1. Addiction: Sin, Disease, or Psychological Defect SPEARS Decision-Making Model is Key to Real BioPsychoSpiritual Treatment by Integrating Science and Faith By Karl Benzio, MD

2. Copyright 2014 - Lighthouse Network

4. ADDICTION Sin? Disease? Personality Defect? Copyright 2014 - Lighthouse Network

5. HELP! I prayed, took meds, and love my mother! I’m DYING Psychological Defect- Tell me about your mother! Sin- Have more Faith! Disease- Take your MEDS! Copyright 2014 - Lighthouse Network

6. Darwin and Freud Faith: the assurance of things hoped for, the conviction of things not seen. Science: Hard Data, Measurables Definitions Collide Do they work together? Copyright 2012 - Lighthouse Network6

7. Science is: The study of what God made Understanding how He designed it to work Learning how to maximally steward it for God’s glory and our abundant living Copyright 2012 - Lighthouse Network7

8. God’s Great Gifts Mind/Heart Free Will: Decision Making Copyright 2012 - Lighthouse Network8 Science is a tool. So let’s not ignore the science. Science is a tool. So let’s not ignore the science.

9. What is Addiction? Science and Bible Perspectives

10. DSM 4 TR… Substance Abuse One or more of the following: Failure to fulfill major obligations at work, school or home Use when physically hazardous Recurrent legal problems Recurrent social or interpersonal problems Copyright 2014 - Lighthouse Network

11. DSM 4 TR… Substance Dependence (Addiction) Three or more of the following: High or increased Tolerance Withdrawal Consumption of larger amounts over longer period of time than intended Copyright 2014 - Lighthouse Network

12. DSM 4 TR… Substance Dependence (Addiction) Three or more of the following (cont): Unsuccessful efforts in cutting down Significant time spent obtaining, using, thinking about or recovering from the substance Substance time replaces social, occupational, or recreational activities Continued use despite adverse consequences physical, psychological (spiritual) Copyright 2014 - Lighthouse Network

13. DSM 5: Substance Use Disorders Not using the word ‘addiction’ Behavioral Category – gambling(was Impulse DO) Considered Sex, Eating, Caffeine, Internet Internet Gaming and Caffeine Use DO in the appendix Use same 11 Criteria but: Craving will be added, Legal issues dropped 0-1, 2-3, 4-5, 6+ Copyright 2014 - Lighthouse Network

14. American Society of Addiction Medicine  Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry.  Dysfunction in these circuits leads to characteristic biological, psychological, social, and spiritual manifestations.  This circuitry and resultant manifestations lead to the individual pursuing reward and/or relief by substance use and other behaviors. Copyright 2014 - Lighthouse Network

15. American Society of Addiction Medicine Inability to consistently Abstain; Impairment in Behavioral control; Craving Diminished recognition of problems with one’s behaviors and interpersonal relationships; and A dysfunctional Emotional response. Copyright 2014 - Lighthouse Network

16. 5 Levels of SA/Addiction EXPERIMENTAL USE: trying substance once or twice. RECREATIONAL USE: using a substance socially, only with friends or at a party CIRCUMSTANTIAL USE: using a substance to escape or avoid personal problems or life circumstances OR using a substance to get through a challenging situation (e.g.: taking caffeine-laced pills to stay awake to study for exams). INTENSIFIED USE: increasing over a long period of time. This describes the regular user who experiences on-going symptoms because of their drug use (physical, psychological, emotional, spiritual). COMPULSIVE USE: True addicts who can’t “voluntarily” give up their substance abuse. They can no longer choose not to use, and suffer significant life and heath disruption because of their addiction. Copyright 2014 - Lighthouse Network

17. Bible Definition Exodus 20:3 You shall have no other gods before Me. Exodus 20:4,5 You shall not make for yourself an idol, or any likeness of what is in heaven above or on the earth beneath or in the water under the earth. You shall not worship them or serve them; for I, the Lord your God, am a jealous God, Copyright 2014 - Lighthouse Network

