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'Individual%2C+Couples%2C+Family+and+Group+Therapy%3B+Chemical%2C+Sexual+and+Gambling+Addictions%3B+Cultivating+Sexual+Health+in+relationships%3B+Pre-Marital%2C+Marital+and+Family+Counseling%3B+Traumatization+and+Abuse%3B+Depression%2C+Grief%2C+Domestic+Violence%3B+Faith-based+Issues%3B+Mens+and+Womens+Issues%3B+Students+and+Student%2F+Professional+Athletes%3B+Cultural+Diversity+issues++++Marriage+and+Family+Issues+++Addictions+or+Substance+Abuse+++Spirituality+++Relationship+Issues++Depression++Anxiety+or+Fears++Divorce++Domestic+Abuse+or+Violence++Gay+Lesbian+Issues++Life+Coaching++Loss+or+Grief++OCD++Parenting++Sex+Therapy++Trauma+and+PTSD++Impulse+Control+Disorders++++The+Crucible+Encounter+%28Part+I%29++++For+many+of+us%2C+the+notion+of+subjecting+ourselves+to+some+type+of+excruciating+and+painful+process+is+the+last+thing+we+would+consider+engaging+in+willingly.+Even+at+the+age+of+46%2C+I%E2%80%99m+not+particularly+fond+of+the+idea+of+having+my+physician+or+dentist+poke%2C+prod%2C+squeeze%2C+puncture%2C+pull+or+apply+pressure+to+any+part+of+my+body.++Mentally%2C+I+am+just+not+up+for+it%2C+and+sometimes+I+dread+the+days+leading+up+to+the+appointment.++Interestingly%2C+I+know+that+upon+leaving+their+office%2C+I+am+in+a+better+physical+state+%28with+great+relief+mentally%29+than+when+I+arrived%2C+largely+due+to+allowing+the+professional+to+practice+his+or+her+expertise+with+me%2C+their+patient.++Usually%2C+it+is+not+as+bad+as+I+conceptualized%2C+and+upon+leaving%2C+I+certainly+do+enjoy+either+hearing%2C+or+knowing+what+I+have+to+work+on%2C+in+order+to+receive+a+clean+bill+of+health.++++Perhaps+the+way+I+envision+going+to+the+physician+is+the+way+that+some+may+envision+engaging+in+the+psychotherapeutic+process+with+a+counselor.++Days+before+a+scheduled+session%2C+some+may+wonder+if+the+therapist+%E2%80%9Cwill+be+sensitive+to+this+particularly+painful+part+of+my+life+I+am+disclosing%E2%80%9D+or+%E2%80%9Cwill+he+be+judgmental+and+provide+a+simplistic+%E2%80%98remedy%E2%80%99+for+this+area+my+life+that+I+have+struggled+with+for+decades%3F%E2%80%9D++Certainly+we+know+that+sensitive+areas+will+be+discussed+in+the+therapy+hour%2C+but+if+you+are+like+me%2C+you+would+like+to+leave+that+time+knowing+and+feeling+like+help%2C+and+healing+is+on+the+horizon%2C+and+is+visible.++++I+like+to+describe+therapy+as+the+engagement+in+a+crucible+encounter.++A+crucible+is+a+vessel+used+for+melting+materials+at+high+temperatures%2C+and+the+origin+of+the+word+is+the+Latin+word+%E2%80%9Ccrux%E2%80%9D+or+%E2%80%9Ccross.%E2%80%9D+We+also+derive+our+English+word+%E2%80%9Cexcruciate%E2%80%9D+from+crux+as+well.++Typically%2C+when+a+material+enters+the+crucible%2C+it+is+altered%2C+changed+and+transformed+into+a+different+state+or+outcome+than+when+it+entered+the+crucible.++++++You+may+be+thinking+about+now%2C+that+there+is+not+much+to+like+about+melting+at+high+temperatures%2C+engaging+in+an+excruciating+process%2C+coupled+with+all+of+the+process+that+respectfully+occurred+with+the+Cross.++You%E2%80%99re+right.++There+is+a+lot+of+pain+associated+with+the+changing+of+mindsets%2C+behaviors+and+with+the+transformation+and+growth+of+the+heart.++And+yet+I+would+remind+you+that+you+are+not+alone+in+the+life-altering%2C+crucible+process.++Let+me+share+what+I+mean+about+this.++++The+English+word+%E2%80%9CTherapist%E2%80%9D+comes+from+the+Greek+word%2C+%E2%80%9CTherapon%2C%E2%80%9D+translated+in+the+New+Testament+as+%E2%80%9Chealing%E2%80%9D+%28Matt.+10%3A+1%2C+8%29.