In large part, your behavior is driven by the actual, physical functioning of your brain. When your brain works right, you are more likely to act in thoughtful, conscientious ways that help you to live longer. When your brain is troubled, you are much more likely to act in impulsive, careless, thoughtless ways that put you at risk for illness and early death. Jose’s story is a perfect example.
Jose and Angela on Dr. Phil
In early 2010, a producer from the Dr. Phil Show called and asked if I would help with a program on infidelity. They wanted me to evaluate and do SPECT scans on Jose, a compulsive cheater.
When I first met Jose, he and his wife, Angela, were struggling with his infidelity, lies, and his addiction to porn. As far as she knew, in their 4-year relationship, Jose had cheated on her 8 times. On the show, Dr. Phil replied to the 8 incidences of infidelity by saying, “My father used to say for every rat you see there are 50 you don’t.”
They had been married 3 months when Angela found out Jose was cheating on her. She discovered that he had been with another girl when he asked her to marry him, when they were planning the wedding, and just 2 days after they had Bella, their now 3-year-old little girl.
“I was devastated and very angry,” Angela said. “I gave my gun to my mom because I thought I was going to shoot him. After I took him back I found out he cheated on me with numerous girls. He is a chronic liar and he is very good at it. One of my friends told me that she saw Jose on a sex tape punching a girl in the face. She was passed out and pretty messed up. He likes rough sex and had tried to have rough sex with me. He tries to push to see how far he can go. He is a thrill seeker and needs constant stimulation. I got involved with Sexaholics Anonymous because I thought he had a problem, but instead he starting using it as an excuse. He would say, ‘It‘s an addiction, I can’t help it.’ That’s a bunch of crap. He doesn’t think. He just does things and then afterwards says he will find a way to deal with it.”
Jose said, “I have always been the kind of guy who would just hook up when someone comes along. I was out of the home for 5 weeks before we decided to patch things up. Before we got married I never felt guilt. My father was a cheater. I am worried I have a sexual addiction because I have a need for something stimulating, such as affairs, fast cars, living on the edge. I lost my driver’s license for getting 4 speeding tickets. In the last year I have been faithful, but had a problem with pornography.”
On the show, Dr. Phil asked Jose, “If this is your proclivity, why not get a divorce and go do what you wanted to do?” Jose replied that it was not what he wanted. He wanted to be married, to have a family and to raise his daughter. His father was a cheater, which had a negative effect on his family. He wanted to be a positive influence for his daughter.
When I saw Jose, he had a number of issues besides the chronic infidelity. He was an adrenaline junkie who had a high need for speed, along with excitement seeking behavior.
His brain SPECT scan showed 3 highly significant abnormalities:
- Increased activity in a part of the front part of the brain called the anterior cingulate gyrus, which is the brain’s gear shifter. Increased activity in this part of the brain is often associated with compulsive behavior, where the gear shifter becomes stuck on negative thoughts or negative behaviors. In addition to the cheating, Jose compulsively got tattoos. He was tattooed from head to toe. Even though Jose was a smart man, the tattoos had prevented him from getting work.
- Decreased activity in another part of the front part of the brain called the prefrontal cortex. The prefrontal cortex acts like the cop in your head and helps you stay on track toward your goals without going down the wrong path. The prefrontal cortex is also thought of as the brain’s brake and helps prevent us from saying or acting on the first thing that comes to mind. From Jose’s scan and behavior his prefrontal cortex was in trouble.
- A head injury pattern. Jose scan clearly showed evidence of brain trauma, with areas damaged in the front and back part of his brain.
Initially, I asked Jose if he ever had a brain injury. He said no. But, after scanning tens of thousands of patients I knew the pattern in Jose’s brain was connected to a head injury, so I persisted. Again, he said no.
I have heard this same story so often that it is a running joke at the Amen Clinics. People initially tell us they have not had significant head injuries. Then we see the obvious pattern of a brain injury on their scans and persist in probing further. Eventually they will tell us things like, “I fell out of second story windows” or “I fell down the stairs” or “I broke my car windshield with my head” in forgotten accidents. Or, as was the case with one of our NFL players, he got into an accident where his car crashed through a mountain guardrail and fell 150 feet to a river bed below, knocking him unconscious.
I asked Jose again if he had ever had a brain injury.
“Yes,” he said. “I played football in high school.” He then told me about a number of times he had concussions. Next, he volunteered that he was a bull rider and a Mixed Martial Artist and had been hit hard in the head many times. And then, almost underneath his breath he said,
“And, I am a head banger.”
“Excuse me?!” I responded.
With an embarrassed smile, Jose said, “I used to break thinks with my head. It was like a party trick. I could break cans and beer bottles with my forehead.”
All of us have a running dialogue in our minds whenever we are talking to others. Psychiatrists are no different. When I heard Jose say that he used to break bottles with his head, I thought to myself, this is not the sign of intelligent life. But I did not say it out loud, because I have good prefrontal cortex function and a fairly strong internal brake.
But then Jose added, “When I got drunk I have often put dents in doors and walls with my head. I can usually find the studs in the walls with my head.”
At this, my own internal brake betrayed me and I said out loud, “That is not the sign of intelligent life.” Jose agreed. The day of the Dr. Phil Show taping was emotional. Angela was angry and wanted Jose to change. She thought he could just will it to be so.
Angela said, “Unless I see a complete change I am done.”
I knew better. Even the best intentions are thwarted by an unhealthy brain.
