Intermittent reward addiction

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As we continue to grow Amatus Health, the need to stay competitive and differentiate ourselves in unique ways is crucial. Building creative approaches to reach more people will take our company to new heights. This is why I am pleased to announce that we are officially rebranding. Our new national name, TruHealing Addiction & Mental Health Treatment, will eventually replace Amatus Recovery Centers.

You may be asking, “Why are we doing this?” This new name will give us national uniformity and help brand ourselves as a whole, which will be done in phases. You will still see our existing facility names co-branded with TruHealing for the time being.

Healing is what we do. Everyone who comes through our doors is in a moment of profound struggle in their lives. We support them through a life-changing process of healing and recovery, and they leave our facilities changed. This new name is a representation of that process. As mentioned above, it also allows us to have a national brand, which will make us a recognizable name in the addiction and mental health field.

In summation, these changes present an excellent opportunity for our organization to develop our mission, vision, and purpose. I look forward to prosperous growth as we head in a new and positive direction.

Sincerely,

Mark Gold
CEO
Amatus Health

Dr. Adam Cusner, PhD is an organizational psychologist by training and has brought his decade-plus experience to the healthcare field serving as the Executive Vice President of Operations for a 22-facility portfolio of skilled nursing facilities, assisted living and independent living centers across Ohio and Arizona, with an annual revenue over $250MM. While serving in this position, Dr. Cusner brought accelerated growth to these facilities, while increasing employee retention and workflow optimization. Dr. Cusner has a proven track record in the healthcare industry of providing successful leadership through his financial acumen, strategic planning, interpersonal skills, along with his ability to build strong, effective teams.

Dr. Cusner’s credentials include a Philosophy Doctorate in Organizational Psychology (PhD) from Cleveland State University, a Master of Arts in Psychology (MA) from Boston College with an emphasis on Psychology of Work, a Bachelor of Science in Psychology (BS) from Boston University with an emphasis in Organizational Behavior in Business and is a board-certified Nursing Home Administrator (LNHA). He has published and presented research articles in the field of organizational psychology at national healthcare conferences. Dr. Cusner is completing a book on organizational psychology in the healthcare field, which is expected to be published late early summer 2022. He is also a member of the American Psychological Association (APA), has served as the APA’s Division 17 communications chair, is a member of the Society for Industrial Organizational Psychologists (SIOP), and was selected as a professional reviewer for national conference research presentations.

Dr. Cusner is an advocate for his employees and is drawn to the tie between culture and quality. His extensive strategic and operational skills have delivered a high degree of success across all department levels. Dr. Cusner facilitated the establishment of an in-house financial team to provide billing and collections, accounts payable, vendor management, along with financial reporting. This provided $1.5MM annualized savings. Further, he developed department efficiencies for: Medical Staff recruitment, service-line growth, quality and safety, corporate accountability of budgetary expectations balanced with direct reporting to investor groups.

Dr. Cusner coordinated the financial turnaround of a 300 bed CCRC (skilled nursing, assisted living and an independent living center) in Arizona, which has been epitomized as the most financially challenging state to manage CCRC facilities. Dr. Cusner also strengthened the business growth of the Ohio facilities by 12%. He was recognized by the Governor for demonstrating a “care-conscious approach” during COVID, when Dr. Cusner carefully consolidated facility residents to accommodate staff and improve clinical care. Dr. Cusner demonstrates a results-driven culture by delivering a high-quality level of care and employee engagement.

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Yaffa Atias is the Director of Special Projects at Amatus Health. Atias is a leadership professional with a decade of experience in healthcare. She holds a BA in interdisciplinary studies from Thomas Edison State College, and a Master’s in Healthcare Management with a concentration in project management from Stevenson University. She completed her graduate capstone at Mosaic Community Services, now an affiliate of Sheppard Pratt.

In her role at Amatus, Atias leads and manages interdisciplinary team projects, creates solutions for any operational gaps, and continually strives for quality improvement in all processes. Atias led the organization’s COVID-19 preparedness strategy, resulting in all facilities remaining operational, and in 600 employees being retained as staff without resigning out of fear. In her role so far, she implemented licensure for three new states.

Atias believes Amatus Health and TruHealing stand out because every employee, from corporate to center staff, has a real passion for helping people. Atias shares this passion, “My natural compass always tugged me to behavioral health. I’ve always been fascinated by the human psyche. I have also been intimately privy to those suffering from mental illness and substance use. I later understood that my experiences weren’t unique, and quickly realized how pressing the need really is to effectively prevent and address. Moreover, how life-changing proper intervention truly is.”