++This+word+and+process+suggests+that+as+a+result+of+the+care%2C+attention+and+help+that+is+rendered+in+the+therapeutic+and+crucible+encounter%2C+that+healing+is+one+of+the+outcomes%3A+The+therapon+%28therapist%29%2C+provides+the+therapeia+%28therapy%29%2C+and+the+result+is+therapeuo+%28therapeutic%29.++What+is+most+important+and+underlies+this+healing+opportunity+is+the+fact+that+salient+spiritual+ingredients+are+in%2C+and+at+work%2C+in+the+lives+of+the+therapist%2C+and+in+the+live%28s%29+of+the+participants+who+seek+assistance.++Both+bring+measures+of+the+Fruit+of+the+Holy+Spirit+%28love%2C+patience%2C+kindness%2C+self-control%E2%80%A6%29+to+this+crucible+process%2C+and+it+is+usually+Christ%E2%80%99s+transparent%2C+yet+powerful+energy+that+effects+the+change+and+altering+process.++Although+the+process+of+change+is+excruciating%2C+there+is+hope+in+knowing+that+the+person+that+I+am+when+I+leave+the+crucible+encounter+is+not+the+person+I+was+previously+before+I+entered+the+encounter.+++I%E2%80%99ll+say+more+about+how+the+crucible+encounter+impacts+our+humanity+in+the+next+section.+++++++The+Crucible+Encounter+%28Part++II%29++++Earlier+I+shared+how+I+liken+the+therapeutic+process+to+entering+a+crucible%2C+and+as+a+result+of+entering+the+crucible+with+the+therapist%2C+and+with+the+power+of+Christ+present%2C+the+participant+leaves+the+encounter+very+different%2C+and+in+a+changed+and+transformed+state+than+when+he+or+she+entered+the+process.++In+this+section%2C+I+want+to+specifically+and+practically+elaborate+on+how+this+occurs+in+the+crucible+encounter%2C+as+other+salient+%E2%80%9Cingredients%E2%80%9D+are+identified+in+this+change+process.++They+are+identified+in+an+encounter+that+Jesus+had+with+a+person+in+Luke+10%3A+25+%E2%80%93+28.++++++In+this+passage%2C+Jesus+was+asked+the+question%3A++%E2%80%9CWhat+must+I+do+to+inherit+eternal+life%3F%E2%80%9D++Jesus+directed+the+man+to+consider+the+devotion+of+his+whole+life+to+God%2C+eventually+replying+to+him%2C+%E2%80%9CDo+this+and+you+will+live.%E2%80%9D++The+interesting+thing+is+the+word+%E2%80%9Clive%E2%80%9D+infers+that+we+%E2%80%9Clive+as+one+recovering+from+an+illness%2C%E2%80%9D+which%2C+for+some%2C+may+speak+to+the+life+condition+where+change%2C+healing+and+growth+is+desired%2C+regarding+the+life+challenges+that+have+been+encountered.++Greater+still%2C+Jesus+identifies+7+Core+Area+of+our+life+%28Spiritual%2C+Cognitive%2C+Emotional%2C+Biological%2C+Sexual%2C+Relational%2C+and+Environmental%29%2C+that+represent+the+whole+and+totality+of+our+being%2C+as+well+as+how+we+interact+with+the+world.++What+I+hear+in+Jesus%E2%80%99+response%2C+is+that+He+encourages+us%2C+to+examine+how+our+thoughts%2C+feelings+and+behavior+in+these+7+Core+Areas+could+be+purposefully+and+powerfully+effected+by+the+edifying+touch+of+the+Holy+Spirit%2C+and+addressed+thoroughly+in+a+%E2%80%9Ccrucible+relationship%E2%80%9D+with+a+trusted+other+%28our+therapist%2C+and+other+important%2C+but+safe+people+in+our+lives%29.++++++Take+a+look+at+the+7+Core+Areas.++To+love+%28%E2%80%9Cagapao%E2%80%9D%29+God+means+we+are+to+%E2%80%9Ccherish%2C+honor%2C+favor%2C+respect%2C+accept%2C+relish%2C+prize%2C+esteem+and+be+devoted+to%E2%80%9D+His+process+of+seeing+these+areas+developed+to+their+fullest%2C+not+only+for+us+to+give+ourselves+the+chance+to+see+change+occur%2C+but+also+to+enter+into+a+process+of+beginning+to+live+beyond+our+current+and+challenging+circumstances.++Like+a+good+physician+would+assess+and+diagnose+how+all+parts+of+the+body+are+functioning%2C+God+would+have+us+to+critically+examine+these+areas+of+our+lives%2C+in+order+to+gain+insight%2C+and+to+respond+regarding+to+what+personal+and+relational+adjustments+we+need+to+make+in+order+to+begin%2C+or+continue+a+process+of+change++growth+in+our+lives.