On the show, Jose said he was excited to see the results of the scans. In his no-nonsense Texas drawl, Dr. Phil said, “It is odd to hear someone say they are excited to have brain damage. You think this gives you a pass. It is like, ‘Hey, it’s not my fault, my brain’s not right.”
Jose then said something very profound. “I am not thinking of this as an excuse, but I am hoping this might be a key to help change my behavior.”
The show then took an interesting twist. Dr. Phil asked the audience whether they thought sexual addiction was a real biological phenomena or just an excuse for bad behavior. The audience was of the opinion that it was just an excuse.
I understand why people feel this way, but from the brain scans I have seen and my years of experience in helping people unravel from addictions, I know there are strong brain issues at play. I have seen sexual addictions ruin people’s lives and have brought many addicts to the point of financial ruin and even suicide.
I also believe that addictions – including sexual ones – are going to get worse in our society as we continue wearing out the brain’s pleasure centers with constant exposure to highly stimulating activities like video games, text messaging, sexting, internet pornography, scary movies, and highly addictive foods like cinnamon rolls and double cheeseburgers.
There is an area deep in the brain called the nucleus accumbens that is responsive to the pleasure and motivation chemical dopamine. Think of the nucleus accumbens as one of the main pleasure levers in the brain. Whenever we feel pleasure a little bit of dopamine has pressed on the lever and we feel pleasure. If the lever is push too hard, such as with drugs like cocaine, we can feel a rush of pleasure that causes us to lose control over our behavior; or if it is pushed too often, it becomes sensitized or numb and we need more and more pleasure in order to feel anything at all.
Plus, if you have low activity in the braking activity of the prefrontal cortex the nucleus accumbens can literally take control of your life, as in Jose’s case.
In order to live long it is important to protect your pleasure centers and prefrontal cortex.
Even though it sounds odd, be careful with experiencing too much pleasure. I think one of the reasons actors and high performance athletes have problems with depression and addiction is because their success can bring free access to anything they want at any given moment, and this often wears out their pleasure centers.
After the show, Jose and Angela agreed to see me for help. He was in enough pain that he was willing to follow my recommendations.
Jose’s Prescription:
- Stop drinking alcohol. Alcohol lowers Jose’s prefrontal cortex and decreases his brain’s braking power to help him say no to his urges.
- Get enough sleep to maintain healthy brain function. Getting less than 6 hours of sleep at night has been associated with lower overall blood flow to the brain, which means more bad decisions.
- Clean up his diet. Only eat healthy food that serves his optimal brain function. Eat multiple times a day to keep his blood sugar stable. Low blood sugar equates to more bad decisions.
- Eliminate the caffeine and energy drinks, which were a staple of his diet. Caffeine constricts blood flow to the brain. Anything that lowers or constricts blood flow to the brain increases bad decision-making.
- Add the following supplements to enhance his brain:
- Serotonin Mood Support to support healthy serotonin levels and calm his anterior cingulate gyrus and compulsive behaviors.
- Focus and Energy Optimizer to support healthy dopamine levels and boost his prefrontal cortex, focus and impulse control.
- Brain and Memory Power Boost to help restore healthy brain function. This is the same supplement we used in our NFL brain rehabilitation study.
- High quality fish oil.
Over the next 7 months I regularly saw Jose, Angela and their adorable daughter, Bella, to monitor their progress. In our sessions we discussed his nutrition, supplements and strategies to control his urges, which were becoming less and less powerful.
I had Jose plant two words in his head: “Then what?”
Before acting, stopping to ask himself, “then what,” helped him boost his prefrontal cortex by thinking about the future consequences of his behavior.
It finally clicked when he heard the chorus of the Clay Walker song “Then What?” Jose realized that if he didn’t ask “then what?” and make new, better choices, he was going to be somebody who “aint anybody anyone’s gonna trust.”
Things were going so well for Jose and Angela that they started to discuss having another child. They went to Hawaii on vacation to talk more about their future together. While there Jose saw people jumping off a 60-foot cliff into the water below. His immediate reaction was that he wanted to do it too. Being a thrill seeker had been part of his life for a very long time. Some would say it was part of his DNA. As Jose hiked up the hillside, Angela rolled her eyes, thinking yet again to herself, He is such a Show Off. She had seen him do so many stupid things throughout their time together. Would it ever end?
But this time things were different. Very different.
When Jose got to the top of the cliff and looked down, something happened in his mind. He started to feel uncomfortable, even anxious. Even though he saw other people jumping off the cliff he could not clearly see the rocks jutting up in the water in order to avoid them.
He thought to himself, “then what? What if I land wrong? What if I get hurt? What if I am paralyzed? I have a wife and child, and we want another child. Being paralyzed will not help any of us. Do I really need to do this?”
He stepped out of line to think about his next move. This level of thought, pausing to contemplate the consequences of a risky action, was new for Jose. After a minute or so he decided not to jump. With a sense of freedom he began walking down the hillside. Angela was stunned. She had never seen Jose do anything like that before. Maybe there was hope.
Shortly after his trip to Hawaii we did a follow up SPECT scan on Jose, which showed dramatic improvement from 7 months earlier.
By working the treatment plan, Jose literally changed his brain and dramatically improved and likely extended his life. As I write this story it has been over a year and a half since I first met Jose, Angela and Bella. They remain happy, together and hopeful about their future as an intact family. Angela no longer feels she needs to give her gun to her mother and Jose has been faithful and is making decisions that will likely extend his life through better forethought.