it was a really brutal internship, but it was awesome. I got a really well rounded experience. And, and then serve three years after that. And you come into the internship as an officer, you're a lieutenant in the Navy, which is an O three grade, so you're, you know, st in line with a captain in the army. And so, prior to coming to the insurance internship, you do you go to Officer Development School, which is five weeks of pretty much how to be an officer in the Navy, like Navy 101, how to be an officer. So you do that, and then you go to internship, and now you're, you know, a pre doctoral intern, learning how you know, your final year of training really, and learning how to be a Navy officer and learning how to be a navy psychologist because Navy psychology is a little bit different than civilian psychology and learning all these things. And yeah,

Unknown Speaker  39:30  
I would have never guessed the path like from from knowing you like now you also have like, just the rewind, you went to boot camp. You entered it the Navy this way through a boot camp.

Dr. Reichmann  39:42  
So if you if I would, if you told someone enlisted that what I you know, what I went through was not boot camp. I call it baby boot camp. It was it was more learning about the military and marching around the base. Yeah, versus boot camp up there yelling at you more there. Yeah, it's a different vibe, because I'm essentially the people that would be yelling at you. I already outrank them. So they would have to be like, Sir, I need you to do this because technically I came in already outranking just because of my education. Wow. And I remember when we were leaving, I said, I really thought this was going to be more physically intensive. And the commanding officer of the base said, Look, you all are professionals work, you know, if I break a dentist's hand, because I assigned too many push ups, or we made you do burpees. Now that dentist, which were short, you know, we have a shortage of them. Now, they're useless to us. So if I go break up pilots hand, we got plenty of them, but no big deal. But we're sure IT professionals? Well, I can't be heard of you bootcamp.

Unknown Speaker  40:56  
Wow. It's interesting. I guess I've never understood maybe most people don't, how do you leave graduate school or professional license? With a degree you enter the military are all the branches kind of operating in that way, it's not as severe boot camp, they're trying to get officers and specialized professionals in, like, entry to just come on in?

Dr. Reichmann  41:20  
Yeah, well, for so I was a staff officer, which means again, I was I was going to be a you know, a doctor. Versus if you're, if someone's coming in, and they're gonna eventually be working on, you know, a ship. And they're going to be in charge of the sonar, you know, whatever, kind of, they go through a very different experience, they go through what's called candidacy school where that's way more physically intensive, that's longer, they're getting yelled at, they don't come in with a rank yet. They're, you know, they have no rank. And so they earn it after they complete it. So they have a very different experience. We saw them across the way. You know, we're drinking coffee during our meals and chatting, eating a doughnut, and

Unknown Speaker  42:02  
they get your nails filed, who

Dr. Reichmann  42:06  
pretty much pretty much they're, you know, they're like, not allowed to talk and get, you know, one glass of Gatorade and their cups of water and have to shave their heads. And it's from, you know, a psychologist or a doctor in the military, versus someone who's going to be like a line officer, something that Oh, then she'd be in charge of a ship.

Unknown Speaker  42:29  
I didn't know how that worked. Wow. Cool. So this sounds awesome. So like an awesome experience you take, take an opportunity to go into the Navy, which creates job security, or profession now that your doc you have your doctorate in. What is the first application of your degree that you you found fulfilling? You're like this is it? This is my profession. That's why I'm doing this. Where were you? And what were you doing?

Dr. Reichmann  43:06  
I don't, I don't remember this specific instance. Because it's like the the internship training was like drinking through a firehose. But if I fast forward, a few years completed internship, oh, by the way, after you complete internship, you have to do what's called a postdoc. So now I have my doctorate. But I still need another year of supervision to be licensed to act independently. So I still have to work under a licensed psychologist and have them read my notes and meet with them weekly or weekly. So you do that.

Unknown Speaker  43:48  
I forgot about that. I've heard like, I always forget that that's an aspect of it that my cousin just just completed that a year ago, when we had a celebration for last Christmas. It's a long road,

Dr. Reichmann  44:03  
you don't realize that one because you think, oh, okay, four years of undergrad, five years of grads of you know, a doctoral program. Wait, now, you still need to do another year to get licensed. So it's really it's 10 years, so you can like kind of hang up, hang up the shingle. But once I got that, and I did it in the a lot, the time that the Navy kind of expects you to write, you know, I wasn't some people there at the end of their commitment that four year and they haven't even gotten licensed yet. Because the list is tough. I mean, it's it's like a 50% pass rate. So it is a tough exam. And some of it you have to learn and you never use it again. But I was actually selected to be the assistant department head of the Navy's substance abuse program. And I feel like that's where it was, it was just kind of like, oh, wait, like, I never would have thought that would have happened, especially from even starting in grad school. And it's like, I'm gonna be the number To in charge of the military's because the Navy had the largest largest subsidies program in the military.

Unknown Speaker  45:10  
That's overwhelming. That's a huge position to take the, how many we're talking to hundreds of 1000s of possible people that this?