Atias was born in Los Angeles, California and grew up in Israel and Maryland.

Melissa McCarthy is the Vice President of Business Development at Amatus Health. With a decade of experience in the behavioral healthcare and addiction treatment industry, McCarthy is passionate about recovery. She has her finger on the pulse of marketing trends, with the end goal of helping businesses grow so they can serve more people in need.

McCarthy has worked at large enterprise recovery centers across the country spearheading business development teams. She has a wide range of experience, including transforming a third-party digital marketing and client acquisition services company into a full-continuum behavioral healthcare provider, managing several successful rebrands, and growing annual revenue fivefold.

As VP of Business Development, McCarthy leads a team of over 20 business development professionals nationwide. She manages client acquisition, coordinates in-service trainings with various referents and hospitals, and presents at conferences on addiction and mental health disorder treatment.

“Sadly, many individuals die waiting for access to life-saving behavioral healthcare services,” says McCarthy. “I am in relentless pursuit of better—better access, better care delivery and better outcomes. I consider it a privilege to work in an environment where miracles unfold daily.”

McCarthy lives in Maryland with her daughter.

Hometown: Saugus, MA

Passions & interests: The greatest passion of mine is being able to dig into the work with men in early recovery. There is nothing better than witnessing and being a part of the change. My journey in long-term recovery has taught me to value the little things in life that I am now able to do. I love to do anything that allows me to be present with my wife, family, and friends. My wife and I enjoy traveling, trying new foods, and taking long motorcycle rides with our friends. If I am not on the road working or with my wife, I am studying or playing softball.

The best part of my job is being able to show up for my team and clients; they all mean the world to me. I get to brainstorm and strategize with tons of different personalities. A lot of the team does not know, but I love learning from them. If I am not learning something about our industry or workplace, I am certainly learning how to effectively collaborate with different types of individuals.

Together, we can change the narrative and be a part of the solution to better treat those trapped in the problem.

Allison was born in Columbus, Ohio and was raised in South Florida. She graduated from the University of Florida’s College of Journalism and Communications. After college, Allison started working at the largest talent agency in the world, William Morris Endeavor. There, she learned marketing from top leaders specializing in global PR and endorsement campaigns, in both the Latin and English markets.

Through strategic public relations and creative campaign concepts, Allison has secured more than 200 national broadcast and print media placements for behavioral healthcare organizations. She brings over 15 years of marketing and PR experience, with a strong background in leading communications strategy for addiction treatment and behavioral healthcare facilities. In her role as VP of Communications, she oversees branding, public relations, social media, marketing, events, and content creation.

In her spare time, she loves cooking, boating, yoga, and traveling. She and her husband Bryan reside in Boca Raton, Florida.

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Avi Burstein is VP of Clinical Services at Amatus Health. He manages all therapeutic programming at all facilities nationwide.

Avi is originally from New York, and graduated from Ferkauf Graduate School of Psychology. He brings over 13 years of experience in the Behavioral Healthcare Industry, in both the public and private sectors. He is passionate about therapeutic communities and the fellowship they foster between patients. Through his work in LGBTQIA, urban, rural, and religiously observant populations, Avi recognizes that each patient is unique. Therefore, he strives to ensure clinical approaches, staffing, administration, and education meet the expectation of each community Amatus Health serves.

“Our work must also include ending the societal stigma surrounding such conditions by building safe and supportive networks that include clients’ families whenever possible,” Avi said. “By valuing change and owning imperfections, we can strive to be better providers and walk through the door of recovery with our clients.”

Avi Burstein is VP of Clinical Services at Amatus Health. He manages all therapeutic programming at all facilities nationwide.

Avi is originally from New York, and graduated from Ferkauf Graduate School of Psychology. He brings over 13 years of experience in the Behavioral Healthcare Industry, in both the public and private sectors. He is passionate about therapeutic communities and the fellowship they foster between patients. Through his work in LGBTQIA, urban, rural, and religiously observant populations, Avi recognizes that each patient is unique. Therefore, he strives to ensure clinical approaches, staffing, administration, and education meet the expectation of each community Amatus Health serves.

