Over the past 30 plus years of data collection and 19 years of training and certifying others in the Subconscious Restructuring™ (SR™) process, the SR™ and Gut Health Checklist have been validated by several psychologists, psychotherapists, and psychiatrists. These clinicians took the time to get trained and performed several, individual and group studies to establish reliability, consistency, and validate that the 17 issues measured are consistent with the questions and statements on the SR™ Checklist and our Gut Health Checklist. This group includes:
- Nina Desjardins, MD
- Janis Smith, PhD
- Ron Clark, EdD
- Jeffery Litchford, PhD
- Elizabeth Kahn, MA
- Sherry Clark, MA
- Brian Harward, PhD
Before validation by the above professional's Burris Institute established 7 key questions or KQ's to define "Behavioral Epidemiology" (Behavior cause and control) and 3 KQ's to determine the data which will best represent a measurable improvement. Once these KQ's were answered, the formation of an evidence-based epidemiologic model could take place, and a normal range of human emotion can be defined. This moved the attention away from subjective behavioral assessment and put the focus on the core issue, which is the emotion driving the behavior and how each person internally processes and stores their life events.
Normal cannot be determined via behavior, but it can be determined via emotion.
The 7 KQ's That Define Behavioral Epidemiology
KQ1. What does all behavior or disordered behavior have in common?
KQ2. What determines emotion and human behavior?
KQ3. How does the subconscious work?
KQ4. What is the difference between the brain, mind, conscious, and subconscious?
KQ5. What is the function of the conscious and subconscious mind?
KQ6. Is depression a disease or disorder?
KQ7. Is depression caused by a chemical imbalance in the brain?
Answers:
KQ1. What does all human behavior or disordered behavior have in common?
Emotion is the constant in all human behavior or disordered behavior. When this fact is recognized, there is no longer a need for diagnosis or disorder categories. The objective changes to simply measuring, monitoring, and empowering your client to take control of their emotional state, which in turn enables them to take control of their behavior.
KQ2. What determines emotion and human behavior?
What determines human emotion and behavior is information. The components of this information are words and pictures.
KQ3. How does the subconscious work?
The subconscious uses two key components to activate an emotional state, which in turn determines your behavior.
1) You must talk to yourself, which usually begins with a question
and
2) By asking a question, the subconscious will always generate an answer which in turn produces a correlating picture. It is from this subconscious picture ones' emotional state is determined and in turn, determines a behavior. In its simplest form, a subconscious process looks like this.
Word – Picture – Emotion – Behavior
The SR™ paradigm interrupts and restructures this process, which in turn reprograms ones' emotional state and behavior.
Example: Keep in mind this is extremely slow motion. If I were to ask you where you went on vacation last, the process occurs like this. You repeat the question to yourself, and this evokes a picture of where you went on vacation. It is from this subconscious picture you are able to tell me where you went on vacation and how you felt about the vacation. This is how the subconscious works and one would not be able to function or communicate without the subconscious going through this process.
KQ4. What is the difference between the brain, mind, conscious, and subconscious?
The brain is the portion of the vertebrate central nervous system that is enclosed within the cranium. The brain would only serve autonomic functions without the input of external information. The mind is in reference to conscious and subconscious. The way the brain processes and stores information is referred to as mind or subconscious. You can think of the brain as the hardware and the mind or subconscious as the software. Software can be subject to programming reprogramming at any time.
KQ5. What is the function of the conscious and subconscious mind?
The single purpose of the conscious mind is to deliver information to the subconscious. The subconscious does everything else. The subconscious uses all information stored from birth to determine how one responds emotionally to the world and, in turn, determines your behavior.
KQ6. Is depression a disease or disorder?
Does a behavior or emotion require a psychological process? If the answer to this question is yes one must ask if it makes sense to classify an aberrant emotional state as a disease? Disease from the days of Hippocrates has been in reference to pathological, physiological processes, which physicians faithfully adhere to. The patient or client's perception of disease is something they did not bring on themselves, and medical or pharmaceutical intervention is the only means of treating it effectively. This makes the initial issue much more complicated, convoluted, and confusing to the patient or client. The clear answer to this question is if emotion and behavior require a psychological process, then it is a disorder. Having said this, depression can bring about a disrupted microbiota, which can then lead to disease or become a self-perpetuating mechanism for depression.
KQ7. Is depression caused by a chemical imbalance in the brain?