18. Bible Definition Mark 12:30 – Greatest Commandment Ezekiel 14 Idols of the heart lead to destruction. God condemns Copyright 2014 - Lighthouse Network

19. For what I am doing, I do not understand; for I am not practicing what I would like to do, but I am doing the very thing I hate So now, no longer am I the one doing it, but sin which dwells in me. For I know that nothing good dwells in me, that is, in my flesh; for the willing is present in me, but the doing of the good is not. For the good that I want, I do not do, but I practice the very evil that I do not want. But if I am doing the very thing I do not want, I am no longer the one doing it, but sin which dwells in me. Copyright 2014 - Lighthouse Network

20. I find then the principle that evil is present in me, the one who wants to do good. For I joyfully concur with the law of God in the inner man, but I see a different law in the members of my body, waging war against the law of my mind and making me a prisoner of the law of sin which is in my members. Wretched man that I am! Who will set me free from the body of this death? Thanks be to God through Jesus Christ our Lord! So then, on the one hand I myself with my mind am serving the law of God, but on the other, with my flesh the law of sin. Copyright 2014 - Lighthouse Network

21. Real Addiction Goes deeper than behavior or brain chemistry. Worship is: Perceiving God accurately and Responding appropriately Addiction: Misplaced Worship, Worshipping the wrong thing Addiction: Promoting something other than Jesus to the center of your life/heart Solomon: all is vanity, under the sun Copyright 2014 - Lighthouse Network

22. Real Addiction Copyright 2014 - Lighthouse Network

23. Real Addiction Addiction Role = Coping skill for stressor management Addiction Goal = COMFORT Addiction Object = the element we turn to thinking it delivers the comfort we desire – Usually a process rather than a concrete object Trading addictions Treatment: Needs to get at the root issues that cause discomfort Copyright 2014 - Lighthouse Network

24. Addiction Statistics Lifetime – not counting abuse Etoh = 13 Illegal Drugs = 8 MJ = 7.5 HS Sr 36%(yr) 23%(mth) 6.5% (daily) Prescription Meds = 6 Nicotine = 21 Caffeine = 32 Shopping = 6 Gambling = 1.5 Porn = 8(M), 3(F) Work = ? Control = ? Comfort = 100% Copyright 2014 - Lighthouse Network

25. Addiction Statistics Past Year = 47% not including caffeine or porn Cause of Death - #1(alcohol, drugs, nicotine, food) Immediate Family Members with addiction = 78% Suicide #2 and addiction a big part Addicted to Comfort = 100% Copyright 2014 - Lighthouse Network

26. Your wish is my command!

27. SOLOMON 1 Kings 3:5, 9-11

28. The Most Important Spiritual Discipline: Copyright 2014 - Lighthouse Network

29. 1.Solomon’s Wish, God was pleased  Most Important Spiritual Discipline/Skill 2.God’s greatest gift you have 100% control of 3.Spiritual Act of Worship Rom 12:1-2 4.Divinely Powerful Weapon 2 Cor 10:3-6 5.Constant Mode of Prayer/Communication 1 Thes 5:16- 22 6.Wellspring of Life Prov 4:23 7.Key to Your Life Deut 30 8.Brain Exercise = Renews the Mind  Neurobiological Intervention 9.Intersection of Spirit, Mind, and Body; Science / Faith 10.Light for Evangelism Copyright 2014 - Lighthouse Network

30. Karl’s Story Why did I become a psychiatrist? Copyright 2014 - Lighthouse Network

31. Karl’s First Beer Copyright 2014 - Lighthouse Network

32. HARDWARE! Copyright 2014 - Lighthouse Network

35. S.P.E.C.T. Scans Single Photon Emission Computerized Tomography A sophisticated nuclear medicine study that looks directly at cerebral blood flow and indirectly at the brain activity (or metabolism) All of the following slides are used with permission from “Images Into Human Behavior - A Brain SPECT Atlas” by Daniel Amen, M.D. © Copyright 2000 Copyright 2014 - Lighthouse Network