++++++++Practically%2C+this+means+that+with+my+therapist%2C+I+pull+out+the+magnifying+glass+and+examine+my+thoughts%2C+feelings+and+behavior+about+God%2C+faith%2C+morals+and+empowerment%2C+as+well+as+how+I+may+need+to+challenge+personal+thought+processes%2C+or%2C+learn+how+to+%E2%80%9Crestructure%E2%80%9D+them%2C+and+replace+negative+thoughts+with+different+or+positive+ones.++I+may+need+to+consider+how+I+could+de-intensify+emotionally+charged+encounters%2C+or+learn+how+to+ask+for+what+I+need+from+others%2C+while+learning+to+tolerate+that+I+%28and+God%29%2C+are+ultimately+responsible+for+my+emotional+well+being.+Along+with+this%2C+I+examine+my+sexuality%2C+and+uncover+what+unnecessary+%E2%80%9Cbaggage%E2%80%9D+I+need+to+discard%2C+as+I+move+on+in+my+life+journey+toward+healthier+sexual+behavior%2C+and+discover+how+the+other+six+core+areas+of+my+being+affect+and+shape+this+personal+yet+powerful+part+of+who+I+am.++All+of+these+core+areas+are+to+be+examined+in+totality%2C+due+to+the+fact+each+area+impacts+the+others+areas%2C+and+if+health+and+healing+is+to+be+experienced%2C+the+whole+of+the+person+is+to+be+explored+and+impacted+in+the+crucible.++++++I+suggest+that+by+entering+into+the+crucible+encounter%2C+and+by+allowing+this+process+of+growth+to+occur%2C+we+give+ourselves+the+opportunity+to+experience+healing+in+our+life+experiences+today+%28Matt.+6%3A+34%3B+its+all+we+have+anyway%29%2C+but+also%2C+for+tomorrow+%28Jeremiah+29%3A11%29.++In+addition%2C+by+allowing+Christ%2C+through+the+Holy+Spirit+to+teach%2C+guide%2C+empower%2C+motivate%2C+lead%2C+comfort%2C+change%2C+cleanse+and+heal+us+in+the+crucible%2C+we+position+ourselves+to+reclaim+and+demonstrate+focused+and+passionate+living+that+our+Lord+intends+for+us+to+experience+in+these+core+areas+of+our+being.++As+you+explore+the+%E2%80%9Ccrux+of+the+matter%2C%E2%80%9D+know+that+I+will+work+for+your+success%3B+to+experience+change%2C+healing+and+growth+%E2%80%93+Dr.+Ken+McGill++++++++++++What+is+SPECT+imaging+%28Single+Photon+Emission+Computer+Tomography%29%3F++--Brain+SPECT+imaging+is+a+nuclear+medicine+procedure+that+evaluates+cerebral+blood+flow.+It+evaluates+areas+of+the+brain+that+work+well%2C+areas+of+the+brain+that+work+too+hard%2C+and+areas+of+the+brain+that+do+no+work+hard+enough.+The+information+from+the+scans%2C+along+with+a+detailed+clinical+history%2C+and+with+other+laboratory+testing%2C+helps+us+understand+the+underlying+brain+patterns+associated+with+our+patients%E2%80%99+problems+and+help+to+pinpoint+the+right+treatment+to+balance+brain+function.++++What+is+the+procedure%3F++--You+will+be+placed+in+a+quiet+room+and+a+small+IV+line+will+be+inserted+into+your+arm.++For+the+concentration+study%2C+you+will+take+a+15+minute+computerized+test+of+attention+and+focus.+Three+or+four+minutes+into+performing+the+test%2C+the+imaging+solution+will+be++injected+through+the+IV%2C+and+then+you+will+complete+the+test.+For+the+baseline+study%2C+you+will+be+instructed+to+sit+quietly.+Several+minutes+later%2C+the+imaging+solution+will+be+injected+through+the+IV.+After+another+short+period+of+time%2C+you+will+lie+on+the+imaging++table+and+the+SPECT+camera+will+slowly+rotate+around+your+head+taking+images+of+brain+blood+flow+%28you+are+not+placed+inside+a+tube%29.+The+time+on+the+table+is+approximately+18+minutes.++Question%3A+What+do+SPECT+scans+show+that+should+change+how+a+patient+is+treated%3F++Amen+response%3A+Many+things%3A+++%E2%80%A2+SPECT+shows+the+function+or+dysfunction+of+specific+brain+regions+implicated+with+specific+problems%2C+such+as+the+prefrontal.+cortex+with+executive+function+and+the+medial+temporal+lobes+with+getting+information+into+long-term+storage.+Thus%2C+we+can+target+brain+systems%2C+not+just+vague+DSM+diagnoses.