Dr. Reichmann  45:19  
Yeah. And I mean, so we were we were on the East Coast, we were like the East Coast subsidies program. And then West Coast had one that was just, you know, a few beds smaller, but it was a 70 to 70. Somewhere, but 70 ish bed facility. Wow, that's huge. And so it,

Unknown Speaker  45:39  
and then, like detox to inpatient care, and then like a continuum for a year, you're kind of staying with someone that's in the Navy that needs his treatment.

Dr. Reichmann  45:49  
They, they didn't do detox in our building. So a lot. They would do it actually at the hospital, like on a on an actual medical UK, when

Unknown Speaker  46:04  
they came to you for therapeutic treatment.

Dr. Reichmann  46:07  
And so our program, we had a, you know, what we call impact, which was like, just a three day kind of prevention course, almost like if someone showing some risky behavior, you we they would do what was called impact, it was like a three day psychoeducational course, just to kind of teaching responsible use. We also have like a level one, which was a two week, again, for maybe like alcohol use disorder, mild, to again, teaching responsible use, and then level two and three, level two is intensive outpatient, which was for alcohol use disorder, or substance use disorder, moderate or severe. And then level three was residential, mod, moderate, severe.

Unknown Speaker  46:51  
And was this designed by the military? It's not that sounds like something I've never heard applied in the world, your level one, we're gonna teach a proper use, how did this get designed? And what was it, you know, not only its effectiveness, the efficacy over a year, but somebody?

Dr. Reichmann  47:15  
So I mean, the military is all about outcomes, because limited time, they don't want to waste money. And so they try and find the form of treatment that works best. So part of it was the model of truth is based off of Are you familiar with ASAM? Criteria? The American Society? Yes, absolutely. Utilizing the ASAM criteria? How, what's the appropriate level of care?

Unknown Speaker  47:39  
Wow. So it's just in, they keep updating that when a Sam's like starts to change? I guess it what surprised me is just saying like appropriate care, I guess that's a really interesting way to say, you know, a you're not, we're not saying you're an alcoholic, or a drug addict is the responsible use, I guess I don't understand the term means and what does that mean? Like, what would that look like? I came in, I'm level one. And I get this four day psychosocial assessment. What am I looking for? Or what would you be looking for in use to give me responsible use?

Dr. Reichmann  48:16  
So maybe, so the military has pretty strict rules? If you know, you're not supposed to drink before? You're 21? You shouldn't obviously, like they have the rule of 00130 drinks, if you're below the age of 21, zero drinks, if you're driving one drink an hour more, no more than three drinks in a sitting.

Unknown Speaker  48:38  
That's pretty cool. Yeah.

Dr. Reichmann  48:41  
And, you know, they're all about like, keep it simple. 0013. And so it might be, let's say, you, maybe you're just you're, you're a 19 year old sailor, and you get caught with alcohol in your barracks. Okay, okay. But all right, it was a one time it was a one time thing, you know, in quotes, whatever. But all right, there doesn't appear to be a problem here. But usually, people want to just do a cya and say, Okay, let's offer him something. Alright, let's give them impact this, you know, three day prevention, just teaching like, hey, responsible use, let's not have it become an issue. Wait till you're 21. And when you do, you know, that kind of overview of, you know, responsible alcohol use,

Unknown Speaker  49:28  
and here any period and the initial kind of encounters, like scenario you described, that maybe you're also like, are they looking for anything that would be trauma, or something, maybe, from their history, their intake history, that would be like, Okay, maybe get caught with a six pack. But, you know, from this assessment that whatever information you're gathering, say was ASAM are these psych social Are you You're looking for individual care, maybe this person needs a different approach. I see trauma or abuse or neglect or a really distressing background, prior to the military, is that something that we look for?

Dr. Reichmann  50:15  
So the way the military at least they did it when I was still in, they would do you would have a substance abuse counselor, do the kind of like just the specific substance abuse screen, and they'd go through the criteria, and at least for the military, assess abuse counselor couldn't make a formal diagnosis. Yeah. So they would kind of get at least the background, alcohol use. And then so they'd have, they'd get screened for the substance abuse counselor, and then they'd have another meeting with a psychologist and they would look for the criteria that correct, you know, alcohol use disorder, substance use disorder criteria, in addition to other mental health stuff.

Unknown Speaker  50:59  
Well, what it was,

Dr. Reichmann  51:03  
I would say, it was a very comprehensive assessment. And I took pride in it. It wasn't like I developed the program. So it's not like, oh, there's a sense of pride that I developed it or any

Unknown Speaker  51:17  
part of my design

Dr. Reichmann  51:20  
is kept the ship going. Our program, I would say, We there was another, there were civilian rehabs in the area. And people, service members had gone to both, you know, some people they either got in trouble with us, or just maybe there's to waitlist. And so they had to, and they've said like, Oh, you guys are better. I mean, our facilities were not pretty by any means. Sometimes the air conditioning went out and it wasn't you know, I always say we weren't like passages Malibu that had like, you know, you get massages, and ride horses.