36. Normal Brain-Top Copyright 2014 - Lighthouse Network

37. Normal Brain-Bottom Copyright 2014 - Lighthouse Network

38. Normal Brain-Active Views Copyright 2014 - Lighthouse Network

39. Motorcycle Accident Copyright 2014 - Lighthouse Network

40. Alzheimer’s Disease Copyright 2014 - Lighthouse Network

41. 25 year Heroin Addiction - 39 yo Copyright 2014 - Lighthouse Network

42. 10 yr Heroin then 7 yr Methadone - 40 yo Copyright 2014 - Lighthouse Network

43. 16 Years of Daily THC (Tetrahydrocannibinol) Use 32 yo Copyright 2014 - Lighthouse Network

44. 2 Years of Daily Marijuana Abuse - 16 yo Copyright 2014 - Lighthouse Network

45. 10 Years of Mostly Weekend Marijuana Use 28 yo Copyright 2014 - Lighthouse Network

46. 2 Years of Frequent Cocaine Use - 24 yo Copyright 2014 - Lighthouse Network

47. 8 Years of Heavy Methamphetamine Use 28 yo Copyright 2014 - Lighthouse Network

48. 17 Years of Heavy Weekend Alcohol Use 38 yo Copyright 2014 - Lighthouse Network

49. 17 Years of Heavy Weekend Alcohol Use 38 yo Copyright 2014 - Lighthouse Network

50. 17 Years of Heavy Weekend Alcohol Use 38 yo Copyright 2014 - Lighthouse Network

51. 27 Year Daily Heavy Cigarette and Coffee Use 45 yo Copyright 2014 - Lighthouse Network

52. PolySubstance Abuse and then 1 yr Clean Copyright 2014 - Lighthouse Network

53. Depression Copyright 2014 - Lighthouse Network Before Treatment After Treatment

54. Anger and ADD Before/After Treatment with Depakote and Adderall Copyright 2014 - Lighthouse Network

55. Paranoid Schizophrenia Before and After Medication/Therapy Copyright 2014 - Lighthouse Network After Treatment

56. PTSD, Depression, and Anxiety Before and After St. John’s Wort and EMDR Copyright 2014 - Lighthouse Network

57. Images of PMS Copyright 2014 - Lighthouse Network Day 2 of Cycle (Worst Time) Day 10 of Cycle (Best Time)

58. Hardware Summary Disease Aspect Our brains are dynamic organs Our brains can be injured or diseased easily Our brains can be strengthened or renewed Not just born this way Copyright 2014 - Lighthouse Network Hardware Summary

59. Goal: Mind of Christ Jesus’ Brain = Perfection! 1.Perceived everything from a Godly perspective 2.Responded with Biblical skills Copyright 2014 - Lighthouse Network

60. BrainWorks – My Brain Based on new scientific research, my brain does 2 things Copyright 2014 - Lighthouse Network Perceives Responds

61. BrainWorks Research Skin GI / Cardiac Panic Disorder Study Copyright 2014 - Lighthouse Network

62. Panic Disorder and Depression Before and After St. John’s Wort and EMDR Copyright 2014 - Lighthouse Network

63. Heart of Transformation: Decision-Making No biological Intervention But Brain Chemistry Improved/Renewed Decision-making is exercise for brain Good decisions = stronger brain Bad decisions = injured brain Copyright 2014 - Lighthouse Network

64. What determines accurate Perception and Response? Human Manuals – Distort lenses and response Holy Bible – God’s Instruction Manual DM: Science and Faith Meet Practical Theology Integration and DM are Key! Copyright 2014 - Lighthouse Network Mind SpiritBody Decision-Making = Spirit, Mind, & BodyIntegration

65. DM: SMBI Brain Chemistry – powerful gift is final step of decisions Mind – Free Will God gives us – DM = EXERCISE for brain chemistry – Perceive/Respond – EXERCISE for brain chemistry Spirit – BIBLE principles and their application determines Decision Making Skills Decision-Making the intersection for Spirit, Mind, and Body Therapy is a neurobiological intervention Copyright 2014 - Lighthouse Network