“Our work must also include ending the societal stigma surrounding such conditions by building safe and supportive networks that include clients’ families whenever possible,” Avi said. “By valuing change and owning imperfections, we can strive to be better providers and walk through the door of recovery with our clients. ”

Marty Markovits is the Chief Information Officer at TruHealing. He oversees the people, processes, and technologies of the whole organization to ensure the business is running smoothly.

Markovits grew up in Brooklyn, NY (which he calls “the greatest city on Earth”) and graduated with a degree in Clinical Psychology from Queens College.

Markovits is a veteran in Information Technology within the healthcare field. He ensures that IT processes are simple, cost-effective, and secure. His expertise spans the entire healthcare domain, from billing and claims, to clinical, to Human Resources. He says, “My passion is to provide fully automated and operationally meaningful Business Intelligence analytics, with absolute data integrity.”

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Hometown: Savannah, GA

Passions & Interests: I spend my time outside of work with my wife and children and am actively involved in various community needs and causes.

The best part of my job is knowing that we are creating a safe, healthy, nonjudgmental environment where people can come and better their lives. There is nothing more satisfying than helping others learn to live again and piece their lives back together as they become strong, productive members of society.

Together, we can bring families back together and promote healing and well-being.

With over 16 years of proven executive leadership and driving company growth, Mark Gold’s momentum for success isn’t slowing down anytime soon. He serves as the CEO of Amatus Health, one of the fastest-growing, behavioral healthcare organizations in the country.

Possessing an excellent handling of clinical compliance and high performance standards, Mark established 14 CARF/JCT accredited addiction and mental health treatment centers and three ancillary healthcare businesses. Mark’s natural leadership skills as well as his creative thought process to generate new revenue strategies make him one of the most sought-after professionals in healthcare. Mark has a track record of leading organizations to outstanding ROI on overall portfolio performance. In addition, his expertise includes workforce planning, growth revenue, high client and investor satisfaction.

Aside from daily business oversight, Mark invests in his staff and helps build their professional development. His commitment to his colleagues and employees toward advancement and inclusiveness helps them achieve goals, builds connections, and provides a competitive advantage in the healthcare field.

Mark has been instrumental in building healthy communities and providing access and quality healthcare to underserved populations. His service in the community is a testament to his passion and selfless dedication to the cause of eradicating addictive disorders and stigma.

He launched several prevention and education programs and created the first-ever “Social Justice” scholarship fund of over $750,000.00 to help communities of color into inpatient drug treatment. Mark says, “The best part of my role is the knowledge that what we do impacts countless lives, with far-reaching effects,” he said. “It is incredibly rewarding to be part of a team that guides individuals onto a safe and accessible path to healing and recovery.”

He is a board member of Ahavas Chaim, a non-profit that offers at-risk teenagers crisis intervention and mental health support. He is also a committee member of the organizations Bonei Olam and Chai Lifeline Mid-Atlantic.

Mark studied Talmudic Law at Yeshiva’s Mir Yerushalayim in Israel. In Mark’s free time, he loves snowboarding, boating, and spending time with his wife and children.

Narcissists Use Trauma Bonding and Intermittent Reinforcement To Get You Addicted To Them: Why Abuse Survivors Stay

Exploitive relationships create betrayal bonds. These occur when a victim bonds with someone who is destructive to him or her. Thus the hostage becomes the champion of the hostage taker, the incest victim covers for the parent and the exploited employee fails to expose the wrongdoing of the boss. Dr. Patrick Carnes

“Why didn’t he or she just leave?” is a question that makes many victims of abuse cringe, and for good reason. Even after years of research about the effects of trauma and abuse and the fact that abuse victims often go back to their abusers an average of seven times before they finally leave, society still does not seem to understand the powerful effects of trauma bonding and intermittent reinforcement in an abusive relationship.

According to Dr. Logan (2018), Trauma bonding is evidenced in any relationship which the connection defies logic and is very hard to break. The components necessary for a trauma bond to form are a power differential, intermittent good and bad treatment, {as well as} high arousal and bonding periods.

Trauma bonding is a bond that develops when two people undergo intense, risky emotional experiences together. In the context of an abusive relationship, this bond is strengthened due to the heightenedintimacy and danger. Similar to the way Stockholm Syndrome manifests, the abuse victim bonds with his or her abuser as both the source of terror and comfort in an attempt to survive the tumultuous relationship. As a result, abuse victims feel a misplaced, unshakeable sense of loyalty and devotion to their abusers, which to anoutsider may appear nonsensical.