Unknown Speaker  51:56  
accessible to you all day, we shop more in the lobby.

Dr. Reichmann  52:02  
But the level of care was was solid. Yeah.

Unknown Speaker  52:06  
I had a guy that today came in from a guest speaker at our outpatient. He said, I've been to the best rehabs, and he has. And I've been to some really shitty ones, like the worst when he ran out? Because you know what the same thing was the answer. When they were nice. And when they were shitty? The answer was the same for me. And I wasn't willing to go all the way to change when it needed to change. Right? I found that funny because, you know, the Navy, it sounds like that's a really efficient approach. You know, bare bones, let's get right down. Which, where's the problem? Do you want to, you want to be a partner in solving if you want, right? We can help you.

Dr. Reichmann  52:47  
Right? And they really did set people up for success as much as possible, because then there was if you completed level two or three, like intensive outpatient or residential, you have to do a year of aftercare. So that's so weak, you're required to report for, for I would the hour long groups to out but you know, at least group therapy once a week. And you had a that there would be someone there called Dabas drug and alcohol program advisors, at least that's what the Navy had, which essentially, they were just someone in charge of making sure service members were following up the way they were supposed to.

Unknown Speaker  53:31  
That was our recovery Sherpas. Exactly. So, Joe, if you had to point at the Navy, having kind of whatever the results are that are producing, say, not only sobriety or what the person deems recovery, stability, emotional stability. Everything I read is what you just said it's a it's a year after care, would you say this is probably the strongest element of it?

Dr. Reichmann  54:01  
Well, I will say there there is a layer of extrinsic motivation. I don't have my dog solid ground, ah, that was my mind. One darkness, basically, there is some extrinsic motivation, because if people do not complete treatment, let's say, you know, you can voluntarily go you can be kind of forced to go for command depending on what, what brought what got you to that point, right? If someone gets a DUI or their command is notified, and they're forced to go to treatment, or they get kicked out of the military, they might even still be getting kicked out of the military. And, and then this aftercare is a requirement. So if someone doesn't do it, they could be at risk of getting kicked out of the military. So if someone values their career, they're not going to they're going to follow through, we used to say we had a 75% success rate, which you know, will close most civilian facilities out of the water. However, what it really what it boiled down to is 75% of people did not get a second alcohol related incident. So the military because of MRIs, you know, again, maybe the DUI, maybe they were drunk on base or disorderly conduct, whatever, or drunken disorderly, you know, Senator representative, but didn't get another one.

Unknown Speaker  55:32  
So that's the metric of that number, the success is there, that there's not a repeat of the term of service. Correct. Okay. That's not a bad metric to run off of.

Dr. Reichmann  55:48  
We're now in the role, realistically, the role of psychologists in the military is to in general, is to keep people in the fight. Is to that's that's the role is if you are, you know, if you're having issues, that the military pays a lot of money to train people they want to retain. So my job is to let's work through it so we can get you back out there and doing what you're supposed, you know, back in the fight. That's the that's the goal. And so the same thing,

Unknown Speaker  56:24  
terminology used to sometimes let's get you back in the fight.

Dr. Reichmann  56:28  
Oh, absolutely. Yeah. How long have you been away from the military? You're out. So I completed my contract and separated in January 2019. I got out.

Unknown Speaker  56:49  
You know, what did that transition look like into the private sector? Is that is that jarring for to leave the Navy, we're in a navy mode. And what you just described to me that's, that's a proficient very, like, I don't know. Very distinct approach to drug and alcohol treatment. Under the Navy's umbrella. What are you doing now? And was that transition weird? Different? In the military?

Dr. Reichmann  57:20  
It was just a little weird. It's funny, because I always thought like, I was never Joe Navy, you know, I know. Right? You know, and it's not like I went in for this, you know, this, this deep meeting, I was like, Oh, this is gonna give me good training. And, and, you know, pay the pay pay? Well, which it's a side note, I used to I worked with some service members that were like, you know, what are these doctors motivation for, you know, for either be here, do they even want to serve their country. And I remember saying to a group of them, I was like, Guys, if I have a loved one, if my wife is sick, and she needs open heart surgery, I don't care if that doctor just likes cutting people, and that they did it as a socially acceptable way to cut people. Like, if, as long as they're going to save my wife's life, like, I don't care what their motivation was for being in the military. Just do your job and do it well, and help, you know, so what does it matter if it's they joined to serve their country, or they joined for whatever benefits of the money like, if there's helping people, that's what matters, but they're for saving lives. But maybe that's just my justification of why I came in. But I that I, the transition was more was weirder than I thought it would be. Because I always thought I've only been for four years, no big deal. But even like, you have to lace your shoes and your boots a certain way. Certain, you know, one side is supposed to go over the other. And that's just stuff like they teach it to you. And it just sticks it stays in your mind. And so or even you know, in the military, you're not supposed to like lean on the wall. You're not supposed to be like walking around drinking a bottle of water. They say that sloppy looking. So you got to look like you got to be clean cut, you got to be what the term used is squared away. Where's that then you get it out? And you're like, oh, people aren't squared away, like, you know. And so that was a little weird. But, you know, having it was still it was four years. It wasn't like, as like, I'm a naval officer. Yeah. But so now I actually work for the VA and that was my goal. Getting out of the military was I wanted to work for the VA. I wanted like a government job. I considered one of the like other government agencies, three letter agencies, but they kind of dictate where you have to live. So I said, I'm not going to go that route. I want to I want to choose where I want to live. I'm getting out of the military for a reason. And so So Yeah, now, I mean, there's very similar bureaucracy, you know, working for the government as there was working for the Department of Defense. So it's not all that differently, I get to choose what I want to wear.