66. Classes in DM? Bible – Jesus, Paul, Solomon, David, Peter, James – Biographies of good and bad Most people – Random – E-M-M-M, R-P-S, Dice, Magic 8 Ball, Coin Flip Bible – Gideon’s fleece, Cast lots, Urim and Thumim, Prayer Dreams Strategy Necessary Copyright 2014 - Lighthouse Network

67. What Determines Good Decision-Making? Creators create awesome things – You and Your Brain Your Creator was kind enough to give you an instruction manual What do you use for your instruction manual? – How is that going Why not use the creators Instruction Manual? – The Holy Bible vs Spiritual Warfare But How?!?!?!?! Copyright 2014 - Lighthouse Network

68. Decision-Making Strategy How many Decisions per day? Decisions Determine the course of your life. Decisions determine whether your brain gets stronger or weaker How do you make decisions? Copyright 2014 - Lighthouse Network

70. For though we walk in the flesh, we are not waging war according to the flesh. For the weapons of our warfare are not of the flesh but have divine power to destroy strongholds. We destroy arguments and every lofty opinion raised against the knowledge of God, and take every thought captive to obey Christ, being ready to punish every disobedience, when your obedience is complete. 2 Corinthians 10:3-6 Copyright 2014 - Lighthouse Network70

71. SPEARS = Practical Theology Psychotherapeutics CBT DBT REBT EFT Mindfulness Meditation Psychodynamic Psychotx Motivational Interviewing Spiritual Jesus Christ Holy Spirit Bible Copyright 2014 - Lighthouse Network

73. John 10:10 The thief comes only to steal and kill and destroy. I came that they may have life and have it abundantly. Copyright 2014 - Lighthouse Network

74. Regarding your former way of life, you were taught to strip off your old man, which is being ruined by its deceptive desires, to be renewed in the spirit of your minds, and to clothe yourselves with the new man, which was created according to the likeness of God in righteousness and true holiness. Ephesians 4:22-24 Copyright 2014 - Lighthouse Network

75. 1 Peter 1:13-15 Therefore, prepare your minds for action, keep a clear head, and set your hope completely on the grace to be given you when Jesus Christ is revealed. As obedient children, do not be conformed to the passions of your former ignorance, but as he who called you is holy, you also be holy in all your conduct. Copyright 2014 - Lighthouse Network

76. Consequences of Wrong DM Mark 12:30-31 Spiritual: – Interferes with our relationship with God – Flesh on throne of heart – Fruit of Flesh Psychological: – Interferes with our relationship with ourselves – Interferes with our relationships with others – Impairs psychological development/maturity Physiological: Short circuits/injures brain chemistry Copyright 2014 - Lighthouse Network

77. The Holy Spirit is perfect We are not. DM is the key Spiritual Discipline Therefore, a strategy exists that we need to follow. All 3 Spheres! Reflect, Detect, Resurrect Nobody ever teaches us thoroughly about decision- making skills. – Jesus, James, Peter, Proverbs, Paul’s letters Copyright 2014 - Lighthouse Network

78. SPEARS All the elements Right sequence Requires thought Requires intention Requires practice Copyright 2014 - Lighthouse Network Stimuli Perception Emotion Assessment Response Summary Thought

79. Stimuli Stimuli is anything that acts on or mobilizes your coping mechanisms All stimuli is neutral God is sovereign Copyright 2014 - Lighthouse Network Stimuli Perception Emotion Assessment Response Summary Thought

80. What word do you see? Copyright 2014 - Lighthouse Network

81. Test How many squares are there? Hint: What is the most important question? Is this the only way to view this? Copyright 2014 - Lighthouse Network

82. Perception Exercise Things are not always as they seem: 84! Assumptions Jumping to conclusions Knee-jerk reactions Copyright 2014 - Lighthouse Network

83. Perception Perception is what really drives the decision-making process Subconscious We are usually unaware of perception because it occurs so fast in the decision-making process Adversary with a Strategy Copyright 2014 - Lighthouse Network Stimuli Perception Emotion Assessment Response Summary Thought