For decades, patients were told that depression is caused by a chemical imbalance, specifically low serotonin, and that antidepressant medication corrects this deficiency. This narrative was not invented by researchers. It was a simplification marketed to clinicians and the public to explain how SSRIs (selective serotonin reuptake inhibitors) work. The problem is that it was never substantiated.
In 2022, Professor Joanna Moncrieff and her team at University College London published a systematic umbrella review in Molecular Psychiatry that examined the most important fields of serotonin research, covering tens of thousands of participants across multiple meta-analyses. The review concluded that there is no convincing evidence that depression is caused by serotonin abnormalities, particularly by lower levels or reduced activity of serotonin [REF: Moncrieff et al., 2022, Mol Psychiatry, 28(8):3243–3256]. Research comparing serotonin levels and its breakdown products in blood and brain fluids found no consistent difference between people diagnosed with depression and healthy controls.
This finding was not a surprise to informed researchers. The serotonin hypothesis, first proposed in 1967, had been questioned within academic psychiatry for years. What the Moncrieff review did was make this critique accessible and comprehensive enough that it could no longer be ignored.
If Not a Chemical Imbalance, Then What?
The failure of the serotonin hypothesis does not mean depression has no biological dimension. It means the biology is far more complex than a single neurotransmitter being too low.
Dr. Helen Mayberg’s research on Area 25 (the subgenual cingulate cortex) offers a more accurate picture. Mayberg found that this brain region is hyperactive in treatment-resistant depression and that its activity could be normalized by two very different interventions: cognitive behavioral therapy (a psychological process) and deep brain stimulation (a direct neurological intervention). Her work did not prove that the mind simply overrides the brain. It demonstrated something more important: that the brain circuits involved in depression can be reached from multiple directions. A change in how a person processes information at the subconscious level can alter the same neural patterns that a direct physical intervention can alter.
This is the principle that makes the SR™ framework coherent. Depression is not caused by one thing. It is a convergence of upstream drivers acting on overlapping brain circuits. At a minimum, three major upstream pathways have been identified.
Three Upstream Pathways to Depression
1. Subconscious Information Processing: How you talk to yourself, the pictures your subconscious generates, and the emotional states those pictures produce create a feedback loop that can sustain or worsen depression. This is what Steps 1 through 5 of the SR™ process address. When you interrupt and restructure maladaptive subconscious patterns, you change the signal reaching the brain, and Mayberg’s research confirms that this kind of cognitive change normalizes the same brain circuits implicated in depression.
2. Gut Barrier Dysfunction and Neuroinflammation: As detailed in Step 6, the intestinal barrier is the body’s largest interface with the external environment. When it fails, microbial endotoxins (lipopolysaccharide, or LPS) enter the bloodstream, cross the blood-brain barrier, activate microglia, and drive neuroinflammation. This mechanism has been directly linked to major depressive disorder, generalized anxiety disorder, bipolar disorder, and post-traumatic stress disorder in peer-reviewed research. Approximately 500 million neurons line the gut, and their signaling can profoundly affect mood independent of any thought process or past trauma. This is a purely physiological pathway to depression, and it must be addressed physiologically.
3. The Interaction Between the Two: These pathways are not independent. Chronic emotional distress alters gut motility, microbiome composition, and barrier integrity. Conversely, gut-driven inflammation alters brain function, mood, and the subconscious processes that generate emotional states. Depression can enter from either direction and sustain itself through the loop. This is why addressing only the cognitive pathway or only the physiological pathway is insufficient. SR™ addresses both.
What This Means for the Old Model
The old model assumed one biological cause (low serotonin) and one biological fix (an SSRI). That model has been discredited. But the correct response is not to replace one reductive explanation with another. The correct response is to recognize that depression has multiple upstream drivers and to build a framework that addresses them.
This is what distinguishes SR™ from other modalities. Most psychotherapeutic approaches address cognition and behavior without addressing the physiological state of the gut. Most medical approaches prescribe medication without teaching the client how thought, emotion, and behavior work at the subconscious level. SR™ does both. Steps 1 through 5 teach the client how to interrupt, restructure, and reprogram the subconscious information processing that drives emotional states. Step 6 addresses the gut barrier, microbiome, and the physiological variables that can sustain or trigger depression independent of any psychological process.
The question is no longer whether depression is biological or psychological. It is both. The question is whether your practitioner is addressing both upstream pathways or only one of them.