+++%E2%80%A2+SPECT+shows+unexpected+findings+that+may+be+contributing+to+the+problem%28s%29%2C+such+as+toxicity%2C+potential+areas+of+seizure+activity%2C+or+past+brain+trauma.+This+dramatically+changes+treatment%2C+such+as+eliminating+the+toxin.+++%E2%80%A2+SPECT+shows+potential+underlying+seizure+activity+that+may+be+contributing+to+the+problem+%28often+more+accurately+seen+by+SPECT+than+standard+EEG%2C+especially+in+the+areas+of+the+medial+temporal+lobes%29.+++%E2%80%A2+SPECT+shows+specific+target+areas+for+treatment%2C+such+as+an+overactive+anterior+cingulate+gyrus+%28seen+with+OCD+spectrum+disorders%29+or+an+underactive+temporal+lobe+%28seen+in+seizure+disorders+and+other+disorders+such+as+trauma%29.+++%E2%80%A2+SPECT+shows+the+specific+effect+of+medication+on+the+brain+and+subsequently+how+to+adjust+dosages.+Patients+often+report+that+SSRIs+are+helpful+but+also+cause+demotivation+or+memory+problems.+SPECT+studies+can+show+when+SSRIs+are+causing+excessive+decreased+prefrontal+or+temporal+lobe+activity+that+clinical+evaluation+only+hints+at.+++++++++++++.+++%E2%80%A2+SPECT+scans+helps+provide+real%2C+demonstrable+answers+to+refractory+symptoms+and%2C+in+addition%2C+helps+clinicians+ask+better+and+more+targeted+questions%E2%80%94about+toxic+exposure%2C+brain+injuries%2C+anoxia%2C+inflammation%2C+or+infection%2C+that+patients+may+have+initially+denied+or+forgotten.+++%E2%80%A2+SPECT+scans+help+clinicians+prevent+mistakes+or+hurting+patients+by+prescribing+the+wrong+treatments%2C+such+as+unnecessarily+stimulating+an+already+overactive+brain+or+calming+an+underactive+one.+++%E2%80%A2+SPECT+scans+help+to+evaluate+those+who+may+be.+at+risk+for+dementia%E2%80%94the+brain+starts+to+change+long+before+people+show+symptoms+of+dementia.+One.+study+reported+that+there+has+to+be+a+loss+of+30%25+in+the+hippocampus+before+symptoms+occur.+Using+autopsy+data+in+54+patients%2C+Bonte+reported+that+brain+SPECT+had+a+positive+predictive+value+for+Alzheimers+disease+of+92%25+.+SPECT+scans+can+help+differentiate+between+types+of+dementia.+++%E2%80%A2+SPECT+scans+can+identify+specific+areas+of+the+brain+hurt+by+trauma+to+better+target+treatment+and+help+deal+with+insurance%2C+legal+and+rehabilitation+issues.+++%E2%80%A2+SPECT+scans+can+often+identify+a+specific+cause+or+reason+that+contributes+to+recovering+alcoholics%2C+drug+addicts%2C+eating+disordered%2C+or+sexual+addicts+relapse+behavior+in+their+recovery+from+an+addictive+process.+For+example%2C+the+patient+may+have+suffered+an+injury+in+the+prefrontal+cortex+or+temporal+lobes+or+have+overactivity+in+basal+ganglia%2C+limbic+system%2C+or+prefrontal+cortex%2C+each+of+which+could+contribute+to+the+relapsing+behaviors.+++%E2%80%A2+SPECT+scans+allow+patients+to+have+a+specific+physical+representation+of+their+problems+that+is+accurate+and+reliable.+++%E2%80%A2+SPECT+scans+help+develop+a+deeper+understanding+of+the+problem+and+lead+to+decreased+shame%2C+guilt%2C+stigma+and+self-loathing.+They+can+increase+self-forgiveness.+Patients+can+see+that+their+problems+are%2C+in+part%2C+a+medical+problem.+++%E2%80%A2+SPECT+scans+help+to+increase+compliance.+The+images+can+powerfully+influence+a+patients+willingness+and+ability+to+accept+and+adhere+to+a+treatment+program+as+they+realize+they+are+not+taking+medication+for+their+problems+of+anxiety%2C+depression%2C+rage%2C+or+ADD%2C+but+rather+to+optimize+brain+function%2C+an+idea+similar+to+needing+glasses+for+their+eyesight.+++%E2%80%A2+SPECT+scans+may+help+families+understand+when+things+will+not+get+better%2C+such+as+having+permanent+brain+damage+from+an+injury%2C+which+allows+patients+and+families+to+accept+the+condition+and+provide+accordingly.