Unknown Speaker  1:00:13  
Wow. Yeah. But there was never a change in the approach, I guess, called bedside manner. But the way you approach a patient or the needs say it will be a lot different.

Dr. Reichmann  1:00:28  
No, I mean, again, being active duty, you get a certain level of street cred being in uniform, you know, seeing an act in the military employees, you know, civilians, there's still we had civilian psychologists that work for us. But you did get a little a little level of street clip cred saying, Hey, I'm in the uniform to I follow the same rules you have to. And so working for the VA? I mean, not that it doesn't enhance care, I think. But I think that's enjoy when I say oh, yeah, I was in the Navy, I'm a veteran as well. I mean, it just gives me a little more street cred. But the veterans way of approaching care treatment is very similar to the military's right, they want evidence based approaches. That's like the big term that's thrown around the military and the VA is we want evidence based practices ebp to make sure it's been something that's been studied, that's effective. Not that we keep someone in treatment forever, but hey, they get their dose of treatment, however many sessions and then okay, let's, let's get them out in the world. That's the goal.

Unknown Speaker  1:01:40  
And so for the vets to, you've seen a level of care and a continuum of care that was consistent 12 months per full bodied, kind of approaching to an addiction, say, Would it be stepped down to a year to outpatient check ins? Encourage peer to peer?

Dr. Reichmann  1:02:01  
Yeah, I'll be honest, I'm not as familiar with the VAs approach to substance use disorders just because one. One thing that's a term that's thrown around a lot is if you've been to one VA, you've been to one VA. So a lot of VAs approach, you know, there's going to be nuanced differences and maybe even major difference.

Unknown Speaker  1:02:26  
Yeah, yes. Do they all have the liberty to take their own approaches to things like VA said, No, that was me to each VA, or you're saying,

Dr. Reichmann  1:02:41  
there is some just even so I manage a program that is designed to treat veterans diagnosed with a severe mental illness so that the VA defines that as psychotic disorders like schizophrenia, bipolar disorder, chronic PTSD and chronic depression. And so the program that I manage if I talk to other VAs everybody kind of managed it somewhat different, we serve the same population. But there, everybody, every program I've talked to is different in how they approach their treatment.

Unknown Speaker  1:03:15  
Wow, you're dealing with some heavy, that's a heavy load psychologically, of problems you can have. These are the heaviest that you can understand psychotic disorders.

Dr. Reichmann  1:03:29  
Yeah, in a way, in a way. But I also always hesitant to say that because I hate the term severe mental illness because, yeah, I mean, one. I mean, I think now, opioid use disorder has surpassed eat anorexia, or eating disorders as the highest more, you know, highest mortality rate among mental illnesses. But for a while it was eating disorders had the highest mortality rate among all mental illnesses. So I mean, to me, that seems pretty severe. Right. But that doesn't get listed under severe mental illness. So I don't love the term. Because also, let's say, let's just let's say you had anxiety, generalized anxiety disorder, and that was crippling your life. And you couldn't leave the house, maybe you had a gore phobia, so you couldn't leave the house. Because you just felt so uncomfortable. And, I mean, that's pretty severe, right? Like that. It's debilitating. And they say, well, but that's not an SMI. You know, that's not one of these four. So I don't love the term. Just because I feel like if I heard if I was suffering with something that wasn't one of those and it was really, you know, devastating my life and it's like, Well, okay, I guess it's not that severe what I'm going through them they just have, but that's the the term that they use. Typically when people say severe mental illness, they think of like psychotic disorders. Generally do

Unknown Speaker  1:04:56  
I'm glad you clarified that because I'm starting to learn a little more what the power of language of what you just described to me. I'm glad that was said, because of the experience generalized anxiety to like us what, agoraphobia now you can't leave your house? What the fuck? I mean, that's like, you're now losing all the norms and standards of your community, you can't be a part of it, like how are you going to sustain a life a job? This is a severe problem. This This is, like debilitating, but it also from my understanding, you work off of spectrums like of describing things xiety From where does that nuance come in? Like, so severity? Can that be applied to say anxiety, depression, and mood disorders? Each one of those problems you described is on a spectrum from severe to moderate to? How does that work? Is that the DSM five kind of approaches? Do they all have different descriptions of severity?

