Expert Profile - Justin Bethony
Justin Bethoney, NP
Integrative Psychiatric Nurse Practitioner
Justin Bethoney’s Bio:
Justin Bethoney is a psychiatric nurse practitioner in private practice in Bend, Oregon. He provides a whole-person approach to mental illness for children and adults in Bend, as well as across the state of Oregon via telemedicine. Recently, Justin self-published a book entitled, The Mental Wellness Diet: Ancient Wisdom – Evolving Science – Modern-day Options. This book provides the groundwork for how diet and lifestyle relate to brain function and our sense of mental and emotional wellness. In treating patients as a psychiatric prescriber for the past several years, Justin has seen the merits of psychiatric medications, and also witnessed their limitations. Justin believes there should be much more to treatment than quick diagnosis and hastily prescribed medications. A search for the underlying causes and contributing factors for any illness should take priority.
What life events or challenges that you’ve experienced (could be minor, could be major) – whether you’ve experienced them directly or via someone close to you, have had any type of impact on your desire to pursue a career in psychiatry?
My parent’s separation and divorce was the first big challenge I faced in my life. The divorce was a challenge for all of us, but I would say that my parents handled everything with care and thoughtfulness. At the time of their separation, my parents were both under a lot of stress. They were also dealing with that stress in very different ways. With me being the youngest in my family, I was somewhat obligated to go with the flow. So I mostly observed all the changes going on around my house. I think that time spent observing my parents and my older sisters was really formative. Later on in life, I realized I had a knack for quickly grasping how others were feeling. I understood how certain things felt really big for others. Starting out after college, I naturally gravitated to jobs where listening, understanding, and relating to others was useful. Eventually, I discovered that becoming a psychiatric nurse practitioner was a great fit, so I went for it.
How did those events impact you emotionally/morally? How, if at all did those events impact the way you view how our current system teaches us to treat patients with mental health challenges?
From my experiences as a kid, I learned that different people can easily react to the same situation in completely different ways. All that time watching, observing, and thinking about my parents and my sisters seemed to help me gain a greater depth of understanding of how people think, feel, and act. It fascinated me. In addition, both of my parents put in the work to help me, and themselves, to better understand the divorce. In the end, I think I gained and understanding that everyone is human and we all have our strengths as well as our limitations… and that’s okay. Now, as I meet with clients, I carry with me extra space in my mind. As I listen, I think about how each individual client has made specific meaning out of their experiences. In my opinion, retelling the story to clients is a massively helpful intervention. In listening and retelling the whole story, I think I have been able to help many clients find greater peace.
When and why did you decide to actually focus on practicing Integrative Psychiatry, specifically, and how was your decision shaped by the experiences above?
As I was finishing up my nurse practitioner degree, I began working on my final thesis project. I chose to study ADHD and how best to supports children and their parents. In my initial research, I stumbled upon the concept of epigenetics. It was a paradigm shift for me. After learning about health and disease through the lens of rote memorization, categorization, and algorithmic treatment approaches over the prior few years, I was taken aback. It was amazing to discover that many chronic diseases are actually more dependent on diet and lifestyle factors than they are on random genetic misfortune. I connected this with a number of nursing theories that I learned about how to approach patient care. In nursing, the aim is to find ways to help the patient help themselves, rather than just help them solely with medication or other treatments. In integrative and functional medicine, the philosophy is actually very similar. I feel lucky that it all came together for me at that time. Ever since, I’ve continued to read and learn as much as I can about the body and brain, and how both are impacted by stress as well as our diet and lifestyle.
What methods or practices do you utilize to help individuals get/feel better?
My assessment and treatment begins with a lot of questions and a healthy dose of therapy. In life, each of us are going to be handed a unique set of challenges, problems, and relative weaknesses. In my view, it’s imperative to begin with mindset. For all of my clients, we begin discussing their pain points. Then we go deeper to identify what kind of meaning they have attached to these situations and events. The meaning we make out of life experiences balances upon prior life experiences, our own natural born personalities, and most critically, the expectations that we (consciously or subconsciously) set for ourselves. A big part of therapy with my clients is about normalizing, validating, and reframing painful situations. The integrative and functional side of treatment, begins with a review of symptoms, both physical and mental/emotional. The most challenging, but also the most exciting part of integrative and functional medicine for me is putting all the information together and telling a story back to the client. It’s a story of how the client’s mental illness symptoms came to be. Contributing factors can include sources of chronic inflammation, nutrient deficiencies, digestive dysfunction, blood sugar imbalances, toxicity, poor diet or food sensitivities, and of course stress and trauma. The pathway to illness is often unique to each client. Yet, recovery often is found, in large part, with the basics – sleep, diet, exercise, and stress management. After working on the basics, if debilitating symptoms remain, we consider targeted nutritional supplements and/or psychiatric medications to help client’s gain some momentum in their recovery.
How did people react when you share this Integrative/Holistic approach with them – whether it be patients or other doctors?
As client’s come in for the first time, their conceptions and beliefs about mental illness and treatment is often readily apparent. Some clients believe strongly in the idea of medications. Some are very afraid of starting psychiatric medications. Further, not all of my clients come to me with an awareness of integrative and functional medicine. In the beginning, the integrative and functional medicine approach will be very comprehensive for some, minimal for others. Integrative and functional medicine treatment is very participatory and requires a lot of learning and effort on the client’s behalf. Everyone enters treatment at their own level of readiness, and that’s okay. My treatment approach is very integrative, but I also try to meet clients where they are at. Overall, most clients seem excited and relieved to hear that there is more than just one option (medication) for treatment. For most, just hearing about the integrative options provides a little extra hope and faith.