3 KQ's Determine the Instruments and Data Used for Measurable Outcomes
KQ1. What is measured?
KQ2. Why is it measured?
KQ3. How is the data generated?
KQ4. How often is data collected?
Following are answers, which are specific to the Subconscious Restructuring™ paradigm. Regardless of the modality, however, these three KQ's must be answered clearly, if there is a claim of evidence-based or measurable outcomes.
Answers:
KQ 1: What is measured?
Emotional Checklist: The 12-point Emotional Checklist consists of a full range of human emotions and issues to collectively indicate a depressed state. There are also individual questions within the Emotional Checklist, which address specific issues. The first three questions indicate anxiety, negative self-talk, and anger levels. These are the first three issues addressed through the initial four-hour seven-step process of Subconscious Restructuring™. Question 4 addresses sleep, question 5 addresses sadness and hopelessness. Question 9 is regarding eating behavior, and question 12 addresses to suicidal ideation.
Behavior Control Checklist: The 5-point Behavior Control Checklist enables the client to grade the practitioner regarding the delivery of information and the clients' ability to comprehend the process. The practitioner is then able to address those issues if the numbers did not adequately come up.
Relationship Satisfaction Scale: The 5-point Relationship Satisfaction Scale addresses how the client relates to people they are closest to in their lives. The Relationship Satisfaction Scale measures how one communicates with people closest to them and how satisfied they are with those relationships.
KQ 2: Why is it Measured?
Depression: Depression is a common psychological disorder that affects about 121 million people worldwide. World Health Organization (WHO) states that depression is the leading cause of disability as measured by Years Lived with Disability (YLDs) and the fourth leading contributor to the global burden of disease.2
People who have depression along with another medical illness tend to have more severe symptoms of both depression and the medical illness, more difficulty adapting to their medical condition, and more medical costs than those who do not have co-existing depression.2
Treating depression can help improve the outcome of treating co-occurring illnesses. About one in 10 Americans aged 12 and over takes antidepressant medication.4
Anxiety: Anxiety disorders affect about 40 million American adults age 18 years and older (about 18%) in a given year, causing them to be filled with fearfulness and uncertainty.
Women are 60% more likely than men to experience an anxiety disorder over their lifetime. Non-Hispanic blacks are 20% less likely, and Hispanics are 30% less likely than non-Hispanic whites to experience an anxiety disorder during their lifetime.
An extensive, national survey of adolescent mental health reported that about 8 percent of teens ages 13–18 have an anxiety disorder, with symptoms commonly emerging around age 6. 5
Negative Self Talk: It is the strength of predominantly negative self-talk that predicts ED severity.6 Automatic negative self-talk is linked to depression, anxiety, and other disorders in children.7 The first component the subconscious uses to bring about an emotional state and behavior is an internal dialogue, and this is the first process to be interrupted, restructured, and reprogrammed with the Subconscious Restructuring™ process.
Anger: Anger and hostility are linked to coronary heart disease in both healthy and CHD populations.8
Sleep: A chronic sleep-restricted state can cause fatigue, daytime sleepiness, clumsiness, and weight loss or weight gain.9 Sleep deprivation adversely affects the brain and cognitive function.10
Eating Behavior: Physiological changes as a result of disordered eating can affect psychology, and in turn, the psychology which brings about disordered eating affects physiology.11
Suicidal Ideation: Suicidal ideation has been linked to hopelessness and anxiety 12 both of which are measured in the Emotional Checklist and numbers, which are monitored. Question 12 is a straightforward indicator of suicidal ideation and many times closely correlate with question 1 (anxiety) and question 5 (hopelessness). The risk of suicide attempts among the PTSD population is six times greater than in the general population.13
KQ 3: How is the Data Generated?
Subconscious Restructuring™ data is generated by the client at BurrisConnect.com. This data cannot be changed by the client or practitioner after it is saved.
Normal Range for the SR™ 3 Instrument 22 Point Checklist
Emotional Checklist: 1 – 4
Behavior Control Checklist: 7 - 10
Relationship Satisfaction Scale: 7 -10
*All instruments are based on a scale of 1-10
Data Analysis
Emotional Checklist: The objective of the Emotional Checklist is to reach the lowest number possible with < 5, indicating a reasonable level of control by the client. A score > 4 indicates an issue to address immediately. A sustained score > 4 on question 12 at the first follow-up after completion of the process requires a recommendation to a functional medicine doctor.