84. Spiritual Warfare Copyright 2014 - Lighthouse Network Your Soul! Satan’s Goal Your mind and brain Battlefield Lies Weapon Lenses Emotions Strategies

85. Devil Dogs Copyright 2014 - Lighthouse Network Bell Meat No Drool Drool

86. Perception Satan gets to us as early as possible, when we are most gullible Unpack Life - FOO Our brains our easily influenced as kids (neuroplasticity) Relationships Maturity is seeing life clearly Copyright 2014 - Lighthouse Network Stimuli Perception Emotion Assessment Response Summary Thought

87. Filters Greatest Perceived Threat GPT Greatest Perceived Need GPN Life Depends On LDO Confidence C Motivation M Copyright 2014 - Lighthouse Network

88. Emotions

89. God has lots of emotions! Anger – Mat 23, Mark 3, John 2, 2 Kings 24 Jealousy – Exodus 20, Deut 6 Sad/Wept – Luke 19, John 11, Heb 5 Troubled – John 12 Forsaken – Matt 27 Abandoned – Matt 27 Tempted – Matt 4 Worried – Luke 22 Copyright 2014 - Lighthouse Network

90. Emotion Warning system Not a decision- making system Distort reality -Court -Doctors Volume Buttons Biblical truths soothe Copyright 2014 - Lighthouse Network Stimuli Perception Emotion Assessment Response Summary Thought

91. Assessment Who is stronger: a tiger or a man? Emotional and intellectual volume – We fail when we let our emotions rule our intellect – Poor tolerance and soothing of negative feelings Copyright 2014 - Lighthouse Network Stimuli Perception Emotion Assessment Response Summary Thought

92. Assessment Options Pros and Cons Weigh pros and cons using the filters (GPT, GPN, LDO, C, M) – SMB Damage/growth – Motivators Copyright 2014 - Lighthouse Network Stimuli Perception Emotion Assessment Response Summary Thought

93. Response We need a relationship with God We need to put on the Armor of God Is this helping me or others become more Christ-like? WWJD? Mark 12:30 Sometimes a combo of options Copyright 2014 - Lighthouse Network Stimuli Perception Emotion Assessment Response Summary Thought

94. After review of each element Celebrate our successes, and learn from our failures Are my responses working for long term health Heart Change Self-reflection and assessment is paramount Autopsy Copyright 2014 - Lighthouse Network Stimuli Perception Emotion Assessment Response Summary Thought

95. Driving Force for Dysfunction Stimuli Perception Emotion Assessment Response Summary Thought Copyright 2014 - Lighthouse Network

96. Main Problems OLD Beliefs-LiesNEW Beliefs-Truth Negative feelings are badNegative feelings are our warning system I am all aloneJesus is with me, hook his yoke We can’t endure negative feelings We can endure and grow; God will meet us and give peace We only have skills and of 8 yoWe have skills and of an adult Talking about them is badTalking abut them is good One variable is same, so all are same One variable is same, so only one is same Copyright 2014 - Lighthouse Network

97. Deconstruction S – “Screen Door is Broken” P – Rubic – Intruding on my agenda for the day GPT – not good enough, incompetent, not in control GPN – control, competency, power, authority LDO – me being in charge to minimize pain C – my ability to control and manipulate, verbally argue, control = power = soothing M – not feel the pain, be in charge or in control, do what I want to do when I want to do it Copyright 2014 - Lighthouse Network

98. Deconstruction E – incompetent, worthless, failure, poor husband, falling behind, angry, E Volume = 8 T Volume = 1 A – ignore, yell(leave me alone, I’m busy), shift blame(you and girls broke it), pick on her(laundry not done), pros/cons based on my filters/motivators R – ignore, then blame them ST – got her off my back and on a different topic, get to do my agenda and watch the game Pain – incompetence, no control, exposed, out of agenda old beliefs: I’m a little kid, people telling me what to do, blaming me, I’m responsible for their feelings, this will ruin my day and all the other activities Copyright 2014 - Lighthouse Network