Dr. Reichmann  1:06:10  
They do. They all do not. And I'm glad you actually read my mind set. That's one of the things I wanted to touch on. So certain certain disorders do like we were just talking about alcohol use disorder, mild, moderate, severe. One thing that I think it's important that I don't know, if everybody always thinks about it this way, is just like physical illnesses are on a spectrum. Let's go with cancer, right? Some people have like, stage zero, you nip it in the bud, maybe it's you treat with some with radiation and never have it again, right? Some people have stage four, they get chemo data, they get rid of it, then it comes back, or they get a different form of cancer, it's you know, different forms of cancer, and maybe eventually, or some people, they, they just all of a sudden they go to the doctor, they've got stage four, and they're dead in a month, right. So just such a range with physical illnesses. And the same thing is the case for mental illnesses. Now, the DSM, the Diagnostic and Statistical Manual of Mental Disorders, it it doesn't. All mental illnesses aren't, don't have the specifier, you know, mild, moderate, severe depression is one of them. Again, that substance use disorders is another However, at the end of the day, they all are on a continuum, some people can meet criteria for generalized anxiety disorder, and they could still, you know, maybe they go to work. And by the time they come home, they're drained, because they just had to, like, hold it all in, and maybe their stomachs, all in knots, and they're having GI issues because of it, and their muscle tension. But they kind of like maybe someone else might not know even what that person is dealing with. Yeah. And then again, on the far end of the spectrum you might have some of that's like, I can't even leave my house because I am so anxious that I'm shaking, and I can't, there's too much worry. And so that's just you know, we're just talking anxiety here. And that's, you know, two ends of the spectrum, just like depression, some people can be depressed and still do quite well. And some people are kind of bedridden from their depression and just can't even get out of bed. They need you know,

Unknown Speaker  1:08:25  
Barb and I know what that felt like in sobriety that rose out limits. Do you find I guess this is two questions, or people? Do people seem surprised especially say with substance use disorder, that you can apply a severity, different stages of addiction or the severity of this addiction, this impulse to use or disregard all connection to your norms of your life? To fulfill the use of the drug or a drink? You find people find it surprising that you're you're giving them I don't know, I don't want to say maybe for lack of better terms of diagnosis, but you're adding a severity Hey, listen, you might not have thought this was anxiety. You may not have thought this was an addiction. But this is the beginning. A mild does that surprise people that there's a spectrum description? Have you ever encountered that

Dr. Reichmann  1:09:30  
I have not found anybody that was surprised by it. I I mean, especially since I've sat on the other end of the chair, I try and really give people the rationale for like where I'm coming from. So the I have not personally I mean, at least I haven't seen any shocked look on their face. But even let's say you're my patient, and I was giving you the feedback like we finished the intake. I I let people know, just like you and I just talked about the DSM. I say, look, there's this this book, this is kind of our, our Bible that we go off of. And it has, you know, all the mental illnesses recognized by the American Psychiatric Association. And, you know, obviously, we're in this case, we're specifically talking substance use disorders. The way it works is, you have the criteria listed. And if you meet a certain amount of the criteria, you meet criteria for the diagnosis, substance use disorder. Yeah, and depending on how many criteria you have, I think if it's two to three, it's mild, four to five, moderate, six or more severe. So depending on how many you check, that's, that's the level of severity that goes along with it. So I usually, that makes sense. Like, oh, okay, got it. So, and I let people know, when we're talking about substance use. So if we're talking about pattern of use, we're not talking like a one time thing. So especially let's say someone, you know, uses under the influence? Well, the DSM says it has to be, you know, again, a pattern. So if someone just doesn't want, that's not a pattern, but if they're like, Yeah, I drink and drive multiple times I get this, this wasn't the first instance, especially when someone comes in for a DUI or a lot of people. So this was the only time. Yeah, it could be. Or it could be the only time you got caught doing it. Right. So but, again, there needs to be that pattern. And I usually err on being pretty conservative with my diagnosis within that area, because I, there's such a high degree of denial. So if I just say, I seems like it, let me you know, disorder severe. I mean, there's already,

Unknown Speaker  1:11:43  
I'll call you tomorrow, look forward.

Dr. Reichmann  1:11:46  
Right. So at least if you're more conservative than a semester, need it. Yeah. And so by explaining, again, I explained that to them. So in the VA, we use the term shared decision making, I'm kind of thinking out loud with the person, let's share this decision

Unknown Speaker  1:12:04  
that builds trust, a deeper sense of empathy, that you've been transparent, and that we kind of make an allegiance with each other that if there was treatment, or the course is going to be with you of treatment. Here I'm a guy you could trust. I'm going to be open with you. There. Here's a book that I'm measuring what you're describing, to me these metrics. I just for fun thought experiment when Joe DSM six gets written. This time next year, it gets released, say hypothetically. Okay, are there new disorders in it?