+++%E2%80%A2+SPECT+scans+help+substance+abusers+decrease+denial+and+increase+motivation+for+treatment+by+seeing+the+damage+they+have+done+to+their+own+specific+brain.+SPECT+scans+can+help+motivate+recovering+alcoholics+and+addicts+to+continue+in+sobriety+as+it+becomes+clear+that+further+use+will+cause+increased+brain+damage.+++%E2%80%A2+SPECT+scans.+physically+show+patients%2C+how+treatments+have+impacted+%28improved+or+worsened%29+brain+function.+++%E2%80%A2+SPECT+scans+help+motivate+verbally+and+physically+abusive+spouses+to+follow+medication+protocols+by+seeing+they+have+a+physical+abnormality+that+may+be+contributing+to+their+problems.+++%E2%80%A2+SPECT+scans+are+useful+for.+patients+who+are+suffering+with+a+post+chemotherapy+toxic+brain.+It+gives+them+insight+into+their+cognitive+struggles+and+also+helps+their+doctors+see+what+is+physical+and+what+might+be+emotional+or+traumatic+sequelae+of+having+cancer.+++%E2%80%A2+SPECT+scans+allow+patients+to+understand+why+specific+treatments+are+indicated%2C+which+medications+are+helpful%2C+and+why+certain+medical+interventions+are+chosen.+++'; var metaContents = 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cipant+leaves+the+encounter+very+different%2C+and+in+a+changed+and+transformed+state+than+when+he+or+she+entered+the+process.++In+this+section%2C+I+want+to+specifically+and+practically+elaborate+on+how+this+occurs+in+the+crucible+encounter%2C+as+other+salient+%E2%80%9Cingredients%E2%80%9D+are+identified+in+this+change+process.++They+are+identified+in+an+encounter+that+Jesus+had+with+a+person+in+Luke+10%3A+25+%E2%80%93+28.++++++In+this+passage%2C+Jesus+was+asked+the+question%3A++%E2%80%9CWhat+must+I+do+to+inherit+eternal+life%3F%E2%80%9D++Jesus+directed+the+man+to+consider+the+devotion+of+his+whole+life+to+God%2C+eventually+replying+to+him%2C+%E2%80%9CDo+this+and+you+will+live.%E2%80%9D++The+interesting+thing+is+the+word+%E2%80%9Clive%E2%80%9D+infers+that+we+%E2%80%9Clive+as+one+recovering+from+an+illness%2C%E2%80%9D+which%2C+for+some%2C+may+speak+to+the+life+condition+where+change%2C+healing+and+growth+is+desired%2C+regarding+the+life+challenges+that+have+been+encountered.++Greater+still%2C+Jesus+identifies+7+Core+Area+of+our+life+%28Spiritual%2C+Cognitive%2C+Emotional%2C+Biological%2C+Sexual%2C+Relational%2C+and+Environmental%29%2C+that+represent+the+whole+and+totality+of+our+being%2C+as+well+as+how+we+interact+with+the+world.++What+I+hear+in+Jesus%E2%80%99+response%2C+is+that+He+encourages+us%2C+to+examine+how+our+thoughts%2C+feelings+and+behavior+in+these+7+Core+Areas+could+be+purposefully+and+powerfully+effected+by+the+edifying+touch+of+the+Holy+Spirit%2C+and+addressed+thoroughly+in+a+%E2%80%9Ccrucible+relationship%E2%80%9D+with+a+trusted+other+%28our+therapist%2C+and+other+important%2C+but+safe+people+in+our+lives%29.++++++Take+a+look+at+the+7+Core+Areas.++To+love+%28%E2%80%9Cagapao%E2%80%9D%29+God+means+we+are+to+%E2%80%9Ccherish%2C+honor%2C+favor%2C+respect%2C+accept%2C+relish%2C+prize%2C+esteem+and+be+devoted+to%E2%80%9D+His+process+of+seeing+these+areas+developed+to+their+fullest%2C+not+only+for+us+to+give+ourselves+the+chance+to+see+change+occur%2C+but+also+to+enter+into+a+process+of+beginning+to+live+beyond+our+current+and+challenging+circumstances.++Like+a+good+physician+would+assess+and+diagnose+how+all+parts+of+the+body+are+functioning%2C+God+would+have+us+to+critically+examine+these+areas+of+our+lives%2C+in+order+to+gain+insight%2C+and+to+respond+regarding+to+what+personal+and+relational+adjustments+we+need+to+make+in+order+to+begin%2C+or+continue+a+process+of+change++growth+in+our+lives.