99. Reconstruction Pain – new beliefs: Neg feelings are only warning system, God is sharing my yoke, God provides peace and comfort, I’m an adult, Won’t last long He brought this for a reason for my growth so embrace it Copyright 2014 - Lighthouse Network

100. Reconstruction S – “Screen Door is Broken” P – Rubick – Opportunity and chance to serve my wife GPT – dishonoring God, Flesh on throne, out of God’s will SMB impact, hurting my wife GPN – God’s will, please God, SMB growth, fruit of Spirit, LDO – Mind of Christ – SMB growth, Ambassador C – God’s promises, Love, Forgiveness, Character, Instruction, His plan has worked in the past M – SMB growth, Fruit of Spirit, giving back to God Copyright 2014 - Lighthouse Network

101. Reconstruction E – interested, curious, connected to wife, slight excitement, sl financial worry but know God provides E Volume = + 4 -1.5 T Volume = 8 A – “wait till I am finished”, teamwork – call handyman, check our budget, go to home depot together pros/cons based on my filters/motivators R – ask her to wait 15 minutes then we check it together, agree we can live with it but if it gets worse, call handyman for advice ST – honored God, wife, myself, SPEARS was good, SMB +, fruit of spirit, no fruit of flesh Pain – not much relational and was able to rely on God to see me thru the slight disruption and financial concern Copyright 2014 - Lighthouse Network

102. Deconstruction/Reconstruction Prospective Retrospective – Autopsy Flexibility Journaling Thinking about it more – then real time use Skills need Practice Behavioral Change Examination of Heart Heart Change leads to Real Transformation Motivators for Change Copyright 2014 - Lighthouse Network

103. Hardware Summary Most important Spiritual Discipline Bible talks the most about DM Exercise for the Brain, Spirit, Mind Intersection of S,M,B Intersection of Science and Faith Need a Strategy, Slow the Mind SPEARS Reveals what’s in the Heart Easiest way to reflect/detect/resurrect Copyright 2014 - Lighthouse Network DM Key Points

104. Summary Science and Spirituality can fit together well Matrix Moments Need a Strategy Learned a sound and SMB Integration model Decision-making is the key spiritual discipline and core competency everyone needs to learn Decision-Making is the exercise of the brain SPEARS is a complete decision-making model – Integrates all 3 spheres – Practical to implement and utilize – Core to any treatment level and modality Copyright 2014 - Lighthouse Network

105. Role of Mentor Facilitator of cure Encouragement, Hope, Raise the Ceiling of Potential and Peace Helping mentee see the truth and understand pros/cons of DM – Showing client how to dig deep to uncover the distortions guiding their life With SPEARS – own out loud, or prompting mentee Trouble shooting external and internal Helping them formulate practices/discipline/strategy that are healthy and sustainable DM renews Brain Chemistry Copyright 2014 - Lighthouse Network

106. Lighthouse NETWORK Resources WITHIN REACH: Disciplines for Real Life Change – 10+ Hours of DVD – 140 Page Workbook EDGING FORWARD: Mastering the Art of Godly Decision-Making – 8 Chapels(25 min each) on DVD Free Stepping Stones Daily Devotional – Emailed daily Life Change with Dr Karl Radio Minute – 460 Christian Radio Stations Addiction: Sin, Disease, or Psychological Defect DVD Can Psych Meds Help Christians? DVD Depression, Cutting, Bipolar DVDs No Other Gods (SPEARS and example) DVD Copyright 2014 - Lighthouse Network

107. Finds addiction and MH treatment options. Expertise about all elements of the system Free to client Saves the clinician incredible amounts of time We find great options for struggling people 844-Life-Change Copyright 2014 - Lighthouse Network

108. Got Questions? Copyright 2014 - Lighthouse Network

109. For if you remain silent at this time, relief and deliverance for the Jews will arise from another place, but you and your father’s family will perish. And who knows but that you have come to your royal position for such a time as this? Copyright 2014 - Lighthouse Network