Dr. Reichmann  1:12:40  
They probably will, or renamed or reclassified? Yeah, they actually just came out with the DSM five TR, the text revision, okay, again, so subtle nuances, but they they like so for example, post traumatic stress disorder, it used to be listed as an anxiety disorder. But now, the DSM five, the DSM for TR, trauma was part of PTSD was part of anxiety disorders. Now, with the DSM five, it's they have a whole new category trauma and stressor related disorders and PTSD is. So they, they they've kind of broken it up a little bit more added different criteria. I think. For substance use disorders, what was the one that they added? Not withdrawal. Craven was added to the DSM five that was that was

Unknown Speaker  1:13:43  
craving as a physical? Or how do they describe it?

Dr. Reichmann  1:13:49  
I don't remember how they, if they how they define it, but I believe I'm pretty sure that was the one that they that was a criteria that they added, I believe.

Unknown Speaker  1:13:58  
Criteria. Yeah. Okay. What has changed since, you know, are your entry into recovery, its definitions from 12 Step organizations. You know, as a young guy who go to school, you're highly specialized, you serve this distinct population. We didn't grow up growing up with the idea of trauma trauma base, might be the source of an addiction. How would you describe that? And is that your school of thought? Do you come from approach an approach that addiction is hiding the deeper trauma? Or is that too generalized? How would you describe it?

Dr. Reichmann  1:14:43  
I would say I would say it could. It really it could. And I think I mean, it's very common for people who are diagnosed with PTSD or, you know, maybe you don't have post traumatic stress disorder. Maybe you don't need For all the criteria that maybe you have, you've experienced trauma, people use alcohol to avoid, right, that's one of the biggest things that keeps trauma kind of alive is we've kind of we throw it in the closet, we try not to think about it, we avoid it, and we don't go there, we don't talk. And what does drugs and alcohol do that really helps people avoid. So it's a very common medication, and especially among the military, because in the military, certain positions, you, you're not really even allowed to take psychotropic medication. So like an antidepressant could make you when I say lose your job and kick you out of the military, as a pilot, a pilot can be grounded, not able to fly, which then, you know, could prevent could prevent promotion in the future, if they're on an antidepressant. Wow. And so, how do they medicate? Oh, there you go, we got a drink. That's, you know, even if you'd get a drug test, you gotta your analysis. Well, if you have alcohol, you know, alcohol is not going to make it pop on the drug test, you know, unless you were drinking right before, you know, that would be acceptable. But if you pop for something else on a drug test, you're going to be in a lot of trouble. So or if you're, you know, oh, I'm feeling depressed, I need an antidepressant. There's concern with being grounded. And so there's that dynamic in the military of people using alcohol, depending on their job as that form of self medication. And you see it all the time, or even people that have been in a really long time. They're just trying to hold it together. So they maybe they've done a lot they've deployed, they've seen a lot. And it's just like, look, they're just they're hard chargers, and that's how they're used. That's how they're coping with alcohol.

Unknown Speaker  1:16:48  
And do you come from the idea with with that, do you think it's a revelation for them that maybe they didn't get addicted to drugs accidentally, like, like, that description that there's hooks in it? I just went too far. And I use too many. Are you always exploring for maybe a trauma in that sense? Like, it's not just that you accidentally are stuck on back pills now? Are you looking for that? And that? Is that kind of what your problem for from the start?

Dr. Reichmann  1:17:20  
Yeah, absolutely. Kind of what cuz you want to look at what, what's the root here, right? I mean, I think the 12 steps do a really good job of focusing on the alcohol part, right? But I mean, you a lot of people coming to AAA are not trained. They're not necessarily like, they're not mental health professionals, right? They're just fellow fellow alcoholics. So I think that can like take people's view of all like, what are some of the issues here? And again, it you have to keep it simple, keep it simple, stupid, I'm all about that. But we can't always do that. We're such complex beings. And if you just I mean, they always say the drink is just a symptom. Yeah, but it's also could be the symptom of other mental illnesses.

Unknown Speaker  1:18:07  
I felt, I mean, I went to therapy right away at this time, you know, I'm sober 14 years relapse. And we talked about two months ago, I was giving a loan out. And my anxiety before I drank was completely unhinged. I mean, it was affecting my life. And I got relief from drinking when I relapsed again, but man, I was in a big jackpot after that, because now I have my life split into a secret life, I don't want to alarm certain people that I'm drinking, because that would hurt them. So this like, in a grown man, a deviance is rising up again, I'm going to have a secret life of drinking. I'm combating anxiety, I'm creating more. It was like a total nightmare. I couldn't see it that way while it was happening, but I went further, I need a more complex help. Right after that, but the fellowship is powerful. And you can live off it, but some of us