++++++++Practically%2C+this+means+that+with+my+therapist%2C+I+pull+out+the+magnifying+glass+and+examine+my+thoughts%2C+feelings+and+behavior+about+God%2C+faith%2C+morals+and+empowerment%2C+as+well+as+how+I+may+need+to+challenge+personal+thought+processes%2C+or%2C+learn+how+to+%E2%80%9Crestructure%E2%80%9D+them%2C+and+replace+negative+thoughts+with+different+or+positive+ones.++I+may+need+to+consider+how+I+could+de-intensify+emotionally+charged+encounters%2C+or+learn+how+to+ask+for+what+I+need+from+others%2C+while+learning+to+tolerate+that+I+%28and+God%29%2C+are+ultimately+responsible+for+my+emotional+well+being.+Along+with+this%2C+I+examine+my+sexuality%2C+and+uncover+what+unnecessary+%E2%80%9Cbaggage%E2%80%9D+I+need+to+discard%2C+as+I+move+on+in+my+life+journey+toward+healthier+sexual+behavior%2C+and+discover+how+the+other+six+core+areas+of+my+being+affect+and+shape+this+personal+yet+powerful+part+of+who+I+am.++All+of+these+core+areas+are+to+be+examined+in+totality%2C+due+to+the+fact+each+area+impacts+the+others+areas%2C+and+if+health+and+healing+is+to+be+experienced%2C+the+whole+of+the+person+is+to+be+explored+and+impacted+in+the+crucible.++++++I+suggest+that+by+entering+into+the+crucible+encounter%2C+and+by+allowing+this+process+of+growth+to+occur%2C+we+give+ourselves+the+opportunity+to+experience+healing+in+our+life+experiences+today+%28Matt.+6%3A+34%3B+its+all+we+have+anyway%29%2C+but+also%2C+for+tomorrow+%28Jeremiah+29%3A11%29.++In+addition%2C+by+allowing+Christ%2C+through+the+Holy+Spirit+to+teach%2C+guide%2C+empower%2C+motivate%2C+lead%2C+comfort%2C+change%2C+cleanse+and+heal+us+in+the+crucible%2C+we+position+ourselves+to+reclaim+and+demonstrate+focused+and+passionate+living+that+our+Lord+intends+for+us+to+experience+in+these+core+areas+of+our+being.++As+you+explore+the+%E2%80%9Ccrux+of+the+matter%2C%E2%80%9D+know+that+I+will+work+for+your+success%3B+to+experience+change%2C+healing+and+growth+%E2%80%93+Dr.+Ken+McGill++++++++++++What+is+SPECT+imaging+%28Single+Photon+Emission+Computer+Tomography%29%3F++--Brain+SPECT+imaging+is+a+nuclear+medicine+procedure+that+evaluates+cerebral+blood+flow.+It+evaluates+areas+of+the+brain+that+work+well%2C+areas+of+the+brain+that+work+too+hard%2C+and+areas+of+the+brain+that+do+no+work+hard+enough.+The+information+from+the+scans%2C+along+with+a+detailed+clinical+history%2C+and+with+other+laboratory+testing%2C+helps+us+understand+the+underlying+brain+patterns+associated+with+our+patients%E2%80%99+problems+and+help+to+pinpoint+the+right+treatment+to+balance+brain+function.++++What+is+the+procedure%3F++--You+will+be+placed+in+a+quiet+room+and+a+small+IV+line+will+be+inserted+into+your+arm.++For+the+concentration+study%2C+you+will+take+a+15+minute+computerized+test+of+attention+and+focus.+Three+or+four+minutes+into+performing+the+test%2C+the+imaging+solution+will+be++injected+through+the+IV%2C+and+then+you+will+complete+the+test.+For+the+baseline+study%2C+you+will+be+instructed+to+sit+quietly.+Several+minutes+later%2C+the+imaging+solution+will+be+injected+through+the+IV.+After+another+short+period+of+time%2C+you+will+lie+on+the+imaging++table+and+the+SPECT+camera+will+slowly+rotate+around+your+head+taking+images+of+brain+blood+flow+%28you+are+not+placed+inside+a+tube%29.+The+time+on+the+table+is+approximately+18+minutes.++Question%3A+What+do+SPECT+scans+show+that+should+change+how+a+patient+is+treated%3F++Amen+response%3A+Many+things%3A+++%E2%80%A2+SPECT+shows+the+function+or+dysfunction+of+specific+brain+regions+implicated+with+specific+problems%2C+such+as+the+prefrontal.+cortex+with+executive+function+and+the+medial+temporal+lobes+with+getting+information+into+long-term+storage.+Thus%2C+we+can+target+brain+systems%2C+not+just+vague+DSM+diagnoses.