As Dr. Patrick writes in his book, The Betrayal Bond, trauma bonding is especially fierce in situations where there are repetitive cycles of abuse, a desire to rescue the abuser, as well as the presence of both seduction and betrayal. He writes:

“Those standing outside see the obvious. All these relationships are about some insane loyalty or attachment. They share exploitation, fear,and danger. They also have elements of kindness, nobility,and righteousness. These are all people who stay involved or wish to stay involved with people who betray them. Emotional pain, severe consequences and even the prospect of death do not stop their caring or commitment. Clinicians call this traumatic bonding. This means that the victims have a certain dysfunctional attachment that occurs in the presence of danger, shame or exploitation. There often is seduction, deception or betrayal. There is always some form of danger or risk.”

Intermittent reinforcement (in the context of psychological abuse) is a pattern of cruel, callous treatment mixed in with random bursts of affection. The abuser hands out rewards such as affection, a compliment, or gifts sporadically and unpredictably throughout the abuse cycle. Think of the violent husband who gives his wife flowers after assaulting her, or the kind words an abusive mother gives to her child after a particularly harsh silent treatment.

Intermittent reinforcement causes the victim to perpetually seek the abuser’s approval while settling for the crumbs of their occasional positive behavior, in the hopes that the abuser will return to the honeymoon phase of the relationship. Like a gambler at a slot machine, victims are unwittingly “hooked” to play the game for a potential win, despite the massive losses.

This manipulation tactic also causes us to perceive their rare positive behaviors in an amplified manner. Dr. Carver describes this as the small kindness perception. As he notes in his article, Love and Stockholm Syndrome:

“In threatening and survival situations, we look for evidence of hope a small sign that the situation may improve. When an abuser/controller shows the victim some small kindness, even though it is to the abusers benefit as well, the victim interprets that small kindness as a positive trait of the captorIn relationships with abusers, a birthday card, a gift (usually provided after a period of abuse), or a special treat are interpreted as not only positive, but evidence that the abuser is not all bad and may at some time correct his/her behavior. Abusers and controllers are often given positive credit for not abusing their partner, when the partner would have normally been subjected to verbal or physical abuse in a certain situation.

As I discuss more in-depth in my books on narcissistic abuse, there is also a biochemical addiction involved when it comes to intermittent reinforcement and trauma bonding. As Helen Fisher (2016) explores, love activates the same areas of the brain responsible for cocaine addiction. In adversity-ridden relationships, the effects of biochemical addiction can be even more powerful. When oxytocin, serotonin, dopamine, cortisol, and adrenaline are involved, the abusive nature of the relationship can actually strengthen, rather than dampen, the bond of the relationship in the brain.

For example, dopamine is a neurotransmitter which plays a key role in the pleasure center of our brains. It creates reward circuits and generates associations in our brain which link our romantic partners with pleasure and even survival. The catch? Dopamine flows more readily in the brain when there is an intermittent reinforcement schedule of affection and attention, rather than a consistent one (Carnell, 2012). The hot and cold behaviors of a toxic relationship actually exacerbate our dangerous attachment to our abusers rather than deterring it – creating an addiction that is not unlike drug addiction.

This is just one of the ways the brain is affected by abuse, so imagine how difficult it can be for a traumatized individual to break the bond.

You might be suffering from a trauma bond if you exhibit the following behaviors:

1. You know they are abusive and manipulative, but you can’t seem to let go. You ruminate over the incidents of abuse, engage in self-blame, and the abuser becomes the sole arbiter of your self-esteem and self-worth.
2. You walk on eggshells trying to please your abuser, even though they give you little in return except for crumbs of affection and more pain.
3. You feel addicted to them without understanding why. You “need” their validation and approval, looking to them as the source of comfort after incidents of abuse. This is evidence of a strong biochemical and psychological attachment to them.
4. You defend your abuser and keep their transgressions a secret. You might refuse to press charges against your abuser or defend them against family members or friends who try to tell you that they are toxic. You may even present your relationship as a happy one to the public eye, attempting to minimize their abusive behavior and romanticizing and exaggerating any positive behaviors they dole out occasionally.
5. Even when you attempt to leave the abuser, you give into the abuser’s faux remorse, crocodile tears and claims to change for the future. The pattern of abuse and its cycle may be evident, but you hold onto the false hope that things can get better.
6. You develop self-sabotaging behaviors and might engage in some form of self-harm or addictions to dissociate from the pain of the abuse and the acute sense of shame caused by the abuse.
7. You are willing to lower your standards time and time again for this toxic person, accepting what you previously believed was unacceptable.
8. You change your own behaviors, appearance and/or personality in an attempt to meet the abuser’s moving goal posts, although the abuser rarely changes their own behavior to please you.