Dr. Reichmann  1:19:09  
say, I mean, the fellowship gives people and it's really special because in other traditional even with the program that I develop, right, like, we're that I develop that I that I manage, when I go home at night. I'm not like on call though, so if, if a veteran needs help, like there, yes, there's the Veterans Crisis Line, you know, just like there's a suicide prevention hotline and, and that, but there's no like, oh, I can call this person and get in touch. It's, you know, you got to use your own resources, and the felt fellowship of AAA. Like, that's, it's there. You have someone that like, likely if you have 510 people's numbers in your phone, and it's 2am One of them's going to pick up if you're having a really hard time, like you have the built in and if you say like, look, I really need to meet I'm really struggling. Someone's going to be there. As long as you have a little bit of a network, and that doesn't exist a lot of time and just traditional mental health land

Unknown Speaker  1:20:10  
to start winding down we've been on for an hour. Joe, what would How would you describe your your personal self care to a C sharp in the field of mental health? Helping people that are in crisis? What's the trend? What do you do as a weight? Is it exercise? Meditation fellowship?

Dr. Reichmann  1:20:31  
My, my biggest thing is like the 100% me time because I personally, I need some time where I could not think about the people I work with the colleagues, my family, you know, I love my family. I love my kids. My wife is amazing. Love my kiddos, but still, you know, I need time where I could just not think, you know, the Bryant brains always go in or obsessing about some whatever my new obsession of the week is. And so working out is usually my go to one for my mental health also for physical health. I mean, it's all connected body mind spirit, right? And so that's my, it's my turn. While I do that, it's kind of like I can unplug, maybe it's only 30 minutes, maybe it's an hour, but it's like, I don't need to think during that time. And that's, that's my main form of self care. I would say.

Unknown Speaker  1:21:23  
That's Joe church.

Dr. Reichmann  1:21:28  
Again, raise house.

Unknown Speaker  1:21:31  
That's good. That's, that's, that's great. Because, you know, to take care of yourself, you're hearing crisis all the time. I don't think people consider that when they're receiving now from a professional. How much you have to care for yourself to hear that all the time.

Dr. Reichmann  1:21:51  
Yeah, and that's the, you know, the patient shouldn't have to work like that, you know, there's something wrong if the patient were like, Oh, I hope I'm not burned. But absolutely, I mean, you, especially if you care, you think about this, and I, I personally, like there's, I worry about some of the people I work with, you know, and even just worrying about my colleagues are they burnt out. And so having that time to kind of unplug, and you know, even being a dad a ton of like, okay, the kids are asleep, now I can just, like, sometimes I just the kids can't sleep, I just sit there and kind of stare at the wall. So I'm like, Alright, I just worked all day. And then

Unknown Speaker  1:22:30  
my old friend wall was out.

Dr. Reichmann  1:22:39  
So the biggest analogy that's used and is kind of like, you know, you have to, I use it with my patients, I use it with other professionals, it's, you know, on the plane, you have to put on your your, the, the oxygen masks, you know, drop because all also pressure, you have to put your mask on before you can help someone else. Because if you pass out, you're no good to anybody else. And so I say that is the same of mental health providers.

Unknown Speaker  1:23:07  
Yeah, that's a great, great, no, I think we go, we could close on, I'd like to have your back and unpack more psychological terms later, because it's, it's a rabbit hole for me. At DSM five, I started thumbing through it I'm not a professional, but mind bending, how the descriptions have changed in just a short period of time with 30 years, they seem to be more intelligent. It's just got to be so hard to write those, like a consensus of the community. And it just that was written. Right, there was

Dr. Reichmann  1:23:43  
just like an AA, you know, everybody has their opinion, you know, and so the absolutely, I mean, just how far we've come. I mean, years ago, homophobia was listed as a mental health diagnosis it was sent to, but it was like, I don't remember what year that but like a DSM had homophobia, or, I'm sorry, homeless, homophobia,

Unknown Speaker  1:24:11  
homosexuality, disorder,

Dr. Reichmann  1:24:14  
this and now, you know,

Unknown Speaker  1:24:18  
joke hysteria, the idea of hysteric feminine hysteria, which, you know, rose from being Bewitched, a witch, a witch. I found this I was thinking about this the other day, I'm talking me through some crazy stuff, and I'll pick up an old book, man, it's a manifest of witches, the hammer of witches, one of the first published books with the brass outside of the Bible, like the first kind of bestseller, and it's this Calvinistic approach of how to interrogate which your encounter Yeah. And it goes through all the standard procedures. It's like an addicting rationale. So They establish a let's take the first half of the book. So they don't think we're crazy established why witches are real. The second half is the application of interrogation and trial. Now, at the same time Copernicus wrote, you know, the spheres of the heaven, this book outsold it, and it was used practically. It was only 400 years ago that most churches wanted to have that book in case they had to boil a woman. looking crazy. We have the DSM five, little more humane. Okay, right. That's not a short. That's how long run through history?