Behavior Control Checklist: A score of > 6 on the Behavior Control Checklist indicates a reasonable understanding of the SR™ process.
Relationship Satisfaction Scale: A score of > 6 indicates reasonable relationship satisfaction on the Relationship Satisfaction Scale.
Independent Evidence-Based Support of the Burris Intervention
Dr. Helen Mayberg(1) inadvertently confirmed the answer to what brings about an emotional state with her research on area 25(2). Dr. Mayberg found using brain scans that the frontal cortex dimmed down, and area 25 lit up in depressed patients. As a patient recovered from depression, area 25 dimmed down, and the frontal cortex lit up. Through the course of experimentation, Dr. Mayberg took a baseline brain scan of a group of healthy people and then asked them to think depressing thoughts. When the follow-up MRI was taken, area 25 showed greater activity, and the frontal cortex had dimmed down. Dr. Maybergs' experiment concluded depression was a result of one's thought process, which in turn affected the brain. While healthy patients recovered quickly, bringing MDD patients back by simply telling them to think positive thoughts was not effective.
The ramifications of Dr. Maybergs' work are far-reaching. Her research has discredited continued claims depression is caused by a chemical imbalance. It established a distinct difference between the effects and interaction of psychology and physiology. To more clearly understand Dr. Maybergs' work, one needs to make a distinct difference between mind and brain. In computer terms, the mind or subconscious would be referred to as the software and the brain as the hardware. In the case of Dr. Maybergs' work, it is the software that is causing the hardware to malfunction.
If depression is induced by one's thought processes, then what would be the best treatment? If one simply understood what the subconscious did with incoming information, the need for deep brain stimulation, ECT, pharmaceuticals, or other high-risk methods could be bypassed for the majority of patients.
Conclusions
From what is measured to how data is tracked and monitored to results produced, Subconscious Restructuring™ represents a comprehensive updated empirically sound paradigm for coaching and behavioral health. Since 1990 Burris Institute has demonstrated that interrupting a thought process before it has an opportunity to cause damage is effective, efficient, and fast.
References
- Much-Hyped Brain-Implant Treatment for Depression Suffers Setback:
https://blogs.scientificamerican.com/cross-check/much-hyped-brain-implan...
2. Reddy MS. Depression: the disorder and the burden. Indian J Psychol Med. 2010;32(1):1-2.
3. Aleksandrov LA, Georgiev VG. [Problems of the work hygiene of hop growers in the manual harvesting and drying of the hops]. Gig Tr Prof Zabol. 1977;(12):46-7.
4. Antidepressant Use in Persons Aged 12 and Over: United States, 2005–2008: http://www.cdc.gov/nchs/data/databriefs/db76.htm
5. Anxiety: Who is at Risk https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml#par...
6. Scott N, Hanstock TL, Thornton C. Dysfunctional self-talk associated with eating disorder severity and symptomatology. J Eat Disord. 2014;2:14.
7. Hogendoorn SM, Wolters LH, Vervoort L, et al. Measuring Negative and Positive Thoughts in Children: An Adaptation of the Children's Automatic Thoughts Scale (CATS). Cognit Ther Res. 2010;34(5):467-478.
8. Chida Y, Steptoe A. The association of anger and hostility with future coronary heart disease: a meta-analytic review of prospective evidence. J Am Coll Cardiol. 2009;53(11):936-46.
9. Taheri S, Lin L, Austin D, Young T, Mignot E. Short sleep duration is associated with reduced leptin, elevated ghrelin, and increased body mass index. PLoS Med. 2004;1(3):e62.
10. Hsieh S, Li TH, Tsai LL. Impact of monetary incentives on cognitive performance and error monitoring following sleep deprivation. Sleep. 2010;33(4):499-507.
11. Vögele C, Florin I. Psychophysiological responses to food exposure: an experimental study in binge eaters. Int J Eat Disord. 1997;21(2):147-57.
12. Beck AT, Brown GK, Steer RA, Dahlsgaard KK, Grisham JR. Suicide ideation at its worst point: a predictor of eventual suicide in psychiatric outpatients. Suicide Life Threat Behav. 1999;29(1):1-9.
13. Sher L. Suicide in war veterans: the role of comorbidity of PTSD and depression. Expert Rev Neurother. 2009;9(7):921-3.
14. Depression Intensifies Anger in Veterans with PTSD:
http://www.apa.org/news/press/releases/2015/05/depression-anger.aspx