The Big Picture

If you are experiencing a trauma bond with an emotional or physical abuser, the first step is awareness. Know that it is the addictive nature of the trauma bond and the effects of intermittent reinforcement which contribute to the source of your bond, not the merits of the abuser or the relationship itself.This will help you to distance yourself from seeing your relationship as a “special” one just in need of more of your time, energy, or patience. Malignant narcissistic abusers follow hardwired behaviors and will not change for you or anyone else.

Get distance from your abuser, even if you feel you cannot leave yet. Work with a trauma-informed counselor to process the trauma, examine the cycle of abuse, reconnect with the reality of the abusive relationship, and place responsibility where it truly belongs.The abuse you endured was not your fault and neither was the trauma bond that formed. You deserve a life free of abuse and mistreatment. You deserve healthy relationships and friendships which nourish you, not deplete and exploit you. You deserve to break the bonds which tether you to your abuser.

Why do we feel happy in toxic relationships and how to get out of them? An excerpt from a book by psychologist Shahida Arabi — Snob

In June, the MIF publishing house published for the first time in Russian a book by psychologist Shahida Arabi “Toxic People. How to protect yourself from narcissists, gaslighters, psychopaths and other manipulators. The author talks about how to understand that a manipulator is next to you, get out of traumatic relationships and recover from them. "Snob" publishes an excerpt from the first chapter

Why We Can't Leave: Biochemical Dependence

"Why is it so hard for me to just cut off relationships and leave?" This is one of the most common questions I get from empathic people in toxic relationships. It is important to answer this question, because it is not the person or the relationship that holds us back. This is something much more dangerous and addictive.

Trauma from toxic relationships takes over our emotional brain, affecting areas such as the amygdala and hippocampus, while shutting down the prefrontal cortex that controls thought activity. These areas of the brain are responsible for experiencing emotions, self-control and impulsivity, fear, memory, learning, planning and decision-making (van der Kolk, 2014). The injury also disrupts the connection between the right and left hemispheres of the brain, slowing down the activity of the left hemisphere, which leads to loss of executive functions - the ability to connect and structure our experiences, solve problems and make the right decisions.

Think about this before you blame yourself for "inappropriate" behavior. In moments of chaos, your brain works against you. At the heart of toxic relationships is what abuse experts call attachment trauma . It occurs when we experience a vivid emotional experience that pushes us to attach to the tormentor in order to survive. Scientist Patrick Carnes calls it treacherous ties : “Exploitative relationships create treacherous ties. This is how a hostage defends his kidnapper, an incest victim covers a parent, and an exploited worker is unable to convict a boss of abuse of power… Such attachment to people who have hurt you lulls vigilance and causes addiction” (Carnes, 2015,6). Karnes describes how victims who have this connection try to correct their tormentor by trying to help him understand that his actions are wrong. Victims often begin to blame themselves for not doing this well. Attachment trauma causes them to lose faith in their own sense of reality, which puts them in even greater danger. Victims try to prevent further abuse by repairing the relationship, but this inevitably leads to more pain.

Understanding why we keep in this relationship can help us stop blaming ourselves and finally break this destructive relationship. Similar to Stockholm Syndrome, attachment trauma forces you to be protective of the abuser even after you have experienced horrific emotional and physical abuse. This bond is difficult to break, and toxic people do everything in their power to keep it alive. continue to terrorize the victim. And the fact that our own brain works against us does not play into our hands at all in such relationships. The biochemical connection to the abuser sustains attachment trauma: chemicals such as oxytocin, dopamine, serotonin, cortisol, and adrenaline play a key role in forming pathological attachments to toxic people.

Incomparable production of dopamine

Love stimulates the parts of the brain involved in creating a sense of satisfaction and creating a reward system. Imagine the effect it has on the brain! For example, rats that received electrical stimulation of the pleasure centers were willing to do everything possible to re-experience pleasurable sensations, even at the risk of receiving a fatal blow. They pressed a special lever to stimulate the brain thousand times - almost as much as we try to relive our honeymoon with a narcissist, despite the heartbreaking pain we experience (Olds & Milner, 1954).