Dr. Reichmann  1:25:39  
No, no. And yeah, I mean, the Met the constantly The idea is gaining that cultural competence, right? Because everybody, I think sometimes when people think of diversity, just think of a cup, or not every not everybody, but often people think about, oh, white and black. Like that's, that's the flow. But there's so many I mean, Latinos Asian, like, I mean, there's just and even just within that, there's so many cultural differences. Even Scranton, Pennsylvania has its own culture, right. So get I think there's a huge push to gaining that cultural competence, which really, at the end of the day is our roles as mental health professionals is to build a bridge over so we could see the world through our patients eyes like that's, that's the that is the goal.

Unknown Speaker  1:26:27  
If there was a closing thought, DSM six, just me saying if it gets written, would you? Would you think most advocates in yourself would want to see the bursar definitions for more at risk populations, diverse populations indigenous? Because they're not having the same psychological problems in certain degrees or nuances? Would you like to see a part of that tech represented more clearly other populations and cultures?

Dr. Reichmann  1:27:00  
Yeah, and that is a battle that clinicians face and I would say good clinicians consults like, I was just part of a consultation group today of I mean, I think a good clinician will consult us to say, Hey, am I seeing this right? Because yeah, if someone's from a different culture, and they're saying they're hearing voices, and you know, we in America think oh, this is schizophrenia, but in other cultures that be like their ancestors talking to them or you know, and so, very, very different experience and part of it could be even consulting with someone a professional from that culture to get a better understanding. So,

Unknown Speaker  1:27:40  
it could be language I mean, we think and language or concepts in a foreign language using two different languages one is taken English say a Second Language Hearing voices can be just elaborate thought it's not auditorium. elucidation, he might lose his liberty telling you totally both are confused and befuddled in the message. Yeah, that's wild. A lot to consider when you're a layperson and I'm looking at this I'm like, wow, that's, that's it's complex.

Dr. Reichmann  1:28:12  
It really because we are all such complex humans, you know, and we're talking about the brain here. We're not talking about not not that what I interested but we're not talking like a broken femur. You know, you see it you get an x ray,

Unknown Speaker  1:28:26  
it's clear cut. You're talking about a quantum computer that we still don't know how it works in my skull, I'm calling it me but I don't even have access to all its information. Yeah, so freaky to be a human being and not have access to what you think you are. Right? Yeah. Weird, a weird idea. And a lot of

Dr. Reichmann  1:28:46  
people don't always like have insight into Hey, you know, this is why I've done this and, and that not everybody engages in introspection. And so I think yeah, I think the field is constantly working one kind of, to destigmatize, but also to gain just a better understanding. And that's taking you know, different cultures into account and but again, it's treating the person like a human what you know, what is your unique lived experience because you're a guy you know, grew up in New York, landed in Scranton, eventually you've been there and what's your experience in Scranton versus I could ask someone else that they could have a very different very different experience.

Unknown Speaker  1:29:30  
Yeah. Wow. Well, Joe, it was great catching up. I hope you enjoyed it. I'm gonna make sure it recorded.

Unknown Speaker  1:29:43  
We got an interruption. So in wrap up there any closing thoughts or ideas you'd like to

Dr. Reichmann  1:29:52  
know? Well, one thing I just want to put the plug in and not that it's anything we talked about, but the the that number for the suicide crisis line actually changed. It used to be some like 1888 Number, this long, 188 number, and now it's 988.

Unknown Speaker  1:30:12  
I can I attach it to the show? I could do that and put it in the show. Any social media posts? That yeah, I think it's tangible information. Resource. Is it a recent thing that just happened? I didn't I put it

Dr. Reichmann  1:30:27  
within the past year.

Unknown Speaker  1:30:29  
All right. Well, that should get out there. That's important information. Because,

Dr. Reichmann  1:30:33  
yeah, you guys now. Yeah,

Unknown Speaker  1:30:37  
so the line.

Dr. Reichmann  1:30:38  
Yeah, the suicide and crisis lifeline. It's called that's call and so 988 You don't have to like remember this huge, long number anymore. And it's actually the same number for veterans. They just, you know, veterans press Option one, and you get the Veterans Crisis Line. So it's, but it's 988. So it's just a very you

Unknown Speaker  1:30:58  
988. And you're, you're you're talking? Yeah. Awesome. Well, Joe, I'm going to wrap it up. And can you stay on? For a second? Yeah,

Dr. Reichmann  1:31:13  
absolutely. Thank you for having me. Thank you.

Joe Van Wie  1:31:22  
I'd like to thank you for listening to another episode of all better find us on all better.fm or listened to us on Apple podcasts. Spotify, Google, podcasts, Stitcher, I Heart Radio, and Alexa. Special thanks to our producer John Edwards, an engineering company 570. Drone. Please like or subscribe to us on YouTube, Facebook, Instagram or Twitter. And if you're not on social media, you're awesome. Looking forward to seeing you again. And remember, just because you're sober, doesn't mean you're right.

Transcribed by https://otter.ai