+++%E2%80%A2+SPECT+shows+unexpected+findings+that+may+be+contributing+to+the+problem%28s%29%2C+such+as+toxicity%2C+potential+areas+of+seizure+activity%2C+or+past+brain+trauma.+This+dramatically+changes+treatment%2C+such+as+eliminating+the+toxin.+++%E2%80%A2+SPECT+shows+potential+underlying+seizure+activity+that+may+be+contributing+to+the+problem+%28often+more+accurately+seen+by+SPECT+than+standard+EEG%2C+especially+in+the+areas+of+the+medial+temporal+lobes%29.+++%E2%80%A2+SPECT+shows+specific+target+areas+for+treatment%2C+such+as+an+overactive+anterior+cingulate+gyrus+%28seen+with+OCD+spectrum+disorders%29+or+an+underactive+temporal+lobe+%28seen+in+seizure+disorders+and+other+disorders+such+as+trauma%29.+++%E2%80%A2+SPECT+shows+the+specific+effect+of+medication+on+the+brain+and+subsequently+how+to+adjust+dosages.+Patients+often+report+that+SSRIs+are+helpful+but+also+cause+demotivation+or+memory+problems.+SPECT+studies+can+show+when+SSRIs+are+causing+excessive+decreased+prefrontal+or+temporal+lobe+activity+that+clinical+evaluation+only+hints+at.+++++++++++++.+++%E2%80%A2+SPECT+scans+helps+provide+real%2C+demonstrable+answers+to+refractory+symptoms+and%2C+in+addition%2C+helps+clinicians+ask+better+and+more+targeted+questions%E2%80%94about+toxic+exposure%2C+brain+injuries%2C+anoxia%2C+inflammation%2C+or+infection%2C+that+patients+may+have+initially+denied+or+forgotten.+++%E2%80%A2+SPECT+scans+help+clinicians+prevent+mistakes+or+hurting+patients+by+prescribing+the+wrong+treatments%2C+such+as+unnecessarily+stimulating+an+already+overactive+brain+or+calming+an+underactive+one.+++%E2%80%A2+SPECT+scans+help+to+evaluate+those+who+may+be.+at+risk+for+dementia%E2%80%94the+brain+starts+to+change+long+before+people+show+symptoms+of+dementia.+One.+study+reported+that+there+has+to+be+a+loss+of+30%25+in+the+hippocampus+before+symptoms+occur.+Using+autopsy+data+in+54+patients%2C+Bonte+reported+that+brain+SPECT+had+a+positive+predictive+value+for+Alzheimers+disease+of+92%25+.+SPECT+scans+can+help+differentiate+between+types+of+dementia.+++%E2%80%A2+SPECT+scans+can+identify+specific+areas+of+the+brain+hurt+by+trauma+to+better+target+treatment+and+help+deal+with+insurance%2C+legal+and+rehabilitation+issues.+++%E2%80%A2+SPECT+scans+can+often+identify+a+specific+cause+or+reason+that+contributes+to+recovering+alcoholics%2C+drug+addicts%2C+eating+disordered%2C+or+sexual+addicts+relapse+behavior+in+their+recovery+from+an+addictive+process.+For+example%2C+the+patient+may+have+suffered+an+injury+in+the+prefrontal+cortex+or+temporal+lobes+or+have+overactivity+in+basal+ganglia%2C+limbic+system%2C+or+prefrontal+cortex%2C+each+of+which+could+contribute+to+the+relapsing+behaviors.+++%E2%80%A2+SPECT+scans+allow+patients+to+have+a+specific+physical+representation+of+their+problems+that+is+accurate+and+reliable.+++%E2%80%A2+SPECT+scans+help+develop+a+deeper+understanding+of+the+problem+and+lead+to+decreased+shame%2C+guilt%2C+stigma+and+self-loathing.+They+can+increase+self-forgiveness.+Patients+can+see+that+their+problems+are%2C+in+part%2C+a+medical+problem.+++%E2%80%A2+SPECT+scans+help+to+increase+compliance.+The+images+can+powerfully+influence+a+patients+willingness+and+ability+to+accept+and+adhere+to+a+treatment+program+as+they+realize+they+are+not+taking+medication+for+their+problems+of+anxiety%2C+depression%2C+rage%2C+or+ADD%2C+but+rather+to+optimize+brain+function%2C+an+idea+similar+to+needing+glasses+for+their+eyesight.+++%E2%80%A2+SPECT+scans+may+help+families+understand+when+things+will+not+get+better%2C+such+as+having+permanent+brain+damage+from+an+injury%2C+which+allows+patients+and+families+to+accept+the+condition+and+provide+accordingly.+++%E2%80%A2+SPECT+scans+help+substance+abusers+decrease+denial+and+increase+motivation+for+treatment+by+seeing+the+damage+they+have+done+to+their+own+specific+brain.+SPECT+scans+can+help+motivate+recovering+alcoholics+and+addicts+to+continue+in+sobriety+as+it+becomes+clear+that+further+use+will+cause+increased+brain+damage.+++%E2%80%A2+SPECT+scans.+physically+show+patients%2C+how+treatments+have+impacted+%28improved+or+worsened%29+brain+function.+++%E2%80%A2+SPECT+scans+help+motivate+verbally+and+physically+abusive+spouses+to+follow+medication+protocols+by+seeing+they+have+a+physical+abnormality+that+may+be+contributing+to+their+problems.+++%E2%80%A2+SPECT+scans+are+useful+for.+patients+who+are+suffering+with+a+post+chemotherapy+toxic+brain.+It+gives+them+insight+into+their+cognitive+struggles+and+also+helps+their+doctors+see+what+is+physical+and+what+might+be+emotional+or+traumatic+sequelae+of+having+cancer.+++%E2%80%A2+SPECT+scans+allow+patients+to+understand+why+specific+treatments+are+indicated%2C+which+medications+are+helpful%2C+and+why+certain+medical+interventions+are+chosen.+++'; theSitetree.getById = function(id, ar) { if (typeof(ar) == 'undefined'){ ar = this; } for (var i=0; i < ar.length; i++) { if (ar[i][POS_ID] == id){ return ar[i]; } if (ar[i][POS_CHILDS].length > 0) { var result=this.getById(id, ar[i][POS_CHILDS]); if (result != null){ return result; } } } return null; }; theSitetree.getParentById = function(id, ar) { if (typeof(ar) == 'undefined'){ ar = this; } for (var i=0; i < ar.length; i++) { for (var j = 0; j < ar[i][POS_CHILDS].length; j++) { if (ar[i][POS_CHILDS][j][POS_ID] == id) { // child found return ar[i]; } var result=this.getParentById(id, ar[i][POS_CHILDS]); if (result != null){ return result; } } } return null; }; theSitetree.getName = function(id) { var elem = this.getById(id); if (elem != null){ return elem[POS_NAME]; } return null; }; theSitetree.getNavigationText = function(id) { var elem = this.getById(id); if (elem != null){ return elem[POS_NAVIGATIONTEXT]; } return null; }; theSitetree.getHREF = function(id) { var elem = this.getById(id); if (elem != null){ return elem[POS_HREF]; } return null; }; theSitetree.getIsNavigation = function(id) { var elem = this.getById(id); if (elem != null){ return elem[POS_ISNAVIGATION]; } return null; }; theSitetree.getTemplateName = function(id, lastTemplateName, ar) { if (typeof(lastTemplateName) == 'undefined'){ lastTemplateName = this.topTemplateName; } if (typeof(ar) == 'undefined'){ ar = this; } for (var i=0; i < ar.length; i++) { var actTemplateName = ar[i][POS_TEMPLATENAME]; if (actTemplateName == ''){ actTemplateName = lastTemplateName; } if (ar[i][POS_ID] == id) { return actTemplateName; } if (ar[i][POS_CHILDS].length > 0) { var result=this.getTemplateName(id, actTemplateName, ar[i][POS_CHILDS]); if (result != null){ return result; } } } return null; }; theSitetree.getByXx = function(lookup, xx, ar) { if (typeof(ar) == 'undefined'){ ar = this; } for (var i=0; i < ar.length; i++) { if (ar[i][xx] == lookup){ return ar[i]; } if (ar[i][POS_CHILDS].length > 0) { var result=this.getByXx(lookup, xx, ar[i][POS_CHILDS]); if (result != null){ return result; } } } return null; }; function gotoPage(lookup) { if(__path_prefix__ == "/servlet/CMServeRES" && typeof (changePage) == 'function'){ changePage(lookup); return; } var page = theSitetree.getHREF(lookup); if (!page) { var testFor = [ POS_NAME, POS_NAVIGATIONTEXT ]; for (var i=0 ; i < testFor.length ; i++) { var p = theSitetree.getByXx(lookup, testFor[i]); if (p != null) { page = p[POS_HREF]; break; } } } document.location.href = (new URL(__path_prefix__ + page, true, true)).toString(); };